Journal of anesthesia
-
Journal of anesthesia · Oct 2011
Propofol protects against impairment of learning-memory and imbalance of hippocampal Glu/GABA induced by electroconvulsive shock in depressed rats.
General anesthetics are believed to induce amnesia. However, propofol can ameliorate cognitive deficits induced by electroconvulsive therapy (ECT), a treatment for mental disorders. This study aimed at investigating the possible molecular mechanism as well as the effects of propofol on learning-memory impairment in depressed rats induced by ECS (electroconvulsive shock, the analog of ECT to animals). ⋯ The data suggest that propofol alleviated ECS-induced learning-memory impairment without interfering with the antidepressant efficacy of ECS, possibly by inhibiting excessive expression of GAD65 and maintaining the balance between glutamatergic and GABAergic amino acids neurotransmitters in the hippocampus.
-
Journal of anesthesia · Oct 2011
Case ReportsSuccessful treatment of acute respiratory distress syndrome after hysterectomy for life-threatening atonic bleeding by inhaled nitric oxide.
We report a case of a 33-year-old female who developed severe acute respiratory distress syndrome (ARDS) after emergency hysterectomy for life-threatening atonic bleeding. A marked decline in pulmonary oxygenation was observed during the surgery, which led to a diagnosis of ARDS. ⋯ Inhaled nitric oxide (NO 10 ppm) was administered to the patient as a rescue treatment, resulting in a gradual but dramatic improvement in pulmonary oxygenation. Although several randomized trials have failed to confirm the beneficial effects of NO on morbidity in patients with ARDS, NO administration is worth consideration as treatment prior to invasive treatments, such as extracorporeal membrane oxygenation, for patients with acute lung injury/ARDS.
-
Journal of anesthesia · Oct 2011
Prognostic factors associated with mortality in patients undergoing emergency surgery for abdominal aortic aneurysms.
Surgical mortality rates following emergency surgery for ruptured abdominal aortic aneurysms (AAAs) remain high. This study investigated the mortality rate and identified prognostic factors affecting mortality in patients undergoing emergency repair of AAAs in our hospital. ⋯ The authors clarified that certain features such as age, persistent preoperative shock, and greater amounts of transfusion associated with greater blood loss and anemia were factors affecting the mortality in patients undergoing emergency surgery for AAAs. It might be of great importance to correct preoperative shock and anemia caused by massive bleeding before the onset of hemodynamic deterioration.
-
Journal of anesthesia · Oct 2011
Backboard insertion in the operating table increases chest compression depth: a manikin study.
The quality of chest compression (CC) is influenced by the surface supporting the patient. The present study compared chest compression depth with and without a rigid backboard on an operating table with a pressure-distributing mattress. We hypothesized that the presence of a backboard would result in an increased depth of chest compression on the operating table with a pressure-distributing mattress. ⋯ Mean chest compression depth increased from 4.9 ± 0.4 to 5.4 ± 0.3 mm (P < 0.0001) when a backboard was present. Mean proportion of compressions >50 mm increased significantly with the presence of a backboard (53.6% ± 32.3%-81.8% ± 15.0%, P < 0.0001). Applying a backboard significantly increased CC depth during cardiopulmonary resuscitation of a manikin model on an operating table with a pressure-distributing mattress.
-
Journal of anesthesia · Oct 2011
Case ReportsMultilevel nerve stimulator-guided paravertebral block as a sole anesthetic technique for breast cancer surgery in morbidly obese patients.
In this case series, we present the effectiveness of multilevel nerve stimulator-guided paravertebral block (PVB) technique in obese women of body mass index ≥30 kg/m(2) undergoing breast cancer surgery with or without axillary dissection. Twenty-six obese women were included in this case series. Block classification, hemodynamics and complication rate, postoperative nausea and vomiting, postoperative analgesic consumption, post-anesthesia care unit (PACU) stay, and hospital stay were recorded. ⋯ Confirmation of the landmark was established from the initial attempt in 61.5%. Surgical PVB was achieved in 76.9% of the patients; the failure rate of the technique was 11.5%. This case series suggested that the multilevel nerve stimulator-guided PVB may be an effective technique for obese patients undergoing breast cancer surgery, although further studies are needed to compare PVB and general anesthesia.