Masui. The Japanese journal of anesthesiology
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We report two cases for anesthetic management of gastrectomy for gastric cancer which took place after receiving coronary artery bypass grafting (CABG) using the right gastroepiploic artery (RGEA). The first patient was a 75-year-old man after CABG using the RGEA 14 years before. He was diagnosed with gastric cancer and was scheduled for total gastrectomy. ⋯ Preoperative CAG showed the RCA partially occluded and the RGEA remaining patent. He received the scheduled surgery after confirmation of the success of PCI, performed preoperatively for reperfusion of the occluded segments. Although the RGEA was incised during the surgery, gastrectomy was accomplished without any problems in the cardiac function.
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Case Reports
[Awake fiberoptic nasal intubation using a Parker spiral tube in a patient with a giant thyroid tumor].
A 62-year-old man was scheduled for resection of a giant thyroid tumor. We planned awake fiberoptic nasotracheal intubation using a Parker spiral tube. ⋯ The operation was performed without any complications. We conclude that a Parker spiral tube is useful for fiberoptic awake nasal intubation in a patient with a giant thyroid tumor.
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The system for treating waste anesthetic gases, Anesclean, has been developed recently. This system can collect volatile anesthetics from waste anesthetic gases, and then decompose nitrous oxide (N2O) into N2 and O2 immediately. The purpose of this study was to investigate the efficacy of this treating system, Anesclean, on removal of greenhouse effect gases in our university hospital. ⋯ The waste anesthetic gas treating system, Anesclean, was effective to some degree in collection of sevoflurane and decomposition of N2O. However, in order to increase collection rate of sevoflurane, we need to pay more attention to minimize gas leak during anesthetic procedure.
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Tobacco use can be the most common preventable cause of death. Smoking-related disorders such as pulmonary and cardiovascular diseases increase perioperative risk, and smoking itself could increase the risk of morbidity, which may be reduced by abstinence from smoking. ⋯ However, it is important to know the fact that some important adverse effects in pulmonary and cardiovascular system induced by nicotine and CO could be restored within 24 to 48 hours of smoking cessation. Thus, even in the brief preoperative period, it is important that medical staff (including anesthesiologists, surgeons, and nurses) should advise patients to quit tobacco use.
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We evaluated Disposable Crystal Laryngoscope Blades in terms of preventing infection. Most anesthesiologists were satisfied with the view offered by the Disposable Crystal Laryngoscope Blade; however more force is necessary to lift the epiglottis during intubation. It may be more difficult to use by residents, inexperienced anesthesiologist, or emergency medical technicians, although the Disposable Crystal Laryngoscope blade is useful for preventing infection.