Journal of anesthesia
-
Journal of anesthesia · Jan 2008
Case ReportsMalignant hyperthermia developing during esophageal resection in an 82-year-old man.
Malignant hyperthermia (MH) is a rare but fatal complication that develops under general anesthesia. Reports on MH in patients over the age of 80 years are unusual. We experienced a case of MH in an 82-year-old patient during esophageal resection. ⋯ With continuous infusion of dantrolene when the patient was transferred to the intensive care unit (ICU), BT remained within the normal range. The next day re-operation was performed, without further complications or recurrence of MH during the postoperative period. Because it is necessary to initiate treatment in the early stage of MH, as soon as possible, although MH prevalence is low in the elderly, it is important to suspect MH when hypercapnia and/or hyperthermia are seen.
-
Journal of anesthesia · Jan 2008
Comparative StudyIn-line head and neck position is preferable for tracheal intubation with the Airtraq laryngoscope compared to the sniffing position.
We aimed to determine which position, the in-line head and neck position or the sniffing position, was preferable for tracheal intubation with the Airtraq laryngoscope. In all, 20 anesthetists performed tracheal intubations on a manikin with either an in-line head and neck position or the sniffing position. ⋯ The score for preference of position, on a visual analogue scale, was better for the in-line head and neck position than for the sniffing position (P < 0.01). We concluded that the in-line head and neck position was preferable for tracheal intubation with the Airtraq laryngoscope compared to the sniffing position.
-
The Airway Scope (Pentax, Tokyo, Japan) is a new device used for tracheal intubation. It allows visualization of the glottis through a non-line-of sight view. The aim of the present study was to evaluate the suitability of this device for the tracheal intubation of surgical patients. ⋯ No dental damage was encountered, though minor mucosal injury caused by the blade was experienced in 2 patients. The Airway Scope consistently permitted a better intubation environment. With its potential advantages, the Airway Scope could be an effective aid to airway management in surgical patients.
-
Journal of anesthesia · Jan 2008
Dopamine D2 receptor Taq IA polymorphism is associated with postoperative nausea and vomiting.
The dopamine D2 receptor (DRD2) is considered to be involved in the development of postoperative nausea and vomiting (PONV). Our aim was to examine the relationship between DRD2 Taq IA polymorphism and the occurrence of PONV. ⋯ The DRD2 Taq IA polymorphism affected the occurrence of early PONV. Analysis of patients' genetic backgrounds may improve risk-stratification for PONV.
-
Journal of anesthesia · Jan 2008
Case ReportsTotal intravenous anesthesia without muscle relaxant in a patient with amyotrophic lateral sclerosis.
A 63-year-old woman with amyotrophic lateral sclerosis (ALS) was scheduled for open reduction and internal fixation of the right tibia. Total intravenous anesthesia using propofol and remifentanil without muscle relaxant was selected as the anesthetic method, in order to avoid the possible occurrence of ventilatory depression due to abnormal responses to muscle relaxants and exacerbation of the motor neuron disease. ⋯ Intubation was successful and there were no remarkable events during anesthesia, except for three brief hypotensive events; there was no exacerbation of ALS itself during or after the anesthesia. She was discharged on postoperative day 3, without any discomfort.