Masui. The Japanese journal of anesthesiology
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A 71-year-old woman was scheduled for arthroscopic knee surgery. Anesthesia was administered with sevoflurane, fentanyl, and rocuronium bromide. Total dose of fentanyl was 200 microg and total dose of rocuronium bromide was 40mg. ⋯ The cause of difficult ventilation was surmised to be upper airway reflex or muscle rigidity caused by reaction to fentanyl. We thought the phenomenon was clearly manifested by rapid recovery from muscle relaxation by injection of sugammadex. Before injection of sugammadex, it is necessary to confirm the effects of anesthetics on the patient's condition.
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We report successful awake intubation using AWS combined with surface anesthesia of the upper airway via nebulizer. The two cases are suitable for awake intubation due to difficult airway. ⋯ The patients and author did not buck during intubation. The present case shows that it is possible to perform awake intubate safely with less stress with the combination of AWS and surface airway anesthesia via nebulizer.
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We operated rescue activities in Tohoku area after the earthquake of March 11th, 2011. From our hospital, a doctor-helicopter flew to the staging care unit at Hanamaki airport with two members of the disaster medical assistance team (DMAT), one of whom was an anesthesiologist. ⋯ The missions was quite different from our usual job as an anesthesiologist, but we could transfer the patients safely by using some knowledge of stabilizing the unstable patients as flight doctors. We report the details of our activities by our doctor-helicopters in Tohoku area.
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We present a case of anesthetic management in a child with myotubular myopathy. A 3-month-old, 3.0 kg, male patient, who had been suspected of a congenital myopathy, was scheduled for the muscle biopsy. He was intubated at birth in NICU. ⋯ These anesthetic courses were uneventful without symptoms of malignant hyperthermia nor propofol infusion syndrome. We did not use sugammadex, because there is still no evidence to the safe use of sugammadex in infants (aged 28 days-23 months). Congenital myopathy is related to malignant hyperthermia, and total intravenous anesthesia (TIVA) is a preferable and safe method for children with this disease.