Masui. The Japanese journal of anesthesiology
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Case Reports
[Case report of endotracheal intubation using AirWay Scope (Pentax-AWS) in a Forestier's disease patient].
A Forestier's disease patient was scheduled for endoscopic mucosal resection under general anesthesia, because of his hypoxic episode during gastric endoscopy. Endotracheal intubation was planned while awake, because he was suspected as a case of difficult airway. ⋯ The procedure was successful with no complications. AWS seems to be a useful device for endotracheal intubation in Forestier's disease.
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Case Reports
[Case of spinal anesthesia for pyrolomyotomy in a former preterm infant with chronic lung disease].
A former premature infant (1,795 g) with chronic lung disease underwent pyrolomyotomy under spinal anesthesia. She had been managed with artificial ventilation for 2 months after birth and had developed chronic lung disease. She showed frequent apnea with desaturation several times per day and 21 x min(-1) of oxygen had been administered. ⋯ After we confirmed the anesthesia level up to T5, surgery was commenced. She was managed with mask CPAP to prevent deasaturation under spontaneous respiration during surgery. She required nasal-CPAP to prevent apnea after surgery and she was transferred back to the referred hospital on the 3rd postoperative day without any sequela.
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Case Reports
[Two cases of preceded aortic valve replacement for severe aortic stenosis before the cancer operations].
We report two cases of aortic valve replacement (AVR) for severe aortic stenosis (AS) before the cancer operations. Severe AS poses a great risk for noncardiac surgery. In the ACC/AHA 2007 Guideline on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery, if the AS is symptomatic, elective noncardiac surgery should generally be postponed or canceled. ⋯ In our cases the patients underwent the cardiac surgery and noncardiac surgery in a short period without serious complication in the perioperative management. It is very important to discuss among surgeon, cardiovascular surgeon, cardiologist and anesthesiologist. Especially anesthesiologist should take an important role in organizing these departments for such patients.
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Unrecognized esophageal intubation remains a significant cause of anesthetic morbidity. Extensive data showed that clinical signs and methods for confirming proper tracheal tube placement were not always reliable. Advancing tracheal tube into the trachea can be detected by palpating the cricoid cartilage. We evaluated the reliability of detecting tracheal intubation by cricoid palpation methods (CPM) in this study. ⋯ The CPM alone is imperfect for tracheal tube placement confirmation. Multiple methods for detecting correct tube placement should be used, since no single method has perfect reliability.
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Randomized Controlled Trial
[Preoperative intravenous administration of droperidol (1.25 mg) reduced postoperative nausea and vomiting after intrathecal morphine administration].
Intrathecal morphine (ITM) is an excellent postoperative analgesic, but may often cause postoperative nausea and vomiting (PONV). We designed this prospective, randomized and controlled study to evaluate the antiemetic efficacy of low-dose droperidol for the treatment of PONV caused by ITM. ⋯ Single intravenous administration of 1.25 mg droperidol before operation showed prophylactic efficacy in early PONV caused by ITM. The duration of droperidol action was shorter than that of ITM. Hence we recommend that droperidol should be administered more frequently or continuously in the postoperative period.