Masui. The Japanese journal of anesthesiology
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Comparative Study
[Endotracheal tube selection in children: which is the better predictor for the selection, tracheal internal diameter in X-ray photograph or age-based formula?].
Age-based formula has been widely used to predict the appropriate size of the endotracheal tube in children. Tracheal internal diameter in X-ray photograph is reported to show higher correlation with a correct tube than age. In our institution, X-ray photographs were stored as digital images, enabling us to measure tracheal internal diameters more accurately than conventional X-ray films. Therefore, we investigated whether tracheal size in digital X-ray photograph is a better predictor for the tube selection than age. ⋯ The age-based formula is more reliable and appropriate to decide the size of endotracheal tube for children than the tracheal size.
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We report general anesthesia for a patient with multiple sclerosis (MS). A 40-year-old male patient with a 13-year history of MS was scheduled for laparoscopic surgery. The symptoms of MS had been exacerbated during feverish state or under surgical stress in the previous surgeries. ⋯ Flurbiprofen axetil was used for slight postoperative fever. There was no clinical exacerbation of MS during perioperative period. In conclusion, appropriate control of surgical stress and prevention of fever are important for perioperative anesthetic management of patients suffering from MS.
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Epidural catheter insertion is a common procedure for gynecological surgeries. Epidural puncture is usually performed according to the anatomical landmarks without radiographic means. The aim of his study was to confirm the actual level of puncture, and the distance as well as the direction of epidural catheters threaded. ⋯ Only 11.7% of the catheters were actually inserted from T12-L1 and advanced in cephalad direction over one vertebra as we had intended.
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Co-administration of ketamine and remifentanil may offer preemptive analgesia and prevention of opioid-induced hyperalgesia, resulting in reduction of postoperative pain. ⋯ Results in this study suggest that anesthetic management using ketamine and remifentanil may be useful for postoperative pain management, probably by preemptive analgesic effects of both agents and preventive effects of ketamine against opioid-induced hyperalgesia.
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Comparative Study
[Basic study on the mechanism of postanesthetic recovery acceleration caused by infusion of bicarbonated Ringer's solution].
Effect of bicarbonated Ringer's solution (BRS) on the liver function of rats with metabolic acidosis was compared with that of lactated Ringer's solution (LRS) and Ringer's solutions (RS). Furthermore, the effect of acidosis on the plasma protein binding ratio of propofol was examined. ⋯ These results suggest that metabolic acidosis induced the delay of awakening from anesthesia, suggesting that BRS accelerates recovery from anesthesia through amelioration of acidosis.