Journal of anesthesia
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Journal of anesthesia · Feb 2025
Margin of safety for needle puncture of a radial artery in children: Recommendation for ultrasound-guided cannulation.
The radial artery is commonly selected for arterial puncture and cannulation, but radial nerve palsy may occur. To minimize possible damage to the nerve, needle puncture should be made within the margin of safety (between the wrist to the distal end of the radial artery and the radial nerve running in parallel). In adults, the margin of safety for radial artery puncture is approximately 6.8 cm from the wrist in men and approximately 5.4 cm in women, but the margin of safety is not known in children of different age groups. ⋯ jRCT1032230243.
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Journal of anesthesia · Feb 2025
The effects of frailty on opioid consumption after total knee arthroplasty.
This study evaluated the effects of frailty on postoperative opioid consumption in elderly patients. ⋯ Our study results indicate that frailty, easily assessed preoperatively in elderly surgical patients, is a significant predictor of postoperative opioid consumption.
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Journal of anesthesia · Feb 2025
Impact of low-dose sevoflurane with propofol-based anesthesia on motor-evoked potentials in infants: a single-arm crossover pilot study.
The influence of anesthetic interactions on motor-evoked potentials in infants has rarely been reported. In infants, adding a small dose of sevoflurane to propofol-based total intravenous anesthesia is reasonable for reducing propofol administration. We collected preliminary data regarding the effect of low-dose sevoflurane in propofol-based total intravenous anesthesia on motor-evoked potentials in infants. ⋯ Adding even 0.1-0.15 age-adjusted minimum alveolar concentration sevoflurane to propofol-based total intravenous anesthesia attenuated the motor-evoked potential amplitudes in the lower extremities. A further prospective interventional study with an appropriate sample size is required to investigate the study hypothesis.
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Journal of anesthesia · Feb 2025
Observational StudyUltrasound assessment of the frequency and variation of arteries in the interscalene region.
Given the abundance of arteries in the neck, a significant risk of puncturing arteries exists when performing a brachial plexus block. Therefore, it is important to confirm the presence of arteries when performing a brachial plexus block via the interscalene approach. This study aimed to investigate the frequency and variations of arteries in the interscalene region in healthy Japanese adults using ultrasonography. ⋯ Interscalene observations using ultrasound devices revealed a high artery frequency, with numerous topographic variations.
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Journal of anesthesia · Feb 2025
Post-esophagectomy patients presenting for general anesthesia induction: a survey of practice among US anesthesiologists (PESO-GAIN-S).
Following esophagectomy, annually several thousand patients in the United States (US) reach a stable post-esophagectomy status. Such patients may require general anesthesia (GA) for elective procedures, but no generally accepted guidelines exist for the induction of GA in post-esophagectomy patients. ⋯ US attending anesthesiologists' approach to induction of GA in a patient with a history of successful esophagectomy was not uniform. The majority of responses reflected a concern for aspiration in such a patient. Considering surgical and non-surgical upper gastrointestinal changes, establishment of practice guidance to optimize perioperative care is an unmet need.