Journal of anesthesia
-
Journal of anesthesia · Jan 2009
Randomized Controlled TrialEffects of landiolol, a short-acting beta-1 blocker, on hemodynamic variables during emergence from anesthesia and tracheal extubation in elderly patients with and without hypertension.
Tracheal extubation and emergence procedures induce abrupt changes in hemodynamics and humoral responses. We conducted a prospective randomized study to examine the effects of the short-acting beta-1 blocker, landiolol, on hemodynamics during emergence from anesthesia in elderly patients with and without hypertension. ⋯ This study indicates that the use of a landiolol infusion for preventing hemodynamic instability in elderly patients during the emergence period would be dependent on the presence or absence of hypertension in these patients.
-
Journal of anesthesia · Jan 2009
Case ReportsLife-threatening hemothorax resulting from right brachiocephalic vein perforation during right internal jugular vein catheterization.
We present a life-threatening case of hemothorax resulting from right brachiocephalic vein perforation during right internal jugular vein catheterization. We considered that the guidewire had punctured the right brachiocephalic vein extraluminally and the catheter inserted over the guidewire had enlarged the size of the perforation. Despite the use of proper technique, an angle-tip guidewire may perforate the venous wall. Therefore, when there is negative aspiration after central venous catheterization, it is important to perform an emergency chest radiograph before proceeding with surgery; it is also important not to use an angle-tip guidewire.
-
Journal of anesthesia · Jan 2009
Case ReportsAnesthetic management of a child with Langer-Giedion (TRPS II) syndrome.
We describe the anesthetic and perioperative management of a child with Langer-Giedion syndrome (trichorhinophalangeal syndrome type II). This is a very rare genetic syndrome caused by 8q chromosome deletion. The clinical features of this syndrome include craniofacial and urogenital abnormities, variable postnatal growth deficiency with mental retardation, multiple exostoses, hyperflexible joints, and recurrent respiratory tract infections. Potential perioperative problems are highlighted.
-
Journal of anesthesia · Jan 2009
Before-after study of a restricted fluid infusion strategy for management of donor hepatectomy for living-donor liver transplantation.
Intraoperative fluid infusion strategy remains controversial. Many animal model studies have shown that restricted fluid infusion reduces blood loss, though reports on this topic in humans are rare. The purpose of this study was to determine the effects on volume of blood loss of a restricted fluid infusion strategy for hepatectomy in donors for living donor liver transplantation. ⋯ Our restricted-volume strategy reduced blood loss and had no adverse effects during living-donor hepatectomy.
-
Journal of anesthesia · Jan 2009
Case ReportsAnesthetic management of a patient with hyperthyroidism due to hydatidiform mole.
Secondary hyperthyroidism can often complicate gestational trophoblastic disease, a malignant uterine cancer. We report here the perioperative management of hyperthyroidism due to hydatidiform mole. A 53-year-old woman underwent emergency surgery due to suspicion of hydatidiform mole. ⋯ Intraoperative events included hypotension and tachycardia, although in general, tachycardia was prevented with antiarrhythmic agents and transfusion with a plasma expander and crystalloid fluid. Hyperthyroidism was highly suspected from the patient's clinical course and was confirmed by high levels of preoperative serum free triiodothyronine (T3) and thyroxine (T4). The patient became euthyroid within a few days after mole evacuation and did not require an antiarrhythmic agent after her return to the inpatient ward.