Masui. The Japanese journal of anesthesiology
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We report the successful combined use of continuous epidural anesthesia and transversus abdominis plane block for the management of postoperative pain following a cesarean delivery in a patient whose paralysis and pain were not well controlled after two previous cesarean deliveries. A 28-year-old female patient with no remarkable medical history was scheduled to undergo cesarean delivery at 38 weeks and 3 days of pregnancy. She had undergone cesarean deliveries twice previously, at 23 and 25 years of age. ⋯ Therefore, during the third operation, the concentration of the continuous epidural anesthesia infusion was decreased to prevent complications, and a transversus abdominis plane block was added. The patient experienced no postoperative pain and fewer complications. We think that the combined use of these blocks provided good postoperative pain control with fewer complications.
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Comparative Study
[Comparison of TaperGuard tube and the Portex Softseal for prevention of vomitus leakage in an in vitro simulation airway model].
Microaspiration of vomitus can cause a serious condition known as Mendelson's syndrome. The present study used simulated stomach contents and an airway model to compare a tracheal tube with a tapered cuff (Taper) to the conventional high volume low pressure cuff (HVLP) in their abilities to prevent microaspiration. ⋯ We conclude that the Taper may be more effective than the conventional HVLP in preventing vomitus microaspiration in an airway model simulation.
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A 19-year-old male was admitted with diabetic ketoacidosis. A central venous catheter for fluid loading and insulin administration was inserted from the right femoral vein. The catheter was placed for 4days and was removal. ⋯ The surgeon also implanted an inferior vena caval filter. The patient was weaned from ventilator assist next day and was discharged from the hospital 13 days later. This case suggests that deep vein thrombosis should be checked in diabetic ketoacidosis even after removal of a central venous catheter implanted at the femoral vein.
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Comparative Study
[Difference in nitrous oxide-mediated increases in intracuff pressure between two tracheal tubes in a simulated pediatric lung model].
The purpose of this study was to compare the nitrous oxide-mediated increases in cuff pressure between a tracheal tube with a tapered cuff (Taper) or conventional high volume low pressure cuff (HVLP) utilizing a simulated pediatric lung model. ⋯ These findings suggest that the Taper may be more effective than the HVLP in preventing hyperinflation of the tracheal tube cuff in response to nitrous oxide exposure in children.
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A 71-year-old male was scheduled for a laparoscopic cholecystectomy. The plan was to intubate him using direct laryngoscopy. After induction of anesthesia and analgesia direct laryngoscopy was performed but it was difficult to get a good view of epiglottis, and at 2nd attempt there was laryngeal edema, which made the procedure more difficult. ⋯ After the operation, the patient was extubated from the trachea with the Aura-i still in place. When sufficient respiration returned, the Aura-i was removed. There was no bleeding in the mouth after removal of the Aura-i.