Journal of anesthesia
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Journal of anesthesia · Aug 2021
Randomized Controlled TrialEffectiveness of nebulized dexmedetomidine for treatment of post-dural puncture headache in parturients undergoing elective cesarean section under spinal anesthesia: a randomized controlled study.
The need for effective treatment for post-dural puncture headache (PDPH) is a growing research entity. This study aimed to test the effectiveness of additional dexmedetomidine (DEX) to PDPH conservative management and evaluate its cerebral hemodynamic effects trans-cranial Doppler. ⋯ The addition of DEX nebulization (1 µg/kg twice daily) to the PDPH conservative care effectively relieved the symptoms and lowered pain scores which could be due to its analgesic and cerebral vasoconstrictive effects.
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Journal of anesthesia · Jun 2021
Randomized Controlled TrialErector spinae block for postoperative pain management in lumbar disc hernia repair.
Lumbar disc herniation is the most common spinal disorder and various less invasive techniques such as microdiscectomy have been described. However, postoperative pain management in patients undergoing discectomy is still commonly inadequate. Erector spinae plane (ESP) block is a relatively easier technique with lower risks of complications, and can be performed to provide postoperative analgesia for various procedures. The current study aimed to determine the effect of ESP block on postoperative analgesia in patients who underwent elective lumbar disc herniation repair surgeries. ⋯ NCT03744689.
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Journal of anesthesia · Apr 2021
Randomized Controlled TrialIncidence and effects of postoperative migration of interscalene catheter tips placed using ultrasound-guided anterior and posterior approaches.
Continuous interscalene brachial plexus block (CISB) provides analgesia after shoulder surgery. However, even a catheter securely fixed at the insertion site may be susceptible to migration, precluding the block from working consistently. We examined to see if catheter tip migration would occur with no catheter-at-skin change after anterior and posterior approaches to CISB in patients undergoing shoulder surgery, and compared the incidence rate and pain scores between approaches and between catheters with and without tip migration, respectively. ⋯ In patients undergoing shoulder surgery, an interscalene catheter tip can migrate after both anterior and posterior approaches at a similar rate, even if the catheter insertion length is not changed. The tip migration does decrease the analgesic effect of CISB.
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Journal of anesthesia · Apr 2021
Randomized Controlled TrialGeneric rocuronium reduces withdrawal movements compared to original rocuronium under target-controlled infusion induction with propofol.
Rocuronium-induced injection pain often causes withdrawal movements leading to accidental disruption of indwelling needles. Generic rocuronium (Maruishi Pharmaceutical Co., Ltd, Osaka, Japan) with a novel solution has been reported to reduce the injection pain compared to original rocuronium [Esmeron® (Eslax®), MSD Co. Ltd, Tokyo, Japan], however, no reports have compared the injection pain under sedation with propofol, the most frequently used general anesthetic. This study was carried out to compare the injection pain caused by generic rocuronium and that caused by original rocuronium in patients anesthetized by propofol with a target-controlled infusion system. ⋯ Generic rocuronium was considered more suitable than the original rocuronium for induction of anesthesia by propofol performed with a target-controlled infusion system.
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Journal of anesthesia · Apr 2021
Randomized Controlled TrialThe usefulness of Smart Pilot View for fast recovery from desflurane general anesthesia.
Smart Pilot View (SPV) (Dräger Medical) provide information about the estimated drug effect of anesthetic drugs. We conducted a prospective randomized trial to evaluated the recovery time in SPV-guided general anesthesia compared with usual practice in patients with desflurane general anesthesia. ⋯ Smart Pilot View guided anesthesia enabled faster recovery from desflurane general anesthesia.