Journal of anesthesia
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Journal of anesthesia · Jan 2005
Delayed discharge and acceptability of ambulatory surgery in adult outpatients receiving general anesthesia.
Delay in discharge after ambulatory surgery impairs its cost-effectiveness. However, it is not self-evident that prolonged postoperative stay is associated with low quality of care and patient acceptability of ambulatory surgery. The aims of this study were to document factors affecting delay in discharge, recovery profiles, and patient acceptability in adult outpatients. ⋯ Delays in discharge are mainly due to adverse symptoms or social/system problems. Delayed discharge is associated with increased postdischarge pain, lower RNA level, and patient acceptability. Appropriate care of postoperative symptoms and system management could prevent delay in discharge and improve patient RNA level and acceptability.
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Journal of anesthesia · Jan 2005
Risk factors for prolonged ICU stay in patients following coronary artery bypass grafting with a long duration of cardiopulmonary bypass.
Risk factors for prolonged stay in the intensive care unit (ICU) in patients following coronary artery bypass grafting (CABG) have been reported in many previous studies. However few have focused on circulatory and respiratory status as immediate postoperative risk factors. Therefore we examined immediate postoperative risk factors for prolonged ICU stay after CABG with a long duration of cardiopulmonary bypass (CPB). ⋯ Advanced age, increased MPAP, and decreased PF ratio on admission to the ICU were significant risk factors for a prolonged ICU stay of more than 3 days.
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Journal of anesthesia · Jan 2005
Case ReportsPercutaneous radiofrequency lumbar facet rhizotomy guided by computed tomography fluoroscopy.
X-ray fluoroscopy-guided percutaneous radiofrequency facet rhizotomy is used to treat chronic low back pain. The traditional fluoroscopic approach to the medial branch of the posterior rami, however, is associated with a small incidence of complications. We describe a new method for radiofrequency lumbar facet rhizotomy in which computed tomography (CT) fluoroscopy is used to guide needle placement. ⋯ Pain scores of all patients were reduced after the procedure without any complications such as paralysis or neuritic pain. None of the patients complained of severe discomfort during the procedure. CT fluoroscopy-guided percutaneous lumbar facet rhizotomy appears to be safe, fast, and effective for patients with lumbar facet pain.
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Journal of anesthesia · Jan 2005
Combined spinal-propofol anesthesia with noninvasive positive-pressure ventilation.
Twenty-three adult patients undergoing repair of inguinal hernia under spinal anesthesia received propofol infusion for sedation with the assist of noninvasive positive-pressure ventilation (NPPV). Circulatory and respiratory parameters, such as percutaneous oxygen saturation, transcutaneous carbon dioxide tension, respiratory rate, tidal volume, blood pressure, and heart rate, were maintained within physiological ranges during the anesthesia. There were no adverse effects. These findings suggest that the application of NPPV in patients receiving propofol infusion for sedation is clinically practicable during anesthesia.
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Journal of anesthesia · Jan 2005
Effects of olprinone on hepatosplanchnic circulation and mitochondrial oxidation in a porcine model of endotoxemia.
This study was performed in order to assess the effects of olprinone, a phosphodiesterase III inhibitor, on hepatic oxygen delivery (DO2H), oxygen consumption (VO2H), and mitochondrial oxidation in the liver of a porcine endotoxemia model. ⋯ Our data for this porcine endotoxemia model suggest that olprinone may have beneficial therapeutic effects in restoring not only systemic and hepatic circulation but also mitochondrial oxidation in the liver.