Journal of anesthesia
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Journal of anesthesia · Apr 2018
Randomized Controlled Trial Comparative StudyComparison of propofol and desflurane for postanaesthetic morbidity in patients undergoing surgery for aneurysmal SAH: a randomized clinical trial.
Surgery for aneurysmal clipping after subarachnoid haemorrhage (SAH) poses a unique anaesthetic challenge. However, data on the influence of anaesthetic agents in these patients are lacking. The study aims to evaluate the superiority of propofol over desflurane for postanaesthetic morbidity in patients undergoing surgery following aneurysmal SAH. ⋯ Propofol and desflurane are comparable in terms of postoperative morbidity in patients undergoing aneurysm neck clipping following SAH.
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Journal of anesthesia · Apr 2018
Complex issues in new ultrasound-guided nerve blocks: how to name, where to inject, and how to publish.
The recent development of ultrasound-guide nerve block has led to innovation in anesthesia and pain clinics. However, it has also led to some complex issues, including (1) how to name a new technique, (2) the appropriateness of an intramuscular approach, and (3) how to publicize a new technique. This review addresses naming strategy, feasibility of intramuscular approach block, and methods of publication. ⋯ Second, it is lack of evidences to facilitate muscle injection, and adequate preparation and adherence to proper technique for intramuscular approach block should be considered; confirmation of abnormal signs at the injection area, use of a thin needle and the lowest concentration and volume of local anesthetic without supplementation with steroid or epinephrine, compressing hemostasis, and sufficient interval of the blocks. Third, adequate dissemination of information would also be necessary through publication in appropriate media. We hope this review boost reasonable development of nerve block.
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Journal of anesthesia · Apr 2018
The effect of sevoflurane on retinal angiogenesis in a mouse model of oxygen-induced retinopathy.
Sevoflurane is commonly used in general anesthesia for premature neonates. The main mechanism of retinopathy of prematurity (ROP) is increased levels of vascular endothelial growth factor (VEGF). For the investigation of sevoflurane's effect on angiogenesis, the angiogenesis and VEGF expression in the retina were measured after administering sevoflurane in an oxygen-induced retinopathy mice model. ⋯ Sevoflurane can inhibit retinal angiogenesis via suppressing VEGF expression in an OIR mice model with exposure to relative hypoxia. Nevertheless, it is still difficult to apply the results of this study immediately to humans because of the heterogeneity of responses to sevoflurane.
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Journal of anesthesia · Apr 2018
Changes in tissue and cerebral oxygenation following spinal anesthesia in infants: a prospective study.
Use of spinal anesthesia (SA) in children may address concerns about potential neurocognitive effects of general anesthesia. We used near-infrared spectroscopy (NIRS) to assess the effects of SA on cerebral and tissue oxygenation in 19 patients aged 7 ± 3 months. Prior to SA placement, NIRS monitors were placed on the forehead (cerebral) and the thigh (tissue). ⋯ All patients breathed spontaneously on room air without changes in oxygen saturation. Blood pressure and heart rate decreased after SA placement, but no changes in hemodynamic parameters required treatment. These data provide further evidence of the neutral effect of SA on cerebral oxygenation 30 min after block placement.
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Journal of anesthesia · Apr 2018
Observational StudyPredictors of severe postoperative hyperglycemia after cardiac surgery in infants: a single-center, retrospective, observational study.
Hyperglycemia is a common issue in infants after cardiac surgery for congenital heart disease. Poor glycemic control is suspected to be associated with adverse postoperative outcomes. This study was performed to investigate clinical factors contributing to hyperglycemia in the perioperative period in infats. ⋯ Adding to hyperglycemia during the operation, longer CPB time younger age and chromosomal abnormality were identified as predictors of high blood glucose levels at ICU admission.