JA Clinical Reports最新文献_第7页

Noradrenaline infusion prevents anesthesia-induced hypotension in severe aortic stenosis patients undergoing transcatheter aortic valve replacement: a retrospective observational study. 在接受经导管主动脉瓣置换术的重度主动脉瓣狭窄患者中输注去甲肾上腺素可预防麻醉引起的低血压：一项回顾性观察研究。

IF 0.9

JA Clinical Reports Pub Date : 2024-06-13 DOI: 10.1186/s40981-024-00721-4

Kenta Onishi, Masashi Yoshida, Hisakatsu Ito, Masaaki Kawakami, Tomonori Takazawa

{"title":"Noradrenaline infusion prevents anesthesia-induced hypotension in severe aortic stenosis patients undergoing transcatheter aortic valve replacement: a retrospective observational study.","authors":"Kenta Onishi, Masashi Yoshida, Hisakatsu Ito, Masaaki Kawakami, Tomonori Takazawa","doi":"10.1186/s40981-024-00721-4","DOIUrl":"10.1186/s40981-024-00721-4","url":null,"abstract":"Background: Patients with severe aortic valve stenosis (AS) are particularly prone to developing hypotension during general anesthesia induction, which increases postoperative morbidity and mortality. Although the preventive effect of a single vasopressor dose on anesthesia-induced hypotension has been reported, the effects of continuous vasopressor infusion are unknown. This study aimed to assess the effect of noradrenaline (NAd) infusion on hemodynamic stability during general anesthesia induction in severe AS patients undergoing transcatheter aortic valve replacement (TAVR).Methods: This single-center, retrospective study included severe AS patients who underwent elective TAVR. Patients in the NAd group received a continuous prophylactic NAd infusion of 0.1 μg/kg/min from the time of anesthesia induction. The control group received inotropes and vasopressors as indicated by the occurrence of hypotension. The primary outcome was the lowest mean blood pressure (MBP) before the start of surgery.Results: The study included 68 patients in the NAd group and 113 in the control group. The lowest MBP before the start of surgery was significantly higher in the NAd group than in the control group (63 ± 15 vs 47 ± 13 mmHg, P < 0.01). MBP immediately before intubation was also significantly higher in the NAd group (75 ± 17 vs 57 ± 16 mmHg, P < 0.01). Differences in postoperative complications between the groups were negligible.Conclusion: Continuous administration of NAd at 0.1 μg/kg/min in patients with severe AS might prevent hypotension during general anesthesia induction for TAVR.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"39"},"PeriodicalIF":0.9,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11176125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A new perspective on amino acid infusion: from perioperative parenteral nutrition to renal protection. 氨基酸输注的新视角：从围手术期肠外营养到肾脏保护。

IF 0.9

JA Clinical Reports Pub Date : 2024-06-13 DOI: 10.1186/s40981-024-00723-2

Yoshitaka Aoki, Yoshiki Nakajima

引用次数: 0

Second-degree atrioventricular block induced by electrical stimulation of transcranial motor-evoked potential: a case report. 经颅运动诱发电位电刺激诱发二度房室传导阻滞：病例报告。

IF 0.9

JA Clinical Reports Pub Date : 2024-06-12 DOI: 10.1186/s40981-024-00722-3

Toru Murakami, Satoshi Tanaka, Ryusuke Tanaka, Mariko Ito, Takashi Ishida, Mikito Kawamata

{"title":"Second-degree atrioventricular block induced by electrical stimulation of transcranial motor-evoked potential: a case report.","authors":"Toru Murakami, Satoshi Tanaka, Ryusuke Tanaka, Mariko Ito, Takashi Ishida, Mikito Kawamata","doi":"10.1186/s40981-024-00722-3","DOIUrl":"10.1186/s40981-024-00722-3","url":null,"abstract":"Background: Although several complications of transcranial motor-evoked potentials (Tc-MEPs) have been reported, reports of arrhythmias during Tc-MEP are very rare.Case presentation: A 71-year-old woman underwent transforaminal lumbar interbody fusion under general anesthesia, with intraoperative Tc-MEP monitoring. Preoperative electrocardiography showed an incomplete right bundle branch block but no cardiovascular events in her life. After induction of anesthesia, Tc-MEP was recorded prior to the surgery. During the Tc-MEP monitoring, electrocardiography and arterial blood pressure showed a second-degree atrioventricular block, but it improved rapidly at the end of the stimulation, and the patient was hemodynamically stable. Tc-MEP was recorded seven times during surgery; the incidence of P waves without QRS complexes was significantly higher than before stimulation. The surgery was uneventful, and she was discharged eight days postoperatively without complications.Conclusions: Our case suggests that electrical stimulation for Tc-MEP can cause arrhythmia. Electrocardiography and blood pressure must be closely monitored during Tc-MEP monitoring.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"38"},"PeriodicalIF":0.9,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11166606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pros and cons of using rapid sequence induction in all cases requiring general anesthesia. 在所有需要全身麻醉的病例中使用快速序列诱导的利弊。

IF 0.9

JA Clinical Reports Pub Date : 2024-06-06 DOI: 10.1186/s40981-024-00720-5

Keisuke Yoshida, Atsushi Takizuka, Ko Kakinouchi, Satoki Inoue

引用次数: 0

Retraction Note: Acute coronary syndrome due to left main coronary trunk compression 2 months after left atrial auricle clipping: a case report. 撤稿说明：左心耳剪切术后 2 个月因左冠状动脉主干受压导致的急性冠状动脉综合征：病例报告。

IF 0.9

JA Clinical Reports Pub Date : 2024-06-06 DOI: 10.1186/s40981-024-00719-y

Satoshi Uchida, Daiki Takekawa, Koudai Kato, Kazuyoshi Hirota

引用次数: 0

3D transesophageal echocardiographic visualization of the pulmonary artery catheter through the tricuspid valve and their position relative to the tricuspid valve leaflets. 三维经食道超声心动图显示肺动脉导管穿过三尖瓣的情况及其与三尖瓣瓣叶的相对位置。

IF 0.9

JA Clinical Reports Pub Date : 2024-05-30 DOI: 10.1186/s40981-024-00718-z

Shoko Takada, Tomoko Fujimoto, Akiko Tomita-Kobayashi, Yukio Hayashi

{"title":"3D transesophageal echocardiographic visualization of the pulmonary artery catheter through the tricuspid valve and their position relative to the tricuspid valve leaflets.","authors":"Shoko Takada, Tomoko Fujimoto, Akiko Tomita-Kobayashi, Yukio Hayashi","doi":"10.1186/s40981-024-00718-z","DOIUrl":"10.1186/s40981-024-00718-z","url":null,"abstract":"Background: The tricuspid valve is an atrioventricular valve consisting of three lobes. We used the 3D transesophageal echocardiography to visualize position of the pulmonary artery catheter at the tricuspid valve annulus and examined where the catheter passed through at the level of the tricuspid annulus.Methods: In this prospective and observational study, we monitored the pressure wave on patients undergoing cardiac surgery with the catheter placement by monitoring the pressure waveform for 8 months. We measured the time required for the catheter to pass through the tricuspid and pulmonary valves, respectively. We acquired the 3D image of the tricuspid valve by transesophageal echocardiography and determined the position of the pulmonary artery catheter at the level of the tricuspid annulus. The data were analyzed by Kruskal-Wallis test followed by Mann-Whitney test with Holm multiple comparisons. P < 0.05 was considered significant.Results: Of the 116 cases, the pulmonary artery catheter passed through the tricuspid valve between antero-posterior leaflets in 78 cases (67.2 %), between septal-posterior leaflets in 25 cases (21.6 %), and between antero-septal leaflets in 2 cases (1.7 %) and the center in 11 cases (9.5 %), respectively. The time required for the catheter to pass through the pulmonary valves was significantly different among the catheter positions at the level of the tricuspid annulus.Conclusion: The pulmonary artery catheter location at the level of the tricuspid annulus can be identified using 3D transesophageal echocardiography. The location of the catheter significantly affects the pulmonary artery catheter placement time.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"35"},"PeriodicalIF":0.9,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11139813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Remimazolam for general anesthesia in a patient with aortic stenosis and severe obesity undergoing transcatheter aortic valve implantation. 雷马唑仑用于接受经导管主动脉瓣植入术的主动脉瓣狭窄和重度肥胖患者的全身麻醉。

IF 0.9

JA Clinical Reports Pub Date : 2024-05-27 DOI: 10.1186/s40981-024-00716-1

Atsushi Kainuma, Ayaka Koyama, Mao Kinoshita, Jun Iida, Teiji Sawa

{"title":"Remimazolam for general anesthesia in a patient with aortic stenosis and severe obesity undergoing transcatheter aortic valve implantation.","authors":"Atsushi Kainuma, Ayaka Koyama, Mao Kinoshita, Jun Iida, Teiji Sawa","doi":"10.1186/s40981-024-00716-1","DOIUrl":"10.1186/s40981-024-00716-1","url":null,"abstract":"Introduction: There is currently limited research on the clinical use of remimazolam in severely obese patients. In this report, we describe the anesthesia management of transcatheter aortic valve implantation (TAVI) in a severely obese patient using remimazolam.Case description: A 76-year-old woman (height 1.54 m; total body weight 104 kg; body mass index 43.9 kg/m2) was scheduled for TAVI via the femoral artery approach for aortic valve stenosis. Preoperative echocardiography showed an aortic valve peak flow of 4.0 m/s and an effective orifice area of 0.75 cm2. Anesthesia induction was performed with a bolus dose of 100 μg fentanyl, 15 mg remimazolam, 60 mg rocuronium, and a continuous infusion of remifentanil at 0.4 mg/h. Intraoperatively, remimazolam was administered at a rate of 35 mg/h. General anesthesia management was completed without any complications, although the patient required temporary catecholamine and inhalation anesthesia assistance due to hemodynamic changes.Conclusion: Owing to its pharmacological advantages, remimazolam may be an option for anesthesia induction and maintenance in severely obese patients with unstable circulation.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"34"},"PeriodicalIF":0.9,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11128417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictive model for post-induction hypotension in patients undergoing transcatheter aortic valve implantation: a retrospective observational study. 经导管主动脉瓣植入术患者诱导后低血压的预测模型：一项回顾性观察研究。

IF 0.9

JA Clinical Reports Pub Date : 2024-05-24 DOI: 10.1186/s40981-024-00717-0

Kohei Noto, Satoshi Uchida, Hirotaka Kinoshita, Daiki Takekawa, Tetsuya Kushikata, Kazuyoshi Hirota

{"title":"Predictive model for post-induction hypotension in patients undergoing transcatheter aortic valve implantation: a retrospective observational study.","authors":"Kohei Noto, Satoshi Uchida, Hirotaka Kinoshita, Daiki Takekawa, Tetsuya Kushikata, Kazuyoshi Hirota","doi":"10.1186/s40981-024-00717-0","DOIUrl":"10.1186/s40981-024-00717-0","url":null,"abstract":"Purpose: Post-induction hypotension (PIH) is an independent risk factor for prolonged postoperative stay and hospital death. Patients undergoing transcatheter aortic valve implantation (TAVI) are prone to develop PIH. This study aimed to develop a predictive model for PIH in patients undergoing TAVI.Methods: This single-center retrospective observational study included 163 patients who underwent TAVI. PIH was defined as at least one measurement of systolic arterial pressure <90 mmHg or at least one incident of norepinephrine infusion at a rate >6 µg/min from anesthetic induction until 20 min post-induction. Multivariate logistic regression analysis was performed to develop a predictive model for PIH in patients undergoing TAVI.Results: In total, 161 patients were analyzed. The prevalence of PIH was 57.8%. Multivariable logistic regression analysis showed that baseline mean arterial pressure ≥90 mmHg [adjusted odds ratio (aOR): 0.413, 95% confidence interval (95% CI): 0.193-0.887; p=0.023] and higher doses of fentanyl (per 1-µg/kg increase, aOR: 0.619, 95% CI: 0.418-0.915; p=0.016) and ketamine (per 1-mg/kg increase, aOR: 0.163, 95% CI: 0.062-0.430; p=0.002) for induction were significantly associated with lower risk of PIH. A higher dose of propofol (per 1-mg/kg increase, aOR: 3.240, 95% CI: 1.320-7.920; p=0.010) for induction was significantly associated with higher risk of PIH. The area under the curve (AUC) for this model was 0.802.Conclusion: The present study developed predictive models for PIH in patients who underwent TAVI. This model may be helpful for anesthesiologists in preventing PIH in patients undergoing TAVI.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"33"},"PeriodicalIF":0.9,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11126397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of pediatric Perthes' disease with unexplained hyperlactatemia at the time of initial surgery and anesthetic management with remimazolam for the subsequent surgery. 一例小儿珀尔特氏病患者在初次手术时出现不明原因的高乳酸血症，并在随后的手术中使用了瑞马唑仑进行麻醉处理。

IF 0.9

JA Clinical Reports Pub Date : 2024-05-24 DOI: 10.1186/s40981-024-00715-2

Ko Ishikawa, Tadanao Hiroki, Sachiko Ito, Chizu Aso, Shigeru Saito

{"title":"A case of pediatric Perthes' disease with unexplained hyperlactatemia at the time of initial surgery and anesthetic management with remimazolam for the subsequent surgery.","authors":"Ko Ishikawa, Tadanao Hiroki, Sachiko Ito, Chizu Aso, Shigeru Saito","doi":"10.1186/s40981-024-00715-2","DOIUrl":"10.1186/s40981-024-00715-2","url":null,"abstract":"Background: The causes of perioperative hyperlactatemia vary, but they are generally associated with hypoperfusion. Here, we report the case of a pediatric patient who developed unexplained hyperlactatemia during anesthesia with propofol and sevoflurane, which recurred during a second surgery under anesthesia with remimazolam.Case presentation: An 8-year-old boy with Perthes disease and no remarkable past or family history was scheduled for an osteotomy. Anesthesia was induced with propofol and rocuronium and then maintained with sevoflurane and remifentanil. The patient developed lactic acidosis without hemodynamic instability during anesthesia, with a normal lactate/pyruvate ratio after surgery, suggesting a lack of hypoperfusion. We used remimazolam instead of propofol during the second surgery 6 months later, considering the possibility of drug-induced lactic acidosis, including malignant hyperthermia and propofol infusion syndrome, where the unexplained hyperlactatemia recurred.Conclusions: Distinguishing the causes of hyperlactatemia, particularly in the absence of other symptoms, is challenging. The lactate/pyruvate ratio during episodes of hyperlactatemia can provide insights into the underlying pathology.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"31"},"PeriodicalIF":0.9,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11126548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment-resistant hiccups during general anesthesia possibly caused by remimazolam: a case report. 可能由瑞咪唑安定引起的全身麻醉期间的治疗抵抗性打嗝：一份病例报告。

IF 0.8

JA Clinical Reports Pub Date : 2024-05-24 DOI: 10.1186/s40981-024-00714-3

Miku Sakurai, Yusuke Matsui, Tomonori Takazawa, Yoji Kabasawa, Wataru Nagumo, Ryo Takada, Shigeru Saito

{"title":"Treatment-resistant hiccups during general anesthesia possibly caused by remimazolam: a case report.","authors":"Miku Sakurai, Yusuke Matsui, Tomonori Takazawa, Yoji Kabasawa, Wataru Nagumo, Ryo Takada, Shigeru Saito","doi":"10.1186/s40981-024-00714-3","DOIUrl":"10.1186/s40981-024-00714-3","url":null,"abstract":"Background: Previous reports have described hiccups during general anesthesia that were possibly induced by drugs, including benzodiazepines. However, there are few reports of hiccups caused by remimazolam. Case presentation A 75-year-old woman underwent corneal transplantation under general anesthesia with remimazolam. She presented with hiccups once the effects of muscle relaxants used during induction wore off, which persisted even after various treatments, such as the administration of antipsychotic drugs. However, when remimazolam administration was terminated after surgery to awaken the patient, the hiccups stopped and did not recur after extubation. Evaluation of predicted blood levels of remimazolam suggests that higher levels of remimazolam might cause hiccups.Conclusion: Remimazolam might induce hiccups during general anesthesia. Anesthesiologists should consider administering muscle relaxants or changing the anesthetic in cases of refractory hiccups under general anesthesia.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"10 1","pages":"32"},"PeriodicalIF":0.8,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11126544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0