1．麻酔と麻酔関連機器

Anesthesia and Anesthesia-related Technology

胸部外科手術（心臓外科，呼吸器外科，食道外科）の麻酔管理では心臓や肺自体，またはその近傍が術野になるため，ほかの術野とは異なる術中の循環呼吸管理が求められることが多い．その困難な管理に対応できる麻酔法を麻酔科医は日々工夫して編み出し，麻酔関連機器も新たに臨床で使用されるようになっている．

Although there is no remarkable change of anesthetics or anesthesia methods in recent years, several new technologies are used for safety management of cardiac, lung or thoracic surgery. Stroke volume variation （SVV） monitoring indicates SVV, a parameter to optimize fluid infusion and is used to avoid edema or congestive heart damage due to over hydration. SmartPilot View, a pharmacokinetic simulator during anesthesia, represents the measured effective site concentration of anesthetics and contributes the optimization of induction and maintenance of anesthesia.

Pressure controlled ventilation-volume guarantee （PCV-VG） is a ventilation mode that can secure preset tidal volume even under PCV to avoid hypoxemia and hypercapnia, even when unexpected airway pressure raised. AutoFlow system supplies tidal volume at the lowest airway pressure and has the function of maintaining tidal volume while keeping low airway pressure according to the change of pulmonary compliance.

In 2017, we modified the position of cuff air delivery lumen while maintaining the strength and elasticity of double-lumen tube （DLT） made by a company to avoid deflation failure of bronchial cuff by our team.