Journal of anesthesia
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Journal of anesthesia · Aug 2011
The usefulness of an earphone-type infrared tympanic thermometer during cardiac surgery with cardiopulmonary bypass: clinical report.
We evaluated the usefulness of a novel earphone-type infrared tympanic thermometer (IRT) during cardiac surgery with cardiopulmonary bypass. Tympanic membrane temperature (T(Tym)) was monitored using the IRT inserted into the right ear canal of 12 adult patients (ASA III) who had been scheduled for elective cardiac surgery with cardiopulmonary bypass under general anesthesia. Rectum (T(Rec)) and nasopharyngeal temperatures (T(Naso)) were also monitored, and all temperatures were recorded at 5-min intervals during cardiopulmonary bypass. ⋯ Significant correlations were seen between T(Tym) and T(Naso) (r = 0.971, P < 0.001), and T(Tym) and T(Rec) (r = 0.759, P < 0.001). A Bland-Altman plot showed that average temperature of T (Tym) was 0.06°C above T(Naso) (±0.66°C, 2 SD) and 0.12°C below T(Rec) (±1.78°C, 2 SD). We conclude that an earphone-type IRT is noninvasive and hygienic and could continuously evaluate selective cerebral temperature during cardiopulmonary bypass in adults.
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Journal of anesthesia · Aug 2011
Comparison of Laryngeal Mask Supreme® and Soft Seal® for airway management in several positions.
In emergency situations, rescuers occasionally must secure the airway while the patient is in a position other than the ideal supine position. We hypothesized that the laryngeal mask airway Supreme(®) (Supreme) may be useful for emergent airway management in several positions and compared the utility of the Supreme with that of the conventional Soft Seal(®) (Soft Seal) device. ⋯ Airway management attempts by novice doctors were more successful with the Supreme than the Soft Seal in the right-LT, prone, and sitting positions in the manikin. The Supreme may therefore be useful for emergent airway management.
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Journal of anesthesia · Aug 2011
Case ReportsAdministration of dexmedetomidine alone during diagnostic cardiac catheterization in adults with congenital heart disease: two case reports.
We report the clinical management of 2 adults with mental retardation because of trisomy 21 who were sedated with high-dose dexmedetomidine (DEX) alone during diagnostic cardiac catheterization (DCC). The first patient was a 25-year-old man with aortic regurgitation and ventricular septal defect. DEX increased his Ramsay sedation score; however, a high dose and bolus injection of DEX were required to perform an invasive procedure. ⋯ Percutaneous oxygen saturation was kept above 83%, because of the suspicion that DEX may increase the ratio of pulmonary artery flow to systemic artery flow. In both cases, no respiratory system complications occurred despite inspiration of room air, indicating the usefulness of DEX for DCC. However, because of DEX may affect DCC data, it is necessary to pay careful attention to the use of DEX during DCC.
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Journal of anesthesia · Aug 2011
Evaluation of estimation of physiologic ability and surgical stress to predict in-hospital mortality in cardiac surgery.
Prediction of postoperative risk in cardiac surgery is important for cardiac surgeons and anesthesiologists. We generated a prediction rule for elective digestive surgery, designated as Estimation of Physiologic Ability and Surgical Stress (E-PASS). This study was undertaken to evaluate the accuracy of E-PASS in predicting postoperative risk in cardiac surgery. ⋯ E-PASS may accurately predict postoperative risk in cardiac surgery. Because the variables are different between cardiac-specific models and E-PASS, patients' risks can be double-checked by cardiac surgeons using cardiac-specific models and by anesthesiologists using E-PASS.