Journal of anesthesia
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Journal of anesthesia · Apr 2019
Observational StudyAbdominal girth has a strong correlation with ultrasound-estimated epidural depth in parturients: a prospective observational study.
Preprocedural ultrasound examination of vertebral column guides to locate desired intervertebral space and provides a prevision of needle trajectory and estimated needle depth in parturients. The objective of this study was to assess the correlation between ultrasound-estimated epidural depth (ED) with abdominal girth (AG), body mass index (BMI), weight, height, and age. ⋯ Abdominal girth has a strong correlation with ultrasound-estimated epidural depth in parturients.
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Journal of anesthesia · Apr 2019
ReviewAmyotrophic lateral sclerosis and anesthesia: a case series and review of the literature.
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that leads to death due to respiratory failure. This report describes the perioperative characteristics of ALS patients who underwent procedures with anesthesia at our institution. ⋯ When caring for patients with ALS, the perioperative team must be prepared to treat potentially complex medical conditions that may not be directly related to the procedure and anesthetic management. However, minor procedures performed with minimal sedation may be safely performed on an ambulatory basis.
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Journal of anesthesia · Apr 2019
Meta Analysis Comparative StudyComparative effectiveness of interventions for managing postoperative catheter-related bladder discomfort: a systematic review and network meta-analysis.
Although many drugs or interventions have been studied to manage catheter-related bladder discomfort (CRBD), their comparative effectiveness is unknown. We attempted to assess the comparative effectiveness of the strategies to manage CRBD in patients undergoing urologic surgery including amikacin, solifenacin, darifenacin, butylscopolamine, dexmedetomidine, gabapentin, glycopyrrolate, ketamine, oxybutynin, resiniferatoxin, tolterodine, tramadol, caudal block, dorsal penile nerve block, lidocaine-prilocaine cream. ⋯ Gabapentin was ranked best regarding the overall incidence of CRBD, while tolterodine was ranked best in reducing the severity of CRBD. However, a firm conclusion cannot be made from our analysis due to small-study number and heterogeneity regarding study setting and outcome measurement.
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Journal of anesthesia · Apr 2019
ReviewLasting effects of general anesthetics on the brain in the young and elderly: "mixed picture" of neurotoxicity, neuroprotection and cognitive impairment.
General anesthetics are commonly used in major surgery. To achieve the depth of anesthesia for surgery, patients are being subjected to a variety of general anesthetics, alone or in combination. It has been long held an illusory concept that the general anesthesia is entirely reversible and that the central nervous system is returned to its pristine state once the anesthetic agent is eliminated from the active site. ⋯ The vulnerability of aging brain to general anesthetics, specifically in the context of cognitive disorders and Alzheimer's disease pathogeneses are also discussed. Moreover, we will review emerging evidence regarding the neuroprotective property of xenon and anesthetic adjuvant dexmedetomidine in the immature and mature brains. In conclusion, "mixed picture" effects of general anesthetics should be well acknowledged and should be implemented into daily clinical practice for better patient outcome.
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Journal of anesthesia · Apr 2019
Randomized Controlled Trial Comparative StudyInfluence of intraoperative sevoflurane or desflurane on postoperative sore throat: a prospective randomized study.
Tracheal intubation for general anesthesia causes postoperative sore throat. The purpose of this study was to evaluate the effect of sevoflurane and desflurane on prevalence of postoperative sore throat in patients after general anesthesia. ⋯ We have shown that sevoflurane was associated with less frequent sore throat than desflurane in patients undergoing orthopedic lower extremity surgery.