Korean journal of anesthesiology
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This study was designed to measure in vivo effects of propofol, isoflurane and sevoflurane on apoptosis by measuring caspase-3 and tumor necrosis factor (TNF)-related apoptosis inducing ligand (TRAIL) blood level as apoptotic markers. ⋯ This study concluded that isoflurane is superior and sevoflurane is the least effective among the three anesthetics in protection against apoptosis. This study neither proved nor excluded propofol-induced apoptosis. Further studies are required during lengthy procedure and in compromised patients.
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Korean J Anesthesiol · Jul 2012
Effect of a target-controlled infusion of remifentanil in combination with desflurane during the "maintenance" phase of general anesthesia.
The goal of this study was to determine the optimal target-controlled concentration of remifentanil combined with desflurane, by using a more widely and decreasing end-tidal concentration of desflurane. ⋯ We recommend the use of 2 ng/ml or less remifentanil combined with desflurane for decreasing concentrations of desflurane without significant side effects, during the "maintenance" phase, and not during the induction phase of general anesthesia.
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Korean J Anesthesiol · Jul 2012
Effects of increasing the dose of ropivacaine on vertical infraclavicular block using neurostimulation.
Use of an infraclavicular block is appropriate for surgery of the upper limb. However, it does not consistently block the entire brachial plexus. The aim of this study was to investigate whether increasing the dose of ropivacaine could enhance the success rate, onset time, and efficacy of the sensory and motor block during the use of a vertical infraclavicular block using neurostimulation in upper limb surgery. ⋯ Although the efficacy of the motor block was significantly improved, success rate, onset time, and efficacy of sensory block were not enhanced significantly among groups despite differences in volume and volume/concentration of the local anesthetic.
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Korean J Anesthesiol · Jul 2012
Anesthetic review of emergency peripartum hysterectomy following vaginal and cesarean delivery: a retrospective study.
The purpose of this study was to review incidence, indications, complications, and the anesthetic management of emergency obstetric hysterectomies. ⋯ Abnormal placenta has been an main indication of emergency hysterectomy. Anesthesiologists should be eligible to aware of high risk of emergency hysterectomy and deal with massive hemorrhage.
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Korean J Anesthesiol · Jul 2012
Concerns of the anesthesiologist: anesthetic induction in severe sepsis or septic shock patients.
Septic patients portray instable hemodynamic states because of hypotension or cardiomyopathy, caused by vasodilation, thus, impairing global tissue perfusion and oxygenation threatening functions of critical organs. Therefore, it has become the primary concern of anesthesiologists in conducting anesthesia (induction, maintenance, recovery, and postoperative care), especially in the induction of those who are prone to fall into hemodynamic crisis, due to hemodynamic instability. The anesthesiologist must have a precise anesthetic plan based on a thorough preanesthetic evaluation because many cases are emergent. ⋯ In order to hemodynamically stabilize septic patients, adequate fluid resuscitation must be given before induction. Most anesthetic induction agents cause blood pressure decline, however, it may be useful to use drugs, such as ketamine or etomidate, which carry less cardiovascular instability effects than propofol, thiopental and midazolam. However, if blood pressure is unstable, despite these efforts, vasopressors and inotropic agents must be administered to maintain adequate perfusion of organs and cellular oxygen uptake.