Journal of anesthesia
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Journal of anesthesia · Apr 2011
ReviewAnesthetic management of noncardiac surgery for patients with single ventricle physiology.
Patients with congenital heart diseases are a growing population, and noncardiac surgeries will become an important health care issue. Patients with single ventricle physiology are a particularly challenging population who will undergo staged, palliative repair toward a final step of Fontan circulation. Although Fontan surgery creates a serial circulation in which the ventricle pumps blood to the systemic circuit, pulmonary blood flow occurs without a dedicated ventricle. ⋯ Health care professionals must prepare for these patients to present to noncardiac surgery at any stage of intervention, possibly with complications. Given that staged, palliative repair has undergone multiple modifications, patients who present for surgery can vary in types and timing of the repair. Anesthesiologists who care for them must be familiar with perioperative issues to optimize outcomes, especially because congenital heart disease is a risk factor for increased mortality for noncardiac surgery.
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Journal of anesthesia · Apr 2011
Scientific publications in anesthesiology journals from East Asia: a 10-year survey of the literature.
The scientific publications in anesthesiology research from East Asian authors have not been reported yet. The present study was designed to analyze the contribution of articles from East Asia to anesthesiology research. Articles published in 17 journals in anesthesiology originating from Japan, China, and South Korea from 2000 to 2009 were retrieved from the PubMed database and Web of Science. ⋯ Our analysis showed that Japan was the most productive region in East Asia, but there was a notable decrease in publications from Japan in 2000-2009. The impact factor of the articles suggests similar levels of scholarship. Anesthesia & Analgesia was the most popular journal in East Asia.
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Journal of anesthesia · Apr 2011
Randomized Controlled TrialLow-dose ropivacaine or levobupivacaine walking spinal anesthesia in ambulatory inguinal herniorrhaphy.
The purpose of our study was to compare the equipotent doses of ropivacaine and levobupivacaine for walk-out criteria and the characteristics of spinal anesthesia in inguinal herniorrhaphy surgery. ⋯ We suggest that both local anesthetics can be used in walking spinal technique. Levobupivacaine may be an alternative local anesthetic for walking spinal anesthesia as it provides minimum motor block and a long duration of postoperative analgesia, even if its use is not associated with a shorter home discharge time.
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Journal of anesthesia · Apr 2011
Randomized Controlled TrialThe effect of ketamine on tracheal intubating conditions without neuromuscular blockade during sevoflurane induction in children.
The purpose of this study was to investigate the effect of ketamine on intubating conditions for tracheal intubation during anesthesia induction with sevoflurane and alfentanil in pediatric patients. ⋯ This study demonstrated that administration of ketamine 0.5 mg/kg could improve intubating conditions for tracheal intubation without neuromuscular blockade and preserve hemodynamic stability during sevoflurane inhalation induction with alfentanil in children.
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Journal of anesthesia · Apr 2011
Case ReportsEpiglottic prolapse induced by lighted stylet tracheal intubation.
We report a case of epiglottic prolapse induced by lighted stylet tracheal intubation perceived by following upper gastrointestinal endoscopy. A 68-year-old male was to undergo endoscopic mucosal resection (EMR) under general anesthesia for a superficial orolarynx cancer spreading over the root of the tongue. Because the mucosal change was so minimal, intubation was performed with a lighted stylet instead of a direct laryngoscope, to prevent its metal blade spoiling the delicate endoscopic findings. ⋯ The postoperative course was uneventful and he was discharged on the sixth postoperative day. Retrospective evaluation of preoperative gastrointestinal endoscopy showed the epiglottis was flat and thin enough to have a tendency to become attached to the posterior pharynx wall, even though the procedure was performed in the decubitus position. Epiglottic prolapse induced by lighted stylet tracheal intubation is a quite rare complication but we should be aware of it as a potential injury which could cause upper airway obstruction if not recognized before extubation.