Journal of anesthesia
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Journal of anesthesia · Oct 2012
Peribulbar block in patients scheduled for eye procedures and treated with clopidogrel.
Our hypothesis was that the continuation of clopidogrel does not increase the risk of eye hemorrhage, compared to patients not treated with clopidogrel, when a peribulbar anesthesia is required. Our prospective case-control study enrolled two groups of 1,000 patients scheduled for intraocular eye surgery requiring a peribulbar block. Patients treated with clopidogrel were included in group A (1,000 patients). ⋯ No grade 2, 3, or 4 hemorrhage was encountered. There was no significant difference in the grading of hemorrhage between the groups (p = 0.017). Clopidogrel was not associated with a significant increase in potentially sight-threatening local anesthetic complications.
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Journal of anesthesia · Oct 2012
Case ReportsUltrasound-guided supraclavicular central venous catheterization in patients with malignant hematologic diseases.
We present two cases of central venous catheterization (CVC) in which an ultrasound-guided in-plane approach was used. Case 1 was a 60-year-old man with acute myelogenous leukemia in whom a right supraclavicular CVC was performed. He had pancytopenia (leukocytes 2,000/μL; erythrocytes 350 × 10(4)/μL; platelets 5.6 × 10(4)/μL), and abnormal coagulability (prothrombin time-international normalized ratio 1.35). ⋯ Case 2 was a 64-year-old women with malignant lymphoma whose right internal jugular vein was surrounded by abnormally enlarged lymph nodes. CVC was performed by the in-plane supraclavicular approach, avoiding puncture of the lymph node. This novel CVC technique is useful to minimize the risk of complications and patient discomfort by indwelling catheter.
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Journal of anesthesia · Oct 2012
Impact of changes of positive end-expiratory pressure on functional residual capacity at low tidal volume ventilation during general anesthesia.
Several reports in the literature have described the effects of positive end-expiratory pressure (PEEP) level upon functional residual capacity (FRC) in ventilated patients during general anesthesia. This study compares FRC in mechanically low tidal volume ventilation with different PEEP levels during upper abdominal surgery. ⋯ Results suggest that PEEP at 10 cmH(2)O is necessary to maintain lung function if low tidal volume ventilation is used during upper abdominal surgery.
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Journal of anesthesia · Oct 2012
Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) severe respiratory failure in Japan.
To evaluate procedures and outcomes of extracorporeal membrane oxygenation (ECMO) therapy applied to 2009 influenza A(H1N1) severe respiratory failure patients in Japan. ⋯ ECMO therapy for H1N1-related severe respiratory failure in Japan has very poor outcomes, and most patients developed adverse events. However, this result does not refute the effectiveness of ECMO. One possible cause of these poor outcomes is the lack of satisfactory equipment, therapeutic guidelines, and systems for patient transfer to central facilities.
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Journal of anesthesia · Oct 2012
Case ReportsSuccessful epidural analgesia for a vaso-occlusive crisis of sickle cell disease during pregnancy: a case report.
We describe a 19-year-old Cameroonian primigravid young woman with sickle cell disease who was admitted to a local hospital in Cameroon where the first author performed his internship gynecology and obstetrics. She presented at 28 weeks of gestation with severe pain in her left leg caused by a vaso-occlusive crisis. ⋯ Lumbar epidural blockade with bupivacaine combined with sufentanil successfully alleviated her severe peripheral ischemic pain induced by a vaso-occlusive crisis caused by sickle cell disease. Until now, only one case report and no clinical trials have been published concerning the use of epidural analgesia for treatment of a vaso-occlusive crisis of sickle cell anemia in a pregnant woman who is not in labor.