Masui. The Japanese journal of anesthesiology
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Upper abdominal surgery leads to severe postoperative pain. Insufficient postoperative analgesia accompanies a high incidence of complications. Therefore, postoperative analgesia is very important. ⋯ We experienced two cases of the rectus sheath block in upper abdominal surgery under ultrasound guidance. Ultrasound guided rectus sheath block can reduce the risk of peritoneal puncture, bleeding, and other complications. Rectus sheath block is very effective to reduce postoperative pain in upper abdominal surgery as an alternative method to epidural anesthesia in anticoagulated patients.
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Rapid sequence intubation is a common procedure in emergency patients at risk for pulmonary gastric aspiration. However, in some of these cases may accompany a difficult airway. ⋯ All patients were successfully intubated without any complication. We believe that AWS is a useful device for rapid sequence intubation.
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To determine the learning process in endotracheal intubation using the Macintosh laryngoscope, we investigated time needed for instrumentation and rate of erroneous esophageal intubation. ⋯ Two month training course for anesthesia management in our institution seems to be insufficient for learning skills in endotracheal intubation. It is most likely to require 6 months to acquire the sufficient skill in endotracheal intubation.
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Randomized Controlled Trial Comparative Study
[Remifentanil provides fast recovery and hemodynamic stability in laryngomicrosurgery anesthesia].
Stressful procedures such as intratracheal intubation and direct laryngoscopy in very short operations make anesthetic management for laryngomicrosurgery difficult. This study was conducted to evaluate which anesthetic agent, remifentanil or fentanyl, is suitable in anesthesia for laryngomicrosurgery. ⋯ Remifentanil provided faster recovery and hemodynamic stability. Therefore, remifentanil seems to be more suitable than fentanyl in anesthesia for laryngomicrosurgery.
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We experienced anaphylactic shock after introduction of the general anesthesia twice in the same patient. After the first incidence of anaphylactic shock, we judged that the allergen was a latex. ⋯ After the first incidence, it was necessary to retrieve the antigen from all the agents used. When we encounter the anaphylactic shock, it is necessary to examine all the medicines, and should have two or more suspectible medicines in mind.