Journal of anesthesia
-
Journal of anesthesia · Dec 2011
Review Meta AnalysisAccuracy of stroke volume variation in predicting fluid responsiveness: a systematic review and meta-analysis.
Stroke volume variation (SVV) appears to be a good predictor of fluid responsiveness in critically ill patients. However, a wide range of its predictive values has been reported in recent years. We therefore undertook a systematic review and meta-analysis of clinical trials that investigated the diagnostic value of SVV in predicting fluid responsiveness. ⋯ SVV is of diagnostic value in predicting fluid responsiveness in various settings.
-
Journal of anesthesia · Dec 2011
Randomized Controlled TrialPerioperative infusion of dexmedetomidine at a high dose reduces postoperative analgesic requirements: a randomized control trial.
We hypothesized that a high dose of dexmedetomidine (1 μg/kg/h) could reduce postoperative analgesic requirements of patients. ⋯ Among this small patient cohort, perioperative infusion of dexmedetomidine (1 μg/kg/h) resulted in antinociception without severe side effects. These results suggest that this method could be of interest with respect to improving postoperative pain status.
-
Journal of anesthesia · Dec 2011
Case ReportsInternal jugular vein thrombosis associated with venous hypoplasia and protein S deficiency revealed by ultrasonography.
A 41-year-old woman, who had no thrombotic risk factors and past history except congenital scoliosis, underwent central venous catheterization (CVC) before correction of the scoliosis. When internal jugular vein (IJV) catheterization using the anatomical landmark technique failed, CVC under ultrasound guidance was tried. As a consequence, thrombosis and hypoplasia of the right IJV were incidentally detected by ultrasonography. ⋯ Also, after examinations to rule out the possibility of pulmonary embolism and to clarify the causes of the IJV thrombosis, the patient was found to have protein S deficiency. CVC under ultrasound guidance should be recommended to prevent the failure of cannulation and complications such as thromboembolism in patients who could possibly have anomalies of vessels as a result of anatomical deformities caused by severe scoliosis, even if patients do not have thrombotic risk factors such as a history of central catheter insertion or intravenous drug abuse, cancer, advanced age, cerebral infarction, and left ventricular dysfunction. Also, if venous thrombosis is found in patients without predisposing risk factors, one should ascertain the cause of the hypercoagulable state, for example protein S deficiency, and perform appropriate treatment and prevention of venous thromboembolism.
-
Journal of anesthesia · Dec 2011
Randomized Controlled TrialEffects of adjunct intrathecal magnesium sulfate to bupivacaine for spinal anesthesia: a randomized, double-blind trial in patients undergoing lower extremity surgery.
The aim of this study was to evaluate the effect of additional magnesium sulfate (MgSO(4)) 100 mg to intrathecal (IT) isobaric 0.5% bupivacaine 3 ml on spinal anesthesia in patients undergoing lower extremity orthopedic surgery. ⋯ In patients undergoing lower extremity surgery with spinal anesthesia, the addition of 100 mg IT MgSO(4) to 15 mg bupivacaine without opioid supplement, prolonged the duration of the sensory block, decreased postoperative analgesic consumption, and significantly prolonged the onset of spinal anesthesia.
-
Journal of anesthesia · Dec 2011
Randomized Controlled Trial Clinical TrialPentazocine increases bispectral index without surgical stimulation during nitrous oxide-sevoflurane anesthesia.
Although there have been a large number of reports on the effects of opioids on the bispectral index (BIS) during anesthesia, the effects of pentazocine on the BIS have not been reported. In this study, 60 patients scheduled for elective oral surgery [30 females, 30 males; all American Society of Anesthesiologists Physical Status (ASA PS) category 1] were enrolled in the trials. Maintaining gender parity, we randomly assigned the patients to one of three groups: pentazocine group (0.3 mg/kg; n = 20), fentanyl group (1 μg/kg; n = 20), or saline group (n = 20); these opioids were administered intravenously 15 min after the intubation. ⋯ BIS values significantly increased between 5 and 15 min after the intubation relative to the baseline value in the pentazocine group (P < 0.001), and BIS values in this group were significantly during this time period than those in the fentanyl and saline group (P < 0.001). BIS values were not significantly different between the fentanyl group and saline group. These results indicated that pentazocine, but not fentanyl, under nitrous oxide-sevoflurane anesthesia caused a statistically significant increase in BIS in our patients.