Masui. The Japanese journal of anesthesiology
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Perioperative complications are prevalent among current smokers. Smoking cessation program is covered by national insurance for patients who meet certain criteria in Japan. We established a smoking cessation program in a preoperative clinic of our anesthesia department in July 2010. ⋯ Smoking cessation program is effective when offered to patients right before surgery. Preoperative anesthesia clinic may be one of the most suitable opportunities for the program.
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Historical Article
[The first labor analgesia with drug was performed in late Meiji Period (1868-1912). Hypnosis also attracted attention as a method of labor analgesia in mid-Meiji Period].
Ether or chloroform, was in use for ambulatory surgery after 1861 in Japan. An inhalational anesthetic, especially chloroform, was administered for cesarean section in early Meiji Period (from 1868) up to 1897. ⋯ However, it is uncertain whether inhalational anesthetic had been utilized for vaginal deliveries before 1903. There is evidence that hypnosis had attracted attention as a method of labor analgesia around that time.
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Increasing number of patients are suffering from chronic kidney disease (CKD). Accordingly, the opportunity of anesthesiologists taking care of patients with CKD will be expected to increase. This issue highlights the anesthetic management of patients with CKD, so that every anesthesiologist may refresh knowledge and clinical skills to manage patients with CKD.
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Although the use of cuffed tracheal tubes (CTT) in children less than 8 years of age has increased, the criteria for selecting CTTs of appropriate sizes have not been determined. ⋯ We recommend the pediatric use of CTTs because of the very low tube-exchange ratio and the acceptable incidence of stridor. However, the protocol may require modification.
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It is known that blood concentration of rocuronium increases after administration of sugammadex, but this is not clear in the case of vecuronium. We report a pediatric case in which serum vecuronium concentration increased following sugammadex administration after prolonged sedation using vecuronium. A 19-month-old girl weighing 7.8 kg had a history of aortic valvuloplasty at 4 months of age due to truncus arteriosus. ⋯ Recurarization might occur after sugammadex reversal in patients after long-term administration of vecuronium, especially if relatively smaller doses of sugammadex were given. We experienced a pediatric case in which serum vecuronium concentration increased following sugammadex administration after prolonged sedation using vecuronium. There is a risk of recurarization after sugammadex reversal in patients after long-term administration of vecuronium.