Journal of anesthesia
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Journal of anesthesia · Dec 2015
Effect of dexmedetomidine on the QT interval in pediatric patients undergoing general anesthesia.
Recent years have seen an increase in the use of dexmedetomidine in pediatric patients presenting for surgical procedures. However, only a limited number of studies have evaluated its effects on the QT interval in this patient group. To address this lack of knowledge, we have evaluated the effects of dexmedetomidine on the QT interval in children receiving sevoflurane anesthesia. ⋯ A progressive lengthening of the QTc interval following the administration of sevoflurane was observed in the control group. In the dexmedetomidine group, there was a significant shortening of the QTc interval following the administration of dexmedetomidine compared to the length of the post-induction QTc interval and when compared to the control group.
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Journal of anesthesia · Dec 2015
Evaluating the detailed position of the subclavian artery to avoid inadvertent subclavian artery puncture during right internal jugular vein catheterization.
Central venous catheter placement is useful but is associated with complications. Inadvertent subclavian artery (SCA) puncture is a rare complication associated with internal jugular vein (IJV) catheterization. We determined the position of the SCA by ultrasonography, and propose a needle-insertion position for avoiding inadvertent SCA puncture. ⋯ Puncturing the RIJV away from the center should avoid SCA puncture; puncturing it while approaching the clavicle is more dangerous. The exact location of the SCA varies from person to person; thus, confirming SCA position by ultrasonography is recommended every time before puncturing.
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Journal of anesthesia · Dec 2015
Preoperative anxiety induces no clinically relevant effect on intraoperative nociceptive levels during breast surgery under general anesthesia.
Anxiety can affect acute and chronic postoperative pain after breast surgery. Nociceptive response during surgery might also be affected by preoperative anxiety even under unconscious state during general anesthesia. The aim of this retrospective study was to investigate nociceptive responses during breast surgery under general anesthesia in patients with or without preoperative anxiety. ⋯ No significant differences in discriminant score were seen between groups (p = 0.10). Although we performed propensity score-matching to reduce the bias due to confounding variables in this retrospective study, there was also no significant difference in levels of nociceptive response between groups (p = 0.06). In conclusion, the level of nociception during breast surgery is not significantly affected by preoperative anxiety.
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Journal of anesthesia · Dec 2015
Incidence of hypoxia and related events detected by pulse oximeters provided by the Lifebox Foundation in the maternity unit at Sylvanus Olympio University Teaching Hospital, Togo.
In recent decades anesthesia safety has not been improved in low-income countries. This prospective audit describes the incidence of hypoxia and related events detected among a cohort of patients undergoing surgery in the maternity unit at Sylvanus Olympio University Teaching Hospital, Togo, West Africa, by using pulse oximeters donated by the Lifebox Foundation. The Lifebox oximeter enables early detection of hypoxia for patients undergoing surgery before irreversible damage occurs. Pulse oximetry is cost-effective intervention and should be more accessible in all operating rooms of this type.
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Journal of anesthesia · Dec 2015
Personal hand gel for improved hand hygiene compliance on the regional anesthesia team.
Hand hygiene reduces healthcare-associated infections, and several recent publications have examined hand hygiene in the perioperative period. Our institution's policy is to perform hand hygiene before and after patient contact. However, observation suggests poor compliance. This is a retrospective review of a quality improvement database showing the effect of personal gel dispensers on perioperative hand hygiene compliance on a regional anesthesia team. ⋯ On the Acute Pain Service, compliance with hand hygiene policy improves when individual sanitation gel dispensing devices are worn on the person.