Masui. The Japanese journal of anesthesiology
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Noninvasive monitoring of regional cerebral oxygen saturation has been introduced in clinical settings for estimation of cerebral perfusion and cerebral blood flow. In this article, I have described several issues regarding the usefulness and clinical limitations associated with the use of these monitors, as well as relevant information on basic principles of monitoring. At present, there is not enough clinical data concerning critical levels of measured variables that are essential for safe perioperative management of patients susceptible for cerebral ischemia.
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Comparative Study
[Comparison of Cormack/Lehane classification grades decided by novice residents and those by board certified anesthesiologists].
Tracheal intubation training is one of the most important ones in anesthesia training. But it is difficult to evaluate from the outside whether the laryngeal view obtained with the laryngoscope is appropriate or not. ⋯ We considered it useful in the tracheal intubation training that certified anesthesiologists evaluate patients' Cormack/Lehane classification grades before novice residents do, because we can obtain necessary information on laryngeal view and intubation difficulty in advance.
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A 35-year-old parturient highly suspicious of the placenta accreta/increta was scheduled for cesarean hysterectomy. She had received two cesarean sections and two intrauterine curettages. Prior to cesarean hysterectomy, 900 g of autologous blood was stored for the predictable massive bleeding. ⋯ The postoperative course was uneventful and the patient was discharged 14 days after operation. Histopathological diagnosis was placenta accreta. We successfully managed the anesthesia for cesarean hysterectomy in a parturient with placenta accreta under a combination of general anesthesia and epidural anesthesia.
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Development of pulse oximeter technology has made it possible to measure total hemoglobin noninvasively. The use of Radical-7 would improve patient care in emergency medicine and chronic internal medicine as well as perioperative medicine, and could reduce the burden of the patient.
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Randomized Controlled Trial
[Effects of the injection method of lidocaine on preventing injection pain during anesthesia induction by target controlled infusion with propofol].
We conducted a prospective randomized study to assess the effects of preceding lidocaine on the incidence and intensity of propofol-induced pain. ⋯ We conclude that pre-administration of lidocaine without infusion and restart infusion before propofol injecting into a dorsal hand vein is clinically useful.