Masui. The Japanese journal of anesthesiology
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We evaluated the changes in the bispectral index (BIS) as a potential indicator of level of consciousness in infants and children undergoing fast track cardiac surgery. ⋯ BIS was kept within the level of adequate sedation during surgery. However, since the increase in BIS during the rewarming phase could reflect light anesthesia, caution should be taken around this phase.
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Several maneuvers such as, Trendelenburg position or breath holding, are proposed to increase success rate and decrease complications during internal jugular vein cannulation. We investigated the relationship between the cross-sectional area of the right internal jugular vein (RIJV) and several maneuvers in anesthetized patients. ⋯ Breath holding at 20 cmH2O and 10 degrees T-position showed almost the same dilatation effects on RIJV (164%, 159%). Simultaneous performance of the both maneuvers was most effective (222%) in dilating cross-sectional area of RIJV in anesthetized patients.
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The effect of nitrous oxide either as a sole agent or with volatile anesthetic agents on the central nervous system has been well studied. However, it has not been clarified during various levels of propofol anesthesia. We therefore evaluated the effect of nitrous oxide on the central nervous system using bispectral index (BIS) and suppression ratio (SR) under various levels of propofol anesthesia. ⋯ We conclude that nitrous oxide has different effects on BIS according to their basal propofol concentrations.
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Randomized Controlled Trial Clinical Trial
[Effect of respiratory care on pulmonary function in patients after cardiopulmonary bypass].
Respiratory failure after cardiopulmonary bypass (CPB) remains one of the major complications after cardiac surgery. This study was designed to evaluate effects of respiratory care after CPB on pulmonary function. ⋯ Although pulmonary function deteriorated after CPB. PEEP could improve oxygenation in all the patients. There were no significant differences in the degree of these improvements between patients receiving PEEP of 5 cmH2O and patients with PEEP adjusted to their LIP. There was no significant relationship between preoperative pulmonary function and changes in oxygenation after CPB.
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Case Reports
[Anesthetic management of two patients with Brugada-type ECG and of different clinical severity].
Brugada syndrome is an arrhythmia syndrome characterized by typical electrocardiogram (Brugada-type ECG) and development of ventricular fibrillation (Vf) without any distinct structural heart diseases. The essential goal in the management of Brugada syndrome is to avoid the development of Vf. ⋯ We recently experienced two cases of anesthetic managements for patients with Brugada-type ECG. Based on these experiences and recent cardiological progress on the risk stratification of Brugada syndrome, we thoroughly discuss on the peri-operative managements for patients with Brugada-type ECG.