Journal of anesthesia
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Journal of anesthesia · Aug 2010
Randomized Controlled TrialThe effects of intravenous dexmedetomidine on spinal hyperbaric ropivacaine anesthesia.
In this study we investigated the effects of intravenously administered dexmedetomidine on the duration of hyperbaric ropivacaine in spinal anesthesia, and the side effects. ⋯ Our results show that intravenously administered dexmedetomidine prolonged the duration of spinal anesthesia, provided sufficient sedation, and had few side effects. Therefore, dexmedetomidine is appropriate during spinal anesthesia, if the anesthesiologist is alert for development of bradycardia.
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Journal of anesthesia · Aug 2010
Case ReportsTracheal intubation using Airway Scope in two patients with difficult airway during cardiopulmonary resuscitation.
The Airway Scope AWS-S100 (AWS, Pentax, Tokyo), a rigid video laryngoscope with integrated tube guidance that has recently become commercially available, helped the authors to establish airways in two patients with in-hospital cardiopulmonary arrest, after failed attempts to intubate the patients using the Macintosh laryngoscope (that only commanded the Cormack-Lehane grade 4 glottic views), the laryngeal mask airway, and even surgical cricothyroidotomy for the second case. This showed the utility of the AWS in the management of difficult airway cases even in emergency settings.
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Journal of anesthesia · Aug 2010
Case ReportsSuperficial venous thrombophlebitis caused by rocuronium.
Pain is one of the major disadvantages of rocuronium, which is used during induction of anesthesia. Even at subparalyzing doses, 50-100% of patients complain of intense pain. ⋯ However, in both of our cases, visible reactions occurred and both patients were diagnosed with venous superficial thrombophlebitis. Therefore, we believe that rocuronium-related pain may, in part, be because of direct venous injury.
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Journal of anesthesia · Aug 2010
Case ReportsDexmedetomidine for anesthetic management of anterior mediastinal mass.
Anesthetic management of anterior mediastinal masses (AMM) is challenging. We describe the successful anesthetic management of two patients with AMM in which dexmedetomidine was used at supra-sedative doses. Our first case was a 41-year-old man who presented with a 10 x 9 x 11 cm AMM, a pericardial effusion, compression of the right atrium, and superior vena cava syndrome. ⋯ Both patients were fiberoptically intubated awake under sedation using a dexmedetomidine infusion, followed by general anesthesia (mainly using higher doses of dexmedetomidine), thus maintaining spontaneous ventilation and avoiding muscle relaxation during a very stimulating procedure. The amnestic and analgesic properties of dexmedetomidine were particularly helpful. Maintaining spontaneous ventilation with dexmedetomidine as almost the sole anesthetic could be very advantageous and may reduce the risk of complete airway obstruction in the anesthetic management of AMMs.
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Journal of anesthesia · Aug 2010
Validation of the Pentax-AWS Airwayscope utility as an intubation device during cardiopulmonary resuscitation on the ground.
The 2005 American Heart Association guidelines for cardiopulmonary resuscitation emphasize that all rescuers should minimize interruption of chest compressions even for endotracheal intubation. We previously reported that the utility of the Pentax-AWS Airwayscope (AWS) was superior to that of the Macintosh laryngoscope (McL) for securing airways during chest compression in "on the bed" simulated circumstances. However, because most cardiopulmonary arrest happens "on the ground" in the real world, we compared the utility of the McL and the AWS during chest compression on the ground and on the bed. ⋯ We conclude that the AWS is an effective device for endotracheal intubation during chest compression not only on the bed but also on the ground.