Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Comparative Study
[Use of gum elastic bougie for tracheal intubation: comparison of different tracheal tubes].
Gum elastic bougie (GEB) is one of the most useful devices for patients whose tracheas are difficult to intubate during anesthetic induction. But no previous study has evaluated the effects of the types of the tracheal tube. We hypothesized that wire-reinforced tracheal tubes were superior to standard tracheal tubes in the success rate of tracheal intubation when using GEB. We compared these two different types of tracheal tubes in using GEB. ⋯ The type of tracheal tube would not affect the success rate and time of intubation when using gum elastic bougie.
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Comparative Study
[Prevention of postoperative nausea and vomiting by metoclopramide combined with dexamethasone in gynecological surgery].
The authors evaluated the efficacy of a combination of dexamethasone and metoclopramide for the prophylaxis of postoperative nausea and vomiting (PONV) after gynecological abdominal surgery. ⋯ A combination of metoclopramide and dexamethasone was more effective in preventing PONV compared with metoclopramide alone.
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Case Reports
[Anesthetic management of a patient with transfusion-related acute lung injury (TRALI)].
Transfusion-related acute lung injury (TRALI) is characterized by pulmonary edema and hypoxemia within 6 hours of transfusion in the absence of other causes of acute lung injury or circulatory overload and is now considered the leading cause of transfusion-related death. We report a female patient who showed hypoxemia after transfusion without any other causes of acute lung injury. The patient is a 43-year-old woman, who received emergency transurethral hemostasis for bladder hemorrhage with hematuria and low hemoglobin concentration (3.2 g x dl(-1)). ⋯ The next day, hypoxemia was improved under PEEP therapy. The anti-HLA antibody in the transfused plasma was positive. We conclude that the early recognition and management of TRALI is essential during and after operation.
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Comparative Study
[Comparison of the effects of sevoflurane and propofol on changes in leukocyte-count induced by surgical stress].
It is well known that surgical stress causes granulocytosis and lymphopenia. However, effects of general anesthetics on changes in leukocyte-count induced by surgical stress are not still clear. ⋯ There were significant differences in effects of sevoflurane and propofol on changes in lymphocyte-count induced by surgical stress. Results of this study imply the efficiency of propofol to prevent lymphopenia, which may play an important role in postoperative immunosuppression caused by surgical stress.
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A patient having an anti-acetylcholine receptor (AChR) antibody without myasthenia gravis was scheduled for thymectomy. Neuromuscular blockade monitoring showed a normal response to vecuronium in the patient. This finding suggests that sensitivities to neuromuscular blocking agents in the patients depend not on the titers of the antibody but also on the presence or absence of the preoperative symptoms such as muscle weakness. It is, however, recommended that neuromuscular blocking agents should be administered carefully under monitoring the neuromuscular function, as is the case for myasthenia gravis, because little is understood about the effect of neuromuscular blocking agent on the neuromuscular function in the asymptomatic patients having anti-AChR antibody.