Masui. The Japanese journal of anesthesiology
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We report a case of intraoperative kinking of an endotracheal tube (ETT) in a prone patient during spine surgery. We postulate that one of the risk factors involved with kinking was the inadequate withdrawal maneuver of Pentax-AWS Airway Scope (AWS). Patient was a 69-year-old woman with hypertension, diabetes mellitus, and rheumatoid arthritis, undergoing C4-6 laminoplasty under general anesthesia in the prone position. ⋯ The subsequent anesthetic course was uneventful. Kinking of the ETT in the oral cavity is an uncommon problem but we must keep in mind as one of the differential diagnoses. When using the AWS for endotracheal intubation, we recommend the confirmation of the position of the ETT to be normal in the oral cavity by direct laryngoscopy.
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Historical Article
[American contributions to Japanese anesthesiology--a historical view].
The origin of anesthesiology in Japan can be traced back to 1804, when Seishu Hanaoka administered anesthesia. However, the present day anesthesiology in Japan was shaped by two programs in the 1950s supported by the United States (US) Government. The first US program to influence anesthesiology in Japan was the Unitarian Service Committee (USC) Medical Mission. ⋯ Under this program, two Japanese physicians finished anesthesiology training in the US. Examining the history of our profession helps us understand the dedication and commitment of our pioneers, and prepares us to take on existing challenges to further the vision and goals set by our pioneers. The past provides us with a framework and understanding for how we pursue future opportunities and aspirations.
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Meta Analysis Comparative Study
[Efficacy of Pentax-AWS in difficult airways: a meta-analysis of randomized controlled trials].
Increased evidence indicates that the Pentax-AWS (AWS) is useful for difficult airways. The aim of this meta-analysis was to assess the efficacy of the AWS in difficult airways, comparing that of Macintosh laryngoscopy. ⋯ There is considerable evidence that AWS has an advantage over Macintosh laryngoscope in difficult airways.
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A 46-year-old man was diagnosed with descending colon cancer and was planned to undergo left hemicolectomy under general anesthesia. His body mass index was 42.6 and due to his small mouth and jaw, we anticipated difficult mask ventilation and tracheal intubation. ⋯ Then, we replaced the air-Q with an outside diameter 8.5 mm tracheal tube. This case was a successful use of the air-Q under moderate sedation for airway management in the setting of anticipated difficult mask ventilation and tracheal intubation.
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Case Reports
[A case of late drug-eluting stent thrombosis during postoperative period after 5 years of stent implantation].
Stent thrombosis during perioperative period is a critical complication for patients treated with drug-eluting stent (DES). We experienced a case of late DES thrombosis 5 years after initial implantation. A 48-year-old man with familial hyperlipidemia, angina pectoris and chronic pulmonary emphysema, was diagnosed with esophageal carcinoma, and scheduled for esophagectomy. ⋯ Emergent coronary angiography revealed re-stenosis of the right coronary artery treated with DES 5 years ago. At present, there was no definite guideline, on the management of DES during perioperative period. It is important for us to decide continuing antiplatelet therapy balancing the risk of stent thrombosis with surgical bleeding in each patient.