Masui. The Japanese journal of anesthesiology
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The goal of this multicenter survey was to examine the variety of pediatric endotracheal tube (PETT) management methods utilized by anesthesiologists. ⋯ The present study revealed that practice of PETT management depends on anesthesiologists. PETT management should be sophisticated with wide use of cuffed PETTs.
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Vocal cord paralysis after tracheal intubation is rare. It causes severe hoarseness and aspiration, and delays recovery and discharge. Arytenoid cartilage dislocation and recurrent nerve paralysis are main causes of vocal cord paralysis. ⋯ In pediatric cardiac surgery, vocal cord paralysis occurs in 1 (0.1-0.5%) of 200-1,000 patients. We classified the severity of vocal cord paralysis as I, severe hoarseness; II, aspiration or dysphagia; and III, bilateral vocal cord paralysis, aspiration pneumonia, or the need for tracheal re-intubation or tracheotomy. We discuss the importance of informed consent for the patient and family.
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Case Reports
[Successful sedation with landiolol and dexmedetomidine during spinal anesthesia in a patient with active dementia].
We report a successful case of sedation during spinal anesthesia using continuous administration of landiolol and dexmedetomidine in a patient with severe dementia. An 86-year-old man weighing 63 kg with severe dementia and chronic obstructive pulmonary disease was scheduled for emergent open reduction of fracture under spinal anesthesia. On admission, he presented with delirium as a result of pain and environmental change. ⋯ After 10 minutes, he was sedated and agreed to undergo spinal anesthesia. Spinal anesthesia was successful with isobaric bupivacaine 3.0 mI. The patient showed no untoward behavior during anesthesia and the operation.
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Observational Study
[Examination of the criteria for selecting the size of a cuffed tracheal tube in children].
This paper examined the criteria for selecting Mallinckrodt Hi-Contour pediatric cuffed tracheal tubes. ⋯ Based on these criteria, tube replacement was not necessary in 93% of pediatric patients.
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Blocking conduction in the saphenous nerve is important in providing surgical anesthesia of the lower leg. The aim of this retrospective study was to determine the efficacy of ultrasound-guided paravenous approach for saphenous nerve block. ⋯ Paravenous approach for saphenous nerve block may be effective particularly with limited resources.