Masui. The Japanese journal of anesthesiology
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We experienced two cases of anaphylaxis during anesthesia using rocuronium in two months. In both cases, we carried out intradermal test and positive reaction occurred with rocuronium. In both cases, the second anesthesia without neuromuscular blockade was uneventful. Though it is difficult to diagnose anaphylaxis, we should suspect anaphylaxis when cardiovascular collapse, bronchospasm and/or dermal symptoms occur after induction of anesthesia.
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A 34-year-old woman who was 25 weeks pregnant showed neurological symptoms of bitemporal hemianopsia and vision loss on the left side. MRI study revealed a pituitary tumor requiring surgical removal. We planned cesarean section after 32 weeks of pregnancy and removal of pituitary tumor after the improvement of general conditions of the paturient following cersarean section. ⋯ Therefore, we decided to perform the cesarean section at 30 weeks and 3 days of pregnancy and simultaneous surgical removal of the pituitary tumor. As soon as cesarean section was successfully performed with epidural anesthesia, the pituitary tumor was removed trans-sphenoidally under general anesthesia. Postoperative conditions of the mother and newborn were good and neurological symptoms of the mother improved markedly.
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The i-gel, invented by Muhammed Aslam Nasir, is a new supraglottic airway, consisting of a mask and a tube. One notable feature of the i-gel is that the rim of the mask is designed to conform to the anatomical shape of the larynx. This enables the device to provide an airtight seal without the cuff mechanism. ⋯ No airway complications occurred during the anesthesia, and spontaneous breathing could be maintained. No blood was detected on the device, after uneventful removal in all the patients. We believe that the i-gel is useful in maintaining a clear airway during general anesthesia.
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The GlideScope video laryngoscope (Verathon Inc. Bothell, Washington, USA) is a relatively new device for tracheal intubation, which provides a excellent glottic visualization. We here report the clinical experience of the GlideScope (small) in 50 pediatric patients. ⋯ GlideScope seemed to be a novel device in pediatric patients. Further studies are required to evaluate the usefulness in neonates, small infants and children with a difficult airway.
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Randomized Controlled Trial Comparative Study
[Technical advantages of ultrasound-guided obturator nerve block compared with the nerve stimulating technique].
We investigated the onset time of obturator nerve block and time required for the nerve block comparing two groups in a prospective randomized study. ⋯ Ultrasound imaging facilitated the identification of obturator nerves between adductor muscles. Ultrasound-guided obturator nerve block is a safe, quick and useful technique.