Masui. The Japanese journal of anesthesiology
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We experienced a case of the abortive malignant hyperthermia (MH) that had developed during operation. The patient was a 14-year-old girl, and plastic surgery was scheduled under general anesthesia. Serum creatine kinase (CK) levels were high with 505 IU x l(-1) at the preoperative examination. ⋯ As sevoflurane, promotes the CICR (calcium-induced calcium release) mechanism, the trigger of this case is probably sevoflurane. As for the symptom that makes us doubt MH first, there is a maked rapid rises of Et(CO2). Therefore, it is important monitor and recognize the first symptom of MH.
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An AirWay Scope (AWS, PENTAX Corporation, Tokyo, Japan) is a video-laryngoscope with a built-in LCD monitor used for tracheal intubation, while INTLOCK (PENTAX Corporation) is a specialized laryngoscope blade that encases the tip of AWS. The characteristic shape of INTLOCK fits the oropharyngeal anatomy and enables even less experienced operators to obtain an optimal view during tracheal intubation procedures, although it is limited to tracheal tubes of less than 11.5 mm outer diameter. Therefore, AWS is not suitable for double-lumen endobronchial tube (DLT) insertion. To resolve this issue, we developed modified INTLOCK for DLT insertion in cooperation with PENTAX, in which a portion of the tube guide was removed. ⋯ We were able to insert DLT in all subjects using modified INTLOCK without serious complications. The results indicate the usability of the device.