Journal of anesthesia
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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
Case ReportsSuperficial venous thrombophlebitis caused by rocuronium.
Pain is one of the major disadvantages of rocuronium, which is used during induction of anesthesia. Even at subparalyzing doses, 50-100% of patients complain of intense pain. ⋯ However, in both of our cases, visible reactions occurred and both patients were diagnosed with venous superficial thrombophlebitis. Therefore, we believe that rocuronium-related pain may, in part, be because of direct venous injury.
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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
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
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.