Journal of anesthesia
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Journal of anesthesia · Jan 2009
Case Reports Comparative StudyPentax-AWS airway Scope as an alternative for awake flexible fiberoptic intubation of a morbidly obese patient in the semi-sitting position.
For anesthesia induction in a morbidly obese patient with a full stomach, awake flexible fiberoptic bronchoscope (FOB) intubation in the semi-sitting position may be a suitable choice. A new rigid indirect videolaryngoscope, the Pentax-AWS system, has a unique feature of an adjustable built-in monitor and is designed to be used in patients in various positions. However, the efficacy of its use in such situations has not been investigated or reported. ⋯ The patient's trachea was intubated with the Pentax-AWS by an anesthesiologist positioned at the patient's right and facing her. The Pentax-AWS offered easy intubation under good visualization of the glottic aperture as a consequence of its adjustable integrated monitor, in contrast to difficult intubation with other videolaryngoscopes which require an external monitor. This report illustrates that the Pentax-AWS is useful as an alternative for flexible fiberoptic intubation under these circumstances, as a consequence of its adjustable built-in monitor and integrated tube channel.
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialEffects of landiolol, a short-acting beta-1 blocker, on hemodynamic variables during emergence from anesthesia and tracheal extubation in elderly patients with and without hypertension.
Tracheal extubation and emergence procedures induce abrupt changes in hemodynamics and humoral responses. We conducted a prospective randomized study to examine the effects of the short-acting beta-1 blocker, landiolol, on hemodynamics during emergence from anesthesia in elderly patients with and without hypertension. ⋯ This study indicates that the use of a landiolol infusion for preventing hemodynamic instability in elderly patients during the emergence period would be dependent on the presence or absence of hypertension in these patients.
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Journal of anesthesia · Jan 2009
Comparative StudyComparison of Parker-tipped and Murphy-tipped tracheal tubes in Airway Scope-assisted intubation in a manikin.
We tested our hypothesis that a Parker-tipped tracheal tube could improve the reliability of tracheal tube passage as compared to a Murphy-tipped tracheal tube during Airway Scope-assisted intubation in a manikin. ⋯ When the advancement of a conventional tracheal tube during Airway Scope-assisted intubation is likely to result in collision with the glottis or other laryngeal structures, the selection of a Parker-tipped tracheal tube is a better option.
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Journal of anesthesia · Jan 2009
Recovery of dynamic balance after general anesthesia with sevoflurane in short-duration oral surgery.
Recovery of dynamic balance, involving adjustment of the center of gravity, is essential for safe discharge on foot after ambulatory anesthesia. The purpose of this study was to assess the recovery of dynamic balance after general anesthesia with sevoflurane, using two computerized dynamic posturographies. ⋯ The recovery times for dynamic balance and psychomotor function seem to be within 150 min after emergence from general anesthesia with sevoflurane in patients undergoing oral surgery of less than 2-h duration.
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Journal of anesthesia · Jan 2009
Case ReportsSuccessful treatment with hydrocortisone for heat stroke with critical illness-related corticosteroid insufficiency: transitional changes in serum cytokine and cortisol concentrations.
A 37-year-old man was transferred to our emergency center because of heat stroke with circulatory shock. Despite aggressive body cooling, massive intravenous transfusion, and supply of inotropic agents, shock was persistent. To evaluate adrenal function, an adrenocorticotropic hormone stimulation test was conducted and the results indicated that he had critical illness-related corticosteroid insufficiency (CIRCI) as a result of adrenal insufficiency. ⋯ He was discharged on the thirty-seventh hospital day. Serum cortisol and cytokine concentrations were initially high and the cytokines decreased subsequent to hydrocortisone administration. It is speculated that CIRCI is an exacerbating factor in heat stroke, and hydrocortisone may be a potential therapeutic approach in such patients.