Masui. The Japanese journal of anesthesiology
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Preventing surgical site infection (SSI) is important in providing safe and high-quality surgical care. Antimicrobial prophylaxis is given to prevent SSI. Many reports revealed that antimicrobial prophylaxis is effective to reduce SSI rates, when its initial dose is given at proper timing and additional dose is properly given in longer operations. ⋯ In United States, Surgical Care Improvement Project (SCIP) is ongoing to reduce complications after surgery. Proper usage of antimicrobial prophylaxis is strongly recommended to reduce SSI in this project. Surgical team hopes to reduce SSI by proper administration of antimicrobial prophylaxis with the cooperatiing of anesthesiologists and operating room staffs.
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Central venous catheterization is usually done in operating theater after general anesthesia. However, life-threatening complications can occasionally occur. Recently, application of ultrasound especially ultrasound-guided venipuncture has become popular for safe and reliable procedure. ⋯ The most common ultrasound device was iLook (37% of anesthesiologists, Japan Sherwood). The survey showed that 79% of anesthesiologists apply ultrasound for central venous catheterization in the operating theater. Establishing the standard technique and training methods will be the subsequent issue.
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Comparative Study
[Ultrasound guided T2 intercostal nerve block: a comparison with stellate ganglion block under the blind technique and ultrasound guided technique].
The aim of this study is to compare the efficacy of stellate ganglion block, performed by ultrasound guided technique and blind technique, and ultrasound guided T2 intercostal nerve block. ⋯ Compared to stellate ganglion block (blind technique), ultrasound guided stellate ganglion block and T2 ultrasound-guided intercostal nerve block provided a similar efficacy.
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A morbidly obese woman with a huge ovarian tumor was scheduled to undergo tumor resection under general anesthesia. Under slight sedation with midazolam and fentanyl, a tracheal tube was inserted smoothly using Pentax-AWS Airway Scope, and general anesthesia was thereafter maintained by sevoflurane. ⋯ Then resection of the ovarian tumor and abdominal wall tissue was performed in supine position. Periooperative course was uneventful.
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Williams syndrome is caused by the deletion of genetic material from chromosome 7, including the elastin gene. Affected individuals frequently have connective tissue disorders and skeletal hypoplasia, resulting in micrognathia and mandibular retrusion. These conditions hinder adequate visualization of the larynx and render intubation difficult. ⋯ After 8% lidocaine spray to the larynx, and then 4% lidocaine spray to the vocal cords and trachea using a bronchoscope, we accomplished awake, fibreoptic-guided orotracheal intubation easily and quickly on the first attempt using a Parker Flex-Tip tube. Difficult tracheal intubation should be anticipated in Williams syndrome patients. Awake, fibreoptic-guided technique is easier and safer than direct laryngoscopy for intubating such patients.