Masui. The Japanese journal of anesthesiology
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Comparative Study
[The KINGVISION: clinical assessment of performance in 50 patients].
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We report a 61-year-old woman (weight 49 kg, height 156 cm) with Kugelberg-Welander disease who was scheduled for bilateral mastectomy under general anesthesia. We administered rocuronium 10 mg (0.20 mg x kg(-1)) for tracheal intubation. After 80 min, train-of-four ratio (TOFR) was 46%. ⋯ After 4 min, TOFR became above 90%, and the patient was extubated. There was no respiratory distress, muscle weakness, or neurologic untoward event after the use of sugammadex in the postoperative period. Sugammadex was effective in reversing rocuronium induced neuromuscular block in a patient with Kugelberg-Welander disease.
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The use of positive end-expiratory pressure (PEEP) is a practical intervention to improve oxygenation during anesthetic management; however, the underlying mechanisms have not been elucidated. ⋯ These results suggest that the mechanisms for improved oxygenation by PEEP under sevoflurane anesthesia are different from those under propofol anesthesia. The improved oxygenation after the application of PEEP under sevoflurane anesthesia is mainly due to reduction of atelectasis, whereas reduction of atelectasis as well as reduction of intrapulmonary shunt is associated with the improved oxygenation after the application of PEEP under propofol anesthesia.
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Comparative Study
[Safety and beneficial effects of spinal morphine on the postoperative course of elderly patients undergoing surgical fixation of the femoral neck fracture].
We performed a retrospective study of the efficacy and safety of spinal anesthesia with 0.1 mg morphine in the postoperative course of elderly patients with femoral neck fracture. ⋯ The spinal administration of 0.1 mg morphine had beneficial effects and was safe in the postoperative period of elderly patients with femoral neck fracture provided that sufficient observation was given.
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Case Reports
[A child with Klippel-Feil syndrome in whom GlideScope was effective for tracheal intubation].
GlideScope videolaryngoscope (GlideScope, herein-after referred to as "GS", Verathon Medical, Bothell, WA, USA), with a high-resolution camera positioned on a blade, enables operators to confirm the position of the larynx and a tube through clear view, thereby conducting intubation safely in a patient whose neck is difficult to be bent back. As the blade is slim, GS is indicated for use in children whose oral cavity is narrow. We herein report safe and smooth intubation with GS in a child with Klippel-Feil syndrome in whom difficult intubation was predicted.