Masui. The Japanese journal of anesthesiology
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Pentax-AWS (AWS) (Pentax, Japan) is a rigid video laryngoscope with built-in 2.4 inch color CCD monitor paired with a disposal blade. It is developed for management of both normal and difficult airways. We used AWS in a 68-year-old male patient with known (Cormack grade 3a) difficult airway. ⋯ Visualization of the patient's vocal cords was achieved easily (with POGO score 70%). The AWS's suction channel was alternatively used for topical anesthesia route with 10 Fr suction tube, and 4% lidocaine was injected onto the vocal cords. Tracheal intubation was successful uneventfully, and the patient's airway was secured without any postoperative complication.
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For a visiting anesthesiologist, the time allowed for explaining anesthesia for patients is limited. A questionnaire survey by anesthesia information sheet was performed and patient's opinions about the work of a visiting anesthesiologist were evaluated. ⋯ However, it is important for a visiting anesthesiologist himself to explain the methods and risks of anesthesia to the patient in order to build a mutual trust between the patient and the anesthesiologist. It is important to obtain an informed consent on anesthesia by the visiting anesthesiologist, but the format of the consent can be variable decided by the anesthesiologist.
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Brain hypothermia therapy has been expected to lead to good neurological outcome in acute brain insults. There are a few positive results which have been proven by multicenter randomized clinical trials (RCT) in the cardiopulmonary arrest (CPA) in patients with ventricular fibrillation. ⋯ For brain hypothermia therapy to become an effective method for acute brain insults, indications, brain oriented intensive cares and biomarkers for the therapy must be established. RCT in acute brain insults beside CPA victims are needed in the near future.
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We review some anesthesiologist's curriculum and demographic characteristics in France to the community of Japanese anesthesiologists. To become a certified anesthesiologist and an intensive care physician currently requires six years' medical education, passing national medical examination, and five years' special training as an intern of anesthesiology and intensive care. This educational course was started in 1984. ⋯ The anaesthesiologist often works in a team with a nurse anaesthetist. The number of certified anesthesiologists in France is larger than that in Japan. Management of anesthesia in France seems to have an advantage in manpower.
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Basic and clinical investigations have been performed, focusing on the mechanism of ischemic brain and spinal cord injuries, and preventive measures against ischemic insults such as drug therapy, hypothermia, maintenace of blood flow to brain and spinal cord, preconditioning, and no use of high dose fentanyl. In this special issue, five experts have provided new relevant information concerning brain and spinal cord protection. Further research in brain and spinal cord protection will contribute to better understanding of ischemic central nervous system injuries and to the establishment of novel therapies for protection of central nervous system.