Journal of anesthesia
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Journal of anesthesia · Feb 2018
Randomized Controlled Trial Comparative StudyComparison of TIVA with different combinations of ketamine-propofol mixtures in pediatric patients.
Adding ketamine to propofol has been suggested to be useful for sedation and general anesthesia. This study aimed to determine the effect of TIVA with different ratios of ketofol on recovery in children. ⋯ TIVA with a 1:10 ratio of ketofol admixture with a 90% reduction of McFarlan regimen can provide improved recovery conditions.
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Journal of anesthesia · Feb 2018
Randomized Controlled TrialEvaluation of pharmacokinetic models of intravenous dexmedetomidine in sedated patients under spinal anesthesia.
Little information is available on the predictive ability of previously published pharmacokinetic models of dexmedetomidine in patients under spinal anesthesia. We evaluated nine published pharmacokinetic models that were constructed in different study settings. ⋯ Hannivoort et al.'s pharmacokinetic model, constructed with a dataset obtained from healthy volunteers, can predict dexmedetomidine concentrations best during continuous infusion under spinal anesthesia.
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Journal of anesthesia · Feb 2018
Randomized Controlled Trial Comparative StudyNovel ultrasound-guided inter-semispinal plane block: a comparative pilot study in healthy volunteers.
We previously reported that a novel multifidus cervicis plane (MCP) block could anesthetize the dorsal rami of the cervical spinal nerves. While MCP sonoanatomy is easily detectable in most patients, it is sometimes difficult to recognize the MCP injection plane, especially in elderly patients. Thus, we proposed the inter-semispinal plane (ISP) block as an alternative for the MCP block. ⋯ The anesthetic area ranged from C4 to T2 (3/8; 37.5%), T3 (2/8; 25%), or T4 (3/8; 37.5%) in the MCP block, and from C4 to T1 (1/8; 12.5%), T2 (3/8; 37.5%), T3 (2/8; 25%), or T4 (1/8; 12.5%) in the ISP block. The mean (standard deviation) duration of sensory loss following MCP and ISP blocks was 329 (77) min and 349 (70) min, respectively. Thus, the ISP block may be a reliable alternative to the MCP block.
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Journal of anesthesia · Feb 2018
Randomized Controlled TrialDoes prophylactic ondansetron reduce norepinephrine consumption in patients undergoing cesarean section with spinal anesthesia?
Spinal anesthesia-induced hypotension (SAIH) during cesarean delivery is not rare and frequently leads to materno-fetal discrepancy and collapse. More recently, norepinephrine has been proposed for the prevention and treatment of SAIH with fewer tendencies to decrease heart rate and cardiac output. Ondansetron has been reported to reduce the incidence of SAIH in patients undergoing cesarean section. The aim of the present study was to assess the effect of prophylactic ondansetron on the incidence of SAIH, norepinephrine consumption, and adverse effects. ⋯ Eight milligrams of intravenous ondansetron given 5 min before spinal anesthesia attenuated but did not prevent spinal anesthesia-induced hypotension in parturients undergoing elective cesarean delivery.
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Journal of anesthesia · Feb 2018
Randomized Controlled TrialIntraoperative administration of dexmedetomidine reduced the postoperative catheter-related bladder discomfort and pain in patients undergoing lumbar microdiscectomy.
We aimed to evaluate the effect of the intraoperative dexmedetomidine (DEX) on the incidence and severity of catheter-related bladder discomfort (CRBD) after non-urologic surgery. The secondary aim was to find the correlation between the levels of CRBD and postoperative pain sensation. ⋯ Intraoperative administration of DEX is a safe and effective practice for the prevention of CRBD after lumbar microdiscectomy and can reduce postoperative pain.