Margin of safety for needle puncture of a radial artery in children: Recommendation for ultrasound-guided cannulation.

Background: The radial artery is commonly selected for arterial puncture and cannulation, but radial nerve palsy may occur. To minimize possible damage to the nerve, needle puncture should be made within the margin of safety (between the wrist to the distal end of the radial artery and the radial nerve running in parallel). In adults, the margin of safety for radial artery puncture is approximately 6.

Efficacy of an aid (gastric tube insertion guide) for oral insertion of a gastric tube: a randomized controlled trial.

Purpose: Insertion of a gastric tube orally may be more difficult than its insertion nasally, and thus, any aid to facilitate its insertion may be useful. Gastric tube insertion guide (Fuji Medical Corporation, Tokyo, Japan) has recently become commercially available. We felt that this device might be useful in facilitating oral insertion of a gastric tube, but there has been no formal study assessing its efficacy.

Efficacy of a gastric tube insertion guide for insertion of a nasogastric tube: a prospective, randomized controlled clinical study.

Purpose: We studied whether a newly available gastric tube insertion guide (Fuji Medical, Tokyo, Japan) was effective in insertion of a nasogastric tube.

Methods: Sixty anesthetized patients were randomly allocated to three groups, and we attempted to insert a nasogastric tube with a blind technique (Group B), with the lateral neck pressure (Group L), or with the tube guide (Group G). If the insertion failed in Group B or L, its insertion was attempted with the tube guide.

Margin of safety for needle puncture of a radial artery.

The radial artery is the preferred site for arterial cannulation because of consistent anatomic accessibility, ease of cannulation, and a low incidence of complications. One possible risk associated with cannulation is an injury to the superficial branch of the radial nerve. The radial nerve divides to the superficial branch and the deep branch at the top of the forearm, and the superficial branch lies behind the brachioradialis muscle close to the lateral side of the radial artery and terminates the lateral side of the radial artery about 7 cm proximal to the wrist.

[Stroke Volume Variation (SVV) as an Indicator of Intraoperative Transfusion Management during Laparoscopic Colectomy.].

Background: Intraoperative transfusion manage- ment is difficult during laparoscopic surgery, because peumoperitoneum affects hemodynamics. We studied whether stroke volume variation (SVV) is useful as an indicator of transfusion management Methods : We studied 44 patients undergoing lapa- roscopic colectomy. Patients were randomly allocated to two groups, and the volume of transfusion was decided with the SVV as an indicator in one group (SVV group, n=22) or with conventional indicators, such as blood pressure, heart rate, volume of urine in the other group (control group, n=22) Results : In the SVV group, total transfusion volume and total blood loss during operation were significantly decreased, and the length of hospital stay was signifi- cantly shorter, compared with the control group.

[Utility of McGRATH MAC for a Patient with a Large Epiglottic Cyst].

A 76-year-old man with an epiglottic cyst was scheduled for transoral rigid endoscopic epiglottic cystectomy under general anesthesia. The epiglottic cyst was found accidentally when he had an operation of radical cystectomy 2 weeks before. When he had the radical cystectomy, the ventilation through a mask was easy.

[Complication and Anesthetics-induced Toxicity of Stellate Ganglion Block].

Stellate ganglion block (SGB) is a commonly used safe procedure. In rare cases, it is associated with life- threatening complications [retropharyngeal hematomas (RPH), local anesthetics-induced toxicity, et al.).

[The Use of a Tracheal Tube for Guiding Nasogastric Tube Insertion].

An obese patient was scheduled for shoulder joint surgery under general anesthesia. After induction of anesthesia and tracheal intubation, insertion of a gastric tube was difficult. A new tracheal tube was prepared, the connecter was removed, and the tube was cut longitudinally.

[Combined Use of a Videolaryngoscope and a Transilluminating Device for Intubation with Two Difficult Airways].

Videolaryngoscope is useful in patients with difficult airways, but it may not be in some patients. We report the use of a lighted stylet to facilitate tracheal intubation in 2 patients in whom laryngoscopy with a videolaryngoscope was difficult. Case 1: A 52-year-old female with loose teeth and lockjaw presented for a scoliosis surgery under general anesthesia.

[Emergency Tracheal Intubation Using Airwayscope in a Patient with Hematoma after Thyroidectomy].

We report a case of emergency awake intubation using Airwayscope (AWS) in a patient with difficulty of the ventilation combined with severe neck swelling due to hematoma after thyroidectomy. A 28-year-old woman with thyroid tumor received, general anesthesia induced, easily with facemask ventilation and tracheal intubation. Her trachea was extubated after she had become awake.

[Use of a new video-laryngoscope (McGRATH MAC) in patients with a difficult airway].

We describe the clinical use of a new video-laryngoscope (McGRATH MAC, McG) in patients with a difficult airway and morbid obesity. In a patient, case no. 2, with a difficult airway, showing a Cormack-Lehane grade III view with Macintosh direct laryngoscope, the glottis opening (Cormack-Lehane grade I) was visualized with McG.

[Effect of landiolol and combined use of landiolol and olprinone on hemodynamics in patients undergoing off-pump coronary artery bypass grafting].

Background: Beta blockers are frequently used to reduce cardiac oxygen demand in off-pump coronary artery bypass grafting (OPCAB). However, significant bradycardia or negative inotropic effects are seen on occasion. We hypothesized that combined use of landiolol (L), an ultra short-acting beta blocker, and olprinone (O), a phosphodiesterase 3 inhibitor, is useful because it can increase cardiac index and prevent tachyarrhythmia even during dislocation of the heart in OPCAB.

[Anesthetic management for a patient with heparin-induced thrombocytopenia (HIT) undergoing off-pump coronary bypass surgery using argatroban, a direct thrombin inhibitor].

HIT type II is one of the severe complications of heparin therapy. The antibody for the heparin-PF 4 complex, which causes thrombocytopenia of less than 100 x 10(3) microl(-1), thrombosis and DIC-like symptoms, is produced. We managed the patient with HIT type II undergoing off-pump CABG.