Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2010
Comparative StudySevoflurane causes greater QTc interval prolongation in elderly patients than in younger patients.
Sevoflurane and droperidol prolong the QT interval, and advancing age is not only associated with a prolongation of the QT interval but is also a risk factor for drug-induced QT interval prolongation. In this study, we compared the effect of sevoflurane and droperidol on the corrected QT (QTc) interval and the dispersion of ventricular repolarization (time interval from the peak to the end of the T wave [Tp-e]) in elderly patients with those in younger patients. ⋯ Sevoflurane causes greater QTc interval prolongation in elderly patients than in younger patients. Although sevoflurane does not affect the transmural dispersion of repolarization and sevoflurane-induced QTc prolongation does not advance with time and by droperidol administration, QT interval prolongation and its associated arrhythmias should be carefully monitored during sevoflurane anesthesia in elderly patients.
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Anesthesia and analgesia · Mar 2010
Scientific publications in anesthesiology journals from mainland China, Taiwan, and Hong Kong: a 10-year survey of the literature.
The past 20 yr have seen significant growth in China's role in the international community. This same growth and international presence is occurring in the field of anesthesiology. The research status in anesthesiology among Chinese individuals in the 3 major regions of China--mainland China, Hong Kong, and Taiwan--is unknown. We analyzed articles published in peer-reviewed international anesthesiology journals cited by both PubMed and Science Citation Index from these 3 regions. ⋯ The total number of articles from China published in highly cited anesthesiology journals increased markedly from 1999 to 2008, with articles from mainland China increasing substantially after 2004, whereas the number of publications from Hong Kong decreased. The average impact factor was similar for all 3 regions, ranging from 2.2 to 2.8. Anesthesia & Analgesia published more articles from Chinese authors from all 3 regions than any other journal.
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Anesthesia and analgesia · Mar 2010
Case ReportsPerioperative analgesia for forequarter amputation in a child: a dual paravertebral approach.
We describe the management of postoperative pain for a 10-year-old girl who underwent forequarter amputation for osteosarcoma of the left humerus. Because the brachial plexus itself was divided and resected during surgery, and the main body part innervated by the nerves from this plexus (the entire upper limb including the scapula and clavicle) was removed, providing analgesia via a brachial plexus block alone would probably not have provided adequate coverage. Because the tissue not resected with this surgery was innervated via the cervical and brachial plexuses and some upper thoracic nerve roots, we elected to combine a perioperative high continuous cervical paravertebral block at the C5 level with a continuous thoracic paravertebral block at the T2 level for postoperative analgesia. Our patient experienced excellent postoperative analgesia and required no narcotics during the immediate postoperative period.
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Anesthesia and analgesia · Mar 2010
The ability of pleth variability index to predict the hemodynamic effects of positive end-expiratory pressure in mechanically ventilated patients under general anesthesia.
Pleth variability index (PVI) is a new algorithm allowing automated and continuous monitoring of respiratory variations in the pulse oximetry plethysmographic waveform amplitude. PVI can predict fluid responsiveness noninvasively in mechanically ventilated patients during general anesthesia. We hypothesized that PVI could predict the hemodynamic effects of 10 cm H2O positive end-expiratory pressure (PEEP). ⋯ PVI may be useful in automatically and noninvasively detecting the hemodynamic effects of PEEP when V(T) is >8 mL/kg in ventilated and sedated patients with acceptable sensitivity and specificity.