Journal of anesthesia
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Journal of anesthesia · Jan 2007
Randomized Controlled TrialEffects of magnesium sulfate on neuromuscular function and spontaneous breathing during sevoflurane and spinal anesthesia.
The purpose of the present study was to determine the effects of magnesium sulfate (MgSO(4)) on the neuromuscular function and spontaneous breathing of patients under sevoflurane and spinal anesthesia. Twenty-two patients with a history of arrhythmia undergoing elective knee surgery were randomly assigned to two groups: group M (n = 11), administered with MgSO(4) 40 mg.kg(-1), and group S (n = 11), administered with saline. A combination of spinal anesthesia with 2% sevoflurane inhalation was applied to all patients under spontaneous breathing. ⋯ The VT: , RR, and ET(CO) (2) showed little change in either group, and there was no significant difference between, the groups. The single-twitch response showed significant differences between the two groups (P = 0.0006). The present study indicated that the MgSO(4) had a minimal effect on spontaneous breathing in patients undergoing sevoflurane and spinal anaesthesia, but that it attenuated the safety margin of neuromuscular function.
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Journal of anesthesia · Jan 2007
The skin-traction method increases the cross-sectional area of the internal jugular vein by increasing its anteroposterior diameter.
We developed a novel "skin-traction method" in which the puncture point of the skin over the internal jugular vein (IJV) is stretched upward with several pieces of surgical tape in the cephalad and caudad directions to facilitate cannulation of the IJV. We investigated whether this method increases the cross-sectional area of the IJV. ⋯ This method significantly increased the cross-sectional area of the RIJV by increasing the anteroposterior diameter of the RIJV. Even in the flat position, this method was almost as efficacious as the Trendelenburg position. This method thus appears to facilitate IJV cannulation.
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Journal of anesthesia · Jan 2007
ReviewPrevention of postoperative nausea and vomiting in children following adenotonsillectomy, using tropisetron with or without low-dose dexamethasone.
Postoperative nausea and vomiting (PONV) after adenotonsillectomy in children is, in spite of the prophylactic administration of tropisetron, still a frequent event. The aim of this study was to evaluate the benefit of the additional systemic administration of low-dose dexamethasone (0.15 mg x kg(-1)) for the prevention of PONV. ⋯ A low-dose bolus of dexamethasone (0.15 mg x kg(-1)) in combination with tropisetron, compared to tropisetron alone, considerably reduced the incidence of vomiting in children following pediatric adenotonsillectomy.
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Journal of anesthesia · Jan 2007
Case ReportsBilateral tension pneumothoraces following jet ventilation via an airway exchange catheter.
We report a case involving a 55-year-old man who had a recent resection of tracheal carcinoma and tracheal reanastomosis. He subsequently developed tracheomalacia and anastomotic dehiscence requiring airway stenting via an armored endotracheal tube (ETT). Placement of the armored ETT was technically difficult. ⋯ The patient was quickly recovered, stabilized, and later discharged after a prolonged intensive care unit (ICU) course. We review the recommendations for jet ventilation via airway exchange catheters, common problems during this technique, and potential methods for avoiding these problems. The risk of barotrauma and pneumothoraces during jet ventilation via an airway exchange catheter should be kept in mind.
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Journal of anesthesia · Jan 2007
Randomized Controlled Trial Comparative StudyEfficacy of a heat and moisture exchanger in inhalation anesthesia at two different flow rates.
In general anesthesia with endotracheal intubation, a circle system with a heat and moisture exchanger (HME) and a low total flow is often used to prevent hypothermia and to maintain inspired gas humidity. The purpose of the present study was to compare the inspired gas humidity and body temperature, in general anesthesia with or without an HME at two different total flow rates. Eighty patients (American Society of Anesthesiologists [ASA] I or II) scheduled to undergo either orthopedic or head and neck surgery were studied. ⋯ Group 4L had significantly lower absolute humidity than group 2L. The pharyngeal temperature did not decrease significantly for 2 h in any of the groups. During general anesthesia with a total flow of 2 lxmin(-1) in 2 h, HME might not be necessary, while with a total flow of 4 lxmin(-1), HME could be useful to maintain inspired gas humidity.