Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Clinical Trial
[Influence of preanesthetic medication on the effect of a local anesthetic tape].
We investigated the influence of preanesthetic medication on the pain relieving effect of the lidocaine tape during needle insertion for venous cannulation. Ninety patients scheduled for elective surgery were randomly divided into three groups of 30 each; patients without preanesthetic medication (group N), patients who received 0.1 mg.kg-1 of diazepam (group D) and 5 micrograms.kg-1 of clonidine (group C) as a preanesthetic medication. ⋯ No significant difference of the pain score was seen between the groups. We concluded that the effect of lidocaine tape was not influenced by the preanesthetic medication.
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Comparative Study
[Assessment of the practice of endotracheal intubation by levering Laryngoscope in teaching of undergraduate medical students].
Twenty-nine inexperienced medical students tried to intubate endotracheal tubes using both levering laryngoscope (McCoy laryngoscope) and Macintosh laryngoscope in adult mannikin the Cormack and Lehane Grade 2. The number of successful intubations by McCoy type was close to those by Macintosh type. ⋯ But the grade of handling difficulty of McCoy type was significantly higher than that of Macintosh type, because Macintosh type was simpler to handle than McCoy type. It was suggested that Macintosh laryngoscope was more useful than McCoy laryngoscope for teaching of inexperienced medical students.
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Femoral to radial artery pressure gradient was evaluated in 14 patients undergoing coronary artery bypass graft under normothermic cardiopulmonary bypass (CPB). CPB was instituted at a flow rate of 2.6 l.min-1.m-2, using non-pulsatile pump and blood temperature of pump arterial line was controlled to maintain bladder temperature between 36 and 37 degrees C. Pressure gradients occurred 30 min after commencement of CPB and the mean gradients of systolic, diastolic and mean artery pressure were maximum all at the end of CPB (38 +/- 7 mmHg, 4 +/- 1 mmHg and 10 +/- 2 mmHg). ⋯ Throughout the operation, nasopharyngeal and blood temperature remained unchanged, while mean palm temperature increased from 31.8 degrees C (after induction) to 34.6 degrees C (30 min after commencement of CPB) and thereafter remained between 33.3 and 33.9 degrees C. This increase in peripheral temperature might indicate that normothermic CPB was accompanied by peripheral vasodilatation. These results indicate that the magnitude of femoral to radial pressure gradient during normothermic CPB is similar to that during mild hypothermic CPB.
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We experienced the anesthetic management for two patients with congenital tracheomalacia. Inhaled anesthetics are considered to worsen the respiratory condition of tracheomalacia because of its bronchodilating effect. ⋯ Inhaled anesthetics have possibility of worsening the degree of tracheomalacia and have been used very carefully. However, we considered that slow induction with inhaled anesthetics in children with congenital tracheomalacia is a safe and necessary technique, under careful observation of respiratory conditions.
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We experienced three cases of successful balloon catheter dilatation for bronchial stenosis under general anesthesia. There was no problem for two patients, but the third patient planned for stent insertion had bronchiomediastinal fistula. This procedure is generally performed under local anesthesia but more safely done under general anesthesia with muscle relaxants considering operative failure by bucking, pain of patients and prolonged procedure.