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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
Shiho Satomi, Shinji Kawahito, Hiroyuki Kinoshita
No abstract text is available yet for this article.
September 19, 2018: Journal of Anesthesia
Kirk J Levins, S Prendeville, S Conlon, D J Buggy
BACKGROUND: Clinical histological studies demonstrate that the distribution of natural killer (NK) cells, other immune cells and μ-opioid receptors (MOR) within cancer tissue can predict cancer prognosis. No clinical study has evaluated whether anesthetic technique influences immune cell and MOR expression within human breast cancer. METHODS: Excised preoperative biopsies and intraoperative breast cancer specimens from 20 patients randomly chosen from patients previously enrolled in an ongoing, prospective, randomized trial (NCT00418457) investigating the effect of anesthetic technique on long-term breast cancer outcome were immunohistochemically stained and microscopically examined by two independent investigators, masked to randomization, to quantify MOR and immune cell infiltration: CD56, CD57 (NK cells), CD4 (T helper cells), CD8 (cytotoxic T cells) and CD68 (macrophages)...
September 18, 2018: Journal of Anesthesia
Liu-Jia-Zi Shao, Fu-Shan Xue, Rui-Juan Guo
No abstract text is available yet for this article.
September 17, 2018: Journal of Anesthesia
Tatsuo Horiuchi, Tomonori Takazawa, Masaki Orihara, Shinya Sakamoto, Akihiko Yokohama, Junko Takahashi, Akihiro Tomioka, Nagahide Yoshida, Kazuaki Hagiwara, Shigeru Saito
PURPOSE: Identifying the causative agent of perioperative anaphylaxis is key to preventing its recurrence. Besides skin testing, the basophil activation test (BAT) is increasingly being accepted as an additional and reliable method. Cefazolin seems to be a major cause of perioperative anaphylaxis. However, few studies have described use of the BAT for cefazolin-induced anaphylaxis. In this study, we aimed to determine the optimum cefazolin concentration required in the BAT for an accurate diagnosis...
September 17, 2018: Journal of Anesthesia
Tak Kyu Oh, Sunghee Han, Ah-Young Oh, Saeyeon Kim, Jung-Hee Ryu
BACKGROUND: The relationship between preoperative hyperglycemia and postoperative acute kidney injury (AKI) occurrence in non-cardiac surgery including laparoscopic surgery remains unclear. This study aimed to assess the relationship between preoperative chronic hyperglycemia and postoperative AKI occurrence after a major laparoscopic abdominal surgery. METHODS: We retrospectively reviewed medical records of diabetic patients (≥ 20 years old) who underwent elective major laparoscopic abdominal surgery procedures between 2010 and 2016...
September 14, 2018: Journal of Anesthesia
Kun Niu, Hui Liu, Ruo-Wen Chen, Qi-Wu Fang, Hui Wen, Su-Mei Guo, John P Williams, Jian-Xiong An
PURPOSE: Nausea and vomiting are common, undesirable symptoms during cesarean section. We conducted this study to assess the antiemetic properties of propofol for the prevention and immediate treatment of post-delivery nausea and vomiting during cesarean section under combined spinal-epidural anesthesia. METHODS: Eighty women undergoing elective cesarean delivery under combined spinal-epidural anesthesia were randomized to receive either propofol at a plasma concentration of 1000 ng/mL or normal saline immediately after clamping of the umbilical cord...
September 12, 2018: Journal of Anesthesia
Tatsunori Watanabe, Koji Moriya, Naoto Tsubokawa, Hiroshi Baba
Opioid-related postoperative nausea and vomiting should not occur following remifentanil administration because of its relatively short time to elimination. However, studies have indicated that the incidence of postoperative nausea and vomiting associated with remifentanil is similar to that with other opioids. Hence, we aimed to determine whether intraoperative remifentanil itself is associated with postoperative nausea and vomiting when postoperative pain is managed without opioid use. In this prospective pilot study, 150 patients who underwent unilateral upper limb surgery under general anesthesia with brachial plexus block were included...
September 11, 2018: Journal of Anesthesia
Shigeru Maeda, Tsugunobu Andoh, Rieko Onishi, Yumiko Tomoyasu, Hitoshi Higuchi, Takuya Miyawaki
PURPOSE: Neuronal inflammation is caused by systemic inflammation and induces cognitive dysfunction. IL-6 plays a crucial role in therapies for neuronal inflammation and cognitive dysfunction. Remifentanil, an ultra-short-acting opioid, controls inflammatory reactions in the periphery, but not in the brain. Therefore, the anti-inflammatory effects of remifentanil in neuronal tissue and the involvement of cAMP in these effects were investigated in the present study. METHODS: Mice were divided into 4 groups: control, remifentanil, LPS, and LPS + remifentanil...
August 30, 2018: Journal of Anesthesia
Moustafa Abdelaziz Moustafa, Alaa A Kandeel
BACKGROUND: This study compared proximal and distal approaches of intercostobrachial nerve block (ICBNB) combined with infraclavicular brachial plexus block (ICBPB) during superficialization of arteriovenous fistula. METHODS: Seventy adult patients were randomized to receive ICBPB and 6 ml 0.25% bupivacaine at the level of the 3rd rib in the anterior axillary line between pectoralis minor and serratus anterior muscles (group P) or subcutaneously along the medial side of the upper arm (group D)...
August 23, 2018: Journal of Anesthesia
Manabu Yoshimura, Toshiyuki Nakanishi, Seishi Sakamoto, Takashi Toriumi
Precise identification of the femoral nerve (FN) is essential for an ultrasound-guided femoral nerve block. We hypothesized that the distance between the FN and the femoral artery (FA) is correlated with patient age. In this prospective observational study, we evaluated the FN-FA (from the lateral edge of the FA to the medial edge of the FN) distance [0.42 ± 0.42 (mean ± standard deviation) cm] in 102 patients using ultrasound. In addition, we calculated the cross-sectional area of the iliopsoas muscle using computed tomography or magnetic resonance imaging...
August 21, 2018: Journal of Anesthesia
Li-Jun Bo, Pei-Xia Yu, Fu-Zhen Zhang, Zhen-Ming Dong
BACKGROUND: Epidemiologic studies suggest the possibility of a modestly elevated risk of adverse neurodevelopmental outcomes in children exposed to anesthesia during early childhood. Sevoflurane is widely used in pediatric anesthetic practice because of its rapid induction and lower pungency. However, it is reported that sevoflurane leads to the long-term cognitive impairment. Some evidence revealed that the selective α2-adrenoreceptor agonist dexmedetomidine (DEX) exerts neuroprotective effects in various brain injury models of animals...
August 20, 2018: Journal of Anesthesia
Yuichi Ohgoshi, Yosuke Usui, Shinichi Ishikawa, Yoshimasa Takeda, Aiji Ohtsuka
Local anesthetic injection into the medial head of the semispinalis capitis muscle can anesthetize the greater occipital nerve (GON) and third occipital nerve (TON) simultaneously (greater and third occipital nerve block: GTO block). Alternatively, inter-semispinal plane (ISP) block can anesthetize the dorsal rami of the cervical spinal nerves from C4 to T4. The GON, TON, and the dorsal rami of the inferior level cannot be blocked with a single injection. To elucidate this phenomenon from an anatomical standpoint, we performed an ISP block either alone or with a GTO block using water-based acrylic dye in three thiel-embalmed cadavers...
August 20, 2018: Journal of Anesthesia
Kenichi Masui, Sayaka Ishigaki, Atsuko Tomita, Hiroshi Otake
PURPOSE: Equilibration rate constant is necessary to calculate effect-site concentration, which is useful to control drug effect. We developed pharmacodynamic models for published five compartmental pharmacokinetic models published by Wierda, Szenohradszky, Cooper, Alvarez-Gomez, and McCoy. METHODS: We used 3848 train-of-four ratios from 15 male and nine female patients (21-76 years; 44-93 kg body weight; 148-181 cm height; and 17.3-29.8 kg/m2 body mass index) as pharmacodynamic measures, which were collected at the start of 0...
August 11, 2018: Journal of Anesthesia
David P Martin, Walter P Samora, Allan C Beebe, Jan Klamar, Laura Gill, Tarun Bhalla, Giorgio Veneziano, Arlyne Thung, Dmitry Tumin, N'Diris Barry, Julie Rice, Joseph D Tobias
PURPOSE: To provide optimal conditions for neurophysiological monitoring and rapid awakening, remifentanil is commonly used during pediatric spinal surgery. However, remifentanil may induce hyperalgesia and increase postoperative opioid requirements. We evaluated the potential of methadone or magnesium to prevent remifentanil-induced hyperalgesia. METHODS: Using a prospective, randomized, blinded design, adolescents presenting for posterior spinal fusion to treat idiopathic scoliosis were assigned to receive desflurane with remifentanil alone (REMI), remifentanil + methadone (MET) (0...
August 4, 2018: Journal of Anesthesia
Taisuke Yokota, Shigehiko Uchino, Takuo Yoshida, Tomoko Fujii, Masanori Takinami
PURPOSE: Although new-onset atrial fibrillation (AF) is frequently observed in the intensive care unit (ICU), the incidence and predictors for sustained new-onset AF have not been investigated, except for cardiac surgery patients. We have evaluated potential predictors for sustained new-onset AF in a mixed ICU. METHODS: In this retrospective observational study, we screened non-cardiac surgery patients who were admitted to the ICU between January 2010 and December 2013 and had been hospitalized for > 24 h in the ICU...
July 31, 2018: Journal of Anesthesia
Minako Ishii-Maruhama, Hitoshi Higuchi, Mai Nakanou, Yuka Honda-Wakasugi, Akiko Yabuki-Kawase, Shigeru Maeda, Takuya Miyawaki
PURPOSE: It has been reported that oral valproate (VPA) reduces the dose of propofol required for sedation. As  a potential reason for this, it is considered that VPA displaces serum protein-bound propofol and increases the proportion of protein-unbound-free propofol. To examine this hypothesis, the present in vitro study investigated the influence of VPA on the proportion of protein-unbound-free propofol in human serum samples. METHODS: Serum samples were collected from 10 healthy volunteers, who were not taking any medication...
July 30, 2018: Journal of Anesthesia
Makoto Sato, Tomoki Sasakawa, Yuki Izumi, Yoshiko Onodera, Takayuki Kunisawa
PURPOSE: The purpose of this study was to compare the ultrasound image quality at three different transducer positions for ultrasound-guided lumbar plexus block (LPB). METHODS: This prospective comparative study included 30 patients who underwent total hip arthroplasty under general anesthesia in combination with LPB. Using the same ultrasound machine settings for each patient, a transverse view of the lumbar plexus (LP) at the L3-4 vertebral level was obtained with a convex transducer placed at three different positions: immediately lateral to the dorsal midline (medial position), almost 5 cm lateral to the dorsal midline (paravertebral position), and at the abdominal transverse flank (shamrock position)...
July 30, 2018: Journal of Anesthesia
Salim Kadhim, John McDonald, David G Lambert
Neuropathic pain is a common health problem that affects millions of people worldwide. Despite being studied extensively, the cellular and molecular events underlying the central immunomodulation and the pathophysiology of neuropathic pain is still controversial. The idea that 'glial cells are merely housekeepers' is incorrect and with respect to initiation and maintenance of neuropathic pain, microglia and astrocytes have important roles to play. Glial cells differentially express opioid receptors and are thought to be functionally modulated by the activation of these receptors...
July 27, 2018: Journal of Anesthesia
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