Masui. The Japanese journal of anesthesiology
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Since July 2004, the Japanese Ministry of Health, Labor and Welfare approved certified paramedics to perform emergency prehospital tracheal intubation. A specialized training system in tracheal intubation has been established in Kumamoto Prefecture. ⋯ The Medical Control Organization, Kumamoto Prefecture, anesthesiologists and emergency response personnel worked together successfully to promote the training program for clinical tracheal intubation by paramedics.
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Battery powered BONFILS Retromolar Intubation Fiberscope (BRIF) is a nonflexible fiberscope having the same curvature as the Macintosh laryngoscope for difficult airway. We used this device in two patients; A 65-year-old man with small chin and a 35-year-old man with neck spinal cord injury. Two trials of orotracheal intubation were accomplished easily in 20 seconds. We conclude that BRIF is useful for orotracheal intubation in patients in whom neck extension is contra-indicated.
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A 19-year-old man with cervical spondylosis (C4-C6) was scheduled for an anterior spine surgery. Anesthesia was induced with propofol and fentanyl, and nasotracheal intubation was performed without difficulty after vecuronium administration. Anesthesia was maintained with sevoflurane and nitrous oxide in oxygen supplemented with fentanyl. ⋯ After confirming correct position of the LMA, the nasotracheal tube was removed without body movement or coughing. Removal of the LMA was safely performed after recovery of the patient's respiration and consciousness. We believe that the laryngeal mask airway is useful during emergence from anesthesia in the patient whose trachea is intubated nasally.
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Pentazocine is one of the most popular analgesics for postoperative analgesia in Japan. For patient-controlled analgesia (PCA), however, opioid agonists are used commonly, and little information is available concerning PCA by pentazocine. We studied the effects of postoperative PCA using intravenous pentazocine. ⋯ Our program of PCA was safe and effective for postoperative analgesia. But the guidance for patients, surgeons and nursing staff is important using PCA therapy more effectively.