Masui. The Japanese journal of anesthesiology
-
The i-gel is a rescue device for ventilation or tracheal intubation in patients with a difficult airway. The aim of this study was to evaluate the safety and reliability of fiberoptic-guided intubation through the i-gel in anesthetized patients with no history of difficult intubation undergoing elective surgery. ⋯ Fiberoptic-guided intubation could be performed safely through the i-gel. The i-gel is considered to be potentially useful as an alternative conduit for fiberoptic-guided intubation.
-
The primary purpose of this study was to investigate the degree of neck swelling by accumulation of irrigation fluid during shoulder arthroscopy in the beach-chair position. ⋯ Pre- and postoperative measurement of the neck circumference might be an easy and useful measure for prediction of postoperative airway obstruction.
-
We report a successful awake tracheal intubation in an emergency patient with acute exacerbation of aortic stenosis using the Pentax-AWS Airwayscope (AWS). An 83-year-old woman was admitted to our emergency department for severe dyspnea due to exacerbation of aortic stenosis. Her Sp(O2) was 92-93% even after administration of 10 l x min(-1) oxygen through a reservoir-attached face mask. ⋯ The AWS allowed for visualization of the glottis and safe placement of the tracheal tube. Sufficient spontaneous ventilation was maintained during interventions with minimum vital sign changes. Awake intubation in the sitting position with the AWS may be helpful in resolving cardiovascular crisis in patients unable to maintain the supine position.
-
We report on the development of a simulation-based sedation training course (SEDTC). Participants were doctors and medical staff, such as operating room nurses. During the course, we identified issues that medical staff confront in the operating room (OR). ⋯ At the end of the course, participants discussed problems associated with sedation and provided input regarding sedation safety. Participants commented not only on changes in their views regarding sedation, but also on general medical safety in the OR. Our findings suggest that the SEDTC may serve as a vehicle to promote safety with respect to sedation and analgesia.
-
Case Reports
[Awake intubation with landiolol and dexmedetomidine in a patient with anxiety neurosis].
We report a successful case of awake intubation in a patient with anxiety neurosis via continuous administration of landiolol and dexmedetomidine. A 52-year-old woman weighing 46.8 kg with anxiety neurosis experienced postoperative bleeding after left-side thyroidectomy and was scheduled for emergent hemostasis under general anesthesia Due to swelling of the neck, we anticipated a difficult airway and decided to perform awake intubation. ⋯ After 10 minutes, her shivering disappeared, and she agreed to undergo awake intubation, which was performed with the Pentax-AWS Airwayscope and thin Intlock blade. The patient bucked slightly during intubation but hemodynamic changes were minimal.