Journal of anesthesia
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Journal of anesthesia · Jun 2022
Observational StudyCost-effectiveness analysis of sedation and general anesthesia regimens for children undergoing magnetic resonance imaging in Japan.
The anesthesiologist-directed sedation service has not been well established in Japan partly due to reimbursement issue. In this study, we compared the cost-effectiveness of sedation by non-anesthesiologists with that of sedation or general anesthesia by anesthesiologists under the Japanese medical fee schedule. ⋯ Anesthesia-directed sedation would be more cost-effective than oral or rectal sedation by non-anesthesiologists for children undergoing MRI in the Japanese medical fee schedule.
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Journal of anesthesia · Jun 2022
Paths of thoracic epidural catheters in children undergoing the Nuss procedure for pectus excavatum repair.
To investigate the paths of thoracic epidural catheters in children, this retrospective study was performed. ⋯ Our findings indicate that the course of epidural catheters in children is unpredictable after the first 2-3 cm in the thoracic epidural space. Clinicians should be aware of such findings, although further studies are required for confirmation.
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Journal of anesthesia · Jun 2022
Case ReportsCefepime-induced encephalopathy in a COVID-19 patient: a case report.
Prolonged neurological symptoms such as "brain fog" and cognitive impairment have occurred after coronavirus disease 2019 (COVID-19) infection. In this report, we describe impaired consciousness caused by cefepime hydrochloride (CFPM) in a patient with cognitive sequalae of COVID-19. A 56-year-old male patient was diagnosed with penile abscess after COVID-19 infection, and a blood culture detected two drug-resistant Pseudomonas aeruginosa strains. ⋯ The patient's consciousness improved 30 h after the final administration of CFPM. Serum CFPM concentrations were 14.2, 21.7, 21.7, and 11.9 μg/mL on days 1, 2, and 3 after the initiation of CFPM and on the day after CFPM was discontinued, respectively. In conclusion, intensivists should pay attention to new neurological symptoms such as CFPM-induced encephalopathy in patients with prolonged neurological symptoms after COVID-19 infection.