Journal of anesthesia
-
Journal of anesthesia · Feb 2013
Day zero ambulation under modified femoral nerve block after minimally invasive surgery for total knee arthroplasty: preliminary report.
Ambulation in the early postoperative period of total knee arthroplasty is crucial, in order to avoid complications and obtain preferable outcomes. Although a femoral nerve block can provide enough postoperative analgesia after total knee arthroplasty, falling, or other accidents due to motor paresis, are potentially adverse events in patients who have received a conventional femoral nerve block. We devised a modified femoral nerve block to spare voluntary knee extension ability, and clinically applied it to patients who received total knee arthroplasty under minimally invasive surgery. ⋯ Patients were able to not only actively raise their extremities with their knee in extension, but also to flex the knee in the air without pain or aggravation. On day 0, the patients were able to walk around, with the leg that had been operated upon not giving way. Our anesthetic approach can provide better pain relief than a conventional femoral nerve block, while the patients achieve ambulation on the day of the procedure, following minimally invasive knee surgery.
-
Journal of anesthesia · Feb 2013
Randomized Controlled Trial Comparative StudyComparison of effects of propofol and ketamine-propofol mixture (ketofol) on laryngeal mask airway insertion conditions and hemodynamics in elderly patients: a randomized, prospective, double-blind trial.
The objective of this study was to compare the effects of ketamine-propofol mixture (ketofol) and propofol on ProSeal laryngeal mask airway (PLMA) insertion conditions and hemodynamics in elderly patients. ⋯ The same PLMA insertion conditions were found with ketofol and propofol. The number of patients in need of ephedrine and the total ephedrine dose were lower and apnea duration was increased in the ketofol group.
-
Journal of anesthesia · Feb 2013
ReviewHow can we improve mask ventilation in patients with obstructive sleep apnea during anesthesia induction?
Recent evidence suggests the possible development of difficult mask ventilation in patients with obstructive sleep apnea. Based on our current understanding of the pathophysiology of pharyngeal airway obstruction in obstructive sleep apnea patients, we conclude that anesthesiologists can decrease respiratory complications during anesthesia induction by conducting careful pre-induction preparations, including body and head positioning and sufficient preoxygenation, and by using the two-hand mask ventilation technique with effective airway maneuvers and appropriate ventilator settings while continuously assessing ventilation status with capnography.
-
Journal of anesthesia · Feb 2013
Randomized Controlled TrialHyperventilation accelerates rise in arterial blood concentrations of sevoflurane in gynecologic patients.
We investigated whether ventilation volumes affected arterial blood sevoflurane concentration (A (sev)) and its uptake into the body during general anesthesia. ⋯ Hyperventilation accelerated the rate of A (sev) increase immediately after sevoflurane administration, which was time dependent with respect to different alveolar ventilation levels.