Journal of anesthesia
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Journal of anesthesia · Dec 2014
Meta Analysis Comparative StudyKetamine does not increase intracranial pressure compared with opioids: meta-analysis of randomized controlled trials.
Ketamine is traditionally avoided in sedation management of patients with risk of intracranial hypertension. However, results from many clinical trials contradict this concern. We critically analyzed the published data of the effects of ketamine on intracranial pressure (ICP) and other cerebral hemodynamics to determine whether ketamine was safe for patients with hemodynamic instability and brain injuries. ⋯ The results of this study suggest that ketamine does not increase ICP compared with opioids. Ketamine provides good maintenance of hemodynamic status. Clinical application of ketamine should not be discouraged on the basis of ICP-related concerns.
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Journal of anesthesia · Dec 2014
Randomized Controlled Trial Comparative StudyA randomized comparison of long-axis and short-axis imaging for in-plane ultrasound-guided popliteal-sciatic perineural catheter insertion.
Ultrasound-guided long-axis in-plane sciatic perineural catheter insertion has been described but not validated. For the popliteal-sciatic nerve, we hypothesized that a long-axis in-plane technique, placing the catheter parallel and posterior to the nerve, results in faster onset of sensory anesthesia compared to a short-axis in-plane technique. ⋯ Long-axis in-plane popliteal-sciatic perineural catheter insertion requires more time to perform compared to a short-axis in-plane technique without demonstrating any advantages.
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Journal of anesthesia · Dec 2014
Randomized Controlled TrialIntravenous dezocine pretreatment reduces the incidence and intensity of myoclonus induced by etomidate.
To evaluate the suppressive effect of intravenous dezocine on the incidence and severity of myoclonic movements induced by etomidate, a total of 80 patients, American Society of Anesthesiologists physical status I-II, were randomized into two equally sized groups (n = 40). These two groups were assigned to give either intravenous dezocine 0.1 mg/kg or a matching placebo (equal volume of 0.9% saline) 30 s before administration of etomidate. ⋯ Pretreatment with dezocine significantly reduced both the incidence and intensity of myoclonus. These results demonstrate that intravenous dezocine 0.1 mg/kg 30 s prior to induction was effective in suppressing myoclonic movements in our patients.
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Journal of anesthesia · Dec 2014
Randomized Controlled Trial Comparative StudyComparison of cognitive, ambulatory, and psychomotor recovery profiles after day care anesthesia with propofol and sevoflurane.
We compared the recovery profile of propofol and sevoflurane when used for maintenance of anesthesia in elective day care operative procedures. ⋯ Recovery from sevoflurane anesthesia, especially with regard to cognitive functions, may be slightly faster than from propofol, but the difference is not sufficiently significant to affect the time to "home-readiness" in patients undergoing day care surgery.
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Journal of anesthesia · Dec 2014
Remote ischemic preconditioning prevents lipopolysaccharide-induced liver injury through inhibition of NF-κB activation in mice.
Remote ischemic preconditioning (RIPC) is a potent preconditioning stimulus that may confer subsequent protection to organs subjected to potentially lethal injury. The aim of this study was to investigate the effect of RIPC on nuclear factor (NF)-κB activation, tumor necrosis factor (TNF)-α release, and hepatic injury in lipopolysaccharide (LPS)-induced sepsis. ⋯ The results demonstrate that RIPC has protective effects in liver injury via attenuation of TNF-α production in LPS-induced sepsis. The suppressive effect on TNF-α production may be mediated through inhibition of NF-κB activation.