Journal of anesthesia
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Journal of anesthesia · Aug 2015
Randomized Controlled TrialPotential advantages of an additional forearm rubber tourniquet in intravenous regional anesthesia: a randomized clinical trial.
Although the usefulness of an additional forearm tourniquet to conventional intravenous regional anesthesia (IVRA) has been reported, the forearm cuff may disturb the surgical field to some degree, especially in wrist surgery. In the present study, we assessed the clinical efficacy of a temporary additional forearm rubber tourniquet to the conventional upper arm tourniquet on the quality of IVRA. ⋯ The combination of the additional forearm and upper arm tourniquets with a smaller amount of local anesthetic achieved more rapid onset of sensory and motor block, a similar quality of anesthesia and a lower incidence of local anesthetic toxicity compared with the conventional technique.
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Journal of anesthesia · Aug 2015
Randomized Controlled TrialEffect of a new heated and humidified breathing circuit with a fluid-warming device on intraoperative core temperature: a prospective randomized study.
The effect of the Mega Acer kit(@), a new heated and humidified breathing circuit (HHBC) containing a fluid-warming device, was investigated on intraoperative core temperature (T c). ⋯ The Mega significantly reduced the drop in intraoperative T c by delivering warm fluids, compared with the other breathing circuits tested.
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Journal of anesthesia · Aug 2015
Randomized Controlled TrialRecovery of postoperative cognitive function in elderly patients after a long duration of desflurane anesthesia: a pilot study.
Postoperative cognitive dysfunction (POCD) increases morbidity and mortality. The mechanisms underlying POCD remain elusive; however, systemic responses induced by anesthesia and surgery might trigger neuroinflammation and POCD. Desflurane is a preferable volatile anesthetic agent for elderly patients because it facilitates shorter recovery from general anesthesia. ⋯ The Mini-Mental State Examination (MMSE) was used for assessing cognitive function 24 h before and after surgery. Postoperative MMSE score in the D group was significantly improved compared to that in the preoperative period. In conclusion, elderly patients undergoing desflurane anesthesia have significantly better quality of emergence and may have better cognitive function than those in elderly patients undergoing sevoflurane anesthesia.
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Journal of anesthesia · Jun 2015
Randomized Controlled Trial Comparative StudyComparison of tube-guided and guideless videolaryngoscope for tracheal intubation during chest compression in a manikin: a randomized crossover trial.
Previous studies have shown the utility of indirect glottis viewing videolaryngoscopes for tracheal intubation during chest compression, but the efficacy of a videolaryngoscope with tube guide has not been sufficiently validated. We compared the utility of two videolaryngoscopes, the KingVISION(®) (KingV) with or without tube guide blade and Pentax-AWS Airwayscope(®) (AWS), which contain tube guide function, during chest compressions on an adult manikin. ⋯ These findings suggest that the AWS and KingV-Guided devices are more effective than the KingV-Guideless for airway management with chest compressions in adult simulations, especially performed by novice doctors. The tube guide function may contribute to successful airway management during chest compression by the added videolaryngoscopy function.
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Journal of anesthesia · Jun 2015
Randomized Controlled Trial Comparative StudyA comparative study of dexmedetomidine and propofol as sole sedative agents for patients with aneurysmal subarachnoid hemorrhage undergoing diagnostic cerebral angiography.
Subarachnoid hemorrhage is an acute neurological emergency requiring urgent confirmation of the diagnosis for planning definitive management. Due to altered consciousness, most patients require sedation for conducting this procedure smoothly. Currently, it is unclear if any one particular sedative drug has a favorable profile in patients undergoing cerebral angiography. The aim of this study was to compare the traditionally used sedative drug propofol with a newer alternative, dexmedetomidine, in patients with subarachnoid hemorrhage undergoing cerebral angiography. ⋯ Dexmedetomidine appears to be superior to propofol as a sole sedative agent for sedation during cerebral angiography in patients with subarachnoid hemorrhage.