Masui. The Japanese journal of anesthesiology
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General anesthesia was successfully performed in an 86-year-old woman with severe tracheobronchomalacia Tracheobronchomalacia in adult is a very rare disease, characterized by weakness of the trachea and bronchi, causing luminal narrowing during expiration. The patient had laparoscopic cholecystectomy. We used propofol, remifentanil, and rocuronium for induction of anesthesia. ⋯ The patient did well, and was discharged from the hospital 3 days after the operation. In this case, no special care such as postoperative CPAP was necessary, but normally, general anesthesia for a patient with tracheobronchomalacia requires attention. We gave general anesthesia satisfactorily in a patient with tracheobronchomalacia.
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We conducted a retrospective analysis of the intraoperative lactate level and its association with patients' outcome in adult cardiac surgery patients requiring cardiopulmonary bypass. ⋯ Increased lactate concentrations after weaning from CPB were significantly and independently associated with ICU free survival days at POD 28. This finding may be important to physicians in managing patients undergoing cardiac surgery using CPB.
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Comparative Study
[Comparative study of the KingVision videolaryngoscope and Airwayscope using manikins].
KingVision (KV) is a new videolaryngoscope. In this study, we compared the ease of use of the KV with the Airwayscope (AWS) by experienced personnel in a simulated manikin. ⋯ KV may be a suitable device for routine anesthesia care and difficult airway intubation. Further studies in a clinical setting are necessary to confirm these findings.
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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.
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A 31-year-old female, with 22 weeks of pregnancy, presented with sudden onset of severe headache. CT scan showed diffuse subarachnoid hemorrhage. A cerebral angiogram showed dissecting aneurysm of right cerebral artery. ⋯ The patient underwent percutaneous tansluminalangioplasty coil and intraarterial injection of fasudil hydrochloride under local anesthesia. The consciousness recovered fully and the paralysis was improved. The patient delivered the baby by Caesarean sections under combined spinal and epidural anesthesia at 36 weeks without any problems with both the mother and baby.