Masui. The Japanese journal of anesthesiology
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The treatment of chronic pain, whether of cancer or noncancer origin, frequently involves the use of opioids. Delay in GI transit and constipation are the most common and often disabling side effects of opioid analgesics. ⋯ This goal is currently addressed by the use of opioid receptor antagonists with limited absorption such as oral naloxone and by the development of peripheral opioid receptor antagonists such as methylnaltrexone and alvimopan. These drugs hold considerable promise in preventing constipation due to treatments with opioids, whereas the analgesic action of opioids remains unabated.
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Comparative Study
[The KINGVISION: clinical assessment of performance in 50 patients].
The aim of this study was to evaluate the suitability of the KINGVISION videolaryngoscope for tracheal intubation. ⋯ The KINGVISION could be an effective aid to airway management in surgical patients.
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A 46-year-old man was diagnosed with descending colon cancer and was planned to undergo left hemicolectomy under general anesthesia. His body mass index was 42.6 and due to his small mouth and jaw, we anticipated difficult mask ventilation and tracheal intubation. ⋯ Then, we replaced the air-Q with an outside diameter 8.5 mm tracheal tube. This case was a successful use of the air-Q under moderate sedation for airway management in the setting of anticipated difficult mask ventilation and tracheal intubation.
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The Pentax-AWS equipped with a new thinner blade (Introck-T) is an intubation device that provides a non-line-of sight view of the glottis. A non-line-of sight view is expected to cause less movement of the cervical spine during laryngeal visualization. We measured the degree of cervical spine movement during laryngoscopy with the device. ⋯ Laryngeal visualization using the Pentax-AWS with the new thinner Introck-T produces the anterior movement and extension of the cervical spine.
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Case Reports
[A case of late drug-eluting stent thrombosis during postoperative period after 5 years of stent implantation].
Stent thrombosis during perioperative period is a critical complication for patients treated with drug-eluting stent (DES). We experienced a case of late DES thrombosis 5 years after initial implantation. A 48-year-old man with familial hyperlipidemia, angina pectoris and chronic pulmonary emphysema, was diagnosed with esophageal carcinoma, and scheduled for esophagectomy. ⋯ Emergent coronary angiography revealed re-stenosis of the right coronary artery treated with DES 5 years ago. At present, there was no definite guideline, on the management of DES during perioperative period. It is important for us to decide continuing antiplatelet therapy balancing the risk of stent thrombosis with surgical bleeding in each patient.