Journal of anesthesia
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Journal of anesthesia · Aug 2015
Randomized Controlled TrialTransversus abdominis plane block with 0.25 % levobupivacaine: a prospective, randomized, double-blinded clinical study.
Because blood concentrations of local anesthetics sometimes reach toxic levels after transversus abdominis plane (TAP) block, reduction of the dose has been necessary to reduce the risk of systemic toxicity. We therefore investigated the effects of TAP block with 0.25 % levobupivacaine (100 mg) on postoperative pain and measured its plasma concentration after gynecological surgery. ⋯ TAP block with 100 mg levobupivacaine is a safe and efficacious multimodal analgesic regimen for postoperative pain after open gynecological surgery.
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Journal of anesthesia · Aug 2015
Randomized Controlled TrialEffects of dexmedetomidine and propofol on sedation in patients after coronary artery bypass graft surgery in a fast-track recovery room setting.
We aim to compare the effects of propofol and dexmedetomidine infusions on extubation times, hemodynamic and respiratory functions, complication rates and patient satisfaction scores in patients undergoing coronary artery bypass graft (CABG) surgery using a fast-track anesthesia regimen for early extubation. ⋯ Our results show that dexmedetomidine can easily be preferred over propofol in fast-track cardiac anesthesia due to its significant advantages of shorter extubation time and higher postoperative patient satisfaction scores.
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Journal of anesthesia · Aug 2015
The clinical course of anesthetic induction in lung transplant recipients with pulmonary complications after hematopoietic stem cell transplantation.
We examined the clinical course of anesthetic induction in lung transplant recipients with pulmonary complications after hematopoietic stem cell transplantation (post-HSCT), focusing on ventilatory management. We aimed to determine the incidence of oxygen desaturation during anesthetic induction and severe respiratory acidosis after anesthetic induction in post-HSCT lung transplant recipients, and to explore factors associated with their development. ⋯ Oxygen desaturation during anesthetic induction and severe respiratory acidosis after anesthetic induction frequently occur in post-HSCT lung transplant recipients. Low Cdyn may, at least partially, explain oxygen desaturation during anesthetic induction and severe respiratory acidosis after anesthetic induction. Moreover, preoperative hypercapnia and low BMI were predictive of low Cdyn.
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Lidocaine has a biphasic action on smooth muscle of peripheral blood vessels, with vasoconstriction at low concentrations and vasodilation at higher concentrations. Many in vivo studies have demonstrated the effects of lidocaine on aortic or coronary arteries in several animals, but there are few reports about the effect on peripheral vessels. This study was designed to investigate the direct effects of lidocaine on peripheral vessels, namely swine lingual and pulmonary arterial rings. ⋯ Lidocaine-induced vasoconstriction of swine lingual and pulmonary smooth muscle may occur at low concentration when lidocaine is infiltrated into the oral submucosa or administered intravenously for the treatment of ventricular arrhythmia.