Masui. The Japanese journal of anesthesiology
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Recently, rocuronium is being used in patients for caesarean section undergoing general anesthesia instead of suxamethonium. An increased dose of rocuronium improves intubating conditions but prolongs neuromuscular blockade. Sugammadex reverses rapidly and predictably even profound rocuronium-induced neuromuscular blockade. ⋯ However, in one patient who had chronic renal failure (creatinine clearance rate: 12 ml x min(-1)), 10 minutes were required for TOF to recover to more than 0.7, and TOF never reached 0.9. All patients were successfully intubated at the first attempt. No signs of recurarization or adverse effects related to sugammadex were noted in the perioperative period.
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Comparative Study
[Effect on fetal umbilical arterial blood of administration of vasopressors for hypotension after spinal anesthesia during cesarean section].
Spinal anesthesia was performed in 40 patients undergoing cesarean section. When systolic blood pressure dropped below 100 mmHg, phenylephrine 100-200 microg (P group) or ephedrine 5-10 mg (E group) was administered. The pH of the umbilical arterial blood was collected after delivery of the baby. ⋯ Recently, it is reported that the umbilical arterial pH is higher in cases in which phenylephrine is used for hypotension after spinal anesthesia during a cesarean section. However, the optimal dose of phenylephrine is debatable and has not been established. More studies are necessary to determine which drugs should be selected according to the maternal condition.
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A 68-year-old male patient underwent laparoscopic cholecystectomy under general anesthesia. Following anesthesia induction and muscle relaxation, laryngoscopy using Macintosh laryngoscope found a tumor of thumb size above the glottis completely obscuring the vocal cords. There appeared to be a possibility of tumor impaction into the glottis leading to total obstruction when the tumor was pushed down by a tracheal tube. ⋯ N. T. surgeon found no evidence of scarring or healing in the throat. The cyst might have been ruptured at the time of extubation or afterward, or absorbed.
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A 70-year-old man with a severe COPD was scheduled for low anterior resection of the rectum because of rectal cancer. After a week of respiratory rehabilitation, respiratory function was much improved. ⋯ We obtained appropriate sedative and antianxiety effect without causing respiratory depression and hemodynamic changes. Dexmedetomidine was useful for anesthesia for a patient with severe COPD without causing respiratory depression.
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Most of the thermometers used during operations are invasive and non-hygienic. The usefulness of a noncontact continuous tympanic thermometer under general anesthesia has been reported. We evaluated the usefulness of a noncontact continuous tympanic thermometer in patients undergoing cardiac surgery using an artificial heart-lung machine. ⋯ A noncontact continuous tympanic thermometer is useful for measurement of core temperature during cardiac surgery using an artificial heart-lung machine.