Masui. The Japanese journal of anesthesiology
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The present study was designed to evaluate the postoperative values such as body temperature (BT), white blood cells (WBC), P/F ratio and C-reactive protein (CRP) associated with propofol or sevoflurane in patients undergoing thoracic surgery with one-lung ventilation. ⋯ Propofol and sevoflurane had similar effect on BT, WBC, P/F ratio and CRP in patients undergoing thoracic surgery with one-lung ventilation.
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A 20-year-old man diagnosed as idiopathic scoliosis with Cobb angle 146 degrees was scheduled for two-stage operations. Anterior dissection of the thoracic vertebra in the left lateral decubitus position, and the placement of pedicle screws in the prone position were performed as the first-stage operation. ⋯ In the second operation for posterior spinal fusion, the occurrence of liver contusion was prevented by performing abdominal ultrasonography before and after surgery, and monitoring AST/ALT during anesthesia as the indicators of liver contusion. Intraoperative management for organ protection is required during anesthesia in patients with idiopathic scoliosis associated with thoracic deformity.
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Accidental puncture of a vertebral artery can occur through the internal jugular vein during central venous catheterization. ⋯ It is important to identify the location of vertebral arteries under the level of cricoid cartilage and avoid the tap toward the lateral side. We can avoid accidental puncture of vertebral artery by taking care of these points.
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Case Reports
[Difficult Airway Management of a Patient with the Ossification of Anterior Longitudinal Ligament].
We report a case of difficult airway management (DAM) with the ossification of anterior longitudinal ligament (OALL). A 66-year-old man complained of pharyngeal discomfort. ⋯ We expected DAM due to the limitation of cervical mobility and airway obstruction caused by OALL. We succeeded in awake intubation with video laryngoscope and tracheal tube introducer.
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With the advance of diagnosis and therapeutic management for congenital heart disease, increasing numbers of the non-cardiac surgery were performed on patients with post-cardiac surgery, such as the radical operations and Fontan operation. However, there are adult patients who have not received Fontan operation lacking indication. We experienced a case of adult surgical patient for laparoscopic cholecystectomy complicated with tricuspid atresia who was not indicated for Fontan surgery. ⋯ To reduce the influence of intraabdominal pressue on hemodynamics, the insufflations pressure was maintained at 8 mmHg during pneumoperitoneum. To assist ventricular function, dopamine and carperitide were administered perioperatively. We should carefully manage such a patient during perioperative period by understanding the hemodynamic state and considering the influence of pneumoperitoneum and posture.