Journal of anesthesia
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Journal of anesthesia · Jun 2013
ReviewPostoperative apnea, respiratory strategies, and pathogenesis mechanisms: a review.
Recovery from anesthesia is ideally routine and uneventful. After extubation, the recovering postoperative patient ought to breathe without supportive care or additional oxygenation. It has been demonstrated in previous studies that postoperative pulmonary complications are clinically relevant in terms of mortality, morbidity, and length of hospital stay. ⋯ This review describes prevalence and differential diagnosis, including co-morbidities of postoperative apnea. The physiological mechanisms of breathing and prolonged postoperative apnea are also reviewed; these mechanisms include influences from the brainstem, the cerebral cortex, and chemoreceptors in the carotid and aortic body. Causes of prolonged postoperative apnea and management are also discussed.
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Obstetric anesthesia has become a widely evidence-based practice, with an increasing number of specialized anesthesiologists and a permanent research production. We believe that with the review of commonly discussed and controversial points the reader will be able to incorporate an evidence-based practice into their routine and offer to parturients and their babies a safe, reliable and consistent anesthesia care.
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Journal of anesthesia · Jun 2013
Analysis of prehospital endotracheal intubation performed by emergency physicians: retrospective survey of a single emergency medical center in Japan.
Advanced airway management in the prehospital setting is a serious issue in Japan because emergency medical technicians are not authorized to perform such management, whereas physicians-who are authorized to perform advanced airway management-do not usually engage in prehospital emergency medical activity. The purpose of this investigation was to investigate the success rate for endotracheal intubation (ETI) procedures and other methods of airway management employed by physicians in the prehospital setting in a single institution, as well as to examine the risk factors associated with difficult or failed endotracheal intubation (D/F ETI). ⋯ The success rate for ETI performed by physicians in the prehospital setting at a single emergency medical center was high, and the incidence of D/F ETI was 4.31 %. The success rate for ETI in the CPA group was greater than that in the non-CPA group.
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Journal of anesthesia · Jun 2013
Randomized Controlled TrialThe effects of single-dose intravenous dexmedetomidine on hyperbaric bupivacaine spinal anesthesia.
Dexmedetomidine, a selective α2-adrenoceptor agonist, has analgesic and sedative effects. The purpose of this study was to investigate the effects of small, single-dose intravenous dexmedetomidine administration after hyperbaric bupivacaine spinal anesthesia. ⋯ Single-dose intravenous dexmedetomidine 0.25-0.5 μg/kg, administered 5 min after intrathecal injection of hyperbaric bupivacaine, improved the duration of spinal anesthesia without significant side effects. This method may be useful for increasing the duration of spinal anesthesia, even after intrathecal injection of local anesthetics.