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Journal of Clinical Anesthesia

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https://www.readbyqxmd.com/read/28081990/can-we-use-lower-volume-of-local-anesthetic-for-infraclavicular-brachial-plexus-nerve-block-under-ultrasound-guidance-in-children
#1
Ilker Ince, Mehmet Aksoy, Aysenur Dostbil, Kutsi Tuncer
OBJECTIVES: To determine if the infraclavicular brachial plexus block can be applied with lower volume of local anesthetic. DESIGN: Randomised, double-blinded clinical trial. PATIENTS: 60 patients aged 5-15years with ASA I-II who underwent emergent or elective arm, forearm or hand operations were included in the study. INTERVENTIONS: Patients were divided into two groups randomly; standard volume local anesthetic administered group (Group S, n=30) and low volume anesthetic administered group (Group L, n=30)...
January 9, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28077252/incorporating-body-type-apple-vs-pear-in-stop-bang-questionnaire-improves-its-validity-to-detect-osa
#2
Lisa Sangkum, Ikrita Klair, Chok Limsuwat, Sabrina Bent, Leann Myers, Supat Thammasitboon
STUDY OBJECTIVE: The aim of this study is to evaluate whether adding the item of "apple body type" to the STOP-BANG questionnaire enhances diagnostic performance of the questionnaire for detecting obstructive sleep apnea (OSA). DESIGN: Cross-sectional study. SETTING: Sleep center setting. PATIENTS: Two hundred and eight subjects who were referred for an evaluation of possible OSA at Tulane Comprehensive Sleep Center...
January 8, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235540/determination-of-the-diagnostic-value-of-the-modified-mallampati-score-upper-lip-bite-test-and-facial-angle-in-predicting-difficult-intubation-a-prospective-descriptive-study
#3
Ata Mahmoodpoor, Hassan Soleimanpour, Samad Ej Golzari, Arezoo Nejabatian, Tannaz Pourlak, Masoumeh Amani, Saeed Hajmohammadi, Hamzeh Hosseinzadeh, Robab Mehdizadeh Esfanjani
BACKGROUND: Difficult intubation is a significant cause of mortality and morbidity related to anesthesia. We decided to evaluate the value of Modified Mallampati Score, Upper Lip Bite Test and Facial Angle in the prediction of difficult intubation. METHODS: In a prospective descriptive study, data from 132 patients who were candidates for elective maxillofacial surgeries under general anesthesia were gathered. Facial Angles were measured by a maxillofacial surgeon according to cephalometry...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235539/combination-of-femoral-and-genitofemoral-nerve-blocks-is-effective-for-endovascular-aneurysm-repair
#4
LETTER
Yuichi Ohgoshi, Masako Takeda, Mari Miura, Shoichi Kori, Masakazu Matsukawa
No abstract text is available yet for this article.
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235538/perioperative-opioid-administration-in-children-with-and-without-developmental-delay-undergoing-outpatient-dental-surgery
#5
Erin R Conner, Erica D Musser, Kelsey M Colpitts, Dean L Laochamroonvorapongse, Jeffrey L Koh
STUDY OBJECTIVE: Prior research has indicated that children with developmental delay (DD) experience qualitative and quantitative differences in health care (Boulet et al., 2009). In the perioperative setting, there is concern that children with DD may be more likely to experience postoperative complications including agitation and nausea/vomiting than typically developing patients (TDP). Differences in the administration and dosage of perioperative opioids may contribute to this, however, empirical investigations are lacking...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235537/the-concentration-of-desflurane-preventing-spectral-entropy-change-during-surgical-stimulation-a-prospective-randomized-trial
#6
Sun-Sook Han, Sunghee Han, Byung-Gook Kim, Dong-Ho Kim, Jung-Hee Ryu
STUDY OBJECTIVE: To determine the concentration of desflurane necessary to blunt changes in spectral entropy during surgical incision when two different target-controlled effect-site concentrations of remifentanil (1 and 3ng/ml) were infused. DESIGN: Prospective, randomized controlled study. SETTING: Operating room of a university hospital. INTERVENTIONS: Forty-two patients undergoing general anesthesia for elective surgery were enrolled and randomly allocated to the R1 (1ng/ml of remifentanil, n=21) or R3 (3ng/ml of remifentanil, n=21) group...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235536/the-use-of-ultrasound-in-planned-cesarean-delivery-under-spinal-anesthesia-for-patients-having-nonprominent-anatomic-landmarks
#7
Mursel Ekinci, Hacı Ahmet Alici, Ali Ahiskalioglu, Ilker Ince, Mehmet Aksoy, Erkan Cem Celik, Aysenur Dostbil, Mine Celik, Pinar Karaca Baysal, Birzat Emre Golboyu, Ayşe Nur Yeksan
STUDY OBJECTIVE: The aim of the study was to compare conventional landmark method with ultrasound-guided spinal anesthesia in cesarean delivery cases where spinous processes and interspinous spaces were not prominent on physical examination. DESIGN: Randomized controlled clinical trial. SETTING: Operating rooms of university hospital of Erzurum, Turkey. PATIENTS: Sixty-four 18- to 45-year-old American Society of Anesthesiologists I-II patients scheduled for cesarean delivery under spinal anesthesia having hardly palpated anatomic landmarks on vertebral column...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235535/the-effect-of-second-stage-pushing-and-body-mass-index-on-postdural-puncture-headache
#8
Amber M Franz, Shawn Y Jia, Henry T Bahnson, Akash Goel, Ashraf S Habib
STUDY OBJECTIVE: To explore how pushing during labor and body mass index affect the development of postdural puncture headache in parturients who experienced dural puncture with Tuohy needles. DESIGN: Retrospective cohort. SETTING: Obstetric ward and operating rooms at a university-affiliated hospital. PATIENTS: One hundred ninety parturients who had witnessed dural puncture with 17 or 18 gauge Tuohy needles from 1999-2014...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235534/case-reports-should-we-do-away-with-them
#9
Aynur Camkiran Firat, Coskun Araz, Zeynep Kayhan
STUDY OBJECTIVE: There has been a gradual decline in the number of case reports published in leading medical journals in recent years. Since case reports are not highly cited they have an adverse effect on the journal impact factor. On the other hand sharing new experiences, challenges, or discoveries with colleagues is essential for medical community. Should case reports be eliminated from the journals or published only in journals devoted to case reports? DESIGN: Observational study...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235533/comparison-of-ropivacaine-with-and-without-fentanyl-vs-bupivacaine-with-fentanyl-for-postoperative-epidural-analgesia-in-bilateral-total-knee-replacement-surgery
#10
Ashish Khanna, Rakesh Saxena, Amitabh Dutta, Neelam Ganguly, Jayashree Sood
STUDY OBJECTIVES: Pain after total knee replacement (TKR) interferes with early rehabilitation. Although the use of epidural bupivacaine in post-TKR patients is associated with effective analgesia, the associated motor blockade effect delays functional recovery. We compared analgesic efficacy and side effects of postoperative patient-controlled epidural analgesia (PCEA) with plain ropivacaine 0.1% with/without fentanyl 2.5 μg/mL vs plain bupivacaine 0.0625% with fentanyl 2.5 μg/mL in patients undergoing bilateral TKR...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235532/massive-blood-loss-in-elective-spinal-and-orthopedic-surgery-retrospective-review-of-intraoperative-transfusion-strategy
#11
Demicha Rankin, Alix Zuleta-Alarcon, Suren Soghomonyan, Mahmoud Abdel-Rasoul, Karina Castellon-Larios, Sergio D Bergese
OBJECTIVE: To evaluate the perioperative dynamics of hematologic changes and transfusion ratio in patients undergoing a major spinal surgery accompanied with massive bleeding defined as blood loss >5 liters. DESIGN: Retrospective cohort study. SETTING: Operating room of a university-affiliated hospital. PATIENTS: Adult patients who underwent elective neurosurgical, orthopedic, or combined spinal surgical procedure between 2008 and 2012...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235531/effects-of-the-concurrent-use-of-a-reduced-dose-of-propofol-with-divided-supplemental-remifentanil-and-moderate-hyperventilation-on-duration-and-morphology-of-electroconvulsive-therapy-induced-electroencephalographic-seizure-activity-a-randomized-controlled
#12
Kohki Nishikawa, Michiaki Yamakage
STUDY OBJECTIVE: The clinical adequacy of electroconvulsive therapy (ECT) depends on not only seizure duration but also seizure amplitude and postictal suppression. The objective of this study was to evaluate the effects of combination of a reduced dose of propofol and moderate hyperventilation on seizure duration and electrical stimulus requirement for adequate ictal amplitude and postictal suppression. DESIGN: Prospective, randomized, controlled trial. SETTING: Operating room at a municipal hospital...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235530/intraoperative-aberrant-bispectral-index-values-due-to-facial-nerve-monitoring
#13
Dhritiman Chakrabarti, Rohini Mrugank Surve, Deepti Bs, Dheeraj Masapu
Bispectral index is an accepted depth of anaesthesia monitor for guiding intraoperative hypnotic agent administration. Frontalis EMG displayed on BIS monitor may increase due to twitching of frontalis muscle. EMG increases are also known to cause artefactual increases in BIS values. We report a case of artefactual increase of EMG and subsequently BIS values, due to electrical artefact from cranial nerve stimulator being used to identify the facial nerve. An explanation of the effect of stimulator signal on BIS EMG and BIS values has been provided...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235529/dexmedetomidine-decreases-the-required-amount-of-bupivacaine-for-ultrasound-guided-transversus-abdominis-plane-block-in-pediatrics-patients-a-randomized-study
#14
Rehab Abdel Raof, Shahira Ahmed El Metainy, Doaa Abou Alia, Moataza Abdel Wahab
BACKGROUND: The effect of dexmedetomidine on the potency of bupivacaine for transversus abdominis plane (TAP) block in pediatric patients has not been investigated. STUDY OBJECTIVE: The primary objective of this study was to assess the effectiveness of dexmedetomidine to decrease the concentration of bupivacaine needed for analgesia for ultrasound-guided TAP block in a pediatric patient undergoing hernia repair or hydrocelectomy. DESIGN: This is a randomized, double-blind, up-down, dose-finding study...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235528/effects-of-pneumoperitoneum-on-severe-hypernatremia-in-an-adult-patient-who-underwent-laparoscopic-surgery-of-hydatid-cysts
#15
Diego Anta, José M Beleña, Raquel Álvarez, Mónica Núñez
We describe the first case of severe hypernatremia associated to laparoscopic surgery for hydatid cyst in an adult patient after the use of hypertonic saline solution with complete resolution. Severe hypernatremia is an unusual fact at the immediate postoperative period but may have fatal consequences for the patient and need immediate action. The patient reached a serum sodium concentration of 179 mmol/L without adverse effects after 6 days of treatment. Laparoscopy could play a crucial role in Na(+) absorption due to high intraabdominal pressure caused by the pneumoperitoneum and its limitations to avoid peritoneal absorption of hypertonic saline solution...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235527/a-patient-with-postpolio-syndrome-developed-cauda-equina-syndrome-after-neuraxial-anesthesia-a-case-report
#16
Wei-Cheng Tseng, Zhi-Fu Wu, Wen-Jinn Liaw, Su-Yang Hwa, Nan-Kai Hung
Combined spinal anesthesia and postoperative epidural analgesia is widely used in orthopedic surgery. Uncommon but serious neurologic complications of neuraxial anesthesia (NA) include direct trauma during needle or catheter insertion, central nervous system infections, and neurotoxicity of local anesthetics. Cauda equina syndrome (CES) is a rare complication after NA but can result in severe neurologic deterioration that may require surgical intervention. We present a case of a 69-year-old woman with postpolio syndrome who developed CES after combined spinal anesthesia and postoperative epidural analgesia...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235526/cardiac-output-changes-with-phenylephrine-and-ephedrine-infusions-during-spinal-anesthesia-for-cesarean-section-a-randomized-double-blind-trial
#17
W Mon, A Stewart, R Fernando, K Ashpole, N El-Wahab, S MacDonald, P Tamilselvan, M Columb, Y M Liu
Hypotension is a common side effect of spinal anesthesia. Phenylephrine and ephedrine are the two most frequently used vasopressors to treat spinal hypotension during cesarean delivery. In this randomized double-blind study, we aimed to evaluate cardiac output (CO) changes with phenylephrine or ephedrine infusions titrated to maintain baseline systolic blood pressure (bSBP) during spinal anesthesia. Women (n = 40) scheduled for elective cesarean delivery received either phenylephrine 100 μg/min or ephedrine 5 mg/min infusions...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235525/iatrogenic-tracheal-laceration-in-the-setting-of-chronic-steroids
#18
Punit Singh, Margaret Wojnar, Anita Malhotra
We report the case of a 71-year-old woman with end-stage chronic obstructive pulmonary disease who presented with a 10-cm tracheal laceration from a presumed traumatic intubation in the setting of respiratory distress and chronic obstructive pulmonary disease exacerbation and subsequently developed significant subcutaneous emphysema along her neck and mediastinum in addition to her peritoneum and mesentery. We were successfully able to treat this patient conservatively up until the time that tracheostomy was warranted...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235524/awake-tracheal-intubation-in-anticipated-difficult-airways-lma-fastrach-vs-flexible-bronchoscope-a-pilot-study
#19
Sherine F Hanna, Marianne Mikat-Stevens, James Loo, Raj Uppal, W Scott Jellish, Matthew Adams
STUDY OBJECTIVE: To compare the use of LMA Fastrach intubating laryngeal mask airway (ILMA) to flexible bronchoscopy (FB) for awake intubation in patients with difficult airways. DESIGN: Randomized prospective study. SETTING: Large academic medical center. PATIENTS: Forty adult patients, American Society of Anesthesiologists I-IV, meeting the criteria for awake intubation based on history and physical examination. INTERVENTIONS: After sedation and airway topicalization, patients were randomized to either FB group, n=19, or ILMA group, n=21...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235523/fast-track-anesthesia-in-patients-undergoing-outpatient-laparoscopic-cholecystectomy-comparison-of-sevoflurane-with-total-intravenous-anesthesia
#20
Ceyda Özhan Çaparlar, Mehmet Özgür Özhan, Mehmet Anıl Süzer, Dilek Yazicioğlu, Mehmet Burak Eşkin, Serkan Şenkal, Mehmet Ali Çaparlar, Ersin Özkan Imren, Bülent Atik, Nedim Çekmen
BACKGROUND: The use of short-acting anesthetics has introduced a "fast-track anesthesia" concept in outpatient surgery which provides discharge of the patients from operation room directly to the phase II recovery area without entering into postanesthesia care unit. The aim of this prospective and randomized study was to compare general anesthesia using sevoflurane with propofol-remifentanil-based total intravenous anesthesia (TIVA) for fast-track eligibility in patients undergoing outpatient laparoscopic cholecystectomy...
February 2017: Journal of Clinical Anesthesia
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