Masui. The Japanese journal of anesthesiology
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Effects of various lidocaine compounds on cuff pressure of a tracheal tube were studied. Thirty reinforced tracheal tubes (Mallinckrodt Medical, Ireland) were divided into five groups and the cuffs were treated with normal saline, 2% lidocaine jelly, plain lubricant jelly, 4% lidocaine solution or 8% lidocaine pump spray. The cuff pressures of each tube was measured with 5, 10, 15, and 20 ml of air at the time of 0, 30, 60, 90, and 120 min after the treatment. ⋯ In 2 of 10 tubes on which lidocaine had been sprayed, the cuffs were damaged 90 min after the treatment. Any jelly or solution on the cuffs did not influence the cuff pressure-volume relationship. We conclude that lidocaine pump spray should not be used as a lubricant on the cuff of a reinforced tracheal tube.
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A catheter was inserted through the cricothyroid membrane under general anesthesia using a laryngeal mask airway in two patients with pulmonary fungus ball of aspergillosis to administer an antimycotic into the fungus ball. Anesthesia was induced with fentanyl and propofol in both patients. The laryngeal mask airway was inserted using intravenous injection of vecuronium. ⋯ The catheter was inserted through the cricothyroid membrane and placed in the pulmonary fungus ball using bronchoscope. Perioperative and postoperative courses were uneventful in both patients. It was concluded that the laryngeal mask airway is useful for airway management when a catheter is inserted into a pulmonary fungus ball through the cricothyroid membrane.
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Randomized Controlled Trial Clinical Trial
[The effects of propofol anesthesia with or without the use of nitrous oxide on the intraoperative involuntary movement, the postoperative awareness and vomiting].
The authors investigated the effect of anesthesia with nitrous oxide and propofol on intraoperative involuntary movement, muscle relaxant usage, postoperative nausea and vomiting, the total amount of propofol used, and recovery time from anesthesia. Eighty-eight patients for gynecological surgery were randomly divided into group PE: propofol/epidural (n = 44), and group PEG: propofol/epidural/nitrous oxide (n = 44). ⋯ The authors found no correlation between the use of nitrous oxide and intraoperative involuntary movement, subsequent development of postoperative quality of awareness, recovery time, nausea and vomiting. We recommend PEG method for gynecological surgery rather than PE from an economical viewpoint because it is associated with the reduction of mean propofol and muscle relaxant used.
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Randomized Controlled Trial Clinical Trial
[Usefulness of tracheal tube with N2O gas-barrier cuff].
We evaluated three different tracheal tubes, Portex Profile Soft-Seal Cuff (PSSC), Portex Profile Cuff (PC) and Mallincrodt Lo-Contour (LC), when they are used in the artificial trachea and in anesthetized patients. When a cuff was inflated in the artificial trachea, PSSC with a cuff of high N2O gas-barrier property, and PC could achieve air-tight sealing with a smaller amount of injected air, compared with LC. This finding suggests that the inflated cuff-shape and cuff-fold formation are important to block the airway leakage with small volume of air. ⋯ Intracuff pressures were increased significantly with the passage of time. In PSSC group, however, intracuff pressure was 25 +/- 6 mmHg (mean +/- SD) at two hours, and in other two groups it was between 32 and 48 mmHg. The use of a tracheal tube with gas-barrier cuff is recommended to prevent a high tracheal wall pressure.
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A 37-year-old man with exophthalmos underwent resection of the left apical peridontal cyst under general anesthesia. Eye patches (Opticlude) without adherence to epibulbar area were used during anesthesia and surgery. ⋯ Staining with fluorescein dye demonstrated corneal abrasion in the lower third of the left eye. The corneal abrasion healed in two days after topical treatment.