Journal of anesthesia
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Journal of anesthesia · Aug 2010
Randomized Controlled TrialDifferential effects of hyperventilation on cerebral blood flow velocity after tourniquet deflation during sevoflurane, isoflurane, or propofol anesthesia.
The purpose of this study was to compare the degree of increase in middle cerebral artery (MCA) blood flow velocity after tourniquet deflation when modulating hyperventilation during orthopedic surgery under sevoflurane, isoflurane, or propofol anesthesia. Twenty-four patients undergoing elective orthopedic surgery were randomly divided into sevoflurane, isoflurane, and propofol groups. Anesthesia was maintained with sevoflurane, isoflurane, or propofol administration with 33% oxygen and 67% nitrous oxide at anesthetic drug concentrations adequate to maintain bispectral values between 45 and 50. ⋯ In addition, during the study period, no difference in V (mca) after tourniquet deflation was observed between the propofol and sevoflurane groups. Hyperventilation could prevent an increase in V (mca) in the propofol and sevoflurane groups after tourniquet deflation. However, hyperventilation could not prevent an increase in V (mca) in the isoflurane group.
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Journal of anesthesia · Aug 2010
Randomized Controlled TrialEffects of landiolol on systemic and cerebral hemodynamics and recovery from anesthesia in patients undergoing craniotomy.
Maintenance of systemic and cerebral hemodynamics and quick recovery from anesthesia are required for craniotomy. We conducted a prospective randomized study to investigate the effects of continuous infusion of landiolol on hemodynamic responses to various stimuli, changes in systemic and cerebral hemodynamics during anesthesia, and recovery from anesthesia in patients undergoing craniotomy. ⋯ This study indicates that continuous infusion of landiolol suppressed hyperdynamic responses to stimuli during anesthesia while maintaining arterial blood pressure and cerebral oxygen balance during craniotomy. Although landiolol infusion did not affect recovery from anesthesia and incidence of PONV, it reduced intraoperative requirement of fentanyl.
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Journal of anesthesia · Aug 2010
Comparative StudyTime-consumption risk of real-time ultrasound-guided internal jugular vein cannulation in pediatric patients: comparison with two conventional techniques.
To assess the efficacy of three different methods for internal jugular vein (IJV) cannulation in pediatric patients, we conducted a review of patients undergoing cardiovascular surgery over an 11-year period, in which success rates for cannulation and time from induction of anesthesia to cannulation were evaluated. The success rate was better for real-time ultrasound guidance (USG: 90%) than for anatomic landmarks (AL: 76%) or audio-Doppler guidance (ADG: 74%) and the time required was greater for USG (35.0 +/- 13.6 min) than for AL (26.7 +/- 11.2 min) or ADG (29.2 +/- 8.9 min). However, USG resulted in a higher success rate than the other methods with comparable procedure time for smaller-body-weight (<5 kg) patients. Thus real-time USG leads to the highest success rate for IJV cannulation but with a significant time delay, whereas it was the most useful without time delay for the smaller-body-weight subgroup.
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Journal of anesthesia · Aug 2010
Randomized Controlled Trial Comparative StudyEfficacy of epidural dexamethasone versus fentanyl on postoperative analgesia.
Dexamethasone has analgesic, anti-inflammatory, and antiemetic effects. This prospective, randomized, double-blind, controlled study was designed to evaluate the efficacy of adding dexamethasone versus fentanyl to epidural bupivacaine on postoperative analgesia. ⋯ This study revealed that epidural bupivacaine-dexamethasone admixture had almost the same analgesic potency as bupivacaine-fentanyl with opioid-sparing and antiemetic effects. Further studies are required to evaluate the optimum dose of epidural dexamethasone for postoperative analgesia.
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Journal of anesthesia · Aug 2010
Randomized Controlled TrialPretreatment with nafamostat mesilate, a kallikrein inhibitor, to decrease withdrawal response associated with rocuronium.
This randomized, double-blind, placebo-controlled study was conducted to examine the preventive effect of nafamostat mesilate, a kallikrein inhibitor, on the withdrawal response associated with rocuronium injection. ⋯ Pretreatment with 1.5 mg nafamostat mesilate decreased withdrawal response associated with rocuronium injection.