Masui. The Japanese journal of anesthesiology
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Case Reports
[Difficult airway management during emergency tracheostomy in a patient with severe rheumatoid arthritis].
We experienced difficult airway management in a 65-year-old woman with acute dyspnea due to bilateral recurrent nerve palsy suffering from severe rheumatoid arthritis for fifty years. Her cervical spine was ankylosed and could not be extended at all. Tracheostomy was planned under local anesthesia because of difficulty of endotracheal intubation, possibility of airway obstruction and laryngeal edema. ⋯ A rigid tracheal tube could not be inserted through the tracheal incision and SpO2 decreased to 81%. We inserted a percutaneous cricothyroidotomy cannula through the tracheal incision and superimposed HFJV on her spontaneous ventilation. Assisting the ventilation in this way finally, a spiral endtracheal tube was inserted and her oxygenation became stable.
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We evaluated retrospectively the effectiveness of low dose colforsin daropate hydrochloride (CDH) in 12 patients undergoing off-pump coronary artery bypass grafting (CABG). ⋯ Infusion of low dose CDH prevents the elevations of mean pulmonary artery pressure, right atrial pressure and pulmonary artery wedge pressure without reducing systolic bood pressure during coronary artery anastomosis. Cardiac output was significantly increased, and SVR as well as PVR were significantly decreased after the infusion of CDH. In patients undergoing off-pump CABG, we recommend infusion of low dose colforsin daropate hydrochloride from sternotomy to the end of coronary artery anastomosis.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Intraoperative autonomic nervous activities and postoperative analgesia when general anesthesia was applied using an opioid combination].
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Randomized Controlled Trial Clinical Trial
[Postoperative nausea and vomiting caused by epidural infusion following gynecological laparoscopic surgery: fentanyl and ropivacaine versus ropivacaine alone].
Patients who undergo gynecological laparoscopic surgery often begin to eat and ambulate soon after surgery. However, postoperative nausea and vomiting (PONV) can postpone recovery. ⋯ We found that PCEA with ropivacaine alone resulted in a significantly lower incidence of PONV and did not disturb eating and ambulation following gynecological laparoscopic surgery, as compared to patients who received CEA.