Masui. The Japanese journal of anesthesiology
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Several case reports have shown that the Airway Scope is useful in patients with difficult airways. We experienced five patients with known or predicted difficult airways who underwent awake intubation using the Airway Scope. The patients were known or predicted as having a difficult airway due to the following factors: limited head and neck movement (2 cases), risk for aspiration of gastric contents (1 case), and the thyroid tumor causing displacement of the trachea (2 cases). ⋯ First, the Airway Scope allows detection of regurgitation and vomiting during intubation and avoids accidental esophageal intubation. Second, the Airway Scope provides a useful means of teaching and supervising tracheal intubation compared with the conventional Macintosh laryngoscope. We believe that this method can achieve effective, safe and successful awake intubation in patients with known or predicted difficult airways.
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This case report describes a successful anesthetic management of a 74-year-old patient with a giant bulla and pulmonary dysfunction during off-pump coronary artery bypass grafting (OPCAB). BiPAP Vision with a laryngeal mask airway (LMA) was used for intraoperative respiratory management. General anesthesia was induced with propofol. ⋯ The LMA was removed without coughing and bucking soon after the end of the surgery. There was no complication during and after anesthesia. This respiratory management may be beneficial for patients with a giant bulla and pulmonary dysfunction during OPCAB.
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We report a case of bilateral ocular deviation due to droperidol-induced acute dystonia that was initially undiagnosed. A 22-year-old, 72 kg, parturient at 42 weeks' gestation underwent emergency cesarean section for pregnancy-induced hypertension under combined spinal-epidural analgesia. The epidural catheter was inserted through the T11-12 interspace, followed by intrathecal hyperbaric bupivacaine with adjunctive fentanyl. ⋯ Epidural infusion was discontinued without further treatment. Her symptoms completely disappeared within 5 hours. The estimated cumulative dose of intravenous and epidural droperidol was 4.6 mg over 34 hours.
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Randomized Controlled Trial
[Optimum intubating dose of rocuronium for short duration surgery in adult patients].
The aim of this study was to examine optimum intubating dose of rocuronium in adult patients who had been scheduled for short duration surgery. ⋯ For short duration surgeries, rocuronium 0.5 mg x kg(-1) was appropriate to perform safe tracheal intubation and minimize duration of action of rocuronium.
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Although remifentanil produces respiratory depression, its very short duration of action provides a great advantage for the control of hemodynamics during anesthesia for tracheobronchial stent insertion. We compared remifentanil with fentanyl during propofol-based anesthesea for anesthetic management for tracheobronchial stent insertion. ⋯ We conclude that the continuous infusion of low dose remifentanil with propofol produce more efficient respiratory and hemodynamic stability than the bolus infusion of fentanyl with propofol during anesthesia for tracheobronchial stent insertion.