Journal of anesthesia
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Journal of anesthesia · Feb 2023
Randomized Controlled TrialThe effect of tetrastarch on the endothelial glycocalyx layer in early hemorrhagic shock using fluorescence intravital microscopy: a mouse model.
To investigate vascular endothelial dysfunction based on glycocalyx impairment in massive hemorrhage and to evaluate fluid therapy. ⋯ In an acute massive hemorrhage mouse model, initial fluid resuscitation therapy with saline administration impaired glycocalyx and increased vascular permeability. Prior colloid-fluid administration prevented the progression of glycocalyx damage and improve prognosis. Prior HES130 administration may protect endothelial cell function.
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Journal of anesthesia · Dec 2022
Randomized Controlled TrialUsefulness and accuracy of a handheld ultrasound device for epidurssal landmark and depth assessment by anesthesiology residents.
The aim of this study was to assess the usefulness and accuracy of a handheld ultrasound device (Accuro, Rivanna Medical, Charlottesville, VA, USA) for epidural landmark and depth assessment when epidural anesthesia is performed by residents. ⋯ Although there was no significant difference in time from Tuohy needle puncture to loss of resistance, Accuro reduced the number of Tuohy needle redirects and accurately indicated the depth to the epidural space. Accuro may be useful for identifying the needle insertion point and estimating depth to the epidural space when residents perform epidural anesthesia.
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Journal of anesthesia · Aug 2022
Randomized Controlled TrialOxytocin infusion rates for maintaining uterine tone during non-elective cesarean section in laboring patients: a randomized, controlled trial.
Oxytocin infusions for uterine tone maintenance are recommended following initial low oxytocin doses during cesarean section. Very limited literature is available on the optimal infusion rates in laboring patients who have been earlier exposed to oxytocin. ⋯ Oxytocin infusions at 5 IU/h and 10 IU/h are more effective in reducing blood loss and preventing PPH than 2.5 IU/h. The dose of 10 IU/h, although the most efficacious, is associated with a high incidence of side effects. Hence, further studies are needed to find out the optimal maintenance infusion rate of oxytocin during cesarean section in laboring patients who have received oxytocin earlier.
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Journal of anesthesia · Aug 2022
Randomized Controlled TrialEffect of remifentanil on post-operative analgesic consumption in patients undergoing shoulder arthroplasty after interscalene brachial plexus block: a randomized controlled trial.
Remifentanil is useful in balanced anesthesia; however, there is concern regarding opioid-induced hyperalgesia. The effect of remifentanil on rebound pain, characterized by hyperalgesia after peripheral nerve block has rarely been studied. This study evaluated whether intraoperative remifentanil infusion may increase postoperative analgesic requirement in patients receiving preoperative interscalene brachial plexus block (IBP). ⋯ Remifentanil administration during arthroscopic shoulder surgery in patients undergoing preoperative IBP increased postoperative analgesic consumption.
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Journal of anesthesia · Jun 2022
Randomized Controlled TrialContinuing versus withholding angiotensin receptor blocker (ARB)/calcium channel blocker (CCB) combination tablets during perioperative periods in patients undergoing minor surgery: a single-blinded randomized controlled trial.
This trial was conducted to compare effects of continuing versus withholding single-pill combination tablets consisting of angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) on perioperative hemodynamics and clinical outcomes. ⋯ This trial is registered with the Japan Registry of Clinical Trials (jRCT) at Japanese Ministry of Health, Labour, and Welfare (Trial ID: jRCT1031190027).