Journal of anesthesia
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Journal of anesthesia · Apr 2020
Randomized Controlled TrialDifferential effects of sevoflurane and propofol on an electroretinogram and visual evoked potentials.
The purpose of this study was to simultaneously evaluate the effects of sevoflurane and propofol on an electroretinogram (ERG) and visual evoked potentials (VEPs). Twenty-four patients scheduled for elective surgery under general anesthesia were allocated randomly to receive either sevoflurane (group S) or propofol (group P). An ERG and VEPs were recorded in an awake state and during anesthesia with three different minimum alveolar concentrations (MAC; 0.5, 1.0, and 1.5) of sevoflurane in group S or with three different effect-site concentrations (Ce) of 2, 3, and 4 μg/ml by using a target-controlled infusion technique in group P. ⋯ In summary, propofol and sevoflurane at clinical concentrations had little effect on the amplitude of an ERG. Sevoflurane attenuated the amplitudes of VEPs even at low concentrations. Propofol also attenuated the amplitudes of VEPs to a lesser extent compared to sevoflurane.
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Journal of anesthesia · Feb 2020
Randomized Controlled TrialComparison of single minimum dose administration of dexmedetomidine and midazolam for prevention of emergence delirium in children: a randomized controlled trial.
Emergence delirium (ED) is common in children after sevoflurane anesthesia and should be prevented for patient safety. A prospective, double-blind, randomized, controlled study was performed to compare the efficacy of minimal dosage of midazolam versus dexmedetomidine to prevent ED in children undergoing tonsillectomy. ⋯ Dexmedetomidine and midazolam at single minimum dosages had equal effectiveness to prevent ED in children without delaying emergence time, when administered at the end of surgery. With regards to postoperative analgesic efficacy, although dexmedetomidine showed statistically significant higher analgesic effect than midazolam, further clinical investigations are needed to validate our findings.
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Journal of anesthesia · Feb 2020
Randomized Controlled TrialA single paravertebral injection via a needle vs. a catheter for the spreading to multiple intercostal levels: a randomized controlled trial.
Thoracic paravertebral block (TPVB) provides a unilateral nerve block at multiple intercostal levels allowing injection of a local anesthetic into paravertebral space (PVS) via a needle or catheter. However, the most effective injection method remains unclear. This study compared the real-time spread of ropivacaine between two paravertebral injection methods using thoracoscopy. ⋯ Paravertebral injection via a needle typically resulted in spreading to multiple intercostal levels, especially across the ribs on the peripheral side of injection site, whereas injection via a catheter resulted in variable spreading patterns. Therefore, injections via needles are more stable.
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Journal of anesthesia · Feb 2020
Randomized Controlled TrialFeasibility of ultrasound-guided lumbar epidural access using paramedian transverse scanning with the needle in-plane: a comparison with paramedian sagittal scanning.
The present study was designed to compare the feasibility of ultrasound (US)-guided lumbar epidural access using paramedian sagittal scanning (PMSS) and paramedian transverse scanning (PMTS) approaches. ⋯ Chinese Clinical Trial Registry, clinical trial number ChiCTR1800015815, date of registration April 24, 2018.
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Journal of anesthesia · Oct 2019
Randomized Controlled Trial Comparative StudyUse of a curved needle to facilitate lateral sagittal infraclavicular block performance: a randomized clinical trial.
Failed needle-tip positioning in an ultrasound-guided infraclavicular block can be due to improper needle insertion point and steep needle insertion angle. Needle pre-curving enables the user to pass the needle with different curved trajectories on approaching the brachial plexus. Aim of the study was to compare curved and non-curved needles as regards the time needed to perform the lateral sagittal infra-clavicular block. ⋯ The use of a curved needle reduces the time required to perform the lateral sagittal infraclavicular block. The curved needle provides less procedure pain and higher satisfaction levels among anesthetists than the non-curved needle.