Masui. The Japanese journal of anesthesiology
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Although remifentanil produces respiratory depression, its very short duration of action provides a great advantage for the control of hemodynamics during anesthesia for tracheobronchial stent insertion. We compared remifentanil with fentanyl during propofol-based anesthesea for anesthetic management for tracheobronchial stent insertion. ⋯ We conclude that the continuous infusion of low dose remifentanil with propofol produce more efficient respiratory and hemodynamic stability than the bolus infusion of fentanyl with propofol during anesthesia for tracheobronchial stent insertion.
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Anaphylaxis is an acute life-threatening systematic reaction, and it requires early diagnosis and correct management to save the patients. The true incidence of anaphylaxis during general anesthesia is unknown. Although anaphylaxis is a rare intraoperative complication, most drugs used in the perioperative period can lead to anaphylaxis. ⋯ Immediate discontinuation of causal drugs and early administration of epinephrine are cornerstones of treatment. More specific diagnostic tests are required for correct identification of causal drugs. To reduce the risk of anaphylaxis during anesthesia, we hope practical data bases and guidelines for anaphylaxis related to anesthesia will be published in the future.
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Randomized Controlled Trial
[Optimum intubating dose of rocuronium for short duration surgery in adult patients].
The aim of this study was to examine optimum intubating dose of rocuronium in adult patients who had been scheduled for short duration surgery. ⋯ For short duration surgeries, rocuronium 0.5 mg x kg(-1) was appropriate to perform safe tracheal intubation and minimize duration of action of rocuronium.
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Comparative Study
[Comparison of urinary output during general anesthesia, between patients administered with remifentanil and those without remifentanil administration].
Transient renal failure during surgery is caused by increasing secretion of stress hormone such as ADH and renin. We suspected that urinary output varies according to administration of remifentanil with potent analgesic effects. Consequently, we studied intraoperative urinary output of two groups, patients administered with remifentanil and those without remifentanil administration. ⋯ We found a significance difference in urinary output during anesthesia, between patients administered with remifentanil and those without remifentanil administration. We suspect that remifentanil decreases urinary output in the perioperative period.
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Several case reports have shown that the Airway Scope is useful in patients with difficult airways. We experienced five patients with known or predicted difficult airways who underwent awake intubation using the Airway Scope. The patients were known or predicted as having a difficult airway due to the following factors: limited head and neck movement (2 cases), risk for aspiration of gastric contents (1 case), and the thyroid tumor causing displacement of the trachea (2 cases). ⋯ First, the Airway Scope allows detection of regurgitation and vomiting during intubation and avoids accidental esophageal intubation. Second, the Airway Scope provides a useful means of teaching and supervising tracheal intubation compared with the conventional Macintosh laryngoscope. We believe that this method can achieve effective, safe and successful awake intubation in patients with known or predicted difficult airways.