Masui. The Japanese journal of anesthesiology
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Case Reports
[A case of respiratory distress due to massive pleural effusion after surgery for ovarian tumor].
A 59-year-old woman with ovarian tumor was scheduled for radical hysterectomy under general anesthesia. Preoperative examination showed massive ascites and slight pleural effusion. Since respiratory status had improved by oxgen therapy, she underwent a surgery as scheduled, although she complained of slight dyspnea and low Sp(O2). ⋯ Oxygenation improved, and the endotracheal tube was removed. Patients with ovarian tumor with pleural effusion and ascites may have desaturation due to increased pleural effusion during the operation, or pleural effusion might increase preoperatively. Therefore, we need to be cautious about anesthetic management of them and examine chest X-ray and arterial blood gas frequently.
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The transversus abdominis plane (TAP) block is a newly described technique introducing a local anesthetic agent between the internal oblique and the transversus abdominis muscles of the abdominal wall, which is safer and more reliable analgesia in recent years by ultrasound technique. We report the perioperative management of transversus abdominis plane block with catheterization for a patient with severe cardiac dysfunction and chronic kidney failure, who underwent bilateral inguinal hernioplasty. ⋯ During the operation, the patient received a target-controlled infusion of 0.4-0.6 microg x ml(-1) propofol. The perioperative courses were uneventful and there was no adverse effect including central nervous system (CNS) symptoms.
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The goal of this investigation was to evaluate the details of preformed pediatric endotracheal tubes (PPETTs, I. D. 3.0-6.0 mm). ⋯ There are no uniformity in the details of PPETTs. The details of PPETTs including those with high volume low pressure cuff should be updated.
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Every airway maneuver will cause some degree of neck movement. Ventilation via face-mask technique requires lifting the mandible (jaw thrust) to the facemask. A significant degree of cervical spine motion induced by bag-mask ventilation has been reported on human cadavers with destabilized cervical vertebrae. However, to our knowledge, no quantitative data have reported evaluating the effects of bag-mask ventilation on cervical spine motion in living humans. We measured the cervical spine movement during bag-mask ventilation. ⋯ The lifting the mandible causes both extension and anterior disposition in the cervical vertebrae.
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Randomized Controlled Trial
[The preventive effect of flurbiprofen on preventing mesenteric traction syndrome].
Mesenteric traction syndrome (MTS) is associated with facial flushing, hypotension and tachycardia. The ways to treat MTS are fluid replacement, administration of vasopressors and nonsteroidal anti-inflammatory drugs (NSAIDs) such as flurbiprofen. In order to stabilize the hemodynamics during operation, preventing MTS is more reasonable. Thus, we investigated the preventive effect of flurbiprofen on MTS, the only injectable formulation which can be used in Japan. ⋯ Our results indicate that pretreatment with flurbiprofen might prevent MTS.