Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Comparative Study
[Postoperative pain management in video-assisted thoracic surgery using a continuous unilateral intercostal analgesia].
Optimal pain management after video-assisted thoracic surgery (VATS) remains an open issue. We prospectively studied the analgesic effect of intercostal analgegia (ICA) by comparison with epidural analgesia. ⋯ In patients with coagulopathy, multimodal approach using intercostal analgesia supplemented by intravenous patient-controlled analgesia may be an alternative to epidural analgesia for postoperative pain management.
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Randomized Controlled Trial Comparative Study
[Head extension during laryngoscopy for obtaining a best glottic view: comparison of the McGrath and Macintosh laryngoscopes].
Camera eye in the McGrath video-laryngoscope blade is located closer to the larynx, which may allow reduction of the head-neck movement during laryngoscopy compared with a conventional laryngoscope. We compared the degree of head extension during laryngoscopy with McGrath laryngoscope and that with Macintosh laryngoscope. ⋯ The McGrath laryngoscope may be a reasonable technique of choice for intubation when minimal cervical spine movement is indispensable because of reduction of head extension during laryngoscopy compared with the conventional laryngoscopy.
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Comparative Study
[Comparison of difficulty in airway intubation with aging. Study on 71 subjects who had an airway intubation 20-or-more years earlier].
Although there are reports targeting children with micrognathia, there is no report how orotracheal intubation difficulty of normal adult patients changes with aging. We surveyed orotracheal intubation episodes after more than 20 years from the initial surgery. ⋯ We conclude that in adult patients, if there are no changes in the degree of opening mouth and neck mobility, almost all patients remained in the same situation regarding orotracheal intubation after 23 years in average.
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Aeroperitoneum increases intra-occular pressure (IOP). We measured IOP during robotic-assisted laparoscopic radical prostectomy (RALP) that requires steeper Trenderenburg position. ⋯ Long time RALP might be risky for IOP.
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We experienced a case of negative pressure pulmonary edema (NPPE) after administration of sugammadex under general anesthesia with LMA Supreme. Sugammadex was administered to a 76-year-old female patient following spontaneous ventilation. ⋯ However, a chest x-ray at this time showed pulmonary edema We suspected that sugammadex administration had triggered the laryngospasm, causing postoperative NPPE. When selecting a LMA under general anesthesia for airway management, we have to keep in mind the possibility of NPPE followed by laryngospasm.