Journal of anesthesia
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Journal of anesthesia · Jun 2017
ReviewPerioperative risk factors for death among patients with symptomatic pulmonary thromboembolism.
Perioperative pulmonary thromboembolism (PTE) is a fatal complication that may occur in patients who are undergoing surgery. This study aimed to identify risk factors for PTE-related death. This study evaluated data for the most recent 5-year period (2007-2011) from the Japanese Society of Anesthesiologists' database of patients who experienced perioperative PTE. ⋯ Logistic regression analyses revealed that male sex, an age of ≥ 80 years, bedridden status, heart failure, and the non-use of anticoagulant therapy were independent risk factors for PTE-related death. We found that male sex, an age of ≥ 80 years, bedridden status, heart failure, and the non-use of anticoagulant therapy were independent risk factors for perioperative PTE-related death. Therefore, appropriate interventions for bedridden patients and thromboprophylaxis using anticoagulants may help reduce the incidence of perioperative PTE-related mortality.
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Journal of anesthesia · Jun 2017
Effect of oral carbohydrate with amino acid solution on serum oxidative/anti-oxidative status in healthy volunteers.
The aim of this work was to investigate the effect of oral carbohydrate with amino acid [oral nutritional supplement (ONS)] solution on oxidative stress in healthy persons. Fourteen healthy volunteers were segregated into control and ONS groups. Volunteers in the ONS group ingested 250 ml of Arginaid Water (Nestle Japan, Tokyo, Japan) in the evening before the experiment and at 7:00 am on the day of the experiment. ⋯ CARR, respectively, p = 0.018), while the serum BAP level was significantly higher than the control group (2410 ± 432 and 1979 ± 397 µmol/l, respectively, p = 0.005). The OXY level of Arginaid Water was much higher than preOp drink (Nutricia, Ireland). In conclusion, our study showed that an ONS with arginine loading could decrease oxidative stress and increase antioxidant capacity in healthy volunteers.
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Journal of anesthesia · Jun 2017
Comparative StudyPoint-of-care testing for coagulation function: CoaguChek(®) XS System versus standard laboratory testing in pediatric patients with normal and abnormal coagulation function.
Intraoperative abnormalities of coagulation function may occur for various reasons. In most scenarios, treatment is directed by laboratory parameters. Unfortunately, standard laboratory testing may take 1-2 h. The purpose of the current study was to evaluate a point-of-care testing device (CoaguChek®XS System) in pediatric patients. ⋯ INR values obtained from CoaguChek®XS showed a moderate correlation with reference laboratory values within the normal range. However, in the presence of coagulopathy, the discrepancy was significantly greater, thereby making the CoaguChek®XS clinically unreliable.
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Journal of anesthesia · Jun 2017
Case ReportsUltrasound-guided peripheral nerve stimulation for neuropathic pain after brachial plexus injury: two case reports.
Brachial plexus injury (BPI) often causes severe neuropathic pain that becomes chronic and difficult to treat pharmacologically or surgically. Here, we describe two cases of successful treatment of BPI with peripheral nerve stimulation (PNS). ⋯ Both patients were satisfied with their improved sleep and quality of life. We conclude that PNS could be an alternative therapeutic modality for neuropathic pain after BPI as it provides direct nerve stimulation, has few complications, and is easy to perform.
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Journal of anesthesia · Jun 2017
Case ReportsAnesthetic management of abdominal radical trachelectomy for uterine cervical cancer during pregnancy.
Abdominal radical trachelectomy has been identified as a surgical option for fertility preservation in cervical cancer patients, particularly in pregnant women who strongly desire to continue their pregnancy. Since this procedure requires operating in the uterus, the hardness of the uterus can affect the ease of surgery. Generally, sevoflurane is used for anesthesia in non-obstetric surgery for pregnant women because uterine relaxation is advantageous for uterine blood flow maintenance. ⋯ Although frequent fetal heart rate monitoring of the pre-viable fetus is not recommended, if fetal bradycardia is detected, sevoflurane may then be used to improve fetal circulation. Additionally, if the fetal heartbeat stops, a radical hysterectomy would then be required. Therefore, we consider that fetal heart rate monitoring during this procedure is necessary, and propofol is suitable as an anesthetic for this surgery during pregnancy.