Journal of anesthesia
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Journal of anesthesia · Jan 2009
Case ReportsThe videolaryngoscope is less traumatic than the classic laryngoscope for a difficult airway in an obese patient.
This report describes the anesthetic management of an obese patient with a difficult airway and the merits of videolaryngoscopy, specifically in terms of the reduced risk of dental damage during intubation. A 49-year-old woman (body mass index; BMI, 36 kg.m(-2)), was scheduled to undergo an elective laparoscopic cholecystectomy because of cholelithiasis. ⋯ Intubation using a video-assisted Macintosh laryngoscope (V-Mac; Karl Storz, Tuttlingen, Germany) was successful upon the first attempt. The maximum force exerted on the patient's maxillary incisors was 61 N by direct laryngoscopy and 7.6 N using the indirect videolaryngoscope, both using a Macintosh blade.
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialEffect of landiolol hydrochloride on suxamethonium-induced neuromuscular block.
The aim of this study was to examine the effect of landiolol hydrochloride, an ultrashort-acting beta(1)-blocker, on suxamethonium-induced neuromuscular block. ⋯ Landiolol delayed recovery from suxamethonium-induced paralysis. However, the interaction between the drugs seemed to be small in the clinical setting.
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialIntravenous famotidine does not always change core temperature during general anesthesia.
It has been reported that oral premedication with the H(2) receptor antagonist famotidine augmented intraoperative hypothermia. We again investigated whether the H(2) receptor antagonist famotidine significantly affected body temperature during open abdominal surgery under general anesthesia. We studied 20 female patients undergoing elective gynecological surgery. ⋯ T(Tym) gradually and significantly decreased in both groups during anesthesia, and no significant differences in these values were observed between the two groups. Grad(a-f) did not differ significantly between the two groups during anesthesia. We conclude that intravenous famotidine does not always change the core temperature during general anesthesia.
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Journal of anesthesia · Jan 2009
ReviewComplexity of blood volume control system and its implications in perioperative fluid management.
The use of fluid therapy attempts to optimize blood circulation by manipulating the circulating blood volume (BV). BV may be a key intermediate parameter between fluid therapy and the blood circulation, and it has been assumed that BV can be controlled by fluid therapy. In order to construct a fluid therapy protocol, firstly, we have to confirm whether BV can actually be controlled by fluid therapy. ⋯ Because inflammation and some hormones control vascular permeability and the renal adjustment of solutes and fluids, such factors may readjust the BV even after interventional fluid therapy. Perioperative BV may be predominantly controlled by an internal regulatory system, regardless of whether "restrictive" or "liberal" fluid management strategies are employed. Recognizing this physiological control of BV may help us to develop individualized fluid management strategies.
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Journal of anesthesia · Jan 2009
Case ReportsThree-dimensional CT image analysis of a tracheal bronchus in a patient undergoing cardiac surgery with one-lung ventilation.
The incidence of a tracheal bronchus--that is, a congenitally abnormal bronchus originating from the trachea or main bronchi--is 0.1%-2%. Serious hypoxia and atelectasis can develop in such patients with intubation and one-lung ventilation. ⋯ A type I tracheal bronchus and segmental tracheal stenosis were identified on postoperative three-dimensional (3D) computed tomographic (CT) images. Preoperative examination of chest X-rays, CT images, and preoperative tracheal 3D images should preempt such complications and assist in securing safe and optimal one-lung ventilation.