Journal of anesthesia
-
Perioperative anaphylaxis is a life-threatening clinical condition that is typically the result of drugs or substances used for anesthesia or surgery. The most common cause of anaphylaxis during anesthesia is reportedly neuromuscular blocking agents. Of the many muscle relaxants that are clinically available, rocuronium is becoming popular in many countries. ⋯ Thus, anesthesiologists should be familiar with the epidemiology, mechanisms, and clinical presentations of anaphylaxis induced by these drugs. In this review, we focus on the diagnosis and treatment of anaphylaxis to sugammadex and neuromuscular blocking agents. Moreover, we discuss recent studies in this field, including the diagnostic utility of flow cytometry and improvement of rocuronium-induced anaphylaxis with the use of sugammadex.
-
Journal of anesthesia · Apr 2016
Optimal length of the pre-inserted tracheal tube for excellent view in nasal fiberoptic intubation.
Inexperienced physicians frequently have difficulty performing nasal fiberoptic intubation. A pre-inserted tracheal tube of the appropriate length allows an excellent view of the laryngeal opening. The purpose of this study was to determine the ideal length of a pre-inserted tracheal tube for nasal fiberoptic intubation and to investigate if it could be predicted from easily measureable patient parameters. ⋯ The optimal length of pre-inserted tracheal tube for nasal fiberoptic intubation can be predicted using a newly developed formula with three patient parameters, namely, height, the NM distance, and weight. Application of this equation in the clinical setting should facilitate nasal fiberoptic intubation.
-
Journal of anesthesia · Apr 2016
Cuff depth and continuous chest auscultation method for determination of tracheal tube insertion depth in nasal intubation: observational study.
Incorrect endobronchial placement of the tracheal tube can lead to serious complications. Hence, it is necessary to determine the accuracy of tracheal tube positioning. Markers are included on tracheal tubes, in the process of their manufacture, as indicators of approximate intubation depth. In addition, continuous chest auscultation has been used for determining the proper position of the tube. We examined insertion depth using the cuff depth and continuous chest auscultation method (CC method), compared with insertion depth determined by the marker method, to assess the accuracy of these methods. ⋯ UMIN No. UMIN000011375.
-
Journal of anesthesia · Apr 2016
Randomized Controlled TrialEffect of intraoperative application of ketamine on postoperative depressed mood in patients undergoing elective orthopedic surgery.
A depressed mood frequently occurs in perioperative patients, negatively impacting patient recovery. Recent studies suggested that ketamine has a rapid, obvious, and persistent antidepressant effect. The purpose of this study was to investigate the impact of intraoperative application of ketamine on postoperative depressive mood in patients undergoing elective orthopedic surgery. ⋯ Intraoperative application of ketamine was associated with improved scores for depressed mood and increased serum BDNF levels in patients undergoing elective orthopedic surgery.
-
Journal of anesthesia · Apr 2016
Case ReportsMonitoring cerebral tissue oxygen saturation at frontal and parietal regions during carotid artery stenting.
Cerebral oximetry is normally placed on the upper forehead to monitor the frontal lobe cerebral tissue oxygen saturation (SctO2). We present a case in which the SctO2 was simultaneously monitored at both frontal and parietal regions during internal carotid artery (ICA) stenting. Our case involves a 79-year-old man who presented after a sudden fall and was later diagnosed with a watershed ischemic stroke in the distal fields perfused by the left middle cerebral artery. ⋯ The SctO2-MAP correlation was more consistent on the stroked hemisphere than the non-stroked hemisphere. This case showed that SctO2 can be reliably monitored at the parietal region, which is primarily perfused by the ICA. SctO2 of the stroked brain is more pressure dependent than the non-stroked brain.