Masui. The Japanese journal of anesthesiology
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It has been reported that postanesthetic shivering is associated with general anesthesia using remifentanil infusion. The aim of this retrospective study was to evaluate the factors leading to postanesthetic shivering. ⋯ These data suggest that fentanyl concentration may be important for avoiding postanesthetic shivering and the duration of surgery may be a predictor for postanesthetic shivering.
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Angelman syndrome is a hereditary disease described by Angelman. The clinical features of Angelman syndrome are characterized by mental retardation, puppet-like ataxia, easily excitable personality, seizures, paroxysmal laughter, strabismus and macroglossia. A 4-year-old girl with Angelman syndrome underwent strabismus repair under general anesthesia. ⋯ Tracheal intubation was performed after administration of rocuronium. During and after anesthesia, no adverse events regarding circulatory and respiratory systems occurred. However, this case demonstrates that it is necessary to pay attention to airway troubles including the difficulty of tracheal intubation, management of body temperature and chronotropic action or respiratory depression by anesthetic agents.
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The Airtraq optical laryngoscope allows visualization of the glottis through a non-line-of sight view. The aim of the present study was to evaluate the suitability of this device for the tracheal intubation of surgical patients. ⋯ The Airtraq optical laryngoscope consistently permitted a better intubation environment. With its potential advantages, the Airtraq optical laryngoscope could be an effective aid to airway management in surgical patients.
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Craniotomy sometimes causes pseudoankylosis of the mandible, i.e., limited mouth opening, leading to a difficult airway. We describe a case of difficult airway due to pseudoankylosis of the mandible after craniotomy, in which orotracheal intubation was successfully performed with an AirWay Scope (AWS). A 60-year-old woman was scheduled for clipping of an unruptured cerebral aneurysm. ⋯ After careful induction with fentanyl and propofol, the blade was inserted smoothly. Her glottic opening was easily visualized, and her trachea was intubated without any difficulty or any distinct hemodynamic disturbance. Careful assessment of the interincisor distance is essential in patients who have previously undergone craniotomy.
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In tracheal intubation assisted by tube-guiding devices passing through the tube, such as fiberoptic scopes, bougies, tracheal tube exchange catheters, and light wands, passage of the tube-guiding device, by itself, is often easy. But advancing a tracheal tube with a conventional distal tip over these tube-guiding devices is frequently difficult or impossible, because its rigid, side-beveled tip frequently catches on anatomical features of the airway. ⋯ The gapless, midline travel of the Parker tube leads to a greater incidence of first-attempt intubation success with tube-guiding devices, because there is less risk of tube tip hang-ups on the arytenoids and the vocal cords. Clinically, use of the Parker tube is helpful for oral and nasal intubations, especially in patients with difficult airways.