Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2014
Randomized Controlled Trial Comparative StudyA comparison of posterior and medial cord stimulation for neurostimulation-guided vertical infraclavicular block: a randomized noninferiority clinical trial.
We investigated whether medial cord stimulation is inferior to posterior cord stimulation for vertical infraclavicular block with respect to block success. ⋯ Needle manipulation to elicit medial cord response is noninferior to posterior cord response of block success during neurostimulation-guided vertical infraclavicular block.
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Anesthesia and analgesia · Apr 2014
Comparative StudyIntraoperative three-dimensional versus two-dimensional echocardiography for left ventricular assessment.
Three-dimensional (3D) transesophageal echocardiography (TEE) technology is now widely used intraoperatively in cardiac surgery. Left ventricular (LV) measurements with 3D transthoracic echocardiography correlate better with cardiac magnetic resonance measurements compared with traditional two-dimensional (2D) transthoracic echocardiography. In this study, we compared intraoperative 3D TEE against 2D TEE regarding quantitative indices of LV function. ⋯ Intraoperative 3D TEE quantification of LV global function, image acquisition time, and reproducibility was not statistically different when compared with 2D TEE. It was however associated with calculation of larger LV volumes and a longer analysis time. Nevertheless, the 3-zone error grid analysis of the LV indexed volumes showed that the difference between 3D and 2D measurements does not affect the LV classification as normal, mildly to moderately dilated, or severely dilated.
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Anesthesia and analgesia · Apr 2014
Comparative StudyChanges in plasma orexin-a levels in sevoflurane-remifentanil anesthesia in young and elderly patients undergoing elective lumbar surgery.
Delayed emergence from general anesthesia frequently occurs in elderly patients, but the reason is not clear. Orexin has been shown to be involved in arousal from general anesthesia. In this study, we examined plasma orexin-A levels in both elderly and young patients during the anesthesia arousal cycle. ⋯ Plasma orexin-A levels are not responsible for the delayed emergence from general anesthesia in elderly patients.
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Anesthesia and analgesia · Apr 2014
Intraneural and Perineural Inflammatory Changes in Piglets After Injection of Ultrasound Gel, Endotoxin, 0.9% NaCl, or Needle Insertion without Injection.
Ultrasound gel nerve inflammation has been reported. We evaluated the extent and nature of inflammation after gel injection with endotoxin (positive), saline, or dry needle puncture (negative) controls after peripheral blocks in piglets. ⋯ Perineural gel injections cause significant inflammation. The lack of cytokines suggests injectate-related changes rather than mechanical trauma.