Masui. The Japanese journal of anesthesiology
-
The evaluation of the lung has usually been considered off-limits for ultrasound, because ultrasound energy is rapidly dissipated by air. Lung ultrasound is not useful for the evaluation of the pulmonary parenchyma and the pleural line. However ultrasound machines have become more portable, with decreased start-up time, while simultaneously providing improved image quality and ease of image acquisition. ⋯ Since lung ultrasound abnormalities, however, are well defined and easy to recognize, learn and reproduce, operator dependence is minimal. So let's try lung ultrasound. In this article, the author will discuss the examination method for adequate lung ultrasonographic images, lung ultrasonographic findings and signs, leading to the diagnosis.
-
Comparative Study
[Anesthetic management for cesarean section involving placenta previa].
There are few consistent anesthetic guidelines how to manage cesarean section in the presence of placenta previa. Main problem may be hemorrhage, as occasionary unexpected massive bleeding leads to life-threatening hemorrhage. ⋯ These results indicate that regional and general anesthesia did not differ in the intraoperative incidence. In all cases at least two anesthesiologists and at least two venous lines are necessary to manage cesarean section in the presence of placenta previa.
-
Point-of-care ultrasonography has become widely used in diagnosis and managements of patients. In the field of anesthesiology, ultrasound guided nerve blocks and central venous catheterization (CVC), and transesophageal echocardiography (TEE) have become popular. Now, ultrasound devices are familiar to anesthesiologists. ⋯ Because of less invasive technique, whole body ultrasound evaluation is suitable to use when anesthesiologists may have questions whether the patient's condition is good or not. No doubt that point-of-care ultrasonography by anesthesiologists themselves in pre-anesthesia. clinic can be the useful decision making tool of anesthesia plan. To be tomorrow's anesthesiologists, please start point-of-care pre-anesthetic ultrasonographic assessment.
-
A 58-year-old woman underwent oophorectomy for an ovarian tumor. Anesthesia was maintained with epidural block, and propofol and fentanyl anesthesia using a laryngeal mask airway. After the operation, she complained of hoarseness and difficulty in swallowing. ⋯ The condition returned to normal two months after the operation. We have to have in mind that vocal cord palsy may occur even if we use a laryngeal mask airway. At least we have to pay attention to intra-cuff pressures and the position of the laryngeal mask airway.
-
Case Reports
[Successful nasal intubation using airway scope with gum elastic bougie in a case of difficult airway].
AWS (Airway Scope, Pentax, Tokyo), a new videolaryngoscope, was originally designed to facilitate oral laryngoscopy and tracheal intubation. We describe a successful case of nasal intubation with a combination of AWS and GEB (gum elastic bougie). A 50-year-old man with a past history of difficult intubation was scheduled to undergo subtotal esophagectomy. ⋯ Oral insertion of AWS showed full view of the glottis and nasal insertion of GEB was easily advanced into the trachea through an endotracheal tube, allowing tracheal intubation while utilizing GEB as a stylet. No complication occured in this case. In conclusion, nasal intubation using AWS combination with GEB is useful for patients with difficult airways and is easy to perform.