Journal of anesthesia
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Journal of anesthesia · Jun 2012
Postoperative neurological complications and risk factors for pre-existing silent brain infarction in elderly patients undergoing coronary artery bypass grafting.
Elderly patients with multiple infarctions revealed a high prevalence of postoperative stroke after coronary artery bypass grafting (CABG). However, postoperative neurological complications and characteristics of silent brain infarction (SBI) have not been evaluated in elderly patients undergoing CABG. ⋯ Patients with SBI were ranked at moderate risk of neurological complications after CABG between control and BI. Increased age, renal dysfunction, and preoperative cognitive impairment appeared to be strongly associated with SBI.
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Journal of anesthesia · Jun 2012
Case ReportsAnesthetic management of three pediatric cases with Pena-Shokeir syndrome.
Pena-Shokeir syndrome is a rare, early lethal disease. It is characterized by fetal growth restriction; craniofacial deformities, for example micrognathia and microcephaly; multiple ankyloses; and pulmonary hypoplasia. ⋯ Anesthetic procedures including mask ventilation, tracheal intubation, and extubation were successfully performed without complications during and after surgery. In patients with Pena-Shokeir syndrome, inhalational anesthetics can be safely used for induction and maintenance of anesthesia, although it is important to assume that difficult airway management might be encountered.
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Journal of anesthesia · Jun 2012
Case ReportsStridor due to an innominate artery compression and posterior mediastinal mass in a pediatric patient.
There are many causes for stridor in a pediatric patient. We present an interesting case of a pediatric patient who had stridor due to an innominate artery compression and posterior mediastinal mass. We discuss the anesthetic complication and management of patients with stridor.
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Journal of anesthesia · Jun 2012
Clinical experience with a new endobrochial blocker: the EZ-blocker.
In some thoracic surgical procedures, the insertion of a double-lumen tube (DLT) is not feasible, or the altered use of a DLT and a single-lumen tube (SLT) is justified during the surgery. In the present article we report our experience with a new bronchial blocker, the EZ-blocker, in clinical use. ⋯ Use of the EZ-blocker is easy and safe. The short insertion time and short lung deflation time through the lumen of the SLT allows its use in emergency situations or in cases of a difficult airway.
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Journal of anesthesia · Jun 2012
Dexmedetomidine and hydroxyzine synergistically potentiate the hypnotic activity of propofol in mice.
Investigation into the characteristics of anesthetic interactions may provide clues to anesthesia mechanisms. Dexmedetomidine, an α(2)-adrenergic receptor agonist, has become a popular sedative in intensive care, and hydroxyzine, a histamine receptor antagonist, is well known as a tranquilizing premedication for anesthesia. However, no experimental or pharmacological evaluation has been reported concerning their combination with propofol. Thus, we studied their combined effect with a hypnotic dose of propofol in ddY mice. ⋯ Dexmedetomidine and hydroxyzine demonstrated no hypnotic action alone; however, their coadministration potentiated the hypnotic activity of propofol. Although reduction in the dose of propofol was similar, only dexmedetomidine prolonged the duration of hypnosis.