Journal of anesthesia
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Journal of anesthesia · Jun 2011
Randomized Controlled Trial Comparative StudyAntiemetic prophylaxis in thyroid surgery: a randomized, double-blind comparison of three 5-HT3 agents.
The aim of this double-blind randomized study was to compare the antiemetic efficacy of three 5-hydroxytryptamine type 3 antagonists in terms of the incidence and intensity of postoperative nausea and vomiting (PONV) in a homogenous group of female patients undergoing thyroidectomy. ⋯ Among the female patients of this study undergoing thyroid surgery, granisetron 3 mg provided the best prophylaxis from PONV. Ondansetron 4 mg was equally effective, but its action lasted only 6 h, whereas tropisetron 5 mg was found ineffective.
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Journal of anesthesia · Jun 2011
Randomized Controlled TrialEffects of maternal supplementary oxygen on the newborn for elective cesarean deliveries under spinal anesthesia.
The aim of this investigation was to determine whether supplementary oxygen provided by either nasal cannula or face mask versus room air might affect fetal oxygenation during elective cesarean section under spinal anesthesia by assessing maternal and neonatal regional cerebral oxygenation (rSO(2)) with a cerebral oximeter. ⋯ The effect of maternal supplementary oxygen on the newborn has been demonstrated by a cerebral oximeter monitor and supported by umbilical cord blood gas analysis and Apgar scores.
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Journal of anesthesia · Jun 2011
Case ReportsPostoperative respiratory failure caused by acute exacerbation of idiopathic interstitial pneumonia.
We herein report a case of postoperative respiratory failure caused by acute exacerbation of undiagnosed interstitial pneumonia (IP). A 76-year-old woman underwent two subsequent operations, cholecystectomy and resection of lipoma in the neck, under general anesthesia at an interval of 12 days. Although the postoperative course of the first operation was uneventful, the patient abruptly developed respiratory failure on the 4th postoperative day (POD) of the second operation. ⋯ Thus, we concluded that idiopathic IP had gradually advanced preoperatively, and acute exacerbation was triggered by perioperative stress. The present case warned us that acute exacerbation of IP could occur in a patient with mild symptoms. Therefore, preoperative proper diagnosis is thought to be important as acute exacerbation of IP is a highly morbid clinical event.
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Journal of anesthesia · Jun 2011
Randomized Controlled TrialEffect of pressure-reducing devices on the quality of anterior orbit anesthesia.
Needle length is an important consideration in the safe conduct of ophthalmic blocks. A shorter needle could be used to insert the local anesthetic before the globe equator in the anterior orbit and to direct the injectable posteriorly using Honan's balloon to produce the desired effect. However, the use of pressure-reducing devices is not advisable in procedures with impaired retinal blood flow. ⋯ Ocular akinesia was assessed 10 min later; if inadequate, supplementary anesthesia was provided. No difference was detected in terms of volume injected, supplementation, and akinesia score. Under the conditions of this study, Honan's balloon did not contribute to the quality of the anterior orbit anesthesia, and the technique can be successfully used when ocular compression is contraindicated.
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Journal of anesthesia · Jun 2011
Time course of changes in cerebral blood flow velocity after tourniquet deflation in patients with diabetes mellitus or previous stroke under sevoflurane anesthesia.
We observed an increase in mean middle cerebral artery blood flow velocity (V(mca)) after tourniquet deflation during orthopedic surgery under sevoflurane anesthesia in patients with diabetes mellitus or previous stroke. Eight controls, seven insulin-treated diabetic patients, and eight previous stroke patients were studied. Arterial blood pressure, heart rate, V(mca), arterial blood gases, and plasma lactate levels were measured every minute for 10 min after tourniquet release in all patients. ⋯ V(mca) in all three groups increased after tourniquet deflation, the increase lasting for 4 or 5 min. However, the degree of increase in V(mca) in the diabetic patients was smaller than that in the other two groups after tourniquet deflation (at 2 min after tourniquet deflation: control 58.5 ± 3.3, previous stroke 58.4 ± 4.6, diabetes 51.7 ± 2.3; P < 0.05 compared with the other two groups). In conclusion, the degree of increase in V (mca) in diabetic patients is smaller than that in controls and patients with previous stroke.