Journal of anesthesia
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Journal of anesthesia · Feb 2019
Randomized Controlled Trial Comparative StudyLocal anesthetic spread into the paravertebral space with two types of quadratus lumborum blocks: a crossover volunteer study.
Previous work showed that 20 mL of local anesthetic (LA) did not spread into the paravertebral space (PVS) via the intramuscular quadratus lumborum block (QLBi). If spread of LA into the PVS can be achieved by increasing the total LA volume, QLBi can be more effective. We hypothesized that a larger volume of LA for the QLBi would spread into the PVS. ⋯ LA administered by the QLB2 spreads into the PVS of T10-T12, resulting in lower and lateral abdominal sensory loss. In contrast, LA administered by the QLBi does not spread into the PVS and results in only lateral abdominal sensory loss.
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Journal of anesthesia · Feb 2019
Multicenter Study Comparative Study Observational StudyCrystalloid coloading vs. colloid coloading in elective Caesarean section: postspinal hypotension and vasopressor consumption, a prospective, observational clinical trial.
Maternal hypotension is a common side effect of spinal anaesthesia for Caesarean section. The combination of colloid coloading and vasopressors was considered our standard for its prevention and treatment. As the safety of hydroxyethyl starch is under debate, we replaced colloid with crystalloid coloading. ⋯ Crystalloid coloading was associated with a greater drop in mean blood pressure and a higher incidence of hypotension when compared with colloid coloading. Neonatal outcome was, however, unaffected by the type of fluid.
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Journal of anesthesia · Feb 2019
The influence of morbid obesity on difficult intubation and difficult mask ventilation.
To determine the influence of morbid obesity on the incidence of difficult mask ventilation and difficult intubation. ⋯ Morbidly obese patients do not have a higher incidence of difficult intubation compared to non-morbidly obese patients. However, they have a significantly higher incidence of difficult mask ventilation. Other factors that are predictive of both difficult mask ventilation and difficult intubation include age > 46 years, male sex, and Mallampati 3-4.
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Journal of anesthesia · Feb 2019
Effects of crystalloids and colloids on microcirculation, central venous oxygen saturation, and central venous-to-arterial carbon dioxide gap in a rabbit model of hemorrhagic shock.
The effects of hydroxyethyl starch (HES) on microcirculation, central venous oxygen saturation (ScvO2), and the central venous-to-arterial carbon dioxide gap (dCO2) are studied in a rabbit model of hemorrhagic shock for elucidating the advantages and drawbacks of resuscitation with HES compared with crystalloids. ⋯ Intravenous infusion of HES effectively maintains adequate tissue oxygenation and perfusion in hemorrhagic shock.
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Journal of anesthesia · Feb 2019
Comment LetterAdding dextran to local anesthetic enhances analgesia.
Abstract