Journal of anesthesia
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Journal of anesthesia · Dec 2011
ReviewManagement of postoperative nausea and vomiting in women scheduled for breast cancer surgery.
Breast cancer surgery performed under general anesthesia is associated with a high incidence of postoperative nausea and vomiting (PONV). A number of approaches are available for the management of PONV after breast cancer surgery. First, the risk factors related to patient characteristics, surgical procedure, anesthetic technique, and postoperative care can be reduced. ⋯ Unfortunately, the use of glucocorticoids and SR antagonists for preventing PONV is not permitted in Japan according to national health insurance guidelines. Fourth, electro-acupoint stimulation at the P6 point (Nei-Guwan) as a non-pharmacologic therapy is as effective as ondansetron for preventing PONV. Knowledge of the risk factors for PONV, antiemetics, and a non-pharmacologic approach are needed for the management of PONV in women undergoing breast cancer surgery.
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Journal of anesthesia · Dec 2011
Randomized Controlled TrialEffect of tranexamic acid on blood loss in pediatric cardiac surgery: a randomized trial.
The benefit of tranexamic acid (TXA) in pediatric cardiac surgery on postoperative bleeding has varied among studies. It is also unclear whether the effects of TXA differ between cyanotic patients and acyanotic patients. The aim of this study was to test the benefit of TXA in pediatric cardiac surgery in a well-balanced study population of cyanotic and acyanotic patients. ⋯ TXA can reduce blood loss in pediatric cardiac surgery but not the transfusion requirement (http://ClinicalTrials.gov number NCT00994994).
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Journal of anesthesia · Dec 2011
Randomized Controlled TrialDexmedetomidine can stabilize hemodynamics and spare anesthetics before cardiopulmonary bypass.
We previously confirmed the effectiveness of dexmedetomidine (DEX) for stabilizing hemodynamics as well as sparing anesthetics during anesthetic induction in patients undergoing cardiac surgery (Kunisawa et al. in J Clin Anesth 21:194-199, 1). In this study, we investigated whether these effects of DEX continue until the start of cardiopulmonary bypass (CPB). ⋯ DEX combined with 2 ng/ml fentanyl before CPB can suppress the decrease in blood pressure at the pre- and post-SI periods, can blunt the cardiovascular responses to SI and St, and can spare the required ESC of propofol despite fentanyl concentration, which was half of that in the placebo group.
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Journal of anesthesia · Dec 2011
Randomized Controlled TrialAmino acid infusions started after development of intraoperative core hypothermia do not affect rewarming but reduce the incidence of postoperative shivering during major abdominal surgery: a randomized trial.
Previous studies have demonstrated that amino acid infusions exert enhanced thermogenic effects during general anesthesia. This study was conducted to investigate whether amino acid infusions started after development of intraoperative core hypothermia can accelerate rewarming. ⋯ Amino acid infusions started after development of intraoperative core hypothermia failed to accelerate rewarming. However, amino acid infusions reduced the incidence of postoperative shivering. Use of amino acid infusions to reduce thermoregulatory vasoconstriction at emergence might contribute to a decrease in the development of postoperative shivering.
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Journal of anesthesia · Dec 2011
Comparison of recovery times from rocuronium-induced muscle relaxation after reversal with three different doses of sugammadex and succinylcholine during electroconvulsive therapy.
This study was conducted to compare recovery times from rocuronium-induced muscle relaxation after reversal with three different doses of sugammadex with succinylcholine during electroconvulsive therapy (ECT). ⋯ This study demonstrates the efficacy of rocuronium-sugammadex as an alternative to SCC for muscle relaxation during ECT, and indicates that 8 mg/kg sugammadex produces equally rapid recovery from rocuronium muscular relaxation compared with spontaneous recovery from 1 mg/kg SCC during ECT.