Articles: general-anesthesia.
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Journal of anesthesia · Apr 2022
Randomized Controlled TrialRemimazolam decreased the incidence of early postoperative nausea and vomiting compared to desflurane after laparoscopic gynecological surgery.
Postoperative nausea and vomiting (PONV) is a common adverse event after surgery. Remimazolam is a novel sedative agent recently approved for general anesthesia in Japan. This study evaluated the efficacy of remimazolam in the incidence of PONV after laparoscopic gynecological surgery under general anesthesia. ⋯ Remimazolam can reduce the incidence of PONV after laparoscopic gynecological surgery compared to general anesthesia with desflurane during the early postoperative period.
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J Clin Monit Comput · Apr 2022
Assessment of the 50 % and 95 % effective paratracheal forces for occluding the esophagus in anesthetized patients.
This study aimed to evaluate the 50% and 95% effective paratracheal forces for occluding the esophagus in anesthetized patients. In 46 anesthetized patients, the upper esophagus was examined using ultrasonography, and the lower paratracheal area over the esophagus just above the clavicle was marked. Manual paratracheal force was applied over that area using a novel pressure sensing device set-up. ⋯ According to Dixon and Mood method, the 50% effective paratracheal force (confidence interval) was 18.4 (17.5‒19.3) N with the use of a 12-Fr esophageal stethoscope and 12.8 (11.0‒14.6) N with the use of an 18-Fr esophageal stethoscope. Using probit regression analysis, the 50% and 95% effective paratracheal forces were 18.4 (16.8‒19.6) N and 20.6 (19.4‒27.9) N, respectively, with the use of a 12-Fr esophageal stethoscope, and 12.4 (8.3‒14.4) N and 16.9 (14.7‒37.3) N, respectively, with the use of an 18-Fr esophageal stethoscope. Our findings suggest a guide for applying paratracheal force during rapid sequence induction and tracheal intubation.
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J. Cardiothorac. Vasc. Anesth. · Apr 2022
General Anesthesia Leads to Underestimation of Regurgitation Severity in Patients With Secondary Mitral Regurgitation Undergoing Transcatheter Mitral Valve Repair.
To evaluate the effect of general anesthesia (GA) on severity of mitral regurgitation (MR) in patients undergoing transcatheter mitral valve repair (TMVR). ⋯ GA underestimates regurgitation severity in patients with secondary, but not primary MR, undergoing TMVR. This effect must be considered when evaluating the immediate result of the procedure.
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The aim of this study is to retrospectively analyze and evaluate the effect of transverse thoracic muscle plane (TTP) block as a routine analgesic strategy for cardiac enhanced recovery after surgery in sternotomy. Patients received TTP block after general anesthesia and tracheal intubation were included in this study. The baseline clinical data of the patients, intraoperative use of sufentanil, internal mammary artery separating time, the postoperative duration of invasive ventilation, visual analogue scale, the compression times of patient-controlled intravenous analgesia in the first 3 days after surgery, and postoperative nausea and vomiting were recorded. ⋯ The postoperative duration of invasive ventilation of patients with normal and mildly impaired pulmonary function was significantly correlated to the use of sufentanil (P = .027, .009). TTP block has certain analgesic effect and can reduce sufentanil use in medium-length cardiac surgery and postoperative use of opioids. It is indicated that TTP block can be used as a routine enhanced recovery after surgery strategy for sternotomy in cardiac surgery.