Korean journal of anesthesiology
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Korean J Anesthesiol · Jun 2015
ReviewAirway management of patients with traumatic brain injury/C-spine injury.
Traumatic brain injury (TBI) is usually combined with cervical spine (C-spine) injury. The possibility of C-spine injury is always considered when performing endotracheal intubation in these patients. Rapid sequence intubation is recommended with adequate sedative or analgesics and a muscle relaxant to prevent an increase in intracranial pressure during intubation in TBI patients. ⋯ A lightwand also reduced cervical motion across all segments. A fiberoptic bronchoscope-guided nasal intubation is the best method to reduce cervical movement, but a skilled operator is required. In conclusion, a video laryngoscope assists airway management in TBI patients with C-spine injury.
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Korean J Anesthesiol · Jun 2015
Predictive value of rotational thromboelastometry during cardiopulmonary bypass for thrombocytopenia and hypofibrinogenemia after weaning of cardiopulmonary bypass.
The early detection of coagulopathy helps guide decisions regarding optimal transfusion management during cardiac surgery. This study aimed to determine whether rotational thromboelastometry (ROTEM) analysis during cardiopulmonary bypass (CPB) could predict thrombocytopenia and hypofibrinogenemia after CPB. ⋯ EXTEM, PLTEM, and FIBTEM parameters during CPB may be useful for predicting thrombocytopenia and hypofibrinogenemia after weaning of CPB.
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Korean J Anesthesiol · Jun 2015
Vasopressin ameliorates hypotension induced by beach chair positioning in a dose-dependent manner in patients undergoing arthroscopic shoulder surgery under general anesthesia.
The beach chair position (BCP) is associated with hypotension that may lead to cerebral ischemia. Arginine vasopressin (AVP), a potent vasoconstrictor, has been shown to prevent hypotension in BCP. It also improves cerebral oxygenation in different animal models. The present study examined the effect of escalating doses of AVP on systemic hemodynamics and cerebral oxygenation during surgery in BCP under general anesthesia. ⋯ AVP ameliorates hypotension associated with BCP in a dose-dependent manner in patients undergoing shoulder surgery under general anesthesia. However, AVP may have negative effects on SctO2 before and after BCP and on SjvO2 before BCP.
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Korean J Anesthesiol · Jun 2015
Adsorption of desflurane by the silica gel filters in breathing circuits: an in vitro study.
During general anesthesia, a heated breathing circuit (HBC) is used to replace the heat and moisture exchange function of the upper airway. One HBC uses an air dryer filter that employs silica gel (SG) as a desiccant. SG is capable of adsorbing many organic compounds. Therefore, we undertook an in vitro study of the adsorption of desflurane by SG filters. ⋯ The adsorption of desflurane with the use of an air dryer filter was verified in this in vitro study. Careful attention is needed when using air dryer gel filters during general anesthesia.
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Korean J Anesthesiol · Jun 2015
The effects of deep and light propofol anesthesia on stress response in patients undergoing open lung surgery: a randomized controlled trial.
This prospective, randomized controlled study was undertaken to compare stress hormone response to open thoracotomy for lung resection at different anesthetic depths, as determined by bispectral index (BIS) monitoring, in patients under propofol-remifentanil anesthesia. ⋯ A deep level of anesthesia achieved using high propofol infusion rates during lung surgery provided lower perioperative norepinephrine and glucose responses than light level of anesthesia during the early postoperative period but failed to affect immediate postoperative outcomes.