Masui. The Japanese journal of anesthesiology
-
A 65-year-old man underwent transversal colectomy for colon cancer under combined epidural and general anesthesia. On the 1st postoperative day, he developed consciousness loss and low SpO2 (< 90%) after walking, and pulmonary embolism was diagnosed by CT-scan and pulmonary scintigraphy. His consciousness and hemodynamic state recovered, and anticoagulation therapy was started after extraction of the epidural catheter. ⋯ The day after laminectomy, injection of heparin was started and 1 g x day(-1) of methylpredonisolone administered for 3 days. His paraplegia did not improve after the laminectomy. We discussed about pulmonary embolism and epidural hematoma.
-
Case Reports
[Successful nasal intubation using airway scope with gum elastic bougie in a case of difficult airway].
AWS (Airway Scope, Pentax, Tokyo), a new videolaryngoscope, was originally designed to facilitate oral laryngoscopy and tracheal intubation. We describe a successful case of nasal intubation with a combination of AWS and GEB (gum elastic bougie). A 50-year-old man with a past history of difficult intubation was scheduled to undergo subtotal esophagectomy. ⋯ Oral insertion of AWS showed full view of the glottis and nasal insertion of GEB was easily advanced into the trachea through an endotracheal tube, allowing tracheal intubation while utilizing GEB as a stylet. No complication occured in this case. In conclusion, nasal intubation using AWS combination with GEB is useful for patients with difficult airways and is easy to perform.
-
Lidocaine is frequently used as a local anesthetic and has very low incidence of serious complications. I report on a case of lidocaine intoxication in a 66-year-old man who presented with seizure and cardiac periarrest following the brachial plexus block with 450 mg of lidocaine. ⋯ Bradycardia and subsequent cardiovascular depression were found 74 minutes after the lidocaine block. The patient was successfully treated with diazepam, atropine sulphate and transcutaneous pacing for each symptom, respectively.