Journal of anesthesia
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Journal of anesthesia · Feb 2019
Age-dependent error in creatinine clearance estimated by Cockcroft-Gault equation for the elderly patients in a Japanese hospital: a cross-sectional study.
The aim of this study is to assess the accuracy of creatinine clearance (CCr) calculated by the Cockcroft-Gault (CG) equation for elderly patients in a Japanese hospital. This study was a retrospective chart review of patients aged ≥ 55 years with a CCr measurement by a 24-h urine collection (24-h) prior to general surgery in our hospital between April 2009 and March 2017. In total, 1028 Japanese patients were included (mean age 73.0 ± 8.9 years). ⋯ The error was reached at 21.7 ± 13.2 mL/min in patients aged ≥ 90 years (P < 0.001). The age-dependent errors almost completely disappeared when the modified CG equation was used, in which the term of age in the original CG equation was constantly regarded as 65, if the patient was 65 years or older. Anesthesiologists and intensivists should pay attention to the potential risk of underestimating kidney function when using the CG equation for Japanese elderly patients.
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Journal of anesthesia · Feb 2019
What is the predictor of the intraoperative body temperature in abdominal surgery?
Inadvertent hypothermia is a relatively common intraoperative complication. Few studies have investigated predictors of body temperature change or the effect of the blanket type used with a forced-air warming device during the intraoperative period. We investigated the predictive factors of intraoperative body temperature change in scheduled abdominal surgery. ⋯ The blanket type of the forced-air warmer, age, sex, laparoscopic surgery, and BMI are predictors of intraoperative core temperature change.
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Journal of anesthesia · Feb 2019
Practice GuidelinePractical guide for the management of systemic toxicity caused by local anesthetics.
Systemic toxicity from local anesthetics can occur in any of the wide range of situations in which these agents are used. This practical guide is created to generate a shared awareness of the prevention, diagnosis, and treatment of local anesthetic systemic toxicity among all medical professionals who perform nerve blocks. Systemic toxicity of local anesthetic is induced by an increase of its protein-unbound plasma concentration. ⋯ If systemic toxicity is suspected, halt administration of local anesthetic, request assistance, secure venous line, airway, administration of 100% oxygen and if necessary tracheal intubation and artificial respiration should be immediately performed. Benzodiazepines are recommended to treat convulsions. Administration of 20% lipid emulsion according to the protocol is recommended to treat severe hypotension and arrhythmia.
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Journal of anesthesia · Feb 2019
Efficacy of abdominal peripheral nerve block and caudal block during robot-assisted laparoscopic surgery: a retrospective clinical study.
We retrospectively analyzed the efficacy of abdominal peripheral nerve block (PNB) and caudal block (CB) in patients undergoing robot-assisted laparoscopic radical prostatectomy (RARP). ⋯ 2016-1059.
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Journal of anesthesia · Feb 2019
Comment LetterFuture blood pressure monitoring for cesarean delivery.
Abstract