Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Clinical Trial
[Influence of injection speed of the spread of 4.0 ml of 0.5% isobaric bupivacaine in spinal anesthesia].
Influence of injection speed on the spread of isobaric 0.5% bupivacaine 4.0 ml was studied in 100 patients to analyze the correlation between analgesia levels and patient's characteristics. All patients (ASA PS I. II) were scheduled for orthopedic or urological procedures, and received no premedication. ⋯ The maximum sensory block was tested by pinprick method, and no significant difference in the height of sensory block was observed between the two groups. No significant correlation with patient's characteristics was observed except body weight in group 1. This study suggests that the speed of injection does not influence the spread of isobaric 0.5% bupivacaine 4.0 ml.
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A 58 year-old male was scheduled for surgery of his hepatic cancer. Tumor invaded to the right atrium through the inferior vena cava. The operative method of removing the tumor in the right atrium was scheduled under extracorporeal circulation after the left lobe hepatectomy. ⋯ Due to massive blood loss during hepatectomy, the capacity in the right atrium decreased and the tumor was often about to engage the tricuspid valve. After the rapid fluid therapy, the right atrium capacity increased preventing the engagement of the tumor. TEE was useful not only to observe the movement of the tumor in the right atrium but also to monitor the circulating blood volume.
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We modified the technique for laryngeal mask airway (LMA) insertion in children. This modification involves inserting a two-thirds inflated LMA with its lumen facing laterally toward left and then rotating it 90 degrees clockwise as it passes downwards into position behind the larynx. Then the cuff is inflated fully. ⋯ There were no significant differences in vital signs between pre- and post-insertion. Only one child was found to have attachment of blood clots on the surface of the removed LMA. We conclude that our technique would be one recommended method in pediatric practice.