Masui. The Japanese journal of anesthesiology
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We report a case showing a bispectral index (BIS) value "10" during anesthesia maintained with propofol. Vital signs of the patient including blood pressure and heart rate were stable and the depth of anesthesia was considered as adequate. The serum concentration of propofol measured later was 2.5 and 2.2 microg ml(-1) when BIS indicated 10 and 35, respectively. The age of patient was 81 and the BIS values in elderly might decrease in accordance with the reduction of brain function.
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Early detection of complications after craniotomies are important and remifentanil may be beneficial for that purpose because of the short and constant context-sensitive half time. To examine the efficacy of remifentanil in neuroanesthesia, we investigated hemodynamic properities and recovery from anesthsia in craniotomies. ⋯ Remifentanil is suitable for neuroanesthesia because of the hemodynamic stability and quick recovery from anesthesia.
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The Airway Scope (AWS) is a new videolaryngoscope which consists of an optical system and a single-use blade. The blade of the device is designed according with the pharyngeal anatomy, and thus the AWS is expected to have a role in the management of difficult airway. ⋯ The AWS provides a view of the glottis with Cormack-Lehane grade 1 and resulted in successful intubation in the 15 patients. The AWS is useful for the management of difficult airway.
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The pain associated with spinal puncture is severe, and the memory of this uncomfortable procedure often deters patients from undergoing the procedure again. Therefore, it is important to make the patient as comfortable as possible when this procedure is performed. ⋯ In the patients aged <70 years, intravenous administration of 0.023-0.044 mg x kg(-1) of midazolam was very effective in preventing a bad memory concerning the spinal-tap procedure; however, it is important to note that the number of side effects associated with this procedure increases in patients aged > or =60 years.
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Theoretically, sciatic nerve block can be used alone or in combination with lumbar plexus block or femoral nerve block for anesthesia and/or analgesia of lower limb surgery. However, clinical use of sciatic nerve block was limited by technical difficulties in performing the block since techniques used relies only on surface anatomical landmarks. ⋯ In this article we describe the anatomy of the sciatic nerve, sonographic features, and technique of three major approaches including subgluteal, anterior, and popliteal approaches. The use of this technique for postoperative analgesia is also discussed.