Journal of anesthesia
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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
Case ReportsAnesthetic management of a patient with polycythemia vera for neurosurgery.
Polycythemia vera (PV) is a myeloproliferative disorder characterized by excess red cell clonality. The increased number of red blood cells can lead to increased viscosity of the blood and ultimately compromise the blood supply to the end organs. ⋯ Patients with PV presenting with neurological diseases that require surgical intervention are at an increased risk due to various factors, such as immobility, prolonged surgical time, hypothermia and dehydration. We report anesthetic management of a patient with PV who underwent neurosurgical intervention for vestibular schwannoma excision.
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Journal of anesthesia · Oct 2016
Intravenous loading of nitroglycerin during rewarming of cardiopulmonary bypass improves metabolic homeostasis in cardiac surgery: a retrospective analysis.
The aim of the study was to evaluate the effects of high-dose nitroglycerine (NTG) on glucose metabolism, tissue oxygenation and postoperative recovery in cardiac surgical patients. ⋯ Intravenous loading of NTG during and after CPB is safe and effective for attenuating the hyperglycemic response and reduce the incidence of hyperlactatemia during cardiac surgery with CPB.
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Journal of anesthesia · Oct 2016
Roles of endotracheal tubes and slip joints in respiratory pressure loss: a laboratory study.
The endotracheal tube (ETT) constitutes a significant component of total airway resistance. However, a discrepancy between measured and theoretical values has been reported in airway resistance through ETTs. The causes of the discrepancy were estimated by physical and rheological simulations. ⋯ Especially in small sized tubes, the pressure loss through the slip joint accounts for a large percentage of the total pressure loss through the ETT. The pressure loss through the slip joint may play a role in the discrepancy between measured and theoretical pressure losses through ETTs.
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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.