Masui. The Japanese journal of anesthesiology
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Hoarseness often follows endotracheal intubation. A 58 year old man suffered from hoarseness due to recurrent nerve palsy and submucosal hemorrhage of the right vocal cord after general anesthesia. He was scheduled for resection of chronic pyoderma of the buttocks and atheroma of the right retroauricular region. ⋯ Right recurrent nerve palsy and submucosal hematoma were observed. Without any treatment, hematoma disappeared in 70 days and hoarseness in 183 days. These hematoma and recurrent nerve palsy might be due to the compression of the vocal cord and recurrent nerve by tracheal tube and traction of the recurrent nerve by rotation of the neck.
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We describe a case of Freeman-Sheldon syndrome that presented some problems for anesthetic management. A 2-yr-old girl required orthopedic surgery for the bilateral lower extremities. Anesthesia was induced via a mask with oxygen (2 l.min-1), nitrous oxide (4 l.min-1) and sevoflurane (approximately 5%). ⋯ Combined caudal epidural block was, however, avoided because spina bifida occulta was suspected. Spina bifida occulta was revealed postoperatively by X-ray. For anesthetic management of a patient with Freeman-Sheldon syndrome, the spine should be evaluated preoperatively when performing epidural/spinal anesthesia.
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Effects of autologous blood transfusion and isovolemic colloids transfusion on hemorrhagic shock model in rats were investigated. The hemorrhagic shock model in rats was prepared by rapid exsanguination and the blood pressure was kept at 40 mmHg for 30 min. As a marker of hemodynamic change, the blood gas analysis was performed, and the tissue oxygen pressure of the liver and the spleen was also measured. ⋯ However, the liver PtO2 did not show any changes during hemorrhagic shock, although the spleen PtO2 tended to decrease. These changes seen at the hemorrhagic shock were equally restored after the treatment with either autologous blood transfusion or isovolemic colloids transfusion. These results indicate that either autologous blood transfusion or isovolemic colloids transfusion can be useful for the therapy of severe hemorrhagic shock, and the NO production in the liver can participate in the maintenance of homeostasis under hemorrhagic shock.
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The effects of vasodilators and anesthetics on the circulatory and metabolic conditions were compared during hypotensive anesthesia. Forty two subjects undergoing tympanoplasty were divided into 6 groups: PG + S: N2O/sevoflurane with prostaglandinE1 (PG), TM + S: N2O/sevoflurane with trimetaphan (TM), NG + S: N2O/sevoflurane with trinitoglycerin (NG), PG + P: N2O/propofol with PGE1, TM + P: N2O/propofol with TM, NG + P: N2O/propofol with NG. ⋯ Although pHi decreased slightly during hypotensive anesthesia in all groups, pHi was not decreased below the critical level of 7.30. The circulatory and metabolic conditions under induced hypotensive anesthesia were influenced by both vasodilators and anesthetics, and the dosage of vasodilator to decrease arterial blood pressure was dependent on the anesthetic used simultaneously.