Masui. The Japanese journal of anesthesiology
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We describe successful anesthetic management of three morbidly obese patients, using inhalation induction with high concentrations of sevoflurane. In morbidly obese patients, reduced airway space of the pharynx can cause upper airway obstruction after the induction of general anesthesia and may explain difficult mask ventilation. ⋯ In inhalation induction with sevoflurane, the incidence of transient apnea is lower and the control over depth of anesthesia is easier as compared with intravenous induction. Therefore, sevoflurane may be an excellent induction agent in morbidly obese patients with a potentially difficult airway.
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Pulmonary thromboembolism (PTE) is increasingly recognized as a significant perioperative complication in Japan. A recent study reported that the incidence was 0.32 patients per 10,000 people per year in Japan. The aim of this investigation is to elucidate the incidence and characteristics of perioperative pulmonary thromboembolism in Japan. ⋯ The incidence of perioperative PTE is not low in Japan and is 13 times higher than the rate observed in the general population. The use of thromboprophylaxis should be considered in patients with risk factors.