Masui. The Japanese journal of anesthesiology
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Comparative Study
[Comparison of Cormack/Lehane classification grades decided by novice residents and those by board certified anesthesiologists].
Tracheal intubation training is one of the most important ones in anesthesia training. But it is difficult to evaluate from the outside whether the laryngeal view obtained with the laryngoscope is appropriate or not. ⋯ We considered it useful in the tracheal intubation training that certified anesthesiologists evaluate patients' Cormack/Lehane classification grades before novice residents do, because we can obtain necessary information on laryngeal view and intubation difficulty in advance.
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Development of pulse oximeter technology has made it possible to measure total hemoglobin noninvasively. The use of Radical-7 would improve patient care in emergency medicine and chronic internal medicine as well as perioperative medicine, and could reduce the burden of the patient.
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Randomized Controlled Trial
[Effects of the injection method of lidocaine on preventing injection pain during anesthesia induction by target controlled infusion with propofol].
We conducted a prospective randomized study to assess the effects of preceding lidocaine on the incidence and intensity of propofol-induced pain. ⋯ We conclude that pre-administration of lidocaine without infusion and restart infusion before propofol injecting into a dorsal hand vein is clinically useful.
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In Japan, over 50 thousand pulmonary artery catheters (PAC) per year were used for hemodynamic monitoring system perioperatively since 1970s. PAC provides many quantitative circulatory data, such as pulmonary capillary wedge pressure, cardiac output and continuous mixed venous oxygen saturation. On the contrary, several studies pointed out the problems of PAC and advocated the limitations of perioperative PAC monitoring in 2000s. ⋯ It is also important to use PAC in proper patients. I have also discussed other monitoring systems, such as aortic wave form analysis and central venous oxygen saturation, which were less invasive compared with PAC. I think abundant training, correct education and strict management must be employed to increase the benefit of PAC.
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A 35-year-old parturient highly suspicious of the placenta accreta/increta was scheduled for cesarean hysterectomy. She had received two cesarean sections and two intrauterine curettages. Prior to cesarean hysterectomy, 900 g of autologous blood was stored for the predictable massive bleeding. ⋯ The postoperative course was uneventful and the patient was discharged 14 days after operation. Histopathological diagnosis was placenta accreta. We successfully managed the anesthesia for cesarean hysterectomy in a parturient with placenta accreta under a combination of general anesthesia and epidural anesthesia.