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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

Impact of age on postoperative complication rates among elderly patients with hip fracture: a retrospective matched study
This study was performed to assess the impact of age of ≥ 90 years on predicting postoperative complications. We retrospectively identified all patients aged ≥ 65 years who underwent surgical repair of hip fractures over a 4.5-year period in our hospital. In total, 261 patients were identified (mean age, 86.2 ± 6.8 years). Ninety-one pati ents were aged ≥ 90 years (oldest-old group), and the remaining 170 were aged
Source: Journal of Anesthesia - April 16, 2018 Category: Anesthesiology Source Type: research

Different ventilation techniques and hemodynamic optimization to maintain regional cerebral oxygen saturation (rScO 2 ) during laparoscopic bariatric surgery: a prospective randomized interventional study
ConclusionIn obese patients, subjected to laparoscopic bariatric surgery in reverse trendelenburg position, adjustment of ventilation strategies and hemodynamic optimization succeeded to improve rScO2. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - April 6, 2018 Category: Anesthesiology Source Type: research

In reply: Why remifentanil?
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - April 3, 2018 Category: Anesthesiology Source Type: research

Accuracy and trending ability of the fourth-generation FloTrac/Vigileo System ™ in patients undergoing abdominal aortic aneurysm surgery
AbstractPurposeThe fourth-generation FloTrac/Vigileo ™ improved its algorithm to follow changes in systemic vascular resistance index (SVRI). This revision may improve the accuracy and trending ability of CI even in patients who undergo abdominal aortic aneurysm (AAA) surgery which cause drastic change of SVRI by aortic clamping. The purpose of this study is to elucidate the accuracy and trending ability of the fourth-generation FloTrac/Vigileo™ in patients with AAA surgery by comparing the FloTrac/Vigileo™-derived CI (CIFT) with that measured by three-dimensional echocardiography (CI3D).MethodsTwenty-six...
Source: Journal of Anesthesia - April 3, 2018 Category: Anesthesiology Source Type: research

…why remifentanil?
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 28, 2018 Category: Anesthesiology Source Type: research

Prevalence and associated factors of preoperative functional disability in elective surgical patients over 55  years old: a prospective cohort study
ConclusionsIn total, 29.2% of preoperative patients had functional disability. Obesity, nutritional deficiency, respiratory complications, and low serum albumin values were determined as potentially modifiable factors. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 27, 2018 Category: Anesthesiology Source Type: research

Association of body mass index with chronic pain prevalence: a large population-based cross-sectional study in Japan
ConclusionThere was a U-shaped association between BMI and chronic pain prevalence among men ≥ 50 years, and a dose–response association among women. Our finding suggests that underweight should be considered in older men suffering chronic pain. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 26, 2018 Category: Anesthesiology Source Type: research

The evaluation of the effect of venous diameter measurement by ultrasonography on pain and withdrawal response
ConclusionIn this study, we found a reduction in the incidence and severity of pain and withdrawal movements in intravenous propofol and rocuronium administration through peripheral venous vessels of large diameter. We believe that the clinical drug injection through vessels with large venous diameter with the help of USG may be a non-invasive, simple, and reliable method to reduce pain and withdrawal movements in propofol and rocuronium injections. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 23, 2018 Category: Anesthesiology Source Type: research

Comparison of catheter-over-needle and catheter-through-needle on leakage from the catheter insertion site during continuous femoral nerve block
AbstractThe aim of this study was to compare the incidences of leakage from the catheter insertion site during continuous femoral nerve block when using the catheter-through-needle, Contiplex Touhy ™ (CT) and the newly developed catheter-over-needle, Contiplex C™ (CC). Forty adult patients who were scheduled to undergo continuous femoral nerve block for pain control following knee surgery were enrolled and were randomly assigned to a CT group or a CC group. After finishing surgery, a cathe ter for continuous femoral nerve block was placed using ultrasound. A catheter was advanced along the femoral nerve 5&ndash...
Source: Journal of Anesthesia - March 22, 2018 Category: Anesthesiology Source Type: research

Intraoperative red blood cell transfusion, delayed graft function, and infection after kidney transplant: an observational cohort study
ConclusionsIntraoperative RBC transfusion during kidney transplant is not associated with improved allograft function or incisional SSI, but is associated with postoperative sepsis. RBCs should not be liberally transfused during kidney transplant surgery to improve graft outcomes. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 20, 2018 Category: Anesthesiology Source Type: research

Feasibility and safety of general anesthesia for bronchial thermoplasty: a description of early 10 treatments
AbstractBronchial thermoplasty (BT) is a recently introduced bronchoscopic treatment for patients with asthma refractory to pharmacotherapy. Intraprocedural sedation management is important for successful performance of BT. However, the results of general anesthesia in patients undergoing BT have not been well described. The aim of this study was to evaluate the feasibility and safety of general anesthesia in patients undergoing BT. We retrospectively reviewed the records of 10 consecutive BT treatments performed under general anesthesia in 4 patients. The feasibility outcomes were coughing and body movement during the pro...
Source: Journal of Anesthesia - March 20, 2018 Category: Anesthesiology Source Type: research

Endotracheal tube size to leakage ventilation and tracheal dilatation
ConclusionThe initial ETT OD/TD ratio is a predictor for LV and TDn. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 13, 2018 Category: Anesthesiology Source Type: research

New-onset atrial fibrillation: an update
AbstractNew-onset atrial fibrillation (NOAF) is the most common perioperative complication of heart surgery, typically occurring in the perioperative period. NOAF commonly occurs in patients who are elderly, or have left atrial enlargement, or left ventricular hypertrophy. Various factors have been identified as being involved in the development of NOAF, and numerous approaches have been proposed for its prevention and treatment. Risk factors include diabetes, obesity, and metabolic syndrome. For prevention of NOAF, β-blockers and amiodarone are particularly effective and are recommended by guidelines. NOAF can be tre...
Source: Journal of Anesthesia - March 9, 2018 Category: Anesthesiology Source Type: research

The role of simulation training in anesthesiology resident education
AbstractAn increasing number of reports indicate the efficacy of simulation training in anesthesiology resident education. Simulation education helps learners to acquire clinical skills in a safe learning environment without putting real patients at risk. This useful tool allows anesthesiology residents to obtain medical knowledge and both technical and non-technical skills. For faculty members, simulation-based settings provide the valuable opportunity to evaluate residents ’ performance in scenarios including airway management and regional, cardiac, and obstetric anesthesiology. However, it is still unclear what ty...
Source: Journal of Anesthesia - March 9, 2018 Category: Anesthesiology Source Type: research

Prevalence of chronic postsurgical pain after thoracotomy and total knee arthroplasty: a retrospective multicenter study in Japan (Japanese Study Group of Subacute Postoperative Pain)
AbstractWe performed a multicenter observational study to assess the prevalence and risk factors of persistent pain after lung cancer surgery and total knee arthroplasty (TKA) in the Japanese population. After receiving Ethics Committee approval, a retrospective chart review was performed for patients who underwent surgery at seven university hospitals in Japan in 2013. A total of 511 patients who underwent lung cancer surgery and 298 patients who underwent TKA were included. The prevalence of chronic postsurgical pain (CPSP) at 3 and 6  months was 18 and 12% after lung surgery and 49 and 33% after TKA, respectively. ...
Source: Journal of Anesthesia - March 9, 2018 Category: Anesthesiology Source Type: research

The role of sciatic nerve block to complement femoral nerve block in total knee arthroplasty: a meta-analysis of randomized controlled trials
AbstractIntroductionFemoral nerve block (FNB) appears to have higher postoperative analgesic benefits compared with the patient-controlled analgesia (PCA) in total knee arthroplasty (TKA). However, the role of sciatic nerve block (SNB) as a complement to FNB remains controversial. We performed a meta-analysis assessing the benefits of the SNB as a complement to FNB, as well as comparing the efficacy of single-injection versus continuous SNB in TKA.MethodsOur group conducted a systematic literature search in PubMed, EMBASE and Google Scholar. We retrieved randomized trials comparing either SNB versus placebo or continuous v...
Source: Journal of Anesthesia - March 8, 2018 Category: Anesthesiology Source Type: research

Diaphragmatic paralysis in obese patients in arthroscopic shoulder surgery: consequences and causes
This study aims to assess consequences of diaphragmatic paralysis in obese patients.MethodsThis prospective observational study screened patients with body mass index (BMI)  ≥ 30 kg/m2 undergoing acromioplasty or supraspinatus tendon repair. Surgery was performed using brachial plexus block, and the method of brachial plexus block was left at the discretion of attending anesthesiologists. Post-operative hemidiaphragmatic paralysis was evaluated using M-mode ultrasonography and its consequences on patient ventilation were assessed: occurrence of hypoxic episode defined as oxygen saturation less than 90...
Source: Journal of Anesthesia - March 6, 2018 Category: Anesthesiology Source Type: research

Local infiltration analgesia combined with a standardized multimodal approach including an adductor canal block in total knee arthroplasty: a prospective randomized, placebo-controlled, double-blinded clinical trial
ConclusionsPerforming LIA in addition to a standardized multimodal analgesia regimen results in superior pain control, demonstrated as reduced opioid needs and lower resting and dynamic pain intensity scores on the first postoperative day after TKA. Further studies are needed to establish an LIA protocol that could maximize postoperative pain control. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 5, 2018 Category: Anesthesiology Source Type: research

Nicorandil increased the cerebral blood flow via nitric oxide pathway and ATP-sensitive potassium channel opening in mice
AbstractPurposeNicorandil has dual properties and acts as a nitric oxide donor and an ATP-sensitive potassium (KATP) channel opener. Considering its pharmacological profile, nicorandil might exert protective effects on the brain as well as on the heart. The purpose of this study was to directly evaluate the effect of nicorandil on cerebral blood flow (CBF) in mice using a transcranial Doppler method.MethodsUnder general anesthesia, the nicorandil groups received a single-bolus intraperitoneal injection of the respective doses of nicorandil (1, 5, or 10  mg/kg), while the control group received vehicle only. CBF was...
Source: Journal of Anesthesia - March 5, 2018 Category: Anesthesiology Source Type: research

Satisfaction rate of patients undergoing sleeve gastrectomy as day-case surgery compared to conventional hospitalization: a prospective non-randomized study
ConclusionOverall satisfaction of patients undergoing SG as day-case surgery was not inferior to that of patients managed by conventional hospitalization. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - March 2, 2018 Category: Anesthesiology Source Type: research

Comparison of propofol and desflurane for postanaesthetic morbidity in patients undergoing surgery for aneurysmal SAH: a randomized clinical trial
AbstractPurposeSurgery for aneurysmal clipping after subarachnoid haemorrhage (SAH) poses a unique anaesthetic challenge. However, data on the influence of anaesthetic agents in these patients are lacking. The study aims to evaluate the superiority of propofol over desflurane for postanaesthetic morbidity in patients undergoing surgery following aneurysmal SAH.MethodsSeventy World Federation of Neurosurgeons Grade I and II patients were  randomized into propofol (n = 35) and desflurane groups (n = 35). Anaesthesia was maintained with propofol/fentanyl in propofol group and desflurane/fentanyl in th...
Source: Journal of Anesthesia - March 1, 2018 Category: Anesthesiology Source Type: research

Ultrasound versus fiberscope-guided tracheal intubation
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - February 27, 2018 Category: Anesthesiology Source Type: research

In reply
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - February 27, 2018 Category: Anesthesiology Source Type: research

Does local factors alter discharge times after surgery?
(Source: Journal of Anesthesia)
Source: Journal of Anesthesia - February 27, 2018 Category: Anesthesiology Source Type: research

Positive end-expiratory pressure-induced increase in external jugular venous pressure does not predict fluid responsiveness in laparoscopic prostatectomy
ConclusionOur study results suggested that SVV and increase in EJVP after applying PEEP were not accurate predictors of fluid responsiveness during RALP. Further studies are required to find an adequate preload index in robot-assisted urologic surgery with steep Trendelenburg position. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - February 27, 2018 Category: Anesthesiology Source Type: research

A case of anosmia and hypogeusia as a complication of propofol
We describe a case of anosmia and hypogeusia for 6  weeks after recovery from a uterine curettage operation in a 32-year-old woman. The case is unusual because propofol was the only anesthetic used during surgery and anesthesia. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed no abnormality. This case may highly suggest that propofol could induce smell and taste disorders. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - February 23, 2018 Category: Anesthesiology Source Type: research

Lessons from the sky: an aviation-based framework for maximizing the delivery of quality anesthetic care
This article reviews specific components of crisis management and root cause analysis in aviation that can serve as models for improving those same aspects within anesthesiology. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - February 23, 2018 Category: Anesthesiology Source Type: research

Impact of clinical factors and UGT1A9 and CYP2B6 genotype on inter-individual differences in propofol pharmacokinetics
This study aimed to identify factors determining propofol pharmacokinetics.MethodsEighty-three patients were enrolled, and their blood samples were collected 1, 5, 10, and 15  min after administering a single intravenous bolus of propofol at a dose of 2.0 ml/kg to measure propofol plasma concentration. Area under the time–plasma concentration curve from zero up to the last measurable time point (AUC15min) was determined from the concentration data. The inter-individual variability of the propofol pharmacokinetics was evaluated by investigating relationships between AUC15min and genotype of UGT1A9 and CYP2B6...
Source: Journal of Anesthesia - February 21, 2018 Category: Anesthesiology Source Type: research

Ultrasound-guided bilateral superficial cervical block and preemptive single-dose oral tizanidine for post-thyroidectomy pain: a randomized-controlled double-blind study
AbstractPurposesThe postoperative analgesic effect of tizanidine has not yet been evaluated sufficiently. The role of bilateral superficial cervical plexus block (BSCPB) for postoperative analgesia after thyroidectomy remains questionable. We aimed to evaluate the analgesic effect of combined use of BSCPB and a single-dose oral tizanidine in patients undergoing elective thyroid surgery.MethodsSixty patients undergoing thyroidectomy were randomized into 3 groups. The control group (Group C,n = 20) received BSCPB with 0.9% saline plus oral placebo. The superficial cervical group (Group SC,n = 20) received...
Source: Journal of Anesthesia - February 21, 2018 Category: Anesthesiology Source Type: research

The effect of sevoflurane on retinal angiogenesis in a mouse model of oxygen-induced retinopathy
ConclusionsSevoflurane can inhibit retinal angiogenesis via suppressing VEGF expression in an OIR mice model with exposure to relative hypoxia. Nevertheless, it is still difficult to apply the results of this study immediately to humans because of the heterogeneity of responses to sevoflurane. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - February 20, 2018 Category: Anesthesiology Source Type: research

Interrater variability in ASA physical status assignment: an analysis in the pediatric cancer setting
ConclusionIn contrast to observations in earlier studies, findings indicate poor agreement in inter-rater reliability. Although there was moderate agreement in intra-rater reliability, one would expect to find stronger, even perfect, intra-rater reliability. These findings suggest the need to develop a specific physical status classification system directed toward patients with a systemic illness such as cancer in both young and adult patients. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - February 13, 2018 Category: Anesthesiology Source Type: research

Ultrasound-guided bilateral rectus sheath block reduces early postoperative pain after laparoscopic gynecologic surgery: a randomized study
ConclusionUS-BRSB reduces the immediate postoperative pain and opioid consumption during the early postoperative period.ClinicalTrials.gov identifierNCT02476799,https://clinicaltrials.gov/ct2/show/NCT02476799. (Source: Journal of Anesthesia)
Source: Journal of Anesthesia - February 8, 2018 Category: Anesthesiology Source Type: research