Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial
[McGRATH® MAC Is Useful to Learn Tracheal Intubation Using a Macintosh Laryngoscope].
Learning tracheal intubation using a Macintosh laryngoscope (McL) is important although video laryngoscope is becoming popular. The purpose of this study was to compare the usefulness as a training device for intubation technique using McL with three devices; McGRATH® MAC (MAC), Airwayscope® (AWS) and McL. ⋯ The McGRATH® MAC may possess advantages compared to Airwayscope® and Macintosh laryngoscope as a training device for learning intubation technique using Macintosh laryngoscope and understanding anatomy of the larynx.
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Randomized Controlled Trial Comparative Study
[Efficacy of Ultrasound-guided Thoracic Paravertebral Block Compared with the Epidural Analgesia in Patients Undergoing Video-assisted Thoracoscopic Surgery].
Thoracic paravertebral block (TPVB) has proven to be safer by using ultrasound imaging. This prospective randomized study was designed to investigate postoperative pain relief and intraoperative hemodynamics in patients undergoing ultrasound-guided TPVB or epidural analgesia. ⋯ Ultrasound guided TPVB was performed affecting hemodynamics less than the epidural anesthetic. There was less postoperative analgesic effect on TPBV than on epidural analgesia after thora- coscopic surgery when continuously infusing 0.2% ropivacaine 6 ml · hr(-1).
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Major abdominal surgery accompanies the higher magnitude of physiological stress response and may require an additional replacement fluid for the redistributed volume. Intraoperative volume restriction strategy is recommended to avoid fluid overload leading to increased mortality. We conducted a comparative study of the perioperative effects of intraoperative fluid restriction in abdominal versus thoracic surgery. ⋯ Restrictive fluid therapy with intraoperative crystalloid of 5 ml · kg(-1) · hr(-1) can be safely used with no serious adverse events in abdominal surgery. In conclusion we had better not make any traditional difference in intraoperative fluid management between abdominal and thoracic surgery even if their stress response differs in magnitude.
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We report a case of epidural hematoma in an elderly patient with normal coagulability and without difficulty in epidural catheterization. A 76-year-old man with a history of cervical myelopathy was scheduled for gastrojejunostomy under combined epidural and general anesthesia. He had normal bleeding time, coagulation test results, and platelet count. ⋯ On the second postoperative day, MRI of the spine demonstrated a hematoma-like lesion, and severe thoracic and lumbar spinal canal stenosis. Severe vertebral deformation, especially in cases of the elderly, is a potential risk for epidural hematoma after epidural catheterization, because a small hematoma may compress the spinal cord. A careful preoperative evaluation whether to perform epidural catheterization and postoperative observation are required for elderly patients with severe vertebral deformation.
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The McGRATH® MAC videolaryngoscope (McG) is a new device for tracheal intubation. Its utility has been reported in both tracheal intubation in children and difficult tracheal intubation for adults. Initially, the blade introduced was for adult use only, but the one for children was also in the market. We examined the usefulness of the McG for tracheal intubation in 100 children. ⋯ McG is useful in both routine and difficult airway management for children.