Masui. The Japanese journal of anesthesiology
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The role of various monitors contributing to achieving and standardizing safety has been increasing in the management of general anesthesia. In particular, sufficient oxygenation is one of the most basic requirements to ensure the safety of patients under general anesthesia. In this report, pulse oximetry, mixed venous oxygen saturation, and central venous oxygen saturation are reexamined as monitors, based on evaluation of the respiratory system and tissue oxygenation, in order to evaluate their usefulness in measurements. Regarding pulse oximeters, the models with added functions are introduced, and in this article mixed venous and central venous oxygen saturation, the early goal-directed therapy (EGDT) and the core of the Surviving Sepsis Campaign (SSC) guidelines from 2008, are examined.
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The goals of monitoring are to improve the safety of perioperative care and to improve patient's outcome. Various invasive and non-invasive monitors are currently used. ⋯ We must continue to improve the functions of monitors. The existence of a well-trained competent anesthesiologist at bedside is essential to integrate all the information gained by five senses, the monitors, blood tests and close communication with surgeons on top of deep understanding of the patient's preoperative status.
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The innovation of ultrasound-guided regional anesthesia technique has enabled the anesthesiologist to secure an accurate needle position and to monitor the distribution of the local anesthetic in real time. However, the evidence is necessary concerning increased benefits and reduced complications compared to conventional guidance techniques. ⋯ Common complications of nerve blocks can be avoided with major principles of ultrasound-guided technique, which involves similar risk of complications and requires similar amount of knowledge for management. It is necessary to establish the recommendations for the scope of practice, teaching curriculum and the opinion for implementing the medical practice of ultrasound-guided regional anesthesia.
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Review Case Reports
[Risk management in regional anesthesia: current trends in medical professional liability insurance].
This article aims to highlight current trends in medical professional liability insurance. We present two cases of the lawsuit associated with regional anesthesia. ⋯ To avoid malpractice risks, it is important to fully understand the risks of this clinical role and how to protect yourself from potential lawsuits. Every anesthesiologist should feel obliged to pay attention to legal questions concerning medical subjects, though judgments on the contents and the extent of the informationthat must be given to patients are complex and difficult to understand for anybody not experienced in law.
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Review Case Reports
[Fever in non-neurological critically ill patients; friends or foe?].