Masui. The Japanese journal of anesthesiology
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In the mid 18th century, Monro, Kite, and others stared to perform tracheal intubation during cardiopul- monary resuscitation. In 1790's, it was found that tra- cheal intubation using Kite's device and method was technically difficult and, because of the design of the tube, an inserted tube might frequently obstruct the airway. ⋯ In addition, Leroy invented a device to facilitate tracheal intubation. Despite these efforts, tracheal intubation during cardiopulmonary resuscitation was abandoned afterwards because of "unexpected" reasons.
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Fibrinogen replacement therapy con- tributes to effective hemostasis and saving blood trans- fusions in critical hemorrhage. We retrospectively studied the efficacy and indication for cryoprecipitate or fibrinogen concentrate in thoracic aortic surgery. ⋯ The fibrinogen amount of 2-3 g (per 50-70 kg in body weight) in cryoprecipitate or fibrino- gen concentrate effectively reduces postoperative bleeding and perioperative blood transfusions when a fibrinogen level is less than 100-130 mg · dl⁻¹ during cardiopulmonary bypass.
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Regional anesthesia for lower limb surgery not only provides satisfactory analgesia, but also improves the overall postoperative outcome with less postoperative nausea and vomiting by decreasing the opioid con- sumption, encouraging early postoperative mobility. Therefore, high-quality anesthesia and postoperative analgesia accelerate the rehabilitation process and shorten the hospital stay. ⋯ In the decades to come, we hope to obtain more established evidence supporting the utility of ultra- sound-guided techniques for lower extremity nerve blocks based on high-quality clinical studies. These findings may support the development of sustained- release formulation local anesthetics and new devices or techniques in the future.
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Historical Article
[History of Resuscitation: 2. Development of Resuscitation in the Mid-18 Century-2 : Background of Development of Resuscitation and Rescue Methods].
In the mid-18th century, a growing number of peo- ple started to attempt resuscitation of "apparently dead" people as a result of drowning or other causes. In this article, I describe the background for this movement (which was likely to be related to a fear of being buried alive and of being dissected alive). I also describe a historical development of rescue methods of drowned people.
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With recent changes in surgical procedures and perioperative management, there has been a growing interest in peripheral nerve blocks of the trunk in patients undergoing thoracic and breast surgery. Tho- racic truncal blocks include paravertebral, pecs, intercostal, and retrolaminar blocks. Previous studies have demonstrated that paravertebral block provides similar analgesic effects and better hemodynamic stability compared with epidural analgesia. ⋯ The novel ultrasound-guided techniques for intercostal nerve blocks have also been reported. Although some case series support that these pecs and intercostal nerve blocks appear to be safe and effective, prospective randomized studies to confirm their clinical usefulness are lacking. Whether to con- duct these thoracic truncal blocks or not will become a standard clinical practice for thoracic and breast sur- gery is yet to be determined.