Masui. The Japanese journal of anesthesiology
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The sacroiliac joint (SIJ) is recognized as a potential source for low back pain especially in elderly people. Previous studies indicated that in patients with SIJ pain, posterior sacroiliac ligament injections are more effective than intra articular injections. The aim of this study was to assess usefulness of ultrasound sonography (US) in performing posterior sacroiliac ligament injection. ⋯ Our study suggests that US can be useful in performing posterior sacroiliac ligament injections. Sufficient anatomical knowledge and extensive US experience are essential in performing these injections.
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Comparative Study
[Comparison of difficulty in airway intubation with aging. Study on 71 subjects who had an airway intubation 20-or-more years earlier].
Although there are reports targeting children with micrognathia, there is no report how orotracheal intubation difficulty of normal adult patients changes with aging. We surveyed orotracheal intubation episodes after more than 20 years from the initial surgery. ⋯ We conclude that in adult patients, if there are no changes in the degree of opening mouth and neck mobility, almost all patients remained in the same situation regarding orotracheal intubation after 23 years in average.
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We experienced a case of negative pressure pulmonary edema (NPPE) after administration of sugammadex under general anesthesia with LMA Supreme. Sugammadex was administered to a 76-year-old female patient following spontaneous ventilation. ⋯ However, a chest x-ray at this time showed pulmonary edema We suspected that sugammadex administration had triggered the laryngospasm, causing postoperative NPPE. When selecting a LMA under general anesthesia for airway management, we have to keep in mind the possibility of NPPE followed by laryngospasm.
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Previously, we reported that pre- and postoperative measurement of the neck circumference might be an easy and useful measure for prediction of postoperative airway obstruction in shoulder arthroscopy. However, it is suggested that airway pressure to cause a cuff leak around the tracheal tube in a cuff deflated condition (cuff leak pressure) is a predictor of postoperative airway obstruction. We studied a correlation between the neck circumference and the cuff leak pressure. ⋯ The rate of increase in neck circumference shows the swelling of external tissue of the neck. However, it may not reflect the swelling of the internal tissue containing pharynx, larynx and retrotracheal space. Alternatively, pre- and postoperative measurement of the cuff leak pressure could be a more substantial predictor of postoperative airway obstruction than the rate of increase in neck circumference.