Journal of anesthesia
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Journal of anesthesia · Jun 2011
Clinical TrialOnset of rocuronium-induced neuromuscular block evaluated subjectively and accerelomyographically at the masseter muscle.
The main aim of this study was to compare the onset times of rocuronium evaluated subjectively and by acceleromyography at the masseter muscle (MM). ⋯ Subjective evaluation of contractions of the MM by an anesthesiologist's hand may be reliable to determine faster timing for safe tracheal intubation.
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Journal of anesthesia · Jun 2011
Randomized Controlled TrialEffect of pressure-reducing devices on the quality of anterior orbit anesthesia.
Needle length is an important consideration in the safe conduct of ophthalmic blocks. A shorter needle could be used to insert the local anesthetic before the globe equator in the anterior orbit and to direct the injectable posteriorly using Honan's balloon to produce the desired effect. However, the use of pressure-reducing devices is not advisable in procedures with impaired retinal blood flow. ⋯ Ocular akinesia was assessed 10 min later; if inadequate, supplementary anesthesia was provided. No difference was detected in terms of volume injected, supplementation, and akinesia score. Under the conditions of this study, Honan's balloon did not contribute to the quality of the anterior orbit anesthesia, and the technique can be successfully used when ocular compression is contraindicated.
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Journal of anesthesia · Jun 2011
Clinical TrialLevobupivacaine plasma concentrations following major liver resection.
Levobupivacaine is metabolized hepatically. Whether postoperative epidural analgesia with levobupivacaine can lead to critical accumulation in patients undergoing major hepatic resection is unknown. Therefore, levobupivacaine concentrations were prospectively monitored in patients undergoing major liver resection and compared to patients undergoing rectal resection, who served as controls. Furthermore, we correlated levobupivacaine plasma concentrations with established liver function tests. ⋯ Patients undergoing liver resection revealed significantly higher levobupivacaine concentrations compared to patients undergoing anterior rectal resection. However, although intraoperative levobupivacaine concentrations remained below 2.0 μg/ml, postoperative concentrations accumulated to a concentration above this threshold. This risk of levobupivacaine accumulation in patients with compromised liver function correlated best with ICG clearance.