Masui. The Japanese journal of anesthesiology
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Meta Analysis Comparative Study
[Efficacy of Glidescope video laryngoscope in difficult airways: a meta-analysis of randomized controlled trials].
Increased evidence indicates that the Glidescope video laryngoscope (GVL) is useful for difficult tracheal intubations. The aim of this meta-analysis was to assess the efficacy of the GVL in difficult tracheal intubations, comparing with that of Macintosh laryngoscopy. ⋯ Our meta-analysis showed that GVL has an advantage over Macintosh laryngoscope in respect to the success rate for difficult tracheal intubations.
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Case Reports
[A case of subglottic stenosis with bridging granuloma after intubation with double-lumen endotracheal tube].
We present a case of subglottic stenosis with rare bridging granuloma after intubation with double-lumen endotracheal tube. An 81-year-old woman was diagnosed with the lung tumor and scheduled for the thoracoscopic surgery. We induced anesthesia with propofol, remifentanil and rocuronium. ⋯ Laryngoscopic examination revealed bridging granuloma leading to tracheal stenosis. Tracheostomy and resection of granuloma were performed, and her symptom improved. If we feel resistance in intubating a double-lumen endotracheal tube in a patient with a history of intubation with a tracheal tube, we should operate gently adjusting the size of the tracheal tube.
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A 40-year-old man (168 cm tall and weighing 71 kg) with intractable pneumothorax was operated for resection of a bulla in the left lung. After insertion of epidural catheter via T 5-6 interspace, general anesthesia was induced and maintained with propofol, remifentanil and rocuronium. The duration of surgery was 1h 48 min and rocuronium given during surgery was 110 mg. ⋯ Reoperation lasted for 43 minutes and rocuronium infused was 100 mg. Nasal airway was inserted to prevent airway obstruction by the tongue and extubation was performed under muscle relaxation with infusion of rocuronium 10 mg. And then, immediate administration of sugammadex 400 mg could elicit spontaneous respiration without cough reflex.
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We investigated the perioperative courses of 129 elderly patients with hip fracture with different types of surgical repair under spinal anesthesia. ⋯ Although the elderly patients with hip fracture have several pre- and postoperative complications, it is likely that they can fare well during perioperative period under spinal anesthesia regardless of the type of surgical repair.
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We present here anesthetic management for children undergoing MRI at the Department of Anesthesia in NCCHD. Remaining motionless in the scanner of MRI is extremely important for data integrity because motion will blur the image. In patients who cannot remain still and in small children, general anesthesia or sedation is required for MRI. ⋯ We describe two cases of anesthetic management for children undergoing MRI by using propofol and in these cases we found that it should be better to follow the conventional setting for general anesthesia including monitoring system. Some hospitals encountered with serious complications such as cardiac arrest during MRI scanning under general anesthesia/sedation. MRI scanning under general anesthesia/sedation has a high risk due to the environment, indicating that we should be careful about the safety of the patients.