Masui. The Japanese journal of anesthesiology
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We describe a case of an esophageal injury caused by insertion of a transesophageal cardiac echo probe in a 66-year-old man with an aberrant right subclavian artery, who was scheduled for Bentall surgery for aortic regurgitation and annuloaortic ectasia. Preoperative CT scan showed an aberrant right subclavian artery compressed from the back of the esophagus. General anesthesia was induced with midazolam and fentanyl, and maintained with midazolam, remifentanil and fentanyl. ⋯ GIF on the postoperative day 16 revealed that ulcers had healed. Transesophageal echo probe insertion is potentially hazardous in a patient with an aberrant right subclavian artery. Although aberrant right subclavian artery is rare, transesophageal echocardiography should be performed with extreme caution.
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Case Reports
[Percutaneous vertebroplasty for vertebral compression fractures in the patient with acute lymphoblastic leukemia].
Percutaneous vertebroplasty (PVP) is an interventional treatment for painful vertebral compression fractures caused by osteoporosis and malignant diseases such as multiple myeloma and metastatic bone tumors. We present the first case of PVP performed on a man in his thirties with vertebral compression fractures secondary to acute lymphoblastic leukemia. PVP at T11 and L1 levels resulted in a marked improvement in refractory pain although he developed delayed pyogenic spondylitis two months after the intervention. This case suggests that PVP could be one of the useful therapeutic procedures for intractable back pain associated with vertebral compression fractures in acute lymphoblastic leukemia if we are extremely vigilant for the risk of spondylitis.
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The role of various monitors contributing to achieving and standardizing safety has been increasing in the management of general anesthesia. In particular, sufficient oxygenation is one of the most basic requirements to ensure the safety of patients under general anesthesia. In this report, pulse oximetry, mixed venous oxygen saturation, and central venous oxygen saturation are reexamined as monitors, based on evaluation of the respiratory system and tissue oxygenation, in order to evaluate their usefulness in measurements. Regarding pulse oximeters, the models with added functions are introduced, and in this article mixed venous and central venous oxygen saturation, the early goal-directed therapy (EGDT) and the core of the Surviving Sepsis Campaign (SSC) guidelines from 2008, are examined.
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Randomized Controlled Trial
[Effectiveness of gum elastic bougie for tracheal intubation with Airtraq optical laryngoscope].
Although Airtraq (ATQ) is well accepted as a useful device for tracheal intubation especially in cases of difficult airway management, we sometimes encounter difficulty in insertion of a tracheal tube along the blade of ATQ across the vocal cord in spite of ATQ assistance. Gum Elastic Bougie (GEB) is well known as a practical device for intubation assistance with Macintosh laryngoscope. We studied the efficacy of GEB for intubation with ATQ. ⋯ For the people with less experience of intubation, GEB is useful assistance for intubation with ATQ. It was concluded that the combined use of ATQ and GEB is a simple and effective process for ordinary doctors or paramedics.
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Randomized Controlled Trial
[Effect of amino acid and glucose infusion on perioperative body temperature and postoperative infection in patients undergoing total knee arthroplasty].
We investigated whether the perioperative amino acid infusion with glucose is effective for preventing perioperative hypothermia and postoperative infection in patients undregoing total knee arthroplasty (TKA). ⋯ These results suggest that in patients undergoing TKA receiveing amino acid infusion perioperatively, thermogenic effect and prevention of postoperative infection are similar whether exogenous glucose is infused or not.