Journal of anesthesia
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Journal of anesthesia · Oct 2018
Observational StudyAge is a predictive factor in the femoral nerve positioning: an anatomical ultrasound study.
Precise identification of the femoral nerve (FN) is essential for an ultrasound-guided femoral nerve block. We hypothesized that the distance between the FN and the femoral artery (FA) is correlated with patient age. In this prospective observational study, we evaluated the FN-FA (from the lateral edge of the FA to the medial edge of the FN) distance [0.42 ± 0.42 (mean ± standard deviation) cm] in 102 patients using ultrasound. ⋯ Multiple regression analyses revealed that age was significantly and positively correlated with the FN-FA distance (R2 = 0.72, p < 0.001) and that this correlation was greater than that between height, weight, or gender and the FN-FA distance. Further, the cross-sectional area of the iliopsoas muscle per weight was significantly correlated with age (R2 = 0.54, p < 0.001) and the FN-FA distance (R2 = 0.50, p < 0.001). These findings may help refine the ultrasound techniques used for the femoral nerve block.
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Journal of anesthesia · Oct 2018
Multicenter Study Observational StudyHypotension after induction of general anesthesia: occurrence, risk factors, and therapy. A prospective multicentre observational study.
Hypotension after induction of general anesthesia (GAIH) is common in anesthesiology practice and can impact outcomes. ⋯ GAIH rate depends on age, degree of blood pressure decompensation prior the surgery, and presence of diabetes mellitus type II.
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Journal of anesthesia · Oct 2018
Biochemically diagnosed hypothyroidism and postoperative complications after cardiac surgery: a retrospective cohort analysis.
To determine whether hypothyroidism is associated with cardiovascular complications and surgical wound infections after cardiac surgery. ⋯ Hypothyroidism was associated with lower risk of atrial fibrillation than euthyroidism, and corrected hypothyroidism was associated with a shorter length of stay than euthyroidism.
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Journal of anesthesia · Oct 2018
Accuracy of identifying the cricothyroid membrane in children using palpation.
Accurate identification of the cricothyroid membrane (CTM) has paramount importance in the event of a 'cannot intubate, cannot oxygenate' scenario. We sought to determine the ability of anesthesiologists to correctly identify the CTM in obese and non-obese children. Anesthesiologists were asked to mark the entry point of the cricothyroidotomy device with an ultraviolet invisible pen on obese and non-obese (BMI < 95th percentile for age and sex) children aged 7-12 years. ⋯ Accuracy was not correlated with any demographic or morphometric features of the children. Percutaneous identification of the CTM in children aged 7-12 years was poor and not significantly different for obese and non-obese children. Pre-procedural ultrasonography may help to identify the landmarks for cricothyroidotomy.
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Journal of anesthesia · Oct 2018
In vitro changes in the proportion of protein-unbound-free propofol induced by valproate.
It has been reported that oral valproate (VPA) reduces the dose of propofol required for sedation. As a potential reason for this, it is considered that VPA displaces serum protein-bound propofol and increases the proportion of protein-unbound-free propofol. To examine this hypothesis, the present in vitro study investigated the influence of VPA on the proportion of protein-unbound-free propofol in human serum samples. ⋯ VPA might increase the proportion of protein-unbound-free propofol in human serum via displacement reactions.