Aggressive Wound Care by a Multidisciplinary Team Improves Wound Healing after Infrainguinal Bypass in Patients with Critical Limb Ischemia.

Background: A long period is generally required for ischemic ulcer to heal after revascularization. The strategy of postoperative wound care can affect wound healing. This study was conducted to investigate the degree to which aggressive wound care (AWC) by a team of multidisciplinary specialists actually shortens the time to wound healing and increases the rate of wound healing in limbs undergoing surgical bypass for ischemic tissue loss in a real clinical setting.

[Efficacy of bougie in difficult intubation with the Airway Scope caused by inability to lift the epiglottis directly].

Background: There are some disadvantages of the Airway Scope (AWS), and the most crucial one is that the AWS has only one fixed-size AWS blade. When the blade is too short to reach beneath the epiglottis and to lift it directly, an endotracheal tube hits the epiglottis and cannot be advanced into the glottic aperture even when it is visible. A bougie may solve this difficulty because its angulated tip can be controlled in a desired direction.

[Electrical infusion pumps for postoperative epidural analgesia].

Two types of new electrical infusion pumps (pump) scheduled to be introduced to the Japanese market in this autumn, were featured focusing on patient controlled analgesia (PCA). For the successful introduction of PCA pumps into clinical practice, initial investments including both finance and manpower may be required. The clinical application of these PCA pumps should benefit both patients and medical staffs and gain more than the initial investment eventually.

Postoperative management using intensive patient-controlled epidural analgesia and early rehabilitation after an esophagectomy.

Purpose: Patient-controlled epidural analgesia (PCEA) was developed for use after surgery for thoracic esophageal cancer to relieve wound pain, introduce early rehabilitation, and provide an uneventful postoperative recovery.

Methods: This retrospective study investigated 22 patients who underwent esophageal surgery to determine the efficacy of postoperative management with PCEA. In the PCEA group (n = 12), patients had two epidural catheters inserted to cover both the thoracic and abdominal incision with a patient-controlled bolus capability.

Approach combining the airway scope and the bougie for minimizing movement of the cervical spine during endotracheal intubation.

Background: The Airway Scope (AWS, AWS-S100; Hoya-Pentax, Tokyo, Japan), a recently introduced video laryngoscope, has been reported to reduce movement of the cervical spine during intubation attempts in comparison with conventional laryngoscopes. Use of the bougie as an aid for the AWS may cause further reduction. The authors compared cervical spine movement during intubation with the AWS with and without a bougie.

Combination of Airway Scope and bougie for a full-stomach patient with difficult intubation caused by unanticipated anatomical factors and cricoid pressure.

The Airway Scope, one of the newest video-laryngoscopes, provides an excellent view of the larynx on a built-in monitor screen. Difficulty in introducing an endotracheal tube into the laryngeal aperture may occur, even though the aperture is visible. The bougie may solve this difficulty because its angulated tip can be controlled in a desired direction.

The sniffing position provides greater occipito-atlanto-axial angulation than simple head extension: a radiological study.

Purpose: While the anatomic sniffing position has traditionally been considered the standard head and neck position for laryngoscopy, recent evidence suggests that the sniffing position provides no significant advantage over simple head extension. To establish if the sniffing position provides an anatomic advantage, we compared the occipito-atlanto-axial extension angle, a key determinant for obtaining a good laryngeal view during laryngoscopy, in simple head extension and sniffing positions.

Methods: Thirty volunteers with normal cervical spines were studied.

[Electrical infusion pump for patient-controlled analgesia].

Electrical infusion pumps (pump) were featured with the focus on patient-controlled analgesia (PCA). The specification and functional aspects of four types of PCA pumps were briefly summarized and listed in two tables. The clinical application of these PCA pumps should benefit both patients and medical staffs.

Preoperative evaluation of extension capacity of the occipitoatlantoaxial complex in patients with rheumatoid arthritis: comparison between the Bellhouse test and a new method, hyomental distance ratio.

Background: The authors devised a new method, the hyomental distance ratio (HMDR), for preoperatively identifying patients with a reduced occipitoatlantoaxial extension capacity, which was defined as the ratio of the hyomental distance in head extension position to that in the neutral position. They compared the accuracy of the HMDR with that of the Bellhouse test in 40 patients with rheumatoid arthritis.

Methods: Each patient wearing goggles on which a goniometer was mounted sat upright with the head in the neutral position and then extended the head maximally.

[Anesthetic management for a patient with remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome].

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome, described by McCarty et al., is a form of "seronegative rheumatoid arthritis" characterized by an acute-onset polyarthritis with pitting edema of the dorsum of both hands and/or both feet. The syndrome is prevalent in elderly men, completely remitted with a small dose of steroid over a relatively short period, and has a benign clinical course.