Journal of anesthesia
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Journal of anesthesia · Dec 2011
Randomized Controlled TrialSevoflurane to alleviate pain on propofol injection.
Since the introduction of propofol, several drugs and methods have been used to alleviate the pain on its injection. This study was designed to evaluate the effect of adding sevoflurane 3% during preoxygenation in alleviation of pain on propofol injection. ⋯ The addition of 3% sevoflurane at the time of preoxygenation for 1 min along with routine use of lidocaine-tourniquet completely prevented pain upon propofol injection, whereas sevoflurane by itself provided similar analgesia to premixed lidocaine with propofol.
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Journal of anesthesia · Dec 2011
Comparative StudyComparison of Pentax-AWS Airwayscope video laryngoscope, Airtraq optic laryngoscope, and Macintosh laryngoscope during cardiopulmonary resuscitation under cervical stabilization: a manikin study.
The 2010 American Heart Association or European Resuscitation Council guidelines for cardiopulmonary resuscitation emphasize that rescuers should minimize interruption of chest compressions, even for endotracheal intubation. Cervical stabilization should also be maintained during traumatic cardiac arrest. The utility of the Pentax-AWS Airwayscope (AWS) video laryngoscope and Airtraq (ATQ) optic laryngoscope for airway management has been reported under cervical stabilization. We first evaluated ATQ utility during chest compression with or without cervical stabilization and then compared the AWS, ATQ, and Macintosh laryngoscope (McL) during chest compressions under cervical stabilization in a manikin. ⋯ The AWS was superior to McL and ATQ for endotracheal intubation during simulated cervical stabilization and chest compression.
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Journal of anesthesia · Dec 2011
Clinical TrialTissue Doppler imaging is useful for predicting the need for inotropic support after cardiac surgery.
Low preoperative left ventricular ejection fraction (EF) is a predictor of the need for inotropic support after cardiac surgery. However, EF can be misinterpreted and difficult to measure in some cases. The purpose of this study was to compare the value of preoperative EF and intraoperative tissue Doppler imaging variables in predicting the need for postoperative inotropic support. ⋯ This study suggests that those patients who have decreased S(m) and extended CPB times are more likely to require inotropic support after surgery, independent of a preserved left ventricular EF.
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Journal of anesthesia · Dec 2011
Impact of remifentanil introduction on practice patterns in general anesthesia.
The introduction of new medicine can change clinical practice patterns and may affect patient outcomes. In the present study, we investigated whether introduction of remifentanil in Japan affected the practice patterns of anesthesia. ⋯ Our data revealed rapid changes in practice patterns in anesthesia after the introduction of remifentanil in Japan. Remifentanil was used more often in patients with comorbidities and without epidural anesthesia, and its introduction did not affect increase in total medical costs.
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Journal of anesthesia · Dec 2011
Clinical TrialAssessment of cardiac preload status by pulse pressure variation in patients after anesthesia induction: comparison with central venous pressure and initial distribution volume of glucose.
Recognition of intraoperative hypovolemia is important for fluid management. Previous studies demonstrated functional preload parameter pulse pressure variation (PPV) could predict volume changes in response to fluid loading and loss. In this study, we examined the correlation between PPV and other two cardiac preload indicators, central venous pressure (CVP) or initial distribution volume of glucose (IDVG), in patients after anesthesia induction. ⋯ As an indicator of cardiac preload, PPV has a negative linear correlation with IDVG in patients after anesthesia induction. It does not correlate well with CVP in the normal range. Our results imply that an individual PPV, not CVP, is equivalent to IDVG in assessing volume status after induction.