Masui. The Japanese journal of anesthesiology
-
Randomized Controlled Trial Comparative Study
[Prevention of spinal hypotension associated with cesarean section by aortocaval compression--left 15 degree table tilt vs. uterine displacement by hand].
Women undergoing elective cesarean delivery were randomly assigned to receive a spinal anesthesia in either the semi-lateral (group SL) position or the supine position with uterine displacement (group UD). After spinal injection, group SL patients were turned to a 15 degrees left lateral supine position, and group UD patients had uterine displacement by hand. ⋯ Mean ephedrine requirement was significantly less in the SL group (P < 0.05). Apgar scores did not differ, but umbilical artery pH values were significantly higher in patients of the group SL (P < 0.01).
-
Case Reports
[Case of difficult ventilation due to trachea stricture during general anesthesia in a morbidly obese patient].
Obesity has various coexisting illnesses, and the risk of the anesthesia management in an obese patient is high. We report a case of difficult ventilation by trachea stricture during general anesthesia in a morbidly obese patient.
-
Stiff-person syndrome is an uncommon disease characterized by muscular rigidity and painful spasms in the axial and limb muscles. We report a 58-year-old woman with stiff-person syndrome undergoing thymectomy under general anesthesia. Before surgery, her medications were 25 mg of diazepam, 2 mg of clonazepam, and 15 mg of gabapentin per day. ⋯ After surgery, she was fully awake and TOFR recovered to 100%, but tidal volume was too low to remove the tracheal tube, and mechanical ventilation was continued in ICU. On the next day, the tracheal tube was removed, and she was discharged from ICU. Because anesthetics may delay the recovery of respiratory function in a patient with stiff-person syndrome, careful assessment of respiratory function is needed at the emergence from general anesthesia.
-
Comparative Study
[Comparison of the Parker flex-tip tube with the standard tube for Airtraq intubation].
During tracheal intubation with the Airtraq laryngoscope (AL), the tracheal tube tip sometimes impinges on the glottis or other laryngeal structures. We tested a hypothesis that Parker flex-tip tube (PT) makes AL assisted tracheal intubation easier and faster than a conventional tube (Mallinckrod Hi-Lo tube : HT). ⋯ PT significantly reduced the number of impingements. The shape of tube tip and the smaller angle of PT when fitted in AL contributed to the relative ease of tube passage.
-
The risk factors for postoperative myasthenic crisis (MC) in patients with myasthenia gravis (MG) receiving preoperative corticosteroids were unknown. ⋯ Based on this study, we concluded that the existence of preoperative bulbar symptoms seems to be a predictor for the development of postoperative-MC in patients with MG undergoing a transsternal thymectomy.