Masui. The Japanese journal of anesthesiology
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Comparative Study Clinical Trial Controlled Clinical Trial
[Total intravenous anesthesia with propofol and fentanyl for laparoscopic cholecystectomy].
The postoperative antiemetic effect of total intravenous anesthesia with propofol and fentanyl was evaluated in 40 patients for laparoscopic cholecystectomy. Patients were divided into 2 groups. In group P, anesthesia was induced with intravenous fentanyl 0.1 mg and propofol 2 mg.kg-1 and maintained with continuous infusion of propofol. ⋯ No significant differences were found in the incidence of vomiting between the groups. These results suggest that total intravenous anesthesia with propofol and fentanyl is superior to inhalational anesthesia with nitrous oxide and isoflurane in postoperative nausea. This antiemetic effect is, however, limited in the early period after anesthesia.
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Comparative Study Clinical Trial Controlled Clinical Trial
[Changes in epidural pressure during total intravenous anesthesia with propofol, fentanyl and ketamine].
Although ketamine elevates cerebrospinal fluid pressure (CSFP) with an increase in cerebral blood flow, sedatives such as benzodiazepines, barbiturates and opioids have been reported to inhibit it. In this study, we evaluated the changes in epidural pressure (EP) as a good index for CSFP during total intravenous anesthesia with propofol-fentanyl-ketamine (PFK) compared to isofluranenitrous oxide anesthesia (GOI). ⋯ In PFK group, epidural pressure did not increase during the anesthesia, and was significantly lower than in GOI group (30 and 180 min after induction of anesthesia, and 0, 30 and 60 min after stopping anesthetic administration). The present data suggest that PFK may safely be used for patients with intracranial hypertension.
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Comparative Study
[Assessment of the practice of endotracheal intubation by levering Laryngoscope in teaching of undergraduate medical students].
Twenty-nine inexperienced medical students tried to intubate endotracheal tubes using both levering laryngoscope (McCoy laryngoscope) and Macintosh laryngoscope in adult mannikin the Cormack and Lehane Grade 2. The number of successful intubations by McCoy type was close to those by Macintosh type. ⋯ But the grade of handling difficulty of McCoy type was significantly higher than that of Macintosh type, because Macintosh type was simpler to handle than McCoy type. It was suggested that Macintosh laryngoscope was more useful than McCoy laryngoscope for teaching of inexperienced medical students.
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We experienced the anesthetic management for two patients with congenital tracheomalacia. Inhaled anesthetics are considered to worsen the respiratory condition of tracheomalacia because of its bronchodilating effect. ⋯ Inhaled anesthetics have possibility of worsening the degree of tracheomalacia and have been used very carefully. However, we considered that slow induction with inhaled anesthetics in children with congenital tracheomalacia is a safe and necessary technique, under careful observation of respiratory conditions.
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We experienced three cases of successful balloon catheter dilatation for bronchial stenosis under general anesthesia. There was no problem for two patients, but the third patient planned for stent insertion had bronchiomediastinal fistula. This procedure is generally performed under local anesthesia but more safely done under general anesthesia with muscle relaxants considering operative failure by bucking, pain of patients and prolonged procedure.