Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2020
Randomized Controlled Trial Comparative StudyPredicting the Size of a Left Double-Lumen Tube for Asian Women Based on the Combination of the Diameters of the Cricoid Ring and Left Main Bronchus: A Randomized, Prospective, Controlled Trial.
There are limited data about how to choose the correct size of a double-lumen tube (DLT). It is especially difficult to select an appropriate DLT for Asian women because of their small stature. The primary aim of this study was to compare the overall accuracy of the DLT selected based on the combination of transverse diameter of cricoid ring and the equivalent diameter of the left main bronchus (ED-LMB) with that based on the ED-LMB alone for Asian women. ⋯ The correct size of DLT for Asian women should be selected based on the combination of transverse diameter of cricoid ring and the ED-LMB.
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Anesthesia and analgesia · Mar 2020
Randomized Controlled Trial Multicenter Study Comparative StudyFibrinogen Concentrate as an Alternative to Cryoprecipitate in a Postcardiopulmonary Transfusion Algorithm in Infants Undergoing Cardiac Surgery: A Prospective Randomized Controlled Trial.
Infants undergoing cardiac surgery are at risk for bleeding and massive transfusion due to an immature coagulation system, complex surgeries, and cardiopulmonary bypass (CPB) effects. Hemodilution from CPB promotes an acquired hypofibrinogenemia that results in impaired fibrin formation, inadequate clot formation, and increased bleeding. In North America, the current standard of care to supplement fibrinogen is cryoprecipitate. An alternative option is the off-label use of fibrinogen concentrate (FC; RiaSTAP; CSL Behring, Marburg, Germany), a purified fibrinogen. Because perioperative allogenic transfusions are associated with increased morbidity and mortality, we sought to determine whether FC would be an acceptable alternative to cryoprecipitate in a post-CPB transfusion algorithm in infants undergoing open-heart surgery. ⋯ Our findings suggest that FC may be considered as an alternative to cryoprecipitate for the treatment of hypofibrinogenemia in infants with bleeding after CPB. Although we found no significant differences between secondary outcomes or AEs, further studies are needed to assess safety.
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Anesthesia and analgesia · Mar 2020
Randomized Controlled Trial Comparative StudyUltrasound-Assisted Versus Landmark-Guided Spinal Anesthesia in Patients With Abnormal Spinal Anatomy: A Randomized Controlled Trial.
Spinal ultrasound improves first-pass success for patients with abnormal spinal anatomy undergoing spinal block, although there was no difference in total procedure time.
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Anesthesia and analgesia · Mar 2020
Randomized Controlled TrialPharmacokinetic and Pharmacodynamic Analysis of Alfaxalone Administered as a Bolus Intravenous Injection of Phaxan in a Phase 1 Randomized Trial.
Previous formulations of alfaxalone have shown it to be a fast-acting intravenous anesthetic with high therapeutic index. Alfaxalone has been reformulated for human use as Phaxan, an aqueous solution of 10 mg/mL of alfaxalone and 13% betadex. This study assessed the pharmacokinetic (PK) and pharmacodynamic (PD) characteristics of alfaxalone given as a bolus intravenous injection of this formulation to human male volunteers. ⋯ After a single bolus intravenous injection, alfaxalone has a high plasma CL equal to hepatic blood flow as reported for earlier studies of bolus injections of a previous formulation of alfaxalone. The plasma levels associated with BIS values of <60 are comparable to those previously reported in patients anesthetized with alfaxalone. The t1/2keo is relatively high, but the large Hill coefficient contributes to rapid onset and offset of action. This information can inform future studies of this formulation.
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Anesthesia and analgesia · Mar 2020
ReviewAnesthetic Implications of the New Guidelines for Button Battery Ingestion in Children.
New guidelines for paediatric button battery ingestion recommend preoperative administration with honey and/or sucralfate, and post-removal irrigation with 0.25% acetic acid.
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