Masui. The Japanese journal of anesthesiology
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Case Reports
[Successful fiberoptic tracheal intubation via Cobra PLA in a patient with an epiglottic tumor].
A 59-year-old woman with an epiglottic tumor was scheduled for the total removal of the mass by laryngomicrosurgery. The patient had no preoperative respiratory symptoms. ⋯ Post-extubation course was uneventful. The Cobra PLA can be a good alternative supraglottic airway device allowing easy tracheal intubation for difficult airway.
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Case Reports
[A patient rescued from unexpected intraoperative massive hemorrhage with ABO incompatible blood transfusion].
A 67-year-old man was scheduled for resection of thoracic intramedullary tumor. His blood type was AB. Unexpectedly rapid and massive hemorrhage occurred during the operation. ⋯ We decided to transfuse 4 units of ABO incompatible type O RBC. Later, type AB RBC and other blood components became available and the patient recovered. We conclude that transfusion of ABO incompatible blood in patient with critical hemorrhage should be encouraged to save life.
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Randomized Controlled Trial
[Combined intrathecal morphine and bupivacaine for elective post-caesarean pain].
Intrathecal morphine is widely used for analgesia following cesarean section in Europe and North America. In Japan analgesic method of intrathecal morphine was admitted to the insurance adjustment and it is necessary to study optimal dose of the morphine. ⋯ It is concluded that intrathecal morphine 0.1 mg gives effective analgesia with minimum side effects after cesarean section for the Japanese patients.
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Case Reports
[Two cases of transfusion-related acute lung injury following massive transfusion during the perioperative period].
Transfusion-related acute lung injury (TRALI) is a serious complication of transfusion of blood and blood components. TRALI is reported to be the most common cause of transfusion-associated death. TRALI has increasingly become known in the medical community. ⋯ We report two cases of TRALI after massive transfusion due to massive bleeding during cardiovascular surgery. In the perioperative period, the diagnosis of TRALI is difficult to make because of coexistence of various factors leading to hypoxia. Thus, in this report, we discuss the management of these two cases focusing upon the differential diagnosis of TRALI.
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We report a case of grand mal convulsion due to inadvertent intravascular injection of ropivacaine. An 83-year-old woman was scheduled for upper limb surgery. The interscalene block was performed with neurostimulator and 0.5% ropivacaine 30 ml was injected after careful negative aspiration. ⋯ Although careful aspiration was done before the injection of ropivacaine, inadvertent intravenous injection could have occurred during the administration. Intermittent aspiration should be indispensable during the administration, because a large dose of local anesthetic is necessary for interscalene block. In this case, the only cardiovascular manifestation was ventricular premature beats indicating that ropivacaine has less cardiotoxicity.