Masui. The Japanese journal of anesthesiology
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As we have no information whether target-controlled infusion (TCI) for propofol, using pharmacokinetic parameters obtained without chronic renal failure, is available to estimate the drug concentration, we examined the blood concentration of propofol on the patients with chronic renal failure to evaluate the reliability of TCI of propofol. ⋯ TCI system for propofol provided a good estimation of the blood concentration of propofol in patients with chronic renal failure undergoing living-related renal transplantation.
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In Japan, the re-organization of obstetrical medical system is needed and this project is ongoing under Japanese government initiative. However the ratio of using neuraxial analgesia (NA) during labor in Japan has been low and, increased demand for NA during labor is anticipated in near future. ⋯ However, there is no official training program for OB anesthesiologists in Japan. This article reports the clinical practice of the OB anesthesia in one of the biggest hospitals in the United State, the Cleveland Clinic, from the view of an OB anesthesia clinical fellow.
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We reviewed anaesthesia training program in Australia. Anaesthetists in Australia and New Zealand need to obtain the Diploma of Fellowship of the Australian and New Zealand College of Anaesthetists (FANZCA) to be recognised as specialists. The training sequence approved by ANZCA encompasses an initial two-year Prevocational Medical Education, Training (PMET) period, and the five-year period of ANZCA Approved Training, which included two-year Basic Training and three-year Advanced Training. ⋯ There are a number of specific goals to be achieved during training. ANZCA accredits Hospital Departments of Anaesthesia and other training institutions across Australia, New Zealand, and South-East Asia, to provide approved training in anaesthesia for ANZCA trainees. Accreditation requires an onsite review by the College in order to assess a hospital's ability to provide training and supervision of the required standard, and its degree of compliance with ANZCA Professional Documents.
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A 26-year-old man was scheduled for surgical extraction of a large epiglottic cyst. Mask ventilation was possible under propofol anesthesia without muscle relaxant. It was difficult to see the glottis using either a Macintosh laryngoscope or by fiberoptic bronchoscopy. ⋯ A reinforced tube was inserted nasally, and a fiberoptic bronchoscope was passed through the tube into the trachea. The tube was then passed over the fiberscope into the trachea. We believe that the Pentax AWS laryngoscope may lift the epiglottis and its cyst atraumatically, and may facilitate nasal fiberoptic intubation in a patient with a large epiglottic cyst.
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Visual disturbance including visual loss is a rare but devastating complication after non-ophthalmic surgery. Reported incidence of visual disturbances ranged from 0.028 to 0.2% after spine surgery and from 0.0009 to 25.6% after cardiac surgery. ⋯ After cardiac surgery, anterior ischemic optic neuropathy is most prevalent and risk factors included age, diabetes, long cardiopulmonary bypass time and anemia. Anesthesiologists and surgeons should be aware of this complication and further investigations regarding etiology, prevention and managements on postoperative visual disturbances would be required.