Evaluation of alveolar recruitment maneuver on respiratory resistance during general anesthesia: a prospective observational study.

Background: Alveolar recruitment maneuvers enable easily reopening nonaerated lung regions via a transient elevation in transpulmonary pressure. To evaluate the effect of these maneuvers on respiratory resistance, we used an oscillatory technique during mechanical ventilation. This study was conducted to assess the effect of the alveolar recruitment maneuvers on respiratory resistance under routine anesthesia.

Factors Associated with Poor Satisfaction with Anesthesia in Patients Who Had Previous Surgery: A Retrospective Study.

Background: As most studies investigating patient satisfaction with anesthesia have some bias, previous results may underrepresent the true level of dissatisfaction with anesthesia.

Objectives: This study aimed to identify factors associated with patient satisfaction with anesthesia.

Methods: Data from patients aged ≥ 20 years who had previous surgery and were scheduled for additional surgery were obtained retrospectively through preoperative interviews conducted.

Unexpected Collection of Pulmonary Venous Blood from a Pulmonary Artery Catheter: A Case Report.

Background: Pressure and waveform at the catheter tip are continuously monitored during catheterization of pulmonary artery to ensure accurate catheter placement. We present a case in which pulmonary venous blood was unexpectedly collected from the pulmonary artery catheter despite pulmonary artery pressure and waveform detection at the catheter tip, and describe the measures taken to correct the catheter placement.

Case Presentation: A 74-year-old male underwent mitral valve plasty for cardiac failure caused by mitral valve regurgitation.

The Effects of Endotracheal Tube and i-gel® Supraglottic Airway Device on Respiratory Impedance: A Prospective Observational Study.

Background: The forced oscillation technique (FOT) is a non-invasive means of measuring respiratory resistance and reactance. We tested our hypothesis that endotracheal intubation would cause more substantial preoperative increases in FOT parameters than a supraglottic airway device (SGD).

Methods: Forty patients requiring general anesthesia and mechanical ventilation for transurethral bladder tumor resection underwent spirometry the day before surgery.

Factors Causing Post-Anesthetic High Respiratory Resistance in Patients Undergoing Transurethral Resection of Bladder Tumors.

Background: In this study, we investigated the causes of high respiratory resistance that is observed after general anesthesia. We focused on respiratory resistance at 5 Hz (R5), which were measured preoperatively and postoperatively.

Methods: Our prospective observational study enrolled 68 patients who underwent transurethral resection of bladder tumors from April to October 2015.

[A Difficult Airway after Anesthetic Induction in a Patient with Masticatory Muscle Tendon-Aponeurosis Hyperplasia].

We present a case of masticatory muscle tendon- aponeurosis hyperplasia in a patient who underwent general anesthesia for gynecologic surgery. The patient's square-shaped mandible was noticed during preoperative assessment by an anesthesiologist. Further investigation revealed masticatory muscle tendon- aponeurosis hyperplasia.

[The Effects of Tracheal Suction on Respiratory Impedance].

Background: Tracheal suctioning is performed just before extubation to remove sputum from the trachea. Although it is an invasive procedure, its adverse effect on the airway has not been investigated because this is difficult to achieve using conventional tests or monitoring. We performed a study using the forced oscillation technique to investigate whether tracheal suctioning affects respiratory impedance (consisting of respiratory resistance and respiratory reactance).

Unexpected hemorrhage during robot-assisted laparoscopic prostatectomy: a case report.

Background: Robot-assisted laparoscopic prostatectomy is increasingly performed as a minimally invasive option for patients with organ-confined prostate cancer. This technique offers several advantages over other surgical methods. However, concerns have been raised over the effects of the steep head-down tilt necessary during the procedure.

Perioperative evaluation of respiratory impedance using the forced oscillation technique: a prospective observational study.

Background: Intravascular fluid shifts, mechanical ventilation and inhalational anesthetic drugs may contribute to intraoperative lung injury. This prospective observational study measured the changes in respiratory impedance resulting from inhalational anesthesia and mechanical ventilation in adults undergoing transurethral resection of bladder tumors. The components of respiratory impedance (resistance and reactance) were measured using the forced oscillation technique (FOT).

Paraplegia caused by giant intradural herniation of a lumbar disk after combined spinal-epidural anesthesia in total hip arthroplasty.

Total paraplegia after epidural or spinal anesthesia is extremely rare. We herein report a case of total paraplegia caused by a giant intradural herniation of a lumbar disk at the L3-L4 level after total hip arthroplasty for coxarthrosis. The patient had no preoperative neurologic abnormalities.

A postoperative left ventricular-right atrial shunt due to infectious endocarditis after aortic repair with aortic valve replacement detected by transesophageal echocardiography.

Infectious endocarditis (IE) with acute heart failure is a medical emergency. In particular, postoperative IE after aortic repair with an artificial vascular graft is a life-threatening matter. We present a case in which a mobile abscess appeared on the aortic valve annulus with an intra-cardiac shunt in the left ventricle (LV) to the right atrium (RA) after ascending aortic repair with aortic valve replacement (AVR) for acute type A aortic dissection.

Sudden onset of severe pulmonary edema after emergency cesarean section.

Mitral valve stenosis (MS) associated with rheumatic disease no longer represents a major heart problem during the perinatal period in Japan. Here we present a case of acute heart failure due to MS after emergency cesarean section (CS). The patient was transferred due to the development of fetal distress at 36 weeks gestation and underwent an emergency CS under general anesthesia.

Usefulness of intraoperative transesophageal echocardiography for evaluation of circumflex coronary artery fistula with ruptured aneurysm draining into coronary sinus.

A coronary artery aneurysm (CAA) is defined as dilatation of a coronary artery to a diameter >1.5 times that of the adjoining normal coronary artery. Giant CAAs with a diameter ≥ 50 mm are quite rare.

[Postoperative Management and Cost-effectiveness of Epidural Anesthesia in Patients undergoing Abdominal Aortic Replacement Surgery].

Background: The use of epidural anesthesia for ablominal aortic replacement surgery may be problematic because of the amount of heparin used during the procedure, which places the patient at increased risk of epidural hematoma. We evaluated its benefits, risks, postoperative outcomes and costs.

Methods: We retrospectively collected data on 93 patients who underwent Y-graft infra-renal abdominal aortic replacement at our institution between 2008 and 2010.

Change in serum sodium level predicts clinical manifestations of transurethral resection syndrome: a retrospective review.

Background: Patients undergoing transurethral resection (TUR) of the prostate are at risk of TUR syndrome, generally defined as having cardiovascular and/or neurological manifestations, along with serum sodium concentrations less than or equal to 125 mmol/l. As these symptoms can also occur in patients with serum sodium greater than 125 mmol/l, this study aimed to investigate the relationship between serum sodium concentrations and neurological manifestations of TUR syndrome.

Methods: Data on patients who underwent TUR of the prostate under local anesthesia over an 8-year period were retrospectively reviewed.

Fibrin glue on an aortic cusp detected by transesophageal echocardiography after valve-sparing aortic valve replacement: a case report.

Introduction: Fibrin glue is used commonly during cardiac surgery but can behave as an intracardiac abnormal foreign body following surgery. There have been few such cases reported, and they were typically noticed only because of the resulting catastrophic cardiac conditions, such as valvular malfunction. We report a case where, for the first time, transesophageal echocardiography was used to detected fibrin glue that was adherent to the ventricular side of a patient's aortic valve immediately after aortic declamping.

Effect of differences in extubation timing on postoperative care following abdominal aortic replacement surgery: a comparison study.

Background: Abdominal aortic replacement requires an extensive incision and strict blood pressure control, making rapid extubation of the tracheal tube and pain management difficult. The effects of extubation timing on the postoperative course and medical costs in the intensive care unit (ICU) were analyzed.

Methods: Patients who underwent elective abdominal aortic replacement were evaluated retrospectively.

A Perioperative Evaluation of Respiratory Mechanics Using the Forced Oscillation Technique.

Background: The forced oscillation technique is a new approach for assessing perioperative respiratory function.

Methods: This study enrolled 40 patients undergoing general anesthesia: 20 for ≥2 hours and 20 for <2 hours. Respiratory parameters were measured the day before and after surgery using forced oscillation during normal tidal breathing.

Persistent left superior vena cava with absent right superior vena cava detected during emergent coronary artery bypass grafting surgery.

Although persistent left superior vena cava (PLSVC) itself is a common venous anomaly in congenital heart disease, PLSVC with absent right superior vena cava (RSVC) is a rare venous congenital malformation. Due to the lack of symptoms, this malformation is often detected fortuitously when patients undergo central venous catheter placement, pacemaker implantation, or open cardiac surgery. This particular venous malformation is rare, but clinicians in many fields should be well aware of its variations and management techniques to avoid complications.

Prediction of clinical manifestations of transurethral resection syndrome by preoperative ultrasonographic estimation of prostate weight.

Background: This study aimed to investigate the relationship between preoperative estimated prostate weight on ultrasonography and clinical manifestations of transurethral resection (TUR) syndrome.

Methods: The records of patients who underwent TUR of the prostate under regional anesthesia over a 6-year period were retrospectively reviewed. TUR syndrome is usually defined as a serum sodium level of < 125 mmol/l combined with clinical cardiovascular or neurological manifestations.

[A case of a laryngeal granuloma detached by tracheal intubation].

Unique risks are involved in tracheal intubation with a laryngeal granuloma lodged in the subglottis and special precautions must be taken to manage such intubation. Reported is a case of laryngeal granuloma, which was detached from the larynx by the intubation. We discuss the management of tracheal intubation in the aforementioned case.