Masui. The Japanese journal of anesthesiology
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We developed a simulator using "slime" composed of polyvinyl alcohol (PVA) and borax to evaluate this new ultrasound-guided nerve block training model. Seventeen subjects used the training model in the present study. They had no previous experience in performing ultrasound-guided nerve block. ⋯ An in-plane approach was used to visualize the needle for the nerve block, and the amount of time required to stop the needle on the second gauze was measured 5 times for each subject. Significant differences were observed between the times for the first experiment and those for the third experiment to the fifth experiment In the fourth and fifth experiments, all subjects visualized the nerve block needle clearly above the target layer and were able to stop the needle at the target layer. The present simulation using our proposed ultrasound-guided nerve block training model was useful in terms of the amount of time required to perform the procedure and as well as in terms of its safety.
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The purpose of this study was to examine the hemodynamics and bispectral index score during lower abdominal surgery under balanced anesthesia with the two different combination doses of desflurane and remifentanil. ⋯ The patients could be anesthetized adequately during lower abdominal surgery under balanced anesthesia with the two different combination doses of desflurane and remifentanil.
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Here we report our success in performing lateral approach tracheal intubation in a patient with severe respiratory failure due to septic shock caused by shoulder joint abscess. A 71-year-old woman presented with severe respiratory difficulty due to sepsis from a shoulder joint abscess and was scheduled for emergent drainage and irrigation. She could not breathe sufficiently in the supine position and thus maintained a semi-sitting position. ⋯ Mask ventilation was performed using the two-hand technique from the lateral approach. Tracheal intubation was also performed with a left lateral approach utilizing the Pentax-AWS Airwayscope (AWS). Lateral approach for tracheal intubation utilizing AWS may be useful in patients who present with severe respiratory difficulty.
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Here, we report successful anesthetic management of posterior cervical spinal fusion utilizing block of the frontal nerve, the greater occipital nerve, and the superficial cervical plexus in a patient with athetoid cerebral palsy. A 69-year-old woman (height 157 cm; weight 33 kg) with athetoid cerebral palsy was scheduled to undergo posterior cervical spinal fusion for cervical spondylotic myelopathy. After induction of general anesthesia, we performed tracheal intubation using the Pentax-AWS Airwayscope with a thin Intlock. ⋯ Continuous administration of dexmedetomidine was started during operation. Following surgery, smooth spontaneous ventilation was observed following uneventful extubation. No significant pain and no athetoid movement were observed under continuous administration of dexmedetomidine.
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A 64-year-old man was scheduled for radical sinus operation. Preoperatively, we did not expect difficult airway. ⋯ We removed i-gel and fiberscope, leaving the AIC in place, and could easily advance a reinforced tube over the AIC into the trachea. Fiberoptic tracheal intubation via the i-gel and AIC is useful in a patient with difficult intubation.