Masui. The Japanese journal of anesthesiology
-
VATS (video-associated thoracic surgery) is mainly undertaken under general anesthesia only. Considering with patient's respiratory stability and postoperative pain relief, epidural anesthesia has advantages over general anesthesia. According to our clinical experience, side effects of epidural morphine, especially nausea and vomiting, often torture patients, especially woman. ⋯ Statistically significant gender differences of effectiveness and side effects of epidural morphine in VATS were observed only in nausea and vomiting.
-
To determine the dose requirements of pentazocine when administered as a single bolus dose in total intravenous anesthesia with propofol for abdominal surgery. ⋯ Total intravenous anesthesia with propofol and pentazocine is useful to stabilize hemodynamics and to achieve rapid recovery. For the operation within 120 min, 0.7 mg x kg(-1) of pentazocine is necessary whereas 0.8 mg x kg(-1) of pentazocine is needed in the operation of 120-240 min.
-
A patient, 35 weeks and 2 days gestation with twins, was scheduled for cesarean section. Spinal anesthesia was induced with the patient in lateral decubitus position using 2.2 ml hyperbaric bupivacaine 0.5% at the L3-4 interspace. The patient was placed immediately in supine position. ⋯ So patient's body moves to right and left side. We think that the increased anesthesia level was caused by this rolling of the body. We must be cautious about the increased anesthesia level when spinal anesthesia is induced.
-
Osteogenesis imperfecta (OI) is a rare hereditary disorder characterized by an excessive tendency to bone fractures and retarded growth, as well as variable involvement of other connective tissues such as teeth, sclerae, auditory bones and ligaments. A 30-year-old woman (body mass index of 39.6) with OI was scheduled for appendectomy. Because of obesity, abnormal cervical spine mobility and fragile teeth, in addition to the risk of mandibular and facial fractures, general anesthesia including airway management was considered to be difficult and, thus, avoided. ⋯ Although technical difficulty was expected with the blocks as well, epidural and spinal blocks were successfully performed using image intensifier. Neuraxial blocks for patients with skeletal abnormalities in the lumbar spine such as OI have been considered as relative contraindication. However, as described in this case report, these patients, in whom general anesthesia should be avoided, can benefit from neuraxial blocks with the help of image intensifier.
-
Fiberoptic bronchoscope (FOB)-guided intubation is an important and useful technique for unanticipated difficult airway in anesthetized patients. However, many staff anesthesiologists seemed to find it difficult to perform. We speculated that it was because they had not been well trained in the technique. We worked out an easy method for FOB-guided intubation. We had our residents try our method and measured the elapsed time in introducing FOB from the mouth to the tracheal carina. ⋯ We showed that our method helped anesthesiologists to master FOB-guided intubation.