Age is a predictive factor in the femoral nerve positioning: an anatomical ultrasound study
AbstractPrecise identification of the femoral nerve (FN) is essential for an ultrasound-guided femoral nerve block. We hypothesized that the distance between the FN and the femoral artery (FA) is correlated with patient age. In this prospective observational study, we evaluated the FN –FA (from the lateral edge of the FA to the medial edge of the FN) distance [0.42 ± 0.42 (mean ± standard deviation) cm] in 102 patients using ultrasound. In addition, we calculated the cross-sectional area of the iliopsoas muscle using computed tomography or magnetic resonance imaging. Multiple...
Source: Journal of Anesthesia - August 21, 2018 Category: Anesthesiology Source Type: research

The tendinous septum of the semispinalis capitis muscle spatially separates the dorsal ramus between C3 and C4
AbstractLocal anesthetic injection into the medial head of the semispinalis capitis muscle can anesthetize the greater occipital nerve (GON) and third occipital nerve (TON) simultaneously (greater and third occipital nerve block: GTO block). Alternatively, inter-semispinal plane (ISP) block can anesthetize the dorsal rami of the cervical spinal nerves from C4 to T4. The GON, TON, and the dorsal rami of the inferior level cannot be blocked with a single injection. To elucidate this phenomenon from an anatomical standpoint, we performed an ISP block either alone or with a GTO block using water-based acrylic dye in three thie...
Source: Journal of Anesthesia - August 20, 2018 Category: Anesthesiology Source Type: research

Dexmedetomidine mitigates sevoflurane-induced cell cycle arrest in hippocampus
ConclusionSevoflurane suppressed neuron cell proliferation via inhibiting the expression of BDNF and TrkB, and DEX relieved the neurotoxicity induced by sevoflurane via α2 adrenergic receptor. These findings provided new evidence that DEX exerted as a neuroprotective strategy in sevoflurane-induced neuro-damage, and provided new basis for the clinical application of DEX. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - August 20, 2018 Category: Anesthesiology Source Type: research

Rocuronium pharmacodynamic models for published five pharmacokinetic models: age and sex are covariates in pharmacodynamic models
ConclusionEach pharmacodynamic model with the corresponding pharmacokinetic model can be described the time course of rocuronium effect appropriately. The required effect-site concentration of rocuronium for a pharmacodynamic effect was depending on the applied models. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - August 11, 2018 Category: Anesthesiology Source Type: research

Analgesic effects of methadone and magnesium following posterior spinal fusion for idiopathic scoliosis in adolescents: a randomized controlled trial
ConclusionWith the dosing regimens in the current study, the only benefit noted with methadone was a decrease in perioperative opioid requirements. However, given the potential for hyperalgesia with the intraoperative use of remifentanil, adjunctive use of methadone appears warranted. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - August 4, 2018 Category: Anesthesiology Source Type: research

The history and progress of local anesthesia: multiple approaches to elongate the action
AbstractAnalgesia and temporary inhibition of motor activity without interfering with central nervous function have been the essential merits of local anesthesia. Local anesthetics originated from cocaine have played a major role in local analgesia. However, the relatively short duration of action of local anesthetics has been a concern in intra- and post-operative analgesia. From the early age of modern local anesthesia, physicians and medical scientists had been struggling to control the active duration of local anesthetics. Such approach includes: development of long-acting local anesthetics, with physical tourniquet te...
Source: Journal of Anesthesia - July 28, 2018 Category: Anesthesiology Source Type: research

Anatomical basis for simultaneous block of greater and third occipital nerves, with an ultrasound-guided technique
ConclusionsThe medial head of the semispinalis capitis muscle is a suitable landmark for blocking the greater and third occipital nerves simultaneously, by which occipital nerve involvement in various headache disorders may be rapidly examined and treated. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - July 28, 2018 Category: Anesthesiology Source Type: research

Opioids, gliosis and central immunomodulation
AbstractNeuropathic pain is a common health problem that affects millions of people worldwide. Despite being studied extensively, the cellular and molecular events underlying the central immunomodulation and the pathophysiology of neuropathic pain is still controversial. The idea that ‘glial cells are merely housekeepers’ is incorrect and with respect to initiation and maintenance of neuropathic pain, microglia and astrocytes have important roles to play. Glial cells differentially express opioid receptors and are thought to be functionally modulated by the activation of thes e receptors. In this review, we dis...
Source: Journal of Anesthesia - July 27, 2018 Category: Anesthesiology Source Type: research

Accuracy of identifying the cricothyroid membrane in children using palpation
AbstractAccurate identification of the cricothyroid membrane (CTM) has paramount importance in the event of a ‘cannot intubate, cannot oxygenate’ scenario. We sought to determine the ability of anesthesiologists to correctly identify the CTM in obese and non-obese children. Anesthesiologists were asked to mark the entry point of the cricothyroidotomy device with an ultraviolet invisible pen on obese and non-obese (BMI 
Source: Journal of Anesthesia - July 27, 2018 Category: Anesthesiology Source Type: research

Reply to: Acute kidney injury in parturients with severe preeclampsia
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - July 24, 2018 Category: Anesthesiology Source Type: research

Acute kidney injury in parturients with severe preeclampsia
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - July 24, 2018 Category: Anesthesiology Source Type: research

High BIS and low rSO 2 during CPB: seizure?
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - July 21, 2018 Category: Anesthesiology Source Type: research

Hypotension after induction of general anesthesia: occurrence, risk factors, and therapy. A prospective multicentre observational study
ConclusionGAIH rate depends on age, degree of blood pressure decompensation prior the surgery, and presence of diabetes mellitus type II. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - July 19, 2018 Category: Anesthesiology Source Type: research

Superior sealing effect of a three-dimensional printed modified supraglottic airway compared with the i-gel in a three-dimensional printed airway model
ConclusionsThe method of creating the mSGA that we proposed in this study can be applied to development of novel SGAs that is anatomically more suitable for pharyngolaryngeal structure. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - July 18, 2018 Category: Anesthesiology Source Type: research

Biochemically diagnosed hypothyroidism and postoperative complications after cardiac surgery: a retrospective cohort analysis
AbstractPurposeTo determine whether hypothyroidism is associated with cardiovascular complications and surgical wound infections after cardiac surgery.MethodsPatients were categorized as: (1) hypothyroid [patients with increased TSH concentrations ( ≧ 5.5 mIU/L) within 6 months prior to surgery]; (2) corrected hypothyroid [diagnosis of hypothyroidism any time before surgery or on preoperative thyroid supplementation and normal TSH concentration (0.4 \(\le\) TSH\(\le\) 5.5 mIU/L]; and (3) euthyroid [no hypothyroid diagnosis and not on preoperative thyroid supplementation and normal TS...
Source: Journal of Anesthesia - July 16, 2018 Category: Anesthesiology Source Type: research

Ultrasound-guided left lateral transversus abdominis plane block combined with rectus sheath block in peritoneal dialysis catheter placement
This study assessed the utility of ultrasound-guided lateral transversus abdominis plane (TAP) block combined with rectus sheath (RS) block for peritoneal dialysis catheter placement surgery. Thirty consecutive patients with end-stage renal disease scheduled to have peritoneal dialysis catheter placement received a left lateral TAP block combined with RS block performed under ultrasound guidance. The TAP and RS blocks were, respectively, conducted with 15  ml of 0.5% ropivacaine and 10 ml of 0.5% ropivacaine. Pain intensity was evaluated by verbal rating scale during operation, and the degree of patient and surge...
Source: Journal of Anesthesia - July 5, 2018 Category: Anesthesiology Source Type: research

Thoraco-esophageal fistula during percutaneous tracheostomy
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - July 3, 2018 Category: Anesthesiology Source Type: research

Myotoxicity of local anesthetics is equivalent in individuals with and without predisposition to malignant hyperthermia
ConclusionThe myotoxicity of local anesthetics was equivalent in individuals with and without predisposition to MH. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - June 25, 2018 Category: Anesthesiology Source Type: research

Effects of epidural anesthesia on postoperative nausea and vomiting in laparoscopic gynecological surgery: a randomized controlled trial
ConclusionMinimizing intraoperative opioid administration by combining epidural and general anesthesia did not reduce the 24-h incidence of PONV or rescue metoclopramide use after laparoscopic gynecological surgery. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - June 23, 2018 Category: Anesthesiology Source Type: research

The impact of low body mass index on postoperative outcomes in pancreatectomy patients: a retrospective analysis of Japanese administrative data
AbstractPurposeTo comparatively examine in-hospital mortality among different underweight body mass index (BMI) categories in pancreatic cancer patients after pancreatectomy in Japan.MethodsWe conducted a large-scale multi-center retrospective cohort study of adult patients with pancreatic cancer who underwent pancreatectomy between April 1, 2010 and March 31, 2016. Patients were classified according to BMI as follows: normal BMI (18.50 –24.99 kg/m2), mild thinness (17.00 –18.49 kg/m2), moderate thinness (16.00 –16.99 kg/m2), and severe thinness (
Source: Journal of Anesthesia - June 23, 2018 Category: Anesthesiology Source Type: research

Anesthetic management without perioperative platelet transfusion for cervical laminectomy and laminoplasty in a case of May –Hegglin anomaly
We report a case involving a patient with MHA who was perioperativ ely managed without platelet transfusion for cervical laminectomy and laminoplasty. In our case, the platelet count was measured to be 0.6 × 104/ µL using an automatic blood cell counter. Peripheral blood smear and genetic test analyses were performed, leading to a definitive diagnosis of MHA. However, clot retraction, serotonin release, and platelet aggregation were normal. Total intravenous anesthesia with propofol and remifentanil, in com bination with intermittent injection of fentanyl, was administered. The total blood loss vo...
Source: Journal of Anesthesia - June 22, 2018 Category: Anesthesiology Source Type: research

Retraction Note to: Monitoring of vecuronium-induced neuromuscular block at the sternocleidomastoid muscle in anesthetized patients
The Editor-in-Chief has retracted this article [1] because the three studies included in the meta-analysis [2,3 and 4] (cited as references 16, 17 and 18) have been retracted due to concerns regarding the data, which has rendered the results of this meta-analysis invalid. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - June 22, 2018 Category: Anesthesiology Source Type: research

Do fetuses need vasopressors just before their birth?
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - June 21, 2018 Category: Anesthesiology Source Type: research

Interaction between anesthetic conditioning and ischemic preconditioning on metabolic function after hepatic ischemia –reperfusion in rabbits
ConclusionSevoflurane attenuated the decrease of galactose clearance and increase of the blood lactate after reperfusion compared to propofol. Application of ischemic preconditioning was significantly protective under propofol anesthesia. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - June 21, 2018 Category: Anesthesiology Source Type: research

Curvature of the left main bronchus caused by postural change from supine to left lateral position
This study was designed to examine deviation of the bronchus by postural change from supine to lateral position during spontaneous respiration. Fifteen healthy volunteers [13 men and 2 women, mean age: 34  years (range 26–42)] participated. Chest radiograms (anterior–posterior) were acquired in the order of supine, left lateral, and right lateral position. The bilateral bronchus angles and secondary carina angles were measured in the acquired images, and the angles were compared between the supi ne and lateral positions to evaluate deviation of the bronchus in the lateral position. The left secondary carin...
Source: Journal of Anesthesia - June 20, 2018 Category: Anesthesiology Source Type: research

Dexmedetomidine facilitates extubation in children who require intubation and respiratory support after airway foreign body retrieval: a case –cohort analysis of 57 cases
ConclusionsIn mechanical ventilation of pediatric patients following rigid bronchoscopy, in comparison to remifentanil –propofol, dexmedetomidine is proved to have high success rate for weaning strategy.What is already known?Remifentanil is proved to be effective for weaning in ICU patients. Dexmedetomedine can provide similar rates of smooth extubation for pediatric patients who underwent airway surgery.What this article adds?Invasive ventilation is used for patients with severe comorbidity after airway surgery, but the correct strategy for pediatric extubation after removal of airway foreign body remains unclear. F...
Source: Journal of Anesthesia - June 9, 2018 Category: Anesthesiology Source Type: research

Perioperative management of patients with cancer pain treated with opioids: a retrospective study
ConclusionDiscontinuation of baseline opioid increased adverse effects in the early postoperative period, which were attributed to exacerbation of early postoperative pain. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - June 6, 2018 Category: Anesthesiology Source Type: research

Comparison of Duke Activity Status Index with cardiopulmonary exercise testing in cancer patients
ConclusionIn summary, both the limits of agreement and bias between the measured and DASI-predicted pVO2 were substantial. The DASI-predicted pVO2 based on patient ’s assessment of their functional status could not be considered a reliable surrogate of measured pVO2 during CPET for the population of patients pending major cancer surgery and cannot, therefore, be used as a triage tool for referral to CPET centres for objective risk assessment. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - May 29, 2018 Category: Anesthesiology Source Type: research

Dependent functional status is associated with unplanned postoperative intubation after elective cervical spine surgery: a national registry analysis
AbstractPurposeThe impact of preoperative functional status on 30-day unplanned postoperative intubation and clinical outcomes among patients who underwent cervical spine surgery is not well-described. We hypothesized that functional dependence is associated with 30-day unplanned postoperative intubation and that among the reintubated cohort, functional dependence is associated with adverse postoperative clinical outcomes after cervical spine surgery.MethodsUtilizing the 2007 –2016 American College of Surgeons National Surgical Quality Improvement Program database, we identified adult elective anterior and posterior ...
Source: Journal of Anesthesia - May 28, 2018 Category: Anesthesiology Source Type: research

Spinal anesthesia for surgery longer than 60 min in infants: experience from the first 2  years of a spinal anesthesia program
ConclusionsSA is a highly successful technique and may offer an alternative to GA in children undergoing appropriate surgery expected to last as long as 60 –100 min. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - May 28, 2018 Category: Anesthesiology Source Type: research

Nalbuphine as an adjuvant to 0.25% levobupivacaine in ultrasound-guided supraclavicular block provided prolonged sensory block and similar motor block durations (RCT)
ConclusionsAdding 20  mg nalbuphine to 25 ml of 0.25% levobupivacaine in supraclavicular block provided prolonged duration of sensory block with similar duration of motor block. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - May 28, 2018 Category: Anesthesiology Source Type: research

Evaluation of external reference levels for central venous pressure measurements of severely obese patients in the supine position
AbstractPurposeA proper reference level is important for measuring intracardiac pressures, especially for parameters with small normal values such as central venous pressure (CVP). Although several external zero reference levels (eZRLs) have been proposed for non-obese patients, none has been reported for severely obese patients. The aim of this study was to investigate an appropriate eZRL for CVP measurements of severely obese patients.MethodsChest computed tomography images of 65 patients with body mass index (BMI)  ≥ 35 kg/m2 were retrospectively reviewed. The anteroposterior thoracic diameter and ...
Source: Journal of Anesthesia - May 28, 2018 Category: Anesthesiology Source Type: research

Relationship between fresh frozen plasma to packed red blood cell transfusion ratio and mortality in cardiovascular surgery
AbstractPurposeThe aim of this study was to examine the relationship between FFP (fresh frozen plasma)/pRBC (packed red blood cell) transfusion ratio and outcomes in patients undergoing cardiovascular surgery.MethodsThis is a single center retrospective cohort study performed in a cardiovascular center. Patients undergoing cardiovascular surgery between January 2012 and October 2016 with or without massive transfusion (n = 1453). Patients’ outcomes were compared based on FFP/pRBC transfusion ratio (FFP/pRBC >  1 or FFP/pRBC ≤ 1).ResultsIn hospital mortality and rate of ...
Source: Journal of Anesthesia - May 22, 2018 Category: Anesthesiology Source Type: research

Introduction of a modified double-lumen tube
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - May 22, 2018 Category: Anesthesiology Source Type: research

Endothelium-dependent vasodilation in the cerebral arterioles of rats deteriorates during acute hyperglycemia and then is restored by reducing the glucose level
ConclusionAcute hyperglycemia induces a dysfunction of the endothelium-dependent vasodilation of rat cerebral arterioles. The dysfunction can be reversed by improving the acute hyperglycemia and it can be prevented entirely by the administration of NADPH oxidase inhibitors. These results could suggest that controlling the glucose levels works protectivity to endothelium function of cerebral arterioles. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - May 21, 2018 Category: Anesthesiology Source Type: research

Effects of cardiac output on the onset of rocuronium-induced neuromuscular block in elderly patients
ConclusionsIn the elderly, CO influences the onset of action of rocuronium. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - May 21, 2018 Category: Anesthesiology Source Type: research

Dexmedetomidine as an adjuvant during general anesthesia
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - May 15, 2018 Category: Anesthesiology Source Type: research

Inhibiting EZH2 rescued bupivacaine-induced neuronal apoptosis in spinal cord dorsal root ganglia in mice
ConclusionEZH2 is upregulated, whereas inhibiting EZH2 exerted rescuing effect in anesthetics (bupivacaine)-induced spinal cord DRG. The possible downstream target of EZH2 inhibition may interact with caspase and TrkC signaling pathways. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - May 11, 2018 Category: Anesthesiology Source Type: research

Executive summary of the Clinical Guidelines of Pharmacotherapy for Neuropathic Pain: second edition by the Japanese Society of Pain Clinicians
AbstractNeuropathic pain has a substantial effect on quality of life (QOL). The Japanese Society of Pain Clinicians (JSPC) has developed clinical guidelines of pharmacotherapy for neuropathic pain. These guidelines offer clarity on recommendations based on both the most recent scientific evidence and expert opinions. Understanding the concept, disease entity, and burden of neuropathic pain, as well as its screening and diagnosis are important steps before starting pharmacotherapy. As well as other guidelines, the guidelines propose several lines of pharmacotherapies in a step-wise manner. To name a few different points, ou...
Source: Journal of Anesthesia - May 8, 2018 Category: Anesthesiology Source Type: research

Reliability and validity of the Japanese translation of the DN4 Diagnostic Questionnaire in patients with neuropathic pain
ConclusionThe Japanese version of the DN4 was found to be a helpful tool for discriminating between neuropathic and non-neuropathic pain. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - May 5, 2018 Category: Anesthesiology Source Type: research

ED50 of remifentanil for providing excellent intubating conditions when co-administered with a single standard dose of propofol without the use of muscle relaxants in children: dose-finding clinical trial
This study was designed to find the minimum effective dose of remifentanil for excellent intubation conditions of children when co-administered with propofol, without neuromuscular relaxant drugs.MethodBlinded adaptive clinical trial, with sequential allocation of 27 children between 2 and 9 years-old, American Society of Anesthesiologists ’ physical status PI or PII, scheduled for elective surgery under general anesthesia. Remifentanil dose began at 2 µg/kg and varied by 0.25 µg/kg according to the sequential allocation up-and-down rule designed by Dixon and Massey. Remifentanil was infused in ...
Source: Journal of Anesthesia - May 4, 2018 Category: Anesthesiology Source Type: research

Postoperative renal function in parturients with severe preeclampsia who underwent cesarean delivery: a retrospective observational study
AbstractAlthough postoperative renal dysfunction is relatively rare after cesarean delivery, preeclampsia is considered as the high-risk population. On the other hand, hydroxyethyl starch (HES) administration for preventing maternal hypotension induced by spinal anesthesia for cesarean delivery is a common practice. However, the effect of HES administration during cesarean delivery on postoperative kidney function in parturients with severe preeclampsia is not well investigated. We retrospectively reviewed both medical and anesthesia records of patients with severe preeclampsia who underwent cesarean delivery from January ...
Source: Journal of Anesthesia - May 4, 2018 Category: Anesthesiology Source Type: research

The unique action of nicorandil on cerebral circulation
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - May 4, 2018 Category: Anesthesiology Source Type: research

Involvement of acute neuroinflammation in postoperative delirium-like cognitive deficits in rats
ConclusionOur findings indicate that surgery-induced acute, transient, brain-wide neuroinflammation may be involved in the pathogenesis of the postoperative delirium-like cognitive deficits in rats. Furthermore, neuroinflammation may convert from acute to chronic in an age- and hippocampal-specific manner, likely resulting in the development of sustained cognitive dysfunction. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - May 3, 2018 Category: Anesthesiology Source Type: research

Comparison of effect of dexmedetomidine and lidocaine on intracranial and systemic hemodynamic response to chest physiotherapy and tracheal suctioning in patients with severe traumatic brain injury
ConclusionsBoth dexmedetomidine and lidocaine were effective to blunt rise in HR, MAP and ICP in response to CP and TS in patients with sTBI. However, intravenous dexmedetomidine caused significant decrease in MAP and CPP as compared to the baseline and lidocaine. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - May 3, 2018 Category: Anesthesiology Source Type: research

Comparison of a new simplified acid –base tool to the original Stewart–Figge approach: a study on cardiac surgical patients
ConclusionsThe [BICgap] model bears a very good agreement with the [SIG] model while being simpler and easier to apply at the bedside. [BICgap] could be used as an alternative tool for the diagnosis of unmeasured ion acidosis. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - May 3, 2018 Category: Anesthesiology Source Type: research

The Pringle maneuver reduces the infusion rate of rocuronium required to maintain surgical muscle relaxation during hepatectomy
ConclusionIn case of continuous administration of rocuronium during surgery performing the Pringle maneuver, it was considered necessary to regulate the administration of rocuronium using muscle relaxant monitoring in order to deal with the decrease in muscle relaxant requirement by the Pringle maneuver. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - April 27, 2018 Category: Anesthesiology Source Type: research

Correction to: Evaluation of pharmacokinetic models of intravenous dexmedetomidine in sedated patients under spinal anesthesia
Inadvertently, the reference [8] was published incorrectly in the original publication of the article. The correct reference [8] is provided below: (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - April 27, 2018 Category: Anesthesiology Source Type: research

Blind method regarding the effect of dexmedetomidine on CRBD
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - April 26, 2018 Category: Anesthesiology Source Type: research

Pecs II block for intractable postherpetic neuralgia
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - April 25, 2018 Category: Anesthesiology Source Type: research