Journal of anesthesia
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Journal of anesthesia · Jan 2008
A neutrophil elastase inhibitor, sivelestat, improved respiratory and cardiac function in pediatric cardiovascular surgery with cardiopulmonary bypass.
Several reports indicate that a neutrophil elastase inhibitor, sivelestat, may have prophylactic efficacy against a systemic inflammatory response after cardiovascular surgery with cardiopulmonary bypass (CPB). We evaluated the clinical pulmonary and cardiac effects of sivelestat. ⋯ We have shown that pediatric patients who underwent cardiovascular surgery with CPB who received sivelestat had a higher P/F ratio, a lower RI, and better FAC of the LV in the postoperative course.
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Journal of anesthesia · Jan 2008
Case ReportsDelayed respiratory depression associated with 0.15 mg intrathecal morphine for cesarean section: a review of 1915 cases.
A low dose of morphine, given intrathecally is an effective postoperative analgesic technique and is widely used in cesarean section. Delayed respiratory depression is the most feared side effect of this technique. However, this side effect has not been thoroughly reported in the obstetric population. The aim of this study was to describe respiratory depression associated with intrathecal morphine in postcesarean women, and to estimate its incidence. ⋯ Of 1915 patients, 5 women (0.26%) developed bradypnea associated with 0.15 mg intrathecal morphine. The incidence of severe bradypnea requiring naloxone was 1/1915 (0.052%).
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Journal of anesthesia · Jan 2008
Medication errors in anesthesia: an 8-year retrospective analysis at an urban university hospital.
The Japanese Society of Anesthesiologists (JSA) has investigated critical events in several fields of anesthesiology. However, the types, frequency, and characteristics of medication errors related to anesthesia have not been investigated. By analyzing incident reports retrospectively, we investigated medication errors that occurred during anesthetic practice over the past 8 years at our institution. ⋯ We found that overdose, substitution, and omission were the main causes of anesthesia-related medication errors in our department.
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Journal of anesthesia · Jan 2008
Comparative StudyAnatomical features of the right internal jugular vein in infants and young children undergoing heart surgery for congenital disease: comparison between cyanotic and noncyanotic patients.
It has been reported that children with cyanotic heart disease have elevated systemic levels of vascular endothelial growth factor, which may be related to the development of vessels. However, it is unknown whether the anatomical features of the internal jugular vein (IJV) differ between cyanotic and noncyanotic children. In this study, we compared anatomical information about the IJV of these two groups of patients. ⋯ The anatomical features of the right IJV in infants and young children with congenital heart disease were not different in cyanotic and noncyanotic patients, except for the relationship between diameter and the demographic data. In the small patients examined in our study (72% of them were infants), the diameter of the IJV was not sufficiently enlarged by the Trendelenburg position, regardless of whether the patients were cyanotic or noncyanotic.
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Journal of anesthesia · Jan 2008
Randomized Controlled Trial Comparative StudyComparison of the effects of room air and N2O + O2 used for ProSeal LMA cuff inflation on cuff pressure and oropharyngeal structure.
This study aimed to evaluate the effects of different inflating gases used for ProSeal LMA (PLMA) cuff inflation on cuff pressure, oropharyngeal structure, and the incidence of sore throat. Eighty patients (American Society of Anesthesiologists; ASA I-II) were randomly divided into two groups. PLMA cuff inflation was achieved with appropriate volumes of 50% N2O + 50% O2 in group I and room air in group II, respectively. ⋯ Cuff pressure was positively correlated with the length of the operation in group II, and negatively correlated in group I. PLMA cuff inflation with room air led to increased cuff pressure during the operation, possibly due to the diffusion of N2O into the cuff. We consider that a PLMA cuff inflated with an N2O-O2 mixture is convenient, especially in operations in which N2O has been used.