Masui. The Japanese journal of anesthesiology
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Recent advancement in ultrasound technology allows us to visualize detailed structures around the airway. One of the important roles of the airway ultrasound is to identify cricothyroid membrane where the emergent invasive access should be performed. ⋯ Airway ultrasound can also be used to confirm correct position of the tracheal tube and laryngeal mask, difficult laryngoscopy prediction in obese patients, assessing vocal cord function, prediction of the post extubation stridor, and so on. We also introduce perioperative evaluation of the airway via sonography (PEAS) protocol in this review.
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Comparative Study
[Effects of amino acid infusion in preventing intraoperative hypothermia: comparison between sevoflurane versus propofol].
Amino acid infusion was reported to be effective in preventing hypothermia during surgery. We investigated whether the antihypothermic effects of amino acid infusion depend on the anesthetic agent used for surgery. ⋯ Core and peripheral temperatures increased after amino acid infusion in patients receiving sevoflurane or propofol. Our results suggest that the antihypothermic effects of amino acid infusion do not depend on the anesthetic used.
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A 27-year-old parturient (height, 130 cm; weight, 43 kg) with achondroplasia, which is characterized by rhizomeric short stature, large head and frontal bossing, was scheduled for elective caesarean section (C/S) because of her contracted pelvis. Her first delivery had been performed by C/S under general anesthesia at a regional hospital 6 years before. Preoperative airway assessment showed normal mouth opening and mobile cervical spine. ⋯ The patient and baby had an uneventful perioperative course. Underdevelopment of bone formation results in characteristic craniofacial and vertebral abnormalities in patients with achondroplasia. Anesthetic management of achondroplastic parturients should be specified to individual basis based on careful preoperative assessment of craniofacial and vertebral deformities.
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Case Reports
[Anesthetic management of a patient with Sturge-Weber syndrome associated with a giant facial hemangioma].
A 32-year old man with Sturge-Weber syndrome, a rare congenital disease of multiple angiomatous lesions including cervical cortex, face, oral soft tissues, larynx and trachea, underwent the excision of a back lipoma. His hemangioma which extended into the region of the right ophthalmic nerve and superior maxillary nerve is extremely large. He also had mental retardation and epilepsy. ⋯ He was extubated without bleeding and respiratory problems. We experienced general anesthesia of a patient with Sturge-Weber syndrome who had a giant facial hemangioma. With full-face NIPPV mask we safely induced general anesthesia.
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It is reported that hypotension during general anesthesia is associated with adverse outcomes in patients having both noncardiac and cardiac surgery. The present retrospective study was undertaken to evaluate the incidence and the predictors of hypotension after induction of general anesthesia (GA) until the start of operation. ⋯ The result in this study indicated that the age was a significant predictor for hypotension from tracheal intubation to start of operation.