Journal of anesthesia
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Journal of anesthesia · Aug 2010
Validation of the Pentax-AWS Airwayscope utility as an intubation device during cardiopulmonary resuscitation on the ground.
The 2005 American Heart Association guidelines for cardiopulmonary resuscitation emphasize that all rescuers should minimize interruption of chest compressions even for endotracheal intubation. We previously reported that the utility of the Pentax-AWS Airwayscope (AWS) was superior to that of the Macintosh laryngoscope (McL) for securing airways during chest compression in "on the bed" simulated circumstances. However, because most cardiopulmonary arrest happens "on the ground" in the real world, we compared the utility of the McL and the AWS during chest compression on the ground and on the bed. ⋯ We conclude that the AWS is an effective device for endotracheal intubation during chest compression not only on the bed but also on the ground.
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Journal of anesthesia · Aug 2010
Comparative StudyDo local anesthetics interact preferentially with membrane lipid rafts? Comparative interactivities with raft-like membranes.
Membranous lipid bilayers have been reconsidered as the site of action of local anesthetics (LAs). Recent understanding of biomembranes indicates the existence of lipid raft microdomains enriched in cholesterol and sphingolipids as potential platforms for channels and receptors. Based on the hypothesis that LAs may interact preferentially with lipid rafts over non-raft membranes, we compared their effects on raft model membranes and cardiolipin-containing biomimetic membranes. ⋯ LAs interacted with biomimetic membranes with the potency being R(+)-bupivacaine > racemic bupivacaine > S(-)-bupivacaine > ropivacaine > lidocaine > prilocaine, which is consistent with the rank order of pharmacotoxicological potency. However, raft model membranes showed neither structure-dependence nor stereoselectivity. The relevance of membrane lipid rafts to LAs is questionable at least in their effects on raft-like liquid-ordered membranes.
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Journal of anesthesia · Aug 2010
Postoperative cognitive dysfunction: computerized and conventional tests showed only moderate inter-rater reliability.
The incidence of postoperative cognitive dysfunction (POCD) depends on the test battery and calculation method used. The measurements may be performed with a paper and pencil test battery or with a computerized test battery. The objective of this study was to measure the incidence and congruence of POCD by comparing a computerized test battery with a paper and pencil test battery in the same patient population. ⋯ In our study we demonstrated that the incidence of POCD measured with computerized test battery and paper and pencil test battery showed moderate inter-rater reliability. Use of neuropsychological test batteries theoretically covering the same cognitive domains does not automatically lead to the same classification of POCD.
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Journal of anesthesia · Aug 2010
Anesthesia protocols for early vitrectomy in former preterm infants diagnosed with aggressive posterior retinopathy of prematurity.
Aggressive posterior retinopathy of prematurity (ROP) can, if left untreated, rapidly progress to total retinal detachment within 1-2 weeks. Early surgical intervention with vitrectomy has been attempted to treat and prevent further retinal detachment. We investigated the anesthetic management of 29 infants with aggressive posterior ROP undergoing early vitrectomy. ⋯ Early vitrectomy for aggressive posterior ROP may be effective despite associated perioperative risks. As this condition progresses rapidly, prompt preoperative organization, including anesthetic planning, is important and useful. Anesthesiologists can play an important role in the perioperative management of such high-risk infants.
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Journal of anesthesia · Aug 2010
Can a NICO monitor substitute for thermodilution to measure cardiac output in patients with coexisting tricuspid regurgitation?
The validity of measuring cardiac output (CO) using thermodilution via pulmonary artery catheterization in the presence of tricuspid regurgitation (TR) remains controversial. ⋯ These findings demonstrate that measuring CO using the thermodilution technique is less accurate in patients with moderate-to-severe TR and that the NICO monitor is more accurate for such patients. We postulate that the NICO monitor measures CO more accurately and reproducibly than thermodilution in patients with coexisting TR.