Masui. The Japanese journal of anesthesiology
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A forty-year old man hanged himself and was transported to our hospital. On arrival his consciousness was clear but he showed dyspnea, dysphagia, and oral bleeding. Tracheal intubation was attempted but was failed and emergency tracheostomy was successfully accomplished. ⋯ Orotracheal intubation was accomplished with StyletScope. It worked very well for the destroyed trachea. StyletScope is a useful device for intubation, especially in difficult airway management.
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Postoperative nausea and vomiting (PONV) are the most frequent side effects after anesthesia. Patients with persistent PONV continue to be impaired in performing their normal daily activities. We studied the controlling effect of dexamethasone (4 mg) before the induction of general anesthesia in the prevention of PONV. ⋯ Combination therapy with dexamethasone and droperidol may reduce PONV in patients undergoing surgery.
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The i-gel, which has been introduced into clinical practice in Japan in 2010, has a potential role in maintaining a clear airway during general anesthesia. ⋯ We believe that the i-gel is useful in maintaining a clear airway during general anesthesia.
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Shoulder arthroscopy has been performed in beach-chair position. In our hospital, the postoperative complications of the airway were reported in the patients who had undergone the operation in this position (hoarseness: 4 cases, paralysis of recurrent nerve: 2 cases, arytenoids dislocation: 1 case). ⋯ The results showed that the neck bending significantly increases the intra-cuff pressure of endotrachial tube. Therefore, we conclude that it is necessary to pay attention to neck position to avoid postoperative complications of the airway in the patients who have the operation in beach-chair position.
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Case Reports
[Peripheral nerve blocks for a patient with spondylolysis undergoing anterior cruciate ligament reconstruction].
A 24-year-old man, 178 cm tall and weighting 82 kg, underwent anterior cruciate ligament reconstruction. We gave general anesthesia and ultrasound-guided combined femoral and sciatic nerve block. Neuraxial blocks increase the risk of neuropathy in the patient with spondylolysis compared with peripheral nerve blocks. In this report, we describe the successful postoperative pain control with peripheral nerve blocks to a patient with spondylolysis.