[Anesthesia management by residents does not alter the incidence of recall of tracheal extubation: a teaching hospital-based propensity score analysis].

Background And Objectives: The memory of emergence from anesthesia is recognized as one type of anesthesia awareness. Apart from planed awake extubation, unintentional recall of tracheal extubation is thought to be the results of inadequate anesthesia management; therefore, the incidence can be related with the experience of anesthetists. To assess whether the incidence of recall of tracheal extubation is related to anesthetists' experience, we compared the incidence of recall of tracheal extubation between patients managed by anesthesia residents or by experienced anesthetists.

Is an urban legend true in the teaching hospital that "you will get hurt if you go to hospital at the beginning of the fiscal year"?

An urban legend that "you will get hurt if you go to hospital at the beginning of the fiscal year" is in circulation, because people in general suppose that inexperienced newcomers start to work at clinical practice during that time period. We tried to determine whether this urban legend was true or not by using data from our operation management system. We retrospectively conducted a study to investigate whether the number of cannulation failures, which was used as an index of patient disadvantages at clinical practice, could be affected by the volume of residents in clinical participation.

Use of a laryngeal mask airway to stop a supraglottic air leak which prevented adequate ventilation via a tracheostomy in a patient with cerebral palsy and pneumonia.

We report an adolescent developing ventilation failure due to supraglottic air leakage with the use of an uncuffed hand-made tracheal tube fit to her tracheobronchial deformity. To eliminate the supraglottic air leakage, a size 2.5 laryngeal mask airway (LMA) was inserted into the oral pharynx.

Evaluation of combined use of transcranial and direct cortical motor evoked potential monitoring during unruptured aneurysm surgery.

The feasibility and reliability of combined use of transcranial and direct cortical motor evoked potential (MEP) monitoring during unruptured aneurysm surgery were evaluated. Forty-eight patients with unruptured cerebral aneurysms underwent craniotomy and neck clipping accompanied by muscle MEP monitoring. MEPs were elicited successfully by transcranial electrical stimulation in all patients.

Assessment of intraoperative motor evoked potentials for predicting postoperative paraplegia in thoracic and thoracoabdominal aortic aneurysm repair.

Purpose: Monitoring motor evoked potentials (MEPs) has been recognized as a highly reliable method to detect intraoperative spinal cord ischemia (SCI) in aortic repair. However, the data regarding the sensitivity and specificity of MEPs for predicting postoperative paraplegia are limited. We retrospectively assessed the value of intraoperative MEP amplitudes for predicting postoperative paraplegia.

Metoclopramide does not prolong duration of action of landiolol attenuating the hemodynamic response to induction of anesthesia and tracheal intubation.

Landiolol is a new ultra-short-acting beta 1-selective adrenoreceptor antagonist, which is metabolized rapidly by plasma cholinesterase (PCHE). Metoclopramide has been shown to inhibit PCHE in vitro. Therefore, metoclopramide might prolong beta blocking effects of landiolol and spoil its ultimate-short-acting property.

Effects of landiolol on systemic and cerebral hemodynamics and recovery from anesthesia in patients undergoing craniotomy.

Purpose: Maintenance of systemic and cerebral hemodynamics and quick recovery from anesthesia are required for craniotomy. We conducted a prospective randomized study to investigate the effects of continuous infusion of landiolol on hemodynamic responses to various stimuli, changes in systemic and cerebral hemodynamics during anesthesia, and recovery from anesthesia in patients undergoing craniotomy.

Methods: Thirty patients undergoing elective craniotomy were randomly divided into two groups: a landiolol group and a control (saline) group.

Evaluation of posttetanic motor evoked potentials--the influences of repetitive use, the residual effects of tetanic stimulation to peripheral nerve, and the variability.

Background: Recently, we developed a new technique to augment myogenic motor evoked potentials (MEPs), called as posttetanic MEPs (p-MEPs), in which tetanic stimulation is applied to peripheral nerve before transcranial stimulation. However, the data on p-MEPs are limited. This study was conducted; (1) to evaluate the influences of repetitive use of p-MEPs on p-MEP amplitudes, (2) to evaluate the residual effects of use of p-MEPs on subsequent conventional MEPs (c-MEPs), and (3) to compare the variability of p-MEPs with that of c-MEPs.

Evaluation of the applicability of sevoflurane during post-tetanic myogenic motor evoked potential monitoring in patients undergoing spinal surgery.

Purpose: Recent evidence has indicated that post-tetanic motor evoked potentials (p-MEPs) can be used to improve the reliability of the monitoring of motor function during spinal surgery. However, data on p-MEP monitoring are limited to those in subjects under propofol anesthesia. The present study was conducted to assess the applicability of sevoflurane during p-MEP monitoring in patients undergoing spinal surgery.

Airway management with the laryngeal tube in rabbits.

The rabbit's oropharyngeal anatomy complicates the use of endotracheal intubation for airway management during surgical procedures. To determine if the laryngeal tube is useful for airway management in rabbits, the authors applied the device and evaluated its efficacy to ventilate the lungs. The laryngeal tube was inserted blindly and without difficulty in six healthy male New Zealand White rabbits; all of the rabbits were ventilated adequately with and without neuromuscular blockade.

[Four cases of diplopia following spinal anesthesia].

Many complications after spinal anesthesia have been reported, but diplopia is rare. We had four cases of diplopia in 794 cases of spinal anesthesia in three years at Nara Medical University Hospital. These 4 cases were not characterized by any major factors including gender, age, or anesthetic choice.