Journal of anesthesia
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Journal of anesthesia · Aug 2019
The effects of transmuscular quadratus lumborum blocks on postoperative pain in arthroscopic hip surgery: a cohort analysis.
The Transmuscular Quadratus Lumborum block (TQLB) is one of the newest blocks and has been used as an effective analgesic option for various surgeries. However, it is still uncertain whether the TQLB provides beneficial analgesic outcomes for hip arthroscopic surgeries. Therefore, we aimed to investigate effects of the preoperative TQLB on postoperative pain levels and perioperative opioid consumption in patients who underwent outpatient arthroscopic hip surgery. ⋯ The present study did not find the preoperative TQLB to be an effective analgesic technique for patients who underwent arthroscopic hip surgery for FAI. A randomized clinical trial may further validate these results.
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Journal of anesthesia · Aug 2019
Randomized Controlled Trial Comparative StudyComparison between hemodynamic effects of propofol and thiopental during general anesthesia induction with remifentanil infusion: a double-blind, age-stratified, randomized study.
Propofol is commonly used with remifentanil for induction of general anesthesia (GA); however, it often leads to hypotension. Intraoperative hypotension is associated with postoperative adverse events. By contrast, thiopental has less negative inotropic effects on hemodynamics compared to propofol, which could be suitable to prevent hypotension during GA induction. In the present age-stratified, randomized, assessor-blinded study, using the ClearSight® system, we compared the hemodynamic effects of propofol and thiopental during GA induction under remifentanil infusion in non-cardiac surgery. ⋯ Thiopental is a more suitable agent than propofol for avoiding hypotension during GA induction under remifentanil infusion in the middle and elderly patients.
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Journal of anesthesia · Aug 2019
Review Meta AnalysisThe efficacy and safety of prophylactic use of levosimendan on patients undergoing coronary artery bypass graft: a systematic review and meta-analysis.
Prophylactic use of levosimendan in cardiac surgery remains controversial and no meta-analysis has been done exclusively about that in patients undergoing coronary artery bypass graft (CABG) surgery. We conducted this systematic review and meta-analysis of levosimendan in CABG using PubMed, Embase, Scopus, and Cochrane Library (till April 20, 2018). ⋯ Subgroup analyses revealed that such a benefit was mainly observed in the isolated CABG, the preoperative administration, with-bolus and on-pump subgroups. More high-quality and well-designed prospective studies are needed to confirm or disprove our findings in future.
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Journal of anesthesia · Aug 2019
ReviewPerioperative management of patients with atrial fibrillation receiving anticoagulant therapy.
The number of patients with atrial fibrillation (AF) and the number of patients indicated for anticoagulant therapy have been increasing because AF would affect patient survival due to thromboembolism. Once AF develops, following the disappearance of pulsation, the circumstances within the atrium become prothrombotic and thrombus formation within the left atrium occurs in patients with AF. In recent years, not only warfarin but also new oral anticoagulants were introduced clinically and have become used as oral anticoagulants. ⋯ In addition, knowledge of the characteristics of each oral anticoagulant is required at drug cessation and resumption. Unlike warfarin, which has been used in the past five decades, direct oral anticoagulants (DOACs) do not have sensitive indicators such as prothrombin time-international normalized ratio. To avoid major hemorrhages and thromboembolism, quantitative assays can be implemented for DOAC monitoring and for reversal therapies in perioperative settings.
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Journal of anesthesia · Aug 2019
Observational StudyPreoperative sleep disruption and postoperative functional disability in lung surgery patients: a prospective observational study.
Our aims were to evaluate the prevalence of preoperative acute sleep disruption in the hospital and to assess perioperative sleep quality and the effects of acute sleep disruption on postoperative functional recovery in a surgical setting. ⋯ Our results showed a high prevalence of acute sleep disturbance. Patients with acute sleep disruption had low postoperative sleep efficiency and impaired functional ability three months after surgery.