Journal of anesthesia
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Journal of anesthesia · Dec 2022
Randomized Controlled TrialUsefulness and accuracy of a handheld ultrasound device for epidurssal landmark and depth assessment by anesthesiology residents.
The aim of this study was to assess the usefulness and accuracy of a handheld ultrasound device (Accuro, Rivanna Medical, Charlottesville, VA, USA) for epidural landmark and depth assessment when epidural anesthesia is performed by residents. ⋯ Although there was no significant difference in time from Tuohy needle puncture to loss of resistance, Accuro reduced the number of Tuohy needle redirects and accurately indicated the depth to the epidural space. Accuro may be useful for identifying the needle insertion point and estimating depth to the epidural space when residents perform epidural anesthesia.
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Journal of anesthesia · Dec 2022
Preoperative dipstick albuminuria is associated with acute kidney injury in high-risk patients following non-cardiac surgery: a single-center prospective cohort study.
This study aimed to investigate the association between preoperative dipstick albuminuria (DA) and acute kidney injury (AKI) in high-risk patients following non-cardiac surgery. ⋯ Preoperative DA was independently associated with AKI in high-risk patients following non-cardiac surgery. Preoperative routine urinalysis for determination of DA status was suggested in early risk stratification.
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Journal of anesthesia · Dec 2022
Association of the placenta accreta spectrum score and estimated blood loss in placenta accreta spectrum patients with placenta previa: a retrospective cohort study.
The placenta accreta spectrum (PAS) score calculated by the scoring system may predict patients with PAS. We aim to find the relationship between estimated blood loss and the PAS score. Further, find the inflection point, identify PAS patients with placenta previa who were at risk for major bleeding. ⋯ There was a non-linear relationship between estimated intraoperative blood loss and PAS score. When the PAS score was greater than 9, hemorrhage, the risk of major bleeding, the need for transfusions, and the placement of an abdominal aortic balloon all increase significantly.
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Journal of anesthesia · Dec 2022
Future liver remnant volume is associated with postoperative fentanyl consumption following open donor hepatectomy: a retrospective multivariate analysis.
Liver resection has a risk of postoperative hepatic dysfunction, including drug metabolism. Since fentanyl is primarily metabolized in the liver, liver resection requires exercising caution against fentanyl overdose in postoperative analgesia. The rationale for dose adjustment of fentanyl in the preoperative prescription for patients undergoing liver resection remains unclear. We examined whether postoperative fentanyl consumption is associated with the future liver remnant after liver resection and investigated factors influencing fentanyl consumption. ⋯ Future liver remnant volume was significantly associated with postoperative fentanyl consumption. Smaller remnant liver volume and older age (≥ 45 years) were independent factors reducing postoperative fentanyl consumption in patients undergoing open donor hepatectomy.