Masui. The Japanese journal of anesthesiology
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Majority of severe anesthetic complications result from airway difficulties. Among the airway difficulties, difficult mask ventilation is a key critical condition in the currently proposed difficult airway algorithms, and is probably the most life-threatening event. ⋯ Lateral neck radiographs for patients with suspected airway difficulties may provide useful information for identification of potential patients with difficult mask ventilation. Among the parameters measured by the radiographs, I recommend anesthesiologists to measure distance between the hyoid bone and mandibular plane, which possibly reflects anatomical balance of the upper airway maintenance.
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A 79-year-old man underwent aortic arch replacement for thoracic aortic aneurysm. He had a history of smoking, coronary stenting for ischemic heart disease and replacement with artificial blood vessel for abdominal aortic aneurysm. Anesthesia was induced and maintained with midazolam, fentanyl, sevoflurane, and vecuronium. ⋯ However, as he developed compartment syndrome on the left lower limb due to reperfusion injury postoperatively, fascitomy was performed. On the 58th postoperative day, he was discharged from our hospital. Measurement by Doppler is useful for the early diagnosis of the lower leg arterial occlusion.
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Objective structured clinical examination: OSCE is now widely used in educational scene in medical schools before medical students start their clinical training. However, the utility of OSCE on BLS education has not been confirmed yet. The effect of OSCE on BLS education was examined using questionnaires. ⋯ OSCE improved medical students' knowledge of BLS, but did not contribute to prevent forgetting for a long time. Thus, reeducation in BLS is still necessary for students after passing OSCE.