Journal of anesthesia
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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 StudyA comparative study of dexmedetomidine and propofol as sole sedative agents for patients with aneurysmal subarachnoid hemorrhage undergoing diagnostic cerebral angiography.
Subarachnoid hemorrhage is an acute neurological emergency requiring urgent confirmation of the diagnosis for planning definitive management. Due to altered consciousness, most patients require sedation for conducting this procedure smoothly. Currently, it is unclear if any one particular sedative drug has a favorable profile in patients undergoing cerebral angiography. The aim of this study was to compare the traditionally used sedative drug propofol with a newer alternative, dexmedetomidine, in patients with subarachnoid hemorrhage undergoing cerebral angiography. ⋯ Dexmedetomidine appears to be superior to propofol as a sole sedative agent for sedation during cerebral angiography in patients with subarachnoid hemorrhage.
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Journal of anesthesia · Jun 2015
Randomized Controlled Trial Comparative StudyThe effect of 0.5 L 6 % hydroxyethyl starch 130/0.42 versus 1 L Ringer's lactate preload on the hemodynamic status of parturients undergoing spinal anesthesia for elective cesarean delivery using arterial pulse contour analysis.
Fluid loading attenuates the hypotensive response to spinal anesthesia (SA). This study aimed to compare the preload efficacy of 0.5 L hydroxyethyl starch (HES) versus 1 L Ringer's lactate (R/L) in the prevention of hypotension after SA for elective cesarean delivery (CD). Assessment of maternal hemodynamic variables using FloTrac/Vigileo™ and neonatal outcome constituted secondary outcomes. ⋯ Preloading with 0.5 L HES 130/0.42 produced more stable hemodynamics compared to 1 L R/L solution in obstetric patients.
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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
Randomized Controlled Trial Comparative StudyComparison of tube-guided and guideless videolaryngoscope for tracheal intubation during chest compression in a manikin: a randomized crossover trial.
Previous studies have shown the utility of indirect glottis viewing videolaryngoscopes for tracheal intubation during chest compression, but the efficacy of a videolaryngoscope with tube guide has not been sufficiently validated. We compared the utility of two videolaryngoscopes, the KingVISION(®) (KingV) with or without tube guide blade and Pentax-AWS Airwayscope(®) (AWS), which contain tube guide function, during chest compressions on an adult manikin. ⋯ These findings suggest that the AWS and KingV-Guided devices are more effective than the KingV-Guideless for airway management with chest compressions in adult simulations, especially performed by novice doctors. The tube guide function may contribute to successful airway management during chest compression by the added videolaryngoscopy function.