Journal of anesthesia
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Journal of anesthesia · Apr 2022
Randomized Controlled TrialComparison of clinical effects of meperidine and sufentanil added to 0.5% hyperbaric bupivacaine for spinal anesthesia in patients undergoing cesarean delivery: a randomized controlled trial.
The objective of this study was to compare the effect of adding meperidine or sufentanil to hyperbaric bupivacaine in patients undergoing elective cesarean delivery (CD) under spinal anesthesia. The primary outcome was the first analgesic request time, and secondary outcomes included an analgesic requirement in the first 24 h and intraoperative and postoperative side effects. ⋯ ClinicalTrials.gov (NCT04446715).
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Journal of anesthesia · Apr 2022
Randomized Controlled TrialRemimazolam decreased the incidence of early postoperative nausea and vomiting compared to desflurane after laparoscopic gynecological surgery.
Postoperative nausea and vomiting (PONV) is a common adverse event after surgery. Remimazolam is a novel sedative agent recently approved for general anesthesia in Japan. This study evaluated the efficacy of remimazolam in the incidence of PONV after laparoscopic gynecological surgery under general anesthesia. ⋯ Remimazolam can reduce the incidence of PONV after laparoscopic gynecological surgery compared to general anesthesia with desflurane during the early postoperative period.
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Journal of anesthesia · Apr 2022
Feasibility of continuous epidural analgesia in patients with failed back surgery syndrome and spinal stenosis.
The purpose of this study was to outline the feasibility of continuous epidural analgesia in the treatment of failed back surgery syndrome (FBSS) or spinal stenosis. ⋯ Continuous epidural analgesia is feasible in patients with FBSS or spinal stenosis. This treatment enables extensive physiotherapeutic treatment even in patients with severe pain conditions and can be considered as an alternative to epidural injections. An increased complication rate in comparison to short-term perioperative or perinatal application was not observed.
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Journal of anesthesia · Apr 2022
Case ReportsSuccessful management of segmental zoster paresis on the upper arm with temporally burst spinal cord stimulation.
Segmental zoster paresis (SZP) of the limbs is characterized by a focal, asymmetric neurogenic weakness that may occur in an extremity affected by herpes zoster (HZ). In this case report, we describe the case of a patient with SZP who presented with these problems and responded well to temporary spinal cord stimulation (SCS) and systematic rehabilitation. A 62-year-old female patient was referred for right upper limb pain, weakness, and insomnia due to pain. ⋯ Furthermore, the grip strength of the right hands increased from 6.7 to 16.8 kg at discharge. We induced temporal SCS and rehabilitation of the right upper limb SZP and successfully reduced the pain. An in-depth understanding of the neurological complications secondary to HZ should be emphasized, with temporal SCS and rehabilitation expected to play a crucial role in the motor recovery of patients with SZP.
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Journal of anesthesia · Apr 2022
Observational StudyRisk factors of cardiac arrest and failure to achieve return of spontaneous circulation during anesthesia: a 20-year retrospective observational study from a tertiary care university hospital.
There is still a lack of robust data on the epidemiology of cardiac arrest during anesthesia. We investigated the frequency and risk factors of cardiac arrest during anesthesia over the past two decades at a tertiary care university hospital in Japan. ⋯ Blood loss was the most common cause of cardiac arrest and blood loss-induced cardiac arrest was independently associated with failure to achieve ROSC. Further improvements in treatment strategies for bleeding may reduce the future incidence of cardiac arrest and death during anesthesia.