Masui. The Japanese journal of anesthesiology
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It is more than 60 years since averaged somatosensory evoked potentials (SEPs) were devised. During this period, other evoked potentials including spinal cord evoked potentials and motor evoked potentials (MEPs) were developed. ⋯ The combination of these evoked potentials (multimodality monitoring) has been demonstrated to be sensitive and specific for detecting intraoperative neurologic injury during spine surgery. Although there is still a low level of evidence that intraoperative evoked potentials reduce the rate of new or worsened perioperative neurologic deficits, it is recommended to monitor MEP for thoracoabdominal aortic surgery and multimodal evoked potentials including at least spinal cord evoked potentials and MEP for spine surgery, when the spinal cord is considered to be at risk.
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Randomized Controlled Trial
[Effectiveness of gum elastic bougie for tracheal intubation with Airtraq optical laryngoscope].
Although Airtraq (ATQ) is well accepted as a useful device for tracheal intubation especially in cases of difficult airway management, we sometimes encounter difficulty in insertion of a tracheal tube along the blade of ATQ across the vocal cord in spite of ATQ assistance. Gum Elastic Bougie (GEB) is well known as a practical device for intubation assistance with Macintosh laryngoscope. We studied the efficacy of GEB for intubation with ATQ. ⋯ For the people with less experience of intubation, GEB is useful assistance for intubation with ATQ. It was concluded that the combined use of ATQ and GEB is a simple and effective process for ordinary doctors or paramedics.
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Randomized Controlled Trial
[Effect of amino acid and glucose infusion on perioperative body temperature and postoperative infection in patients undergoing total knee arthroplasty].
We investigated whether the perioperative amino acid infusion with glucose is effective for preventing perioperative hypothermia and postoperative infection in patients undregoing total knee arthroplasty (TKA). ⋯ These results suggest that in patients undergoing TKA receiveing amino acid infusion perioperatively, thermogenic effect and prevention of postoperative infection are similar whether exogenous glucose is infused or not.
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Axillary veins (AxV) are increasingly selected instead of the subclavian veins (SCV) for safe and successful catheterization in adults using ultrasound echo although quite rarely in children. The diameters and depths of the pediatric internal jugular veins (IJV) are well known but those of pediatric AxV are unfamiliar even to anesthesiologists. We evaluated the diameters and the depths of the AxV and IJV in children undergoing cardiac surgery. ⋯ The diameters of the AxV are about 0.6 times and the depths are about 1.5 times those of the IJV and it seems difficult to use AxV for pediatric CVC from the standpoint of venous diameters and depths.
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A 64-year-old man was diagnosed to have a tracheal tumor 2 cm proximal to the carina. He was scheduled for tracheal resection and reconstruction with omentopexy. An epidual tube was placed at the level of T5-6. ⋯ After the operation, he was extubated under anesthesia without coughing. No pain was complained during postoperative course. Epidural anesthesia combined with TAPB provided sufficient postoperative analgesia, especially in tracheal resection and reconstruction with omentopexy.