Masui. The Japanese journal of anesthesiology
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Williams syndrome is characterized by the triad of supravalvular aortic stenosis (SAS), mental retardation and elfin facies. Generally, difficult airway is expected in patients with Williams syndrome by characteristic face. A 26-year-old female with Williams syndrome was scheduled for abdominal myomectomy under general anesthesia. ⋯ After induction of anesthesia, anesthetic course was uneventful. According to the most previous clinical reports in patients with Williams syndrome in Japan, mask ventilation and tracheal intubation were performed easily contrary to preoperative airway assessment. In view of SAS, mental retardation, airway deformity and airway assessment in previous clinical reports, we should select the optimal strategy for airway management in patients with Williams syndrome.
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Randomized Controlled Trial
[Effect of pentazocine on the bispectral index during nitrous oxide-sevoflurane anesthesia].
The effect of pentazocine on the bispectral index (BIS) has not been reported. In this study, we have examined whether pentazocine alters the bispectral index during nitrous oxide-sevoflurane anesthesia. ⋯ We observed that intravenous pentazocine caused a significant increase in BIS under nitrous oxide-sevoflurane anesthesia. The depth of sedation should be assessed carefully using a bispectral index monitor when pentazocine is used together.
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Randomized Controlled Trial Comparative Study
[Effect of different perioperative analgesic methods on postoperative cognitive dysfunction in elderly patients undergoing upper abdominal surgery].
We investigated whether the early postoperative cognitive dysfunction (POCD) was affected by different perioperative analgesia methods using intravenous remifentanil or epidural ropivacaine in the elderly undergoing major upper abdominal surgery. ⋯ Perioperative analgesia using intravenous remifentanil and epidural ropivacaine showed no significant difference in the incidence of early POCD after upper abdominal surgery in elderly patients.
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Little is known about doses and onset times of rocuronium after sugammadex reversal. We report a 2-year-old girl receiving readministration of rocuronium for reoperation 30 minutes after sugammadex reversal. The patient underwent ventriculoperitoneal shunting for hydrocephalus under general anesthesia with muscle relaxation by rocuronium. ⋯ As the efficacy of rocuronium was definitively reduced, a higher dose (2 mg x kg(-1)) and a longer onset time (6 minutes) were required to establish maximal block (T1 0%). There were no apparent problems with the clinical duration of rocuronium or repetitive antagonization by sugammadex. Under appropriate monitoring, repetitive muscular relaxation by rocuronium can be safely established.
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Randomized Controlled Trial Comparative Study
[Influence of tidal volume on functional residual capacity during general anesthesia].
Ventilation with lower tidal volume improves outcome in acute respiratory distress syndrome (ARDS). However, it is questionable if ventilation strategy using lower tidal volumes created for patients with ARDS can be transferred to healthy patients undergoing general anesthesia. We assessed the effects of ventilation with lower tidal volumes and conventional tidal volumes on functional residual capacity (FRC) and Pa(O2)/FI(O2) (P/F) ratio in patients undergoing general anesthesia for upper abdominal surgery. ⋯ Lower tidal volumes are better than conventional tidal volumes in view of airway pressure and lung protective strategy during general anesthesia.