Mehmet Guzel, Emre Sertac Bingul, Emine Aysu Salviz, Emre Senturk, Mehmet Faruk Cosgun, Meltem Savran Karadeniz
PURPOSE: Costoclavicular brachial plexus block has been described recently as a new technique in adults and pediatric patients. In this study, we aimed to compare the supraclavicular and costoclavicular approaches, which are claimed to be effective and practical in pediatric patients. METHODS: Sixty children were randomized to receive supraclavicular (SC group) or costoclavicular (CC group) brachial plexus blocks prior to surgical incision. Block performance times were recorded as the primary outcome...
November 27, 2022: Journal of Anesthesia
Mutsuhito Kikura, Yoko Tobetto, Kaori Yamamoto, Masahiro Uraoka, Ritsuko Go
PURPOSE: This study aimed to examine the effect of fibrinogen replacement therapy with cryoprecipitate or fibrinogen concentrate on bleeding outcomes and 1-year mortality in patients undergoing thoracic aortic surgery. METHODS: We retrospectively studied 439 consecutive patients who underwent thoracic aortic surgery with cardiopulmonary bypass between January 1st, 2010 and December 31st, 2019 and identified patients who received cryoprecipitate or fibrinogen concentrate (the fibrinogen replacement group) and those who did not (the control group)...
November 27, 2022: Journal of Anesthesia
Tadao Ando, Kohji Uzawa, Takahiro Yoshikawa, Shingo Mitsuda, Yoshihiro Akimoto, Tomoko Yorozu, Akira Ushiyama
PURPOSE: To investigate vascular endothelial dysfunction based on glycocalyx impairment in massive hemorrhage and to evaluate fluid therapy. METHODS: In this randomized controlled animal study, we withdrew 1.5 mL blood and administered 1.5 mL resuscitation fluid. Mice were divided into six groups according to the infusion type and administration timing: NS-NS (normal saline), NS-HES ([hydroxyethyl starch]130), HES-NS, NS-ALB (albumin), ALB-NS, and C (control) groups...
November 24, 2022: Journal of Anesthesia
Kanji Uchida, Osamu Nishida, Hiroshi Morimatsu, Takahisa Goto, Yutaka Oda, Takashi Asai
The COVID-19 pandemic is ongoing as of September 2022. Since January 2020 when the first case was reported in Japan, the medical community faced a variety of problems both domestically and internationally. It is meaningful to review the impact of COVID-19 from an anesthesiologist's perspective to clarify our policy for future infectious disease outbreaks. In this year's Journal of Anesthesia (JA) symposium, five experts who were deeply involved in the COVID-19 response reviewed the past 2.5 years and made recommendations for potential future pandemics...
November 19, 2022: Journal of Anesthesia
Thrivikrama Padur Tantry, Harish Karanth, Saravana Anniyappa, Pramal K Shetty, Madhusudan Upadya, Sunil P Shenoy, Dinesh Kadam
Information on evaluations of different oxytocin regimens used to prevent post-partum hemorrhage during cesarean delivery is scarce, and there is a lack of statistically pooled results for comparative doses. In this review, we aimed to analyze the effectiveness of different oxytocin regimens used and rank them accordingly. We performed a meta-analysis of randomized controlled trials (RCTs) reporting the incidence of additional uterotonic (AUT) use or amount of blood loss during cesarean delivery, where different oxytocin regimens were compared...
November 16, 2022: Journal of Anesthesia
Takashi Soejima, Kentaro Ueda, Sakae Hasegawa, Hiromitsu Motoe, Kazufumi Okada, Yoichi M Ito, Koji Hoshino, Yuji Morimoto
PURPOSE: Remimazolam is a new ultra-short-acting benzodiazepine with unknown effects on cerebral circulation. We measured total cerebral hemoglobin concentrations, which reflect cerebral blood volume (CBV), and cerebral oxygen saturation, using time-domain near-infrared spectroscopy, which can measure the absolute values of cerebral hemoglobin concentrations. We also measured cerebral blood flow velocity (CBFV) in the middle cerebral artery using transcranial Doppler as an indicator of cerebral blood flow (CBF)...
November 10, 2022: Journal of Anesthesia
Katsuaki Tanaka, Yuko Yoshizumi, Taku Hamada, Kiyonobu Nishikawa, Takashi Mori
PURPOSE: Propofol is commonly used to induce general anesthesia; however, the pain caused during propofol injection is a disadvantage. This study aimed to assess whether deep breathing attenuates propofol injection pain. METHODS: This prospective, single-blind, randomized controlled study included 200 patients who were scheduled to undergo elective surgery under general anesthesia and randomly and equally divided them into group D and group C. The observers were not blinded to the pain-relieving modality, but each patient was blinded...
November 10, 2022: Journal of Anesthesia
Ryu Komatsu, Michael G Nash, Jiang Wu, Emily M Dinges, Carlos M Delgado, Laurent A Bollag
PURPOSE: We developed prediction models for postoperative respiratory depression and respiratory complications for 958 patients who were on methadone preoperatively. METHODS: The primary outcome was postoperative respiratory depression as defined by respiratory rate < 10/min, oxygen saturation (SpO2 ) < 90%, or requirement of naloxone for 48 h postoperatively. Secondary outcome was the composite of postoperative respiratory complications. Prediction models for postoperative respiratory depression and respiratory complications were constructed using multivariate logistic regression with preoperative and intraoperative characteristics as the predictors...
November 10, 2022: Journal of Anesthesia
Kyosuke Takahashi, Takeshi Fukatsu, Sayaka Oki, Yusuke Iizuka, Yuji Otsuka, Masamitsu Sanui, Alan Kawarai Lefor
PURPOSE: Retained foreign bodies (RFBs) are a major complication of surgical procedures. However, the efficacy of preventive measures is not well defined. This study investigates the characteristics of potential (near miss) and actual RFBs, and the contributions of routine practice for the prevention of RFB events. METHODS: We conducted a retrospective review of incident reports regarding near-miss and RFB events in patients who underwent surgery under general anesthesia in our institution between October 2008 and November 2018...
November 8, 2022: Journal of Anesthesia
Ahmed Farag, Nada Ibrahim Hendi, Rehab Adel Diab
Perioperative pain management related to hip surgical procedures is challenging. Pericapsular nerve group (PENG) block is a novel technique that is assumed to provide better analgesia in addition to its post-operative motor-sparing effect. In this review, we aim to assess the safety and efficacy of PENG block on pain management in patients undergoing hip surgeries. Fifteen clinical trials with a total of 837 patients were included. Pain scores favored PENG group when compared to FICB group (fascia iliaca compartment block) or analgesics-only group, but the difference could only be detected in the early post-operative period...
November 7, 2022: Journal of Anesthesia
Fa-Ngam Charoenpol, Nutchanok Khampitak, Charinee Aimnang, Kachit Pachirat, Wichien Sirithanaphol, Ukrit Rompsaithong, Pakorn Kiatsopit, Supanut Lumbiganon
PURPOSE: Transurethral resection of prostate (TURP) with postoperative catheter traction can lead to significant catheter-related bladder discomfort (CRBD). This condition causes many postoperative complications and low patient satisfaction. This study aimed to evaluate the effectiveness of preoperative single-dose intravenous nefopam on the incidence and severity of CRBD and its adverse effects. METHODS: This randomized, controlled, double-blind study included patients who underwent TURP under spinal anesthesia with postoperative urinary catheter traction...
November 2, 2022: Journal of Anesthesia
Shoto Yamada, Yukinori Akiyama, Shunsuke Tachibana, Kengo Hayamizu, Yusuke Kimura, Shuichi Hashimoto, Michiaki Yamakage, Nobuhiro Mikuni
Remimazolam is a short-acting benzodiazepine that was approved for clinical use in 2020. We report three patients who underwent surgery for cerebral and spinal cord tumors, in whom transcranial electrical stimulation-motor-evoked potential (TES-MEP) was successfully monitored under general anesthesia with remimazolam. During total intravenous anesthesia with propofol at a target concentration of 2.7 - 3.5 µg/mL and 0.1 - 0.35 µg/kg/min of remifentanil, delayed awakening, bradycardia, and hypotension during propofol anesthesia were expected in all three cases...
November 1, 2022: Journal of Anesthesia
Yulin Zeng, Yudai Yamamoto, Yoshihito Hayashi, Tokujiro Uchida
PURPOSE: To determine if fibrinogen concentration can be evaluated by dielectric permittivity changes in dielectric blood coagulation testing (DBCM) during cardiovascular surgery with cardiopulmonary bypass (CPB). METHODS: We performed a single-center prospective observational study at a university hospital. One hundred patients undergoing cardiovascular surgery with CPB were enrolled. Whole-blood samples were obtained after weaning from CPB, and dielectric clot strength (DCS) was measured by intrinsic pathway testing with or without heparinase in DBCM...
November 1, 2022: Journal of Anesthesia
Woon-Seok Kang, Seung-Wan Hong, Chung-Sik Oh, Tae-Gyoon Yoon, Byung-Soo Kim, Yubi Kwon, Seong-Hyop Kim
PURPOSE: Congenital heart disease (CHD) is divided into two groups according to cyanosis status. Cyanotic CHD has a low level of systemic oxygenation and is accompanied by increased erythropoiesis. We hypothesized that pediatric patients with CHD would exhibit different thromboelastographic profiles according to their cyanosis status. METHODS: The study recruited 70 pediatric patients younger than 12 months who were undergoing surgery for CHD. Patients were allocated to the acyanotic group or cyanotic group after preoperative evaluations of their diagnosis and peripheral oxygen saturation in the operating room on room air...
October 30, 2022: Journal of Anesthesia
Hiroaki Murata, Akihiro Yokoyama, Tetsuya Hara
No abstract text is available yet for this article.
October 29, 2022: Journal of Anesthesia
Shohei Nakatani, Mitsuru Ida, Kayo Uyama, Yuki Kinugasa, Masahiko Kawaguchi
PURPOSE: Preoperative cognitive impairment is a significant factor influencing post-operative delirium. We have been performing routine pre-operative comprehensive assessments, including evaluation of cognitive function, handgrip strength, oral hygiene, and nutritional status, in patients aged ≥ 65 years since April 2021. This study aimed to examine the completion rate of pre-operative comprehensive assessment and assess the prevalence of pre-operative undiagnosed cognitive impairment...
October 28, 2022: Journal of Anesthesia
Keisuke Yoshida, Shinju Obara, Satoki Inoue
At present, there is no objective and absolute measure of nociception, although various monitoring techniques have been developed. One such technique is the Analgesia Nociception Index (ANI), which is calculated from heart rate variability that reflects the relative parasympathetic tone. ANI is expressed on a non-unit scale of 0-100 (100 indicates maximal relative parasympathetic tone). Several studies indicated that ANI-guided anesthesia may help reduce intraoperative opioid use. The usefulness of ANI in the intensive care unit (ICU) and during surgery has also been reported...
October 22, 2022: Journal of Anesthesia
Sayuri Kawase, Toshinori Horiuchi, Toshihiro Nagahata
PURPOSE: Research has shown that a higher dose of bupivacaine administered in continuous paravertebral block (CPVB) provides a greater analgesic effect after video-assisted thoracoscopic surgery (VATS). In this randomized, controlled, double-blind study, we hypothesized that 0.25% 8 ml/h of levobupivacaine administered in CPVB after VATS provides a greater analgesic effect than 0.125% 8 ml/h. METHODS: Fifty patients who underwent unilateral VATS were randomized to receive a postoperative continuous infusion of 0...
October 18, 2022: Journal of Anesthesia
Daeseok Oh, Soon Ho Cheong, Young Gyun Choi, Sung Ho Moon, Myoung Jin Ko
PURPOSE: We sought to identify clinical predictors of favorable short-term outcomes associated with cervical interlaminar epidural injection (CIEI). Previous studies investigating the predictive factors of CIEI efficacy have shown inconsistent results. Gaining information on the possible response determinants of CIEI is necessary for appropriate treatment selection and outcomes prediction in the treatment of cervical radiculopathy. METHODS: We analyzed the clinical data of 72 patients who received fluoroscopic-guided CIEI using the paramedian approach for cervical radiculopathy to identify the predictive factors for short-term outcomes of CIEI...
October 18, 2022: Journal of Anesthesia
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