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Study objective To evaluate whether nasotracheal intubation using a fiberoptic bronchoscope reduces postoperative sore throat. Design Prospective, double-blinded, randomized, and controlled study. Setting Postoperative areas and surgical ward of a university hospital. Patients Seventy-four patients with American Society of Anesthesiologists physical status I-II who were scheduled for elective general anesthesia requiring nasotracheal intubation. Interventions Patients were randomized to one of two intubation groups, F (fiberoptic bronchoscope–guided) and M (Macintosh laryngoscope–guided), and after induction of general anesthesia, the patients' tracheas were intubated via the nose. Measurements The intensity of postoperative sore throat was evaluated using a numerical rating score (0=none, 10=severe) at 24 hours postoperatively, and the incidence of nasal mucosal trauma, time to completion of intubation, and hemodynamic responses were recorded and compared between groups. Main results The numerical rating score value was significantly lower in group F than in group M ( P =.0047), but the incidence of nasal mucosal trauma was comparable between the two groups. The median time to completion of intubation was shorter for group F than group M ( P Conclusions Fiberoptic bronchoscope–guided intubation is associated with less sore throat after nasotracheal intubation than M intubation. The time to completion of intubation was significantly shorter using the fiberoptic bronchoscope than that using the Macintosh laryngoscope.

To evaluate the current methods of surgical antimicrobial prophylaxis from the viewpoint of pharmacokinetics for patients undergo urologic surgery, this study was designed to measure the serum concentrations of two different prophylactic antimicrobial agents in different types of urologic surgery. This prospective study included 39 patients with prostate cancer, renal pelvic cancer, ureteral cancer or renal cancer treated by radical surgery from August 2005 to March 2006. Blood samples were taken intraoperatively at 30 min and 180 min after the beginning of the first administration. The half-life of the beta phase of cefazolin is 2.46 h and that of piperacillin is 0.7 h according to their manufacturers. The average serum concentration of cefazolin at 30 min was 144 μg/mL in the prostatectomy group and 175 μg/mL in the nephrectomy group. At 180 min, the average concentration of cefazolin was 37 μg/mL in prostatectomy group and 59 μg/mL in the nephrectomy group. The average concentration of piperacillin at 30 min was 134 μg/mL in the prostatectomy group and 137 μg/mL in the nephrectomy group. At 180 min, the average concentration of piperacillin was 10 μg/mL in the prostatectomy group and 22 μg/mL in the nephrectomy group. Thus, the concentration at 180 min after the beginning of infusion was different according to the half-life of each antimicrobial agent. Therefore, up-to-date guidelines for surgical antimicrobial prophylaxis that deal with additional types of intraoperative prophylaxis should be consulted if the operation exceeds two half-lives of the prophylactic antimicrobial agents used in real-life clinical practice.

Background Bone cancer pain has a major impact on the quality of life of cancer patients but is difficult to treat. Therefore, development of a novel strategy for bone cancer pain is needed for improvement of the patient quality of life. In this study, we examined the analgesic effects of the combination of a transient receptor potential vanilloid subfamily 1 (TRPV1) antagonist and morphine on pain-related behaviours in a murine model of bone cancer pain. Methods C3H/HeJ mice underwent injection of osteolytic sarcoma cells into the intramedullary space of the femur. The analgesic effects of intraperitoneal morphine and the analgesic effect of a TRPV1 antagonist, SB366791 [N-(3-methoxyphenyl)-4-chlorocinnamide], on bone cancer pain-related behaviours were examined. The analgesic effects of the combination of SB366791 and morphine on bone cancer pain were also examined. Results Intraperitoneal morphine significantly reduced the number of spontaneous flinches and improved ambulation only at the highest dose of 10 mg kg−1 whereas weight-bearing was not improved. Intraperitoneal SB366791 at doses of 0.3 and 1.0 mg kg−1, but not at a dose of 0.1 mg kg−1, reduced the number of spontaneous flinches, whereas neither weight-bearing nor ambulation was improved. Addition of a sub-analgesic dose of SB366791 (0.1 mg kg−1) to morphine significantly reduced the number of flinches and improved weight-bearing compared with the effects of morphine alone. Conclusions Our findings showed that the combination of morphine and SB366791 has potent analgesic effects on bone cancer pain. The findings of this study may lead to novel strategies for the treatment of bone cancer pain.