Journal of anesthesia
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Journal of anesthesia · Jun 2014
Randomized Controlled TrialA randomized controlled trial of preinsertion ultrasound guidance for spinal anaesthesia in pregnancy: outcomes among obese and lean parturients : Ultrasound for spinal anesthesia in pregnancy.
The present study was conducted to examine if preinsertion lumbar ultrasound scanning helps with performance of spinal puncture, as a tool for decreasing the number of puncture attempts and spinal procedure time and increasing the success rate. We hypothesized that ultrasound can facilitate neuraxial blockade, particularly in pregnant women with difficult topographic anatomy. ⋯ We found a high level of success in the prepuncture ultrasound-determined insertion point. The ultrasound imaging technique can be a reliable guide to facilitate spinal anesthesia, especially in obese parturients.
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Journal of anesthesia · Jun 2014
Randomized Controlled Trial Comparative StudyComparison of randomized preemptive dexketoprofen trometamol or placebo tablets to prevent withdrawal movement caused by rocuronium injection.
Rocuronium is a non-depolarizing neuromuscular blocking agent which is associated with injection pain and induces withdrawal movement of the injected hand or arm or generalized movements of the body after intravenous injection. The aim of this randomized study was to compare the efficacy of pretreatment with oral dexketoprofen trometamol (Arvelles(®); Group A) with placebo (Group P) without tourniquet to prevent the withdrawal response caused by rocuronium injection. The study cohort comprised 150 American Society of Anaesthesiologists class I-III patients aged 18-75 years who were scheduled to undergo elective surgery with general anesthesia. ⋯ The incidence of score 0 withdrawal movements was higher in Group A (69.9 %) than in Group P (35.4 %), that of score 1 withdrawal movements was similar between groups (Group A 21.9 %; Group B 26.1 %) (p = 0.560) and that of score 2 withdrawal movements was lower in Group A (8.2 %) than in Group P (38.5 %) (p < 0.001). There were no score 3 withdrawal movements in either group (p > 0.05). These results demonstrate that the preemptive administration of dexketoprofen trometamol can attenuate the degree of withdrawal movements caused by the pain of the rocuronium injection.
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Journal of anesthesia · Jun 2014
Case ReportsPreoperative morphological analysis by transesophageal echocardiography and predictive value of plasma landiolol concentration during systolic anterior motion mitral valve repair : a report of three cases.
We report three cases with systolic anterior motion (SAM) after mitral valve plasty. Preoperative mitral valve morphology is a risk factor for SAM. ⋯ With the use of 3D transesophageal echocardiography, when mitral valve prolapse was investigated, in all three cases, it was easy to specify lesions. The issue for the future is 3D analysis when SAM is occurring.