Journal of anesthesia
-
Journal of anesthesia · Feb 2016
The efficacy of continuous subcostal transversus abdominis plane block for analgesia after living liver donation: a retrospective study.
Postoperative pain management for living liver donors has become a major concern as a result of the increasing number of living liver donations. Transversus abdominis plane (TAP) block has been known to provide effective analgesia for abdominal surgery. The aim of this study was to evaluate the efficacy of ultrasound-guided continuous subcostal TAP block as a part of a multimodal analgesic regimen in comparison with conventional intravenous (IV) fentanyl-based analgesia in living liver donors. ⋯ In conclusion, continuous subcostal TAP block provided an effective opioid-sparing analgesia for living liver donors.
-
Journal of anesthesia · Feb 2016
Postoperative complications associated with extubation strategies following palatoplasty: a single-center retrospective analysis.
Palatoplasty carries a high risk of airway obstruction as a postoperative complication. Since 2007, the protocol in our hospital has been to leave an endotracheal tube in place after surgery while the patient is moved to the pediatric intensive care unit. Extubation is then performed after achievement of hemostasis and recovery of consciousness. We compared the cases over the 5-year periods before and after the introduction of this revised postsurgical management plan to investigate its effect on postoperative complications. ⋯ Extubation in an intensive care unit was possibly associated with a reduction in postoperative complications.
-
Journal of anesthesia · Feb 2016
Implementing enhanced recovery after bariatric surgery protocol: a retrospective study.
While the demand for bariatric surgery is increasing, hospital capacity remains limited. The ERABS (Enhanced Recovery After Bariatric Surgery) protocol has been implemented in a number of bariatric centers. We retrospectively compared the operating room logistics and postoperative complications between pre-ERABS and ERABS periods in an academic hospital. ⋯ Induction times were reduced from 15.2 (95 % CI 14.3-16.1) min to 12.5 (95 % CI 11.7-13.3) min (P < 0.001). Turnover times were shortened significantly from 38 (95 % CI 44-32) min to 11 (95 % CI 8-14) min. The incidence of re-operations, re-admissions and complications did not change.
-
Journal of anesthesia · Feb 2016
Case ReportsIntraoperative severe hypoglycemia indicative of post-hepatectomy liver failure.
We present the first reported case of a patient with intraoperative hypoglycemia, with no predisposing factors, that was indicative of post-hepatectomy liver failure due to liver injury. A 56-year-old man was hospitalized to undergo left lateral segmentectomy, cholecystectomy and T-tube choledocholithotripsy due to calculi in the intrahepatic and common bile ducts. His medical history was unremarkable. ⋯ His aspartate aminotransferase and alanine aminotransferase levels increased to over 10,000 IU/L, and his blood urea nitrogen and creatinine levels increased postoperatively. Thus, we diagnosed post-hepatectomy liver failure and hepatorenal syndrome and treated the patient conservatively. This case illustrates that, if no other causative factors for severe hypoglycemia occurring during liver resection are present, the anesthesiologist should predict post-hepatectomy liver failure due to liver injury and inform the surgeon in order to enable rapid evaluation and treatment.
-
Journal of anesthesia · Feb 2016
Reduction in amino-acid-induced anti-hypothermic effects during general anesthesia in ovariectomized rats with progesterone replacement.
The aim of the present study was to determine whether the ovarian hormones, estrogen and progesterone, had different influences on amino-acid-induced anti-hypothermic effects during general anesthesia. ⋯ These results suggest that progesterone reduces amino-acid-induced anti-hypothermic effects during general anesthesia.