Journal of anesthesia
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Journal of anesthesia · Oct 2019
Pre-anesthetic ultrasonographic assessment of the internal jugular vein for prediction of hypotension during the induction of general anesthesia.
Severe hypotension caused by anesthetic administration for anesthesia induction, which might cause ischemic stroke, myocardial injury, acute kidney injury and postoperative mortality, should be prevented. Anesthesiologists are familiar with ultrasound examination of the internal jugular vein (IJV). This study aimed to clarify whether ultrasonographic IJV evaluation just before induction could predict the occurrence of such hypotension. ⋯ IJV-A in the Trendelenburg position was an independent predictor of hypotension during induction. Further study is required to examine the diagnostic accuracy of IJV-A as a predictor for hypotension during induction.
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Journal of anesthesia · Oct 2019
Clinical TrialResting pupil size is a predictor of hypotension after induction of general anesthesia.
Arterial hypotension is a major adverse effect of general anesthesia. Patients with pre-existing autonomic dysfunction are at greater risk of hypotension. This study was performed to examine whether objective measurement of the pupillary light reflex is predictive of intraoperative hypotension. ⋯ UMIN000023729 REGISTRY URL: https://www.umin.ac.jp.
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Journal of anesthesia · Oct 2019
Observational StudyRelationship between changes in regional cerebral blood volume and oxygenation and changes in cardiac output and systemic vascular resistance during spinal anesthesia in women undergoing cesarean section.
The decrease in maternal regional cerebral blood volume (rCBV) and oxygenation (rCBO) during spinal anesthesia for cesarean section depends on the severity of hypotension. We examined the relationships between changes in the systemic circulatory parameters, cardiac output (CO) and systemic vascular resistance (SVR), and rCBV and rCBO after induction of spinal anesthesia, evaluated by near-infrared spectroscopy (NIRS) and an arterial pressure-based cardiac output monitoring system (APCOs). ⋯ The decreases in both rCBV and rCBO after induction of spinal anesthesia for cesarean section are probably dependent on the decrease in SVR due to spinal anesthesia.
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Journal of anesthesia · Oct 2019
Propofol inhibits the local activity and connectivity of nuclei in the cortico-reticulo-thalamic loop in rats.
The present study aimed to investigate the effects of different dosages of propofol, that induced different depths of anesthesia, on the local activity and connectivity of nuclei within the cortico-reticulo-thalamic loops, as well as the release of amino acids in those nuclei. ⋯ The cortex rather than the subcortical structures, and the cortex-subcortical connectivity instead of subcortical connectivity might be the more vulnerable targets of propofol during anesthesia.