Masui. The Japanese journal of anesthesiology
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Comparative Study
[Comparison of thoracoscopic and open repair of esophageal atresia with tracheoesophageal fistula].
With the increasing use of endoscopic surgery in children, several papers report the comparison between the thoracoscopic and open repair of the neonatal esophageal atresia with tracheoesophageal fistula (EA/TEF). Most of them focus on the duration and outcome of the surgery with few focusing on the neonatal tolerance to the thoracoscopic procedure and intraoperative anesthetic management. ⋯ Hypercapnia and acidosis were severer in thoracoscopy group. Careful perioperative adjustment of inspired oxygen fraction and ventilator setting is required.
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Epidural anesthesia is widely used in patients who undergo thoracic, abdominal or lower extremity surgeries and generally considered useful for perioperative analgesic management. Epidural catheterization is often associated with some complications including misplacement of the catheter. Epidural catheters are known to be misplaced or migrate into subarachnoidal space, subdural space, vessels and thoracic cavities ; however, frequency, predominant sites of misplacement, and the timing of detection are not fully understood regarding the misplacement of the catheters. ⋯ Epidural catheters were misplaced to subarachnoid space in 6 cases and thoracic cavity in 2 cases. The misplacement of the catheters was found before the induction of general anesthesia in 2 patients, after induction of general anesthesia in 1 patient, during surgical procedure in 3 patients, and postoperatively in 2 patients. Since misplacement of epidural catheters can occur at any moment during perioperative period, continuous monitoring and observation of patients seem to be very important to prevent and minimize the adverse events related to the misplacement of epidural catheters.
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Comparative Study
[Comparison of levobupivacaine and ropivacaine for postoperative epidural analgesia].
Levobupivacaine is a long acting local anesthetic with less cardiovascular toxicity. Recently we can use levobupivacaine for postoperative analgesia. We retrospectively compared levobupivacaine with ropivacaine for the postoperative epidural analgesia in patients undergoing gynecological abdominal surgery. ⋯ These results suggest that the use of epidural 0.24% levobupivacaine in the patients undergoing the gynecological surgery is superior to the use of 0.19% ropivacaine.
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Comparative Study
[Nasotracheal intubation using GlideScope videolaryngoscope or Macintosh laryngoscope by novice laryngoscopists].
We compared the performance of GlideScope videolaryngoscope with that of the conventional Macintosh laryngoscope for nasotracheal intubation by non-anesthesia residents. ⋯ The unobstructed view of the glottic opening on the video monitor helped the laryngoscopist performing the nasal endotracheal intubation while an assistant provided laryngeal manipulation to improve the coordinated effort. GlideScope seems to facilitate nasotracheal intubation for individuals training in airway management.
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Recently, single shot spinal anesthesia using local anesthetic and opiate has been thought to be an ideal anesthetic method for cesarean section. For single shot spinal anesthesia, it is important to administer appropriate dose of drugs. However, optimal regimen for cesarean section in Japanese parturients has not been well studied. ⋯ It is suggested that the studied regimen was valid for most of Japanese parturients.