Journal of anesthesia
-
Journal of anesthesia · Oct 2013
Preoperative left atrial volume index predicts postoperative atrial fibrillation in patients with severe aortic valve stenosis.
Left atrial enlargement correlates with the severity of diastolic dysfunction and is a predictor of cardiovascular complications such as atrial fibrillation. Aortic valve stenosis (AS) causes left atrial enlargement and progression of diastolic dysfunction. The aim of this study was to investigate the efficacy of the preoperative left atrial volume index (LAVI) in predicting postoperative outcome in patients with severe AS. ⋯ In patients with severe AS, a preoperative LAVI of ≥52 ml/m(2) may be a useful predictor of POAF, although the efficacy of this index for predicting other postoperative outcomes has yet to be determined.
-
Journal of anesthesia · Oct 2013
Randomized Controlled Trial Comparative StudyComparison of Pentax-AWS Airwayscope, Airtraq and Miller laryngoscope for tracheal intubation by novice doctors during infant cardiopulmonary resuscitation simulation: a randomized crossover trial.
Recent guidelines for infant cardiopulmonary resuscitation emphasize that all rescuers should minimize interruption of chest compressions, even for endotracheal intubation. We compared the utility of the Pentax-AWS Airway Scope (AWS) with an infant-sized Intlock (AWS-I), Airtraq laryngoscope (ATQ) and Miller laryngoscope during chest compressions on an infant manikin. Twenty-three novice doctors performed tracheal intubation on an infant manikin using the AWS-I, ATQ and Miller laryngoscope, with or without chest compressions. ⋯ In AWS-I trials, all participants succeeded regardless of chest compressions. Intubation time was significantly longer with chest compressions with the Miller laryngoscope and ATQ, but not with the AWS-I. The AWS-I is an effective device for endotracheal intubation during chest compressions in infant simulations managed by novice doctors.
-
Journal of anesthesia · Oct 2013
ReviewDevelopmental anesthetic neurotoxicity: from animals to humans?
Several animal studies have demonstrated that most routinely used general anesthetics induce widespread neuroapoptosis and long-term neurocognitive impairment in the immature brain. These findings have generated great interest among pediatric anesthesiologists and other practitioners regarding the safe use of general anesthetics in pediatric patients. Several human retrospective studies failed to confirm whether or not anesthesia exposure during the crucial phase of brain development induces long-term neurocognitive deficits in humans. ⋯ Clearly, additional prospective randomized controlled trials are needed in humans to determine the effects of general anesthesia on neurodevelopment. In this review, we summarize currently available laboratory and clinical evidence for anesthetic neurotoxicity. Furthermore, we discuss the implications of these results for clinical anesthesia.
-
Journal of anesthesia · Oct 2013
ReviewCan anesthetic techniques or drugs affect cancer recurrence in patients undergoing cancer surgery?
Despite the development of effective chemotherapy and radiotherapy, surgery remains the mainstay treatment of many cancers, requiring anesthesia. Almost all cancer deaths after primary surgery are attributable to recurrence or metastases. ⋯ This review summarizes available experimental information on the potential effects of common anesthetic agents and techniques on cancer metastases and the conflicting retrospective clinical data on regional anesthesia in various types of cancer. A number of prospective, randomized, multicenter, clinical trials are in progress, and their results are eagerly awaited.
-
Journal of anesthesia · Oct 2013
Randomized Controlled TrialEffect of morphine on lower urinary tract discomfort after transurethral resection of prostate under general anesthesia: a randomised clinical study.
Lower urinary tract (LUT) discomfort is a common complaint after transurethral resection of the prostate (TURP), and it may lead to agitation and restlessnes. We have evaluated the efficacy of morphine for preventing TURP-related LUT discomfort symptoms. ⋯ Based on these results, we conclude that morphine effectively reduces LUT discomfort after TURP at a cost of postoperative nausea and vomiting.