Journal of anesthesia
-
Journal of anesthesia · Feb 2013
ReviewHow can we improve mask ventilation in patients with obstructive sleep apnea during anesthesia induction?
Recent evidence suggests the possible development of difficult mask ventilation in patients with obstructive sleep apnea. Based on our current understanding of the pathophysiology of pharyngeal airway obstruction in obstructive sleep apnea patients, we conclude that anesthesiologists can decrease respiratory complications during anesthesia induction by conducting careful pre-induction preparations, including body and head positioning and sufficient preoxygenation, and by using the two-hand mask ventilation technique with effective airway maneuvers and appropriate ventilator settings while continuously assessing ventilation status with capnography.
-
Journal of anesthesia · Feb 2013
ReviewUltrasound-guided trunk and core blocks in infants and children.
Regional anesthetic techniques for perioperative analgesia in children are being increasingly utilized with the reported advantages of providing superior analgesia, decreasing opioid consumption, and reducing opioid-related adverse effects. The following article reviews the available literature regarding core and trunk blocks in infants and children; specifically, transversus abdominis plane, ilioinguinal/iliohypogastric nerve, rectus sheath, lumbar plexus, and paravertebral and intercostal nerve blockade. ⋯ Additionally, the anatomy and techniques needed for their performance are reviewed. Finally, a summary of the relevant literature in relation to each peripheral nerve block technique is included.
-
Journal of anesthesia · Dec 2012
ReviewThe effects of estrogen on various organs: therapeutic approach for sepsis, trauma, and reperfusion injury. Part 2: liver, intestine, spleen, and kidney.
Several clinical studies show a gender dimorphism of immune and organ responsiveness in the susceptibility to and morbidity from shock, trauma, and sepsis. However, there are conflicting reports on the role of gender in outcomes. Animal studies of shock, trauma, and sepsis have confirmed that alterations in immune and organ functions are more markedly depressed in adult males and in ovariectomized and aged females. ⋯ To establish the role of gender in the outcome of these patients, more studies in clinical and experimental settings are required to determine whether gender-specific responses are global across the injuries or are observed in specific injury situations. Studies are also needed to delineate underlying mechanisms responsible for differences between males and females. The findings gained from the experimental studies will help in designing innovative therapeutic approaches for the treatment of sepsis, trauma, and reperfusion injury patients.
-
Journal of anesthesia · Dec 2012
ReviewThe effects of estrogen on various organs: therapeutic approach for sepsis, trauma, and reperfusion injury. Part 1: central nervous system, lung, and heart.
Although several clinical studies show a gender dimorphism of immune and organ responsiveness in the susceptibility to and morbidity from shock, trauma, and sepsis, there are conflicting reports on the role of gender in outcomes. In contrast, results obtained from experimental studies clearly support the suggestion that gender plays a significant role in post-injury pathogenesis. ⋯ In this respect, organ functions and immune responses are depressed in males with sepsis or trauma, whereas they are unchanged or are enhanced in females. This article reviews studies delineating the mechanism by which estrogen regulates cerebral nervous, lung, and heart systems in an experimental model of sepsis, trauma, or reperfusion injury.