Masui. The Japanese journal of anesthesiology
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We present a case of an 18-year-old male who underwent strabismus operation under general anesthesia. In his childhood, tracheostomy had been performed for the repair of cleft lip and palate. ⋯ Following insertion of air-Q®, trachea was intubated via air-Q® guided with fiberscope. The patient was ventilated via tracheal tube with the air-Q® remaining in place during the operation. air-Q® can be effectively utilized for airway management for an adult Apert syndrome patient
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A 51-year-old women with cardiac dysfunction due to catecholamine-induced cardiomyopathy underwent laparoscopic adrenalectomy for pheochromocytoma. Her preoperative cardiac status was New York Heart Association (NYHA) class IIand left ventricular ejection fraction (LVEF) was 45%. ⋯ The operation was completed successfully and postoperative course was almost uneventful. As laparoscopic pheochromocytoma resection is accomplished in a brief period with less surgical invasion compared with laparotomy, it may be possible to manage hemodynamics of the patient with cardiac dysfunction properly under dynamic monitoring using FloTrac® system.
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In recent years, the aging population has been growing, and the operative techniques and anesthetic methods have advanced. With these developments and medical support, the number of operations on very elderly patients has been increasing. ⋯ During the perioperative period, the patient developed delirium that was difficult to manage, but he was discharged from the hospital without any complications on POD 21. As part of the perioperative management, intraoperative cerebral circulatory management with attention to cerebral perfusion and prevention of postoperative delirium is crucial.
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Case Reports
[Intraoperative acute airway obstruction due to the damage of a reinforced endotracheal tube in thyroidectomy].
A 55-year-old woman was scheduled for left thyroidectomy. Anesthesia was induced without problems and maintained without nitrous oxide. Sixteen minutes after the start of the procedure, airway pressures and endtidal carbon dioxide concentration increased suddenly. ⋯ Similar phenomenon was reported in the reuse of endotracheal tube and the use of nitrous oxide. In our case, airway obstruction was caused by the pinhole that was created in a manufacturing process. We have to keep in mind that endotracheal tube itself may be out of order if other causes have been excluded.