Journal of anesthesia
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Journal of anesthesia · Dec 2022
Equilibration rate constant, ke0, to determine effect-site concentration for the Masui remimazolam population pharmacokinetic model in general anesthesia patients.
Effect-site concentration is widely used to determine drug dosage in anesthesia practice. To obtain effect-site concentration, a pharmacokinetic model with a corresponding equilibration rate constant between plasma and effect-site, ke0, is necessary. Remimazolam, a novel short-acting benzodiazepine, has been approved as anesthetic/sedative. ⋯ The ke0 value can be calculated using numerical analysis but not algebraic solution. We provide the detail method of the numerical analysis and a tool to have ke0 value easily for the Masui remimazolam PK model. Additionally, we provide a multiple regression model to have ke0 value for the PK model.
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Journal of anesthesia · Dec 2022
Future liver remnant volume is associated with postoperative fentanyl consumption following open donor hepatectomy: a retrospective multivariate analysis.
Liver resection has a risk of postoperative hepatic dysfunction, including drug metabolism. Since fentanyl is primarily metabolized in the liver, liver resection requires exercising caution against fentanyl overdose in postoperative analgesia. The rationale for dose adjustment of fentanyl in the preoperative prescription for patients undergoing liver resection remains unclear. We examined whether postoperative fentanyl consumption is associated with the future liver remnant after liver resection and investigated factors influencing fentanyl consumption. ⋯ Future liver remnant volume was significantly associated with postoperative fentanyl consumption. Smaller remnant liver volume and older age (≥ 45 years) were independent factors reducing postoperative fentanyl consumption in patients undergoing open donor hepatectomy.
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Journal of anesthesia · Dec 2022
Association of the placenta accreta spectrum score and estimated blood loss in placenta accreta spectrum patients with placenta previa: a retrospective cohort study.
The placenta accreta spectrum (PAS) score calculated by the scoring system may predict patients with PAS. We aim to find the relationship between estimated blood loss and the PAS score. Further, find the inflection point, identify PAS patients with placenta previa who were at risk for major bleeding. ⋯ There was a non-linear relationship between estimated intraoperative blood loss and PAS score. When the PAS score was greater than 9, hemorrhage, the risk of major bleeding, the need for transfusions, and the placement of an abdominal aortic balloon all increase significantly.
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Journal of anesthesia · Dec 2022
Comparison of total intravenous with inhalational anesthesia in terms of postoperative delirium and complications in older patients: a nationwide population-based study.
Postoperative delirium incidences are increasing in older adults. A Cochrane Review found no significant difference in the incidence of postoperative delirium between total intravenous anesthesia (TIVA) and inhalational anesthesia (IA). This study evaluated the differences in postoperative delirium and morbidity between patients who underwent either TIVA or IA. ⋯ This study demonstrated that TIVA was related to a slightly decreased postoperative delirium and incidence of morbidity compared to IA.
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After the signing the Peace Treaty in 1951 and Japan's political independence, the Fulbright Scholarship Program has started sending Japanese to American universities and academic institutions for clinical training and research. During the 1950s, more than two hundred physicians received the scholarship. ⋯ However, among them, five physicians chose anesthesiology as their specialty and completed American anesthesiology residency. The Fulbright Scholarship recipients' contributions to Japanese anesthesiology during their professional career had been notable and is the subject of this article.