Journal of anesthesia
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Journal of anesthesia · Jan 2009
Work stress and workload of full-time anesthesiologists in acute care hospitals in Japan.
The number of anesthesiologists per population in Japan is small compared with that in Europe and North America. While there is a growing concern that hard work causes anesthesiologists' fatigue and may compromise patient safety, the workload and physical stress, as well as the impact of staff support on physicians' stress have not been assessed in detail. The goal of this study was to evaluate the working environment, anesthesia workload, and occupational stress of anesthesiologists in Japan. ⋯ Our results provide a quantitative assessment of the duties of anesthesiologists and show that work stress among anesthesiologists is related to workload and other factors.
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Journal of anesthesia · Jan 2009
A review of perioperative complications during frameless stereotactic surgery: our institutional experience.
Frameless stereotactic neurosurgery is increasingly being used for the biopsy of intracranial tumors and the resection of deep-seated lesions where reliance on surface anatomic landmarks can be misleading, as well as in movement disorders, psychiatric disorders, seizure disorders, and chronic refractory pain. Nascent biological approaches, including gene therapy and stem-cell and tissue transplants for movement disorders, also utilize neuronavigational techniques. These procedures are complex and involve understanding of the basic principles and factors affecting neuronavigation. The procedure may appear to be simple, but serious complications may occur. ⋯ Awareness and vigilance can help in the early identification and better management of the above intraoperative complications.
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Although it has been generally believed that parturients have delayed gastric emptying during anesthesia, the most recent reports suggest that gastric emptying is not delayed during pregnancy except during labor. Electrical slow waves in the stomach determine the frequency and the peristaltic nature of gastric contractions. In this study we performed electrogastrography during and after elective cesarean section (CS) in an attempt to evaluate gastric motility. ⋯ Electrogastrography analysis suggests that the frequency of gastric contractions during CS was less than that in the postpartum period.
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Journal of anesthesia · Jan 2009
Bispectral index during epidural puncture predicts anterograde amnesia in patients given midazolam premedication.
We hypothesized anterograde amnesia could be predicted by the bispectral index (BIS) during epidural puncture in patients premedicated with intramuscular midazolam. ⋯ BIS assessment during epidural puncture is informative for the anesthesiologist to predict amnesia following midazolam premedication.
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Journal of anesthesia · Jan 2009
Does high-dose opioid anesthesia exacerbate ischemic spinal cord injury in rabbits?
Intrathecal morphine given during a post-ischemic period has been reported to have the potential to exacerbate ischemic spinal cord injury. However, it remains unknown whether synthetic opioids administered systemically exacerbate ischemic injury. We sought to compare the damage of the spinal cord after transient spinal cord ischemia in rabbits anesthetized with three different regimens; isoflurane, fentanyl with isoflurane, and remifentanil with isoflurane. ⋯ Our results suggest that neither i.v. fentanyl nor i.v. remifentanil added to 0.5 MAC isoflurane exacerbated ischemic spinal cord injury in rabbits when compared to 1 MAC isoflurane.