Masui. The Japanese journal of anesthesiology
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Recently in Japan, more patients are receiving chronic opioid therapy for cancer pain or chronic pain, and there is an increasing number of such patients presenting for surgery. The anesthesiologist should be familiar with available opioid formulations as well as the change they induce by their chronic administra- tion, such as physical dependence, opioid tolerance and opioid-induced hyperalgesia. ⋯ Furthermore, these patients tend to have increased pain and increased opioid requirements postoperatively, most likely due to opioid tolerance and opioid-induced hyperalgesia. Peri- operative management of these patients require knowledge and skills to manage these phenomena.
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A 46-year-old woman with cervical disc herniation underwent C4-6 laminoplasty and C4-5 foraminotomy under general anesthesia. The patient complained of the tongue deviation toward the right after surgery. ⋯ The cause of hypoglossal nerve palsy was assumed to be possibly direct compression of the hypoglossal nerve by the tracheal tube. In prone position surgery, it is important to take care of pressure to the tongue because the intraoral space tends to be reduced by edema of the face and neck.
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Awake intubation preserving spontaneous ventila- tion, is essential for managing difficult airways, and is recommended by the guidelines of the American Soci- ety of Anesthesiologists. The main indication includes anatomically difficult airways, full stomach, cervical instability, and vital signs indicative of shock. ⋯ Various new airway devices and sedatives are currently avail- able, and anesthesiologists should be familiar with their strengths and limitations. Training for awake intuba- tion should include a combination of clinical experience and simulation training.
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The goal of this study was to evaluate in patients with peripheral arterial disease (PAD) whether ultrasound-guided radial artery catheterization decreased procedural time and number of attempts compared with the traditional palpation technique. ⋯ Ultrasound-guided radial artery cath- eterization took less time to establish the arterial line, and it reduced the number of attempts when com- pared with the palpation technique.
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Modern anesthesiology in Japan developed after Meyer Sakad's lectures at the Japanese-American Joint Conference on Medical Education (JAJCME) in 1950. To assess their influence on the subsequent advance in the specialty, the author surveyed Japanese clinical journals between 1949 and 1953 to find special issues on anesthesiology. ⋯ Because the former issue in the jour- nal "Rinsho" was published before Maeda's presidential address in 1951 at the Annual Meeting of the 51st Japan Surgical Society and Volpitto's lectures at the second JAJCME in 1952, the influence of Maeda's and Volpitto's lectures is excluded from this issue. The traces of Saklad's influence are detected only in two articles by Shimizu et al and Maeda et al, who enjoyed Saklad's lectures.