Masui. The Japanese journal of anesthesiology
-
Case Reports
[Laryngeal edema and vocal cord paralysis due to lithium battery ingestion; a case report].
We report a case of an 8-year-old boy with laryngeal edema and vocal cord paralysis due to lithium battery ingestion. He had ingested a lithium battery of a television remote controller, and was admitted to our hospital. He was suffering from wheezing and retractive respiration with crying. ⋯ He had no difficulty in breathing and eating but the vocal cord paralysis remained. Lithium batteries ingestion may cause severe airway injury in a short period because of their large size and high voltage. Immediate removal and careful management are required.
-
There are many causes for postoperative delirium in elderly patients. Hypotension is considered as one of the causes. In our retrospective study, hypotension during operation was not taken care of strictly. Slight hypotension was observed every so often. We recognized that the drop of cerebral blood flow due to hypotension and duration of hypotension were risk factors of postoperative delirium. ⋯ Our results indicate that permissive hypotension induced the drop of cerebral blood flow and it can be a risk factor of postoperative delirium in elderly patients. To prevent extreme hypotension, to decrease duration of hypotension, and to raise the blood pressure quickly are very important to decrease postoperative delirium in elderly patients.
-
We describe the performance of GlideScope in 34 consecutive patients who required nasal endotracheal intubation for surgical convenience. In the 34 patients, nasal endotracheal intubation was achieved in 52 +/- 22 (mean +/- SD) sec by unexperienced clinicians, and in 50 +/- 17 sec by anesthetists in the department. ⋯ The improved coordination afforded by an image on a video monitor seen by both the assistant providing laryngeal manipulation and the anesthetist handling the laryngoscope resulted in a significant advantage over the conventional laryngoscope technique. GlideScope seems to be a novel useful device for nasal endotracheal intubation.
-
Seven patients were subjected to intraoperative wake-up tests during reconstruction surgery of the anterior crucial ligament (ACL) to measure the tension of the reconstructed ligament. ⋯ Propofol-fentanyl is better than nitrous oxide-sevoflurane-fentanyl as the method of anesthesia for wake-up tests of ACL reconstruction surgery.
-
The incidence of cerebrovascular accidents (CVA) developing in the operating theater has not been investigated on a large scale. In 2004, the Japanese Society of Anesthesiologists (JSA) started to survey neurological as well as life-threatening events in the operating theater. The incidence of CVA developing in the operating theater was examined using data obtained by the 2004 survey. ⋯ The overall incidence of CVA developing in the operating theater in Japan was reported to be 123 among 1.2 million anesthesias. The incidence was high in elderly patients, in patients with poor physical status, and in patients undergoing cardiovascular surgery. Because the prognosis of CVA developing in the operating theater was poor, clinical strategies for prevention, early detection, prompt diagnosis, and appropriate treatment of CVA should be established.