Masui. The Japanese journal of anesthesiology
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Case Reports
[Use of the intubating laryngeal mask for tracheal intubation in three patients with difficult airways].
The intubating laryngeal mask has a potential role for tracheal intubation in patients with difficult airways, but there have been only reports of the techniques of blind tracheal intubation through the intubating laryngeal mask. The success rate of blind intubation at the first attempt may be merely 50-60% even in patients with normal airways. We report the use of the intubating laryngeal mask for tracheal intubation in three patients with difficult airways, in whom a tube was easily inserted through the laryngeal mask into the trachea either blindly, using a fiberoptic bronchoscope or using a lighted stylet.
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Case Reports
[Recurrent transient increases in liver enzymes specifically after isoflurane anesthesia].
A 69 y-old female underwent orthopedic surgery 12 times in our hospital. A variety of agents were used for anesthesia. ⋯ We conclude that her liver dysfunction was not severe enough to cause clinical symptoms. In such susceptible patients we should be careful of our choice of anesthetic drugs.
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A 70-year-old male with renal cell carcinoma extending into the retrohepatic inferior vena cava was scheduled for radical nephrectomy with vena caval resection under general anesthesia. He had received partial gastrectomy for gastric cancer twelve years before. Computed tomography and inferior vena cavography confirmed that the vena cava was almost completely occluded and that a collateral venous network was well established. ⋯ During the 7.3 hr procedure, the pulmonary embolus did not occur and the total blood loss was 5515 ml. The patient made an uncomplicated recovery and was discharged 30 days after the operation. This newly reported partial-CPB method may be safe and effective for the management under anesthesia of other patients.
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Case Reports
[Prolonged isoflurane inhalation in a patient with bronchospasm associated with lung edema].
An 80-year-old female with bronchospasm associated with lung edema, who had been resistive to conventional medical treatment, was mechanically ventilated with isoflurane in oxygen for 386 hours. A total amount of isoflurane given was 277.6 MAC-hours. ⋯ After discontinuation of isoflurane inhalation, serum urea nitrogen and creatinine decreased and no clinical renal dysfunction was observed. We conclude that this subclinical renal dysfunction was due to antibiotics, advanced age, dehydration and prolonged elevation of serum inorganic fluoride concentration.
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Randomized Controlled Trial Clinical Trial
[Effect of deliberate mild hypothermia on the incidence of surgical-wound infection and duration of hospitalization in neurosurgical patients].
We investigated the effect of mild hypothermia on the incidence of surgical-wound infection and duration of hospitalization, retrospectively. We randomly assigned 173 patients undergoing intracranial operation to mild hypothermic group (group H) of 122 patients or normothermic group (group N) of 51 patients. A water blanket and a convective device blanket were used for thermal control in the both groups. ⋯ There were no statistical differences of the incidence of surgical-wound infection and duration of hospitalization between the two groups. However, the duration to suture removal was significantly longer in group H than in group N (8.3 +/- 1.6 vs 7.8 +/- 0.8 days). Although the effects of deliberate mild hypothermia for neurosurgery on the incidence of surgical-wound infection and duration of hospitalization were little, it may affect the recovery process of such patients.