Journal of anesthesia
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Journal of anesthesia · Jun 2011
Fast-track postoperative care for neonatal cardiac surgery: a single-institute experience.
Perioperative fast-track management has gained wide acceptance in the field of neonatal corrective heart surgery. We have examined its impact on morbidity outcomes. ⋯ Fast-track management with simple care for neonates undergoing complete biventricular repair of congenital heart defects was associated with better postoperative recovery.
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Journal of anesthesia · Jun 2011
Case ReportsProvision of stable lung isolation in an unstable patient: an endobronchial blocker through the Murphy eye of the in situ endotracheal tube.
Shortly after repair of a type A aortic dissection, resternotomy was required because of tamponade. During the exploration, it was discovered that the source of bleeding was in the right pleura. Collapse of the right lung was requested. ⋯ Instead, a Coopdech endobronchial blocker was passed into the right lung through the lumen of the in situ ETT. To ensure that the blocker did not migrate into the trachea, it was deliberately passed through the Murphy eye of the ETT, which had been deliberately passed distally to almost touch the carina. This arrangement provided reliable right-lung collapse to facilitate right pleural hemostasis.
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Journal of anesthesia · Jun 2011
The success rate of nasotracheal intubation using lightwand does not depend on the laryngoscopic view.
The purpose of this study was to evaluate the usefulness of Trachlight (TL) for nasotracheal intubation and to determine the relationship between the grade of laryngeal view and the subsequent ease of nasotracheal intubation using TL. ⋯ No relationship was found between the ease of nasotracheal intubation using TL and glottic visualization.
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Journal of anesthesia · Jun 2011
Case ReportsSuccessful treatment of ropivacaine-induced central nervous system toxicity by use of lipid emulsion: effect on total and unbound plasma fractions.
A 24-year-old man underwent surgery for a fractured left clavicle and received an interscalene brachial plexus block for intraoperative and postoperative analgesia. After injection of 40 ml 0.5% ropivacaine and confirmation of analgesia, general anesthesia was induced and maintained with propofol. Although the operation was completed uneventfully, the patient was restless and there was limb twitching during emergence from anesthesia. ⋯ After infusion of lipid emulsion, the ropivacaine concentrations decreased to 1.72 and 0.05 μg/ml, respectively. The patient had no pain, and neurological examination revealed sensory loss around the clavicle. The patient was discharged without any complications.
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Journal of anesthesia · Jun 2011
The antinociceptive effects of estradiol on adjuvant-induced hyperalgesia in rats involve activation of adrenergic and serotonergic systems.
Estradiol is a female hormone required for maintaining pregnancy and developing follicles in the ovary. Estradiol has been shown to perform a variety of physiological activities, including pain reduction. In this study, we tested the hypothesis that estradiol exerts antinociceptive effects in a rat model of inflammatory hyperalgesia. ⋯ Estradiol is known to perform a variety of physiological functions. Our findings suggest that one such function is antinociception via an interaction with α-2 receptors and serotonin receptors.