Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Comparative Study
[Anesthesia for electroconvulsive therapy -- comparison of propofol with sevoflurane].
Electroconvulsive therapy (ECT) is performed under general anesthesia (GA). GA could reduce the vigorous hemodynamic response including hypertension and tachycardia during ECT. This may be beneficial in patients with cardiovascular diseases. On the other hand, however, many intravenous and inhalational anesthetic agents potentially suppress the seizure and shorten the duration. The aim of this study is to elucidate whether propofol is superior to sevoflurane in maintaining the duration of electroencephalographic (EEG) seizure evoked by Thymatron System while stabilizing hemodynamic responses. ⋯ The duration of EEG seizure in ECT was significantly longer with propofol anesthesia than sevoflurane anesthesia. Propofol may provide more benefits than sevoflurane as the anesthetic for ECT.
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Randomized Controlled Trial Comparative Study
[Comparison of usefulness of the dorsal branch of the radial artery with the radial artery for arterial cannulation].
The radial artery cannulation is often associated with damped arterial waveforms with the hand moving. We used cannulation of the dorsal branch of the radial artery (DRA) and compared the stability of measurement, safety and complications with those of the radial artery(RA). ⋯ Arterial line monitoring from DRA had better waveforms compared with RA monitoring without any complications.
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A 17-year-old man was scheduled for ventriculo-peritoneal shunt under general anesthesia. Anesthesia was induced by propofol, rocuronium and pentazocine, and maintained with sevoflurane and nitrous oxide. The operation was finished in 1 hour and 4 minutes without trouble. ⋯ He showed no troubles thereafter, and left hospital. After introduction of sugammadex to clinical use, 7 cases of anaphylactic reaction to sugammadex were reported. We must know that anaphylactic reaction can be induced by sugammadex.
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A 71-year-old woman was scheduled for arthroscopic knee surgery. Anesthesia was administered with sevoflurane, fentanyl, and rocuronium bromide. Total dose of fentanyl was 200 microg and total dose of rocuronium bromide was 40mg. ⋯ The cause of difficult ventilation was surmised to be upper airway reflex or muscle rigidity caused by reaction to fentanyl. We thought the phenomenon was clearly manifested by rapid recovery from muscle relaxation by injection of sugammadex. Before injection of sugammadex, it is necessary to confirm the effects of anesthetics on the patient's condition.
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We report successful awake intubation using AWS combined with surface anesthesia of the upper airway via nebulizer. The two cases are suitable for awake intubation due to difficult airway. ⋯ The patients and author did not buck during intubation. The present case shows that it is possible to perform awake intubate safely with less stress with the combination of AWS and surface airway anesthesia via nebulizer.