Journal of anesthesia
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Journal of anesthesia · Oct 2012
Prediction of volume responsiveness using pleth variability index in patients undergoing cardiac surgery after cardiopulmonary bypass.
The pleth variability index (PVI) is derived from analysis of the plethysmographic curve and is considered to be a noninvasive parameter for prediction of volume responsiveness. The aim of our prospective clinical study was to evaluate if volume responsiveness can be predicted by PVI in patients undergoing cardiac surgery after cardiopulmonary bypass. ⋯ For consideration of fluid responsiveness PVI is as accurate as SVV in patients after cardiopulmonary bypass. Methodological limitations such as instable cardiac rhythm after cardiopulmonary bypass and right- or left ventricular impairment seem to be responsible for low specificity and positive predictive values in both parameters PVI and SVV.
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Journal of anesthesia · Oct 2012
Randomized Controlled TrialIntravenous butorphanol administration reduces intrathecal morphine-induced pruritus after cesarean delivery: a randomized, double-blind, placebo-controlled study.
Pruritus associated with intrathecal opioid administration is a common side effect. There is evidence that κ-opioid receptor agonists have antipruritic activity. Butorphanol has agonist actions at both κ-opioid and μ-opioid receptors. This study was designed to evaluate the antipruritic efficacy of butorphanol after intrathecal morphine administration in the setting of a randomized, double-blind study of parturients undergoing cesarean section. ⋯ Administration of intravenous butorphanol after delivery of the baby can reduce pruritus that has been induced by intrathecal morphine administration in cesarean delivery with combined spinal-epidural anesthesia.
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Journal of anesthesia · Oct 2012
Percutaneous intradiscal high-pressure injection of saline and lidocaine in patients with lumbar intervertebral disc extrusion.
The intradiscal high-pressure injection of saline and lidocaine (IDHP) is a minimally invasive percutaneous procedure for a lumbar intervertebral disc extrusion. The purpose of this study was to investigate the clinical outcomes of IDHP in terms of pain relief, reduction of disability, and risk of complications. Thirty patients with primarily radicular pain due to an extrusion-type disc herniation who underwent IDHP were enrolled in the study. ⋯ The mean JOA score improved significantly (p < 0.01) from 14.7 to 21.3 at 2 weeks post-treatment and 24.6 at 3 months post-treatment. IDHP appeared to produce significant effects in patients with radicular pain, leading to the improvement of VAS and JOA scores. IDHP appears to be a safe, minimally invasive treatment option for a lumbar intervertebral disc extrusion.
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Journal of anesthesia · Oct 2012
Superior recovery profiles of propofol-based regimen as compared to isoflurane-based regimen in patients undergoing craniotomy for primary brain tumor excision: a retrospective study.
Studies comparing the recovery profiles of isoflurane- and propofol-based anesthesia for major intracranial surgery have reported contradictory results. The aim of our study was to clarify the emergence status in both regimens by investigating uniformly managed neuroanesthesia cases. ⋯ Propofol was associated with a better recovery profile and neurological condition than isoflurane, as indicated by shorter extubation and OR discharge times and better postoperative consciousness.
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Journal of anesthesia · Oct 2012
Interleukin-18 levels reflect the long-term prognosis of acute lung injury and acute respiratory distress syndrome.
The purpose of this study was to investigate the relationship between the blood levels of interleukin (IL)-18 measured in the early stage of acute respiratory failure and the prognosis for patient survival. ⋯ The present data demonstrate an inverse correlation between serum IL-18 level and the P/F ratio, suggesting the possible involvement of IL-18 in the pathogenesis of respiratory failure in patients with ALI/ARDS. Early-stage serum IL-18, IL-12, and TNF-α levels appear to reflect the >60-day prognosis in patients with ALI/ARDS.