Journal of anesthesia
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Journal of anesthesia · Dec 2015
Randomized Controlled Trial Comparative StudyFace-to-face tracheal intubation in adult patients: a comparison of the Airtraq™, Glidescope™ and Fastrach™ devices.
Airway management in emergency settings can be difficult due to limited access to the patient. The use of video laryngoscopes along with the Fastrach™ device improves tracheal intubation; however, the use of such devices in a face-to-face intubation model has not been evaluated in adult patients. ⋯ The Airtraq™ device provided faster insertion and intubation times and enabled better Cormack-Lehane grades. Additionally, the Airtraq™ device required the minimum number of optimization maneuvers and was associated with fewer complications and fewer intubation attempts than the Glidescope™ and Fastrach™ devices during face-to-face tracheal intubation.
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Journal of anesthesia · Dec 2015
Randomized Controlled TrialFlurbiprofen axetil increases arterial oxygen partial pressure by decreasing intrapulmonary shunt in patients undergoing one-lung ventilation.
In the present study, we investigated whether flurbiprofen axetil (FA) alleviates hypoxemia during one-lung ventilation (OLV) by reducing the pulmonary shunt/total perfusion (Q s/Q t) ratio, and examined the relationship between the Q s/Q t ratio and the thromboxane B2 (TXB2)/6-keto-prostaglandin F1α (6-K-PGF1α) ratio. ⋯ Treatment with FA reduced the Q s/Q t ratio and further increased the PaO2 level during OLV, possibly due to upregulation of the vasoactive agent TXB2/6-K-PGF1α ratio.
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Journal of anesthesia · Dec 2015
ReviewAirway management in patients undergoing emergency Cesarean section.
Special care is required for airway management of patients undergoing emergency Cesarean section. Although the incidence of difficult intubation and difficult ventilation is similar between pregnant and non-pregnant women, the severity of complications in pregnant patients would be much greater than in non-pregnant patients, if tracheal intubation is found to be difficult: increased risk of pulmonary aspiration, hypoxia, airway obstruction due to laryngeal edema, and a "sleeping baby" being taken out. ⋯ The technique has been evolving, without losing the key premise of minimizing the period of the airway being not protected from pulmonary aspiration, and of permitting rapid wake up if tracheal intubation fails. In this review, I describe the appropriate airway management, based on the current state of knowledge, in a patient undergoing emergency Cesarean section under general anesthesia.
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Journal of anesthesia · Dec 2015
Biological processes and pathway changes in isoflurane-induced anesthesia revealed by bioinformatics analysis of gene expression profiles.
To identify differentially expressed genes (DEGs) and further analyze potential biological processes and pathways involved in isoflurane-induced anesthesia. ⋯ The identified DEGs significantly enriched in biological processes and KEGG pathways might be implicated in isoflurane-induced anesthesia.
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Journal of anesthesia · Dec 2015
Case ReportsPercutaneous adjustment method for transversely migrated spinal cord stimulation leads: a technical report.
Lead migration is the most common complication of spinal cord stimulation (SCS). However, the only corrective method for lead migration is revision surgery, which may cause additional complications. Here, we describe a new technique for adjusting a transversely migrated SCS lead. ⋯ After re-adjustment of the SCS lead, good coverage of the electrical stimulation was confirmed. Patients were followed for 9-19 months and they reported satisfactory pain relief and good electrical coverage after adjusting the SCS lead. Here, we describe a new technique for adjusting a transversely migrated SCS lead using a percutaneous epidural approach as a simple, safe, and cost-effective alternative to revision surgery.