Masui. The Japanese journal of anesthesiology
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A 21-day-old female neonate weighing 3.2 kg was scheduled for surgical excision of a maxillary tumor under general anesthesia. The lesion was present since birth, with gradual enlargement since then. Preoperatively, the lesion measured 25 mm in diameter, although it was not known whether it was benign or malignant. ⋯ The surgical procedure lasted for 27 minutes and at the end of the surgery we successfully intubated the patient's trachea with a spiral tube using a guide wire and bronchofiber. After adequate blood transfusion to restore the patient's blood volume, a nasogastric tube was inserted and the patient was extubated in a fully awake state with establishment of adequate spontaneous breathing. Postoperatively, histopathologic examination revealed that the tumor was a jawbone medullary hemangioma.
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It has been reported that multiple puncture more than or equal to 3 times is a factor associated with the development of CVC-related complications. The present retrospective study was undertaken to evaluate the predictors and risks of multiple puncture during the insertion of CVC. ⋯ The results of the study indicate that the age less than 6 years is a significant predictor for multiple puncture during the CVC insertion.
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We report a case of 30-second cardiac arrest that occurred during carotid body tumor resection due to the carotid sinus reflex. The patient was a 20-year-old man diagnosed with a carotid body tumor and scheduled for tumor resection. General anesthesia was induced and maintained with target controlled infusion of propofol. ⋯ Surgery was resumed after placing a temporary pacemaker through the left subclavian vein. The surgery was successfully performed without any other bradycardia complications, and the patient recovered from general anesthesia without sequelae. Thus, the findings indicate the importance of considering the pacemaker placement before carotid body tumor resection.
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The WHO Surgical Safety Checklist was published in 2008 as an attempt to decrease complications and death from surgery. This checklist was implemented and evaluated using questionnaires in an intermediate size general hospital. We attempted to confirm how the WHO checklist has been implemented and assessed as a medical safety system. ⋯ According to our questionnaires, after the adoption of our checklist, which amended the WHO Surgical Safety Checklist, positive evaluation increased significantly after one year, compared with evaluation immediately following implementation. At least one year was required for the checklist to be favorably received by anesthesiologists, surgeons and operating room nurses. We anticipate that the WHO Surgical Safety Checklist, amended to meet the circumstances of individual facilities, will be effectively implemented and firmly established.
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Case Reports
[Use of Airwayscope with pediatric intlock in a patient with first and second branchial arch syndrome].
First and second branchial arch syndrome is a congenital anomaly of craniofacial dysplasia involving organs derived from the second branchial arch. The main characteristics are microtia and mandibular hypoplasia. A 6-year-old boy was scheduled for adenoidectomy and bilateral myringotomy and tube placement. ⋯ Control of the bronchoscope consequently became easy We successfully guided it to his glottis and performed tracheal intubation. His condition was stable during the procedure. In conclusion, we safely performed tracheal intubation in a patient with first and second branchial arch syndrome using the AWS and a fiberoptic bronchoscope.