Journal of anesthesia
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Journal of anesthesia · Dec 2019
Gastric emptying time after breakfast in healthy adult volunteers using ultrasonography.
There is little evidence of gastric excretion after ingestion of solids. We examined gastric emptying times after ingesting normal breakfast in healthy adult volunteer using ultrasonography. Eight adult volunteers fasted for 8 h, and we examined the gastric antral area in the right lateral decubitus position using ultrasonography. ⋯ The calculated gastric emptying time was 276.4 ± 58.9 min. This result shows that gastric emptying time was lower than 5 h average after a typical breakfast that contains various food in healthy adult volunteers. However, further research is necessary to establish the clinical safety implications of these findings.
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Journal of anesthesia · Dec 2019
Distinct, sex-dependent miRNA signatures in piglet hippocampus induced by a clinically relevant isoflurane exposure: a pilot study.
To evaluate the effects of sex on miRNA expression in the hippocampus after isoflurane anesthesia in a neonatal piglet model. ⋯ In the neonatal piglet hippocampus, miRNA expression was highly conserved. There was no overlap in miRNA expression between isoflurane-exposed males and females, suggesting sex differences in isoflurane-induced miRNA expression. These results support the hypothesis that a clinically relevant exposure to isoflurane induces distinct miRNA signatures in the hippocampus of neonatal male and female piglets. Their functional relevance in anesthesia-induced neurotoxicity remains unknown, although changes in specific miRNAs may either contribute to or protect against anesthesia-induced neurotoxicity.
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Journal of anesthesia · Dec 2019
Case ReportsCerebral regional oxygen saturation: a useful monitor during a surgical procedure involving the right-sided aortic arch in an infant.
A right aortic arch with an aberrant left subclavian artery and a Kommerell's diverticulum represents a rare anatomic variant carrying the risk of dissection or rupture. Resection of the diverticulum and re-implantation of the left subclavian artery during childhood have been recommended. Because of the risk of cerebral blood flow reduction during the aberrant subclavian artery re-implantation to the common carotid artery, monitoring and prompt measures to curb blood flow reduction are required. ⋯ We increased the end-tidal CO2 (EtCO2), mean arterial pressure, and a fraction of inspired oxygen, successfully restoring the rSO2 to the initial level. No postoperative neurological complications were observed. Our experience with this patient suggests that rSO2 monitoring is a useful, and intervention protocol including hypercapnia, elevated mean arterial pressure, and hyperoxia to counter the decreased cerebral blood flow is effective in infant patients undergoing right-sided aortic arch surgery.
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Journal of anesthesia · Dec 2019
Associated factors with delayed ambulation after abdominal surgery.
After abdominal surgery, ambulatory status is an important indicator of postoperative recovery. This study investigated the inability to ambulate on postoperative day 1 and identified associated predictive factors in patients undergoing abdominal surgery, focusing on preoperative hematologic markers such as the neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index. ⋯ The NLR, surgical duration, and American Society of Anesthesiologists physical status were significantly associated with the inability to ambulate without human assistance on postoperative day 1 and prolonged hospitalization.
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Journal of anesthesia · Dec 2019
Comparative StudyTwo-stage goal-directed therapy protocol for non-donor open hepatectomy: an interventional before-after study.
Hemodynamic management during low central venous pressure (L-CVP)-assisted hepatectomy involves fluid restriction during resection and fluid resuscitation after resection. Recently, high stroke volume variation (SVV) has been reported as an alternative to L-CVP for reducing blood loss during a hepatectomy. The current study evaluated the impact of a newly implemented SVV-based goal-directed therapy (GDT) protocol on blood loss during hepatectomy. ⋯ Compared to conventional management, SVV-guided GDT may reduce blood loss during hepatectomies.