Assessing volume responsiveness using right ventricular dynamic indicators of preload
AbstractPurposeDynamic indicators of preload currently only do reflect preload requirements of the left ventricle. To date, no dynamic indicators of right ventricular preload have been established. The aim of this study was to calculate dynamic indicators of right ventricular preload and assess their ability to predict ventricular volume responsiveness.Materials and methodsThe study was designed as experimental trial in 20 anaesthetized pigs. Micro-tip catheters and ultrasonic flow probes were used as experimental reference to enable measurement of right ventricular stroke volume and pulse pressure. Hypovolemia was induced...
Source: Journal of Anesthesia - May 5, 2021 Category: Anesthesiology Source Type: research

Factors associated with quality of dreams during general anesthesia: a prospective observational study
AbstractPatients frequently report having dreams during general anesthesia, and the dreams are often reported to be pleasant dreams. However, factors associated with the quality of dreams during general anesthesia have not been clarified. The aim of this study was to determine the relationships between the quality of dreams during general anesthesia and perioperative factors. This prospective observational study included patients scheduled for elective surgery under general anesthesia. Preoperative mental status was assessed by the Hospital Anxiety and Depression Scale (HADS). A postoperative interview was carried out in t...
Source: Journal of Anesthesia - May 5, 2021 Category: Anesthesiology Source Type: research

Correction to: Associations of preoperative stroke and tranexamic acid administration with convulsive seizures in valvular open-heart surgery
A correction to this paper has been published: https://doi.org/10.1007/s00540-021-02936-6 (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - April 28, 2021 Category: Anesthesiology Source Type: research

ORi ™: a new indicator of oxygenation
AbstractIn the perioperative period, hypoxemia and hyperoxia are crucial factors that require attention, because they greatly affect patient prognoses. The pulse oximeter has been the only noninvasive monitor that can be used as a reference of oxygenation in current anesthetic management; however, in recent years, a new monitoring method that uses the oxygen reserve index (ORi ™) has been developed by Masimo Corp. ORi is an index that reflects the state of moderate hyperoxia (partial pressure of arterial oxygen [PaO2] between 100 and 200  mmHg) using a non-unit scale between 0.00 and 1.00. ORi monitoring perform...
Source: Journal of Anesthesia - April 26, 2021 Category: Anesthesiology Source Type: research

Correction to: COVID-19: accurate interpretation of diagnostic tests —a statistical point of view
A correction to this paper has been published: https://doi.org/10.1007/s00540-021-02939-3 (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - April 26, 2021 Category: Anesthesiology Source Type: research

Double-C hold for bag-mask ventilation during resuscitation
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - April 24, 2021 Category: Anesthesiology Source Type: research

Effects of estimated glomerular filtration rate and diabetes mellitus on the effect of insulin for treating hyperkalemia during anesthesia
AbstractPurposeWe analyzed the effectiveness of insulin for treating hyperkalemia ( ≥ 5 mEq/L) during anesthesia and the effects of the estimated glomerular filtration rate (eGFR) and diabetes mellitus (DM) on the insulin treatment.MethodsPatients 18  years of age and older who received intravenous insulin lispro for hyperkalemia under general anesthesia between January 2010 and March 2020 were enrolled. We performed three propensity score matching analyses according to eGFR stages (eGFR ≥ 60 vs. 30 ≤ eGFR 
Source: Journal of Anesthesia - April 16, 2021 Category: Anesthesiology Source Type: research

Higher preoperative Qp/Qs ratio is associated with lower preoperative regional cerebral oxygen saturation in children with ventricular septal defect
AbstractPurposeThe relationship between regional cerebral oxygen saturation (rSO2) and the amount of left-to-right shunt in ventricular septal defect (VSD) patients has not yet been investigated. The purpose of this study was to identify the association of preoperative pulmonary to systemic blood flow (Qp/Qs) ratio and preoperative rSO2 in patients with VSD.MethodsWe retrospectively evaluated 49 VSD surgical closure candidates at a single institution. Preoperative Qp/Qs ratio was compared with rSO2 measurements at the time of VSD closure surgery.ResultsForty-nine were eligible for the final analysis. The median age at surg...
Source: Journal of Anesthesia - April 13, 2021 Category: Anesthesiology Source Type: research

Margin of safety for needle puncture of a radial artery
In conclusion, we have shown that the margin of safety for needle puncture of a radial artery is about 6.8 cm from the wrist for in men, and 5.4 cm from the wrist for in women. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - April 12, 2021 Category: Anesthesiology Source Type: research

Is there a role for pregabalin as premedication in pediatric anesthesia?
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - April 9, 2021 Category: Anesthesiology Source Type: research

Baseline HbA1c in acute kidney injury after cardiac surgery
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - April 9, 2021 Category: Anesthesiology Source Type: research

Propofol reduces the amplitude of transcranial electrical motor-evoked potential without affecting spinal motor neurons: a prospective, single-arm, interventional study
AbstractPurposePropofol inhibits the amplitudes of transcranial electrical motor-evoked potentials (TCE-MEP) in a dose-dependent manner. However, the mechanisms of this effect remain unknown. Hence, we investigated the spinal mechanisms of the inhibitory effect of propofol on TCE-MEP amplitudes by evaluating evoked electromyograms (H-reflex and F-wave) under general anesthesia.MethodsWe conducted a prospective, single-arm, interventional study including 15 patients scheduled for spine surgery under general anesthesia. Evoked electromyograms of the soleus muscle and TCE-MEPs were measured at three propofol concentrations us...
Source: Journal of Anesthesia - April 7, 2021 Category: Anesthesiology Source Type: research

Associations of preoperative stroke and tranexamic acid administration with convulsive seizures in valvular open-heart surgery
AbstractIn cardiac surgery, use of the antifibrinolytic agent tranexamic acid (TXA) and acute perioperative stroke are both associated with convulsive seizures. We hypothesized that an older (preoperative) stroke increases the risk of TXA-associated seizures as well. To test this hypothesis, we retrospectively analyzed data from 16,110 patients who had undergone open-heart valvular surgery at our institution between 2009 and 2020. The dosing of TXA was moderate. Use of TXA and a history of stroke were both independently associated with convulsive seizure with an adjusted odds ratio (OR) of 2.40 (95%CI: 1.71 –3.37) an...
Source: Journal of Anesthesia - April 6, 2021 Category: Anesthesiology Source Type: research

A mechanism of re-sedation caused by remimazolam
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - April 6, 2021 Category: Anesthesiology Source Type: research

Dexmedetomidine ameliorates lipopolysaccharide-induced acute lung injury by inhibiting the PI3K/Akt/FoxO1 signaling pathway
ConclusionsThese data suggest that DEX ameliorates LPS-induced acute lung injury partly through the PI3K/Akt/FoxO1 signaling pathway. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - April 5, 2021 Category: Anesthesiology Source Type: research

Ethnic disparities in postpartum hemorrhage after cesarean delivery: a retrospective case –control study
ConclusionUygur have more tendency to PPH compared to Han, and risk factors for PPH in Uygur and Han groups may differ. Knowing these differences may be meaningful when planning interventions and resources for high-risk patients undergoing cesarean delivery, and we need more research aimed at risk factors for PPH. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 17, 2021 Category: Anesthesiology Source Type: research

Concerns for labor analgesia and autism spectrum disorders
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 17, 2021 Category: Anesthesiology Source Type: research

Journal of anesthesia, history, current status, and future direction
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 9, 2021 Category: Anesthesiology Source Type: research

Re-sleeping after reversal of remimazolam by flumazenil
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 9, 2021 Category: Anesthesiology Source Type: research

The uterine contraction evaluation is tricky in the in vivo
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 9, 2021 Category: Anesthesiology Source Type: research

Sugammadex versus neostigmine on postoperative pulmonary complications after robot-assisted laparoscopic prostatectomy: a propensity score-matched analysis
AbstractPurposeRobot-assisted laparoscopic prostatectomy (RALP) requires particular surgical conditions, such as carbon dioxide pneumoperitoneum and steep Trendelenburg positioning, which may have adverse effects on the respiratory system. The effect of sugammadex on postoperative pulmonary complications (PPCs) is controversial. Therefore, we evaluated the incidence of PPCs according to the type of neuromuscular blockade reversal agents in RALP.MethodsWe retrospectively analyzed RALP patients. We compared the incidence of PPCs between patients receiving neostigmine (neostigmine group) and those receiving sugammadex (sugamm...
Source: Journal of Anesthesia - March 8, 2021 Category: Anesthesiology Source Type: research

Cervical erector spinae plane block as a perioperative analgesia method for shoulder arthroscopy: a case series
AbstractShoulder arthroscopy, a common intervention for severe rotator cuff injuries, is associated with severe postoperative pain. Upon performing cervical erector spinae plane (ESP) blocks at the C7 TP (tip or posterior tip) or the posterior tip of the C6 TP posterior tubercle in six patients undergoing shoulder arthroscopy, sensory block was detectable in congruent cervico-thoracic dermatomes. Effective intraoperative and postoperative analgesia were consistently obtained for all six patients. This preliminary study illustrated that the cervical ESP block can be considered a potential simple regional anesthesia method f...
Source: Journal of Anesthesia - March 8, 2021 Category: Anesthesiology Source Type: research

Delivery and neuraxial technique outcomes in patients with hemophilia and in hemophilia carriers: a systematic review
AbstractFemale carriers are more common than males with hemophilia and unrecognized factor VIII or IX deficiency is associated with intrauterine growth retardation, epidural hematomas, blood transfusion, and peripartum hemorrhage. A review was conducted to assess the evidence for professional society recommendations for  >  50% factor levels during labor. Two searches of Pubmed, CINAHL, Cochrane, and Google Scholar were completed in October 2019. The first for case reports and series described neuraxial techniques in patients with hemophilia—regardless of sex, age, or pregnant status. The second for ...
Source: Journal of Anesthesia - March 8, 2021 Category: Anesthesiology Source Type: research

Association between ionized magnesium and postoperative shivering
ConclusionA decrease in the [iMg] during surgery was significantly associated with postoperative shivering. Subjects who had an [iMg] lower than 0.6  mmol/L post-surgery and decreased [iMg] during surgery had a significantly higher risk of postoperative shivering. Intraoperative depletion of [iMg] was significantly associated with shivering. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 7, 2021 Category: Anesthesiology Source Type: research

Aerosol extractor for airway management of COVID-19 patients
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 7, 2021 Category: Anesthesiology Source Type: research

An introductory guide to quality improvement in perioperative medicine
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 4, 2021 Category: Anesthesiology Source Type: research

Clinical profiles and outcome of patients with COVID-19 in a specialized hospital in Japan
AbstractPurposeTo characterize the clinical features and outcome of patients treated at a specialized hospital for coronavirus disease 2019 (COVID-19).MethodsWe retrospectively reviewed the symptoms on admission, treatment, and outcome of a total of 300 patients with mild (peripheral oxygen saturation (SpO2)  ≥ 96%), moderate I (93% 
Source: Journal of Anesthesia - March 4, 2021 Category: Anesthesiology Source Type: research

Malignant hyperthermia in a 16-day-old infant with congenital diaphragmatic hernia: a case report
We report the case of a 16-day-old infant undergoing laparoscopic surgery. The patient developed hyperthermia and hypercarbia with muscle rigidity. After the diagnosis of MH, dantrolene was administered with sufficient hydration. The patient was transferred to the pediatric intensive care unit for monitoring and treatment of acute renal injury due to myoglobinuria. Subsequently, two variants of the ryanodine receptor 1 (RYR1) gene were identified in the patient as the mutation point at c.1589G  >  A p.Arg530His and c.1841G >  T p.Arg614Leu, which are known to be associated with MH. This wa...
Source: Journal of Anesthesia - February 24, 2021 Category: Anesthesiology Source Type: research

The ability of pulse oximetry-derived peripheral perfusion index to detect fluid responsiveness in patients with septic shock
Conclusion∆PPI showed moderate ability to detect fluid responsiveness in patients with septic shock on norepinephrine infusion. Increased PPI after 200 mL crystalloid challenge can detect fluid responsiveness with a positive predictive value of 92%; however, failure of the PPI to increase does not exclude fluid responsiveness.Clinical trial identifierNCT03805321. Date of registration: 15 January 2019. Clinical trial registration URL:https://clinicaltrials.gov/ct2/show/NCT03805321?term=ahmed+hasanin&rank=9. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - February 22, 2021 Category: Anesthesiology Source Type: research

The usefulness of Smart Pilot View for fast recovery from desflurane general anesthesia
ConclusionSmart Pilot View guided anesthesia enabled faster recovery from desflurane general anesthesia. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - February 13, 2021 Category: Anesthesiology Source Type: research

Incidence of accidental events during anesthesia from 2012 to 2016: survey on anesthesia-related events by the Japanese Society of Anesthesiologists
ConclusionThe incidence of cardiac arrest during this period was 2.63/10,000, which was lower the incidence reported in other countries. While no change was observed in the incidence of severe hypotension over the survey period, the incidence of severe hypoxia and life-threatening arrhythmia decreased by 20 –25% during those 5 years. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - February 10, 2021 Category: Anesthesiology Source Type: research

Intraoperative hypotension and perioperative acute ischemic stroke in patients having major elective non-cardiovascular non-neurological surgery
AbstractPurposeThe association between intraoperative hypotension and perioperative acute ischemic stroke is not well described. We hypothesized that intraoperative hypotension would be associated with perioperative acute ischemic stroke.MethodsFour-year retrospective cohort study of elective non-cardiovascular, non-neurological surgical patients. Characteristics of patients who had perioperative acute ischemic stroke were compared against those of patients who did not have acute ischemic stroke. Multivariable logistic regression was used to determine whether hypotension was independently associated with increased odds of ...
Source: Journal of Anesthesia - February 9, 2021 Category: Anesthesiology Source Type: research

Experiential learning in simulated parapharyngeal abscess in breathing cadavers
ConclusionsSurgical modifications of cadavers to simulate difficult airways such as parapharyngeal abscess with edema and stridor can be incorporated into advanced airway management courses to enhance experiential learning in airway management by awake fibreoptic intubation, and promote patient safety. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - February 8, 2021 Category: Anesthesiology Source Type: research

Current status of variations in in-hospital cardiac arrest call numbers in Japan: a nationwide survey
AbstractThe use of standardized internal hospital phone numbers for cardiac arrest is advocated in Europe. We evaluated the current status of variations in medical emergency call numbers for in-hospital patients in Japan and whether anesthesiologists would approve a standardized number. From June 2018 to August 2018, a questionnaire survey was mailed to anesthesiologists in 1373 Japanese Society of Anesthesiologists (JSA)-accredited hospitals. The basis for opinions on using a standardized cardiac arrest call number in all Japanese hospitals was evaluated. Of 1373 facilities (response rate, 58%,n = 800), 741/...
Source: Journal of Anesthesia - February 8, 2021 Category: Anesthesiology Source Type: research

Dermatomal coverage of single-injection ultrasound-guided parasagittal approach to anterior quadratus lumborum block at the lateral supra-arcuate ligament
In this study, we determined the effectiveness of a new ultrasound-guided parasagittal approach to anterior QL block at the lateral supra-arcuate ligament. Twenty six patients scheduled for laparoscopic renal surgery were enrolled. The parasagittal approach to the anterior QL block at the lateral supra-arcuate ligament was carried out preoperatively. Our data showed that at 5 and 10  min after injection, the patients achieved the sensory block of dermatomes T9–T12 and T7–L1, respectively. Some patients achieved coverage as cephalad as T5 and as caudal as L3. Four patients (16.7%) developed quadriceps weakn...
Source: Journal of Anesthesia - February 7, 2021 Category: Anesthesiology Source Type: research

The characteristics, types of intervention, and outcomes of postoperative patients who required rapid response system intervention: a nationwide database analysis
ConclusionApproximately, 70% of the RRS activations occurred within postoperative day 3. Circulatory problems were a more frequent cause of RRS activation in the postoperative group than in the non-postoperative group. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - February 1, 2021 Category: Anesthesiology Source Type: research

Clotting functional stability of withdrawing blood in storage for acute normovolemic hemodilution: a pilot study
ConclusionEven though the MCE significantly decreased in a time-dependent manner, MCF of FIBTEM and EXTEM was normal up to 24  h storage. The blood of ANH can use for the purpose of hemostasis at least 8 h stored at room temperature after blood withdrawal. Future studies are needed to elucidate the clinical impact on the patient after delayed transfusion of ANH blood with regard to patient’s hemostasis. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - January 27, 2021 Category: Anesthesiology Source Type: research

Interval-dependent neurotoxicity after multiple ketamine injections in late postnatal mice
ConclusionsMultiple ketamine injections induce interval-dependent, long-lasting synaptic changes and behavioral impairments. Future studies should carefully consider the dosing interval as a significant factor when studying the neurotoxic effects of multiple anesthetic exposures. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - January 27, 2021 Category: Anesthesiology Source Type: research

A modified algorithm for choosing the most appropriate intraoperative pacemaker mode for patients with permanent pacemaker in non-cardiac surgery
AbstractTo avoid the risk of R-on-T incident and the unnecessary decrease of cardiac output, we devised an algorithm consisting of six steps for choosing the most appropriate intraoperative pacemaker (PM) mode, which is modified from Heart Rhythm Society and the American Society of Anesthesiologists expert consensus statement. Following this algorithm, we reviewed previous operations at our hospital to evaluate the appropriateness of the choices. Six of 78 cases (7.7%) were unfit to the algorithm because of an inappropriate mode change. The PM mode was changed preoperatively in four patients, even though the surgical site ...
Source: Journal of Anesthesia - January 27, 2021 Category: Anesthesiology Source Type: research

Suprazygomatic maxillary nerve block: an ultrasound and cadaveric study to identify correct sonoanatomical landmarks
ConclusionAn improved understanding of the sonoanatomy will aid clinicians who are learning, performing and teaching the ultrasound-guided suprazygomatic approach to the maxillary nerve block. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - January 27, 2021 Category: Anesthesiology Source Type: research

Trends in PACU utilization in Japanese children ’s hospitals
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - January 26, 2021 Category: Anesthesiology Source Type: research

Clinical characteristics and outcomes of critically ill patients with COVID-19 in Kobe, Japan: a single-center, retrospective, observational study
ConclusionDuring the first months of the outbreak in Kobe, most critically ill patients were men aged  ≥ 60 years with at least one comorbidity and on mechanical ventilation; the ICU capacity was not strained, and the case-fatality rate was 19%. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - January 23, 2021 Category: Anesthesiology Source Type: research

Perioperative management of Fontan operation for the child with panhypopituitarism: a case report
AbstractWith the surgical improvement of congenital heart disease, Fontan operation has been applied to many complicated patients in recent years. This is the first report of a child with panhypopituitarism who underwent Fontan operation. A 5-year-old boy was scheduled for Fontan operation. He previously underwent Blalock-Taussig shunt and bidirectional Glenn operations for univentricular heart with double-outlet right ventricle and pulmonary atresia. He was receiving hydrocortisone and 1-desamino-8-D-arginine vasopressin (DDAVP) for panhypopituitarism secondary to removal of craniopharyngioma performed at the age of three...
Source: Journal of Anesthesia - January 15, 2021 Category: Anesthesiology Source Type: research

Methadone: applications in pediatric anesthesiology and critical care medicine
AbstractLike morphine, methadone is a pure agonist at the µ opioid receptor. However, in distinction to morphine which has an elimination half-life of 2–3 h, methadone has an elimination half-life of 24–36 h. In addition to its effects at the µ opioid receptor, methadone is an antagonist at then-methyl-d-aspartate (NMDA) receptor and also inhibits the reuptake of the neurotransmitters, serotonin and norepinephrine, in the central nervous system. Given its long half-life and high oral bioavailability, methadone has had a primary role in the outpatient treatment of patients with a history of...
Source: Journal of Anesthesia - January 12, 2021 Category: Anesthesiology Source Type: research

Error grid analysis for risk management in the difference between invasive and noninvasive blood pressure measurements
ConclusionsThe error grid analysis indicated that the differences between IAP and NIBP for mean blood pressure were not clinically acceptable and had the risk of leading to unnecessary treatments. Continuous phenylephrine administration and age were the significant factors of an increased clinical risk of the discrepancies between IAP and NIBP. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - January 11, 2021 Category: Anesthesiology Source Type: research

Generic rocuronium reduces withdrawal movements compared to original rocuronium under target-controlled infusion induction with propofol
This study was carried out to compare the injection pain caused by generic rocuronium and that caused by original rocuronium in patients anesthetized by propofol with a target-controlled infusion system.MethodsForty patients were randomly assigned to two groups in this single-center, prospective, randomized, double-blind study. One group was administered generic rocuronium after sedation with propofol with a target-controlled infusion system. The other group was administered original rocuronium after anesthesia with propofol. Patient ’s withdrawal movements were assessed with the scale. The primary outcome was the to...
Source: Journal of Anesthesia - January 9, 2021 Category: Anesthesiology Source Type: research

Drug-induced anaphylaxis during general anesthesia in 14 tertiary hospitals in Japan: a retrospective, multicenter, observational study
AbstractSince perioperative anaphylaxis occurs suddenly, and it can be life-threatening, anesthesiologists need to have sufficient knowledge of the epidemiology of perioperative anaphylaxis and appropriate coping strategies to deal with it. Recent studies conducted in Western countries reported the characteristics of perioperative anaphylaxis in each country. However, there are few studies of perioperative anaphylaxis in Japan. To bridge the gap between Japan and other countries, the data of 46 anaphylaxis patients at Gunma University Hospital and 13 neighboring hospitals between 2012 and 2018 were collected and analyzed. ...
Source: Journal of Anesthesia - January 9, 2021 Category: Anesthesiology Source Type: research

Incidence and effects of postoperative migration of interscalene catheter tips placed using ultrasound-guided anterior and posterior approaches
We examined to see if catheter tip migration would occur with no catheter-at-skin change after anterior and posterior approaches to CISB in patients undergoing shoulder surgery, and compared the incidence rate and pain scores between approaches and between catheters with and without tip migration, respectively.MethodsPatients were randomly assigned to receive CISB using either anterior or posterior approach. Catheter tip was observed using a cross-sectional view. The rates of catheter tip migration with no catheter-at-skin change at 24  h after the two approaches were calculated and compared, and pain scores were comp...
Source: Journal of Anesthesia - January 8, 2021 Category: Anesthesiology Source Type: research

Reply to the letter
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - January 8, 2021 Category: Anesthesiology Source Type: research

Cardiopulmonary bypass and halogenated agents
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - January 7, 2021 Category: Anesthesiology Source Type: research