Masui. The Japanese journal of anesthesiology
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Case Reports
[Anesthetic management of a patient with congenital plasminogen activator inhibitor-1 deficiency].
Congenital plasminogen activator inhibitor-1 (PAI-1) deficiency is an extremely rare disorder characterized by a bleeding diathesis due to hyperfibrinolysis as a result of decreased PAI-1 activity. A 21-year-old male with congenital PAI-1 deficiency underwent wisdom teeth extraction of the mandible under general anesthesia using propofol, nitrous oxide, sevoflurane, fentanyl, and vecuronium. No complications including prolonged bleeding and rebleeding after the operation were observed because hemostatic management was successful by using intravenous tranexamic acid.
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Randomized Controlled Trial Comparative Study Clinical Trial
["Tube scratching" in the trachea on nasotracheal intubation: comparison of Macintosh and McCoy laryngoscopes].
"Tube scratching" in the trachea, the intratracheal resistance of a tube, on nasotracheal intubation was evaluated using the Macintosh and the McCoy laryngoscope blade. ⋯ An excessive lifting of the epiglottis, often observed in using McCoy laryngoscope, causes "Tube scratching" in the trachea on nasotracheal intubation.
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Randomized Controlled Trial Clinical Trial
[The effects of colloid preload on hemodynamics and plasma concentration of atrial natriuretic peptide during spinal anesthesia in elderly patients].
We evaluated the effects of moderate colloid preloading on hemodynamics and plasma concentration of atrial natriuretic peptide (ANP) during spinal anesthesia in elderly patients undergoing low extremity surgery. Twenty patients (aged 66-90 yr) were randomly divided into two groups. ⋯ The concentration of ANP decreased significantly by 23% in control group, whereas it increased significantly by 86% in hydration group, suggesting that cardiac preload might increase with volume expansion effect of prehydration with HES. In conclusion, colloid preloading with moderate volume might prevent the decrease in cardiac preload with increasing ANP, whereas it did not prevent spinal-induced hypotension in elderly patients.
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Case Reports
[A successfully treated case of intraoperative latex anaphylaxis during abdominal aorta aneurysm resection].
We experienced resuscitation from latex anaphylaxis induced by surgical gloves during elective abdominal aorta aneurysm resection in a low risk adult with latex allergy. The patient developed severe circulatory collapse 10 minutes after the start of surgery. Although administration of dopamine, norepinephrine, and a large amount of fluid could not normalize this circulatory collapse, but addition of famotidine and chlorpheniramine could restore blood pressure. ⋯ Y-shaped graft replacement was performed, and the perioperative course was uneventful. Latex is the second leading cause of intraoperative anaphylaxis, and the high-risk cases could be easily detected through the questionnaires, focusing on latex and other tropical fruits allergy. Moreover, because it is easy to get latex-free products, we recommend that a set of latex free products should be prepared at least for a high-risk case of latex allergy.
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Case Reports
[Septic shock associated with pyogenic liver abscess rescued with percutaneous transhepatic abscess drainage].
We report a case of septic shock associated with pyogenic liver abscess rescued with percutaneous transhepatic abscess drainage (PTAD). A 70-year-old male patient was admitted to our outpatient department of internal medicine with general fatigue, dullness of bilateral shoulders and extremities, appetite loss, weight loss, headache, and vertigo. Laboratory tests showed severe inflammatory indications, anemia, and high values of hepatobiliary enzymes and blood sugar. ⋯ We conclude that patients in septic shock should undergo further examinations immediately and treatment of the infected tissue should be started as soon as possible. PTAD may be an additional effective procedure for pyogenic liver abscess in septic shock. Furthermore, local antibiotic lavage through a PTAD tube into the liver abscess space may be an important supplementary method in the management of the illness.