Masui. The Japanese journal of anesthesiology
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Comparative Study
[Perioperative management of lung transplantations in patients with pulmonary arterial hypertension compared with that in patients with lymphangiomyomatosis].
The number of lung transplantation has tended to increase as a treatment for patients with pulmonary arterial hypertension (PAH) and lymphangiomyomatosis (LAM) in Japan. However, we have little evidence about the comparison of perioperative management in patients with PAH and that in patients with LAM. ⋯ The large difference in perioperative management between patients with PAH and those with LAM is an important knowledge for anesthesist.
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We experienced management of general anesthesia in a patients with Coffin-Siris syndrome (CS syndrome) which is an autosomal dominant disorder characterized by mental retardation, growth failure, hypoplasia of the fifth finger's distal phalanx and limb, and syndrome-specific facial appearance. Anesthesia was induced by sevoflurane by mask. ⋯ Surgical procedures and anes-thetic management were performed uneventfully. This case demonstrates usefulness of AWS in pediatric patients with difficult intubation.
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We report a case of delayed awakening with characteristic repeated loss of consciousness after remifentanil infusion complicated by leakage from an intravenous catheter. A 30-year-old male underwent microlaryngeal surgery for a vocal cord polyp. During anesthetic induction, infiltration from an intravenous (IV) line in the left forearm was observed 10 min after initiating a continuous infusion of remifentanil 0.5 microg x kg-1 x min -1. ⋯ Blood gases, electrolytes, glucose values, and body temperature were within normal ranges throughout the perioperative period. Brain computed tomography, mag- netic resonance imaging, and electroencephalography showed no abnormalities. It was considered that the incidental subcutaneous remifentanil accumulation may have caused the respiratory suppression and delayed awakening.
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Review
[ECMO for the patients with severe respiratory failure associated with ARDS due to influenza].
Although the survival rate of H1N1-related severe respiratory failure following ECMO therapy was high in several countries, the rate in Japan has been low. Efforts should be made to supply suitable equipments, to train the physicians, and to establish transport system for the patient.
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Randomized Controlled Trial
[Continuous infusion of low-dose remifentanil for palliation of pain with epidural catheterization].
To prospectively determine the safety and effectiveness of continuous infusion of low-dose remifentanil for the reduction of pain in patients for epidural catheterization. ⋯ Continuous infusion of low-dose remifentanil is a safe and effective method for palliation of pain in epidural catheterization.