Masui. The Japanese journal of anesthesiology
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Using an algorithm by which the effect-site concentration of propofol (esTEC) necessary for BIS level set from information input from BIS monitor and TCI pump is estimated, the effect of remifentanil on esTEC was investigated. ⋯ A mutual interaction was observed between propofol esTEC and remifetanil. For anesthetic management with less variation in BIS levels, it was considered that 10 ng x ml(-1) or higher of the effect-site concentration of remifetanil would be necessary.
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Case Reports
[Anesthetic Management for Endoscopic Sinus Surgery in a Patient with Transplanted Heart--A Case Report].
A 19-year-old male patient with transplanted heart received endoscopic sinus surgery. He was with X-linked dilated cardiomyopathy, and was one year after the transplantation. Preanesthetic study showed lactate dehydrogenase elevation estimated to have derived from striated muscle. ⋯ No inotropic agent was administered. He was discharged from the hospital 5 days after the operation without any complications. We used usual anesthetic management but we had to be careful about both denervated heart and myopathy.
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Randomized Controlled Trial
[Effect of Preoperative Oral Rehydration on Onset Time and Recovery Time of Rocuronium].
Preoperative oral rehydration solution (ORS) prevents hypovolemia. The aim of this study was to compare the effect of intubating dose of rocuronium in patients taking and those not taking preoperative ORS. ⋯ Preoperative oral rehydration possibly increases circulating blood volume, and shortens the duration of rocuronium effect.
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Mediastinal angiosarcoma is a rare intrathoracic tumor that can cause severe pleural and pericardial fibrosis. ⋯ ECMO is a useful option to secure adequate gas exchange and circulation during anesthesia induction in patients with severe cardiopulmonary problems due to mediastinal tumors.
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A 56-year-old male with distal myopathy of rimmed vacuoles underwent laparoscopic nephrectomy. Anesthesia was induced with propofol, remifentanil and ketamine. Tracheal intubation using McGRATH was uneventful without using muscle relaxants. ⋯ Good surgical condition and pneumoperitoneum were maintained without using muscle relaxants. His postoperative course was smooth and uneventful, even though a small amount of fentanyl was administrated to relieve wound pain. This case suggests that McGRATH and ultrasound-guided TPVB can be one of the options to avoid using muscle relaxants in patient with neuromuscular disease.