Masui. The Japanese journal of anesthesiology
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Several previous reports have established the Pentax Airway Scope (Pentax AWS, S-100, HOYA-PENTAX, Tokyo, Japan) as an efficient tool for endotracheal intubation in adult patients. To date, however, there are no reports on its use with the INTLOCK blade for neonatal and pediatric patients. In this case, we performed tracheal intubation using a Pentax AWS attached to a neonatal-type INTLOCK blade (ITL-N) twice, 1 day and 10 days after birth, in a neonatal patient complicated with Arnold-Chiari malformation. ⋯ We initially attempted tracheal intubation using a Miller's laryngoscope in the first operation and a Macintosh laryngoscope in the second, but we could not achieve tracheal intubation with either of these instruments. Upon switching to a Pentax AWS with an ITL-N, however, we successfully achieved tracheal intubation in both operations. Further research is needed to facilitate the effective use of the Pentax AWS in such cases.
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It has been demonstrated that preparatory ultrasound scanning can facilitate lumbar epidural anesthesia. We compared longitudinal with transverse approach of ultrasound imaging to test the precision and the quality of acquired images in cesar ean delivery patients. ⋯ Both planes provided accurate information about the epidural space and depth, and the longitudinal plane was superior in the imaging quality. It was suggested that both approaches may help identify epidural spaces.
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Ultrasound guided nerve block has become popular in pediatric practice. We applied this technique to infants undergoing pyloromyotomy. ⋯ We performed ultrasound guided nerve block safely in infants undergoing pyloromyotomy.
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There are only a few reports on cesarean section in a patient with cervical fracture without spinal cord injury (SCI). Such patients have high risks for deterioration of SCI following general or regional anesthesia. Here, we present a patient with a fracture of C2 vertebra who underwent cesarean section safely under combined spinal and epidural anesthesia(CSEA). ⋯ Pre-viability amniorrhexis was seen at 37 weeks' gestation, and an emergency cesarean section was scheduled under combined epidural and spinal anesthesia (CSEA). Her neck and head were carefully fixed before, during and after surgery in order to prevent subsequent SCI. As a result, cesarean section under CSEA was successfully performed in the patient without any deterioration of the spine and/or SCI.
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Intensive perioperative management is required for adrenalectomy in patients with pheocromocytoma because of the unstable hemodynamics and life threatening cardiovascular disturbances due to catecholamine surge from the neuroendocrine tumors. The aim of this study was to assess the perioperative factors contributing to the hemodynamic changes during surgery in pheochromocytoma. ⋯ The decreases of blood pressure after resections of the central veins are dependent on the perioperative blood NA levels, the level of NA in the perioperative urine testig, and tumor sizes.