Masui. The Japanese journal of anesthesiology
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Men and women have different body compositions such as fat and fluid, and hormonal environments which affect both pharmacokinetics and pharmacodynamics of anesthesia-related drugs. The knowledge on gender differences in the effects of these drugs has been accumulated. ⋯ Then, gender differences in the effects of commonly used anesthesia-related agents are discussed. Although there have not been remarkable differences demonstrated, better understanding of the difference may lead to satisfying perioperative anesthetic cares for each sex.
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Postoperative nausea and vomiting (PONV) are two of the commonest and most distressing complications of general anesthesia and surgery. Factors affecting PONV are patient characteristics, surgical procedure, anesthetic technique, and postoperative care. Female patients have 1.5-3 times greater incidence of PONV than males, due to increased plasma progesterone levels during their menstrual cycles. ⋯ Most of published trials indicate improved prophylaxis against PONV by avoiding risk factors and/or by using effective antiemetic therapy (e. g., traditional and non-traditional antiemetics, serotonin receptor antagonists). Non-pharmacotherapy (e. g., P6 acupressure) is also important. Knowledge regarding prophylactic antiemetic therapy is necessary to management of PONV in female patients.
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Comparative Study
[Comparative study of anesthesia with remifentanil VS fentanyl in terms of postoperative pain and shivering].
Remifentanil is reported to be cleared rapidly more than other any opioids. It is considered that this characteristic may lead to an increase in postoperative pain and shivering after general anesthesia with remifentanil. This study was aimed to examine the influence of remifentanil to these adverse symptoms in comparison with fentanyl. ⋯ Careful management of intraoperative body temperature is important to prevent the occurrence of shivering after total intravenous general anesthesia with remifentanil.
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Comparative Study
[Comparison of performance of endotracheal intubation by senior residents in anesthesiology using Airway Scope VS Macintosh laryngoscope].
To evaluate the performance of the Airway Scope, we studied the time to complete endotracheal intubation performed by senior residents in anesthesiology. ⋯ The Airway Scope performed as well as the Macintosh laryngoscope when used by senior residents in anesthesiology on patients with normal airway.
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A 59-year-old man with poor pulmonary functions was scheduled for thoracoscopic lung resection because of right pneumothorax. In order to preserve spontaneous breathing and prevent left pneumothorax, we selected epidural anesthesia and intravenous dexmedetomidine. We could provide appropriate sedative and antianxiety effect without respiratory depression and hemodynamic change. With its unique features, dexmedetomidine is useful for thoracoscopic surgery in a patient with poor lung functions.