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Journal of Anesthesia

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Systemic toxicity from local anesthetics can occur in any of the wide range of situations in which these agents are used. This practical guide is created to generate a shared awareness of the prevention, diagnosis, and treatment of local anesthetic systemic toxicity among all medical professionals who perform nerve blocks. Systemic toxicity of local anesthetic is induced by an increase of its protein-unbound plasma concentration. Initial symptoms are characterized by central nervous system signs such as excitation, convulsions, followed by loss of consciousness and respiratory arrest...
November 11, 2018: Journal of Anesthesia
Hiroki Iida, Kazuhiro Kito, Kumiko Tanabe
No abstract text is available yet for this article.
November 11, 2018: Journal of Anesthesia
Takahiro Tamura, Shuichi Yokota, Shigeki Ito, Yasuyuki Shibata, Kimitoshi Nishiwaki
PURPOSE: Previous work showed that 20 mL of local anesthetic (LA) did not spread into the paravertebral space (PVS) via the intramuscular quadratus lumborum block (QLBi). If spread of LA into the PVS can be achieved by increasing the total LA volume, QLBi can be more effective. We hypothesized that a larger volume of LA for the QLBi would spread into the PVS. METHODS: This crossover volunteer study included five healthy men. For comparison, both the ultrasound-guided QLB type 2 (QLB2) and QLBi were employed on opposite sides of each volunteer, and the spread of LA solution (0...
November 9, 2018: Journal of Anesthesia
Masahiko Tsuchiya, Koh Mizutani, Wasa Ueda
No abstract text is available yet for this article.
November 7, 2018: Journal of Anesthesia
Takahiko Kaneko, Nobutaka Kariya, Munetaka Hirose
PURPOSE: In healthy pregnant women undergoing Cesarean section, treatment of post-spinal hypotension (PSH) with phenylephrine is reportedly more efficacious than ephedrine in preventing a decline in umbilical artery pH (UApH), which is an indicator of fetal acidosis. However, phenylephrine has the potential to reduce placental blood flow and consequently decrease UApH in women who develop hypertensive disorders of pregnancy (HDP), due to decreased cardiac function and placental vascular abnormalities...
October 30, 2018: Journal of Anesthesia
Nobuko Fujita, Naida M Cole, Yasuko Nagasaka
The use of pain relief for labor has gained popularity in Japan. However, its acceptance is still low among laboring women: only 6.1% of Japanese parturients receive labor analgesia, in contrast with the United States, where approximately 70% receive labor analgesia. Unfortunately, several maternal deaths associated with labor analgesia have been reported in recent years in Japan and how to achieve safer obstetric care is a pressing concern. In this review, we focus on current approaches to labor analgesia in the United States as they compare to existing practices in Japan...
October 30, 2018: Journal of Anesthesia
Deokkyu Kim, Hyung-Sun Lim, Myung-Jong Kim, WooJoo Jeong, Seonghoon Ko
PURPOSE: The purpose of this study was to determine whether intraoperative infusion of remifentanil induces acute tolerance to opioids, and compare the postoperative pain and opioid consumption by the effect site concentrations of remifentanil. METHODS: One hundred and ninety-eight patients undergoing gastrectomy were randomly assigned to maintain target effect site concentrations of remifentanil at 0 (Group 1, n = 39), 2 (Group 2, n = 40), 4 (Group 3, n = 39), 8 (Group 4, n = 40), or 12 ng/ml (Group 5, n = 40) during operation...
October 29, 2018: Journal of Anesthesia
Kensuke Kobayashi, Soichiro Mimuro, Tsunehisa Sato, Atsushi Kobayashi, Shingo Kawashima, Hiroshi Makino, Matsuyuki Doi, Takasumi Katoh, Yoshiki Nakajima
PURPOSE: Heatstroke causes systemic inflammation, followed by vascular endothelial damage. The normal vascular endothelium is coated by endothelial glycocalyx (EGCX). Dexmedetomidine (DEX) has an anti-inflammatory effect, but there has been little investigation on the influence of heatstroke on EGCX and the effect of DEX on this condition. Therefore, we examined whether EGCX was disrupted in heatstroke and if DEX improved survival and preserves EGCX. METHODS: Anesthetized Wistar rats were randomly assigned to three groups: a DEX group treated with DEX (5 µg/kg/h) and 0...
October 29, 2018: Journal of Anesthesia
Fumimasa Amaya
No abstract text is available yet for this article.
October 26, 2018: Journal of Anesthesia
Kazuhiro Shirozu, Keitaro Murayama, Yuji Karashima, Hidekazu Setoguchi, Tomofumi Miura, Sumio Hoka
OBJECTIVES: Seizure duration and morphology, postictal suppression, and sympathetic nervous system activation are all recommended as assessments of adequate seizure in electroconvulsive therapy (ECT). However, blood pressure and heart rate are not typically assessed as part of sympathetic nervous system activation because of the administration of anesthetic or cardiovascular agents during ECT. Although the pupils are known to reflect to the activity of autonomic nervous system and the degree of brain damage, previous studies have not examined the relationship between seizure of electroconvulsive therapy and pupillary response...
October 16, 2018: Journal of Anesthesia
C J Lai, K C Yeh, M L Wang, W H Tai, Ya-Jung Cheng
PURPOSE: In patients receiving non-intubated video-assisted thoracic surgery (NIVATS), transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) has been applied instead of oxygen mask for better oxygenation. However, the THRIVE effects on intraoperative temperature decrease have not been investigated. METHODS: Pre- and postoperative temperatures, measured by an infrared tympanic ear thermometer, taken before sending patients to the operation room and immediately upon their arrival in the postoperative anesthesia unit, were collected from medical records of patients who received NIVATS either with oxygen mask or THRIVE...
October 15, 2018: Journal of Anesthesia
Berrin Gunaydin, Selin Erel
BACKGROUND AND AIM: Neuraxial analgesia techniques are not limited to just standard epidural and CSE blocks. A novel approach called dural puncture epidural (DPE) which is a modification of CSE in terms of practice has gained popularity after its description and use in the obstetric population.  The aim of this review is to address the practice of DPE technique as a novel option by reviewing its benefits as well as side and/or adverse effects and to understand how neuraxial labor analgesia differs by approach based on the information available in the current literature DISCUSSION: Despite controversies and concerns, more rapid onset of analgesia, early bilateral sacral analgesia, lower incidence of asymmetric block and fewer maternal and fetal side effects are provided with DPE when compared to epidural...
October 6, 2018: Journal of Anesthesia
Xiaowei Ding, Xingzhu Ju, Yan Lu, Wei Chen, Jiaqiang Wang, Changhong Miao, Jiawei Chen
PURPOSE: Angiotensin II (Ang II) has been shown to be involved in neurological disorders. Propofol demonstrated neuroprotective effects in neurons. METHODS: Mouse hippocampal HT22 cells were pre-treated with propofol, followed by Ang II treatment. The expression of synaptic proteins (synapsin I and PSD95) was examined. The effects of propofol on Ang II-induced NADPH oxidase expression and superoxide anion generation were examined. The effects of propofol on intracellular calcium concentration, the activation of calcium/calmodulin-dependent protein kinase II (CaMKII), and protein kinase C (PKC) were measured...
October 6, 2018: Journal of Anesthesia
Mostafa M Hussein
PURPOSE: Quadratus lumborum (QL) block has four approaches. However, there is difference between the four approaches regarding efficacy, safety and adverse effects. The primary objective of this study is to compare the analgesic effect between trans-muscular and intra-muscular approaches of the QL block in pediatric patients for elective lower abdominal surgery. METHODS: 54 patients aged between 1 and 6 years were enrolled. Patients of both genders were selected...
October 5, 2018: Journal of Anesthesia
Sachiko Yata, Mitsuru Ida, Hiroko Shimotsuji, Yosuke Nakagawa, Nobuhiro Ueda, Tsunenori Takatani, Hideki Shigematsu, Yasushi Motoyama, Hiroyuki Nakase, Tadaaki Kirita, Masahiko Kawaguchi
PURPOSE: The incidence of bite injuries associated with transcranial electrical stimulation motor-evoked potentials monitoring reportedly ranges from 0.13 to 0.19%. However, in clinical practice, bite injuries appear to occur more frequently than previously reported. Our aim was to identify the incidence of and perioperative risk factors associated with bite injuries caused by transcranial electrical stimulation motor-evoked potential monitoring. METHODS: Patients who underwent elective surgery with transcranial electrical stimulation motor-evoked potential monitoring at a single tertiary hospital in Japan between June 2017 and December 2017 were included in this study...
October 5, 2018: Journal of Anesthesia
Takashi Juri, Koichi Suehiro, Aya Kimura, Akira Mukai, Katsuaki Tanaka, Tokuhiro Yamada, Takashi Mori, Kiyonobu Nishikawa
PURPOSE: This study aimed to investigate the efficacy of the ClearSight™ system (Edwards Lifesciences, Irvine, CA) for reducing the incidence of hypotension compared with the traditional oscillometric blood pressure monitoring in cesarean delivery under spinal anesthesia. METHODS: Forty patients undergoing cesarean delivery under spinal anesthesia were enrolled. The patients were randomly divided into two groups (Control and ClearSight groups). All patients received spinal anesthesia using 0...
September 28, 2018: Journal of Anesthesia
Tianjiao Li, Shuo Zhang, Jiro Kurata
PURPOSE: Although cerebral structural and functional changes were uncovered by neuroimaging in patients with chronic low back pain (CLBP), their associations remain to be clarified. We co-analyzed anatomical and functional magnetic resonance imaging data in those patients and tested whether cortical gray matter volume changes are associated with altered pain modulatory networks underlying chronification of pain. METHODS: In 16 patients with CLBP and 16 heathy controls, we performed functional magnetic resonance imaging during mechanical pain stimulation on the lower back followed by anatomical imaging...
September 27, 2018: Journal of Anesthesia
Kris Vermeylen, F Soetens, I Leunen, A Hadzic, S Van Boxtael, J Pomés, A Prats-Galino, M Van de Velde, A Neyrinck, X Sala-Blanch
The fascia iliaca compartment is the compartment confined by the fascia iliaca (FI) and a muscular layer formed by the iliac- and psoas muscle. This compartment creates a virtual tunnel that contains the femoral nerve (FN), the obturator nerve (ON), and the lateral femoral cutaneous nerve (LFCN) of the lumbar plexus. In this pilot study, we aimed to determine the suggested volume needed to reach the three target nerves of the lumbar plexus (FN, ON, and LFCN) with a single-injection ultrasound-guided supra-inguinal fascia iliaca compartment (S-FICB)...
September 24, 2018: Journal of Anesthesia
Keisuke Jimbo, Yutaka Itsuji, Erika Kubo, Masamichi Kumagai, Kuniharu Masui, Yoshiro Yamamura
PURPOSE: Intravenous administration of the brand formulation of rocuronium bromide, currently used as a muscle relaxant, has been associated with vascular pain accompanied by withdrawal movements of the arm and wrist. The purpose of this study was to identify the cause of vascular pain induced by the brand formulation and to develop a new rocuronium formulation, not causing vascular pain, using a vascular pain-evoked flexor reflex response model of anesthetized rats. METHODS: A rat flexor reflex model, monitored by electromyography, was used to evaluate a flexor reflex response as the index of vascular pain...
September 21, 2018: Journal of Anesthesia
Rumiko Hosokawa, Shinichi Ito, Jun Hirokawa, Yu Oshima, Takeshi Yokoyama
PURPOSE: There are no sufficient evidences for the sedative effect of gabapentin during anesthesia, especially intravenous sedation (IVS). The purpose of this study was to evaluate the sedative effect of gabapentin as preanesthetic medication during the IVS with propofol. METHODS: 10 volunteer subjects joined this study. They underwent propofol IVS three times on separate days. On the first day, the IVS without gabapentin was performed as a control. On the second and the third day, gabapentin 200 mg and 400 mg were administered before the IVS, respectively...
September 20, 2018: Journal of Anesthesia
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