Masui. The Japanese journal of anesthesiology
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There are several specific considerations regarding seizure control during the perioperative period in patients who are on a ketogenic diet (KD). A KD is high in fat and low in protein and carbohydrates and has a long history of use for treatment of intractable seizures in children. ⋯ We report a case in which a 3-year-old boy with seizure was on a KD and scheduled for the treatment of left undescended testis under propofol anesthesia and acetate Ringer administration. Induction and maintaining of anesthesia using propofol was safe and reasonable for a patient on a KD.
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A forty-year old man hanged himself and was transported to our hospital. On arrival his consciousness was clear but he showed dyspnea, dysphagia, and oral bleeding. Tracheal intubation was attempted but was failed and emergency tracheostomy was successfully accomplished. ⋯ Orotracheal intubation was accomplished with StyletScope. It worked very well for the destroyed trachea. StyletScope is a useful device for intubation, especially in difficult airway management.
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Postoperative nausea and vomiting (PONV) are the most frequent side effects after anesthesia. Patients with persistent PONV continue to be impaired in performing their normal daily activities. We studied the controlling effect of dexamethasone (4 mg) before the induction of general anesthesia in the prevention of PONV. ⋯ Combination therapy with dexamethasone and droperidol may reduce PONV in patients undergoing surgery.
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The i-gel, which has been introduced into clinical practice in Japan in 2010, has a potential role in maintaining a clear airway during general anesthesia. ⋯ We believe that the i-gel is useful in maintaining a clear airway during general anesthesia.
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Shoulder arthroscopy has been performed in beach-chair position. In our hospital, the postoperative complications of the airway were reported in the patients who had undergone the operation in this position (hoarseness: 4 cases, paralysis of recurrent nerve: 2 cases, arytenoids dislocation: 1 case). ⋯ The results showed that the neck bending significantly increases the intra-cuff pressure of endotrachial tube. Therefore, we conclude that it is necessary to pay attention to neck position to avoid postoperative complications of the airway in the patients who have the operation in beach-chair position.