Masui. The Japanese journal of anesthesiology
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Vocal cord paralysis after tracheal intubation is rare. It causes severe hoarseness and aspiration, and delays recovery and discharge. Arytenoid cartilage dislocation and recurrent nerve paralysis are main causes of vocal cord paralysis. ⋯ In pediatric cardiac surgery, vocal cord paralysis occurs in 1 (0.1-0.5%) of 200-1,000 patients. We classified the severity of vocal cord paralysis as I, severe hoarseness; II, aspiration or dysphagia; and III, bilateral vocal cord paralysis, aspiration pneumonia, or the need for tracheal re-intubation or tracheotomy. We discuss the importance of informed consent for the patient and family.
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Case Reports
[Successful sedation with landiolol and dexmedetomidine during spinal anesthesia in a patient with active dementia].
We report a successful case of sedation during spinal anesthesia using continuous administration of landiolol and dexmedetomidine in a patient with severe dementia. An 86-year-old man weighing 63 kg with severe dementia and chronic obstructive pulmonary disease was scheduled for emergent open reduction of fracture under spinal anesthesia. On admission, he presented with delirium as a result of pain and environmental change. ⋯ After 10 minutes, he was sedated and agreed to undergo spinal anesthesia. Spinal anesthesia was successful with isobaric bupivacaine 3.0 mI. The patient showed no untoward behavior during anesthesia and the operation.