Masui. The Japanese journal of anesthesiology
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It is recommended to avoid overinflation of the bronchial cuff, leading to ischemic pressure damages to the respiratory mucosa and bronchial rupture. We investigated the minimum bronchial cuff pressure of 35 Fr double lumen tubes (DLTs) during one lung ventilation using a capnometer. ⋯ In this study, the bronchial pressure higher than 12 cmH2O was not necessary for one lung ventilation. If high intracuff pressure is necessary to seal the bronchus, there are possibilities of the incompatibility of the size of DLT and the herniation of the bronchial cuff to the proximal side. The method of confirmation of OLV using a capnometer can display the non ventilated condition on the monitor objectively. We can thus decrease troubles during operations.
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Here, we report the development of a simulation-based perioperative training course. Participants were anesthesiologists and operating room nurses. Three different courses were held with different themes, such as airway management, circulation management and central venous management. ⋯ At the end of each course, participants discussed problems associated with medical safety in the context of each theme. Participants commented not only on changes in their views regarding individual technical or non-technical improvements, but also on general medical safety in the operating room. Our findings suggest that simulation-based perioperative team training may serve as a vehicle to promote operating room safety.
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Interscalene brachial plexus block (ISBPB) complications depend usually on the dose administered. ⋯ The use of low-volume ultrasound-guided ISBPB is associated with less respiratory depression and hemidiaphragmatic paralysis.
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Historical Article
[Did Seikyo Sugita Perform Two Surgical Operations under Ether Anesthesia in 1855?].
Although Seikyou Sugita is said to have provided ether anesthesia for two surgical oprations in 1855 including the scur resection of burned fingers of a man and the resection of a breast cancer of a woman. The details of his administration of the drug were not known because he did not describe these cases at all. According to Treatise on Inhalation of Ether written in 1863 by Shinryo Tsuboi, Sugita failed to provide successful general anesthesia using ether for these patients. The ether he used was prepared by Ryuho Shima, and the failures were likely to be due to impure nature of the agent.
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Serratus-intercostal plane block (SIPB) is a novel ultrasound-guided thoracic wall nerve block reported recently. We performed SIPB for perioperative analgesia together with general anesthesia in patients undergoing partial mastectomy. ⋯ SIPB provides effective analgesia for breast surgery of upper to lower lateral quadrant and/or subareolar region. However, it should be administered with other additional analgesic agents when axillary dissection is performed, because sensory loss of T1 is difficult to achieve.