Masui. The Japanese journal of anesthesiology
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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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Despite a drastic decline in anesthesia-related morbidity and mortality, perioperative mortality remains still high with an overall rate around 1 to 2%. To improve postsurgical outcomes ultimately, anesthesiologists should move forward to take more responsibility in the perioperative management of patients. In this issue, we selected several types of highly invasive surgical procedures and reviewed anesthesia and perioperative management for the patients undergoing these surgeries. Team approach by various professionals may facilitate organizing pre-, intra-, and postoperative care.
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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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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.
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We report a case of an accidental loss of anesthesia records through network failure of an anesthesia information management system (AIMS). The backup data were not kept in the anesthesia workstations or the server during the failure. Accordingly, anesthesia records of five patients were lost for one hour. ⋯ Despite the redundant pathways, transient power failures of network switches caused interruptions in both pathways. Our case indicates that, to improve the robustness of the AIMS as electronic medical records, every network apparatus of AIMS, should be supplied with an uninterrupted power supply. Furthermore, each anesthesia workstation should function independently as an anesthesia record keeping client when network failure occurs.