Masui. The Japanese journal of anesthesiology
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We report a patient who was suspected of transfusion-related acute lung injury. A 60-year-old man underwent emergency thoracotomy and hemostasis after pneumonectomy. The SpO2, decreased abruptly to 66% 90 minutes after transfusion of packed red blood cells and fresh frozen plasma. ⋯ The SPO2 returned to 100% in 3 minutes. Postoperative chest radiography showed diffuse pulmonary infiltrates. The pulmonary edema improved in 12 hours with mechanical ventilation.
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Marked hypertension may occur during induction of isoflurane anesthesia. The hemodynamic responses to mask ventilation using isoflurane and subsequent tracheal intubation were evaluated. ⋯ Inhalation of 4% isoflurane during induction of anesthesia induces lasting hypertension in some patients and this pressor response has no relation with the tachycardia. Tracheal intubation induced a larger increase in blood pressure in the isoflurane-induced hypertensive patients, but the increase is within the limits of that seen in patients without pressor response to isoflurane.
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We reported the incidence of general anesthesia using nitrous oxide (N2O), one of the greenhouse gases in the atmosphere, and the total consumption of N2O in our institute in 1990, 1995, 2000, and 2004. Nitrous oxide was used in 93%, 97%, 89%, and 49% of general anesthesia in 1990, 1995, 2000, and 2004, respectively. ⋯ Moreover, low flow anesthesia (total gas flow not exceeding 2 l x min(-1)) was vigorously introduced. We consequently decreased the amount of N2O consumed during inhalational anesthesia despite the increase in cases of general anesthesia in recent years.