Journal of anesthesia
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Journal of anesthesia · Dec 2022
ReviewConsensus statement on smoking cessation in patients with pain.
Smoking is closely associated with the development of various cancers and tobacco-related illnesses such as cardiovascular and respiratory disorders. However, data are scarce on the relationship between smoking and both acute and chronic pain. In addition to nicotine, tobacco smoke contains more than 4000 different compounds. ⋯ Despite the acute analgesic effects of nicotine, long-term exposure leads to tolerance and increased pain sensitivity due to nicotinic acetylcholine receptor desensitization and neuronal plastic changes. The purpose of smoking cessation interventions in smoking patients with pain is primarily not only to reduce their pain and associated limitations in activities of daily living, but also to improve the outcomes of underlying pain-causing conditions and reduce the risks of tobacco-related disorders. This statement aims to summarize the available evidence on the impact of smoking on pain and to inform medical professionals of the significance of smoking cessation in patients with pain.
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Journal of anesthesia · Dec 2022
Randomized Controlled TrialUsefulness and accuracy of a handheld ultrasound device for epidurssal landmark and depth assessment by anesthesiology residents.
The aim of this study was to assess the usefulness and accuracy of a handheld ultrasound device (Accuro, Rivanna Medical, Charlottesville, VA, USA) for epidural landmark and depth assessment when epidural anesthesia is performed by residents. ⋯ Although there was no significant difference in time from Tuohy needle puncture to loss of resistance, Accuro reduced the number of Tuohy needle redirects and accurately indicated the depth to the epidural space. Accuro may be useful for identifying the needle insertion point and estimating depth to the epidural space when residents perform epidural anesthesia.
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Journal of anesthesia · Dec 2022
ReviewPreoxygenation: from hardcore physiology to the operating room.
If we define the human body by the mass of the elements that compose it, we could say that we are oxygen and other elements. Oxygen, in addition to being fundamental in our composition, is an element that we constantly need to support cellular respiration and, therefore, life. ⋯ Accordingly, the ability to induce the cessation of ventilation in a patient must be accompanied by different technical and non-technical skills that allow the patient's safety to be maintained in this highly vulnerable state. Through the use of basic mathematical tools and comparative physiology, we hereby propose to review the physiological foundations of preoxygenation to understand the reasons behind the clinical recommendations in this field.
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Journal of anesthesia · Dec 2022
Observational StudyThe relationship between years of anesthesia experience and first-time intubation success rate with direct laryngoscope and video laryngoscope in infants: a retrospective observational study.
Studies in adults have reported that video laryngoscope is more useful than direct laryngoscope when training less experienced anesthesiologists. However, whether this is true for infants remains unclear. Therefore, this study aimed to evaluate whether the use of video laryngoscope would result in smaller differences in success rate according to anesthesiologists' expertise than those in direct laryngoscope. ⋯ The differences in success rate according to the anesthesiologists' years of experience were non-significant when using video laryngoscope in infants, compared to those in direct laryngoscope.
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Journal of anesthesia · Dec 2022
Preoperative dipstick albuminuria is associated with acute kidney injury in high-risk patients following non-cardiac surgery: a single-center prospective cohort study.
This study aimed to investigate the association between preoperative dipstick albuminuria (DA) and acute kidney injury (AKI) in high-risk patients following non-cardiac surgery. ⋯ Preoperative DA was independently associated with AKI in high-risk patients following non-cardiac surgery. Preoperative routine urinalysis for determination of DA status was suggested in early risk stratification.