Masui. The Japanese journal of anesthesiology
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GlideScope Cobalt video laryngoscope is a novel indirect laryngoscope for tracheal intubation. It consists of a reusable high-resolution miniature video camera and light source, and a disposable transparent sheath that enshrouds the video camera, thereby preventing contact with the patient. To evaluate the per- formance of GlideScope Cobalt, endotracheal intubation was performed in 100 consecutive patients requiring tracheal intubation for surgery. ⋯ GlideScope Cobalt provided Cormack-Lehane grade 1 or 2 visualization of the glottis in 100 patients. It was easily handled not only by experienced anesthetists but also by novice personnel. GlideScope Cobalt could be an effective aid to airway management in surgical patients.
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Relationships between common carotid arteries (CCA) and internal jugular veins (IJV) have been investigated both in adults and children. Overlapping of CCA and IJV are reported in 70 to 90% of cases; however we seldom observe overlapping cases in children. We evaluate the relationships between CCA and IJV in children. ⋯ There appears to be little danger of puncturing the CCA during internal jugular venipuncture from the viewpoint of anatomical relationships between the CCA and IJV
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A baby girl, 15-month-old, 75.6 cm in height, and 7.5 kg in weight, was scheduled to undergo ventricular septal defect repair. The right IJV, 3.0 mm in thickness and 7.0 mm in depth, was punctured to place a central venous catheter with a 19-mm-long 24G puncture needle. Non-pulsatile bright red blood appeared during the 15.8-mm-long needle insertion and dark red blood appeared during the 14.7-mm-long needle insertion. ⋯ The 14.7-mm-long needle inserted at a 45-degree angle reached about 10.4 mm, which is near the posterior wall of the IJV It seemed that a small artery behind the IJV was punctured mistakenly. In withdrawing blood from a cyanotic patient, it may be difficult to judge if the blood was arterial because it was non-pulsatile when it appeared. We should be careful to know the existence of small arteries behind IJVs and to confirm which vessels the returned blood comes from.
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Mid-axillary transversus abdominis plane block (TAP-B) and subcostal TAP-B have become well-known blocks to provide considerable analgesia for abdominal surgery. However, proper approach and adequate volume of injectate have not still been clarified. In this study, a combination of mid-axillary TAP-B and subcostal TAP-B was performed in cadavers to establish the spread of injectate and segmental nerve involvement. ⋯ This study demonstrated that the combination of ultrasound-guided mid-axillary TAP-B and subcostal TAP-B involve T8-L1 nerves. This technique can be used not only in lower abdominal surgery but also in upper abdominal surgery.
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Sugammadex was synthesized as a selective reversal agent for rocuronium, a steroidal non-depolarizing neuromuscular blocking (NMB) agent. Sugammadex exerts its effect by forming very tight water-soluble complexes at a 1 : 1 ratio with steroidal NMB agents. Because the reversal of NMB could not sufficiently be completed by anti-cholinesterase agents such as neostigmine, we often had to wait until their spontaneous recovery. ⋯ There is no interaction with cholinergic systems. Therefore, undesired side effects attendant with anti-cholinesterases are not seen. This article provides information on the characteristics and effectiveness of sugammadex.