Articles: general-anesthesia.
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High-risk surgeries for patients with severe aortic stenosis (AS) are challenging for anesthesiologists and can result in hemodynamic deterioration and even mortality. We describe a case in which remimazolam was used to induce and maintain general anesthesia for a high-risk, noncardiac surgery accompanied by ongoing bleeding. ⋯ Throughout the anesthetic process, the patient's cardiac index and systemic vascular resistance were well preserved without any vasopressor support. Remimazolam seems to have possible effectiveness as a relatively safe agent for the induction and maintenance of general anesthesia in patients with severe AS who are undergoing high-risk, noncardiac surgery with bleeding.
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Observational Study
Effect of intraoperative operating table rotation on lower limb perfusion index in patients in the lithotomy position.
We focused on "returning to the horizontal position," one of the measures for preventing well leg compartment syndrome implemented at our hospital, and aimed to clarify the effect of intraoperative positional changes by operating table rotation on blood perfusion in the lower extremities during lithotomy in patients under general anesthesia. This prospective observational study examined 64 patients scheduled to undergo general anesthesia in the lithotomy position from March 2021 to May 2022. The primary endpoint was the perfusion index (PI) of the lower limb before and after operating table rotation. ⋯ After operating table rotation from the Trendelenburg to the horizontal position, the lower limb PI did not change significantly after 15 min. However, lower leg pressure showed a significant decrease immediately after returning to the horizontal position. This result provides evidence for operating table rotation as a preventive measure for well leg compartment syndrome.
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Randomized Controlled Trial
Comparing Preoperative Anxiety Effects of Brachial Plexus Block and General Anesthesia for Orthopedic Upper-Extremity Surgery: A Randomized, Controlled Trial.
Background and objectives: Preoperative anxiety is an enormous feeling of fear that is seen in all patients undergoing surgery. The severity of anxiety may vary depending on the type of surgery and anesthesia to be performed. The aim of this study is to compare the effects of brachial plexus blocks and general anesthesia methods on preoperative anxiety levels in patients who will undergo orthopedic upper-extremity surgery and to determine the factors affecting anxiety. ⋯ VAS score medians at 1, 4, and 8 h postoperatively were found to be significantly higher in the GA group (p < 0.001, p < 0.001 and p = 0.044, respectively). Conclusions: USG-guided BPB may cause less anxiety than GA in patients who will undergo elective upper-extremity surgery. However, these patients have moderate anxiety, although it is more associated with advanced age, female gender, and education level.
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This study aimed to investigate the effects of morning and afternoon surgeries on the early postoperative sleep function in patients undergoing general anesthesia. ⋯ Both morning and afternoon surgeries have significant impacts on the sleep function in patients undergoing general anesthesia, while afternoon surgery has a more serious impact on sleep function.