Masui. The Japanese journal of anesthesiology
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A 58 year-old male was scheduled for surgery of his hepatic cancer. Tumor invaded to the right atrium through the inferior vena cava. The operative method of removing the tumor in the right atrium was scheduled under extracorporeal circulation after the left lobe hepatectomy. ⋯ Due to massive blood loss during hepatectomy, the capacity in the right atrium decreased and the tumor was often about to engage the tricuspid valve. After the rapid fluid therapy, the right atrium capacity increased preventing the engagement of the tumor. TEE was useful not only to observe the movement of the tumor in the right atrium but also to monitor the circulating blood volume.
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We modified the technique for laryngeal mask airway (LMA) insertion in children. This modification involves inserting a two-thirds inflated LMA with its lumen facing laterally toward left and then rotating it 90 degrees clockwise as it passes downwards into position behind the larynx. Then the cuff is inflated fully. ⋯ There were no significant differences in vital signs between pre- and post-insertion. Only one child was found to have attachment of blood clots on the surface of the removed LMA. We conclude that our technique would be one recommended method in pediatric practice.
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We report anesthetic experience of two patients suffering from polymyositis. The first case is a 56 year old woman who underwent tympanoplasty for cholesteatoma of the middle ear. Anesthesia was induced with thiopental and deepened with oxygen-nitrous oxide and sevoflurane. ⋯ Concerning the anesthetic management of a patient with polymyositis, there are some informations on the appropriate use of muscle relaxants. It is generally believed that the patient is sensitive to nondepolarizing muscle relaxants and the use of antagonist drug (reversal) may cause muscle weakness, severe dysrhythmia, et al. Therefore we think it is appropriate to manage such a patient without muscle relaxants.