Journal of anesthesia
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Journal of anesthesia · Jun 2018
Multicenter StudyPrevalence of chronic postsurgical pain after thoracotomy and total knee arthroplasty: a retrospective multicenter study in Japan (Japanese Study Group of Subacute Postoperative Pain).
We performed a multicenter observational study to assess the prevalence and risk factors of persistent pain after lung cancer surgery and total knee arthroplasty (TKA) in the Japanese population. After receiving Ethics Committee approval, a retrospective chart review was performed for patients who underwent surgery at seven university hospitals in Japan in 2013. A total of 511 patients who underwent lung cancer surgery and 298 patients who underwent TKA were included. ⋯ Anesthetic methods or techniques during both types of surgery did not significantly affect the prevalence of CPSP. This is the first study in which the prevalence of CPSP after lung surgery and TKA in Japanese population was extensively evaluated in a multicenter trial. Further prospective studies are needed to confirm the prevalence of CPSP in the Japanese population and to identify risk factors and prevention methods.
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Journal of anesthesia · Jun 2018
Randomized Controlled Trial Comparative StudyComparison of catheter-over-needle and catheter-through-needle on leakage from the catheter insertion site during continuous femoral nerve block.
The aim of this study was to compare the incidences of leakage from the catheter insertion site during continuous femoral nerve block when using the catheter-through-needle, Contiplex Touhy™ (CT) and the newly developed catheter-over-needle, Contiplex C™ (CC). Forty adult patients who were scheduled to undergo continuous femoral nerve block for pain control following knee surgery were enrolled and were randomly assigned to a CT group or a CC group. After finishing surgery, a catheter for continuous femoral nerve block was placed using ultrasound. ⋯ In the CT group, leakage from the catheter insertion site was observed in 11 of 20 patients during the observation period. On the other hand, none of the patients in the CC group showed leakage. Contiplex C™ is more effective than Contiplex Touphy™ for prevention of leakage of local anesthetics from the insertion site during continuous femoral nerve block.
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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
Clinical TrialThe Pringle maneuver reduces the infusion rate of rocuronium required to maintain surgical muscle relaxation during hepatectomy.
We investigated the continuous infusion rates of rocuronium necessary to obtain the surgical muscle relaxation before, during, and after the Pringle maneuver on patients who underwent hepatectomy. ⋯ In case of continuous administration of rocuronium during surgery performing the Pringle maneuver, it was considered necessary to regulate the administration of rocuronium using muscle relaxant monitoring in order to deal with the decrease in muscle relaxant requirement by the Pringle maneuver.