Journal of anesthesia
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Journal of anesthesia · Oct 2017
Randomized Controlled TrialProtective multimodal analgesia with etoricoxib and spinal anesthesia in inguinal hernia repair: a randomized controlled trial.
Inguinal hernia repair is a common procedure, and can be performed under spinal anesthesia. Although adequate analgesia is crucial to postoperative recovery, the optimal protective analgesic regimen remains to be established. ⋯ The addition of etoricoxib to spinal anesthesia as a multimodal protective regimen can improve pain control after inguinal hernia repair. The optimal dose and applicability to other operations remains to be established.
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Journal of anesthesia · Oct 2017
Randomized Controlled Trial Comparative StudyElectroencephalographic effect of age-adjusted 1 MAC desflurane and sevoflurane in young, middle-aged, and elderly patients.
We examined the hypothesis that 1 minimum alveolar concentration (MAC) of desflurane and sevoflurane provides different depth of anesthesia. ⋯ BIS as well as SEF95 were lower in patients receiving 1 MAC desflurane than those receiving 1 MAC sevoflurane, suggesting that desflurane provides higher depth of anesthesia than sevoflurane at 1 MAC.
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Journal of anesthesia · Oct 2017
ReviewA clinical review of inhalation anesthesia with sevoflurane: from early research to emerging topics.
A large number of studies during the past two decades have demonstrated the efficacy and safety of sevoflurane across patient populations. Clinical researchers have also investigated the effects of sevoflurane, its hemodynamic characteristics, its potential protective effects on several organ systems, and the incidence of delirium and cognitive deficiency. This review examines the clinical profiles of sevoflurane and other anesthetic agents, and focuses upon emerging topics such as organ protection, postoperative cognitive deficiency and delirium, and novel ways to improve postanesthesia outcomes.
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Journal of anesthesia · Oct 2017
Feasibility of the head-mounted display for ultrasound-guided nerve blocks: a pilot simulator study.
The head-mounted display (HMD) has the potential to improve the quality of ultrasound-guided procedures. The aim of this non-clinical crossover designed study is to evaluate the feasibility of the HMD for ultrasound-guided nerve block. Eight experienced anesthesiologists performed ultrasound-guided peripheral nerve blocks on a training simulator with a standard approach and with an upside-down approach. ⋯ The needle insertion times were 10.4 ± 7.2 s with the control method and 6.8 ± 5.3 s with the HMD method for the standard approach (p = 0.03), and 18.1 ± 10.1 with the control method and 11.8 ± 9.5 s with the HMD method for the upside-down approach (p = 0.002). The fractional percentages of time with the needle visible on the ultrasound image were 34.1 ± 20.9 with the control method and 56.5 ± 13.6% with the HMD method for the standard approach (p < 0.001), and 20.1 ± 13.4 with the control method and 38.2 ± 21.2% with the HMD method for the upside-down approach (p = 0.001). In conclusion, this pilot study using a simulation model indicated that the use of an HMD shortened the procedure time and improved the needle visibility on ultrasound.
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Journal of anesthesia · Oct 2017
Comparative Study Observational StudyComparison of the incidences of hyponatremia in adult postoperative critically ill patients receiving intravenous maintenance fluids with 140 mmol/L or 35 mmol/L of sodium: retrospective before/after observational study.
The purpose of this study was to compare the incidences of hyponatremia in adult postoperative critically ill patients receiving isotonic and hypotonic maintenance fluids. ⋯ In this study, the use of intravenous maintenance fluid with 35 mmol/L of sodium was significantly associated with an increased risk of hyponatremia compared to that with 140 mmol/L of sodium in adult postoperative critically ill patients.