Masui. The Japanese journal of anesthesiology
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Case Reports
[Awake intubation with landiolol and dexmedetomidine in a patient with anxiety neurosis].
We report a successful case of awake intubation in a patient with anxiety neurosis via continuous administration of landiolol and dexmedetomidine. A 52-year-old woman weighing 46.8 kg with anxiety neurosis experienced postoperative bleeding after left-side thyroidectomy and was scheduled for emergent hemostasis under general anesthesia Due to swelling of the neck, we anticipated a difficult airway and decided to perform awake intubation. ⋯ After 10 minutes, her shivering disappeared, and she agreed to undergo awake intubation, which was performed with the Pentax-AWS Airwayscope and thin Intlock blade. The patient bucked slightly during intubation but hemodynamic changes were minimal.
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Case Reports
[Case of respiratory arrest during intraoperative magnetic resonance imaging (iMRI) for awake craniotomy].
We had a neurosurgical patient who developed apnea during iMRI. She was suspected of obstructive sleep apnea. The tumor had a risk of motor aphasia, and therefore awake craniotomy with iMRI was planned. ⋯ Awake craniotomy could be challenging because of unsecured airway with risks of vomitting, epileptic attacks or unstable level of consciousness. It is considered that the patient monitoring becomes more difficult when iMRI is performed because the patient's face cannot be obsereved directly. We should remember that conscious level as well as respiration pattern may change during operation.
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General anesthesia was successfully performed in an 86-year-old woman with severe tracheobronchomalacia Tracheobronchomalacia in adult is a very rare disease, characterized by weakness of the trachea and bronchi, causing luminal narrowing during expiration. The patient had laparoscopic cholecystectomy. We used propofol, remifentanil, and rocuronium for induction of anesthesia. ⋯ The patient did well, and was discharged from the hospital 3 days after the operation. In this case, no special care such as postoperative CPAP was necessary, but normally, general anesthesia for a patient with tracheobronchomalacia requires attention. We gave general anesthesia satisfactorily in a patient with tracheobronchomalacia.
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We conducted a retrospective analysis of the intraoperative lactate level and its association with patients' outcome in adult cardiac surgery patients requiring cardiopulmonary bypass. ⋯ Increased lactate concentrations after weaning from CPB were significantly and independently associated with ICU free survival days at POD 28. This finding may be important to physicians in managing patients undergoing cardiac surgery using CPB.
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Comparative Study
[Comparative study of the KingVision videolaryngoscope and Airwayscope using manikins].
KingVision (KV) is a new videolaryngoscope. In this study, we compared the ease of use of the KV with the Airwayscope (AWS) by experienced personnel in a simulated manikin. ⋯ KV may be a suitable device for routine anesthesia care and difficult airway intubation. Further studies in a clinical setting are necessary to confirm these findings.