Journal of anesthesia
-
Journal of anesthesia · Dec 2020
Randomized Controlled TrialThe effectiveness of the intramuscular quadratus lumborum block in postoperative analgesia after cesarean section with vertical incision: a randomized, double-blinded placebo-controlled study.
Quadratus lumborum block (QLB) has recently been used for postoperative analgesia after abdominal surgery. Although there are several approaches to QLB, the effectiveness of intramuscular QLB (QLBi) remains controversial. The aim of the present study was to examine the effectiveness of QLBi for postoperative analgesia after cesarean section with a vertical midline incision. ⋯ QLBi with the concentration and amount of local anesthetic used in the present study was clinically slightly effective, and the effect was limited for postoperative analgesia after cesarean section.
-
Journal of anesthesia · Dec 2020
Evaluation of a new face mask concept for oxygen administration: a crossover study in healthy volunteers.
We developed a new face mask concept for oxygen administration using non-woven textiles. The aim of this study was to evaluate whether the new mask improves acceptability without compromising O2 delivery and CO2 elimination. 10 healthy adult volunteers were randomized to either the conventional plastic face mask-first group or the new face mask-first group. Participants were asked to wear the assigned mask with O2 at 3 L/min for 10 min while seated. ⋯ Median et-O2 with the new mask was 33%, compared with 30% with the conventional mask (P = 0.008). There were no significant differences in et-CO2 by mask type (new, 32 mmHg; conventional, 30 mmHg). In conclusion, the new mask was more comfortable and provided higher et-O2 than the conventional mask.
-
Journal of anesthesia · Dec 2020
Why the natural frequency and the damping coefficient do not evaluate the dynamic response of clinically used pressure monitoring circuits correctly.
The dynamic response of pressure monitoring circuits must be evaluated to obtain true invasive blood pressure values. Since Gardner's recommendations in 1981, the natural frequency and the damping coefficient have become standard parameters for anesthesiologists. In 2006, we published a new dynamic response evaluation method (step response analysis) that can plot frequency spectrum curves instantly in clinical situations. We also described the possibility of the defect of the standard parameters. However, the natural frequency and the damping coefficient are considered the gold standard and are even included in a major anesthesiology textbook. Therefore, we attempted to clarify the issues of these parameters with easy-to-understand pressure waves and basic numerical formulae. ⋯ The natural frequency and the damping coefficient are inadequate for the dynamic response evaluation. These parameters are primarily obtained from the phase spectrum curve and not from the amplitude spectrum curve. We strongly recommend an evaluation using the amplitude spectrum curve with our step response analysis method. It is crucial to maintain an amplitude gain of 1 (input amplitude = output amplitude) in the pressure wave frequency range of 0-20 Hz.
-
Journal of anesthesia · Dec 2020
ReviewAnalogy between classical Yoga/Zen breathing and modern clinical respiratory therapy.
Anesthesiologists and intensivists are modern-day professionals who provide appropriate respiratory care, vital for patient survival. Recently, anesthesiologists have increasingly focused their attention on the type of spontaneous breathing made by non-intubated patients with pulmonary disease cared for in an intensive care unit, and also patients with chronic pain receiving cognitive behavioral therapy. Prior to our modern understanding of respiratory physiology, Zen meditators recognized that breathing has a significant impact on a person's mental state and general physical well-being. ⋯ In the present review, we examine the effect of classical breathing methods and find an analogy between typical Yoga/Zen breathing and modern clinical respiratory therapy. Evidence is increasing about historical breathing and related meditation techniques that may be effective in modern clinical practice, especially in the field of anesthesiology, such as in improving respiratory function and reducing chronic pain. Clarification of the detailed mechanisms involved is anticipated.
-
Journal of anesthesia · Dec 2020
Randomized Controlled TrialOpen randomized trial of the effects of 6% hydroxyethyl starch 130/0.4/9 and 5% albumin on safety profile, volume efficacy, and glycocalyx degradation in hepatic and pancreatic surgery.
The aim of this study was to evaluate the effects of hydroxyethyl starch (HES) 130/0.4/9 compared to 5% albumin on renal and coagulation safety profiles, volume efficacy and glycocalyx degradation in major abdominal surgery. ⋯ HES 130/0.4/9 can be used as safely and effectively as 5% albumin. Glycocalyx degradation did not differ between use of these solutions in major abdominal surgery.