Masui. The Japanese journal of anesthesiology
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Point-of-care ultrasonography has become widely used in diagnosis and managements of patients. In the field of anesthesiology, ultrasound guided nerve blocks and central venous catheterization (CVC), and transesophageal echocardiography (TEE) have become popular. Now, ultrasound devices are familiar to anesthesiologists. ⋯ Because of less invasive technique, whole body ultrasound evaluation is suitable to use when anesthesiologists may have questions whether the patient's condition is good or not. No doubt that point-of-care ultrasonography by anesthesiologists themselves in pre-anesthesia. clinic can be the useful decision making tool of anesthesia plan. To be tomorrow's anesthesiologists, please start point-of-care pre-anesthetic ultrasonographic assessment.
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Klippel-Feil syndrome (KFS) is a complex syndrome of osseous and visceral anomalies that include the classical clinical triad of short neck, limitation of head and neck movement and low posterior hairline. It may also be associated with anomalies of the genitourinary, musculoskeletal, neurologic and cardiac systems. ⋯ We had to secure the field of operation and airway management involved difficult tracheal intubation. Careful postoperative care and respiratory management are also required for the patient afflicted with KFS.
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Point-of-care ultrasound (POCUS) in the diagnoses of postoperative complications is discussed. POCUS is useful in many situations such as abdominal distension, elevated liver enzymes, abdominal pain, and fever, which are the common complications encountered after surgical operations. In the patients with abdominal distention, bowel distention or ascites can be easily detected by POCUS. ⋯ In patients with fever, US is useful not only for the diagnosis of abdominal abscess but also for the drainage. By evaluating the colon with POCUS, we can detect the pseudomembranous colitis which often is overlooked. In conclusion, POCUS is an essential tool for the proper management of postoperative patients.
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We experienced rocuronium-induced anaphylaxis in a 62-year-old man who was scheduled for laparoscopic ileocecal excision for cecal cancer under general anes- thesia. The patient did not have a preoperative history and examinations suggestive of heart disease, or pre- disposing factors for myocardial infarction. Just after induction of anesthesia, we noticed abnormally low blood pressure and ST segment elevation on his elec- trocardiogram. ⋯ The sur- gery was performed safely with this protocol. It is likely that his symptoms in the first general anesthesia were caused by Kounis syndrome. We conclude that the basophil activation test seems to be valuable in determining the causative agent of anaphylaxis, partic- ularly when a patient does not agree to undergo skin tests.
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In the mid 18th century, Monro, Kite, and others stared to perform tracheal intubation during cardiopul- monary resuscitation. In 1790's, it was found that tra- cheal intubation using Kite's device and method was technically difficult and, because of the design of the tube, an inserted tube might frequently obstruct the airway. ⋯ In addition, Leroy invented a device to facilitate tracheal intubation. Despite these efforts, tracheal intubation during cardiopulmonary resuscitation was abandoned afterwards because of "unexpected" reasons.