Journal of anesthesia
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Journal of anesthesia · Jun 2015
Case Reports Multicenter StudyIncidence of cannot intubate-cannot ventilate (CICV): results of a 3-year retrospective multicenter clinical study in a network of university hospitals.
The purpose of this study was to investigate the incidence of cannot intubate-cannot ventilate (CICV) during general anesthesia during a 3-year period in a network of university hospitals and to evaluate the events related to it. ⋯ In our survey, we found that the incidence of CICV during a 3-year period (2010-2012) was 0.003% or 1 in 32,000 cases. The three CICV situations occurred after repeated intubation attempts with multiple devices. The appropriate airway devices to be used in a particular difficult airway situation should be carefully considered before performing multiple attempts.
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Journal of anesthesia · Jun 2015
The effect of preeclampsia on the skin to subarachnoid distance in spinal anesthesia.
Preeclampsia is characterized by increased extracellular fluid which manifests as generalized edema due to endothelial injury and subsequent capillary leak. Therefore, preeclampsia may lead to increased skin to subarachnoid distance (SSD) which may influence daily clinical practice in this particular gravid population. ⋯ Knowing that the SSD is increased in preeclamptics compared to normotensive gravidas may be of value in terms of selecting needle, and providing safe and comfortable anesthesia.
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Journal of anesthesia · Jun 2015
Editorial CommentCannot intubate cannot ventilate-focus on the 'ventilate'
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Journal of anesthesia · Jun 2015
Randomized Controlled Trial Comparative StudyThe effects of nicardipine or esmolol on the onset time of rocuronium and intubation conditions during rapid sequence induction: a randomized double-blind trial.
The main aims of rapid sequence induction (RSI) are prompt and adequate muscle relaxation for tracheal intubation and hemodynamic stability during and after intubation. The purpose of the present study was to investigate the effects of nicardipine and esmolol on the action of rocuronium and intubation conditions during RSI. ⋯ Pretreatment with nicardipine for RSI improved intubation conditions and shortened the onset time of rocuronium and attenuated changes in MAP after intubation. Esmolol may disturb intubation conditions and the onset of action of rocuronium, despite being effective in alleviating responses of HR after RSI.
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Journal of anesthesia · Jun 2015
Randomized Controlled Trial Comparative StudyUltrasound-guided continuous thoracic paravertebral block provides comparable analgesia and fewer episodes of hypotension than continuous epidural block after lung surgery.
Both paravertebral block (PVB) and thoracic epidural block (TEB) are recommended for postoperative pain relief after lung surgery. The addition of fentanyl to the anesthetic solution became popular for TEB because of the stronger effects; however, there have been few comparable trials about the addition of fentanyl to PVB. The purpose of this study was thus to compare postoperative analgesia, side effects, and complications between ultrasound-guided PVB (USG-PVB) and TEB with the addition of fentanyl to ropivacaine after lung surgery. ⋯ USG-PVB achieved similar pain relief and lowered the incidence of hypotension compared with TEB. We conclude that both blocks with the same concentration of ropivacaine and fentanyl can provide adequate postoperative analgesia for VATS.