International journal of clinical and experimental medicine
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A 64-yr-old man was admitted because of repeated pneumonia. Both fiberoptic bronchoscopy and esophagoscopy revealed a large tracheoesophageal fistula (15 mm) in the right posterior trachea 1 cm beyond the carina. ⋯ We took advantage of laryngeal mask airway to insert the fiberoptic bronchoscope to guide the stent placement. Our method of sealing a large tracheoesophageal fistula with LMA under total intravenous anesthesia was successful.
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Many scholars are seeking for an anesthesia induction regimen to meet the requirements of both intubation and instant recovery of spontaneous breathing in case of "cannot intubate, cannot ventilate" to prevent severe consequences. This study aims to investigate whether the combination use of remifentanil 1 μg/kg and small dose of succinylcholine (0.6 mg/kg) is superior to single use of remifentanil 1.5 μg/kg in improving intubation conditions and shortening apnea time under anesthesia induction with propofol. ⋯ Compared with single use of remifentanil 1.5 μg/kg, the combination use of remifentanil 1 μg/kg and succinylcholine 0.6 mg/kg may offer better intubation conditions and may not prolong apnea time under anesthesia induction with propofol 2 mg/kg.
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Continuous spinal anesthesia may provide excellent labor analgesia. The incidence of accidental intrathecal injection of megadose of ropivacaine, as one of the possible complications during cesarean section, is very rare. Present case report provides reference to clinical practice.
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There is no generally accepted treatment strategy for cervical esophageal carcinoma. The purpose of this study was to evaluate the operative outcomes of reconstruction after resection of cervical esophageal and hypopharynx-esophagus junction carcinoma with larynx preservation. ⋯ Surgical resection of cervical esophageal carcinoma and laryngeal preservation is possible. Complete esophagectomy should be performed when the resection extends below the thoracic inlet. The reconstruction methods we performed were safe and effective for the immediate restoration of alimentary continuity after resection of cervical esophageal and pharyngo-cervical esophageal carcinoma; and the patients with PMF/CWSG reconstruction had a better survival than those with GP or CI reconstruction. Combined with radiotherapy, the resectability rate and survival rate of cervical esophageal carcinoma can be improved.
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It is controversial that whether the GABA receptors contribute to the hypnotic action of volatile anesthetics. This study was to detect the effect of GABA receptors on the hypnotic action of volatile anesthetics by evaluation of the effect of intravenous flumazenil on sevoflurane minimum alveolar anesthetic concentration-awake (MAC-Awake) and emergence mental status. ⋯ We found that an IV flumazenil (0.006 mg/Kg) has no effect on sevoflurane MAC-Awake in humans. A single intravenous injection of flumazenil (0.006 mg/Kg) can partially reverse the hypnotic effect of sevoflurane/sulfentanil but do not contribute to reduction in the time to recovery and extubation.