Masui. The Japanese journal of anesthesiology
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We report a successful management of anesthesia in a 55-year-old male patient with spinal and bulbar muscular atrophy (SBMA). His respiratory and swallowing functions were preserved preoperatively. ⋯ In this case, the effect of an intubating dose of rocuronium (0.5 mg · kg(-1)) was markedly prolonged, but it was completely reversed by sugammadex (2 mg · kg(-1)). Postoperative course was uneventful and clinical symptoms of SBMA did not become exacerbated.
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Comparative Study
[Comparison of the Pressure on the Larynx and Tongue Using McGRATH® MAC Video Laryngoscope--Direct Vision versus Indirect Vision].
Studies show that McGRATH® MAC (McG) is useful during direct laryngoscopy. However, no study has examined whether McG re- duces pressure on the upper airway tract We compared direct vision with indirect vision concerning pressure on the larynx and tongue. ⋯ McG with indirect vision can reduce pressure on the upper airway tract.
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Comparative Study
[Comparison of Tracheal Intubation Performance between Macintosh Direct Laryngoscope and McGRATH® MAC Video Laryngoscope among Anesthesia Trainees].
From April 2013, Macintosh direct laryngoscopes (DL) were replaced by McGRATH® MAC video laryngoscopes (VL), and VL were distributed in all of our operating rooms and used as routine first choice devices. Purpose of this study was to compare the success rate of the first attempt tracheal intubation by the trainees with VL and DL. Incidence of tracheal intubation related injuries were also assessed. ⋯ VL notably improved the first success rate of tracheal intubation compared with DL among trainees.
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A 39-year-old female with facioscapulohumeral muscular dystrophy (FSHD) was scheduled for thoracoscopic resection of an anterior mediastinal tumor. She had slowly progressive weakness and atrophy in the fascial and shoulder girdle muscles. General anesthesia was induced and maintained with propofol, remifentanil, and fentanyl combined with thoracic paravertebral block. ⋯ In contrast twitch responses at the masseter and adductor pollicis muscles to TOF stimulation could be evoked and the duration of action of rocuronium was found to be similar to that of the normal population. The perioperative course was uneventful. Neuromuscular monitoring sites should be carefully selected in FSHD patients because of possible inability to monitor neuromuscular function at the atrophic muscles.
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Case Reports
[Successful Resuscitation from Cardiac Arrest due to Pulmonary Artery Rupture Utilizing Cardiopulmonary Bypass].
We report a case of successful resuscitation from cardiac arrest due to pulmonary artery rupture utilizing cardiopulmonary bypass. A 79-year-old man was diagnosed with lung cancer; segment resection of the upper lung was scheduled under general anesthesia. Anesthesia was induced uneventfully and surgery began in the right lateral position. ⋯ Yet, bleeding from the ruptured artery did not stop. Cardiopulmonary bypass with pulmonary artery blood removal and femoral artery blood transmission stopped the bleeding of the damaged part, leading to the repair of the artery. Rapid establishment of cardiopulmonary bypass may be useful in cases of pulmonary artery damage.