Masui. The Japanese journal of anesthesiology
-
The video intubating laryngoscope (VIL) can share information with co-workers, that otherwise only one probationer could obtain. Tracheal intubation was reviewed using recorded videotapes via VIL. It was supposed that the esophageal changes by laryngoscope might cause esophageal intubation. In this study, we investigated the impressions about the changed esophagus caused by laryngoscope, and our purpose is to find better educational method for tracheal intubation. ⋯ It was clarified that probationers significantly more often recognized the changed esophagus as the glottis opening. It is very important for us to teach and emphasize those points when we instruct the inexperienced in tracheal intubation.
-
Comparative Study Clinical Trial
[Comparative study of sublingual midazolam with oral midazolam for premedication in pediatric anesthesia].
We studied the efficacy of sublingual midazolam compared with oral midazolam for predmedication in children. ⋯ Sublingual midazolam 0.2 mg x kg(-1) is useful for premedication in pediatric anesthesia, and it equals with oral midazolam 0.5 mg x kg(-1) in efficacy.
-
Randomized Controlled Trial
[Exposure to nitrous oxide may increase airway inflammation during sevoflurane anesthesia].
The purpose of this study was to examine whether nitrous oxide increases the inflammatory reaction in the airway in patients undergoing minor surgery. ⋯ The pulmonary immunologic function changed progressively during anesthesia, surgery and positive pressure mechanical ventilation. The data from this study suggest that the immune ability of the lung may possibly change due to the administration of nitrous oxide. As a result, our findings suggest that the postoperative inflammatory reaction in the lung may increase when sevoflurane plus nitrous oxide are used during general anesthesia.
-
Case Reports
[Awake intubation using lightwand technique under conscious sedation with remifentanil].
We experienced two cases of difficult airway due to deformities in the oral cavities. The first patient was a 62-year-old woman with a large benign soft palate tumor and the second was a 64-year-old woman with macroglossia secondary to acromegaly. Both patients were evaluated difficult to ventilate via face mask and presenting serious risks for tracheal intubation under general anesthesia. ⋯ Tracheal intubation was managed successfully in both cases and the operations were completed under general anesthesia. Although the patients were aware of being intubated, they could not recall the procedures postoperatively. The awake intubation technique using the lightwand under conscious sedation with remifentanil can be safely applied to a patient with difficult airway.
-
We present a 35-year-old healthy male patient who developed pulmonary edema (PE) probably due to venous air embolism during craniotomy in the semi-sitting position for arteriovenous malformation (AVM). Anesthesia was maintained with oxygen, nitrous oxide, propofol and fentanyl. During craniotomy, end-tidal carbon dioxide pressure decreased suddenly from 26 to 9 mmHg. ⋯ Transoesophageal echocardiography and pulmonary artery catheter were used. Saline was filled at the surgical site to prevent aspiration of air bubbles and surgical procedure was performed carefully without large vein injury and uneventfully. During neurosurgical intervention in the sitting position, special attention should be paid to entry of air bubbles into the venous system which may lead to PE.