Journal of anesthesia
-
Journal of anesthesia · Jun 2017
Possible utility of contrast-enhanced ultrasonography for detecting spread of local anesthetic in nerve block.
This study demonstrated the effects of perfluorobutane (Sonazoid®) with contrast-enhanced ultrasonography (CEUS) to identify the spread of local anesthetics in ultrasound-guided nerve block. ⋯ CEUS with 100-fold diluted Sonazoid®could identify the spread of local anesthetic as well as radiography and anatomical dissection, and distinguish between intra- and extraneuronal injections without neurodegeneration.
-
Journal of anesthesia · Jun 2017
Randomized Controlled TrialAnalgesia and side effects of the addition of 10 or 20 µg fentanyl to articaine in spinal anesthesia for knee arthroscopy: a randomized and observer-blinded study.
Articaine, a popular and rapidly acting local anesthetic in dentistry, has been also found to be beneficial in ambulatory spinal anesthesia. Analgesia in the intraoperative and immediate postoperative period may be further improved by adding fentanyl to the local anesthetic solution for spinal anesthesia. The aim was to evaluate dose-dependency of analgesia and side effects associated with intrathecal fentanyl additive to articaine for spinal anesthesia in knee arthroscopy patients. ⋯ Fentanyl 10 or 20 µg as additive to articaine for spinal anesthesia prolonged the duration of sensory block significantly and similarly. Fentanyl 20 µg was more often associated with pruritus than fentanyl 10 µg.
-
Journal of anesthesia · Jun 2017
Sivelestat sodium and mortality in pneumonia patients requiring mechanical ventilation: propensity score analysis of a Japanese nationwide database.
Sivelestat is widely used in Japan for the treatment of acute respiratory distress syndrome caused by pneumonia. Although the efficacy of sivelestat was reported in several Japanese studies in the early 2000 s, a multinational randomized control trial did not support these findings. We therefore conducted the present study to examine the association between the use of sivelestat and mortality in pneumonia patients requiring mechanical ventilation. ⋯ The propensity-matched analyses revealed that the use of sivelestat was not associated with decreased mortality for pneumonia patients requiring mechanical ventilation.
-
Journal of anesthesia · Jun 2017
ReviewPrevention of chronic post-surgical pain: the importance of early identification of risk factors.
Chronic post-surgical pain (CPSP) is currently an inevitable surgical complication. Despite the advances in surgical techniques and the development of new modalities for pain management, CPSP can affect 15-60% of all surgical patients. The development of chronic pain represents a burden to both the patient and to the community. ⋯ Unfortunately, evidence about any effective actions to reduce this condition is limited. This review will focus on providing context to the challenging problem of CPSP. The possible role of both the surgeon and anesthesiologist in reducing the incidence of this problem will be explored.
-
Journal of anesthesia · Jun 2017
Can the descending aortic stroke volume be estimated by transesophageal descending aortic photoplethysmography?
The aim of this study was to investigate the ability of transesophageal photoplethysmography detected from the descending aorta (dPPG) for predicting low descending aortic stroke volume (dSV) level in cardiac surgical patients. ⋯ The AC and AUC extracted from the dPPG signal provided a sensitive and qualitative prediction for dSV level. The dSV value could not be accurately measured by dPPG metrics.