Masui. The Japanese journal of anesthesiology
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Preoperative oral hydration is an important component of "enhanced recovery after surgery" strategies. This was originally developed for patients undergoing colon surgery. The Obstetric Anesthesia Practice Guideline issued by American Society of Anesthesiologists states that intake of minimum amount of clear fluid 2 hours prior to surgery may be safe. ⋯ Moreover, some articles suggest that oral hydration may improve utero-placental perfusion. Therefore, we have to balance risks and benefits of oral hydration in parturients. Further investigations are needed among this specific subgroup of patients in order to establish the safe application of preoperative oral hydration.
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Effect of epidural anesthesia is affected by catheter tip position. Migration of an epidural catheter is known and several methods were reported to secure fixation of the catheter, but there were no gold standard method to fix it. ⋯ We conclude that fixation of epidural catheter by only Tegaderm can not be a gold standard even if circular loop and record label are used.
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Preoperative fasting period is required in order to reducing the risk of pulmonary aspiration which may occur during pediatric general anesthesia. Overnight fasting is still prevalent in Japan. ⋯ Cochrane Database evaluated this guideline twice in 2005 and in 2009. In this article, recent tactics of preoperative fasting in children is reviewed along the ASA guideline and the Cochrane report.
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Postoperative delirium increases the morbidity and mortality in elderly patients. The present study was carried out to evaluate whether the difference of anesthetics has influence on the incidence of postoperative delirium, retrospectively. ⋯ Propofol anesthesia decreases postoperative delirium in elderly patients compared with sevoflurane anesthesia.
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A morbidly obese patient, with a body mass index of 43 kg m(-2), was scheduled to undergo open reduction and internal fixation (ORIF) to his left fibular fracture under general anesthesia in the lateral position. Before the induction of general anesthesia the patient positioned himself comfortably in right lateral. General anesthesia was induced with intravenous propofol and remifentanil infusions. ⋯ As soon as he awoke, LMA was removed in the lateral position. The patient turned to the supine position himself and was discharged to general ward. We consider our method, the induction of general anesthesia and the LMA insertion in the lateral position, was a selectable option to a morbidly obese patient who underwent an operation in the lateral position.