Masui. The Japanese journal of anesthesiology
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Pentax-AWS laryngoscope (Pentax, Tokyo, Japan) consists of a disposable anatomically shaped blade, a 12-cm cable with a charge-coupled device (CCD) camera and a 2.4-inch liquid crystal device (LCD) color monitor display. A tracheal tube can be attached to the right side of the blade. The device may be useful in patients with difficult airways. ⋯ The tracheal tube was then easily passed over the bougie into the trachea. We successfully used the same technique in other three patients. We believe that the gum elastic bougie can be useful for tracheal intubation using the Pentax-AWS laryngoscope.
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A shortage of anesthesiologists is having a serious impact on Japanese medicine. The adoption of nurse anesthetists is currently a matter of debate among Japanese surgeons and anesthesiologists. To probe whether future nurse anesthetists exist in Japan, a questionnaire survey of nurses was carried out. ⋯ Our preliminary survey denotes that future nurse anesthetists exist in Japan.
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Case Reports
[Postoperative profound hypoglycemia after resection of adrenaline-predominant pheochromocytoma].
A 54-year-old woman was scheduled for resection of pheochromocytoma. Anesthesia was maintained with general anesthesia combined with thoracic epidural anesthesia. The blood glucose decreased to 30 mg x dl(-1) about four hours after the tumor resection, despite intravenous administration of glucose at a rate of 15 g x hr(-1) with intermittent boluses of 5 g of glucose. The blood glucose levels increased over 100 mg x dl(-1) with intravenous administration of 15 g x hr(-1) glucose, 6 hours after tumor resection.
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Case Reports
[Right bronchial intubation using a left-sided double-lumen tube in a patient with situs inversus].
A 74-year-old man was scheduled for resection of a pulmonary tumor in the left upper lobe. He had asymptomatic complete situs inversus, and therefore his left lung had three lobes whereas his right lung had two. Since the tumor had been growing through the left upper bronchus into the left main bronchus, it seemed that the use of a bronchial blocker in the left bronchus should be avoided. ⋯ The use of a bronchial blocker should be considered first-choice, but sometimes its use is inappropriate as in this case. Commercially available double-lumen tubes are not intended for use in cases of situs inversus. If a double-lumen tube is desired, intentional right bronchial insertion of a left-sided double-lumen tube seems to be an easy and reliable option.
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Comparative Study
[Use of AirWay Scope for tracheal intubation in bright sunlight].
The AirWay Scope (AWS), which is equipped with a wide-angle LCD monitor, has been developed to achieve accurate and safe tracheal intubation under various conditions, including emergency settings. However, since bright sunlight degrades the image quality of LCDs, we investigated its usefulness outdoors in bright sunlight. ⋯ Our findings indicate that successful tracheal intubation with an AWS is difficult to achieve in bright sunlight.