Journal of anesthesia
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Journal of anesthesia · Apr 2018
Interrater variability in ASA physical status assignment: an analysis in the pediatric cancer setting.
The American Society of Anesthesiologists (ASA) physical status is a universal classification system that helps clinicians to categorize their patients preoperatively. However, there is a lack of both inter-rater and intra-rater reliability among clinicians for the ASA physical status classification. Our study focuses on testing these reliabilities within pediatric anesthesia providers in the cancer setting. ⋯ In contrast to observations in earlier studies, findings indicate poor agreement in inter-rater reliability. Although there was moderate agreement in intra-rater reliability, one would expect to find stronger, even perfect, intra-rater reliability. These findings suggest the need to develop a specific physical status classification system directed toward patients with a systemic illness such as cancer in both young and adult patients.
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Journal of anesthesia · Apr 2018
Comparative Study Observational StudySatisfaction rate of patients undergoing sleeve gastrectomy as day-case surgery compared to conventional hospitalization: a prospective non-randomized study.
Day-case surgery (DCS) has boomed over recent years. However, day-case bariatric surgery remains controversial due to a lack of evaluation. The objective of this study was to compare the experiences and satisfaction with general anesthesia of patients undergoing sleeve gastrectomy (SG) as DCS compared to conventional hospitalization. ⋯ Overall satisfaction of patients undergoing SG as day-case surgery was not inferior to that of patients managed by conventional hospitalization.
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Journal of anesthesia · Apr 2018
Complex issues in new ultrasound-guided nerve blocks: how to name, where to inject, and how to publish.
The recent development of ultrasound-guide nerve block has led to innovation in anesthesia and pain clinics. However, it has also led to some complex issues, including (1) how to name a new technique, (2) the appropriateness of an intramuscular approach, and (3) how to publicize a new technique. This review addresses naming strategy, feasibility of intramuscular approach block, and methods of publication. ⋯ Second, it is lack of evidences to facilitate muscle injection, and adequate preparation and adherence to proper technique for intramuscular approach block should be considered; confirmation of abnormal signs at the injection area, use of a thin needle and the lowest concentration and volume of local anesthetic without supplementation with steroid or epinephrine, compressing hemostasis, and sufficient interval of the blocks. Third, adequate dissemination of information would also be necessary through publication in appropriate media. We hope this review boost reasonable development of nerve block.
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Journal of anesthesia · Apr 2018
Case ReportsA case of anosmia and hypogeusia as a complication of propofol.
Anesthetics represent an uncommon cause of taste and smell disorders. We describe a case of anosmia and hypogeusia for 6 weeks after recovery from a uterine curettage operation in a 32-year-old woman. ⋯ Computed tomography (CT) and magnetic resonance imaging (MRI) revealed no abnormality. This case may highly suggest that propofol could induce smell and taste disorders.