Masui. The Japanese journal of anesthesiology
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Case Reports
[Case of transfusion-related acute lung injury associated with severe intraoperative hypoxemia].
A 39-year-old woman, undergoing debridement and flap reconstruction for a soft tissue infection in an upper limb, developed transfusion-related acute lung injury (TRALI) and hypoxemia after an intraoperative transfusion. Perioperatively, she received 8 units of packed red blood cells (RBCs) and 5 units of fresh frozen plasma. Shortly thereafter, hemoglobin oxygen saturation decreased from 100% to 94%, as measured with a pulse oximeter. ⋯ Pulmonary edema improved and the trachea was extubated 34 hours after surgery. Antibodies against HLA were detected in the RBC donor serum sample, and a crossmatch test between the patient lymphocytes and donor serum was positive. We concluded that perioperative transfusion of blood components has a potential to provoke serious TRALI.
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As the number of HIV-infected patients in Japan increases every year, the opportunity for a HIV-positive patient to undergo an operation is also increasing. ⋯ Almost one fourth of anesthesia teaching hospitals experienced HIV-positive cases. Anesthesiologists should know how to manage HIV-positive surgical patients and be prepared for the cases.
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The video intubating laryngoscope (VIL) can share information with co-workers, that otherwise only one probationer could obtain. Tracheal intubation was reviewed using recorded videotapes via VIL. It was supposed that the esophageal changes by laryngoscope might cause esophageal intubation. In this study, we investigated the impressions about the changed esophagus caused by laryngoscope, and our purpose is to find better educational method for tracheal intubation. ⋯ It was clarified that probationers significantly more often recognized the changed esophagus as the glottis opening. It is very important for us to teach and emphasize those points when we instruct the inexperienced in tracheal intubation.
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Comparative Study Clinical Trial
[Comparative study of sublingual midazolam with oral midazolam for premedication in pediatric anesthesia].
We studied the efficacy of sublingual midazolam compared with oral midazolam for predmedication in children. ⋯ Sublingual midazolam 0.2 mg x kg(-1) is useful for premedication in pediatric anesthesia, and it equals with oral midazolam 0.5 mg x kg(-1) in efficacy.
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Randomized Controlled Trial
[Exposure to nitrous oxide may increase airway inflammation during sevoflurane anesthesia].
The purpose of this study was to examine whether nitrous oxide increases the inflammatory reaction in the airway in patients undergoing minor surgery. ⋯ The pulmonary immunologic function changed progressively during anesthesia, surgery and positive pressure mechanical ventilation. The data from this study suggest that the immune ability of the lung may possibly change due to the administration of nitrous oxide. As a result, our findings suggest that the postoperative inflammatory reaction in the lung may increase when sevoflurane plus nitrous oxide are used during general anesthesia.