Journal of anesthesia
-
Journal of anesthesia · Feb 2015
Observational StudyInstitutional resuscitation protocols: do they affect cardiopulmonary resuscitation outcomes? A 6-year study in a single tertiary-care centre.
Despite advances in cardiopulmonary resuscitation and widespread life-support trainings, the outcomes of resuscitation are variable. There is a definitive need for organizational inputs to strengthen the resuscitation process. Our hospital authorities introduced certain changes at the organizational level in our in-house resuscitation protocol. We aimed to study the impact of these changes on the outcomes of resuscitation. ⋯ A strong hospital-based resuscitation policy with well-defined protocols and infrastructure has potential synergistic effect and plays a big role in improving the outcomes of resuscitation.
-
Journal of anesthesia · Feb 2015
Randomized Controlled Trial Comparative StudyComparison of the hemodynamic effects of nitroprusside and remifentanil for controlled hypotension during endoscopic sinus surgery.
Controlled hypotension (CH) is a well-established technique to decrease blood loss and improve surgical visibility. Although nitroprusside and remifentanil have been safely and effectively used for this purpose, the hemodynamic changes that occur during CH are unclear. This study compared the effects of nitroprusside and remifentanil on hemodynamics using a noninvasive cardiac output monitor (Cheetah NICOM(®); Cheetah Medical Inc., Maidenhead, Berkshire, UK) for endoscopic sinus surgery (ESS). ⋯ Both nitroprusside and remifentanil were effective to induce CH and maintain CI during CH.
-
Journal of anesthesia · Feb 2015
ReviewIntensive care unit-related generalized neuromuscular weakness due to critical illness polyneuropathy/myopathy in critically ill patients.
Thirty to fifty percent of critically ill patients admitted to the intensive care unit suffer from generalized neuromuscular weakness due to critical illness polyneuropathy, critical illness myopathy, or a combination of them, thus prolonging mechanical ventilation and their intensive care unit stay. A distinction between these syndromes and other neuromuscular abnormalities beginning either before or after ICU admission is necessary. These intensive care unit-related diseases are associated with both elevated mortality rates and increased morbidity rates. ⋯ The dose and duration of the administration of neuromuscular blocking drugs should be limited, and their concurrent administration with corticosteroids should be avoided. Intensive insulin therapy has also been proven to reduce their incidence. Finally, early mobilization via active exercise or electrical muscle stimulation plays a significant role in their prevention.
-
Journal of anesthesia · Feb 2015
Comparative StudyContinuous transversus abdominis plane block catheter analgesia for postoperative pain control in renal transplant.
Continuous transversus abdominis plane (TAP) block using a catheter has proven its usefulness in reducing opioid requirements and pain scores after lower abdominal surgery. However, there are no reports of its successful use after renal transplant. We tested the hypothesis that continuous TAP block would retrospectively reduce opioid requirement, nausea score and hospital stay after renal transplant surgery. ⋯ The use of continuous TAP analgesia for postoperative analgesia after renal transplant was effective in reducing the morphine-equivalent requirements.
-
Journal of anesthesia · Feb 2015
Influence of intense neuromuscular blockade on surgical conditions during laparotomy: a pig model.
Intense neuromuscular block may improve surgical conditions in ileus laparotomies; however, it is difficult to evaluate. The aim of this study was to investigate if neuromuscular block improved surgical conditions in pigs with artificial ileus laparotomy. ⋯ Intense neuromuscular block prevented abdominal muscle contractions but did not influence the force needed to close the fascia.