Journal of anesthesia
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For direct laryngoscopy, we compared midline and left-molar approaches with respect to ease of intubation, using a Macintosh blade. We investigated the relationship between failure of the left-molar approach and preoperative risk factors for difficult intubation. ⋯ Difficulty in the insertion of the endotracheal tube limits the efficacy of the left-molar approach. It is not possible to predict the failure of intubation with the left-molar approach by considering the preoperative risk factors.
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Journal of anesthesia · Jan 2009
Decreased incidence of headache after unintentional dural puncture in patients with cesarean delivery administered with postoperative epidural analgesia.
To investigate how subsequent placement of a catheter into the epidural space after unintentional dural puncture for postoperative analgesia for 36-72 h affected the incidence of post-dural puncture headache (PDPH). ⋯ Subsequent catheter placement into the epidural space after unintentional dural puncture in cesarean delivery and leaving the catheter for postoperative analgesia for 36-72 h may reduce the incidence of PDPH.
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Journal of anesthesia · Jan 2009
Comparative StudyAuditory evoked potentials index versus bispectral index during propofol sedation in spinal anesthesia.
It is still controversial whether an electroencephalogram could be a useful monitor of sedation levels. The present study was performed to compare the bispectral index (BIS) and the auditory evoked potentials index (AAI) during light sedation with propofol infusion in spinal anesthesia. ⋯ The AAI, but not the BIS, could discriminate slight changes of consciousness during light sedation with propofol infusion in patients with spinal anesthesia.
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Journal of anesthesia · Jan 2009
Case ReportsA plantar flexion response to nerve stimulation indicates needle misplacement in the epidural/spinal space during psoas compartment block.
We report two cases of plantar flexion due to epidural misplacement of the needle during psoas compartment block, providing a response feedback for needle position during this procedure. In one case, the response occurred contralaterally, and in the other bilaterally. ⋯ At this point, 3 ml of radiopaque medium was injected, and it diffused throughout the epidural space. Subsequently, single-shot epidural anesthesia was achieved by injection through this needle.
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Journal of anesthesia · Jan 2009
Case ReportsReal-time three-dimensional ultrasound for continuous interscalene brachial plexus blockade.
Two-dimensional ultrasound guidance is used commonly for regional anesthetic techniques. This report describes the novel use of three-dimensional, ultrasound-guided, continuous interscalene regional analgesia, which was used in a 36-year-old woman undergoing left total elbow arthroplasty. Possible advantages of this novel technology over current two-dimensional methods include a larger area of available scan information that enables multiple planes of view without having to reposition the ultrasound probe, and three-dimensional visualization of local anesthetic deposition perineurally. Current technological limitations include an upper frequency of 7 MHz, which decreases the resolution of superficial scanning.