Masui. The Japanese journal of anesthesiology
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Meta Analysis
[Efficacy of videolaryngoscopes for nasotracheal intubation: a meta-analysis of randomized controlled trials].
Increased evidence indicates that the videolaryngoscope is useful for nasotracheal intubation. The aim of this meta-analysis is to assess the efficacy of videolaryngoscopes (Glidescope, Airtraq and Pentax-AWS) in nasotracheal intubations, comparing with that of Macintosh laryngoscopy. ⋯ Our meta-analysis showed that the videolaryngoscope has an advantage over Macintosh laryngoscope in nasotracheal intubations.
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In Japan, the number of patients with chronic kidney disease (CKD) has increased. Hence, the opportunities for intensive care management of patients with CKD have also increased. Acute kidney injury (AKI) easily develops following CKD, and conversely, it can be a risk factor for CKD. ⋯ While "goal-directed" hemodynamic management, which targets particular hemodynamic variables, might be useful in CKD patients, there is no evidence to prove its efficacy. Renal Replacement Therapy (RRT) is usually started after metabolic acidosis, hyperkalemia, ingestion of dialyzable toxin, volume overload and uremia have occurred. However, it is not clear whether continuous or intermittent RRT is beneficial in these patients.
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Case Reports
[Anesthetic management of emergency cesarean section in a patient with acquired von Willebrand syndrome].
Acquired von Willebrand syndrome (AvWS) is generic name of bleeding disorders caused by acquired decrease of von Willebrand factor. A 25-year-old woman with AvWS underwent emergent cesarean section under combined spinal and epidural anesthesia. Before operation, her APTT was within normal ranges. ⋯ Epidural catheter was removed just after administration of factor VIII concentrate 3 days after operation. The perioperative course was uneventful and the patient was discharged 11 days after the operation. It is important to co-operate with other related departments in managing the perioperative coagulation status in a patient with AvWS.
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A 63-year-man with lung cancer underwent right upper lobectomy under general anesthesia combined with thoracic epidural anesthesia. The surgical course was uneventfully completed. On the second postoperative day, he developed complete paralysis below T4 level 1 hour after removal of the epidural catheter. ⋯ Surgical removal of hematoma was scheduled. However, his neurological condition improved rapidly within a couple of hours, and the surgery was not carried out. The time course of recovery from complete paralysis suggests that extradural hematoma diffused into the extradural space, resulting in a decrease in the epidural pressure.
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In an animal model, neonatal exposure to sevoflurane induces neuroapoptosis, leading to memory deficits in adulthood. A recent study showed that resveratrol (20 mg x kg(-1)) prevent alcohol-induced cognitive deficits and neural apotosis in rat pups postnatally exposed to ethanol. We investigated if resveratorol prevent sevoflurane induced neuroapotosis. ⋯ Resveratrol did not prevent sevoflurane-induced neuroapoptosis in the neonatal mice brain.