Journal of anesthesia
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Journal of anesthesia · Jan 2005
Delayed discharge and acceptability of ambulatory surgery in adult outpatients receiving general anesthesia.
Delay in discharge after ambulatory surgery impairs its cost-effectiveness. However, it is not self-evident that prolonged postoperative stay is associated with low quality of care and patient acceptability of ambulatory surgery. The aims of this study were to document factors affecting delay in discharge, recovery profiles, and patient acceptability in adult outpatients. ⋯ Delays in discharge are mainly due to adverse symptoms or social/system problems. Delayed discharge is associated with increased postdischarge pain, lower RNA level, and patient acceptability. Appropriate care of postoperative symptoms and system management could prevent delay in discharge and improve patient RNA level and acceptability.
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Journal of anesthesia · Jan 2005
Dose effects of propofol on hemodynamic and cytokine responses to endotoxemia in rats.
Our previous studies have demonstrated that propofol inhibits hypotension, metabolic acidosis, and cytokine responses and reduces mortality in endotoxemic rats. The purpose of this study was to elucidate whether these beneficial effects of propofol on hemodynamics and cytokine responses were dose related. ⋯ The effects of propofol on blood pressure and cytokine responses were influenced by the dose of propofol, although the relationship did not follow simple linearity.
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Journal of anesthesia · Jan 2005
Randomized Controlled TrialLandiolol attenuates the cardiovascular response to tracheal intubation.
The objective of this prospective study was to compare the cardiovascular responses with or without landiolol to the induction of general anesthesia and tracheal intubation. ⋯ Continuous administration of landiolol before tracheal intubation results in the attenuation of cardiovascular response for tracheal intubation.
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Journal of anesthesia · Jan 2005
Case ReportsMethemoglobinemia induced by automobile exhaust fumes.
Although methemoglobinemia is an uncommon disorder, it should always be considered in the differential diagnosis of cyanosis. Major causes of acquired methemoglobinemia are nitrates, aniline, and analgesics, though rare cases have been reported to have been caused by automobile exhaust fumes. A 24-year-old man had inhaled a large amount of automobile exhaust fumes, intending to commit suicide. ⋯ The results of final arterial blood gas analysis were a methemoglobin level of 0.4% and a carboxyhemoglobin level of 0.8%. He recovered uneventfully and returned home by himself the next day. To summarize, we successfully treated, with methylene blue given through a nasogastric tube, a young man who had developed severe methemoglobinemia from inhaling automobile exhaust fumes.
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Journal of anesthesia · Jan 2005
Nitrous oxide administration during washout of sevoflurane improves postanesthetic agitation in children.
The use of sevoflurane in pediatric patients, which could enable a more rapid emergence and recovery, is complicated by a high incidence of postanesthetic agitation, probably due to residual sevoflurane during washout. The present study was designed to investigate whether administration of nitrous oxide (N2O) reduces sevoflurane concentration at awakening and suppresses postanesthetic agitation. The study enrolled 20 children classified as ASA physical status I. ⋯ The BIS at awakening was higher (P < 0.01) in the N2O group than in the control group. The point scores of postanesthetic agitation were significantly lower (P < 0.01) in the N2O group than in the control group. Using N2O during washing out of sevoflurane may improve postanesthetic agitation at awakening in children.