Journal of anesthesia
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Journal of anesthesia · Feb 2017
Case ReportsA suspected case of rocuronium-sugammadex complex-induced anaphylactic shock after cesarean section.
An anaphylactic reaction during a cesarean section occurs rarely, and rocuronium is thought to be one of the common agents causing perioperative anaphylaxis. Here we report an anaphylactic shock after cesarean section that is suggested to be induced by the rocuronium-sugammadex complex. A 36-year-old primigravida underwent an elective cesarean section under general anesthesia due to placenta previa. ⋯ We finally concluded that the rocuronium-sugammadex complex is the causative agent in this case. To the best of our knowledge, this is the first report suggesting anaphylaxis caused by the rocuronium-sugammadex complex. This case highlights the importance of appropriate examinations to determinate the pathogenesis of anaphylaxis in order to establish risk reduction strategies.
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Journal of anesthesia · Feb 2017
Preventive effects of dexmedetomidine on the development of cognitive dysfunction following systemic inflammation in aged rats.
In the present study, we examined whether and by what mechanisms dexmedetomidine (DMED) prevents the development of systemic inflammation (SI)-induced cognitive dysfunction in aged rats. ⋯ Our findings highlight that treatment with DMED during, but not after, peripheral SI can prevent subsequent hippocampal neuroinflammation, overexpression of TLR-4 in microglia, and cognitive dysfunction, as mediated by the α2A-AR signaling pathway.
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Journal of anesthesia · Feb 2017
Comparative StudyEffect of posture and extracranial contamination on results of cerebral oximetry by near-infrared spectroscopy.
Near-infrared spectroscopy (NIRS)-based cerebral oximetry is a noninvasive technology used to estimate regional cerebral oxygen saturation (rSO2). Extracranial blood flow is known to substantially affect rSO2 values measured by most clinically available devices. Several studies have also reported that the Trendelenburg position and upright position have a larger effect on rSO2 measurements than the supine position. Therefore, we investigated the effect of these two positions (the Trendelenburg position versus the upright position) and extracranial contamination on rSO2 measurements obtained using two commercially available devices and one prototype device. ⋯ Except when using NIRO-TRS, measurements of rSO2 in the forehead are significantly lower when measured in the upright position than in the supine position. All devices in this study were affected by extracranial contamination.
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Journal of anesthesia · Feb 2017
Randomized Controlled TrialEffects of transcutaneous electrical acupoint stimulation at different frequencies on perioperative anesthetic dosage, recovery, complications, and prognosis in video-assisted thoracic surgical lobectomy: a randomized, double-blinded, placebo-controlled trial.
Transcutaneous electrical acupoint stimulation (TEAS), a non-invasive and non-pharmacological adjunctive intervention for perioperative analgesia, may also reduce the incidence of postoperative pulmonary complications. The effect of TEAS on video-assisted thoracic surgical (VATS) patients is still unknown, however. The purpose of this study was to investigate the effects of TEAS of different frequency on perioperative anesthetic dosage, recovery, complications, and prognosis for patients undergoing VATS lobectomy. ⋯ TEAS is a safe noninvasive adjunctive intervention for anesthesia management among patients undergoing VATS lobectomy. TEAS at 2/100 Hz can reduce intraoperative opioid dosage and slow the decrease of PaO2 during one-lung ventilation. It can also effectively reduce pain score, extubation time, and PACU stay immediately after surgery. Further, 100 Hz TEAS can reduce PONV morbidity.