Journal of anesthesia
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Journal of anesthesia · Aug 2018
ReviewThe history and progress of local anesthesia: multiple approaches to elongate the action.
Analgesia and temporary inhibition of motor activity without interfering with central nervous function have been the essential merits of local anesthesia. Local anesthetics originated from cocaine have played a major role in local analgesia. ⋯ Such approach includes: development of long-acting local anesthetics, with physical tourniquet techniques, co-administration of other medicines such as vaso-constrictive agents or analgesics, development of mechanical devices to continuously or intermittently administer local anesthetics, and utilization of pharmaceutical drug delivery systems. In this review, the historical sequence of studies that have been performed in an effort to elongate the action of local anesthetics is presented, referring to epoch-making medical and scientific studies.
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Journal of anesthesia · Aug 2018
ED50 of remifentanil for providing excellent intubating conditions when co-administered with a single standard dose of propofol without the use of muscle relaxants in children: dose-finding clinical trial.
Previous studies evidenced that orotracheal intubation without neuromuscular blockers is feasible in children and has some potential advantages. Remifentanil has favorable pharmacodynamic and pharmacokinetic properties as an opioid for orotracheal intubation, but its dose for excellent intubation conditions when co-administered with propofol has not been established. This study was designed to find the minimum effective dose of remifentanil for excellent intubation conditions of children when co-administered with propofol, without neuromuscular relaxant drugs. ⋯ Minimum remifentanil effective dose for providing excellent intubating conditions when co-administered with a single standard dose of propofol without the use of neuromuscular blockers in children is 3.04 µg/kg.
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Journal of anesthesia · Aug 2018
Multicenter StudyThe impact of low body mass index on postoperative outcomes in pancreatectomy patients: a retrospective analysis of Japanese administrative data.
To comparatively examine in-hospital mortality among different underweight body mass index (BMI) categories in pancreatic cancer patients after pancreatectomy in Japan. ⋯ Severe thinness was significantly associated with a higher risk of mortality, and extremely low BMI should be considered a risk factor in pancreatectomy patients.
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Journal of anesthesia · Aug 2018
Comparative StudyComparison of Duke Activity Status Index with cardiopulmonary exercise testing in cancer patients.
The Duke Activity Status Index (DASI), a patient-administered questionnaire, is used to quantify functional capacity in patients undergoing cancer surgery. ⋯ In summary, both the limits of agreement and bias between the measured and DASI-predicted pVO2 were substantial. The DASI-predicted pVO2 based on patient's assessment of their functional status could not be considered a reliable surrogate of measured pVO2 during CPET for the population of patients pending major cancer surgery and cannot, therefore, be used as a triage tool for referral to CPET centres for objective risk assessment.
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Journal of anesthesia · Aug 2018
Dependent functional status is associated with unplanned postoperative intubation after elective cervical spine surgery: a national registry analysis.
The impact of preoperative functional status on 30-day unplanned postoperative intubation and clinical outcomes among patients who underwent cervical spine surgery is not well-described. We hypothesized that functional dependence is associated with 30-day unplanned postoperative intubation and that among the reintubated cohort, functional dependence is associated with adverse postoperative clinical outcomes after cervical spine surgery. ⋯ Preoperative functional dependence is a good marker for estimating postoperative unplanned intubation following cervical spine surgery.