Volatile anesthetics such as sevoflurane and desflurane provide immobility but almost no analgesia. This article explains the true meaning of MAC—why “no movement” doesn’t necessarily mean “no pain”—and how balanced anesthesia combines analgesia, hypnosis, and immobility.

MACとは、50％のヒトが有痛刺激に反応しない吸入麻酔薬濃度。年齢や体温で変動する麻酔深度の基礎を、周術期管理チーム試験・麻酔科専門医試験対策として整理します。

Perioperative smoking cessation reduces postoperative complications and should ideally begin ≥4 weeks before surgery. This article reviews the three main pharmacotherapies used around surgery — nicotine replacement therapy (NRT), varenicline, and bupropion — with a focus on perioperative choice, timing, and safety. We summarize evidence (including perioperative RCTs and patient-level meta-analyses), practical decision flows for short vs. longer waiting times, and exam-focused commentary for perioperative management team and anesthesiology board exams.

周術期管理チーム試験対策・麻酔科専門医試験対策向けに，NRT・バレニクリン・ブプロピオンの周術期での使い分けと過去問解説をわかりやすく整理しました．

Midline catheters occupy a practical middle ground between peripheral IVs and PICC lines, suited for short-to-mid-term intravenous therapy (commonly ~5–14 days). This article summarizes definitions, indications/contraindications, ultrasound-guided insertion and management tips, complication recognition and response, and practical decision rules for choosing PIV vs midline vs PICC — all referenced to recent trials, systematic reviews, and INS guidance. Useful for perioperative teams and trainees preparing for perioperative management team and anesthesiology board exam scenarios.

Midlineカテーテルの定義、適応、PIV／PICCとの実務的な使い分け、合併症の初期対応をエビデンスに基づいてわかりやすく整理しました。周術期管理チーム試験対策・麻酔科専門医試験対策に役立つ要点も収録しています。

A step-by-step ASRA-based guide to treating Local Anesthetic Systemic Toxicity (LAST) with early lipid emulsion therapy, seizure control, and modified ACLS.

局所麻酔薬中毒（LAST）の治療・予後をASRA準拠で整理。脂肪乳剤療法やACLSとの違いを明確に解説。周術期管理チーム試験対策・麻酔科専門医試験対策に。

A conversational and practical overview of Local Anesthetic Systemic Toxicity (LAST)—how it starts, what to look for, and how to act fast. This article explains early CNS and cardiovascular signs, key risk factors, and first-line management, presented in a real clinical dialogue style for residents and perioperative staff.