Masui. The Japanese journal of anesthesiology
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After the ingestion or infusion of nutrients, there is an increase in energy expenditure which has been referred to as dietary or nutrient-induced thermogenesis. This thermogenesis induced by protein or amino acids is well known to be largest and most prolonged. ⋯ Amino acid infusion was observed to shift upward the threshold core temperature for thermoregulatory vasoconstriction as well as to increase energy expenditure. Fructose also prevents perioperative hypothermia during surgery by the same mechanisms.
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Since the establishment of Model Core-Curriculum for Medical Education in 2001, undergraduate medical education has been progressively renovated in Japan. We conducted a questionnaire survey to investigate how this curriculum changed undergraduate anesthesiology education and how it affected our work load as the teaching staff of medical schools. ⋯ The result shows that there is still room for improvement in educational environment, including manpower or curriculum. A written informed consent should be completed to provide patients' safety and to fulfill the clinical practice by medical students.
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Pentax-AWS (AWS) (Pentax, Japan) is a rigid video laryngoscope with built-in 2.4 inch color CCD monitor paired with a disposal blade. It is developed for management of both normal and difficult airways. We used AWS in a 68-year-old male patient with known (Cormack grade 3a) difficult airway. ⋯ Visualization of the patient's vocal cords was achieved easily (with POGO score 70%). The AWS's suction channel was alternatively used for topical anesthesia route with 10 Fr suction tube, and 4% lidocaine was injected onto the vocal cords. Tracheal intubation was successful uneventfully, and the patient's airway was secured without any postoperative complication.
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[Usefulness of fentanyl patch (Durotep) in cancer patients when rotated from morphine preparations].
[corrected] The transdermal fentanyl patch (Durote patch) is an opioid preparation requiring replacement once in three days, which is occasionally prescribed to replace morphine preparations. The conversion ratio from morphine to fentanyl has been claimed to be 100:1 or 150:1, but there may exist individual variations. ⋯ The fentanyl patch is a useful agent to control severe cancer pain because of excellent analgesic effect, less adverse effects and more convenience as well as itsundesirable characteristics when transition of patients to home-care is considered or oral administration should be avoided. Above all it offers a great possibility to improve cancer patient's quality of life.
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For a visiting anesthesiologist, the time allowed for explaining anesthesia for patients is limited. A questionnaire survey by anesthesia information sheet was performed and patient's opinions about the work of a visiting anesthesiologist were evaluated. ⋯ However, it is important for a visiting anesthesiologist himself to explain the methods and risks of anesthesia to the patient in order to build a mutual trust between the patient and the anesthesiologist. It is important to obtain an informed consent on anesthesia by the visiting anesthesiologist, but the format of the consent can be variable decided by the anesthesiologist.