Masui. The Japanese journal of anesthesiology
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Comparative Study
[Evaluation of the sedation level with propofol with electroencephalographic Entropy in comparison with bispectral index monitor].
Entropy, a newly available electroencephalographic monitor, demonstrates two parameters, response entropy (RE) and state entropy (SE). The aim of this study is to compare RE and SE with bispectral index (BIS) during anesthetic induction with propofol. ⋯ Response entropy and SE can provide similar information as BIS about the sedation level with propofol.
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We experienced anesthetic management using dexmedetomidine for awake coronary artery bypass grafting (ACAB) in a patient with cerebrovascular and lung diseases. Epidural anesthesia was performed using only local anesthetics, and narcotics were not administered for epidural anesthesia or general anesthesia. The patient complained of discomfort when the surgical maneuver reached the superior extremity of the sternum and when pneumothorax occurred. ⋯ Hemodynamics was stable in the intraoperative period, although the plasma concentration of dexmedetomidine calculated by pharmacokinetic simulation analysis, exceeded 1.6 ng x ml(-1). Aggravation of cerebrovascular or lung disease did not occur in the perioperative period. Dexmedetomidine may be useful for ACAB.
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Randomized Controlled Trial
[Effect of amino acid infusion for prevention of intraoperative hypothermia during laparotomy].
Amino acid infusion prevents intraoperative hypothermia. The purpose of this study is to examine the effect of amino acid infusion on intraoperative core temperature of patients during laparotomy. ⋯ Amino acid infusion has more preventive effect on intraoperative hypothermia than electrolyte solution.
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Case Reports
[Anesthetic management of a patient with mitochondrial encephalomyopathy under total intravenous anesthesia].
This report describes a patient with mitochondrial encephalomyopathy who underwent tracheostomy under total intravenous anesthesia. This 15-year-old girl had been suffering from aspiration pneumonia repeatedly. Anesthesia was induced with propofol (30 mg) and fentanyl (50 microg), and the trachea was intubated without a muscle relaxant. ⋯ The patient showed smooth recovery from anesthesia, and the BIS value returned to the pre-anesthetic level 15 minutes after completion of the anesthesia. Her postoperative course was uneventful. We conclude that total intravenous anesthesia by propofol and fentanyl is a preferable method for the management of the patient with mitochondrial encephalomyopathy.
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Anesthesiologists' opinions regarding the Japanese guidelines for transfusion were surveyed. ⋯ These guidelines for transfusions appear to be widely accepted. The most dominant complaint was the inadequacy of the guidelines for rapid massive bleeding.