Journal of anesthesia
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Journal of anesthesia · Jun 2018
Randomized Controlled TrialDifferent ventilation techniques and hemodynamic optimization to maintain regional cerebral oxygen saturation (rScO2) during laparoscopic bariatric surgery: a prospective randomized interventional study.
The purpose of this study was to assess the changes in regional cerebral oxygen saturation (rScO2) in response to different ventilation strategies: inspired oxygen concentration (FiO2), end-tidal carbon dioxide (EtCO2), and positive end expiratory pressure (PEEP) in addition to optimizing mean arterial pressure (MAP) in obese patients subjected to laparoscopic bariatric surgery in the reverse trendelenburg position. ⋯ In obese patients, subjected to laparoscopic bariatric surgery in reverse trendelenburg position, adjustment of ventilation strategies and hemodynamic optimization succeeded to improve rScO2.
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Journal of anesthesia · Jun 2018
Observational StudyDiaphragmatic paralysis in obese patients in arthroscopic shoulder surgery: consequences and causes.
Ambulatory process in arthroscopic shoulder surgery has boomed over past decades. Some anesthetic techniques such as interscalene block (ISB) and its surrogates are associated with diaphragmatic paralysis and might compromise outpatient procedure. ⋯ In patients with BMI ≥ 30 kg/m2 undergoing arthroscopic shoulder surgery, diaphragmatic paralysis is associated with dyspnea, occurrence of hypoxic episodes and failure of ambulatory procedure. High volume ISB and also, to a lesser extent, low volume ISB were found to be responsible for diaphragmatic paralysis.
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Journal of anesthesia · Jun 2018
Observational StudyPostoperative renal function in parturients with severe preeclampsia who underwent cesarean delivery: a retrospective observational study.
Although postoperative renal dysfunction is relatively rare after cesarean delivery, preeclampsia is considered as the high-risk population. On the other hand, hydroxyethyl starch (HES) administration for preventing maternal hypotension induced by spinal anesthesia for cesarean delivery is a common practice. However, the effect of HES administration during cesarean delivery on postoperative kidney function in parturients with severe preeclampsia is not well investigated. ⋯ The amounts of HES administration were 859 ± 206 mL. There was significant reduction in serum creatinine, from 0.70 ± 0.29 mg/dL preoperatively to 0.62 ± 0.17 mg/dL in 3-7 days after the cesarean. Only one patient had postoperatively elevated serum creatinine up to clinically significant level (from 0.64 mg/dL to 1.35 mg/kg).