Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Clinical Trial
[The efficacy of carbon-fiber resistive-heating in prevention of core hypothermia during major abdominal surgery].
Perioperative hypothermia causes numerous severe complications, such as coagulopathy, surgical wound infections, and morbid myocardial outcomes. For prevention of intraoperative hypothermia, an inexpensive, non-disposable carbon fiber resistive warming system has been developed. ⋯ Even during major abdominal surgery, carbon-fiber resistive-heating maintains core temperature as effectively as forced air.
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Randomized Controlled Trial Clinical Trial
[Effect of propofol on sevoflurane agitation in children].
Sevoflurane may be associated with a high incidence of agitation during recovery from anesthesia in children. We tested the hypothesis that bolus administration of propofol after sevoflurane anesthesia would reduce the incidence of recovery agitation compared with sevoflurane anesthesia alone. ⋯ Bolus administration of propofol after sevoflurane anesthesia prolonged recovery time, but did not inhibit sevoflurane agitation compared with sevoflurane anesthesia alone.
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We reported anesthesia-related mortality and morbidity in Japanese Society of Anesthesiologists Certified Training Hospitals (JSACTH) in the year 2001, as a part of the second series of annual studies in the identical questionnaires form started in 1999. JSA Committee on Operating Room Safety sent confidential questionnaires to 813 JSACTH and received effective answers from 87.9% of the hospitals. A total number of 1,284,957 anesthetics were documented. ⋯ Three major causes of all critical incidents in 52 detailed classification of principal causes were preoperative hemorrhagic shock (31.4%), massive hemorrhage due to surgical procedures (16.9%), and preoperative multiple organ failure/sepsis (9.0%). In conclusion, the obtained incidences as to cardiac arrest and death, either in total number during anesthesia/surgery or in that due to anesthetic management, kept decreasing lineally through 8 years study in 1994-2001. We expect that this second series of annual studies for five-years should reveal precise and definite direction for us to reduce anesthesia-related mortality and morbidity by analyzing further detail with special reference to ASA physical status, age distribution, surgery sites and anesthetic methods.
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Randomized Controlled Trial Clinical Trial
[Intravenous anesthesia using continuous administration of propofol and fentanyl: fentanyl administration procedure and quality of awareness].
We studied total intravenous anesthesia using continuous administration of propofol and fentanyl and examined especially the method of fetanyl administration. ⋯ This continuous administration procedure of fentanyl reduced the total doses of both propofol and fentanyl, allowing high quality of awareness after the recovery.
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A 34-year-old male, weighing 110 kg, with severe obstructive sleep apnea syndrome (OSAS) was urgently taken to the hospital for heart and respiratory failure. His body mass index was 39, showing that he was mobidly obese. He was scheduled for tonsillectomy under general anesthesia. ⋯ Postoperatively he was taken to the intensive care unit and was mechanically ventilated for 6 days because pharyngeal edema could aggravate his respiratory condition when extubated just after the surgery. He was successfully extubated and BiPAP was applied in the same day. We recommend that the patient with morbidly obese OSAS should be cared intensively during perioperative period.