Journal of anesthesia
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Journal of anesthesia · Dec 2011
Randomized Controlled TrialEffect of intravenous dezocine on fentanyl-induced cough during general anesthesia induction: a double-blinded, prospective, randomized, controlled trial.
To evaluate the suppressive effect of intravenous dezocine on fentanyl-induced cough during the induction of general anesthesia. ⋯ These results demonstrate that intravenous dezocine 0.1 mg/kg 10 min prior to induction was effective in suppressing fentanyl-induced cough in our patients.
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Journal of anesthesia · Dec 2011
Randomized Controlled TrialRetrospective analysis of spontaneous recovery from neuromuscular blockade produced by empirical use of rocuronium.
A train-of-four ratio (TOF ratio) of >0.9 should be the clinical cut-off to avoid residual paralysis. However, it is not rare to extubate patients without measurement of the TOF ratio, although the safe interval from the last administration of rocuronium assuring a TOF ratio of >0.9 has not been established in the daily clinical setting. In this study, to estimate the safe interval to avoid residual paralysis, we retrospectively selected patients in whom the TOF ratio was measured during remifentanil administration before extubation, and we studied the characteristics of recovery from the neuromuscular blockade produced by the empirical use of rocuronium. ⋯ Because of the large variation in the recovery from rocuronium-induced paralysis, TOF-based evaluation of residual paralysis is essential to determine the appropriate indication for reversal, especially for elderly patients.
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Journal of anesthesia · Dec 2011
Comparative StudyComparison of Pentax-AWS Airwayscope video laryngoscope, Airtraq optic laryngoscope, and Macintosh laryngoscope during cardiopulmonary resuscitation under cervical stabilization: a manikin study.
The 2010 American Heart Association or European Resuscitation Council guidelines for cardiopulmonary resuscitation emphasize that rescuers should minimize interruption of chest compressions, even for endotracheal intubation. Cervical stabilization should also be maintained during traumatic cardiac arrest. The utility of the Pentax-AWS Airwayscope (AWS) video laryngoscope and Airtraq (ATQ) optic laryngoscope for airway management has been reported under cervical stabilization. We first evaluated ATQ utility during chest compression with or without cervical stabilization and then compared the AWS, ATQ, and Macintosh laryngoscope (McL) during chest compressions under cervical stabilization in a manikin. ⋯ The AWS was superior to McL and ATQ for endotracheal intubation during simulated cervical stabilization and chest compression.
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Journal of anesthesia · Dec 2011
Clinical TrialTissue Doppler imaging is useful for predicting the need for inotropic support after cardiac surgery.
Low preoperative left ventricular ejection fraction (EF) is a predictor of the need for inotropic support after cardiac surgery. However, EF can be misinterpreted and difficult to measure in some cases. The purpose of this study was to compare the value of preoperative EF and intraoperative tissue Doppler imaging variables in predicting the need for postoperative inotropic support. ⋯ This study suggests that those patients who have decreased S(m) and extended CPB times are more likely to require inotropic support after surgery, independent of a preserved left ventricular EF.
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Journal of anesthesia · Dec 2011
Impact of remifentanil introduction on practice patterns in general anesthesia.
The introduction of new medicine can change clinical practice patterns and may affect patient outcomes. In the present study, we investigated whether introduction of remifentanil in Japan affected the practice patterns of anesthesia. ⋯ Our data revealed rapid changes in practice patterns in anesthesia after the introduction of remifentanil in Japan. Remifentanil was used more often in patients with comorbidities and without epidural anesthesia, and its introduction did not affect increase in total medical costs.