Masui. The Japanese journal of anesthesiology
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A 26-year-old woman with Ehlers-Danlos syndrome (EDS) underwent posterior spinal fusion with instrumentation for scoliosis. General anesthesia was maintained using propofol and remifentanil. The procedure was performed examining the motor evoked potential (MEP) and somatosensory evoked potential (SSEP) of the lower extremities with the patient placed in the prone position. ⋯ Brachial plexus injury is the most common among the nerve injuries resulting from intraoperative malpositioning. Patients with EDS are thought to be at high risk for the complications and it has also been reported that patients with joint hypermobility, such as that in EDS or Marfan syndrome, are highly susceptible to nerve injury. Intraoperative monitoring of the MEP and SSEP in the upper extremities should be considered for early detection and prevention of brachial plexus injury in patients with EDS who are thought to be at high risk.
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The aim of this study was to evaluate the suitability of the C-MAC videolaryngoscope for the tracheal intubation especially by novice personnel. ⋯ The C-MAC videolaryngoscope is a useful device in education of endotracheal intubation by novice personnel.
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We experienced an anesthetic management with rocuronium and neurostimulator for a surgical patient with amyotrophic lateral sclerosis. A 61-year-old man was scheduled for intrathecal baclofen pump implantation as treatment for his spasticity under general anesthesia. After oxygenation and totally intravenous induction with propofol and remifentanil, we administered 10 mg of rocuronium repeatedly monitoring with neurostimulator. ⋯ We could confirm his stable and adequate respiration and trachea was extubated without reversal of rocuronium. In the postanesthesia care unit, he showed no discomfort and was returned to the ward. His symptoms did not deteriorate postoperatively and he was discharged on the 36th postoperative day.
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The effect of adding vasoconstrictors to local anesthetics for spinal anesthesia is controversial. The aim of this study was to investigate the effect of phenylephrine on neural blockade and hemodynamic changes in spinal anesthesia in elderly patients. ⋯ The addition of phenylephrine to hyperbaric tetracaine in spinal anesthesia did not affect the extent of sensory blocks and hemodynamic changes in elderly patients.
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In our hospital, the average duration of training in intubation by the emergency medical technician training intubation was 17.9 days. Compared to other reports, our training period is shorter. ⋯ But long training period has been increasing the burden of anesthesiologists and emergency medical technicians. We report a practical method of intubation by emergency medical technician in our hospital.