Journal of anesthesia
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Journal of anesthesia · Oct 2011
Randomized Controlled TrialEffect of flurbiprofen, metoclopramide and droperidol for nausea and emesis during cesarean section under spinal anesthesia.
Nausea and emesis frequently arise during cesarean section performed under spinal or epidural anesthesia, particularly after delivery. We have evaluated the treatment effects of flurbiprofen, metoclopramide and droperidol on nausea and emesis during cesarean section in patients under combined spinal and epidural anesthesia. ⋯ Intravenous flurbiprofen improves nausea and emesis after delivery by cesarean section more effectively than metoclopramide or droperidol.
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Epidural administration of local anesthetics or opioid during general anesthesia is a widespread method for postoperative analgesia. Despite the availability of this technique, inadvertent administration of nonepidural medications into the epidural space can be associated with serious neurological complications. We report a case of accidental epidural rocuronium injection.
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Journal of anesthesia · Oct 2011
Randomized Controlled Trial Clinical TrialA randomized, double blind, placebo controlled clinical trial of the preoperative use of ketamine for reducing inflammation and pain after thoracic surgery.
We hypothesized that patients who received ketamine during thoracic surgery would benefit from suppression of the inflammatory cascade, represented by lower interleukin (IL)-6 and C-reactive protein (CRP) plasma levels. ⋯ These findings suggest that the routine use of a single dose of ketamine prior to chest wall incision is not effective at reducing pain or inflammation in thoracic surgery patients at 24 h postoperatively.
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Journal of anesthesia · Oct 2011
Review Historical ArticleThe role of Certified Registered Nurse Anesthetists in the United States.
Certified Registered Nurse Anesthetists (CRNAs) have been providing anesthesia care in the United States (US) for nearly 150 years. Historically, anesthesia care for surgical patients was mainly provided by trained nurses under the supervision of surgeons until the establishment of anesthesiology as a medical specialty in the US. Currently, all 50 US states utilize CRNAs to perform various kinds of anesthesia care, either under the medical supervision of anesthesiologists in most states, or independently without medical supervision in 16 states; the latter has become an on-going source of conflict between anesthesiologists and CRNAs. Understanding the history and current conditions of anesthesia practice in the US is crucial for countries in which the shortage of anesthesia care providers has become a national issue.
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Journal of anesthesia · Oct 2011
Propofol protects against impairment of learning-memory and imbalance of hippocampal Glu/GABA induced by electroconvulsive shock in depressed rats.
General anesthetics are believed to induce amnesia. However, propofol can ameliorate cognitive deficits induced by electroconvulsive therapy (ECT), a treatment for mental disorders. This study aimed at investigating the possible molecular mechanism as well as the effects of propofol on learning-memory impairment in depressed rats induced by ECS (electroconvulsive shock, the analog of ECT to animals). ⋯ The data suggest that propofol alleviated ECS-induced learning-memory impairment without interfering with the antidepressant efficacy of ECS, possibly by inhibiting excessive expression of GAD65 and maintaining the balance between glutamatergic and GABAergic amino acids neurotransmitters in the hippocampus.