Masui. The Japanese journal of anesthesiology
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We hypothesized that pre-operative BNP levels predict postoperative morbidity and mortality in patients undergoing non-emergent cardiac surgery. ⋯ Preoperative BNP predicted postoperative morbidity and mortality.
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A 12-year-old male patient with Coffin-Lowry syndrome was scheduled for posterior cervical decompression and fusion for cervical spinal injuries. The patient had features of Coffin-Lowry syndrome including mental retardation, prominent forehead, a short nose with a wide tip, a wide mouth with full lips, short stature, microcephaly, and kyphoscoliosis. We anticipated major troubles related to anesthesia such as difficult ventilation and intubation, communication difficulty during induction and extubation, and difficulty in using a naso-pharyngeal airway. ⋯ When the surgery was completed, we extubated using a tube introducer in the trachea. As we found that the patient's airway was open, we removed the introducer. In conclusion, with a thorough planning of the anesthetic management, we successfully managed anesthesia for cervical spinal surgery in a patient with Coffin-Lowry syndrome.
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Comparative Study
[Intraoperative body temperature changes and short-term outcomes of open and minimally invasive esophagectomy].
Esophagectomy is a highly invasive procedure, and recently the use of minimally invasive esophagectomy (MIE) via thoracoscopy and laparoscopy increased, since this technique possibly enhances the recovery and outcomes of the patient compared with open esophagectomy (OE). However there is little data about intraoperative changes in body temperature during OE and MIE. ⋯ Our study showed that the intraoperative temperature during MIE tended to decrease compared with OE, but the short-term outcomes were comparable.
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A 40-year-old man was scheduled for video assisted thoracoscopic surgery due to pneumothorax. He had been diagnosed with inclusion body myositis and received nocturnal non-invasive positive pressure ventilation. Anesthesia was induced with propofol, remifentanil, and rocuronium, and maintained with propofol, remifentanil and fentanyl. ⋯ Rocuronium 10 mg was administered in this case and we thought it could be antagonized by neostigmine, but extubation on the day of operation was impossible. We think this is not because of the residual effect of muscle relaxant, but because of decreases in pulmonary function. In this case, we expected long-term mechanical ventilation might be necessary, but he showed a good postoperative course owing to minimally invasive surgery, NPPV, and suctioning of sputum via Minitrach.