Masui. The Japanese journal of anesthesiology
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We report general anesthesia for a patient with multiple sclerosis (MS). A 40-year-old male patient with a 13-year history of MS was scheduled for laparoscopic surgery. The symptoms of MS had been exacerbated during feverish state or under surgical stress in the previous surgeries. ⋯ Flurbiprofen axetil was used for slight postoperative fever. There was no clinical exacerbation of MS during perioperative period. In conclusion, appropriate control of surgical stress and prevention of fever are important for perioperative anesthetic management of patients suffering from MS.
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Parental presence during induction of anesthesia (PPIA) is widely practiced to prevent preoperative anxiety in children. However, some previous studies described parental presence is less effective than sedative premedication. The purpose of this investigation is to determine whether PPIA is not an effective prevention of preoperative anxiety using a postoperative questionnaire survey to parents. ⋯ PPIA has beneficial effects against preoperative anxiety in both children and parents.
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Comparative Study
[Endotracheal tube selection in children: which is the better predictor for the selection, tracheal internal diameter in X-ray photograph or age-based formula?].
Age-based formula has been widely used to predict the appropriate size of the endotracheal tube in children. Tracheal internal diameter in X-ray photograph is reported to show higher correlation with a correct tube than age. In our institution, X-ray photographs were stored as digital images, enabling us to measure tracheal internal diameters more accurately than conventional X-ray films. Therefore, we investigated whether tracheal size in digital X-ray photograph is a better predictor for the tube selection than age. ⋯ The age-based formula is more reliable and appropriate to decide the size of endotracheal tube for children than the tracheal size.
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Epidural catheter insertion is a common procedure for gynecological surgeries. Epidural puncture is usually performed according to the anatomical landmarks without radiographic means. The aim of his study was to confirm the actual level of puncture, and the distance as well as the direction of epidural catheters threaded. ⋯ Only 11.7% of the catheters were actually inserted from T12-L1 and advanced in cephalad direction over one vertebra as we had intended.
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The population of children undergoing successful surgery for congenital heart disease (CHD) continues to increase. Increasing number of patients with a Fontan circulation is reaching adulthood and requiring anesthesia for noncardiac surgeries. We anesthetized a patient with a Fontan circulation (9 years old) for giant internal carotid-ophthalmic artery aneurysm trapping. ⋯ Anesthetic time was 13 hr and 40 min. The patient was extubated in the operating room. We have to take into consideration that there are anatomical abnormalities and arrhythmia in the patients with a Fontan circulation.