Masui. The Japanese journal of anesthesiology
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Biography Historical Article
[New study on the history of anesthesiology (2)--who is the first Japanese to write a scientific paper for the journal "Anesthesiology"?].
The beginning of modern anesthesiology in Japan dates back to 1950 when Dr M. Saklad of Rhode Island Hospital came to Japan to give his lectures on endotracheal anesthesia and related procedures. Since then, many Japanese surgeons visited the United States to learn anesthesiology in depth and they began to write their papers for foreign journals. ⋯ The first paper based on studies performed in Japan by Japanese authors appeared in 1956. It was entitled as "The spread of drugs used for spinal anesthesia" by Kitahara et al. This paper is the English translation of their Japanese paper which appeared in Nippon Rinsho Geka Ikai Zasshi entitled as "Basic Study on Spinal Anesthesia in 1953".
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Hypertrophied lingual tonsils are rare, but may cause difficulty or inability in tracheal intubation during induction of general anesthesia. A 39-yr-old woman was scheduled for resection of symptomatic hypertrophied lingual tonsils. ⋯ However, transnasal fiberoscopic monitoring could guide the orotracheal fiber into the trachea for intubation. When an anesthesiologist can predict the abnormality of lingual tonsils, this combination might be recommended for difficult airway and intubation.
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We report three cases in which the target-controlled propofol infusion technique was used in obese patients for general anesthesia. General anesthesia was induced by intravenous administration of fentanyl 150-300 micrograms and ketamine 50-80 mg and propofol 2 micrograms.ml-1 to achieve a target blood concentration by target-controlled infusion system. ⋯ The estimated blood concentrations of propofol at emergence from anesthesia calculated by ConGrace ranged from 1.49-1.69 micrograms.ml-1, and it took 230-300 seconds to emerge from anesthesia. The target-controlled propofol infusion technique appears useful to control the depth of anesthesia in obese patients.
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Comparative Study Clinical Trial
[A comparison of bullard laryngoscope and intubating laryngeal mask using fiberoptic guidance for tracheal intubation].
The purpose of this study is to compare the success rate of tracheal intubation, intubation time and laryngoscopic view of the larynx by Bullard laryngoscope or by intubating laryngeal mask using fiberoptic guidance in 50 patients. Following a standardized induction protocol, conventional laryngoscopic view by Macintosh's laryngoscope was obtained and classified by Cormack's grades. We measured the times from incertion of laryngoscopy or laryngeal mask until obtaining the best view of the larynx and until tracheal intubation. ⋯ The success rate of tracheal intubation was higher by Bullard laryngoscopy than by intubating laryngeal mask. The durations of laryngoscopy and tracheal intubation were significantly shorter and Cormack's grades were significantly lower by Bullard laryngoscopy than by laryngeal mask and fiberscopy. These results demonstrate that tracheal intubation by Bullard laryngoscope is faster and more successful compared with intubating laryngeal mask using fiberoptic guidance.
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Case Reports
[Combined intercostal nerve block and epidural anesthesia in a patient with severe aortitis syndrome].
A 74-year-old woman with aortitis syndrome was scheduled for mastectomy. Her left vertebral artery was totally occluded and left carotid arteries, left subclavia artery and bilateral common renal arteries were occluded. For anesthesia a catheter was inserted into the epidural space between T3 and T4. ⋯ Epidural anesthesia alone might be sufficient for anesthesia if higher concentration of local anesthetic was used. However, to avoid hemodynamic change, we used 1% lidocaine and added intercostal nerve block. We conclude that combined intercostal nerve block and epidural anesthesia was useful for a patient with severe aortitis syndrome in oder to monitor consciousness to detect cerebral ischemia and to avoid hemodynamic instability.