Korean journal of anesthesiology
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Korean J Anesthesiol · Apr 2019
ReviewKorean clinical practice guideline for perioperative red blood cell transfusion from Korean Society of Anesthesiologists.
Considering the functional role of red blood cells (RBC) in maintaining oxygen supply to tissues, RBC transfusion can be a life-saving intervention in situations of severe bleeding or anemia. RBC transfusion is often inevitable to address intraoperative massive bleeding; it is a key component in safe perioperative patient management. Unlike general medical resources, packed RBCs (pRBCs) have limited availability because their supply relies entirely on voluntary donations. Additionally, excessive utilization of pRBCs may aggravate prognosis or increase the risk of developing infectious diseases. Appropriate perioperative RBC transfusion is, therefore, crucial for the management of patient safety and medical resource conservation. These concerns motivated us to develop the present clinical practice guideline for evidence-based efficient and safe perioperative RBC transfusion management considering the current clinical landscape. ⋯ This guideline will aid decisions related to RBC transfusion in healthcare settings and minimize patient risk associated with unnecessary pRBC transfusion.
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Korean J Anesthesiol · Feb 2019
Randomized Controlled Trial Comparative StudyComparison of the clinical performance of airway management with the i-gel® and laryngeal mask airway SupremeTM in geriatric patients: a prospective and randomized study.
Geriatric patients are susceptible to respiratory and hemodynamic adverse events during endotracheal intubation and extubation due to anatomic and physiological changes with aging. Supraglottic airway devices (SADs) provide reduced airway morbidity and increased hemodynamic stability in adults. However, studies that have compared the clinical performance of SADs in geriatric patients are limited. Therefore, we evaluated the clinical performance of airway management with i-gel® and laryngeal mask airway Supreme (LMA SupremeTM) in geriatric patients. ⋯ Both devices can be safely applied to geriatric patients with similar success rates and oropharyngeal leak pressures. However, inserting the i-gel® was faster and easier compared to the LMA SupremeTM in geriatric patients.
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Surgical repair of the hip is considered an extremely painful procedure. Managing pain in this surgery is challenging even with several available options, each with limitations. ⋯ Herein, we describe a case of a successful ESP block for pediatric hip surgery. In the future, ESP block could be an alternative technique for providing effective analgesia.
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Korean J Anesthesiol · Feb 2019
ReviewSimulation-based ultrasound-guided regional anesthesia curriculum for anesthesiology residents.
Proficiency in ultrasound-guided regional anesthesia (UGRA) requires the practitioner to acquire cognitive and technical skills. For anesthesiology residents, an assortment of challenges has been identified in learning UGRA skills. ⋯ Simulated practice has been shown to enhance proficiency in UGRA, and a competency-based education with simulation training has been endorsed for anesthesiology residents. The objective of this review is to outline simulation-based training that can be implemented in a UGRA curriculum and to explore educational tools like gamification to facilitate competency in regional anesthesiology.
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Korean J Anesthesiol · Feb 2019
Assignment of ASA-physical status relates to anesthesiologists' experience: a survey-based national-study.
The American Society of Anesthesiologists physical status (ASA-PS) is a grading system adopted worldwide by anesthesiologists to classify the overall health status of patients. Its importance is demonstrated not only by its routinely use in clinical practice, but also by its deployment in other healthcare-related environments. However, a weak/moderate inter-observer agreement for ASA-PS has been previously shown and, although definitions and clinical examples of each class were provided by ASA, doubts remain on the individual factors influencing the assignment to an ASA-PS class. The aim of this study was to investigate whether and how an anesthesiologist's experience conditions the classification into a specific ASA-PS class. ⋯ Low inter-reliability and experience-dependence of ASA-PS must be taken into account when evaluating a patient, particularly in settings where wide differences in experience are present.