Journal of anesthesia
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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.
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Journal of anesthesia · Dec 2024
Ultrasound-guided obturator nerve block technique at the distal end of the obturator canal: case series and cadaver evaluation.
The obturator nerve variably gives off the anterior, posterior, and hip articular branches along its course; however, all branches invariably pass through the obturator canal. Herein, we describe our obturator nerve block technique, which promises to deliver local anesthetic directly into the obturator canal. We performed the obturator nerve block in six patients undergoing transurethral resection of bladder tumor under spinal anesthesia. ⋯ The procedure was repeated using 10-ml dye in a cadaver. No obturator jerks were observed during the transurethral resection of bladder tumors in all six cases. Cadaver examination confirmed the dye stained the obturator nerve, with retrograde spread into the pelvic cavity via the obturator canal.
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Journal of anesthesia · Dec 2024
Randomized Controlled Trial Comparative StudyComparing the hemodynamic effects of ketamine versus fentanyl bolus in patients with septic shock: a randomized controlled trial.
Ketamine and fentanyl are commonly used for sedation and induction of anesthesia in critically ill patients. This study aimed to compare the hemodynamic effects of ketamine versus fentanyl bolus in patients with septic shock. ⋯ gov Identifier: NCT05957302. URL: https://clinicaltrials.gov/study/NCT05957302 .
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Journal of anesthesia · Dec 2024
Review Practice GuidelineRecommendation for the practice of total intravenous anesthesia.
This Recommendation was developed by the Japanese Society of Intravenous Anesthesia Recommendation Making Working Group (JSIVA-WG) to promote the safe and effective practice of total intravenous anesthesia (TIVA), tailored to the current situation in Japan. It presents a policy validated by the members of JSIVA-WG and a review committee for practical anesthesia management. Anesthesiologists should acquire and maintain the necessary knowledge and skills to be able to administer TIVA properly. ⋯ TIVA should be swiftly changed to an alternative method that includes inhalation anesthesia if necessary. Use of antagonists at emergence may be associated with re-sedation risk. Casual administration of antagonists and sending patients back to surgical wards without careful observation are not acceptable.