Journal of anesthesia
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Journal of anesthesia · Jun 2022
Review Meta AnalysisDural puncture epidural versus conventional epidural analgesia for labor: a systematic review and meta-analysis of randomized controlled studies.
Dural puncture epidural (DPE) technique is a modification of the conventional epidural (EP) technique in that the dura is intentionally punctured with a spinal needle but without any spinal injection. This meta-analysis aimed to evaluate the benefits and risks associated with the DPE technique for labor analgesia. Randomized trials comparing DPE analgesia with EP analgesia for labor pain relief were systematically searched in the database of Medline, Embase, Cochrane Controlled Trials Register, Web of Science, and China Biology Medicine till 1st August 2021. ⋯ No adverse event was found with DPE analgesia. We conclude that compared with EP analgesia, DPE analgesia is beneficial for labor pain relief by shortening the time to achieve satisfactory pain control. Meanwhile, DPE analgesia is not associated with increased adverse maternal/fetal events.
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Journal of anesthesia · Jun 2022
Multicenter Study Observational StudyThe frequency of postoperative BNP measurement and intervention threshold of BNP concentration in pediatric cardiac intensive care unit: a prospective multicenter observational study.
The purpose of this study is to investigate the current status of postoperative BNP measurement in the pediatric cardiac intensive care unit (PCICU). ⋯ High BNP concentration, especially more than 1000 pg/ml, was more often intervened upon compared to that of less than 1000 pg/ml.
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Journal of anesthesia · Jun 2022
Effects of anesthetics on expression of dopamine and acetylcholine receptors in the rat brain in vivo.
Dopamine D2 and acetylcholine M1 receptors might be related to post-operative cognitive dysfunction. The aim of the present study is to investigate whether several anesthetics which are used for general anesthesia and/or sedation, affect expression of dopamine D2 and acetylcholine M1 receptors in the rat brain. Thirty-six male rats aged 5-9 weeks old were divided into six groups (n = 6 in each group); five groups for anesthetics and one for control. ⋯ Then, real-time polymerase chain reaction was performed to examine the expression of Drd2 (cord dopamine D2 receptor) and Chrm1 (cord acetylcholine M1 receptor). There were no significant differences among the groups regarding Drd2 and Chrm1 mRNA expression of each region of the brain. Postsynaptic changes of dopamine D2 and acetylcholine M1 receptors due to administration of dexmedetomidine, propofol, midazolam, sevoflurane, and nitrous oxide are unlikely to occur at the doses of each anesthetic used in the present study.
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Journal of anesthesia · Jun 2022
Randomized Controlled TrialContinuing versus withholding angiotensin receptor blocker (ARB)/calcium channel blocker (CCB) combination tablets during perioperative periods in patients undergoing minor surgery: a single-blinded randomized controlled trial.
This trial was conducted to compare effects of continuing versus withholding single-pill combination tablets consisting of angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) on perioperative hemodynamics and clinical outcomes. ⋯ This trial is registered with the Japan Registry of Clinical Trials (jRCT) at Japanese Ministry of Health, Labour, and Welfare (Trial ID: jRCT1031190027).
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Journal of anesthesia · Jun 2022
Observational StudyEpidemiology of constipation in critically ill patients and its impact on in-hospital mortality: a retrospective observational study.
There are several causes for delayed constipation in critically ill patients. Constipation in critically ill patients is reportedly associated with poor outcomes. However, a consistent definition for constipation and reports on the prognosis of critically ill patients with constipation are lacking. Therefore, we aimed to determine the epidemiology of constipation during critical illness, and assess the association between constipation and in-hospital mortality based on the two definitions of constipation used in previous studies. ⋯ Constipation in critically ill patients was not associated with in-hospital mortality based on any definition of constipation used in previous studies. Further prospective studies are necessary to validate our findings.