Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial
[Hypotonic Versus Isotonic Electrolyte Solution for Perioperative Fluid Therapy in Infants].
This study was designed to evaluate the effects of perioperative administration of an isotonic electrolyte solution with 1% glucose (IT) on blood sodium (Na+) and blood glucose (BG) concentrations in pediatric patients < 1-year-old undergoing plastic surgery in comparison with a conventional hypotonic electrolyte solution with 2.6% glucose (HT). ⋯ Isotonic solution with 1% glucose is suggested to be safe in infants during and after surgery.
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The use of epidural anesthesia for ablominal aortic replacement surgery may be problematic because of the amount of heparin used during the procedure, which places the patient at increased risk of epidural hematoma. We evaluated its benefits, risks, postoperative outcomes and costs. ⋯ Epidural anesthesia during abdominal aortic replacement facilitated more rapid extubation, but did not appear to influence other aspects of patient recovery or ICU costs.
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Case Reports
[Use of the i-gel for Tracheostomy in a Patient with Neck Deformity and Tracheal Stenosis].
We report a successful use of the i-gel for tracheostomy in a patient with severe neck deformity and tracheal stenosis. A 20-year-old man, 142 cm, 22 kg, was scheduled for tracheotomy. He had tracheal stenosis with hypoxemia, due to the pressure from the brachiocephalic artery, associated with severe progression of symptomatic scoliosis and thoracic deformity. ⋯ The i-gel was easily inserted, and fiberscope-aided tracheal intubation through the i-gel was attempted, but decided not to intubate the trachea, due to the degree of stenosis. Tracheostomy was performed, while a clear airway was maintained by the i-gel. We consider that the i-gel has a potential role for tracheostomy in a patient with neck deformity and tracheal stenosis.
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Case Reports
[Successful Subarachnoid Phenol Block Therapy in a Patient with Pelvic Tumor-related Rectal Tenesmus].
We report a successful case of subarachnoid phenol block therapy in a patient with refractory rectal tenesmus caused by metastatic breast cancer. A 50-year-old woman with pelvic metastasis of breast cancer had the constant desire for defecation and anal discomfort, although analgesics including opioids relieved her from low abdominal and anal pain. Computed tomography revealed rectal invasion of metastatic breast cancer and the diagnosis of tumor-related rectal tenesmus was made. ⋯ Subarachnoid phenol block in the sitting position, which was neurolytic saddle block and expected to inhibit rectal reflex, was performed and her symptom was dramatically relieved. The effect of the block continued until she died 19 days after. To our knowledge, we first report subarachnoid phenol block therapy for a patient with pelvic-tumor related rectal tenesmus.