Journal of anesthesia
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Journal of anesthesia · Aug 2018
Comparative StudyComparison of a new simplified acid-base tool to the original Stewart-Figge approach: a study on cardiac surgical patients.
To suggest a simplified method for strong ion gap ([SIG]) calculation. ⋯ The [BICgap] model bears a very good agreement with the [SIG] model while being simpler and easier to apply at the bedside. [BICgap] could be used as an alternative tool for the diagnosis of unmeasured ion acidosis.
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Journal of anesthesia · Aug 2018
ED50 of remifentanil for providing excellent intubating conditions when co-administered with a single standard dose of propofol without the use of muscle relaxants in children: dose-finding clinical trial.
Previous studies evidenced that orotracheal intubation without neuromuscular blockers is feasible in children and has some potential advantages. Remifentanil has favorable pharmacodynamic and pharmacokinetic properties as an opioid for orotracheal intubation, but its dose for excellent intubation conditions when co-administered with propofol has not been established. This study was designed to find the minimum effective dose of remifentanil for excellent intubation conditions of children when co-administered with propofol, without neuromuscular relaxant drugs. ⋯ Minimum remifentanil effective dose for providing excellent intubating conditions when co-administered with a single standard dose of propofol without the use of neuromuscular blockers in children is 3.04 µg/kg.
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Journal of anesthesia · Aug 2018
ReviewThe history and progress of local anesthesia: multiple approaches to elongate the action.
Analgesia and temporary inhibition of motor activity without interfering with central nervous function have been the essential merits of local anesthesia. Local anesthetics originated from cocaine have played a major role in local analgesia. ⋯ Such approach includes: development of long-acting local anesthetics, with physical tourniquet techniques, co-administration of other medicines such as vaso-constrictive agents or analgesics, development of mechanical devices to continuously or intermittently administer local anesthetics, and utilization of pharmaceutical drug delivery systems. In this review, the historical sequence of studies that have been performed in an effort to elongate the action of local anesthetics is presented, referring to epoch-making medical and scientific studies.
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Journal of anesthesia · Aug 2018
Curvature of the left main bronchus caused by postural change from supine to left lateral position.
This study was designed to examine deviation of the bronchus by postural change from supine to lateral position during spontaneous respiration. Fifteen healthy volunteers [13 men and 2 women, mean age: 34 years (range 26-42)] participated. Chest radiograms (anterior-posterior) were acquired in the order of supine, left lateral, and right lateral position. ⋯ The left secondary carina angle in the supine position was 61.3° ± 4.0° and it significantly increased to 65.5° ± 6.0° in the left lateral position (P = 0.001), but no significant difference was noted in the left bronchus angle between the supine and left lateral positions (P = 0.158). The curvature of left main bronchus, which we defined more than 5° increase in secondary carina angle, was observed in a half of the male participants during left lateral position. We should be aware of these anatomical changes due to the surgical posture as a possible cause for ventilation failure during one-lung ventilation.
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Journal of anesthesia · Aug 2018
Relationship between fresh frozen plasma to packed red blood cell transfusion ratio and mortality in cardiovascular surgery.
The aim of this study was to examine the relationship between FFP (fresh frozen plasma)/pRBC (packed red blood cell) transfusion ratio and outcomes in patients undergoing cardiovascular surgery. ⋯ Higher FFP/RBC ratio was associated with reduced risk of death, stroke and myocardial infarction only in patients with cardiovascular surgery receiving massive transfusion. Clinicians should be aware that judicious FFP replacement plays a critical role in the successful management of massive transfusion in cardiac surgery.