Journal of anesthesia
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Journal of anesthesia · Dec 2013
Does intravenous landiolol, a β1-adrenergic blocker, affect stroke volume variation?
There are no reports about the effect of bradycardia on stroke volume variation (SVV), and we hypothesized that induced bradycardia alters the value of SVV. Landiolol, an ultra-short-acting adrenergic β1-receptor blocking agent, was reported to induce bradycardia without decreasing blood pressure. The initial aim of this prospective study was to investigate changes in SVV values by induced bradycardia in patients with good cardiac function. ⋯ SVV decreased after continuous administration of a β1-adrenergic blocker, probably because of a decrease in the difference of maximum stroke volume (SV) and minimum SV, or the downward shift of the Frank-Starling curve that occurred after landiolol administration. We believe that SVV values might be overestimated or misinterpreted when HR is decreased by landiolol and might not necessarily indicate that the patient is hypervolemic or normovolemic.
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Journal of anesthesia · Dec 2013
Ultrasound-guided sciatic nerve pulsed radiofrequency for chronic knee pain treatment: a novel approach.
Chronic knee pain management with current nonpharmacological or pharmacological measures often has suboptimal results and significant side effects. Sciatic nerve pulsed radiofrequency (SNPRF) is an unexplored alternative for chronic knee pain management. We show a prospective short series of chronic knee pain patients managed with ultrasound-guided SNPRF. ⋯ No patient reported adverse events during the 1-month follow-up period. Ultrasound-guided SNPRF is a new approach for chronic knee pain management that leads to significant pain reduction in the short term. Randomized studies with adequate size, longer follow-up period, and appropriate evaluating tools are warranted to verify these preliminary data.
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Journal of anesthesia · Dec 2013
Early postoperative cognitive dysfunction is associated with higher cortisol levels in aged patients following hip fracture surgery.
This study aimed to evaluate the relationship between plasma cortisol levels and the occurrence of postoperative cognitive dysfunction (POCD) in aged patients following hip fracture surgery. A total of 175 patients, aged 65 years or older, who were scheduled for hip fracture surgery with spinal anesthesia were enrolled. Perioperative plasma levels of cortisol and neurocognitive tests were determined at 1 day preoperatively and 7 days postoperatively. ⋯ Furthermore, plasma cortisol levels were negatively correlated with mini-mental state examination (MMSE) scores at 7 days postoperatively (P < 0.0001). A specificity of 93 % and a sensitivity of 35 % were identified for the plasma cortisol measurement to discriminate POCD patients from non-POCD patients. The results suggest higher plasma cortisol levels are associated with POCD in aged patients following hip fracture surgery with spinal anesthesia.
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Journal of anesthesia · Dec 2013
New index of pain triggered by spinal activation of voltage-dependent sodium channels.
Voltage-dependent sodium channels (VDSCs) are crucial for pain generation. Here, to develop a new behavioral index of pain induced by spinal VDSC activation, we examined whether intrathecal veratridine injection produced nociceptive behavior. ⋯ Systemic administration of lidocaine and mexiletine, but not amitriptyline, also decreased this response time. Taken together, these results demonstrated that response time of nociceptive behavior induced by intrathecal veratridine injection is a quantitative index of pain triggered by spinal VDSC activation.
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Journal of anesthesia · Dec 2013
The RACHS-1 risk category can be a predictor of perioperative recovery in Asian pediatric cardiac surgery patients.
The Risk Adjustment for Congenital Heart Surgery (RACHS-1) classification was originally designed to facilitate the prediction of in-hospital mortality for pediatric cardiac surgery patients. However, there have been few reports on clinical outcomes predicted by the RACHS-1 category, especially in an Asian population. The aim of this study was to determine whether RACHS-1 classification can predict patient outcomes. ⋯ Based on the results of our analysis, we conclude that the RACHS-1 stratification system can predict in-hospital mortality and patient outcomes in patients undergoing pediatric cardiac surgery.