Masui. The Japanese journal of anesthesiology
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Clinical Trial
[Effect of gargling the throat with Panaxylocaine as a lubricant for the laryngeal mask airway].
We used Panaxylocaine as a suitable lubricant with gargling before insertion of laryngeal mask for twenty preoperative breast cancer patients. Patients were divided into two groups; Control group (N = 10) received water-based lidocaine gel just before insertion of laryngeal mask, and Panaxylocaine group (N = 10) received Panaxylocaine as a premedication for breast cancer operation. ⋯ But there was no difference between two groups about oral paresthesia. We conclude that Panaxylocaine is a good premedication before insertion of laryngeal mask preventing oral and pharyngeal complications.
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We report two patients who developed extrapyramidal reactions after epidural droperidol given to prevent postoperative nausea and vomiting. The reactions may have been related to interactions of drugs given perioperatively. One patient had been taking amlodipine and amitriptyline preoperatively, capable of causing extrapyramidal reactions, and developed akathisia after 2.5 mg of droperidol given epidurally. The other patient had received 1.5 mg of prophylactic epidural droperidol and 10 mg of metoclopramide for postoperative nausea and vomiting, and developed acute dystonia shortly after 0.5 mg of intravenous droperidol.
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There is scant information in the literature regarding central neuraxial blockade in patients with previous back surgery or severe kyphoscoliosis. This report describes a 58-year-old female and an 84-year-old female with spinal instrumentation who presented for orthopedic surgery under neuraxial blockade. ⋯ The anatomical considerations and difficulties in achieving reliable neuraxial blockade after spinal instrumentation are reviewed. Neuraxial blockade using image intensifier may provide less technical difficulty and a more reliable result in such patients.
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We examined the alterations of peripheral vascular responses following ischemic insult during perioperative period of esophagectomy. Increase of palm blood flow after vascular occlusion, i.e., reactive hyperemia (RH), measured by near-infrared spectroscopy (NIRS) was employed to assess forearm vascular responses. ⋯ In particular, patients receiving laparoscopy-assisted surgery showed less decrease of RH than those receiving the standard open laparotomy. These results suggest that vascular responses to increase blood flow against ischemic insult is depressed following esophagectomy.
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We reported 131 cases of ambulatory surgery in adults mainly anaesthetized with propofol infusion. Without any premedication, anesthesia was induced with propofol and fentanyl. A laryngeal mask airway was inserted using intravenous injection of vecuronium. ⋯ In 25 patients (19%) analgesics were needed for postoperative pain. Although 3 patients (2.3%) were unsuccessful as ambulatory surgery due to excessive pain, all patients including these three could be discharged within 24 hours after surgery. We conclude that combined anesthesia with propofol, fentanyl and local anesthetic is suitable for ambulatory surgery in adults.