Journal of Anesthesia

دسترسی یکساله به بیش از ۵۰۰ ژورنال روز جهان موجود در سامانه

ﻣﺪﺕ ﺯﻣﺎﻥ : 365 ﺭﻭﺯ
~~قیمت : 3,800,000 تومان~~
قیمت ویژه : 1,900,000تومان

سفارش

Training in pediatric anesthesia in Japan: how should we come along?

Soichiro Obara & Norifumi Kuratani

doi : 10.1007/s00540-020-02859-8

Journal of Anesthesia volume 35, pages471–474 (2021)

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Accuro ultrasound-based system with computer-aided image interpretation compared to traditional palpation technique for neuraxial anesthesia placement in obese parturients undergoing cesarean delivery: a randomized controlled trial

Xiu Ni, Meng-zhu Li, Shuang-qiong Zhou, Zhen-dong Xu, Yue-qi Zhang, Yi-bing Yu, Jing Su, Li-min Zhang & Zhi-qiang Liu

doi : 10.1007/s00540-021-02922-y

Journal of Anesthesia volume 35, pages475–482 (2021)

Recently, a new handheld ultrasound-based device, called Accuro, has been commercialized with a real-time automated interpretation of lumbar ultrasound images. We hypothesized that the handheld ultrasound device would improve the efficacy and safety of combined spinal-epidural anesthesia (CSEA) for cesarean delivery in obese parturients.

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Effects of estimated glomerular filtration rate and diabetes mellitus on the effect of insulin for treating hyperkalemia during anesthesia

Youngsuk Kwon, Jong Ho Kim, Juhyun Yoon, Jaehyun Park, Sang Soo Kang & Sung Mi Hwang

doi : 10.1007/s00540-021-02933-9

Journal of Anesthesia volume 35, pages483–487 (2021)

We analyzed the effectiveness of insulin for treating hyperkalemia (??5 mEq/L) during anesthesia and the effects of the estimated glomerular filtration rate (eGFR) and diabetes mellitus (DM) on the insulin treatment.

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Assessing volume responsiveness using right ventricular dynamic indicators of preload

Michael F. Graessler, Karin H. Wodack, Hans O. Pinnschmidt, Sarah Nishimoto, Christoph R. Behem, Daniel A. Reuter & Constantin J. C. Trepte

doi : 10.1007/s00540-021-02937-5

Journal of Anesthesia volume 35, pages488–494 (2021)

Dynamic indicators of preload currently only do reflect preload requirements of the left ventricle. To date, no dynamic indicators of right ventricular preload have been established. The aim of this study was to calculate dynamic indicators of right ventricular preload and assess their ability to predict ventricular volume responsiveness.

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Long-term survival differences between sevoflurane and propofol use in general anesthesia for gynecologic cancer surgery

Eriko Takeyama, Masaaki Miyo, Hisanori Matsumoto, Kenji Tatsumi, Eizo Amano, Motohiro Hirao & Hiromi Shibuya

doi : 10.1007/s00540-021-02941-9

Journal of Anesthesia volume 35, pages495–504 (2021)

This study aimed to evaluate the influence of anesthetic management with propofol or sevoflurane on the prognosis of patients undergoing gynecologic cancer surgery.

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Predictors of one year chronic post-surgical pain trajectories following thoracic surgery

Christopher W. Liu, M. Gabrielle Page, Aliza Weinrib, Dorothy Wong, Alexander Huang, Karen McRae, Joseph Fiorellino, Diana Tamir, Michael Kahn, Rita Katznelson, Karim Ladha, Faraj Abdallah, Marcelo Cypel, Kazuhiro Yasufuku, Vincent Chan, Monica Parry, James Khan, Joel Katz & Hance Clarke

doi : 10.1007/s00540-021-02943-7

Journal of Anesthesia volume 35, pages505–514 (2021)

Chronic post-surgical pain (CPSP) is a highly prevalent complication following thoracic surgery. This is a prospective cohort study that aims to describe the pain trajectories of patients undergoing thoracic surgery beginning preoperatively and up to 1 year after surgery

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Effectiveness of nebulized dexmedetomidine for treatment of post-dural puncture headache in parturients undergoing elective cesarean section under spinal anesthesia: a randomized controlled study

Sherif M. S. Mowafy & Shereen E. Abd Ellatif

doi : 10.1007/s00540-021-02944-6

Journal of Anesthesia volume 35, pages515–524 (2021)

The need for effective treatment for post-dural puncture headache (PDPH) is a growing research entity. This study aimed to test the effectiveness of additional dexmedetomidine (DEX) to PDPH conservative management and evaluate its cerebral hemodynamic effects trans-cranial Doppler.

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Effects of dexmedetomidine sedation for magnetic resonance imaging in children: a systematic review and meta-analysis

Ji Yoon Kim, Kyu Nam Kim, Dong Won Kim, Hyun Jin Lim & Bong Soo Lee

doi : 10.1007/s00540-021-02946-4

Journal of Anesthesia volume 35, pages525–535 (2021)

Pediatric sedation is commonly required to obtain high-quality images in magnetic resonance imaging (MRI). We performed a systematic review and meta-analysis to assess the effects of dexmedetomidine sedation for MRI in children.

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Comparison between the effects of normal saline with and without heparin for the prevention and management of arterial catheter occlusion: a triple-blinded randomized trial

Takahiro Tamura, Eri Kobayashi, Mariko Kawaguchi, Yuki Matsuoka, Akiko Fujii, Masahiko Ando, Yoko Kubo, Takahiro Imaizumi, Yasuhiro Miyagawa, Takayuki Inagaki & Kimitoshi Nishiwaki

doi : 10.1007/s00540-021-02949-1

Journal of Anesthesia volume 35, pages536–542 (2021)

We aimed to compare the effects of saline with and without heparin on the catheter-occlusion rate and coagulation-related blood test results for the management of arterial catheters among patients admitted to a short-term intensive care unit postoperatively.

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Development of a multi-patient ventilator circuit with validation in an ARDS porcine model

Benjamin P. Wankum, Riley E. Reynolds, Andrea R. McCain, Nathaniel T. Zollinger, Keely L. Buesing, Russel D. Sindelar, Frank M. Freihaut, Tariku Fekadu & Benjamin S. Terry

doi : 10.1007/s00540-021-02948-2

Journal of Anesthesia volume 35, pages543–554 (2021)

The COVID-19 pandemic threatens our current ICU capabilities nationwide. As the number of COVID-19 positive patients across the nation continues to increase, the need for options to address ventilator shortages is inevitable. Multi-patient ventilation (MPV), in which more than one patient can use a single ventilator base unit, has been proposed as a potential solution to this problem. To our knowledge, this option has been discussed but remains untested in live patients with differing severity of lung pathology.

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Anesthetic strategy for obese patients during gastroscopy: deep sedation or conscious sedation? A prospective randomized controlled trial

Shuai Kang, Jian Lu & Hong-mei Zhou

doi : 10.1007/s00540-021-02951-7

Journal of Anesthesia volume 35, pages555–562 (2021)

This paper aims to compare the incidence of SpO2 values?<?95% and?<?90% of the obese patients between conscious sedation and deep sedation and whether conscious sedation was superior to the deep sedation for obese patients during diagnostic gastroscopy.

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Multisystem inflammatory syndrome in children during the coronavirus disease pandemic of 2019: a review of clinical features and acute phase management

Naohiro Shioji, Kazuyoshi Aoyama, Marina Englesakis, Gail Annich & Jason T. Maynes

doi : 10.1007/s00540-021-02952-6

Journal of Anesthesia volume 35, pages563–570 (2021)

The current coronavirus disease of 2019 (COVID-19) pandemic has presented unique health challenges in the pediatric population. Compared to adults, the most significant change in viral disease manifestation is encompassed by the multisystem inflammatory syndrome in children (MIS-C). MIS-C is a new inflammatory syndrome which develops 2–4 weeks after COVID-19 exposure, with evidence suggesting it is a post-infectious immune reaction. We describe its epidemiology, pathophysiology, diagnosis (which varies based on definition used) and treatment options based on published recommendations. A systematic literature search we conducted through MEDLINE yielded 518 abstracts and identified five studies that reported more than 100 cases of MIS-C and their mortality. Most cases developed multiorgan dysfunction, including cardiovascular, dermatologic, neurological, renal, and respiratory issues, and required intensive care unit (ICU) admission. Many patients admitted to the ICU needed inotrope support and invasive mechanical ventilation, and the most severe cases required extracorporeal membrane oxygenation support. Most clinicians treated MIS-C with intravenous immunoglobulin, systemic steroids, and biological therapies. Overall mortality was low (2–3%) in all studies. Further research is needed to: understand if early intervention can prevent its progression; optimize its treatment; and improve outcomes of this new syndrome for the patients who develop MIS-C.

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Remimazolam anaphylaxis during anesthesia induction

Kota Tsurumi, Shinji Takahashi, Yoshiyuki Hiramoto, Kazuhiro Nagumo, Tomonori Takazawa & Yoichiro Kamiyama

doi : 10.1007/s00540-021-02934-8

Journal of Anesthesia volume 35, pages571–575 (2021)

Anaphylactic shock is a potentially lethal complication during anesthesia and requires appropriate management to save the patient’s life. We report a 32-year-old man who developed anaphylaxis during induction of general anesthesia with remimazolam for hand surgery. He received general anesthesia with midazolam 4 weeks before. This time facial flushing followed by a decrease of peripheral oxygen saturation (SpO2) and blood pressure occurred 2 min after starting continuous remimazolam infusion at 6 mg/kg/h. Hypotension and SpO2 were recovered by repeated administration of adrenaline. Despite no increase of serum tryptase levels, intradermal allergy tests 4 weeks postoperatively revealed that remimazolam and midazolam were positive, suggesting remimazolam as a causative agent for anaphylaxis. In the previous surgery, midazolam, which has a similar structure to remimazolam, may have caused sensitization. This is probably the first case report of anaphylaxis caused by remimazolam.

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Factors associated with quality of dreams during general anesthesia: a prospective observational study

Akari Yoshida, Keisuke Fujii, Takanori Yoshikawa & Tomoyuki Kawamata

doi : 10.1007/s00540-021-02942-8

Journal of Anesthesia volume 35, pages576–580 (2021)

Patients frequently report having dreams during general anesthesia, and the dreams are often reported to be pleasant dreams. However, factors associated with the quality of dreams during general anesthesia have not been clarified. The aim of this study was to determine the relationships between the quality of dreams during general anesthesia and perioperative factors. This prospective observational study included patients scheduled for elective surgery under general anesthesia. Preoperative mental status was assessed by the Hospital Anxiety and Depression Scale (HADS). A postoperative interview was carried out in the operating room after recovery from general anesthesia. Dreams and awareness during general anesthesia were assessed by a modified Brice interview. The quality of dreams was classified in accordance with the patient’s own opinion as pleasant, indifferent, or unpleasant. A total of 1100 patients were included in the study, and 293 (25.4%) of the patients reported having dreams during anesthesia. Half of the patients who experienced dreams during anesthesia (50.2%, 147/293 patients) reported having a pleasant dream. Multivariate logistic regression analysis revealed that only HADS-depression score of less than 11 was related to pleasant dreams (OR: 3.3 [95% CI 1.3–10.0]).

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Effect of remimazolam on intraoperative neuromonitoring during thyroid surgery: a case series

Kengo Hayamizu, Tomohiro Chaki, Shunsuke Tachibana, Naoyuki Hirata & Michiaki Yamakage

doi : 10.1007/s00540-021-02955-3

Journal of Anesthesia volume 35, pages581–585 (2021)

Intraoperative neuromonitoring is widely used to prevent accidental injury during thyroid surgery. Anesthesia should be performed without muscle relaxant or agents with high muscle-relaxant potency. Remimazolam, a novel intravenous anesthetic, became available for clinical use in 2020. Remimazolam is an ultra-short-acting benzodiazepine with a very high clearance rate. However, there are very few data regarding its effect on currently used intraoperative neurological monitoring. Five patients underwent thyroid surgery using intraoperative recurrent laryngeal neuromonitoring. In all cases, intubation was performed after the administration of rocuronium. Anesthesia was maintained by continuous administration of remimazolam at the recommended dose and remifentanil, and no additional rocuronium or sugammadex was administered. Recurrent laryngeal nerve activity could be detected at the first stimulus after surgery was started, and monitoring continued thereafter. Intraoperative monitoring was performed without problems and all surgeries were completed without any complications. Anesthesia with remimazolam at the normal dose did not prolong the time to first positive electromyogram in patients undergoing thyroid surgery, and enables intraoperative recurrent laryngeal nerve monitoring to be performed without any serious perioperative adverse events. Remimazolam may provide a comparable quality of anesthesia to that of existing drugs for neuromonitoring during thyroid surgery.

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Glucose control using an artificial pancreas in a severe COVID-19 patient on extracorporeal membrane oxygenation: a case report

Takuya Hinoue, Tomoaki Yatabe, Himuro Fujiwara & Osamu Nishida

doi : 10.1007/s00540-021-02965-1

Journal of Anesthesia volume 35, pages586–590 (2021)

The usefulness and safety of continuous glucose monitoring (CGM) systems in adult patients with severe coronavirus disease (COVID-19) have been reported. Using CGM might reduce the exposure patients and healthcare workers to COVID-19 and limit the use of personal protective equipment during the pandemic. CGM devices measure glucose in the subcutaneous interstitial fluid, but the accuracy of this technique has not been established in critically ill patients. The artificial pancreas, STG-55 (Nikkiso, Tokyo), is a closed-loop device that conducts continuous blood glucose monitoring using a peripheral vein. We used the STG-55 for glucose control in a 60-year-old woman with severe COVID-19 admitted to the intensive care unit. Due to severe respiratory failure, the patient was intubated, and extracorporeal membrane oxygenation was introduced. Because she had hyperglycemia despite high-dose intravenous insulin therapy, we decided to use STG-55 for glucose control. The STG-55 safely titrated the insulin infusion and monitored glucose levels. Fifty-six hours after adopting the STG-55, it was removed because the blood sampling failed. No episodes of hypoglycemia were observed despite deep sedation during this period. In conclusion, this case demonstrates the potential utility of an artificial pancreas in patients with severe COVID-19.

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A real-time anatomy ?dentification via tool based on artificial ?ntelligence for ultrasound-guided peripheral nerve block procedures: an accuracy study

Irfan Gungor, Berrin Gunaydin, Suna O. Oktar, Beyza M.Buyukgebiz, Selin Bagcaz, Miray Gozde Ozdemir & Gozde Inan

doi : 10.1007/s00540-021-02947-3

Journal of Anesthesia volume 35, pages591–594 (2021)

We aimed to assess the accuracy of an artificial intelligence (AI)-based real-time anatomy identification software specifically developed to ease image interpretation intended for ultrasound-guided peripheral nerve block (UGPNB). Forty healthy participants (20 women, 20 men) were enrolled to perform interscalene, supraclavicular, infraclavicular, and transversus abdominis plane (TAP) blocks under ultrasound guidance using AI software by anesthesiology trainees. During block practice by a trainee, once the software indicates 100% scan success of each block associated anatomic landmarks, both raw and labeled ultrasound images were saved, assessed, and validated using a 5-point scale by expert validators. When trainees reached 100% scan success, accuracy scores of the validators were noted. Correlation analysis was used whether the relationship (r) according to demographics (gender, age, and body mass index: BMI) and block type exist. The BMI (kg/m2) and age (year) of participants were 22.2?±?3 and 32.2?±?5.25, respectively. Assessment scores of validators for all blocks were similar in male and female individuals. Mean assessment scores of validators were not significantly different according to age and BMI except for TAP block, which was inversely correlated with age and BMI (p?=?0.01). AI technology can successfully interpret anatomical structures in real-time sonography while assisting young anesthesiologists during UGPNB practice.

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Utility of three-dimensional modeling of the fetal airway for ex utero intrapartum treatment

Shahar Shalev, Liat Ben-Sira, Oshri Wasserzug, Ruth Shaylor, Shelly I. Shiran & Margaret Ekstein

doi : 10.1007/s00540-021-02950-8

Journal of Anesthesia volume 35, pages595–598 (2021)

Recent technological developments in three-dimensional (3D) printing have created new opportunities for applications in clinical medicine. 3D printing has been adopted for teaching and planning complicated surgeries, including maxillofacial, orthopedic reconstructions, and airway manipulation for one-lung ventilation or airway stenting. We present here the first use of such technology to print a model from in utero imaging for intrapartum treatment planning. A 32-week fetus presented with congenital high airway obstruction syndrome (CHAOS) due to a large cervical lymphatic malformation. An ex utero intrapartum treatment (EXIT) procedure was planned to allow delivery of a viable infant. We printed a 3D model of the fetal airway by printing separate elements: mandible, tongue, mass, larynx, and trachea from the fetal MRI. The elements were stuck together maintaining correct anatomical relationships. Airway planning was then performed in consultation with a pediatric ear nose and throat (ENT) surgeon. 3D modeling in utero presents many challenges: the resolution of the 3D model generated from a fetal MRI is less crisp than from CT images, fetal position may be variable and not in a defined anatomical plane, movement artifact occurs. Nevertheless, pre-procedure simulations with the aid of 3D modeling promoted team cooperation and well-prepared management of the fetus during EXIT.

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