Journal of anesthesia
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Journal of anesthesia · Feb 2023
Observational StudyChange in cerebral circulation during the induction of anesthesia with remimazolam.
Remimazolam is a new ultra-short-acting benzodiazepine with unknown effects on cerebral circulation. We measured total cerebral hemoglobin concentrations, which reflect cerebral blood volume (CBV), and cerebral oxygen saturation, using time-domain near-infrared spectroscopy, which can measure the absolute values of cerebral hemoglobin concentrations. We also measured cerebral blood flow velocity (CBFV) in the middle cerebral artery using transcranial Doppler as an indicator of cerebral blood flow (CBF). We did so to examine the effect of remimazolam on cerebral circulation in humans, as assessed CBV, CBF, and cerebral oxygen saturation. ⋯ We found that anesthetic induction with remimazolam did not alter CBV and reduced CBF in uncomplicated patients.
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Journal of anesthesia · Feb 2023
Prediction of postoperative respiratory depression and respiratory complications in patients on preoperative methadone.
We developed prediction models for postoperative respiratory depression and respiratory complications for 958 patients who were on methadone preoperatively. ⋯ Multivariate logistic regression models including preoperative, and intraoperative characteristics as the predictors performed poorly to predict postoperative respiratory depression, and moderately for postoperative respiratory complications. Neither model is accurate enough to be subject to clinical use.
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Journal of anesthesia · Feb 2023
Obstetrical outcomes of labor with and without analgesia in Robson classification groups 1 and 2a: a single-center retrospective study.
This study aimed to elucidate the effects of neuraxial analgesia on labor in women classified based on the Robson classification system. ⋯ A higher CS rate was observed in deliveries with analgesia than in those without analgesia both in the Robson group 1 and group 2a pregnancies.
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Journal of anesthesia · Feb 2023
Characteristics of retained foreign bodies and near-miss events in the operating room: a ten-year experience at one institution.
Retained foreign bodies (RFBs) are a major complication of surgical procedures. However, the efficacy of preventive measures is not well defined. This study investigates the characteristics of potential (near miss) and actual RFBs, and the contributions of routine practice for the prevention of RFB events. ⋯ The actual incidence of RFB events is higher than previously reported. A standardized counting protocol, communication among staff, and intra- and postoperative X-rays may contribute to the prevention and detection of RFBs.
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Journal of anesthesia · Feb 2023
Randomized Controlled TrialThe effect of tetrastarch on the endothelial glycocalyx layer in early hemorrhagic shock using fluorescence intravital microscopy: a mouse model.
To investigate vascular endothelial dysfunction based on glycocalyx impairment in massive hemorrhage and to evaluate fluid therapy. ⋯ In an acute massive hemorrhage mouse model, initial fluid resuscitation therapy with saline administration impaired glycocalyx and increased vascular permeability. Prior colloid-fluid administration prevented the progression of glycocalyx damage and improve prognosis. Prior HES130 administration may protect endothelial cell function.