Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study
Comparison of the clinical performances of Air-Qsp and i-Gel for airway management under general anesthesia with a muscle relaxant.
Recently, i-Gel intubating laryngeal airway (ILA) has been frequently used because of the ease for airway insertion by residents and young anesthesiologists. However, it sometimes fails to fit or ventilate sufficiently in Japanese patients. Use of Air-Qsp, which is a new non-inflatable cuffed ILA, in a clinical setting has become possible. The purpose of this study was to compare the clinical performance of Air-Qsp with that of i-Gel for airway management in Japanese adult patients. ⋯ Air-Qsp is as useful as i-Gel in Japanese patients and the distributions of the tips of BFs through ILAs are different for Air-Qsp and i-Gel.
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Mowat-Wilson syndrome is a rare congenital syndrome involving multiple system abnormalities. The most consistently present components include facial deformity, mental retardation, and Hirschsprung disease. We report the anesthetic management of a case of Mowat-Wilson syndrome, with a difficult airway, who underwent Duhamel's procedure and colostomy closure.
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Randomized Controlled Trial Comparative Study
Transversus abdominis plane block as a component of multimodal analgesia for laparoscopic cholecystectomy.
To evaluate and compare intercostal-iliac transversus abdominis plane (TAP) and oblique subcostal TAP (OSTAP) blocks for multimodal analgesia in patients receiving laparoscopic cholecystectomy. ⋯ TAP and OSTAP blocks improved postoperative analgesia in patients receiving laparoscopic cholecystectomy, which resulted in lower VAS scores and reduction in total analgesic consumption.
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Randomized Controlled Trial Comparative Study
Comparison of volume-controlled ventilation and pressure-controlled ventilation volume guaranteed during laparoscopic surgery in Trendelenburg position.
To analyze the effects of pressure-controlled ventilation-volume guaranteed (PCV-VG) and volume controlled ventilation (VCV) on airway pressures and respiratory and circulatory indicators during laparoscopic surgery in Trendelenburg position. ⋯ In patients who underwent laparoscopic surgery in Trendelenburg position, PCV-VG was superior to VCV in its ability to provide ventilation with lower peak inspiratory pressure and greater dynamic compliance.
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Randomized Controlled Trial
The optimal combination of mechanical ventilator parameters under general anesthesia in obese patients undergoing laparoscopic surgery.
Pulmonary dysfunction after laparoscopic surgery is commonly seen in the high-risk group of obese patients. To reduce or avoid this complication caused by an improper combination of mechanical ventilation parameters, we conducted the following trial of 3 factors with 3 levels of mechanical ventilation, aimed to obtain the low airway pressure with good ventilator effects. ⋯ The best combination of respiratory parameters is A3B1C2, that is, f=9beats per minute, VT=8mL/kg, and I:E=1:2.0. That is, neither small tidal volume and faster frequency nor slow frequency large tidal volume is a good choice. To let obese patients under general anesthesia can obtain a lung protective effect of low airway pressure with good ventilation; it is noteworthy that (1) I:E of airway pressure (PIP, Pmean) is the important impact factor for the protection of the lung and (2) I:E of airway pressure (PIP, Pmean) is the factor with opposite properties.