Journal of anesthesia
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Journal of anesthesia · Jun 2022
Randomized Controlled TrialComparison of three obturator nerve block techniques for injectate spread into the obturator canal: a randomized controlled trial.
The obturator nerve branches into the obturator canal; therefore, local anesthetic spread into the obturator canal predicts the success of the obturator nerve block (ONB). We compared three ONB techniques for the spread of local anesthetic mixed with contrast medium into the obturator canal. ⋯ Local anesthetic spread into the obturator canal using the UMA was superior to that using the PA and IA. Both branches of the obturator nerve could be blocked using the UMA.
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Journal of anesthesia · Jun 2022
Genesis of "negative pressure" during hanging drop; the answer is positive pressure.
A drop of saline placed within the hub of an epidural needle is sucked in when the needle is advanced and penetrates through a polyurethane foam cube. This phenomenon might be explained by the release of compressed air inside of the needle into the air. ⋯ To prove this hypothesis, the pressure inside of the needle was measured during needle advancement, and it increased gradually and then dropped to zero suddenly when the needle fully penetrated the polyurethane foam block. We can speculate that the same phenomenon occurs during hanging-drop method of epidural anesthesia, and this may occur regardless of whether epidural subatmospheric pressure exists or not.
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Journal of anesthesia · Jun 2022
Evaluation of contrast-enhanced ultrasonography with Sonazoid® in visualization of local anesthetic distribution in rectus sheath block: a prospective, clinical study.
Clear visualization of ultrasound (US) images is crucial for successful US-guided nerve block. However, accurate determination of local anesthetic (LA) distribution from US images remains difficult. Sonazoid®, which comprises perflubutane microbubbles, is used to diagnose hepatic and breast tumors. This study aimed to investigate the visibility of Sonazoid® in perioperative US-guided nerve block. ⋯ Sonazoid diluted 100-fold® was clearly visualized real-time, and the enhancement was sustained and measurable after RSB. Sonazoid® could potentially be used for the contrast agent of US-guided nerve block.
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Journal of anesthesia · Jun 2022
Paths of thoracic epidural catheters in children undergoing the Nuss procedure for pectus excavatum repair.
To investigate the paths of thoracic epidural catheters in children, this retrospective study was performed. ⋯ Our findings indicate that the course of epidural catheters in children is unpredictable after the first 2-3 cm in the thoracic epidural space. Clinicians should be aware of such findings, although further studies are required for confirmation.
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Journal of anesthesia · Jun 2022
Case ReportsVenoarterial extracorporeal membrane oxygenation for septic cardiomyopathy caused by Pasteurella multocida infection: a case report.
Pasteurella is a gram-negative coccobacillus that is commonly transmitted through cat and dog bites and causes various diseases in humans. In the present case, kissing an animal caused Pasteurella multocida infection, leading to sepsis and cardiogenic shock. We used venoarterial extracorporeal membrane oxygenation (VA-ECMO) to support the cardiovascular system until recovery. ⋯ He was discharged home and resumed his former life 50 days later. Pasteurella multocida infection can cause sepsis followed by severe cardiac dysfunction in healthy adults. Therefore, VA-ECMO may be a useful treatment option in patients with sepsis-induced myocardial dysfunction and refractory cardiogenic shock.