Journal of anesthesia
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Journal of anesthesia · Aug 2021
Randomized Controlled TrialAccuro ultrasound-based system with computer-aided image interpretation compared to traditional palpation technique for neuraxial anesthesia placement in obese parturients undergoing cesarean delivery: a randomized controlled trial.
Recently, a new handheld ultrasound-based device, called Accuro, has been commercialized with a real-time automated interpretation of lumbar ultrasound images. We hypothesized that the handheld ultrasound device would improve the efficacy and safety of combined spinal-epidural anesthesia (CSEA) for cesarean delivery in obese parturients. ⋯ Our study suggests using the Accuro ultrasound device can enhance the efficacy and safety of CSEA in obese parturients when executed by experienced anesthesiologists, and its automated estimation of epidural depth is accurate.
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Journal of anesthesia · Aug 2021
Randomized Controlled TrialEffectiveness of nebulized dexmedetomidine for treatment of post-dural puncture headache in parturients undergoing elective cesarean section under spinal anesthesia: a randomized controlled study.
The need for effective treatment for post-dural puncture headache (PDPH) is a growing research entity. This study aimed to test the effectiveness of additional dexmedetomidine (DEX) to PDPH conservative management and evaluate its cerebral hemodynamic effects trans-cranial Doppler. ⋯ The addition of DEX nebulization (1 µg/kg twice daily) to the PDPH conservative care effectively relieved the symptoms and lowered pain scores which could be due to its analgesic and cerebral vasoconstrictive effects.
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Journal of anesthesia · Aug 2021
Long-term survival differences between sevoflurane and propofol use in general anesthesia for gynecologic cancer surgery.
This study aimed to evaluate the influence of anesthetic management with propofol or sevoflurane on the prognosis of patients undergoing gynecologic cancer surgery. ⋯ In patients undergoing gynecologic cancer surgery, sevoflurane anesthesia was associated with worse overall, cancer-specific, and recurrence-free survival than propofol anesthesia.
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Journal of anesthesia · Aug 2021
Observational StudyFactors associated with quality of dreams during general anesthesia: a prospective observational study.
Patients frequently report having dreams during general anesthesia, and the dreams are often reported to be pleasant dreams. However, factors associated with the quality of dreams during general anesthesia have not been clarified. The aim of this study was to determine the relationships between the quality of dreams during general anesthesia and perioperative factors. ⋯ A total of 1100 patients were included in the study, and 293 (25.4%) of the patients reported having dreams during anesthesia. Half of the patients who experienced dreams during anesthesia (50.2%, 147/293 patients) reported having a pleasant dream. Multivariate logistic regression analysis revealed that only HADS-depression score of less than 11 was related to pleasant dreams (OR: 3.3 [95% CI 1.3-10.0]).
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Journal of anesthesia · Aug 2021
Case ReportsGlucose control using an artificial pancreas in a severe COVID-19 patient on extracorporeal membrane oxygenation: a case report.
The usefulness and safety of continuous glucose monitoring (CGM) systems in adult patients with severe coronavirus disease (COVID-19) have been reported. Using CGM might reduce the exposure patients and healthcare workers to COVID-19 and limit the use of personal protective equipment during the pandemic. CGM devices measure glucose in the subcutaneous interstitial fluid, but the accuracy of this technique has not been established in critically ill patients. ⋯ Fifty-six hours after adopting the STG-55, it was removed because the blood sampling failed. No episodes of hypoglycemia were observed despite deep sedation during this period. In conclusion, this case demonstrates the potential utility of an artificial pancreas in patients with severe COVID-19.