Masui. The Japanese journal of anesthesiology
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Sevoflurane is one of the commonly used volatile anesthetics in cancer patients. The protective effect of sevoflurane preconditioning has raised concerns about whether sevoflurane could act advantageously for survival even of cancer cells. Therefore, we investigated the effects of sevoflurane on proliferation in colon cancer cell lines. ⋯ We had shown that 1% sevoflurane for 6 hr potentially enhances cell proliferation via K(ATP) channels in cancer cells.
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Here we report a case of successful awake nasal intubation with the McGrath videolaryngscope (McGrath) in conjunction with a soft-tipped extra firm exchange catheter in a patient with a necrotic mandible developing a hole. An 81-year-old woman underwent partial tongue resection and cervical lymph node dissection. After additional radiation therapy, she developed a necrotic mandible with a hole from the oral cavity to the neck region. ⋯ Upon sedation with dexmedetomidine 1.0 μg xkg-(1 )-xhr-(1 )and applying topical anesthesia with lido-aine, we inserted the McGrath orally and the soft- ipped extra firm tube exchange catheter (TE) nasally. Under the guide of the McGrath's monitor, we inserted the TE, using Magill forceps, into her trachea. A 6.0 mm internal diameter spiral tracheal tube was inserted via the TE uneventfully.
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Bispectral index (BIS) monitoring has been used since the 1990 s, and many studies on BIS monitoring have demonstrated its usefulness and safety. Currently, BIS monitoring has become indispensable for observation of patients under general anesthesia. However, we observed the development of postoperative skin lesions in 13 patients (11 female and 2 male; age range, 14-76 years) resulting from contact with the BIS electrodes between May 2012 and April 2013. ⋯ The skin lesions resolved within 1 week without scaring following the application of a steroid-containing ointment. Although the occurrence of such skin complications is rare, some patients may experience postoperative anxiety because skin lesions caused by BIS electrodes are noticeable. Therefore, both the usefulness of BIS monitoring and the potential skin complications should be explained to patients preoperatively prior to obtaining patient consent.
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MAC is often required for pediatric examinations outside of operating room. It is difficult to conduct MAC for pediatric population safely. ⋯ This proposal consists of six parts; 1. informed consent 2. pre-sedation patient assessment, 3. back-up team for emergency, 4. pre-sedation NPO, 5. patient monitoring, and 6. post-sedation care. Anesthesiologists are expected to play supervisor roles of sedation operation to make the sedation environment safe, even though they can not conduct sedation by themselves.
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We have noticed the possibility that preoperative spirometry may discover latent COPD patients. When COPD is discovered before operation, we can start to treat COPD promptly. Consequently, the better perioperative care is given to COPD patients. On discharge, patients are referred to their family doctors, so that they can receive COPD treatment. ⋯ Latent COPD patients can be discovered by preoperative spirometry.