Journal of anesthesia
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Journal of anesthesia · Jun 2014
Case ReportsPreoperative morphological analysis by transesophageal echocardiography and predictive value of plasma landiolol concentration during systolic anterior motion mitral valve repair : a report of three cases.
We report three cases with systolic anterior motion (SAM) after mitral valve plasty. Preoperative mitral valve morphology is a risk factor for SAM. ⋯ With the use of 3D transesophageal echocardiography, when mitral valve prolapse was investigated, in all three cases, it was easy to specify lesions. The issue for the future is 3D analysis when SAM is occurring.
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Journal of anesthesia · Jun 2014
Subanalgesic ketamine enhances morphine-induced antinociceptive activity without cortical dysfunction in rats.
Ketamine, a noncompetitive N-methyl-D-aspartate receptor antagonist, has been used for the treatment of cancer pain as an analgesic adjuvant to opioids. However, ketamine is known to produce psychotomimetic side effects including cognitive impairments under a high-dose situation, presumably as the result of cortical dysfunction. Here, we investigated whether low-dose ketamine was useful as an analgesic adjuvant to morphine for pain control, focusing on frontocortical function. ⋯ The present results indicate that the morphine-induced analgesic effect is enhanced by a concomitant subanalgesic dose of ketamine without affecting cortical function. Our findings possibly support the clinical notion that low-dose ketamine as an analgesic adjuvant has therapeutic potential to reduce opioid dosage, thereby improving the quality of life in cancer pain patients.
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Journal of anesthesia · Jun 2014
Comparative StudyDifferences in tip visibility and nerve block parameters between two echogenic needles during a simulation study with inexperienced anesthesia trainees.
Needle tip visualization during ultrasound-guided regional anesthesia (UGRA) is necessary for safety and efficacy. However, disruption of the image of the needle tip driven toward the target is a general problem, especially for beginners. The purpose of this study was to compare performance parameters between using the Sonoplex and Stimuplex D-Plus echogenic needles in a simulated ultrasound-guided interventional task by inexperienced anaesthesia residents. ⋯ The procedures that used the Sonoplex echogenic needle had significantly better tip visibility and shorter total procedure time at insertion angles between 42° and 64° relative to the phantom surface. We have demonstrated that inexperienced users who used the Sonoplex echogenic needle were able to complete the procedure more quickly. Needles with improved visibility would be a very useful addition to UGRA for inexperienced users.
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Journal of anesthesia · Jun 2014
Utility of the Aintree Intubation Catheter in fiberoptic tracheal intubation through the three types of intubating supraglottic airways: a manikin simulation study.
The purpose of this study was to examine the utility of the Aintree Intubation Catheter (AIC) with three types of supraglottic airway devices for tracheal intubation (ISGAs) using a manikin. ⋯ Among the ISGAs tested, intubation took longer with the FSU, and the FSU had a higher failure rate than the other ISGAs. AIC significantly decreased the number of collisions with the FSU and air-Q. These findings suggest that the AIC is effective in reducing collisions with the tracheal tube and thus will reduce the risk of mechanical injury to the airway.