Journal of anesthesia
-
Journal of anesthesia · Apr 2017
Influence of saline-based hydroxyethyl starch on umbilical cord blood electrolytes.
Hydroxyethyl starch (HES) is widely used to prevent and treat spinal anesthesia-induced hypotension during cesarean section. However, the use of saline-based HES may lead to hyperchloremia. This study aimed to clarify the effects of saline-based HES on umbilical cord chloride level at delivery. ⋯ The umbilical cord chloride level at delivery was statistically significantly higher in group A than in group B, but clinically similar (108 ± 2 vs. 107 ± 2 mmol/l, P = 0.02). No differences were observed in the Apgar score or other umbilical cord laboratory data at delivery (Na(+), K(+), pH, base excess). In conclusion, we suggest that although the use of up to 500 ml of saline-based HES during cesarean section influences umbilical cord blood electrolytes, the effect is not of a clinically significant magnitude.
-
Journal of anesthesia · Apr 2017
Case ReportsAnesthesia management of cesarean section in parturient with anti-N-methyl-D-aspartate receptor encephalitis: a case report.
A 24-year-old woman at 29 weeks' gestation, and with psychiatric symptoms, was admitted to hospital and diagnosed as having anti-N-methyl-D-aspartate receptor encephalitis. After 4 weeks of immunotherapy with little effect, an emergency cesarean section was performed at 33+4 weeks gestation under general anesthesia. The parturient was intubated after rapid sequence induction with etomidate, remifentanil and succinylcholine. ⋯ She was extubated on the 6th day after surgery and was transferred to the general ward of the neurology department to control her seizures. After the seizures were controlled, she was discharged home on the 80th postoperative day and her neurological symptoms had slowly improved half a year later. This case report presents the anesthetic considerations in patients with anti-NMDAR encephalitis undergoing cesarean section.
-
Journal of anesthesia · Apr 2017
The impact of liver disorders on perioperative management of reoperative cardiac surgery: a retrospective study in adult congenital heart disease patients.
We evaluated the preoperative prevalence of risk factors for liver disorders and the relationship between the liver disorders and perioperative outcomes in adult congenital heart disease (ACHD) patients. ⋯ ACHD patients who underwent reoperative cardiac surgery had a high prevalence of risk factors for liver disorders preoperatively, and liver disorders aggravated some intraoperative outcomes. These findings suggest that the prevention of liver disorders is important for reducing the occurrence of poor outcomes, and that ACHD patients with liver disorders need attentive perioperative management.
-
Journal of anesthesia · Apr 2017
Fear-avoidance beliefs are independently associated with the prevalence of chronic pain in Japanese workers.
Pain is a global public health problem with implications for both personal and social heath. Fear-avoidance beliefs (FABs) have been demonstrated to negatively impact and prolong pain in many Western countries, but little is known about the association between FABs and chronic pain (CP) in Asian countries, including Japan. We examined the relationship between FABs and CP in Japanese white-collar workers, a growing population with a high prevalence of CP. ⋯ We found a significant association between high TSK scores and CP in Japanese white-collar workers when controlling for other known factors that influence CP such as work-related psychosocial characteristics and depressive conditions. This finding suggests that FABs are independently associated with prevalence of CP.