Masui. The Japanese journal of anesthesiology
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A 70-year-old man with a severe COPD was scheduled for low anterior resection of the rectum because of rectal cancer. After a week of respiratory rehabilitation, respiratory function was much improved. ⋯ We obtained appropriate sedative and antianxiety effect without causing respiratory depression and hemodynamic changes. Dexmedetomidine was useful for anesthesia for a patient with severe COPD without causing respiratory depression.
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Most of the thermometers used during operations are invasive and non-hygienic. The usefulness of a noncontact continuous tympanic thermometer under general anesthesia has been reported. We evaluated the usefulness of a noncontact continuous tympanic thermometer in patients undergoing cardiac surgery using an artificial heart-lung machine. ⋯ A noncontact continuous tympanic thermometer is useful for measurement of core temperature during cardiac surgery using an artificial heart-lung machine.
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Case Reports
[Case of abdominal compartment syndrome (ACS) associated with perforating appendicitis].
A 4-year-old girl with perforating appendicitis developed abdominal compartment syndrome (ACS). Appendicitis in children of preschool age is highly likely to rupture, resulting in serious condition. ⋯ ACS causes progressive multiple organ failure through compromising the respiratory and circulatory systems and injuring multiple organs, leading to generalized inflammatory reactions. We should, therefore, manage ACS patients systemically sharing a notion that they must be treated early with abdominal decompression by laparotomy.
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Preoperative oral carbohydrate administration for adult patients has been recommended by European Society for Parenteral and Enteral Nutrition and Enhanced Recovery After Surgery. Although preoperative oral carbohydrate may improve patient satisfaction and perioperative glucose metabolism, its effects on the gastric contents remain controversial. ⋯ We conclude that preoperative oral carbohydrate can be given safely, although the fasting interval should be 150 minutes in our diet regimen.
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Although the bispectral index (BIS) has been established as a common index of anesthetic depth, there is a possibility that head-up position may influence BIS values under general anesthesia. This study examined whether beach chair position with 57 degrees head-up would cause the variation of BIS values during shoulder surgery. ⋯ To our knowledge, this is the first report of the effect of beach chair position on BIS values intraoperatively. This result indicates that the beach chair position causes a time-dependent decrease in BIS under general anesthesia.