Journal of anesthesia
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Journal of anesthesia · Jun 2020
ReviewA review of dexamethasone as an adjunct to adenotonsillectomy in the pediatric population.
Although one of the most commonly performed surgical procedures in children and frequently performed as outpatient surgery, the postoperative course following tonsillectomy may include nausea, vomiting, poor oral intake, and pain. These problems may last days into the postoperative course. ⋯ Dexamethasone is a frequently administered intraoperatively as an adjunctive agent to decrease inflammation and pain, limit the potential for postoperative nausea and vomiting, and improve the overall postoperative course. The following manuscript reviews the use of dexamethasone to improve outcomes following tonsillectomy or adenotonsillectomy, discusses the controversies regarding its potential association with perioperative bleeding, and investigates options for dosing regimens which may maintain the beneficial physiologic effects while limiting the potential for bleeding.
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Journal of anesthesia · Jun 2020
Randomized Controlled TrialContinuous quadratus lumborum block and femoral nerve block for total hip arthroplasty: a randomized study.
Continuous femoral nerve block (FNB) has been effectively used after total hip arthroplasty (THA). Recently the anterior approach to quadratus lumborum block (QLB) has been shown to produce postoperative pain relief after THA. Continuous QLB would benefit from a catheter insertion site that is farther away from the surgical site compared with continuous FNB. In this randomized controlled study, we compared analgesic effects of the two techniques in patients undergoing THA. ⋯ Analgesic effects of continuous QLB were inferior to those of continuous FNB in patients undergoing THA under the current study condition.
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Journal of anesthesia · Jun 2020
Effects of intravenous injection of indocyanine green on the oxygen reserve index (ORi™).
The oxygen reserve index (ORi™) is a parameter used for the noninvasive evaluation of arterial partial pressure of oxygen (PaO2), specifically in the 100-200 mmHg range. We aimed to report on the impact of indocyanine green (ICG) on the ORi™. ⋯ It is important to consider the initial rapid increase and subsequent slow decrease in ORi™ when using ICG during surgery.
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Journal of anesthesia · Jun 2020
Awake fiberoptic intubation with an epidural catheter in a morbidly obese patient.
We report successful awake intubation in a morbidly obese patient (body mass index of 61.2) using an epidural catheter inserted through the external forceps channel of the fiberscope for delivery of local anesthetic. Direct application of local anesthetic to the pharyngolaryngeal area and proximal tracheal, through the use of a relatively firm epidural catheter. We conclude that awake intubation can be achieved by this method which spares the subsequent use of any sedative drugs.
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Journal of anesthesia · Jun 2020
Risk and protective factors for chronic pain following inguinal hernia repair: a retrospective study.
A large proportion of patients experience chronic post-surgical pain (CPSP) following inguinal hernia repair surgery. The aim of this study was to investigate the predictive risk factors and protective factors for CPSP following inguinal hernia surgery. ⋯ These results indicated that bilateral inguinal hernia repair, preoperative pain, preoperative anxiety, and acute pain at 1 week after the surgery were the independent risk factors for CPSP while low-dose ketamine was the protective factor. These findings may assist with primary prevention by allowing clinicians to screen for individuals with the risk of CPSP.