Journal of anesthesia
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Journal of anesthesia · Jun 2015
Randomized Controlled Trial Comparative StudyComparison of catheter tip migration using flexible and stimulating catheters inserted into the adductor canal in a cadaver model.
Use of adductor canal blocks and catheters for perioperative pain management following total knee arthroplasty is becoming increasingly common. However, the optimal equipment, timing of catheter insertion, and catheter dislodgement rate remain unknown. A previous study has suggested, but not proven, that non-tunneled stimulating catheters may be at increased risk for catheter migration and dislodgement after knee manipulation. ⋯ A blinded regional anesthesiologist performed caliper measurements on the ultrasound images before and after exercise. Changes in catheter tip to nerve distance (p = 0.547) and catheter length within the adductor canal (p = 0.498) were not different between groups. Therefore, catheter type may not affect the risk of catheter tip migration when placed prior to knee arthroplasty.
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Journal of anesthesia · Jun 2015
Randomized Controlled TrialA randomized controlled trial of the effect of preoperative dexmedetomidine on the half maximal effective concentration of propofol for successful i-gel insertion without muscle relaxants.
Dexmedetomidine is a useful anesthetic adjuvant for general anesthesia. We determined whether preoperative dexmedetomidine administration could reduce the half maximal effective concentration (EC50) of propofol for successful i-gel insertion without muscle relaxants. ⋯ Preoperative dexmedetomidine reduced the EC50 of propofol for successful i-gel insertion without muscle relaxants.
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Journal of anesthesia · Jun 2015
The effect of preeclampsia on the skin to subarachnoid distance in spinal anesthesia.
Preeclampsia is characterized by increased extracellular fluid which manifests as generalized edema due to endothelial injury and subsequent capillary leak. Therefore, preeclampsia may lead to increased skin to subarachnoid distance (SSD) which may influence daily clinical practice in this particular gravid population. ⋯ Knowing that the SSD is increased in preeclamptics compared to normotensive gravidas may be of value in terms of selecting needle, and providing safe and comfortable anesthesia.
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Journal of anesthesia · Jun 2015
Case ReportsDexmedetomidine and ketamine combination for a patient with xeroderma pigmentosa.
Patients of xeroderma pigmentosa (XP) have increased sensitivity to ultraviolet light and a defective nucleotide excision repair (NER) mechanism in their DNA. Several types of neurological, dermatological, and ophthalmological complications are common in these patients. ⋯ Some reports have shown uneventful conduct of total intravenous anesthesia in patients of XP. The authors report a case of XP in a young girl for surgery, previously anesthetized with delayed recovery, managed successfully with a combination of intravenous dexmedetomidine and ketamine.
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Journal of anesthesia · Jun 2015
Comparative Study Observational StudyCorrelation of cardiac output measured by non-invasive continuous cardiac output monitoring (NICOM) and thermodilution in patients undergoing off-pump coronary artery bypass surgery.
This observational study was designed to evaluate the clinical value of cardiac output (CO) obtained via bioreactance (NICOM™) as compared with values of CO obtained via thermodilution (using pulmonary artery catheter, Vigilance™) and the thoracic bioimpedance (BioZ.com™), in patients undergoing off-pump coronary artery bypass surgery. ⋯ The NICOM device is a safe, convenient, and reliable device for measuring continuous non-invasive cardiac output and cardiac index, and the trends of change in CO during the surgery are similar between NICOM and PAC.