Masui. The Japanese journal of anesthesiology
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Comparative Study
[Comparison of two methods of local anesthetic administration using three phantom tissue models].
Local anesthetic is often administered around surgical wounds to reduce pain. It remains unknown, however, how the agent diffuses into tissue, or whether the method of administration has any impact on the drug diffusion. We evaluated drug-diffusion areas around wounds after administering a dummy agent by needle injection (NI) and direct infiltration (DI) using three phantom tissue models : agar, sponge, and pork rib. ⋯ The direct infiltration method is likely to diffuse local anesthetic into tissue more uniformly and more extensively than the needle injection method.
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An 86-year-old woman was scheduled to receive fourth reconstructive surgery for femoral bone fracture under general anesthesia. She had been suspected with narrow angle glaucoma due to headache and bloodshot eyes during gastroscopy. During transfer to our hospital, she fell down and suffered from the right femoral neck fracture. ⋯ TOF ratio recovered to 80% 8 minutes after sugammadex 2 mg kg(-1) i.v., and increased to 100% 3 minutes after additional 1 mg x kg(-1). Intraocular pressure stayed below 20 mmHg during the intervention. We could achieve full reversal of neuromuscular blockade and suppress increase in intraocular pressure with use of sugammadex.
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Comparative Study
[Glidescope: a comparison of percentage of glottic opening score between middle size and large size handles].
The aim of the present study was to compare the percent of glottic opening score between middle-size (#3) and large-size (#4) handles during laryngoscopy using the GlideScope videolaryngoscope (GVL) in Japanese women. ⋯ The use of GVL #3 handle is recommended for tracheal intubation for Japanese women.
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Case Reports
[Case of unexpected difficult intubation caused by asymptomatic congenital laryngeal web].
We report a case of unexpected difficult intubation in a patient with an asymptomatic congenital laryngeal web. A 44-year-old female with left ovarian tumor and endometrial polyp was scheduled for abdominal hysterectomy and left salpingo-oophorectomy under general anesthesia. ⋯ We finally could insert a tracheal tube of ID 6.5 mm into the dorsal side of the glottis. Airway Scope may be a useful device for unexpected difficult tracheal intubation.
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Case Reports
[Administration of sugammadex to a patient with myasthenia gravis with fade of the train-of-four ratio].
A 50-year-old man (weight 87 kg, height 171 cm) with myasthenia gravis (MG) was scheduled for extended thymectomy under general anesthesia. His preanesthetic train-of-four ratio (T4/T1) was 59%. The first twitch of the train-of-four (T1) was 130% after calibration. ⋯ After 5 min, T4/T1 had reached 54%, but T1 had not reached the control value; therefore, we administered additional 1.5 m x kg(-1) of sugammadex. Subsequently, T1 reached 120%. Patients with MG with fade on T4/T1 require a full dose of sugammadex, identical to the dose administered to normal patients.