Journal of anesthesia
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Journal of anesthesia · Dec 2013
Ultrasound-guided sciatic nerve pulsed radiofrequency for chronic knee pain treatment: a novel approach.
Chronic knee pain management with current nonpharmacological or pharmacological measures often has suboptimal results and significant side effects. Sciatic nerve pulsed radiofrequency (SNPRF) is an unexplored alternative for chronic knee pain management. We show a prospective short series of chronic knee pain patients managed with ultrasound-guided SNPRF. ⋯ No patient reported adverse events during the 1-month follow-up period. Ultrasound-guided SNPRF is a new approach for chronic knee pain management that leads to significant pain reduction in the short term. Randomized studies with adequate size, longer follow-up period, and appropriate evaluating tools are warranted to verify these preliminary data.
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Journal of anesthesia · Dec 2013
The RACHS-1 risk category can be a predictor of perioperative recovery in Asian pediatric cardiac surgery patients.
The Risk Adjustment for Congenital Heart Surgery (RACHS-1) classification was originally designed to facilitate the prediction of in-hospital mortality for pediatric cardiac surgery patients. However, there have been few reports on clinical outcomes predicted by the RACHS-1 category, especially in an Asian population. The aim of this study was to determine whether RACHS-1 classification can predict patient outcomes. ⋯ Based on the results of our analysis, we conclude that the RACHS-1 stratification system can predict in-hospital mortality and patient outcomes in patients undergoing pediatric cardiac surgery.
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Journal of anesthesia · Dec 2013
Assessing the efficacy of video versus direct laryngoscopy through retrospective comparison of 436 emergency intubation cases.
Video laryngoscopy has become a common practice for tracheal intubations. However, information on its efficacy in emergency intubations is minimal. The external video monitor may act as a means for assistance by present staff, heighten teaching ability, and improve intubation outcomes. ⋯ The presence of the attending anesthesiologist (while the resident intubates) had no effect on complication rates; the number of attempts required and the grade view obtained were nonsignificant (p = 0.91 and p = 0.34, respectively). Overall, use of the C-MAC video laryngoscope provided a better view of the airway structures during an emergency intubation. The success of the C-MAC laryngoscope in intubation after failed direct laryngoscopy suggests the importance of the video laryngoscope as the primary intubation approach during an emergency intubation.
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Journal of anesthesia · Dec 2013
Risk factors for postoperative mortality and morbidities in emergency surgeries.
Emergency surgery itself induces high risk for postoperative mortality and morbidities; however, it remains unknown which concomitant pathological conditions of emergency surgeries are causative factors of deteriorating outcomes. This study examined the causal factors of postoperative mortality and morbidity in cases of emergency surgery. ⋯ State of shock, deteriorated consciousness level, chronic obstructive lung disease, ischemic heart disease, hemorrhage requiring blood transfusion, age over 80 years, cardiovascular surgery, surgeries at night, and surgeries of duration more than 2 h cause patients to be strongly susceptible to postoperative mortality or morbidity in emergency surgeries.
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Journal of anesthesia · Dec 2013
Case ReportsExtensive spinal cord ischemia following endovascular repair of an infrarenal abdominal aortic aneurysm: a rare complication.
Postoperative paraplegia secondary to spinal cord ischemia (SCI) is an extremely rare and devastating complication of endovascular repair in abdominal aortic aneurysm (AAA) surgery. The reported incidence is only 0.21 % worldwide. This case of postoperative paraplegia occurred in a 60-year-old man immediately following endovascular repair of an infrarenal AAA. ⋯ However, neither cerebral spinal fluid drainage nor steroid therapy was effective; he was eventually admitted with no improvement in his neurological status. The mechanism remains multifactorial until now and needs more attention in perioperative management. We report the first case involved in the most significantly extensive SCI after endovascular repair of an infrarenal AAA.