MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Journal of Clinical Anesthesia' source. Tue, 16 Mar 2010 13:42:41 +0100 http://www.medworm.com/index.php?rid=3343388&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003535%2Fabstract%3Frss%3Dyes We read with interest the report of Austin and Parke , regarding the comparative effects of admixtures of propofol 1% with either ephedrine hydrochloride (HCL) or lidocaine HCl on infusion pain and hemodynamic tolerance to anesthesia induction. Based on the theory that a reduction in pH of the propofol emulsion results in more unionized, lipid-phase drug and less free, aqueous phase drug to bind to vascular receptors (which causes injection pain), the authors hypothesized that an admixture of propofol 1% and ephedrine HCl 3% (either one mg or 1.5 mg ephedrine per mL of propofol) would be as effective as adding lidocaine HCl (one mg lidocaine per mL of propofol) in reducing injection pain. Indeed, their hypothesis appears correct, as the occurrence of infusion pain was similar among three g... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343388 Mon, 01 Feb 2010 00:00:00 +0100 3343388 http://www.medworm.com/index.php?rid=3343387&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003511%2Fabstract%3Frss%3Dyes “I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone….” Extract from the Hippocratic Oath, translated from the Greek, (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343387 Mon, 01 Feb 2010 00:00:00 +0100 3343387 http://www.medworm.com/index.php?rid=3343386&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281800900350X%2Fabstract%3Frss%3Dyes Nasotracheal intubation is often required for dental and oral surgery. In conventional nasal intubation, direct laryngoscopy using the Macintosh laryngoscope and Magill forceps or the fiberoptic bronchoscope is applied. However, both of these methods are somewhat difficult to master by personnel who do not often perform nasotracheal intubation. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343386 Mon, 01 Feb 2010 00:00:00 +0100 3343386 http://www.medworm.com/index.php?rid=3343385&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003493%2Fabstract%3Frss%3Dyes It is not widely appreciated that the enzyme-independent decomposition of atracurium and cisatracurium is shared by another drug in anesthesia. Remifentanil undergoes an analogous reaction. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343385 Mon, 01 Feb 2010 00:00:00 +0100 3343385 http://www.medworm.com/index.php?rid=3343384&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003481%2Fabstract%3Frss%3Dyes Cyanoacrylate is the active ingredient in many adhesives, including Super Glue® (Super Glue Corp., Rancho Cucamonga, CA, USA). 2-Octyl cyanoacrylate, or Dermabond™ (Ethicon, West Somerville, NJ, USA) is a new adhesive intended for topical application to hold closed easily approximated skin edges of wounds from surgical incisions . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343384 Mon, 01 Feb 2010 00:00:00 +0100 3343384 http://www.medworm.com/index.php?rid=3343383&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003468%2Fabstract%3Frss%3Dyes Abstract: Transient left ventricular apical ballooning syndrome (TLVAB), also known as Takotsubo cardiomyopathy, is a cardiac syndrome characterized by transient left ventricular dysfunction in the absence of obstructive atherosclerotic coronary artery disease. An episode of emotional and/or physiologic stress frequently precedes presentation of this syndrome. TLVAB may initially present as an acute coronary syndrome characterized by chest pain, pulmonary edema, electrocardiographic changes, elevated cardiac enzymes, and cardiogenic shock. This syndrome is still underestimated today and the potential appearance of TLVAB during the perioperative period can be a great challenge. Adequate β-blockade is the mainstay in the treatment of patients with TLVAB during the acute phase and also for l... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343383 Mon, 01 Feb 2010 00:00:00 +0100 3343383 http://www.medworm.com/index.php?rid=3343381&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281800900333X%2Fabstract%3Frss%3Dyes Abstract: A case of emergency cesarean section due to a prolonged second stage of labor in a 29 year-old woman is presented. She had trigeminal nerve and facial nerve palsy after combined spinal-epidural anesthesia for cesarean section. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343381 Mon, 01 Feb 2010 00:00:00 +0100 3343381 http://www.medworm.com/index.php?rid=3343380&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003365%2Fabstract%3Frss%3Dyes Abstract: Perioperative visual loss following spinal surgery has become of increasing concern among anesthesiologists, surgeons, and patients alike. Perioperative ischemic optic neuropathy often occurs in patients greater than 50 years of age, in association with a number of presumed risk factors, including diabetes, hypertension, small cup-to-disc ratio, preoperative anemia, intraoperative hypotension, prolonged operative time in the prone position, and significant blood loss during surgery. The visual loss is notably devastating, and generally leads to permanent disability. A 44-year-old man whose central visual acuity was completely preserved is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343380 Mon, 01 Feb 2010 00:00:00 +0100 3343380 http://www.medworm.com/index.php?rid=3343378&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003444%2Fabstract%3Frss%3Dyes Abstract: The case of an 18 year-old double-lung transplant recipient recovering from acute respiratory distress syndrome who developed repeated episodes of bradycardia and asystole (maximum duration: 10 sec) during dexmedetomidine administration is presented. Increased baseline vagal tone, paroxysmal coughing spells, and opioid administration were likely contributors to the episodes. Discontinuation of the drug restored regular sinus rhythm. Double-lung transplant recipients may be at especially increased risk for this phenomenon as a result of changes in the autonomic innervation of the heart. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343378 Mon, 01 Feb 2010 00:00:00 +0100 3343378 http://www.medworm.com/index.php?rid=3343377&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003420%2Fabstract%3Frss%3Dyes Conclusions: Fluid infusion volume, fluid balance volume, intraoperative total balance, blood loss volume, and blood transfusion volume were important intraoperative risk factors in the development of postoperative right-sided heart failure. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343377 Mon, 01 Feb 2010 00:00:00 +0100 3343377 http://www.medworm.com/index.php?rid=3343376&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003596%2Fabstract%3Frss%3Dyes Conclusions: Dexmedetomidine in combination with low doses of midazolam is more effective than midazolam alone for sedation in AFOI. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343376 Mon, 01 Feb 2010 00:00:00 +0100 3343376 http://www.medworm.com/index.php?rid=3343375&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003419%2Fabstract%3Frss%3Dyes Conclusions: Overall satisfaction was high, and care provided by anesthesiologists was significantly associated with overall satisfaction. A site in our institution was associated with significantly lower satisfaction as a result of inadequate space and privacy. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343375 Mon, 01 Feb 2010 00:00:00 +0100 3343375 http://www.medworm.com/index.php?rid=3343374&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003407%2Fabstract%3Frss%3Dyes Conclusion: Factors other than nitric oxide-mediated injury is responsible for POCD following major non-cardiac surgery. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343374 Mon, 01 Feb 2010 00:00:00 +0100 3343374 http://www.medworm.com/index.php?rid=3343373&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003456%2Fabstract%3Frss%3Dyes Conclusion: Minor events occur with a surprisingly high incidence and are significantly associated with patient dissatisfaction. Regional anesthesia is associated with fewer patient complaints and significantly higher postoperative patient satisfaction. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343373 Mon, 01 Feb 2010 00:00:00 +0100 3343373 http://www.medworm.com/index.php?rid=3343372&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003390%2Fabstract%3Frss%3Dyes Conclusions: In trauma patients, the fascial pop technique is effective, reduces sedation during axillary brachial plexus block, and has a higher patient acceptance rate than the electrical nerve stimulation technique. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343372 Mon, 01 Feb 2010 00:00:00 +0100 3343372 http://www.medworm.com/index.php?rid=3343371&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003377%2Fabstract%3Frss%3Dyes Conclusion: Fentanyl at doses of one and two μg/kg may induce coughing in pediatric patients. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343371 Mon, 01 Feb 2010 00:00:00 +0100 3343371 http://www.medworm.com/index.php?rid=3343370&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003353%2Fabstract%3Frss%3Dyes Zhang and colleagues describe, in this issue of Journal of Clinical Anesthesia , a 10-second episode of asystole in an adolescent with cystic fibrosis (CF) following double-lung transplant, whose lungs were being mechanically ventilated while receiving a dexmedetomidine infusion for sedation. Dexmedetomidine is a novel alpha-2A adenergic receptor agonist used as a sedative in the intensive care unit and the operating room. It has sedative, analgesic, and sympatholytic properties associated with minimal respiratory depression. Dexmedetomidine is FDA-approved at a dose of one mcg/kg administered over ten plus minutes followed by an infusion of 0.2-0.7 mcg/kg/hr for sedation of mechanically ventilated patients. Because it is sedating without either amnestic or respiratory depressive effects, ... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343370 Mon, 01 Feb 2010 00:00:00 +0100 3343370 http://www.medworm.com/index.php?rid=3343369&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818010000267%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343369 Mon, 01 Feb 2010 00:00:00 +0100 3343369 http://www.medworm.com/index.php?rid=3343368&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818010000255%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343368 Mon, 01 Feb 2010 00:00:00 +0100 3343368 http://www.medworm.com/index.php?rid=3116303&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003316%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116303 Tue, 01 Dec 2009 00:00:00 +0100 3116303 http://www.medworm.com/index.php?rid=3116302&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003304%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116302 Tue, 01 Dec 2009 00:00:00 +0100 3116302 http://www.medworm.com/index.php?rid=3116295&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002840%2Fabstract%3Frss%3Dyes Dr B is an advocate of the use of hyperthermia for palliative cancer treatment. Dr B ran a clinic in California that is one of only 5 or 6 major U.S. institutions that perform hyperthermia. Based in large part on his own research, Dr B claimed that hyperthermia with and without radiation given daily and more often can have beneficial effects, and can also result in lower per-treatment radiation amounts, thus extending the time the patient can receive radiation. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116295 Tue, 01 Dec 2009 00:00:00 +0100 3116295 http://www.medworm.com/index.php?rid=3116281&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003134%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116281 Tue, 01 Dec 2009 00:00:00 +0100 3116281 http://www.medworm.com/index.php?rid=3116280&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009003122%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116280 Tue, 01 Dec 2009 00:00:00 +0100 3116280 http://www.medworm.com/index.php?rid=3116301&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002839%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116301 Mon, 02 Nov 2009 00:00:00 +0100 3116301 http://www.medworm.com/index.php?rid=3085471&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002888%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085471 Sun, 01 Nov 2009 00:00:00 +0100 3085471 http://www.medworm.com/index.php?rid=3085470&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002876%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085470 Sun, 01 Nov 2009 00:00:00 +0100 3085470 http://www.medworm.com/index.php?rid=3116300&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281800900275X%2Fabstract%3Frss%3Dyes Management of the airway is an important aspect of emergency medicine, anesthetic practice, and intensive care. The ideal method of securing a definitive airway is by endotracheal intubation. In acute emergencies, securing the airway can be difficult. Accidental damage to the endotracheal tube (ETT) cuff, pilot balloon, and pilot tube can be catastrophic. Damage to pilot tubes may be salvaged using various methods. Yoon et al. used a needle connector to attach the pilot balloon to the pilot tube. Whitesides and Exler used a jelco cannula attached to the pilot tube to inflate the ETT cuff and used a surgical clamp to prevent the cuff from deflating. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116300 Fri, 30 Oct 2009 00:00:00 +0100 3116300 http://www.medworm.com/index.php?rid=3116299&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002724%2Fabstract%3Frss%3Dyes We report a hazardous technical problem that occurred with two Ambu AuraFlex single-use Laryngeal Mask Airways (LMAs; Intavent-Orthofix, Maidenhead, UK) consecutively during an ear, nose, and throat (ENT) case. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116299 Fri, 30 Oct 2009 00:00:00 +0100 3116299 http://www.medworm.com/index.php?rid=3116294&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002815%2Fabstract%3Frss%3Dyes Abstract: Two patients in whom the bispectral index (BIS) decreased to zero following cardiac arrest during cardiothoracic surgery are described. The BIS value decreased to zero after cardiac arrest, and the value remained low for the remainder of the anesthetic despite successful cardiopulmonary resuscitation. Both patients were found to have severe brain injuries in the postoperative period. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116294 Fri, 30 Oct 2009 00:00:00 +0100 3116294 http://www.medworm.com/index.php?rid=3116291&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281800900261X%2Fabstract%3Frss%3Dyes Abstract: Multidetector ECG-gated CT angiography permits imaging of structures such as the coronary arteries and pulmonary veins with peripheral administration of contrast media. Respiratory motion artifact limits the applicability of this technique in critically ill patients due to an inability to cooperate with prolonged breath holds necessary for quality images. A case in which high-frequency jet ventilation via an uncuffed tracheostomy tube in an unmedicated patient permitted respiratory immobilization sufficient to acquire diagnostic images, is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116291 Wed, 28 Oct 2009 00:00:00 +0100 3116291 http://www.medworm.com/index.php?rid=3085477&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002591%2Fabstract%3Frss%3Dyes Conclusions: As the institution's use of high-dose aprotinin has significantly decreased, the number of patients requiring FFP and FFP/RBC combinations during CPB has significantly increased. Furthermore, a trend toward increasing incidence of unplanned reoperations for excessive clinical bleeding was noted. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085477 Wed, 28 Oct 2009 00:00:00 +0100 3085477 http://www.medworm.com/index.php?rid=3343379&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002700%2Fabstract%3Frss%3Dyes Abstract: A patient with severe right chest pain and mechanical allodynia induced by an intercostal drainage tube to his chest is presented. It was not relieved by treatment with diclofenac sodium and was worsened by movement and touch to the right chest wall. Mechanical allodynia was also present. The patient's wrenching pain disappeared immediately after stitch removal, but the dull pain and mechanical allodynia persisted, gradually decreasing to zero in 7 days. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343379 Mon, 26 Oct 2009 00:00:00 +0100 3343379 http://www.medworm.com/index.php?rid=3116298&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002761%2Fabstract%3Frss%3Dyes Obesity continues to dramatically increase in the United States. Obese and morbidly obese patients are at high-risk for difficult airway management, cardiopulmonary dysfunction, aspiration, and markedly increased perioperative morbidity and mortality . Because of this increased risk, body mass index (BMI) over 45 kg.m−2 is considered a contraindication for outpatient surgery . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116298 Mon, 26 Oct 2009 00:00:00 +0100 3116298 http://www.medworm.com/index.php?rid=3116297&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002736%2Fabstract%3Frss%3Dyes Bag-mask ventilation is a basic life support skill for every medical practitioner in general, and for every anesthesiologist in particular. The correct facemask (FM) holding technique is crucial for effective mask ventilation, prevention of high airway pressure and stomach dilatation, and prevention of early fatigue of the operator. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116297 Mon, 26 Oct 2009 00:00:00 +0100 3116297 http://www.medworm.com/index.php?rid=3116296&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002748%2Fabstract%3Frss%3Dyes The tracheal tube introducer (bougie) is widely used to facilitate difficult intubation. However, single-use introducers, compared to reusable ones, appear to be more traumatic . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116296 Mon, 26 Oct 2009 00:00:00 +0100 3116296 http://www.medworm.com/index.php?rid=3116293&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002682%2Fabstract%3Frss%3Dyes Abstract: A neonate developed red man's syndrome and stridor following perioperative administration of vancomycin. The medical management of stridor and red man's syndrome are presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116293 Mon, 26 Oct 2009 00:00:00 +0100 3116293 http://www.medworm.com/index.php?rid=3116292&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002712%2Fabstract%3Frss%3Dyes Abstract: Interrupting anticoagulation in patients at high risk for thromboembolism, even for critically important surgery, may lead to devastating outcomes. The patient described developed "Locked-in Syndrome" from basilar arterial thrombosis within 24 hours of withholding anticoagulation for urgent airway surgery. Emergency thrombolysis partially restored arterial flow, with recovery of some function. The dangers of hemorrhage during surgery must be balanced against the potentially devastating consequences of withholding anticoagulation in patients at high risk for thrombosis. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116292 Mon, 26 Oct 2009 00:00:00 +0100 3116292 http://www.medworm.com/index.php?rid=3116289&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002827%2Fabstract%3Frss%3Dyes Conclusion: Seizures have been reported with lidocaine at its lowest effective dose (1.5 mg/kg). (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116289 Mon, 26 Oct 2009 00:00:00 +0100 3116289 http://www.medworm.com/index.php?rid=3116288&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002797%2Fabstract%3Frss%3Dyes Conclusion: Cell salvaged blood in liver resection seems to be safe for retransfusion with respect to cytokine release and complement activation, but requires further investigation in regard to bacterial contamination. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116288 Mon, 26 Oct 2009 00:00:00 +0100 3116288 http://www.medworm.com/index.php?rid=3116287&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002803%2Fabstract%3Frss%3Dyes Conclusions: The 8-deep-breaths in 60 seconds technique at an oxygen flow of 10 L/min can achieve adequate preoxygenation with the Mapleson A (Magill), Mapleson D, and circle anesthesia systems. Suboptimal preoxygenation is obtained with the three systems when the oxygen flow used is 5 L/min. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116287 Mon, 26 Oct 2009 00:00:00 +0100 3116287 http://www.medworm.com/index.php?rid=3116286&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002785%2Fabstract%3Frss%3Dyes Conclusion: Four years of age or less and isoflurane inhalation for more than 24 hours were considered to be significant risk factors for the development of reversible psychomotor dysfunction after prolonged sedation with isoflurane. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116286 Mon, 26 Oct 2009 00:00:00 +0100 3116286 http://www.medworm.com/index.php?rid=3116285&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002669%2Fabstract%3Frss%3Dyes Conclusions: LHB improved pulmonary blood flow to the dependent lung and arterial oxygenation during OLV in descending thoracic aortic surgery. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116285 Mon, 26 Oct 2009 00:00:00 +0100 3116285 http://www.medworm.com/index.php?rid=3116283&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002621%2Fabstract%3Frss%3Dyes Conclusions: The A-Line AEP (AAI) is better detects the response to painful stimuli and during recovering from noise of electric cautery than the aepEX. The aepEX shows higher values than the AAI during propofol-fentanyl-nitrous oxide anesthesia. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116283 Mon, 26 Oct 2009 00:00:00 +0100 3116283 http://www.medworm.com/index.php?rid=3116282&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002670%2Fabstract%3Frss%3Dyes Conclusions: Many experienced practitioners in an academic setting lack accurate knowledge of the acquisition costs of common drugs and supplies. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116282 Mon, 26 Oct 2009 00:00:00 +0100 3116282 http://www.medworm.com/index.php?rid=3085489&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002773%2Fabstract%3Frss%3Dyes In a recent letter to the Annals of Thoracic Surgery, Del Duca et al. describe the use of methylene blue to treat two episodes of anaphylaxis during cardiac surgery . There have also been reports of the use of methylene blue to treat norepinephrine- and vasopressin-resistant septic shock . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085489 Mon, 26 Oct 2009 00:00:00 +0100 3085489 http://www.medworm.com/index.php?rid=3085487&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002694%2Fabstract%3Frss%3Dyes Fractures of the distal radius are the most common fractures of the upper extremity, and represent 14% of all fractures treated each year . Pain after wrist fracture manipulation is the major factor compromising early physical therapy and discharge home, and Capdevila et al have shown that total knee arthroplasty patients had shorter and improved rehabilitation following regional analgesia techniques. Senturk et al reported that the intensity of postoperative pain may directly influence the development of complex regional pain syndrome. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085487 Mon, 26 Oct 2009 00:00:00 +0100 3085487 http://www.medworm.com/index.php?rid=3085486&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002633%2Fabstract%3Frss%3Dyes The authors of the paper, “Development and performance of a two-step desflurane-O2/N2O fresh gas flow sequence” , are to be commended on their study. Clearly, significant resources in time, manpower, and other logistic support were deployed to develop their clinical recommendations. Perhaps, however, the question could have been tackled differently. Simulations can be used to test hypotheses. Instead of developing the sequence using 18 patients, the authors could have used a commercially available gas kinetics simulator (Gas Man; Med Man Simulations, Inc., Chestnut Hill, MA, USA). Predicted FA using Gas Man simulation is shown in , and is very similar to B in the Hendrickx et al. paper. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085486 Mon, 26 Oct 2009 00:00:00 +0100 3085486 http://www.medworm.com/index.php?rid=3085484&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002505%2Fabstract%3Frss%3Dyes Abstract: Pulmonary embolism (PE) by solid particles is an infrequent complication encountered during orthopedic procedures. A patent foramen ovale (PFO) allows embolic material into the left-sided circulation, potentially affecting several organs. A case of a 33-year-old woman undergoing total proximal femur resection with megaprosthesis reconstruction is presented. Towards the end of surgery, cement was injected to stabilize the prosthesis. Echodense particulate matter was first seen in the right atrium, subsequently in the right ventricle, and also in significant quantities in the left atrium and ventricle. This was accompanied by significant changes in partial pressure of arterial oxygen. Despite the aforementioned disturbances, hemodynamic stability was observed throughout the event. ... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085484 Mon, 26 Oct 2009 00:00:00 +0100 3085484 http://www.medworm.com/index.php?rid=3085482&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002578%2Fabstract%3Frss%3Dyes Abstract: Spinal epidural hematoma is a rare and devastating complication of epidural catheter removal in an anticoagulated patient. The diagnosis could be quite challenging, especially in patients with preexisting neurological deficits. A 35-year-old patient with remote spinal cord injury and T4 level paraplegia developed a spinal epidural hematoma on the 7th postoperative day. The hematoma developed after epidural catheter removal with concurrent administration of unfractionated heparin. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085482 Mon, 26 Oct 2009 00:00:00 +0100 3085482 http://www.medworm.com/index.php?rid=3085481&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002517%2Fabstract%3Frss%3Dyes Abstract: Mirror syndrome is a condition in which the mother "mirrors" her hydropic fetus and/or hydropic placenta. Physical and laboratory findings of mirror syndrome include generalized edema, hypertension, and proteinuria similar to preeclampsia. However, unlike preeclampsia, mirror syndrome is associated with hemodilutional anemia and fluid overload, which may progress to pulmonary edema. The anesthetic management of a parturient with fetal sacrococcygeal teratoma, hydrops fetalis, and mirror syndrome complicated by markedly elevated maternal serum human chorionic gonadotropin and subsequent clinical hyperthyroidism, is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085481 Mon, 26 Oct 2009 00:00:00 +0100 3085481 http://www.medworm.com/index.php?rid=3085478&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002645%2Fabstract%3Frss%3Dyes Conclusions: The practice of allowing residents who have undergone treatment for substance abuse to return to their training program in clinical anesthesia remains highly controversial. They are often lost to follow-up, making it difficult, if not impossible to determine if re-training in a different medical specialty decreases their risk for relapse. A comprehensive assessment of the outcomes associated with alternatives to re-entry into clinical anesthesia training programs is needed. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085478 Mon, 26 Oct 2009 00:00:00 +0100 3085478 http://www.medworm.com/index.php?rid=3085475&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002566%2Fabstract%3Frss%3Dyes Conclusions: IT baclofen used as an adjuvant to spinal anesthesia for total knee arthroplasty allows for less postoperative opioid usage and less chronic pain at three months. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085475 Mon, 26 Oct 2009 00:00:00 +0100 3085475 http://www.medworm.com/index.php?rid=3085473&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002530%2Fabstract%3Frss%3Dyes Conclusion: A dose of 4 mg of hyperbaric bupivacaine produces a similar level of sensory and motor block as a 5 mg dose but with shorter duration and faster recovery. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085473 Mon, 26 Oct 2009 00:00:00 +0100 3085473 http://www.medworm.com/index.php?rid=3343382&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281800900258X%2Fabstract%3Frss%3Dyes Abstract: Well into the twentieth century, nitrous oxide was often suspected to support life in the manner of oxygen. Authorities contributing to that life-threatening misimpression include Humphry Davy, Gardner Q. Colton, and George W. Crile. Concomitantly, deprivation of oxygen was long touted as a requisite for nitrous oxide anesthesia. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3343382 Fri, 23 Oct 2009 00:00:00 +0100 3343382 http://www.medworm.com/index.php?rid=3116290&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002608%2Fabstract%3Frss%3Dyes Abstract: A case of postoperative epidural hematoma with an atypical presentation and an excellent outcome in an 80 year-old woman who received both prophylactic aspirin and enoxaparin following a primary total knee arthroplasty, is presented. She developed lower limb neurological symptoms, fully recovered, and then deteriorated again. The hematoma was surgically evacuated, resulting in full neurological recovery. Epidural analgesia may not be the best choice for pain management in patients who require the combined use of aspirin and low-molecular weight heparin postoperatively. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116290 Fri, 23 Oct 2009 00:00:00 +0100 3116290 http://www.medworm.com/index.php?rid=3116284&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002657%2Fabstract%3Frss%3Dyes Conclusion: A bolus of landiolol 0.125 mg/kg followed by an infusion of landiolol 0.04 mg/kg/min may reduce the risk of cardiac arrhythmias during induction of anesthesia. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3116284 Fri, 23 Oct 2009 00:00:00 +0100 3116284 http://www.medworm.com/index.php?rid=3085480&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002529%2Fabstract%3Frss%3Dyes Abstract: Insertion of drug-eluting stents is one of the strategies for treating patients with coronary artery disease. These patients can be a perioperative challenge in management as they need to be maintained on antiplatelet therapy to prevent stent thrombosis, which puts them at an increased risk for surgical bleeding. Recently revised guidelines on elective surgery following insertion of a drug-eluting stent recommend dual antiplatelet therapy for a period of twelve months. The management of a patient who presented for surgery more than two years after the insertion of a drug-eluting stent, and who developed in-stent thrombosis intraoperatively, is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085480 Fri, 23 Oct 2009 00:00:00 +0100 3085480 http://www.medworm.com/index.php?rid=3085476&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002542%2Fabstract%3Frss%3Dyes Conclusion: Postoperative 24-hour dexmedetomidine infusion as an adjunct to PCA with opioids might have a morphine-sparing effect as evidenced by the increase in morphine use on postoperative day 2 after the dexmedetomidine infusion was stopped. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085476 Fri, 23 Oct 2009 00:00:00 +0100 3085476 http://www.medworm.com/index.php?rid=3085474&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002554%2Fabstract%3Frss%3Dyes Conclusion: Pregnant women in the second trimester exhibit enhanced spread of spinal analgesia with hyperbaric bupivacaine more so than non-pregnant women. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085474 Fri, 23 Oct 2009 00:00:00 +0100 3085474 http://www.medworm.com/index.php?rid=3085488&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002220%2Fabstract%3Frss%3Dyes Excessive production of growth hormone from a pituitary adenoma can cause acromegaly or gigantism. Both disorders have the same pathogenetic mechanism, but differ with regard to the age of onset. Gigantism occurs early in life, when the skeleton still has the potential to grow, before closing of the epiphyseal bone, thus resulting in accelerated growth. Morphologic deformations also differ between the two diseases . While the airway management difficulties of acromegalic patients are well described , we currently only have one description of specific anesthesia care for the patient with gigantism . Apart from airway management, anesthetic care is accompanied by the problem of drug management. Use of short-acting, intravenous (IV) hypnotic and opioid drugs may be an option as they may be co... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085488 Mon, 14 Sep 2009 00:00:00 +0100 3085488 http://www.medworm.com/index.php?rid=2895688&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002104%2Fabstract%3Frss%3Dyes Abstract: Certain laryngeal procedures require a sedated patient who is responsive to allow for the assessment of vocalization. Dexmedetomidine as a single agent for sedation and anxiolysis for awake laryngoplasty in a patient with unilateral vocal fold paralysis is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895688 Wed, 09 Sep 2009 23:00:00 +0100 2895688 http://www.medworm.com/index.php?rid=3085485&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002256%2Fabstract%3Frss%3Dyes Migration of epidural catheters is generally thought of in terms of potentially dangerous intravascular and intrathecal migration as well as outward migration with dislodgement and loss of function. Inward (superior, rostral, or cephalad) migration of catheters in the epidural space has been described in adults, but it might result in a high neuraxial block in small children. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085485 Wed, 09 Sep 2009 00:00:00 +0100 3085485 http://www.medworm.com/index.php?rid=3085483&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281800900213X%2Fabstract%3Frss%3Dyes Abstract: The use of bronchoscopically placed self-expanding metallic stents (SEMS) and silastic stents in patients suffering from tracheobronchial stenosis or similar problems has proven to be an important clinical option. When complications occur, it may be necessary to remove the device. Removal of a SEMS is usually performed during general anesthesia with muscle relaxation and positive pressure ventilation, often using total intravenous anesthesia. Airway management depends on stent type and location. Intubating patients' tracheas with a tracheal stent requires special caution, as it risks damaging tissue and dislodging the stent distally. Potential complications with removal include tracheal disruption, retained stent pieces, mucosal tears, re-obstruction requiring new stent placement... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085483 Wed, 09 Sep 2009 00:00:00 +0100 3085483 http://www.medworm.com/index.php?rid=3085479&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002177%2Fabstract%3Frss%3Dyes Abstract: A reusable Robertshaw red rubber double-lumen endotracheal tube (DLT) was placed to facilitate lung isolation for thoracoscopy in a 49-year-old atopic patient. In spite of its smooth insertion, it was then not possible to remove the DLT. Direct laryngoscopy showed severe laryngeal edema. After 48 hours of medical treatment with steroids, the trachea was extubated. The laryngeal edema could have been the result of physical and chemical irritation by the reusable rubber DLT itself, or from the substances formed during repeated cleaning and sterilization of the DLT. Atopic patients who are prone to developing latex allergy are also more liable to develop severe reactions to chemical, mechanical, and physical irritation from reusable red rubber DLTs or from the chemical solution used... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085479 Wed, 09 Sep 2009 00:00:00 +0100 3085479 http://www.medworm.com/index.php?rid=2895696&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002232%2Fabstract%3Frss%3Dyes Michard and others have described and advocated the use of “dynamic indices” in predicting whether a fluid challenge will increase a patient's cardiac output (CO). The dynamic indices are systolic pressure variation (SPV), pulse pressure variation (PPV), and stroke volume variation (SVV), measured over the course of the respiratory cycle during positive pressure ventilation. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895696 Tue, 08 Sep 2009 23:00:00 +0100 2895696 http://www.medworm.com/index.php?rid=2895695&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002244%2Fabstract%3Frss%3Dyes When shearing or breaking of catheters occurs, it is often during removal. A sheared peripheral nerve catheter that resulted from needle damage during subcutaneous tunneling is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895695 Tue, 08 Sep 2009 23:00:00 +0100 2895695 http://www.medworm.com/index.php?rid=2895694&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002219%2Fabstract%3Frss%3Dyes Video-assisted throracoscopic surgery (VATS) is becoming an increasingly common surgical procedure . Bilateral VATS is not common, especially for pediatric patients . Our experience using only one Arndt 5-French (Fr) pediatric endobronchial blocker for bilateral one-lung ventilation (OLV) is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895694 Tue, 08 Sep 2009 23:00:00 +0100 2895694 http://www.medworm.com/index.php?rid=2895691&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002207%2Fabstract%3Frss%3Dyes Despite major advancements in the development of surgical methods and technology in the operating room (OR), the clothing of the surgical team has remained essentially the same for many years. By and large, the entire surgical team—surgeons, anesthesiologists, nurses, and technicians—wears the same clothing, and there has been almost no effort to adapt the uniform to the changing needs and tasks of the team. Likewise, the scientific literature available on OR clothing is limited, mostly dealing with aseptic properties of the garments, gloves, hat, and mask , rather than ergonomic and design issues. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895691 Tue, 08 Sep 2009 23:00:00 +0100 2895691 http://www.medworm.com/index.php?rid=2895689&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002189%2Fabstract%3Frss%3Dyes Abstract: Sugammadex is a novel cyclodextrin, the first in a new class of selective binding reversal agents that terminates neuromuscular block (NMB) with the steroidal nondepolarizing agents, rocuronium and vecuronium. Sugammadex can reverse a moderate or deep NMB. The dose required depends on the level of NMB that needs to be reversed. Smaller doses are sufficient for a moderate versus deep NMB. In October 2007, a new drug application for sugammadex was submitted to the U.S. Food and Drug Administration (FDA). The FDA issued a not-approvable letter in July 2008. The manufacturer continues clinical trials. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895689 Tue, 08 Sep 2009 23:00:00 +0100 2895689 http://www.medworm.com/index.php?rid=2895684&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002190%2Fabstract%3Frss%3Dyes Conclusions: Withdrawal response can be significantly reduced for rocuronium injection without lidocaine pretreatment, simply through rapid injection. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895684 Tue, 08 Sep 2009 23:00:00 +0100 2895684 http://www.medworm.com/index.php?rid=2895683&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002153%2Fabstract%3Frss%3Dyes Conclusions: Respiratory mechanics do not fully return to baseline levels after desufflation following laparoscopy; however, lung compliance can be fully restored using a simple alveolar recruitment maneuver. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895683 Tue, 08 Sep 2009 23:00:00 +0100 2895683 http://www.medworm.com/index.php?rid=2895682&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002116%2Fabstract%3Frss%3Dyes Conclusions: Epidural block could not suppress postoperative lymphocyte apoptosis, increases in cortisol, CRP, or ESR compared with general anesthesia. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895682 Tue, 08 Sep 2009 23:00:00 +0100 2895682 http://www.medworm.com/index.php?rid=3085472&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002128%2Fabstract%3Frss%3Dyes Conclusions: The prophylactic administration of 5 mg dexamethasone IV can reduce the frequency of PONV, lower VAS pain scores, facilitate recovery to home readiness, and improve satisfaction in outpatients undergoing anorectal surgery. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=3085472 Mon, 07 Sep 2009 00:00:00 +0100 3085472 http://www.medworm.com/index.php?rid=2895687&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002165%2Fabstract%3Frss%3Dyes Abstract: Lingual tonsillar hyperplasia is rare, and it may cause difficulty with tracheal intubation during induction of general anesthesia. A different orotracheal intubation technique was performed using a double-lumen endotracheal tube, flexible fiberoptic bronchoscope, and a stylet, in an unexpected difficult endobronchial intubation case due to massive lingual tonsillar hyperplasia. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895687 Sun, 06 Sep 2009 23:00:00 +0100 2895687 http://www.medworm.com/index.php?rid=2895681&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002141%2Fabstract%3Frss%3Dyes Conclusion: Patient positioning, not baricity of bupivacaine, significantly affected the cephalad spread of spinal anesthesia, and a 10-minute period in the sitting position limits the maximum cephalad spread to T11. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895681 Sun, 06 Sep 2009 23:00:00 +0100 2895681 http://www.medworm.com/index.php?rid=2895677&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002293%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895677 Mon, 31 Aug 2009 23:00:00 +0100 2895677 http://www.medworm.com/index.php?rid=2895676&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009002281%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895676 Mon, 31 Aug 2009 23:00:00 +0100 2895676 http://www.medworm.com/index.php?rid=2763330&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001858%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763330 Fri, 31 Jul 2009 23:00:00 +0100 2763330 http://www.medworm.com/index.php?rid=2763329&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001846%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763329 Fri, 31 Jul 2009 23:00:00 +0100 2763329 http://www.medworm.com/index.php?rid=2895685&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001810%2Fabstract%3Frss%3Dyes Abstract: The case of a 70 year-old man undergoing bilateral carotid endarterectomy (CEA), for whom alterations in his bispectral index (BIS) values were noted during general anesthesia, is presented. Prior to bypass of the internal carotid artery (ICA), there were no significant differences in bilateral BIS values. After bypass of the left ICA, the left BIS increased to approximately 60, while the right BIS remained at 40. Four months later, no such phenomenon was found during a right CEA. BIS is useful in detecting cerebral hypoperfusion during a lower limit of autoregulation. Attaching bilateral BIS monitors may indicate successful reperfusion of cerebral blood flow in CEA. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895685 Tue, 21 Jul 2009 23:00:00 +0100 2895685 http://www.medworm.com/index.php?rid=2895686&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001792%2Fabstract%3Frss%3Dyes Abstract: The use of a combination of dexmedetomidine and ketamine to provide procedural sedation in a 12-year old boy with a diagnosis of idopathic pulmonary hypertension and a behavioral disorder, undergoing diagnostic cardiac catheterization, is presented. Following a loading dose of ketamine one mg/kg and dexmedetomidine one mcg/kg, an infusion of dexmedetomidine at one mcg/kg/hr was used with the patient breathing spontaneously. Stable hemodynamics were observed throughout the procedure and pulmonary vascular resistance was measured under three conditions. The dexmedetomidine infusion was continued for two hours post-catheterization, facilitating a smooth emergence. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895686 Mon, 20 Jul 2009 23:00:00 +0100 2895686 http://www.medworm.com/index.php?rid=2763343&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001809%2Fabstract%3Frss%3Dyes In early 2000, Dr F, a neurosurgeon, was treating patient SB, an obese woman, for pain from cervical disc protrusions. Dr F suggested that a cervical hemilaminotomy and foraminotomy at C3-4 and C4-5 would be an effective strategy to address SB's pain. SB agreed to the surgery, and SB was admitted to Hospital at 8 am. The surgery began at 10:15 am, with Dr L as the anesthesiologist and nurse anesthetist JS assisting. Dr L, with the assistance of JS, attached several monitors. After these monitors were attached, JS placed an oxygen mask on SB's face and began administering oxygen. General anesthesia was induced and an endotracheal tube was inserted and fixed into place. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763343 Mon, 20 Jul 2009 23:00:00 +0100 2763343 http://www.medworm.com/index.php?rid=2895678&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001755%2Fabstract%3Frss%3Dyes Conclusions: II/IH nerve block using 0.4 mL kg-1 of 0.25% levobupivacaine provided satisfactory postoperative pain relief after inguinal herniorraphy. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895678 Thu, 16 Jul 2009 23:00:00 +0100 2895678 http://www.medworm.com/index.php?rid=2763342&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001780%2Fabstract%3Frss%3Dyes Abstract: The case of a 6 week-old infant who presented with an anterior mediastinal mass that extended to the left neck is reported. During surgical dissection of the mass, the patient exhibited extreme hemodynamic instability consistent with a vasoactive tumor. The patient had a neuroblastoma with its origin in the posterior mediastinum, but with its mass effect in the anterior mediastinum and neck. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763342 Thu, 16 Jul 2009 23:00:00 +0100 2763342 http://www.medworm.com/index.php?rid=2763341&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001779%2Fabstract%3Frss%3Dyes Abstract: The American Society of Anesthesiologists, the Anesthesia Patient Safety Foundation, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), and the Patient Safety and Quality Improvement Act of 2005 encourage anesthesiology departments to institute systematic improvements in patient safety, including but not limited to integration of new safety technologies. The evaluation and method of use of the reciprocating procedure device in central venous access is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763341 Thu, 16 Jul 2009 23:00:00 +0100 2763341 http://www.medworm.com/index.php?rid=2763340&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001767%2Fabstract%3Frss%3Dyes Abstract: A case of bronchobiliary fistula is reported in an adult following liver laceration repair. Since patients with bronchobiliary fistula usually have poor lung condition preoperatively, perioperative respiratory management and intraoperative double-lumen tube insertion assists in the management of these patients. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763340 Wed, 15 Jul 2009 23:00:00 +0100 2763340 http://www.medworm.com/index.php?rid=2895680&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001743%2Fabstract%3Frss%3Dyes Conclusion: Longer tolerance times for the distal tourniquet, prolonged analgesia after tourniquet release, and lower analgesic requirements postoperatively make ropivacaine 0.2% and 0.25% an alternative to lidocaine for IVRA. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895680 Mon, 13 Jul 2009 23:00:00 +0100 2895680 http://www.medworm.com/index.php?rid=2895679&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001731%2Fabstract%3Frss%3Dyes Conclusion: Dexmedetomidine infusion decreases TNF-a, IL-1, and IL-6 levels and IAP more than a propofol infusion. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895679 Sun, 28 Jun 2009 23:00:00 +0100 2895679 http://www.medworm.com/index.php?rid=2763337&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281800900172X%2Fabstract%3Frss%3Dyes Conclusions: Patients selected for AFI were predominantly men, with a Mallampati Class III or IV airway, and BMI ≥ 60 kg/m2. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763337 Sun, 28 Jun 2009 23:00:00 +0100 2763337 http://www.medworm.com/index.php?rid=2763336&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001706%2Fabstract%3Frss%3Dyes Conclusion: Insertion of an EzT appears to reduce time and facilitate placement of an airway device when compared with direct laryngoscopy and tracheal intubation. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763336 Sun, 28 Jun 2009 23:00:00 +0100 2763336 http://www.medworm.com/index.php?rid=2895692&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001718%2Fabstract%3Frss%3Dyes Baldo and Fisher have shown that substituted ammonium ions may serve as allergenic determinants in drug allergy . The widespread prevalence of quaternary and tertiary ammonium ions in cosmetics, foods, and disinfectants has been suggested as a source by which sensitization can take place. The use of cosmetics has been suggested as an explanation for the much higher incidence of allergy to muscle relaxants in women. Similarly, the sixfold greater incidence of allergy to relaxants in Norway (compared with Sweden) has been linked to pholcodine exposure and supports the suggestion that exposure to other compounds may sometimes be the source of anaphylaxis to relaxants during anesthesia . A patient in whom there was an association between the use of theatrical cosmetics and the subsequent devel... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895692 Sun, 21 Jun 2009 23:00:00 +0100 2895692 http://www.medworm.com/index.php?rid=2763335&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281800900169X%2Fabstract%3Frss%3Dyes Conclusions: The Warmflo® fluid warming system can overheat fluids at temperatures considerably above normal body temperatures. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763335 Sun, 21 Jun 2009 23:00:00 +0100 2763335 http://www.medworm.com/index.php?rid=2763334&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001652%2Fabstract%3Frss%3Dyes Conclusions: The modified Atlanta protocol is efficient and safe in controlling blood glucose levels in the perioperative period of hepatic tumor resection. Because of decreased insulin needs in the ICU, the use of a more liberal algorithm successfully reduced the risk of hypoglycemia. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763334 Sun, 21 Jun 2009 23:00:00 +0100 2763334 http://www.medworm.com/index.php?rid=2763332&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001640%2Fabstract%3Frss%3Dyes Conclusions: A CRNA is paid substantially more per OR hour worked, at all pay levels, than an anesthesiology resident. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763332 Sun, 14 Jun 2009 23:00:00 +0100 2763332 http://www.medworm.com/index.php?rid=2485897&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001482%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485897 Sun, 31 May 2009 23:00:00 +0100 2485897 http://www.medworm.com/index.php?rid=2485896&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001470%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485896 Sun, 31 May 2009 23:00:00 +0100 2485896 http://www.medworm.com/index.php?rid=2763339&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001433%2Fabstract%3Frss%3Dyes Abstract: Significant complications following large-volume epidural blood patches (LEBPs) in two parturients following LEBP for postdural puncture headache are reported. A 39-year-old woman developed a spinal subdural hematoma causing both lumbar back and radicular pain following a single LEBP using 58 mL of blood. The second case was a 33-year-old woman who received three LEBPs over a 4-day period totaling 165 mL of blood. She developed arachnoiditis and chronic sacral radiculopathy with resolution 4 months later. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763339 Wed, 20 May 2009 23:00:00 +0100 2763339 http://www.medworm.com/index.php?rid=2763331&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001445%2Fabstract%3Frss%3Dyes I read with interest the article in this issue of Journal of Clinical Anesthesia, “What's An Anesthesiology Resident Worth?” As a graduating resident, I was curious to learn of my value. I feel that the article grossly underestimates the true worth of an anesthesiology resident. The article considers only the total number of hours spent in the operating room (OR) providing anesthesia to determine the cost of replacing an anesthesiology resident with a certified registered nurse-anesthetist (CRNA). No consideration was given to the various other ways in which residents provide value to the anesthesia department, the hospital, and the affiliated medical school. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763331 Wed, 20 May 2009 23:00:00 +0100 2763331 http://www.medworm.com/index.php?rid=2895693&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001354%2Fabstract%3Frss%3Dyes Our neuroanesthesia group performs frequent awake fiberoptic intubations due to a large number of cervical spine procedures. Patient tolerance of the awake intubation is greatly enhanced when the gag and cough reflexes are densely blocked. Not only is it a safety concern for the patient with an unstable cervical spine, but it eases the awake intubation performed for any indication. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895693 Tue, 19 May 2009 23:00:00 +0100 2895693 http://www.medworm.com/index.php?rid=2763348&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281800900138X%2Fabstract%3Frss%3Dyes Thank you for the opportunity to respond to the letter by Xue et al. The technique of using the endotracheal tube (ETT) as a conduit for the bougie is a rescue technique, to be used when the other manipulations mentioned in our letter have failed . It is not our intention that this technique be used if intubation proves easy. As such, this technique is likely to be quicker and less complex than the commonly used alternatives when passage of the ETT through the glottis proves difficult, such as reshaping the stylet or using a different tube. We agree that this technique is not really suitable for small pediatric patients, but then neither are the McGrath and the GlideScope Cobalt videolaryngoscopes. Our recommendation requires that a suitably sized bougie be available. To facilitate the rem... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763348 Sun, 17 May 2009 23:00:00 +0100 2763348 http://www.medworm.com/index.php?rid=2763347&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001378%2Fabstract%3Frss%3Dyes We read with interest the recent letter of Budde and Pott , regarding the endotracheal tube (ETT) as a guide for an Eschmann gum elastic bougie to aid tracheal intubation using the McGrath or GlideScope videolaryngoscope. Advancing the ETT through the glottis into the trachea is a problem during orotracheal or nasotracheal intubation using the video intubating device due to the significantly angulated blade and the fact that the ETT must be presented to the glottis, which may not be in the line of sight. When orotracheal intubation is performed, moreover, ETTs must have stylets inserted so that the ETT's distal tip can be positioned anteriorly. These factors may result in the tube tip impinging on the anterior commissure of the glottis, or anterior wall of the trachea . To overcome this di... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763347 Sun, 17 May 2009 23:00:00 +0100 2763347 http://www.medworm.com/index.php?rid=2763354&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001421%2Fabstract%3Frss%3Dyes Insertion of a nasogastric tube can be a difficult and frustrating experience in patients who are anesthetized . Ozer and Benumof have found that the most common sites of impaction of orogastric and nasogastric tubes are the pyriform sinuses and arytenoid cartilage, leading to coiling in the oropharynx . The basic design of the tube contributes to tube coiling in the oropharynx. The distal 6 cm of the gastric tube has multiple holes that are less firm . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763354 Thu, 14 May 2009 23:00:00 +0100 2763354 http://www.medworm.com/index.php?rid=2763353&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001408%2Fabstract%3Frss%3Dyes It is a common practice to check the placement of the central venous catheter (CVC) in the internal jugular vein (IJV) by attaching intravenous (IV) fluid tubing to the 14-gauge introducer needle and observing for free flow of fluid. However, this practice can be very misleading in certain special situations. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763353 Thu, 14 May 2009 23:00:00 +0100 2763353 http://www.medworm.com/index.php?rid=2763351&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001391%2Fabstract%3Frss%3Dyes We suggest a simplified algorithm for management of the unexpected difficult airway in the obstetric patient (). 1. Existing algorithms recommend the use of the Classic Laryngeal Mask Airway (cLMA; The Laryngeal Mask Airway Co., San Diego, CA), or Laryngeal Mask Airway (LMA; Laryngeal Mask Co., Ltd., Henley-on-Thames, UK) variants, as a rescue airway device for a "cannot ventilate, cannot intubate" situation. We suggest using the multiple use ProSeal LMA (PLMA; The Laryngeal Mask Airway Co.) or the single-use Supreme LMA (The Laryngeal Mask Airway Co.), as a primary rescue airway device in obstetric anesthesia. These devices were developed in an attempt to overcome the cLMA's shortcomings: low-pressure seal and lack of protection against aspiration. Both devices have a modified cuff desig... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763351 Thu, 14 May 2009 23:00:00 +0100 2763351 http://www.medworm.com/index.php?rid=2763350&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001366%2Fabstract%3Frss%3Dyes Iatrogenic neuropathy of the lateral femoral cutaneous nerve (meralgia paresthetica) has been described after orthopedic procedures and following prone or lithotomy positioning. A patient who developed meralgia paresthetica after thoracoscopic surgery in the lateral position is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763350 Thu, 14 May 2009 23:00:00 +0100 2763350 http://www.medworm.com/index.php?rid=2763344&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001056%2Fabstract%3Frss%3Dyes Abstract: The Polestar N-20 Scanner (Medtronic Navigation, Louisville, CO) is an intraoperative magnetic resonance image (iMRI) guidance system designed for neurosurgery. Sixty-five patients underwent craniotomy for tumor resection using the iMRI during the period from April 2005 to December 2006. Anesthesiologists used an iMRI-compatible patient monitoring system (Veris MR, MEDRAD, Indianola, PA), anesthesia machine (Aestiva/5 MRI, Datex-Ohmeda, Madison, WI), and infusion pumps (Continuum; MEDRAD). Average setup time for each case (from intubation to incision) was one hour, 33 minutes and showed learning improvement over the 21-month period. The challenges facing the anesthesiologists in these cases included the need to use longer intravenous (IV) catheters and gas delivery and sampling l... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763344 Thu, 14 May 2009 23:00:00 +0100 2763344 http://www.medworm.com/index.php?rid=2763352&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281800900141X%2Fabstract%3Frss%3Dyes Use of a reinforced gastric tube as a guide to replace the ProSeal Laryngeal Mask Airway (PLMA; The Laryngeal Mask Airway Co., Ltd., Henley-on-Thames, UK) in the lateral position is presented. A 55-year-old, ASA physical status I woman was scheduled for plating of a fractured humerus in the lateral position. Her airway examination showed a Mallampati class II airway, adequate neck extension and mouth opening, and a thyromental distance of 6.5 cm. Dental hygiene was poor, with missing and sharp-edged teeth. After induction of anesthesia with the patient placed supine and with easy facemask ventilation, neuromuscular block was achieved. Laryngoscopy showed a Cormack and Lehane grade 3 view. Three attempts to negotiate an endotracheal tube using a gum elastic bougie and stylet failed. A size ... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763352 Wed, 13 May 2009 23:00:00 +0100 2763352 http://www.medworm.com/index.php?rid=2485908&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281800900107X%2Fabstract%3Frss%3Dyes Abstract: Obstructive sleep apnea (OSA) is associated with postoperative airway obstruction, hypoxemia, cardiac arrhythmias, cardiorespiratory arrest, hypoxic encephalopathy, and death. Three cases highlighting important issues in patients with OSA are presented that occurred prior to and after implementation of an OSA protocol. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485908 Tue, 12 May 2009 23:00:00 +0100 2485908 http://www.medworm.com/index.php?rid=2763338&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001123%2Fabstract%3Frss%3Dyes Abstract: Ventriculopleural shunts are one of the alternatives to ventriculoperitoneal shunts for draining cerebrospinal fluid. They are used in patients who have failed multiple ventriculoperitoneal shunts because of peritonitis, loculated ascites, or pseudocyst formation, or those who are not optimal candidates for vascular shunts. A case of acute recurrent subcutaneous emphysema around the incision of a ventriculopleural shunt is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763338 Mon, 11 May 2009 23:00:00 +0100 2763338 http://www.medworm.com/index.php?rid=2485916&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281800900110X%2Fabstract%3Frss%3Dyes I would like to thank Dr. Xue and his colleagues for their interest in our recent publication . I would also like to reply to some of their comments: Dr. Xue and his colleagues are concerned about the proposed technique to prevent pulmonary aspiration on induction of general anesthesia because of thickness of the GlideScope video laryngoscope (GVL; Diagnostic Ultrasound, Bothell, WA) blade relative to the size of the oral cavity and the fact that the GVL blade is inserted “along the midline of the mouth.” True, in some patients intraoral room may be limited and the maneuverability of multiple devices may be impaired. However, the size of the mouth opening for the described technique may be assessed during a preoperative physical examination, and the Yankauer device does not have to be... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485916 Mon, 11 May 2009 23:00:00 +0100 2485916 http://www.medworm.com/index.php?rid=2485914&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001111%2Fabstract%3Frss%3Dyes The first comment regards the necessity of comparing the pain scores of the Esmarch bandage and limb elevation techniques. Based on our observation, application of an Esmarch bandage could increase pain compared with just simple elevation of a sensitized and injured limb; it could be a subject for another study . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485914 Mon, 11 May 2009 23:00:00 +0100 2485914 http://www.medworm.com/index.php?rid=2485910&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001135%2Fabstract%3Frss%3Dyes Abstract: Two cases of posterolateral corner reconstruction of the knee with postoperative sciatic perineural analgesia using a mixture of clonidine and buprenorphine, are presented. Numeric rating scores for pain with movement were 0-2 out of 10 postoperatively after injection. Gross motor function below the knee was maintained in both cases. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485910 Mon, 11 May 2009 23:00:00 +0100 2485910 http://www.medworm.com/index.php?rid=2485909&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001093%2Fabstract%3Frss%3Dyes Abstract: Following failed intubation attempts via conventional direct laryngoscopy, an Esophageal Tracheal Combitube was successfully placed in the esophagus of a 51-year-old man with a subdural hematoma and uncleared cervical spine. The decision was made to change the Combitube for an endotracheal tube (ETT). After deflation of the large oropharyngeal cuff of the Combitube, video laryngoscopy was performed with the Direct Coupled Interface (DCI) video intubation system, and the Combitube was exchanged for an ETT with the assistance of a gum elastic bougie. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485909 Mon, 11 May 2009 23:00:00 +0100 2485909 http://www.medworm.com/index.php?rid=2485904&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001081%2Fabstract%3Frss%3Dyes Conclusion: The Pentax-AWS appears to require less operator skill than the Macintosh laryngoscope. Use of the Pentax-AWS may reduce the time to secure the airway and the incidence of failed tracheal intubation by non-anesthesia residents. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485904 Mon, 11 May 2009 23:00:00 +0100 2485904 http://www.medworm.com/index.php?rid=2763333&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001068%2Fabstract%3Frss%3Dyes Conclusions: Duration of surgery was greater with RALP, but it was associated with less EBL, fewer transfusions of blood products, and shorter PACU and hospital stays. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763333 Thu, 07 May 2009 23:00:00 +0100 2763333 http://www.medworm.com/index.php?rid=2485898&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001019%2Fabstract%3Frss%3Dyes Perioperative hypothermia is a common occurrence and is associated with physiological and clinical consequences . Hypothermia increases blood viscosity and hematocrit, and slows the enzymatic reactions of the intrinsic and extrinsic coagulation pathways leading to prolongation of partial thromboplastin time and prothrombin time, increased clotting time, impaired platelet function, increased platelet sequestration, and possibly increased fibrinolysis. Hypothermia also suppresses leukocyte migration and phagocytic capacity, reduces the generation of free radicals, and suppresses cytokine and antibody production and complement activation . It can lead to tachycardia, hypertension, and a reduction in cardiac output. Hypothermia also may result in myocardial ischemia, ventricular tachycardia, r... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485898 Thu, 07 May 2009 23:00:00 +0100 2485898 http://www.medworm.com/index.php?rid=2485905&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001044%2Fabstract%3Frss%3Dyes Conclusions: In this group of 200 consecutive patients, the success rate for postoperative analgesia using US guidance only was 99%. Untoward events such as needle paresthesia and persistent neurologic deficits were lower than existing data on nerve stimulation and paresthesia techniques. Ultrasound can be successfully used as a “stand alone” method to perform ISB. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485905 Sun, 03 May 2009 23:00:00 +0100 2485905 http://www.medworm.com/index.php?rid=2485903&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001032%2Fabstract%3Frss%3Dyes Conclusions: Difficult intubation was more prevalent among obese than non-obese patients, but intubation duration and lowest SaO2 levels during intubation were not. Moreover, the modified Mallampati test was found to be a moderately good (60%) predictor of difficult intubation among obese patients. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485903 Sun, 03 May 2009 23:00:00 +0100 2485903 http://www.medworm.com/index.php?rid=2485902&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001020%2Fabstract%3Frss%3Dyes Conclusion: For patients undergoing oromaxillofacial surgery, modified lightwand-guided nasotracheal intubation is feasible with a double curve nasotracheal tube and is an efficient alternative technique. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485902 Sun, 03 May 2009 23:00:00 +0100 2485902 http://www.medworm.com/index.php?rid=2485901&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001007%2Fabstract%3Frss%3Dyes Conclusions: Peripheral nerve block performed preoperatively in an induction area or LA injected in the OR significantly reduces anesthesia-controlled time for ambulatory upper extremity surgery compared with GA. Turnover time is unaffected by anesthetic technique. These results may increase acceptance of RA in the ambulatory surgery setting. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485901 Sun, 03 May 2009 23:00:00 +0100 2485901 http://www.medworm.com/index.php?rid=2428683&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001172%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428683 Fri, 01 May 2009 04:00:00 +0100 2428683 http://www.medworm.com/index.php?rid=2428682&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009001160%2Fabstract%3Frss%3Dyes (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428682 Fri, 01 May 2009 04:00:00 +0100 2428682 http://www.medworm.com/index.php?rid=2428699&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000944%2Fabstract%3Frss%3Dyes This article has been retracted at the request of the authors and/or the Editor-in-Chief. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428699 Wed, 29 Apr 2009 04:00:00 +0100 2428699 http://www.medworm.com/index.php?rid=2428684&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000993%2Fabstract%3Frss%3Dyes This study highlights three very important aspects of anesthesiology education: the use of technology to assist us in our academic mission, the need for rigorous study of our educational methods, and the importance of feedback in anesthesiology education programs. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428684 Mon, 20 Apr 2009 04:00:00 +0100 2428684 http://www.medworm.com/index.php?rid=2763346&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281800900097X%2Fabstract%3Frss%3Dyes Autonomic dysreflexia is usually described, in part, as hypertension occurring in response to stimulation entering the spinal cord below the level of a spinal cord transection. The exact pathophysiology is uncertain but may involve any or all of the following mechanisms: 1) loss of descending inhibitory input, 2) altered baroreceptor reflexes, 3) neuronal plasticity in the spinal cord after injury, 4) up-regulated alpha-1 receptors on resistance arterioles, and 5) decreased norepinephrine reuptake at adrenergic nerve terminals . Increased responsiveness of blood pressure (BP) to vasopressors such as phenylephrine has been described in patients with spinal cord transection above T6 , and this finding is consistent with mechanisms 4) and 5) above. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763346 Sun, 19 Apr 2009 23:00:00 +0100 2763346 http://www.medworm.com/index.php?rid=2485918&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000981%2Fabstract%3Frss%3Dyes We report three additional cases and discuss several mechanisms involved. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485918 Sun, 19 Apr 2009 23:00:00 +0100 2485918 http://www.medworm.com/index.php?rid=2485915&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000968%2Fabstract%3Frss%3Dyes We read with interest the recent letter of Dupanovic and Pichoff , regarding use of the GlideScope videolaryngoscope (GVL) in preventing pulmonary aspiration and a case with a large amount of gastric fluid regurgitation during anesthesia induction. These authors had successfully secured the airway by coordinating laryngoscopy, oropharyngeal suction, and endotracheal intubation with two operators. They provide a useful alternative to prevent pulmonary aspiration during the intubation using a GVL, but some possible technical difficulties must be noted: (a) The wide GVL blade (overall thickness of 18 mm and square design of the posterior part) may occupy significant intraoral room . Also, the requirement of the GVL blade insertion along the midline of mouth can further decrease maneuverabilit... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485915 Sun, 19 Apr 2009 23:00:00 +0100 2485915 http://www.medworm.com/index.php?rid=2485907&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000919%2Fabstract%3Frss%3Dyes Abstract: A patient with advanced Chagas disease presented with symptoms attributable to dilated cardiomyopathy and mitral regurgitation. Although esophageal involvement is part of the constellation of findings in Chagas, transesophageal echocardiography was safely used to guide the mitral valve surgery. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485907 Sun, 19 Apr 2009 23:00:00 +0100 2485907 http://www.medworm.com/index.php?rid=2895690&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000932%2Fabstract%3Frss%3Dyes Abstract: A 39-year-old patient awaiting emergency surgery due to a crush foot injury, with an undiagnosed cyanotic cardiac lesion that was diagnosed later as a complete atrioventricular canal defect, is presented. Complete atrioventricular canal defects usually present in the first few months of life and can be fatal if not treated in the first few years. Adult patients with congenital cardiac malformations seem to be at increased risk for noncardiac surgery. The diagnostic process, perioperative management, and anesthetic implications are discussed. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2895690 Wed, 15 Apr 2009 23:00:00 +0100 2895690 http://www.medworm.com/index.php?rid=2485913&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000956%2Fabstract%3Frss%3Dyes We read with interest the study by Farbood et al regarding comparison of two different methods of limb exsanguination . The risk of local anesthetic toxicity or inadequate effect of the block due to inadequate exsanguinations is always a concern in Bier block. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485913 Wed, 15 Apr 2009 23:00:00 +0100 2485913 http://www.medworm.com/index.php?rid=2485911&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000920%2Fabstract%3Frss%3Dyes Abstract: The fundamental skill required of the anesthesiologist and rescuer is to treat upper airway obstruction and maintain adequate ventilation. Adult one-hand face mask ventilation is a complex technique, often applied with suboptimal results. The adult face mask in use today was not designed for one-handed ventilation but inherited its features from the 19th century face piece. The airway maneuver used with one-handed ventilation is not standardized. An ergonomic face mask has an asymmetrical dome that accommodates the hand grip required for chin lift and may be better for one-hand ventilation. The historical and theoretical considerations patent to the design and technique of the ergonomic face mask are reviewed. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485911 Wed, 15 Apr 2009 23:00:00 +0100 2485911 http://www.medworm.com/index.php?rid=2485906&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000907%2Fabstract%3Frss%3Dyes Abstract: The case of a 65 year-old man with a massive oropharyngeal arteriovenous malformation, with acute deterioration and airway compromise, is presented. Optimal airway management was deemed to be fiberoptic intubation without sedative drugs. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485906 Wed, 15 Apr 2009 23:00:00 +0100 2485906 http://www.medworm.com/index.php?rid=2485900&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000877%2Fabstract%3Frss%3Dyes Conclusions: Transdermal scopolamine in addition to ondansetron benefits patients at high risk for PONV undergoing outpatient plastic surgery for up to 20 hours after surgery. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485900 Wed, 15 Apr 2009 23:00:00 +0100 2485900 http://www.medworm.com/index.php?rid=2428696&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000889%2Fabstract%3Frss%3Dyes Abstract: Perioperative hypertension is a common problem encountered by anesthesiologists, surgeons, internists, and intensivists. Surprisingly, no randomized, placebo-controlled studies exist that show that the treatment of perioperative hypertension reduces morbidity or mortality. Nevertheless, perioperative hypertension requires careful management. While sodium nitroprusside and nitroglycerin are commonly used to treat these conditions, these agents are less than ideal. Intravenous beta blockers and calcium channel blockers have particular appeal in this setting. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428696 Fri, 10 Apr 2009 04:00:00 +0100 2428696 http://www.medworm.com/index.php?rid=2428695&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000890%2Fabstract%3Frss%3Dyes Abstract: The case of a 67-year-old woman with multiple medical problems who presented for resection of a metastatic renal cell carcinoma involving the posterior fossa, is presented. Anesthetic management of the patient, who suffered metastasis to the brain, and who required deep hypothermic circulatory arrest, is discussed. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428695 Thu, 09 Apr 2009 04:00:00 +0100 2428695 http://www.medworm.com/index.php?rid=2428694&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000865%2Fabstract%3Frss%3Dyes Abstract: Dexmedetomidine, which is a relatively selective alpha2-adrenoceptor agonist, is used for sedation and analgesia in intensive care unit patients, during awake craniotomies in pediatric and adult patients, and during magnetic resonance imaging, with minimal depression of respiratory function. The successful use of dexmedetomidine in a pediatric patient undergoing bilateral deep brain stimulator placement for the treatment of generalized dystonia, is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428694 Thu, 09 Apr 2009 04:00:00 +0100 2428694 http://www.medworm.com/index.php?rid=2428693&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS095281800900083X%2Fabstract%3Frss%3Dyes Abstract: The case of a 57-year-old man who underwent major spinal surgery as a result of a traumatic burst fracture of the T12 vertebra, is presented. Changes in somatosensory evoked potentials and motor evoked potentials following the intraoperative epidural administration of ropivacaine, is described. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428693 Thu, 09 Apr 2009 04:00:00 +0100 2428693 http://www.medworm.com/index.php?rid=2428692&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000841%2Fabstract%3Frss%3Dyes Abstract: A complication following placement of the pulmonary artery catheter (PAC) is presented. Resistance was experienced during insertion of the introducer sheath, and the PAC could not be advanced into the right heart. Finally, the PAC was successfully placed through the left internal jugular vein. Perforation of the right innominate vein was identified following emergent exploratory surgery for cardiovascular collapse. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428692 Thu, 09 Apr 2009 04:00:00 +0100 2428692 http://www.medworm.com/index.php?rid=2428689&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000853%2Fabstract%3Frss%3Dyes Conclusions: Seventy percent N2O in O2 given for three minutes was effective for reducing venipuncture pain in children. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428689 Thu, 09 Apr 2009 04:00:00 +0100 2428689 http://www.medworm.com/index.php?rid=2763345&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000816%2Fabstract%3Frss%3Dyes It has been estimated that over 7 million percutaneous central venous cannulations are performed every year in the United States . Because subclavian venous cannulation (SVC) offers convenient and reliable access, it is performed for a wide variety of indications, including perioperative access, pressure monitoring, parenteral nutrition, chemotherapy, plasmapheresis, and hemodialysis. As SVC is performed so frequently, it may appear to be a safe, minor procedure. A case of accidental pulmonary artery (PA) injury resulting in massive hemothorax during attempted SVC is presented. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2763345 Wed, 08 Apr 2009 23:00:00 +0100 2763345 http://www.medworm.com/index.php?rid=2485919&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000786%2Fabstract%3Frss%3Dyes Ropivacaine is a long-acting local anesthetic with a lower toxicity profile than bupivacaine . The onset of central nervous system (CNS) symptoms after intravenous (IV) administration in healthy volunteers is observed at 2.2 μg/mL in venous samples . Despite the safe pharmacokinetic profile of ropivacaine, some researchers have reported side effects caused by ropivacaine's toxicity . (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485919 Wed, 08 Apr 2009 23:00:00 +0100 2485919 http://www.medworm.com/index.php?rid=2485917&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000798%2Fabstract%3Frss%3Dyes We describe a simple device that provides a liquid crystal display (LCD) monitor and recording system for the Airtraq laryngoscope (ATQ; Prodol Meditec S.A., Vizcaya, Spain). A number of new intubation devices such as the ATQ and Airway Scope (AWS; Pentax, Tokyo, Japan), which allow endotracheal intubation without direct view of the glottis, have recently become available. The AWS has a charge-coupled device (CCD) camera and built-in color LCD monitor that can provide a view for staff other than the operator . The ATQ visual guidance system features high-definition optical lenses but no monitor, and view of the glottis is verifiable only by the operator through the viewfinder . Hence, a video system and external monitor are required for other clinical staff to view laryngoscopic procedures... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485917 Wed, 08 Apr 2009 23:00:00 +0100 2485917 http://www.medworm.com/index.php?rid=2485899&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000828%2Fabstract%3Frss%3Dyes Conclusion: Administration of pre-warmed intravenous colloid followed by crystalloids maintained core temperature during Cesarean delivery and induced higher Apgar scores and umbilical arterial pH. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2485899 Wed, 08 Apr 2009 23:00:00 +0100 2485899 http://www.medworm.com/index.php?rid=2428691&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000804%2Fabstract%3Frss%3Dyes Conclusions: Overall satisfaction following day surgery was at least 95% at discharge and at 30 days. However, complete satisfaction was present only in 75% at discharge and decreased to 62% at 30 days. Clinical outcome was strongly related to patient satisfaction at 30 days after surgery. Factors directly controlled by anesthesiologists such as postoperative pain and information provided, also had a significant impact on patient satisfaction. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428691 Wed, 08 Apr 2009 04:00:00 +0100 2428691 http://www.medworm.com/index.php?rid=2428688&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000774%2Fabstract%3Frss%3Dyes Conclusions: A high gas flow rate appears critical to achieving rapid preoxygenation. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428688 Mon, 06 Apr 2009 04:00:00 +0100 2428688 http://www.medworm.com/index.php?rid=2428687&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000750%2Fabstract%3Frss%3Dyes Conclusions: Gender difference has an effect on the mask ventilation learning process, as it was more difficult for female residents to provide a tight air seal in the early stage of training. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428687 Thu, 02 Apr 2009 04:00:00 +0100 2428687 http://www.medworm.com/index.php?rid=2428690&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000762%2Fabstract%3Frss%3Dyes Conclusion: Dexmedetomidine combined with fentanyl during anesthetic induction suppresses the decrease in blood pressure due to anesthetic induction and also blunts the cardiovascular response to tracheal intubation. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428690 Wed, 01 Apr 2009 04:00:00 +0100 2428690 http://www.medworm.com/index.php?rid=2428697&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000749%2Fabstract%3Frss%3Dyes One aphorism says, “When there are problems with any regional technique, look for the cause first on the proximal end of the needle” . Ultrasound-guided nerve blocks have become more and more popular in recent years because ultrasound can provide direct visualization of the nerves, passage of a needle, and distribution of local anesthetic during injection . The operator's skill in aligning the ultrasound probe and the needle should be the most important factor influencing needle visibility when the in-plane technique is used. Slight displacement of the probe and/or the needle may cause passage out of the plane of imaging. It is time-consuming and prone to cause injury—especially for those anesthesiologists who are inexperienced with ultrasonography. We designed a needle guide that ca... Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428697 Tue, 31 Mar 2009 04:00:00 +0100 2428697 http://www.medworm.com/index.php?rid=2428686&cid=s_37062_5_f&fid=37062&url=http%3A%2F%2Fwww.jcafulltextonline.com%2Farticle%2FPIIS0952818009000464%2Fabstract%3Frss%3Dyes Conclusions: In elderly patients, hypercapnia has less effect on cerebral circulation during propofol anesthesia than with sevoflurane. (Source: Journal of Clinical Anesthesia) Journal of Clinical Anesthesia journals http://www.medworm.com/rss/comments.php?id=2428686 Fri, 27 Mar 2009 04:00:00 +0100 2428686