Journal of anesthesia
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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
Multicenter Study Observational StudyProcedural sedation and analgesia in the emergency department in Japan: interim analysis of multicenter prospective observational study.
Procedural sedation and analgesia (PSA) is widely performed outside of the operating theater, often in emergency departments (EDs). The practice and safety of PSA in the ED in an aging society such as in Japan have not been well described. We aimed to characterize the practice pattern of PSA including indications, pharmacology and incidence of adverse events (AEs) in Japan. ⋯ In a multicenter prospective registry in Japan, PSA in the ED appears safe particularly since the patients who underwent PSA were older and had a higher risk profile compared to patients in previous studies in different countries.
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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
Randomized Controlled TrialLow-dose dexmedetomidine provides hemodynamics stabilization during emergence and recovery from general anesthesia in patients undergoing carotid endarterectomy: a randomized double-blind, placebo-controlled trial.
Carotid artery stenosis is a major risk factor for ischemic stroke. Carotid endarterectomy protects patients with severe atherosclerotic carotid artery stenosis against stroke. In such patients, arterial blood pressure is often difficult to control and perioperative hemodynamic instability is associated with high morbidity and mortality after carotid endarterectomy. We performed a randomized double-blind placebo-control trial to evaluate the effects of low-dose dexmedetomidine on hemodynamic stability during the emergence and the recovery phases of general anesthesia in patients undergoing carotid endarterectomy. ⋯ Low-dose dexmedetomidine improves hemodynamic stability during emergence and recovery from general anesthesia in patients receiving carotid endarterectomy.