Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Meta Analysis Comparative Study
[Airtraq for difficult airways: A meta-analysis of randomized controlled trials].
Increased evidence indicates that the Airtraq is useful for difficult tracheal intubations. The aim of this meta-analysis was to assess the efficacy of the Airtraq in difficult airways, comparing with that of Macintosh laryngoscopy. ⋯ There is considerable evidence that Airtraq has an advantage over Macintosh laryngoscope in difficult airways.
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Pregabalin has been available in Japan since June 2010 for neuropathic pain. The adverse effects of pregabalin might be serious, and one must start at minimal doses and increase gradually to effective doses with enough explanation to patients. Pregabalin is a derivative of y-aminobutyric acid (GABA), but it has no effects on GABA receptors. ⋯ The effects of pregabalin is to bind alpha2delta-1 subunit and normalize the numbers of VGCCs at neuron surface and decreases neurotransmission, especially by excitatory amino acid. The descending facilitating serotonergic system from rostral ventromedial medulla may have effects on the occurrence and maintenance for the chronic pain. New drugs with less adverse effects may be developed.
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Case Reports
[Anesthesia for four pediatric patients with difficult airway in whom airway scope was useful for Intubation].
In the field of pediatric anesthesia, devices to solve difficult airway are scant compare to devices for adult difficult airways. We report successful use of an Airway Scope with a pediatric blade in four children with difficult airways. ⋯ Tracheal intubation using an Airway Scope was always easy. We conclude that the Airway Scope with a pediatric blade is potentially useful in children with difficult airways.
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Tramadol/acetaminophen fixed-dose combination tablets (Tramse) combine tramadol, a centrally acting week opioid analgesic, with low-dose acetaminophen. The action of tramadol may be described as a weak agonist at the mu-opioid receptor, inhibition of serotonin reuptake, and inhibition of noradrenaline reuptake. The second component in these tablets, acetaminophen mainly appears to act through central mechanism. ⋯ It is expected that Tramset is going to induce pain relief and to improve disturbance of daily life in patients with intractable chronic pain. However overuse of Tramset may induce severe adverse effects such as addiction, abuse and hepatotoxicity. Therefore clinician should continuously assess pain intensity, activity of daily life, mode of its consumption, and adverse effects after prescription.
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Opioids are available for patients with chronic non-cancer pain. At the start of treatment, side effects such as nausea and vomiting may occur. As these symptoms appear at a dose lower than that at which analgesic actions are achieved, preventive strategies are important. ⋯ It is also effective to use opioid rotation or change the administration route from oral to continuous subcutaneous administration. However, concerning chronic, non-cancer pain, the opioid rotation regimen is limited to a combination of codeine preparations, morphine preparations, and fentanyl patches. For long-term administration, the continuous intravenous/subcutaneous injection of opioids is not indicated.