Journal of clinical anesthesia
-
Controlled Clinical Trial
Minimum effective fluid volume of colloid to prevent hypotension during caesarean section under spinal anesthesia using a prophylactic phenylephrine infusion: An up-down sequential allocation study.
The aim of this study was to de termine the minimum effective fluid volume (MEFV) of hydroxyethyl starch 130/0.4 (HES) infused in a preload fashion which would prevent hypotension in 50% of parturients undergoing caesarean section. A secondary objective was to measure the hemodynamic effect of fluid loading on the subjects. ⋯ Our study is the first to investigate variable fluid loading volumes in this population. A HES preload of approximatively 700 mL prevented maternal hypotension in 50% of the parturients under the conditions of this study. We suggest that up-down sequential allocation design is a useful tool to compare different fluid loading regimens in this setting.
-
Case Reports
Case report: Neuromuscular block induced by rocuronium following sugammadex administration.
We present a case in which rocuronium was applied for muscle relaxation following the administration of sugammadex. An emergency surgery under general anesthesia was planned for a 43-year-old male patient due to an L1 vertebral corpus and right tibia-fibula shaft fracture. Anesthesia was induced with fentanyl, propofol and lidocaine. ⋯ The most suitable time for the re-establishment of rocuronium following sugammadex is currently unclear. This case showed that neuromuscular block can be effectively re-induced by rocuronium following the reversal of rocuronium-induced neuromuscular block with sugammadex. In this case, we consider that the ability to effectively reuse normal induction doses of rocuronium is an important clinical observation.
-
Randomized Controlled Trial Comparative Study
Effective volumes of 1.5% mepivacaine with different sodium concentration for ultrasound guided popliteal block.
To determine if a solution of 1.5% mepivacaine diluted with 5% dextrose, which decreases the sodium concentration by 30%, results in reduced volume requirements for a complete sensory block, in the case of an ultrasound guided popliteal nerve block. ⋯ A dilution of 1.5% mepivacaine with 30% less sodium concentration does not decrease volume requirement for ultrasound guided sciatic nerve block at popliteal level.
-
Randomized Controlled Trial
Anesthesia management with ultrasound-guided thoracic paravertebral block for donor nephrectomy: A prospective randomized study.
To determine the efficacy of ultrasound-guided thoracic paravertebral block intraoperatively and 24 hours postoperatively in patients undergoing donor nephrectomy. ⋯ Continuous thoracic paravertebral block provides good intraoperative stability with a low anesthetic requirement and reduces postoperative morphine consumption for up to 24 hours. Ultrasound guided technique enhanced the safety of TPVB and provides analgesia without major complications.
-
Randomized Controlled Trial
Effect of stellate ganglion block on hemodynamics and stress responses during CO2-pneumoperitoneum in elderly patients.
Elderly patients undergoing elective laparoscopic cholecystectomy (LC) were given right stellate ganglion block (RSGB) to observe its effects on the hemodynamics and stress response during carbon dioxide (CO2)-pneumoperitoneum. ⋯ Right stellate ganglion block can reduce blood catecholamines during CO2-pneumoperitoneum to maintain perioperative hemodynamic stability and prevent adverse cardiovascular events in elderly patients.