Journal of anesthesia
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Journal of anesthesia · Aug 2016
Randomized Controlled Trial Comparative StudyHyperoxic oxidative stress during abdominal surgery: a randomized trial.
The hypothesis of our study is that during anesthesia, administration of 80 % oxygen concentration increases oxidative stress more than 40 % oxygen. ⋯ We found that 80 % FiO2 decreased ETV and PaO2/FiO2 and increased lactate levels and oxidative stress more, inhibiting antioxidant response compared to 40 % FiO2.
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Journal of anesthesia · Aug 2016
Comparative StudyThe predictive ability of six pharmacokinetic models of rocuronium developed using a single bolus: evaluation with bolus and continuous infusion regimen.
Rocuronium concentration prediction using pharmacokinetic (PK) models would be useful for controlling rocuronium effects because neuromuscular monitoring throughout anesthesia can be difficult. This study assessed whether six different compartmental PK models developed from data obtained after bolus administration only could predict the measured plasma concentration (Cp) values of rocuronium delivered by bolus followed by continuous infusion. ⋯ A PK model developed from data obtained after single-bolus dosing can predict Cp values during bolus and continuous infusion. Thus, a mixed-effects modeling approach may be preferable in extrapolating such data.
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Journal of anesthesia · Aug 2016
Observational StudyEpidural pressure changes following caudal blockade: a prospective, observational study.
Recent case reports raise the question as to whether anesthetic agents injected into the epidural space could lead to a 'compartment syndrome' and neurovascular sequelae. Single-shot caudal epidural anesthesia has been established as a safe technique, but changes in pressure in the caudal epidural space have not been described. Our aim was to study pressure changes to provide preliminary information for future studies design. ⋯ Following the administration of the local anesthetic into the caudal epidural space, there was a marked, but transient, increase in the pressure within the epidural space. It appears unlikely that a slow epidural catheter infusion could lead to a sustained increase in epidural pressure.
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Journal of anesthesia · Aug 2016
Case ReportsAlteration of fatal 1:1 conducted atrial flutter to less conducted ratio by landiolol infusion.
An 84-year-old male patient with a past history of atrial-flutter-fibrillation and dementia underwent an urgent femoral neck fracture surgery. Preoperative electrocardiography demonstrated atrial flutter (AFL) with ventricular conduction at a ratio of 2:1-4:1, and transthoracic echocardiography showed severe left ventricular dysfunction with Ejection Fraction of 14.6 %. Femoral nerve block and Lateral femoral cutaneous nerve block with sedation was planned for the surgery. ⋯ A further episode of 1:1 conducted AFL occurred when the pin was inserted to the thighbone, which caused circulatory collapse. Additional bolus dose of landiolol immediately altered it to 2:1 before operating cardioversion and stabilized the hemodynamics. He maintained AFL with 2:1 conduction thereafter, and 1:1 conduction was never seen postoperatively even after discontinuation of landiolol.
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Journal of anesthesia · Aug 2016
Work of breathing using different interfaces in spontaneous positive pressure ventilation: helmet, face-mask, and endotracheal tube.
Noninvasive positive pressure ventilation (NPPV) using a helmet is expected to cause inspiratory trigger delay due to the large collapsible and compliant chamber. We compared the work of breathing (WOB) of NPPV using a helmet or a full face-mask with that of invasive ventilation by tracheal intubation. ⋯ NPPV using a helmet is more effective than the other interfaces for WOB in obstructive lung disease.