Masui. The Japanese journal of anesthesiology
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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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This article describes the first events of general anesthesia in the world by Tokumei Takamine in 1698 and Seishu Hanaoka in 1804, the establishment of anesthesiology in Japan including the meaning of a scientific society, the establishment of Japanese Society of Anesthesiologist and Department of Anesthesiology at University of Tokyo, past contributions to anesthesiology by Japanese anesthesiologists, and contributions to anesthesiology by Journal of Anesthesia and the Japanese Journal of Anesthesiology.
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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
[A case of impossible ventilation after induction of anesthesia in a patient with massive nasal bleeding].
We report a case of impossible ventilation in a patient with severe nasal bleeding. A 47-year-old man with intractable nasal bleeding was scheduled for emergent hemostasis under general anesthesia. He also had alcohol-related cirrhosis and was highly obese (165 cm, 93 kg). ⋯ Mask ventilatidn was impossible even after oral suctioning. We intubated the trachea with the Macintosh laryngoscope and suctioned blood from the trachea; SpO2 gradually improved and the trachea was washed with a large amount of normal saline. The patient was transferred to the intensive care unit and extubated uneventfully on day 3 postoperatively.
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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.