Journal of anesthesia
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Journal of anesthesia · Aug 2018
Randomized Controlled TrialNalbuphine as an adjuvant to 0.25% levobupivacaine in ultrasound-guided supraclavicular block provided prolonged sensory block and similar motor block durations (RCT).
Prolonged postoperative analgesia with early motor recovery for early rehabilitation is a challenge in regional block. The purpose of this study is to evaluate the effect of adding 20 mg nalbuphine to 25 ml of 0.25% levobupivacaine in supraclavicular brachial plexus block. ⋯ Adding 20 mg nalbuphine to 25 ml of 0.25% levobupivacaine in supraclavicular block provided prolonged duration of sensory block with similar duration of motor block.
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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.
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Journal of anesthesia · Aug 2018
Randomized Controlled TrialEffects of epidural anesthesia on postoperative nausea and vomiting in laparoscopic gynecological surgery: a randomized controlled trial.
Patients undergoing laparoscopic gynecological surgery are susceptible to postoperative nausea and vomiting (PONV). We hypothesized that a combination of epidural and general anesthesia to minimize intraoperative opioid administration would reduce the incidence of PONV following laparoscopic gynecological surgery. ⋯ Minimizing intraoperative opioid administration by combining epidural and general anesthesia did not reduce the 24-h incidence of PONV or rescue metoclopramide use after laparoscopic gynecological surgery.
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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
Multicenter StudyThe impact of low body mass index on postoperative outcomes in pancreatectomy patients: a retrospective analysis of Japanese administrative data.
To comparatively examine in-hospital mortality among different underweight body mass index (BMI) categories in pancreatic cancer patients after pancreatectomy in Japan. ⋯ Severe thinness was significantly associated with a higher risk of mortality, and extremely low BMI should be considered a risk factor in pancreatectomy patients.