Journal of anesthesia
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Journal of anesthesia · Oct 2010
Vecuronium requirement during liver transplantation under sevoflurane anesthesia.
In liver transplantation patients under intravenous anesthesia, the vecuronium dose is known to be reduced, especially during the anhepatic phase. Volatile anesthetics potentiate a muscle relaxation effect of neuromuscular blocking agents, so the vecuronium dose is supposed to further decrease if sevoflurane is used during liver transplantation. The purpose of this study was to determine the appropriate dose of vecuronium at each phase of liver transplantation under sevoflurane anesthesia. ⋯ The required vecuronium dose in all phases was less than the known dose in the anhepatic phase (0.036 mg/kg/h) under midazolam-fentanyl anesthesia. In addition, the vecuronium infusion dose was not reduced in the anhepatic phase compared to the dissection phases.
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Journal of anesthesia · Oct 2010
Facilitating the transition to practice: a weekend retreat curriculum for business-of-medicine education of United States anesthesiology residents.
Anesthesiology residents in the United States (US) not only must develop the clinical skills needed to provide independent patient care, but also are required to become familiar with the business aspects of the modern health care system. Unfortunately, practice management education may be inadequate during anesthesiology residency training. ⋯ A strict lecture didactic format was avoided, and presentations were designed to encourage speaker-audience interaction. The program was relatively simple to design and implement, satisfied several Accreditation Council of Graduate Medical Education core competencies for US anesthesiology education, may be altered as practice management evolves, and may be adapted to accommodate the needs of programs in other countries.
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Journal of anesthesia · Oct 2010
Early recovery in hemodynamics after direct hemoperfusion with polymyxin B-immobilized fibers may predict mortality rate in patients with septic shock.
This retrospective and observational study attempted to determine whether the rapid improvement in hemodynamic parameters and the subsequent discontinuation or decrease of catecholamine infusion shortly after direct hemoperfusion with polymyxin B-immobilized fibers (PMX) may be strong predictors of mortality in patients with septic shock. ⋯ We concluded that the early improvement in CAI and VDI shortly after PMX might be prognostic indicators for survival.
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Journal of anesthesia · Oct 2010
Changes in intraocular pressure during cardiac surgery with and without cardiopulmonary bypass.
Data on intraocular pressure (IOP) during cardiac surgery with cardiopulmonary bypass (CPB) and anesthetic management are limited. This study was conducted to investigate changes in IOP during cardiac surgery with and without CPB. ⋯ Results indicate that during cardiac surgery, IOP values decreased during CPB and increased during anastomosis in the head-down position in patients without CPB.