Masui. The Japanese journal of anesthesiology
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Case Reports
[Anesthetic Management for Endoscopic Sinus Surgery in a Patient with Transplanted Heart--A Case Report].
A 19-year-old male patient with transplanted heart received endoscopic sinus surgery. He was with X-linked dilated cardiomyopathy, and was one year after the transplantation. Preanesthetic study showed lactate dehydrogenase elevation estimated to have derived from striated muscle. ⋯ No inotropic agent was administered. He was discharged from the hospital 5 days after the operation without any complications. We used usual anesthetic management but we had to be careful about both denervated heart and myopathy.
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We describe a case of anaphylaxis that occurred in a 33-year-old gravida 1, para 1 term woman scheduled for cesarean delivery for breech presentation. Her past history was unremarkable except for orciprenaline allergy. Spinal anesthesia was performed at L3-4 using 2.5 ml of 0.5% hyperbaric bupivacaine and 0.1 mg morphine. ⋯ The baby's electroencephalogram, however, demonstrated a pattern consistent with mild hypoxic-ischemic encephalopathy. Lymphocyte stimulation test revealed that she was allergic to bupivacaine. If maternal hypotension persists, i.m. or i.v. adrenaline should be administered immediately because maternal hypotension and hypoxemia may cause significant fetal morbidity and mortality and prompt cesarean section should be considered.
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Case Reports
[A case of impossible ventilation after induction of anesthesia in a patient with massive nasal bleeding].
We report a case of impossible ventilation in a patient with severe nasal bleeding. A 47-year-old man with intractable nasal bleeding was scheduled for emergent hemostasis under general anesthesia. He also had alcohol-related cirrhosis and was highly obese (165 cm, 93 kg). ⋯ Mask ventilatidn was impossible even after oral suctioning. We intubated the trachea with the Macintosh laryngoscope and suctioned blood from the trachea; SpO2 gradually improved and the trachea was washed with a large amount of normal saline. The patient was transferred to the intensive care unit and extubated uneventfully on day 3 postoperatively.
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Blocking conduction in the saphenous nerve is important in providing surgical anesthesia of the lower leg. The aim of this retrospective study was to determine the efficacy of ultrasound-guided paravenous approach for saphenous nerve block. ⋯ Paravenous approach for saphenous nerve block may be effective particularly with limited resources.
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The goal of this multicenter survey was to examine the variety of pediatric endotracheal tube (PETT) management methods utilized by anesthesiologists. ⋯ The present study revealed that practice of PETT management depends on anesthesiologists. PETT management should be sophisticated with wide use of cuffed PETTs.