Journal of anesthesia
-
Journal of anesthesia · Aug 2012
Effects of tidal volume and PEEP on arterial blood gases and pulmonary mechanics during one-lung ventilation.
The main problem of one-lung ventilation (OLV) is hypoxemia. The use of a high tidal volume for preventing hypoxemia during OLV is controversial. We compared the effects of a high tidal volume versus a low tidal volume with or without PEEP on arterial oxygen tension (PaO(2)) and pulmonary mechanics during OLV. ⋯ During OLV, mechanical ventilation with a low tidal volume with or without PEEP increased hypoxemia as compared to that when performing OLV with a high tidal volume.
-
Journal of anesthesia · Aug 2012
Case ReportsPerioperative management of a patient with thyroid hormone resistance who underwent total thyroidectomy for thyroid cancer.
Resistance to thyroid hormone (RTH) is a rare, predominantly inherited syndrome that involves impaired tissue responsiveness to thyroid hormones. We describe the perioperative management of a patient with RTH who underwent total thyroidectomy. ⋯ Moreover, thyroid function even after discharge remained unstable despite replacement therapy. We suggest that the parathyroid and thyroid function of patients with RTH be followed very closely and that nociceptive stimulus of the surgery and postoperative pain be reduced as much as possible.
-
Journal of anesthesia · Aug 2012
Prediction of optimal endotracheal tube cuff volume from tracheal diameter and from patient height and age: a prospective cohort trial.
Endotracheal tube intra-cuff pressure should be maintained between 20 and 30 cmH(2)O to prevent damage to the tracheal wall. However, cuff pressure is rarely measured, and clinicians estimate cuff pressure poorly. The goal of the present study was to predict the cuff volume that produces optimal cuff pressure either from tracheal diameter or from patient height and age. ⋯ Optimal cuff volume was better estimated from tracheal diameter and patient height and age than from the manual palpation method.
-
Journal of anesthesia · Aug 2012
Effects of TrkA inhibitory peptide on cancer-induced pain in a mouse melanoma model.
Tropomyosin receptor kinase (Trk) A, a high-affinity receptor of nerve growth factor, is a therapeutic target for both noxious and neuropathic pain. The present study examined the effects of an inhibitory peptide of Trk activity (IPTRK) 3 that inhibits TrkA activity on cancer-induced pain in a mouse melanoma model. ⋯ These results suggest that TrkA inhibitory peptide likely suppress melanoma-induced pain with concomitant reduction in the increased paw volume in a mouse skin cancer pain model.
-
Journal of anesthesia · Aug 2012
Postoperative continuous intravenous infusion of fentanyl is associated with the development of orthostatic intolerance and delayed ambulation in patients after gynecologic laparoscopic surgery.
Early ambulation is essential for rapid functional recovery after surgery; however, orthostatic intolerance may delay recovery and cause syncope, leading to potential serious complications such as falls. Opioids may contribute to orthostatic intolerance because of reduced arterial pressure and associated reduction in cerebral blood flow and oxygenation. This study aimed to examine the effect of postoperative continuous infusion of fentanyl on orthostatic intolerance and delayed ambulation in patients after gynecologic laparoscopic surgery. ⋯ Postoperative continuous infusion of fentanyl is associated with increased orthostatic intolerance and delayed ambulation in patients after gynecologic laparoscopic surgery.