Masui. The Japanese journal of anesthesiology
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Surgery during pregnancy is suspected to have various harmful influences to pregnant patients and fetuses. Although laparoscopic surgery has been recently reported to have some advantages over open surgery in this condition, it often requires general anesthesia. ⋯ General anesthesia during pregnancy is not necessarily associated with harmful influences on mother and babies compared with lumbar and epidural anesthesia if selected appropriately.
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Case Reports
[Use of the Pentax-AWS videolaryngoscope for bougie-assisted exchange of tracheal tubes].
A gum elastic bougie can be useful for tube exchange. One major problem with this technique is that it may not possible to pass a new tube over the bougie into the trachea, because the tip of the tube can collide with tissues around the glottis. We report a case in which tube exchange using the bougie was difficult, but the Pentax-AWS videolaryngoscope enabled tracheal intubation. ⋯ Although it was not possible to see the glottis with the Pentax-AWS, the tube was easily advanced over the bougie into the trachea. Operation went on uneventfully. We believe that, when it is difficult to advance a tracheal tube over a tube exchanger, the use of the Pentax-AWS may facilitate intubation.
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Epidural catheter insertion is a common procedure for gynecological surgeries. Epidural puncture is usually performed according to the anatomical landmarks without radiographic means. The aim of his study was to confirm the actual level of puncture, and the distance as well as the direction of epidural catheters threaded. ⋯ Only 11.7% of the catheters were actually inserted from T12-L1 and advanced in cephalad direction over one vertebra as we had intended.
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Randomized Controlled Trial
[Prospective study on anesthesia for lumbar spine surgery--the effectiveness of the perioperative epidural anesthesia with buprenorphine].
We prospectively evaluated the efficacy of perioperative epidural buprenorphine for lumbar spinal surgery under general anesthesia. Twenty-eight patients were allocated into two groups; in one group (buprenorphine group), patients underwent the surgery under general anesthesia with perioperative epidural buprenorphine 0.2 mg, in the other group (control group), patients underwent the surgery under general anesthesia only. The epidural injection was within 2 levels of the cephalad segment of the operating site. ⋯ In buprenorphine group, requirement of analgesics was less during and after surgery compared with the control group. Neurological evaluation immediately after surgery revealed no neurological side effects in both groups. We conclude that general anesthesia with perioperative epidural buprenorphine for lumbar spinal surgery is safe and useful.