Journal of anesthesia
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Journal of anesthesia · Dec 2024
Transesophageal motor-evoked potentials, a novel method induced by transesophageal spinal cord stimulation, are less sensitive to anesthetics than transcranial motor-evoked potentials.
Intraoperative neurologic monitoring can be useful, but transcranial motor evoked potentials (TcMEPs) are sensitive to anesthetic agents. We compared the effects of anesthetics on the newly developed transesophageal motor evoked potentials (TeMEPs) with those on TcMEPs. ⋯ TeMEPs are more tolerant to anesthesia than TcMEPs and may be a promising MEP monitoring technique for the lower corticospinal tract.
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Journal of anesthesia · Dec 2024
Correlation of preoperative fibrinogen/albumin ratio with morbidity following advanced-age hip fractures: an observational study.
Given the occurrence of comorbidities in geriatric patients, the postoperative period of hip fractures may progress with high morbidity and mortality. Recently, several inflammatory markers have been used to evaluate the treatment course. Herein, we prospectively followed-up and examined the relationship between preoperative fibrinogen/albumin ratio(FAR) and morbidity/mortality in elderly patients with hip fracture. ⋯ Preoperative FAR, which is an inexpensive and readily available test, is a promising index for predicting mortality and complications in patients with hip fracture.
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Journal of anesthesia · Dec 2024
Appropriate tourniquet pressure for peripherally inserted central catheter placement in the upper arm.
A peripherally inserted central catheter (PICC) placement often requires ultrasound guidance. Previous studies using an adult blood pressure cuff have suggested that veins do not easily collapse at the tourniquet pressure from diastolic to systolic blood pressure. When inserting a PICC into the basilic vein of the upper arm, a narrow blood pressure cuff should be used as a tourniquet to avoid concealing the puncture site. The aim of this study was to determine the appropriate tourniquet pressure using a narrow cuff when inserting a PICC into the upper arm. ⋯ D to S is appropriate for PICC placement in the basilic vein of the upper arm in terms of venous collapse.
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Journal of anesthesia · Dec 2024
ReviewConsensus statement on chronic pain treatment in cancer survivors.
In September 2023, the Japan Society of Pain Clinicians (JSPC) issued this consensus statement on chronic pain treatment in cancer survivors. With recent advances in the early diagnosis and treatment of cancer, its prognosis has improved, so prolonged pain in cancer survivors is considered to represent chronic pain and should be addressed. In this statement, we emphasize that not all cancer survivor pain is cancer pain. ⋯ In addition, cancer survivors at any stage of disease have a potentially life-threatening condition and constantly carry the fear of cancer recurrence. Therefore, even non-cancer pain should not be treated in the same way as general chronic pain, but should be managed with consideration of emotional distress. In the future, we plan to create educational tools for healthcare professionals and to conduct online seminars, both with the goal of providing cancer survivors with appropriate assessment and treatment of chronic pain.