Journal of anesthesia
-
Journal of anesthesia · Apr 2017
Comparative Study Observational StudyUltrasound-guided thoracic paravertebral block by the paralaminar in-plane approach using a microconvex array transducer: methodological utility based on anatomical structures.
We evaluated the analgesic feasibility of paralaminar in-plane (PL) approach for ultrasound-guided thoracic paravertebral block (USG-TPVB). As the needle trajectory was expected to be closely affected by the distance from the skin to the lamina-transverse process junction (LTPJ), we examined the correlativity between them on computed tomography (CT) or ultrasonography. ⋯ We demonstrated that PL approach provided feasible analgesia for thoracotomy and the ND was significantly correlated with the morphometric values. This technique allowed for inner catheter insertion route targeting longer anteroposterior thoracic paravertebral space length; this may reduce potential risk of pleural puncture for USG-TPVB. Trial registry number This study was registered in the UMIN Clinical Trials Registry (UMIN-CTR). (URL: http://umin.ac.jp/ctr/ , ID:UMIN000014821).
-
Journal of anesthesia · Apr 2017
Randomized Controlled TrialThe protective effect of human atrial natriuretic peptide on renal damage during cardiac surgery.
Acute kidney injury (AKI) is one of the critical complications after cardiac surgery. In the kidney, angiotensin II (Ang II) is formed by independent mechanisms, and activity of the intrarenal renin-angiotensin-aldosterone (RAAS) system contributes to the progression of kidney damage. Although atrial natriuretic peptide (ANP) exerts protective effects against renal injury by inhibiting the RAAS, the mechanisms of this effect have not been completely clarified. We investigated how human ANP (hANP) could prevent renal damage induced by cardiopulmonary bypass. ⋯ hANP demonstrated renal protective effects during cardiac surgery, and could possibly reduce the incidence of AKI after ischemia-reperfusion surgery. Moreover, this protective effect of hANP is likely induced by inhibition of the intrarenal RAAS.