Masui. The Japanese journal of anesthesiology
-
The intubating laryngeal airway, air-Q ILA, was recently introduced in Japan. It has been used in adult patients for difficult airway management; however, there are few reports available on its use in pediatric patients. We report the use of the air-Q ILA in predicted difficult airway management in a 16-month-old patient with Apert syndrome characterized by acrocephalosyndactyly undergoing a syndactyly operation. ⋯ Five months after this operation, the patient again underwent the same operation. We managed his airway in the same way as previously, and the tracheal was intubated. This case shows that the air-Q ILA can be an alternative device in pediatric difficult airway management.
-
We developed a simple audio recording system using a small personal computer and free audio recording software that makes voice recordings for use in emergencies, particularly for emergency caesarean sections. The system makes a continuous audio recording while the patient receives medical treatment. The recording provides an accurate record of the anesthesia used during treatment. This audio recording system is useful as an auxiliary means of record keeping during medical emergencies.
-
Randomized Controlled Trial Comparative Study
[Local instillation of 0.75% ropivacaine compared with intravenous fentanyl and flurbiprofen for postoperative analgesia following inguinal hernia repair in adults].
We compared postoperative analgesia provided by local instillation of 0.75% ropivacaine with that by intravenous fentanyl and flurbiprofen. ⋯ Local instillation of 0.75% ropivacaine is safe and effective, and provides adequate analgesia for a long period in adult patients following an inguinal hernia repair procedure.
-
Case Reports
[Use of dexmedetomidine in a critically ill patient with hyperactive delirium: a case report].
A 28-year-old male after a traffic accident was hospitalized with the abdominal pain. The abdominal CT showed deep hepatic injury. We immediately performed emergency transcatheter arterial embolization (TAE) and observed him in the ICU. ⋯ Postoperative delirium has been reported to be less with DEX compared to other sedatives. Recent studies have revealed that delirium is one of the most frequent complications and an independent risk factor for prognosis in the ICU patients. DEX may be effective for controlling delirium and provide sufficient sedation without respiratory adverse effects in patients in the ICU.
-
A 54-year-old man (height 155 cm, weight 49 kg) was scheduled for retroperitoneoscopic nephrectomy. He had a history of schizophrenia that had been controlled with propericiazine 10 mg and bromperidol 3 mg daily for 34 years. After induction of anesthesia, 1% mepivacaine 5 ml was administered via an epidural catheter. ⋯ Surgery was cancelled and he was extubated 45 minutes later without any complications. These findings suggest that caution must be exercised when combining general and epidural anesthesia for patients on long-term major tranquilizers. In the event of refractory hypotension, the use of direct-acting vasoconstrictors such as noradrenaline or vasopressin should be considered.