Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial
[The Effect of Preoperative Oral Rehydration on Hemodynamic Changes during Induction of Anesthesia and Intraoperative Fluid Management].
Preoperative oral rehydration solution (ORS) prevents dehydration before surgery. Therefore taking enough ORS possibly reduces the hemodynamic changes during induction of anesthesia, and reduces the amount of fluid needed during anesthesia. ⋯ Preoperative oral rehydration increases circulating blood volume, it keeps high CI during induction of anesthesia, and reduces the amount of intraoperative fluid.
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Case Reports
[Desflurane Anesthesia in a Morbidly Obese Patient with Severe Obstructive Sleep Apnea].
A 33-year-old morbidly obese patient (body mass index = 59.5 kg x m(-2)) with severe obstructive sleep apnea was scheduled to undergo osteosynthesis of right radial, ulnar and femoral fractures under general anesthesia. Awake intubation under conscious sedation using fantanyl and midazolam was performed by the Pentax-AWS Airwayscope. ⋯ Respiratory depression was minimal during postoperative period. In this case desflurane was safely used in a morbidly obese patient with severe obstructive sleep apnea.
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Comparative Study
[Comparison of Seven Intubation Devices in Difficult Airway Model].
The efficacy in tracheal intubation may differ between different video-optical devices, in particular in patients with difficult airways. The purpose of this study was to evaluate the efficacy of video-laryngoscopes and fiberoptic bronchoscope (FOB) in tracheal intubation on a mannequin with several difficult airways, including limited mouth opening, cervical spine rigidity and tongue edema. ⋯ Videolaryngoscopes can generally be useful in patients with all difficult airways, but may be difficult in some circumstances (such as tongue edema). The FOB provided good laryngeal view in all cases, but the success rate of tracheal intubation was low and the time to intubate trachea was long.
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Case Reports
[Anesthesia for Patients with Obstructive Sleep Apnea Syndrome Associated with Severe Obesity].
A 41-year-old woman with concomitant severe obesity, obstructive sleep apnea syndrome, and asthma was scheduled for endoscopic cholecystectomy. She was 165.8 cm tall and weighed 141.2 kg, with BMI of 51.4. We were concerned with difficulty in ventilation and intubation at the time of anesthesia induction and intra- and post-operative ventilatory failure. ⋯ Although she received no nerve block, she did not choke at the time of intubation. Because of airway pressure elevation during surgery, volume-controlled ventilation was changed to pressure-controlled ventilation, and, because of a worsening P/F ratio, the recruitment procedure was performed during surgery, with a consequent improvement in the ratio. Although the use of the reservoir and NPPV equipment after extubation was considered, her respiratory status was stable, and she returned to her room with oxygen mask.
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Comparative Study
[A Clinical Comparison of Continuous Sciatic Nerve Block and Epidural Anesthesia for Postoperative Pain Control in Patients with Fracture of the Foot].
Epidural analgesia provides good pain relief for patients with fracture of the foot Ultrasound-guided peripheral nerve block offers safety and efficacy without affecting the leg. ⋯ Continuous sciatic nerve block developed good postoperative analgesia in ORIF of ankle fracture or calcaneal bone fracture compared with continuous epidural anesthesia.