Masui. The Japanese journal of anesthesiology
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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.
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Since no pre-medication has been widely accepted especially in spinal anesthesia, anesthesiologists should manage the control of patient's anxiety during surgery. Instead of sedatives, we have been using music-therapy during spinal anesthesia. Bispectral index monitoring (BIS) is used as one of the sedation indices in spinal anesthesia. The aim of this study was to assess the music-therapy on reducing anxiety of patients under spinal anesthesia using BIS and interview type psychology test, State Trait Anxiety Inventory (STAI). ⋯ Music-therapy reduced BIS value and was effective to reduce patient's anxiety during spinal anesthesia.
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Case Reports
[Use of the Pentax-AWS videolaryngoscope for bougie-assisted exchange of tracheal tubes].
A gum elastic bougie can be useful for tube exchange. One major problem with this technique is that it may not possible to pass a new tube over the bougie into the trachea, because the tip of the tube can collide with tissues around the glottis. We report a case in which tube exchange using the bougie was difficult, but the Pentax-AWS videolaryngoscope enabled tracheal intubation. ⋯ Although it was not possible to see the glottis with the Pentax-AWS, the tube was easily advanced over the bougie into the trachea. Operation went on uneventfully. We believe that, when it is difficult to advance a tracheal tube over a tube exchanger, the use of the Pentax-AWS may facilitate intubation.
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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.