Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2012
Randomized Controlled Trial Multicenter StudyIs a neutral head position as effective as head rotation during landmark-guided internal jugular vein cannulation? Results of a randomized controlled clinical trial.
Central venous access remains a cornerstone procedure for a variety of clinical conditions. Ultrasound studies suggest that rotation of the head increases the magnitude of the overlap of the internal jugular vein with the carotid artery. The authors assessed whether a neutral position of the head during anatomic landmark-guided cannulation of the internal jugular vein (IJV) was an attractive alternative to rotating the neck to a >45° head turn. ⋯ Because of the lower success rate, the neutral head position is not an attractive alternative for IJV catheterization when compared with the rotated head position in a central landmark IJV approach.
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J. Cardiothorac. Vasc. Anesth. · Dec 2012
Randomized Controlled TrialHigh thoracic epidural analgesia in cardiac surgery. Part 2--high thoracic epidural analgesia does not reduce time in or improve quality of recovery in the intensive care unit.
To evaluate the postoperative effect of high thoracic epidural analgesia on the time in the intensive care unit (ICU) and the quality of cardiac recovery in patients undergoing cardiac surgery. ⋯ HTEA does not reduce the time in the ICU or improve the quality of recovery in the ICU.
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J. Cardiothorac. Vasc. Anesth. · Dec 2012
Randomized Controlled TrialThe effect of depth of anesthesia on the severity of mitral regurgitation as measured by transesophageal echocardiography.
The unloading effect of anesthesia on the left ventricle results in a downgrade of mitral regurgitation (MR) severity, which increases as anesthesia deepens. This study examined how the depth of anesthesia could affect the loading condition of the left ventricle and the severity of MR. ⋯ It may be helpful to measure the severity of MR at a shallower anesthesia depth guided by BIS monitoring to avoid a downgrade of MR under general anesthesia.
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J. Cardiothorac. Vasc. Anesth. · Dec 2012
Randomized Controlled TrialEffect of epidural magnesium on the incidence of chronic postoperative pain after video-assisted thoracic surgery.
The aim of this study was to determine whether the epidural administration of magnesium during the perioperative period decreased the incidence of chronic postoperative pain (CPOP) at 3 months after video-assisted thoracic surgery. ⋯ The epidural administration of magnesium from before the induction of anesthesia to 48 hours postoperatively did not decrease significantly the incidence or severity of CPOP in patients undergoing video-assisted thoracic surgery.
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J. Cardiothorac. Vasc. Anesth. · Dec 2012
Randomized Controlled TrialHigh thoracic epidural analgesia in cardiac surgery. Part 1--high thoracic epidural analgesia improves cardiac performance in cardiac surgery patients.
The purpose of this study was to evaluate the perioperative cardioprotective effect of high thoracic epidural analgesia (HTEA), primarily expressed as an effect on cardiac performance and hemodynamics in patients undergoing cardiac surgery. ⋯ The findings of a higher stroke volume index and central venous oxygenation without an increase in heart rate or mean arterial pressure suggest that HTEA improves cardiac performance in elderly cardiac surgery patients.