Intraoperative Remifentanil Use Reduces Atrial Fibrillation After Coronary Artery Bypass Surgery.

Objectives: Atrial fibrillation after coronary artery bypass grafting is a relatively well known complication that has been observed for a long time. Though the management and drugs in the perioperative period have changed, their impact on the generation of postoperative atrial fibrillation remains unclear. Therefore, we investigated various perioperative management methods and the occurrence of postoperative atrial fibrillation.

An Unexpected Free-Floating Aortic Valve Leaflet Avulsion in the Left Atrium on Transesophageal Echocardiography During Transcatheter Aortic Valve Implantation Under Extracorporeal Membrane Oxygenation.

• Aortic valve leaflet avulsion is a rare complication during TAVI. • Avulsed leaflet traveled to the LA with ECMO flow and migrated to the aorta. • TEE aided in timely management and helped complete the transcatheter intervention.

Usefulness of Tulip Airway in Edentulous Elderly Patients.

Objective: Mask ventilation can be difficult in elderly edentulous patients. Various solutions have been proposed to address this challenge. This study assessed the use of a new airway-securing device called the Tulip Airway and investigated its application in simulated edentulous patients.

Mortality at 180-days is affected by serum haptoglobin levels in septic patients with high magnitude serum high mobility group box-1 levels.

Aim: High mobility group box-1 (HMGB1) is a lethal mediator of sepsis that binds to haptoglobin (Hp) and is associated with its prognosis. We investigated the effect of the combination of HMGB1 and Hp on sepsis prognosis.

Methods: This single-center, retrospective study registered 78 patients with sepsis according to Sepsis-3 criteria on day 1 of diagnosis from July 2016 to November 2018.

Perioperative tight glycemic control using artificial pancreas decreases infectious complications via suppression of inflammatory cytokines in patients who underwent pancreaticoduodenectomy: A prospective, non-randomized clinical trial.

Background: We sought to investigate the efficacy of perioperative tight glycemic control (TGC) in reducing of postoperative infectious complications (POICs) and study its impact on early inflammatory mediators in patients who underwent pancreaticoduodenectomy.

Methods: In this non-randomized trial, the artificial pancreas (AP) group received TGC (target glucose range of 80-110 mg/dL; n = 14), while the control group received conventional glycemic control (range of 80-180 mg/dL; n = 15). The primary endpoint was POICs.

Hyperkalemia caused by rapid red cell transfusion and the potassium absorption filter.

We report a case of transient hyperkalemia during hysterectomy after cesarean section, due to preoperatively undiagnosed placenta accreta that caused unforeseen massive hemorrhage and required rapid red cell transfusion. Hyperkalemia-induced by rapid red cell transfusion is a well-known severe complication of transfusion; however, in patients with sudden massive hemorrhage, rapid red cell transfusion is necessary to save their life. In such cases, it is extremely important to monitor serum potassium levels.

[Case of bronchial obstruction by thrombosis after cardiopulmonary bypass].

A 78-year-old man underwent total arch replacement for an aortic arch aneurysm under cardiopulmonary bypass. After protamine sulfate administration, his peak inspiratory pressure suddenly rose, and his arterial oxygen saturation dropped. We checked his bronchus with a bronchoscope and found that his left main bronchus was blocked by a large thrombus.

Relationship between blood levels of propofol and recovery of memory in electroconvulsive therapy.

Aim: Memory impairment is a potential major adverse effect of electroconvulsive therapy (ECT). Some reports have suggested that propofol, an intravenous anesthetic widely used for general anesthesia in ECT, can minimize adverse effects on memory and cognitive function following ECT. The relation between propofol blood level during ECT and memory impairment after the procedure is unknown.

[General anesthesia for a patient with post-polio syndrome].

We gave anesthesia for a patient with post-polio syndrome undergoing laparoscopic sigmoid colectomy. She is a 68-year-old woman and had been diagnosed as post-polio syndrome since she was 55 years of age. Before the operation, paralysis was observed in her right leg.

[Left ventricular migrating thrombus detected by intraoperative transesophageal echocardiography].

Transesophageal echocardiography (TEE) helps detecting intra-cavity thrombus size, mobility and fragility, which are of great importance in surgical removal of the thrombus. Thrombus characteristics may render surgical thrombectomy incomplete, raising the risk of catastrophic embolization. A 50-year-old man, suffering from congestive heart failure, developed a mobile thrombus in the left ventricle (LV).

[Evaluation of the side effects of intravenous patient controlled analgesia after spine surgery].

Background: We have adopted intrravenous patient controlled analgesia (IV-PCA) for spine surgery. We could not find reports about detailed examinations of the side effects of IV-PCA using morphine after spine surgery, so we investigated retrospectively side effects in cases using morphine IV-PCA.

Methods: Eighty-five patients underwent IV-PCA after spine surgery.