Journal of anesthesia
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Journal of anesthesia · Jun 2016
A case series of re-establishment of neuromuscular block with rocuronium after sugammadex reversal.
We report the use of rocuronium to re-establish neuromuscular block after reversal with sugammadex. The aim of this study was to investigate the relationship between the dose of rocuronium needed to re-establish neuromuscular block and the time interval between sugammadex administration and re-administration of rocuronium. Patients who required re-establishment of neuromuscular block within 12 h after the reversal of rocuronium-induced neuromuscular block with sugammadex were included. ⋯ Intervals between sugammadex and second rocuronium were 12-465 min. Total dose of rocuronium needed to re-establish neuromuscular block was 0.6-1.2 mg/kg. 0.6 mg/kg rocuronium re-established neuromuscular block in all patients who received initial sugammadex more than 3 h previously. However, when the interval between sugammadex and second rocuronium was less than 2 h, more than 0.6 mg/kg rocuronium was necessary to re-establish neuromuscular block.
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Journal of anesthesia · Jun 2016
Evaluation of lead aprons and their maintenance and management at our hospital.
Lead aprons are worn by medical workers to reduce the effects of the radiation doses to which they are exposed during radiography and surgery performed with radioscopic apparatus. Regarding the management of such aprons, the Radiation Protection Section of the Japanese Society of Radiological Technology issued the "Guidelines for the Management of Lead Aprons" in 2000, and common management criteria have been set for all institutions. ⋯ Although no abnormality was detected upon visual and tactile inspections, CT images revealed that protective aprons used for 6 years or more had damaged internal radiation shields, thus risking radiation exposure. In response to these results, we fully realized the need to examine the date of the initial use of currently used lead aprons, to routinely perform visual and tactile inspections, and to regularly evaluate the extent of damage to the internal radiation shields via fluoroscopy in cooperation with the radiation management section.
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Journal of anesthesia · Jun 2016
Randomized Controlled TrialImpact of anesthetic technique on the stress response elicited by laparoscopic cholecystectomy: a randomized trial.
The aim of this randomized, double-blind clinical trial was to elucidate the impact of general anesthesia alone (GA) or supplemented with epidural anesthesia (EpiGA) on surgical stress response during laparoscopic cholecystectomy, using stress hormones, glucose, and C-reactive protein (CRP), as potential markers. Sixty-two patients scheduled to undergo elective laparoscopic cholecystectomy were randomly assigned into two groups to receive either GA or EpiGA. Stress hormones [cortisol (COR), human growth hormone (hGH), prolactine (PRL)], glucose, and CRP were determined 1 day before surgery, intraoperatively, and upon first postoperative day (POD1). ⋯ Although, CRP was minimally affected intraoperatively, a notable augmentation on POD1, comparable in both groups, was recorded. These results indicate that hormonal and metabolic stress response is slightly modulated by the use of epidural block supplemented by general anesthesia, in patients undergoing laparoscopic cholecystectomy cholecystectomy. Nevertheless, inflammatory reaction as assessed by CRP seems to be unaffected by the anesthesia regimen.
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Journal of anesthesia · Jun 2016
Role of MnSOD in propofol protection of human umbilical vein endothelial cells injured by heat stress.
Heat stress stimulation can cause various injuries in human umbilical vein endothelial cells (HUVEC), including apoptotic cell death and an increase in cell permeability. Propofol (PPF), a commonly used anesthetic, is known to have an important role in antioxidation as well as organ protection. Therefore, our aim is to evaluate the protective effects of PPF on heat stress (HS)-induced oxidative stress injury and its possible mechanism of action. ⋯ Propofol protected the heat stress-injured cells, at least partly, through upregulating MnSOD expression, effectively reducing the direct or indirect cell damage caused by oxidative stress.