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 TrialA novel stimulating electrode attachment method designed to maintain electromyography-based neuromuscular monitoring detectability during laparoscopic surgery: a single-center randomized, double-blind, controlled pilot study.
We evaluated the electromyography (EMG)-based neuromuscular monitoring detectability of our novel stimulating electrode attachment method compared to the original Nihon-Kohden (Tokyo, Japan) attachment method. ⋯ Crossing the line connecting the anode and cathode with the ulnar nerve stabilizes EMG-based neuromuscular monitoring detectability.
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Journal of anesthesia · Dec 2024
Lower extremity pain and/or numbness after laparoscopic surgery and robot-assisted surgery in the lithotomy position combined with the Trendelenburg position.
The purpose of this study was to investigate the incidence and risk factors of lower extremity pain and/or numbness after laparoscopic colorectal surgery and robot-assisted laparoscopic radical prostatectomy in the lithotomy position combined with the Trendelenburg position. The relationship between creatine kinase (CK) levels and lower extremity pain and/or numbness was also investigated. ⋯ The incidence of lower extremity pain and/or numbness after laparoscopic colorectal surgery was comparable to that after robot-assisted laparoscopic radical prostatectomy. Prolonged duration of surgery contributed to lower extremity pain and/or numbness. Significantly elevated CK levels in patients with lower extremity pain and/or numbness suggest the involvement of muscle injury in these symptoms.