Journal of anesthesia
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Journal of anesthesia · Oct 2016
Case ReportsAcute left ventricle failure on induction of anesthesia: a case report of reverse stress cardiomyopathy-presentation, diagnosis and treatment.
Reverse takotsubo cardiomyopathy (TCM) is a less common variant of classic TCM that presents within a different patient profile and with its own hemodynamic considerations. A 46-year-old woman was admitted to our hospital for laryngoscopy and possible balloon dilatation for tracheal stenosis under general anesthesia. One year prior to this admission, the patient was admitted after a motor vehicle accident with subdural hematoma, subarachnoid hemorrhage, and fracture of the eighth thoracic vertebra. ⋯ Since her previous admission, she developed posttraumatic anxiety and depression (a neuropsychiatric disorder triggered by subdural hematoma and subarachnoid hemorrhage) and was treated with antianxiety and antidepressant medication. At this admission, the patient developed acute left ventricle failure on induction of anesthesia secondary to reverse TCM. We report a case of reverse TCM, where posttraumatic emotional stress of a neuropsychiatric disorder combined with physical stress from anesthesia and laryngoscopy triggered TCM in a patient with previous uneventful anesthesia 1 year earlier.
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Journal of anesthesia · Oct 2016
Validity of ultrasonographic measurement of gastric volume in fasted pediatric patients without sedation.
Recently, gastric ultrasonography has been used as a noninvasive portable tool for evaluating gastric content and volume in adults and children. Pediatric patients are not always cooperative, especially younger ones, and it may be difficult to keep them in the appropriate scanning position without sedation. Hence, we modified the scanning method and position, and evaluated the efficacy of this alternative scanning technique in pediatric cases. ⋯ The gastric volume was then aspirated using a multi-orifice catheter under general anesthesia. Supine CSA measured via this gastric ultrasonography method was positively correlated with gastric volume (r = 0.56, p < 0.0001). We concluded that our alternative method of measuring antral CSA may be applicable for children minimal gastric contents.
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Journal of anesthesia · Oct 2016
A novel mouthpiece prevents bite injuries caused by intraoperative transcranial electric motor-evoked potential monitoring.
Intraoperative transcranial motor-evoked potential monitoring causes contraction of the masseter muscles, which may cause injuries to the oral cavity and damage to the orotracheal tube. We developed a mouthpiece made from vinyl-silicone impression material to prevent these injuries. The purpose of this study was to examine its efficacy and safety. ⋯ A novel mouthpiece reduced the incidence of damage to the endotracheal tube caused by intraoperative transcranial motor-evoked potential monitoring.
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Journal of anesthesia · Oct 2016
Dexmedetomidine protects against lung ischemia-reperfusion injury by the PI3K/Akt/HIF-1α signaling pathway.
To evaluate the role of the phosphatidylinositol 3 kinase (PI3K)/protein kinase B (Akt)/hypoxia-inducible factor 1α (HIF-1α) signaling pathway in the protection by dexmedetomidine against lung ischemia-reperfusion injury (IRI) in rats. ⋯ Administration of dexmedetomidine before ischemia can provide a protection against lung IRI by re-installing the PI3K/Akt/HIF-1α signaling pathway.
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Journal of anesthesia · Oct 2016
Review Meta Analysis Comparative StudyThe comparison of adductor canal block with femoral nerve block following total knee arthroplasty: a systematic review with meta-analysis.
Although several studies have compared the clinical efficacy of an adductor canal block (ACB) to that of a femoral nerve block (FNB) for analgesia after total knee arthroplasty (TKA), disputes mainly exist in the recovery of quadriceps strength and mobilization ability between the two methods. The aim of the present study was to compare, in a systematic review and meta-analysis, the clinical efficacy of ACB with that of FNB. ⋯ The present study suggests that TKA patients who receive ACB can achieve similar or even better recovery of quadriceps strength and mobilization ability than those treated with FNB. Taken as a whole, ACB may be a better analgesia strategy after TKA at present.