Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2015
Clinical TrialEstimation of shunt fraction by transesophageal echocardiography during one-lung ventilation.
As the blood flow volume in non-dependent lung composed the primary part of the intrapulmonary shunt during one-lung ventilation (OLV), the shunt fraction (SF) during OLV can be represented by the ratio of blood flow volume in non-dependent lung to the bilateral lung. The purpose of this study is to estimate the shunt in non-dependent lung by transesophageal echocardiography (TEE). Fifteen adult patients requiring OLV for thoracic surgery were enrolled in the study. ⋯ There was significant liner correlation between SF and PaO2 (r=0.717), and between BFP and PaO2 (r=0.593). It is feasible to estimate intrapulmonary shunt by TEE in anesthetized patients undergoing OLV. SF measured by TEE has significant correlation with PaO2, and it would expected to be used to predict hypoxemia during OLV.
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J Clin Monit Comput · Apr 2015
Observational StudyThe effects of low-dose ketamine on the analgesia nociception index (ANI) measured with the novel PhysioDoloris™ analgesia monitor: a pilot study.
The PhysioDoloris™ analgesia monitor assesses nociception effects on the autonomic nervous system by analyzing changes in heart rate variability (HRV). This non-invasive device analyses ECG signals and determines the analgesia nociception index (ANI), allowing for quantitative assessment of the analgesia/nociception balance in anesthetized patients. Ketamine, an analgesic adjuvant with sympathomimetic properties, has been shown to improve perioperative pain management. ⋯ The mean (±SD) reduction in ANI values after skin incision was statistically significant (13.65±15.44, p=0.01), which is consistent with increased nociception. A single i.v. bolus of 0.5 μg kg(-1) ketamine did not influence the ANI values of 20 women under standardized general anesthesia conditions and absent noxious stimulation. These results suggest that the ANI derived from the PhysioDoloris™ analgesia monitor is feasible under such clinical conditions.
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J Clin Monit Comput · Apr 2015
Case ReportsThermal imaging evaluation of paravertebral block for mastectomy in high risk patient: case report.
Thoracic paravertebral block is the technique of injecting local anesthetic adjacent to the thoracic vertebra close to where the spinal nerves emerge from the intervertebral foramina. It is effective in treating acute and chronic pain of unilateral origin from the chest and abdomen. This technique causes pain relief with pulmonary function preservation and great hemodynamic stability. 66 year old woman (156 cm, 80 kg, BMI 32) with chronic right heart failure, hypertension and obesity, on chronic oxygen therapy was presented for elective mastectomy due to breast cancer. ⋯ Great cardiovascular stability and very good pulmonary function preservation make this method excellent for high risk patients. Low complication rate is additional advantage. In our opinion this method is recommendable.