Journal of anesthesia
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Journal of anesthesia · Dec 2020
The incidence and reasons for canceled surgical cases in an academic medical center: a retrospective analysis before and after the development of a preoperative anesthesia clinic.
The development of a preoperative anesthesia clinic (PAC) can reduce the number of surgical cases canceled on the day of surgery. However, there are only a few studies on the details of cancellations in the operating room. This study aimed to assess the incidence and reasons for surgical cases canceled from admission to the operating room to the start of surgery. ⋯ The total incidence of surgical case cancellations was 0.037%. Before and after the development of a PAC, cancellation rate was comparable. After the development of a PAC, none case were canceled due to insufficient preoperative anesthetic assessment.
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Journal of anesthesia · Dec 2020
Evaluation of a new face mask concept for oxygen administration: a crossover study in healthy volunteers.
We developed a new face mask concept for oxygen administration using non-woven textiles. The aim of this study was to evaluate whether the new mask improves acceptability without compromising O2 delivery and CO2 elimination. 10 healthy adult volunteers were randomized to either the conventional plastic face mask-first group or the new face mask-first group. Participants were asked to wear the assigned mask with O2 at 3 L/min for 10 min while seated. ⋯ Median et-O2 with the new mask was 33%, compared with 30% with the conventional mask (P = 0.008). There were no significant differences in et-CO2 by mask type (new, 32 mmHg; conventional, 30 mmHg). In conclusion, the new mask was more comfortable and provided higher et-O2 than the conventional mask.
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Journal of anesthesia · Dec 2020
ReviewAligning difficult airway guidelines with the anesthetic COVID-19 guidelines to develop a COVID-19 difficult airway strategy: a narrative review.
The coronavirus disease 2019 (COVID-19) pandemic is caused by a coronavirus that is transmitted primarily via aerosol, droplets or direct contact. This may place anesthetists at higher risk of infection due to their frequent involvement in aerosol-generating airway interventions. Many anesthethetic COVID-19 guidelines have emerged, whose underlying management principles include minimizing aerosol contamination and protecting healthcare workers. ⋯ Our article identifies and compares pre-pandemic difficult airway guidelines with the recent anesthetic COVID-19 guidelines. We combine the principles from both sets of guidelines and explain the necessary modifications to the airway guidelines, to form a failed tracheal intubation airway strategy in the COVID-19 patient. Valuing, and a greater understanding of, these differences and modifications may lead to greater adherence to the new COVID-19 guidelines.
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Journal of anesthesia · Dec 2020
Randomized Controlled TrialOpen randomized trial of the effects of 6% hydroxyethyl starch 130/0.4/9 and 5% albumin on safety profile, volume efficacy, and glycocalyx degradation in hepatic and pancreatic surgery.
The aim of this study was to evaluate the effects of hydroxyethyl starch (HES) 130/0.4/9 compared to 5% albumin on renal and coagulation safety profiles, volume efficacy and glycocalyx degradation in major abdominal surgery. ⋯ HES 130/0.4/9 can be used as safely and effectively as 5% albumin. Glycocalyx degradation did not differ between use of these solutions in major abdominal surgery.
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Journal of anesthesia · Dec 2020
Randomized Controlled TrialThe effectiveness of the intramuscular quadratus lumborum block in postoperative analgesia after cesarean section with vertical incision: a randomized, double-blinded placebo-controlled study.
Quadratus lumborum block (QLB) has recently been used for postoperative analgesia after abdominal surgery. Although there are several approaches to QLB, the effectiveness of intramuscular QLB (QLBi) remains controversial. The aim of the present study was to examine the effectiveness of QLBi for postoperative analgesia after cesarean section with a vertical midline incision. ⋯ QLBi with the concentration and amount of local anesthetic used in the present study was clinically slightly effective, and the effect was limited for postoperative analgesia after cesarean section.