Journal of anesthesia
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialIntravenous famotidine does not always change core temperature during general anesthesia.
It has been reported that oral premedication with the H(2) receptor antagonist famotidine augmented intraoperative hypothermia. We again investigated whether the H(2) receptor antagonist famotidine significantly affected body temperature during open abdominal surgery under general anesthesia. We studied 20 female patients undergoing elective gynecological surgery. ⋯ T(Tym) gradually and significantly decreased in both groups during anesthesia, and no significant differences in these values were observed between the two groups. Grad(a-f) did not differ significantly between the two groups during anesthesia. We conclude that intravenous famotidine does not always change the core temperature during general anesthesia.
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialInsertion length and resistance during advancing of epidural catheter.
The migration of an epidural catheter into the intravascular and subarachnoid spaces sometimes occurs. This study was designed to investigate where the resistance was felt during the advancing of the catheter into the epidural space and whether the length of catheter advanced in the epidural space affected the incidence of catheter migration. ⋯ At approximately 2.5 cm in the epidural space, advancing an epidural catheter causes resistance. Further advancing past this point may cause migration of the catheter into the vessels, or the coiling of the catheter.
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Journal of anesthesia · Jan 2009
Randomized Controlled TrialEffect of landiolol hydrochloride on suxamethonium-induced neuromuscular block.
The aim of this study was to examine the effect of landiolol hydrochloride, an ultrashort-acting beta(1)-blocker, on suxamethonium-induced neuromuscular block. ⋯ Landiolol delayed recovery from suxamethonium-induced paralysis. However, the interaction between the drugs seemed to be small in the clinical setting.
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Journal of anesthesia · Jan 2009
ReviewComplexity of blood volume control system and its implications in perioperative fluid management.
The use of fluid therapy attempts to optimize blood circulation by manipulating the circulating blood volume (BV). BV may be a key intermediate parameter between fluid therapy and the blood circulation, and it has been assumed that BV can be controlled by fluid therapy. In order to construct a fluid therapy protocol, firstly, we have to confirm whether BV can actually be controlled by fluid therapy. ⋯ Because inflammation and some hormones control vascular permeability and the renal adjustment of solutes and fluids, such factors may readjust the BV even after interventional fluid therapy. Perioperative BV may be predominantly controlled by an internal regulatory system, regardless of whether "restrictive" or "liberal" fluid management strategies are employed. Recognizing this physiological control of BV may help us to develop individualized fluid management strategies.
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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.