Masui. The Japanese journal of anesthesiology
-
Malignant hyperthermia occurred 10 hours after surgery in a 72-year-old man who had received emergency laparoscopic cholecystectomy for severe acute cholecystitis with cholelethiasis. He had a high fever (39.4 degrees C) with liver damage before surgery. Anesthesia was induced with propofol and fentanyl and maintained with sevoflurane and epidural block using ropivacaine. ⋯ He had hypoxic brain damage, but was dischanged from the hospital after tracheostomy on the 150th hospital day. From his clinical course, especially decrease in body temperature by dantrolene, he was suspected to have developed malignant hyperthermia. We should consider malignant hyperthermia when patient had a severe high fever postoperatively.
-
Here we report successful rapid-sequence inubation with the McGRATH MAC videolaryngscope (McGRATH) in the face to face sitting position for a patient with severe ileus and restricted mouse opening. A 46-year-old woman with advanced bladder cancer had developed ileus. Ileus tube and octreotide did not relieve her symptoms, and emergency colostomy was planned. ⋯ First an anesthesiologist stood at face to face position to the patients, and the second anesthesiologist kept the head of the patient from the cranial side. After thiamylal and fentanyl administration, cricoid pressure was applied by the third anesthesiologist. Under the guide of the McGRATH's monitor, we could successfully insert the 7.0 mm internal diameter tracheal tube with a stylet uneventfully in the face to face sitting position.
-
Droperidol is an effective antiemetic, but its use is limited because of the warning of drug-induced QT prolongation. Some reports showed that low-dose droperidol does not significantly probing QT interval. This study was aimed to determine the effect of low-dose droperidol (1.25 and 2.5 mg) on QTc interval, and the interaction among droperidol, propofol and sevoflurane. ⋯ Droperidol's effect on QTc prolongation was shown at the dose of 2.5 mg but not 1.25 mg. This prolongation effect was offset by propofol, and was unchanged by sevoflurane.