Masui. The Japanese journal of anesthesiology
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We administered anesthesia for a 20-month-old boy with non-bullous ichthyosiform erythroderma who underwent orthopedic syndactyly repair on two occasions. Anesthetic considerations include the difficult fixation of the tracheal tube and iv cannulas and the risk of hypothermia. Intravenous access placement was also difficult due to the hyperkeratosis and the deformity of extremities. ⋯ To maintain body temperature we used forced air warming device Bair Huggar, which was very useful to avoid hypothermia but resulting in a rather high body temperature. In conclusion, a tube holder was an effective device to fix the tracheal tube in this patient. Forced air warming device was useful to prevent hypothermia.
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The aim of the present study was to evaluate the suitability of Airtraq optical laryngoscope for the tracheal intubation in children. ⋯ The Airtraq optical laryngoscope might be an alternative apparatus for endotracheal intubation in pediatric patients.
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We report a successful use of pediatric Airtraq optical laryngoscope in a pediatric patient with Robin sequence. Robin sequence accompanies a characteristic facies and its clinical presentation is marked by micrognathia, retrognathia, glossoptosis, and respiratory obstruction. ⋯ The Airtraq Pedi provided the glottic view with Cormack-Lehane grade I and a preformed tracheal tube (ID 4 mm) was placed correctly into the trachea through the built-in tube channel. We conclude that the pediatric Airtraq has potential advantages over conventional direct laryngoscopy in children with difficult airway.
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We describe the use of an abdominal aortic occlusion balloon catheter to control excessive blood loss at cesarean hysterectomy for placenta accreta. Prophylactic abdominal aortic occlusion balloon catheter was placed in the angiography suite under local anesthesia before surgery. The 38-year-old parturient was anesthetized with propofol, sevoflurane, ketamine, remifentanil and fentanyl under close monitoring and appropriate respiratory management. ⋯ Intraoperative blood loss was 1,800 g, and 300 g of autologous blood and 4 units of red cell concentrates were transfused. The postoperative course was uneventful. The present case suggests that prophylactic insertion of an aortic occlusion balloon catheter seems to be a safe and an effective method in controlling anticipated bleeding for caesarean hysterectomy in a parturient with placenta accreta.
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With the expanding elderly population in Japan, general anesthesia in patients above 80 years of age has become routine and is increasing. We report on a case of general anesthesia for a 100-year-old woman with chronic heart failure. ⋯ There was no cardiopulmonary instability during the operation, but heart failure became worse postoperatively, and it took nearly a month before the patient could leave the hospital. As for the operation and general anesthesia in the elderly, it is important not only to assess their perioperative physical risks but also to consider family background and postoperative course.