Masui. The Japanese journal of anesthesiology
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Case Reports
[A case of late drug-eluting stent thrombosis during postoperative period after 5 years of stent implantation].
Stent thrombosis during perioperative period is a critical complication for patients treated with drug-eluting stent (DES). We experienced a case of late DES thrombosis 5 years after initial implantation. A 48-year-old man with familial hyperlipidemia, angina pectoris and chronic pulmonary emphysema, was diagnosed with esophageal carcinoma, and scheduled for esophagectomy. ⋯ Emergent coronary angiography revealed re-stenosis of the right coronary artery treated with DES 5 years ago. At present, there was no definite guideline, on the management of DES during perioperative period. It is important for us to decide continuing antiplatelet therapy balancing the risk of stent thrombosis with surgical bleeding in each patient.
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Comparative Study
[The KINGVISION: clinical assessment of performance in 50 patients].
The aim of this study was to evaluate the suitability of the KINGVISION videolaryngoscope for tracheal intubation. ⋯ The KINGVISION could be an effective aid to airway management in surgical patients.
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We report a 61-year-old woman (weight 49 kg, height 156 cm) with Kugelberg-Welander disease who was scheduled for bilateral mastectomy under general anesthesia. We administered rocuronium 10 mg (0.20 mg x kg(-1)) for tracheal intubation. After 80 min, train-of-four ratio (TOFR) was 46%. ⋯ After 4 min, TOFR became above 90%, and the patient was extubated. There was no respiratory distress, muscle weakness, or neurologic untoward event after the use of sugammadex in the postoperative period. Sugammadex was effective in reversing rocuronium induced neuromuscular block in a patient with Kugelberg-Welander disease.
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The use of positive end-expiratory pressure (PEEP) is a practical intervention to improve oxygenation during anesthetic management; however, the underlying mechanisms have not been elucidated. ⋯ These results suggest that the mechanisms for improved oxygenation by PEEP under sevoflurane anesthesia are different from those under propofol anesthesia. The improved oxygenation after the application of PEEP under sevoflurane anesthesia is mainly due to reduction of atelectasis, whereas reduction of atelectasis as well as reduction of intrapulmonary shunt is associated with the improved oxygenation after the application of PEEP under propofol anesthesia.
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Comparative Study
[Safety and beneficial effects of spinal morphine on the postoperative course of elderly patients undergoing surgical fixation of the femoral neck fracture].
We performed a retrospective study of the efficacy and safety of spinal anesthesia with 0.1 mg morphine in the postoperative course of elderly patients with femoral neck fracture. ⋯ The spinal administration of 0.1 mg morphine had beneficial effects and was safe in the postoperative period of elderly patients with femoral neck fracture provided that sufficient observation was given.