Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial
[Effect of amino acid infusion for prevention of intraoperative hypothermia during laparotomy].
Amino acid infusion prevents intraoperative hypothermia. The purpose of this study is to examine the effect of amino acid infusion on intraoperative core temperature of patients during laparotomy. ⋯ Amino acid infusion has more preventive effect on intraoperative hypothermia than electrolyte solution.
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Anesthesiologists' opinions regarding the Japanese guidelines for transfusion were surveyed. ⋯ These guidelines for transfusions appear to be widely accepted. The most dominant complaint was the inadequacy of the guidelines for rapid massive bleeding.
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Case Reports
[Anesthetic management of a patient with mitochondrial encephalomyopathy under total intravenous anesthesia].
This report describes a patient with mitochondrial encephalomyopathy who underwent tracheostomy under total intravenous anesthesia. This 15-year-old girl had been suffering from aspiration pneumonia repeatedly. Anesthesia was induced with propofol (30 mg) and fentanyl (50 microg), and the trachea was intubated without a muscle relaxant. ⋯ The patient showed smooth recovery from anesthesia, and the BIS value returned to the pre-anesthetic level 15 minutes after completion of the anesthesia. Her postoperative course was uneventful. We conclude that total intravenous anesthesia by propofol and fentanyl is a preferable method for the management of the patient with mitochondrial encephalomyopathy.
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We report a case of anaphylactic shock induced by an antibiotic administrated after induction. A 39-year-old man was scheduled for removal of right adrenal tumor. After insertion of an epidural catheter, anesthesia was induced with an intravenous bolus injection of fentanyl 100 microg, propofol 130 mg and vecuronium 6 mg. ⋯ From his past history, penicillin allergy was confirmed. The surgery was rescheduled and anesthesia was managed in the same way as previous one. Surgery was successfully performed using levofloxacin, which had been taken orally before induction of anesthesia.
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A 76-year-old woman was scheduled to undergo distal gastrectomy and cholecystectomy. She had no history of illnesses including hypertension. During the induction of anesthesia, she developed hypertension just after intravenous administration of fentanyl 200 microg. ⋯ For the maintenance of anesthesia, sevoflurane, nitrous oxide, and epidural anesthesia with intermittent administration of 0.75% ropivacaine were used. The operation was finished successfully without any complications. We consider intravenous small dose of fentanyl could be a cause of unexpected marked hypertension in this elderly patient.