Journal of anesthesia
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Journal of anesthesia · Feb 2021
Randomized Controlled TrialEffects of ultrasound-guided erector spinae plane block on postoperative analgesia and plasma cytokine levels after uniportal VATS: a prospective randomized controlled trial.
Although uniportal video-assisted thoracoscopic surgery (VATS) has been widely used, the associated postoperative pain is still severe. Currently, a variety of regional anesthesia methods have been used to relieve postoperative pain. In our study, we wanted to evaluate the effectiveness of ultrasound-guided erector spinae plane block (ESPB) as a postoperative analgesia after uniportal VATS. ⋯ Ultrasound-guided ESPB decreased the consumption of sufentanil both postoperatively and intraoperatively for patients undergoing uniportal VATS and appeared to be an effective treatment option.
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Journal of anesthesia · Feb 2021
Case ReportsSteroid-induced rapid recovery from respiratory dysfunction in a patient with myasthenia gravis after spinal anesthesia.
We report an 83-year-old man with myasthenia gravis (MG) who developed respiratory depression after spinal anesthesia for transurethral laser enucleation of the prostate. He became less responsive after complained of dyspnea, with a decrease of SpO2 to 83% approximately 13 min after intrathecal administration of 0.5% isobaric bupivacaine 3 ml. With a diagnosis of exacerbation of MG, hydrocortisone 100 mg was administered, following which both consciousness and spontaneous respiration rapidly improved. ⋯ We provided general anesthesia without using muscle relaxants until disappearance of the effect of spinal anesthesia. Surgery completed uneventfully and confirmed wearing off the local anesthetics effect. He was discharged without respiratory problems on postoperative 3 day.
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Journal of anesthesia · Feb 2021
Intraoperative hyperglycemia in patients with an elevated preoperative C-reactive protein level may increase the risk of acute kidney injury after cardiac surgery.
The effect of hyperglycemia on acute kidney injury (AKI) in patients undergoing cardiac surgery is unclear and may involve as yet unexplored factors. We hypothesized differential effects of intraoperative hyperglycemia on AKI after cardiac surgery depending on baseline inflammatory status, as reflected by the C-reactive protein (CRP) level. ⋯ Intraoperative hyperglycemia in patients with an elevated preoperative CRP level was significantly related to an increased risk of AKI after cardiac surgery. Individualized perioperative glycemic control may therefore be necessary in these patients.
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Journal of anesthesia · Feb 2021
Clotting functional stability of withdrawing blood in storage for acute normovolemic hemodilution: a pilot study.
This study was conducted to time-course changes of clotting function of withdrawing blood for acute normovolemic hemodilution (ANH). ⋯ Even though the MCE significantly decreased in a time-dependent manner, MCF of FIBTEM and EXTEM was normal up to 24 h storage. The blood of ANH can use for the purpose of hemostasis at least 8 h stored at room temperature after blood withdrawal. Future studies are needed to elucidate the clinical impact on the patient after delayed transfusion of ANH blood with regard to patient's hemostasis.
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Journal of anesthesia · Feb 2021
Validation of the Japanese version of the Bath CRPS Body Perception Disturbance Scale for CRPS.
Body perception disturbance is a common symptom and may be one of the key targets of treatment intervention in complex regional pain syndrome (CRPS). As a comprehensive assessment tool of body perception in patients with CRPS, the Bath Body Perception Disturbance Scale (BPDS) was developed, and its adequate reliability and validity have been reported. However, there is no available Japanese version. Therefore, this study aimed to develop a Japanese version of BPDS (BPDS-J) and to investigate the validity of this scale in Japanese patients with CRPS. ⋯ BPDS-J has good internal consistency and concurrent validity for assessing body perception disturbance in Japanese patients with CRPS. Disturbed body perception may be worth evaluating when managing patients with CRPS using BPDS.