Masui. The Japanese journal of anesthesiology
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Case Reports
[Landiolol hydrochloride is useful for anesthetic management of cesarean section in a patient with Basedow disease].
We report successful anesthetic management of elective cesarean section in a 30-year-old patient with Basedow disease using landiolol hydrochloride, a short-acting beta-1 adrenergic blocker of which greatest advantages are its short duration of action, rapid clearance and high beta-1 selectivity. The patient received landiolol for the prevention of aggravated tachycardia and tachyarrhythmia during cesarean section. ⋯ No severe adverse effects were observed in the infant. In conculusion, landiolol is useful for maintaining the hemodynamics stable in a pregnant woman with Basedow disease and keeping the infant safe from any adverse effect by infusion of landiolol.
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We studied the effect of the initial loading dose of dexmedetomidine on hemodynamics in pediatric patient undergoing cardiac surgery. ⋯ Any clinical problems leading to a major increase in blood pressure were not encountered. But these results suggest that it is necessary to devise a method of administration of dexmedetomidine in consideration of the patient's condition and the drug effect in severe cases.
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Anesthesia training system and operation theater management at St Vincent's hospital Melbourne in Australia, are very well organized, including tutorials, invitation lecture, transesophageal echocardiography conference as well as working hour, operation room, organization of comedical staffs such as nursing and technician staff, and day surgery and anesthesia. Good anesthesia training system and efficient operation theater management are necessary to establish better quality of medical services.
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Several case reports have shown that the Airway Scope is useful in patients with difficult airways. We experienced five patients with known or predicted difficult airways who underwent awake intubation using the Airway Scope. The patients were known or predicted as having a difficult airway due to the following factors: limited head and neck movement (2 cases), risk for aspiration of gastric contents (1 case), and the thyroid tumor causing displacement of the trachea (2 cases). ⋯ First, the Airway Scope allows detection of regurgitation and vomiting during intubation and avoids accidental esophageal intubation. Second, the Airway Scope provides a useful means of teaching and supervising tracheal intubation compared with the conventional Macintosh laryngoscope. We believe that this method can achieve effective, safe and successful awake intubation in patients with known or predicted difficult airways.