Journal of Anesthesia and Clinical Research最新文献_第3页

Journal of Anesthesia and Clinical Research Pub Date : 2020-06-18 DOI: 10.31487/j.acr.2020.01.04

Anne Clémence Goubin, C. Motamed, L. Bordenave

引用次数: 0

Clinical Update on Anaesthetic Management of Free Flap Surgery in Cervico Facial Cancer Patients 颈面部癌游离皮瓣手术麻醉管理的临床进展

Journal of Anesthesia and Clinical Research Pub Date : 2020-06-03 DOI: 10.31487/j.acr.2020.01.03

C. Motamed, L. Bordenave, S. Suria

引用次数: 0

Postoperative Management of Patients with Cervicofacial Free Flap in Surgical Intensive Care Unit: An Updated Clinical Protocol 外科重症监护病房颈面游离皮瓣患者的术后处理:更新的临床方案

Journal of Anesthesia and Clinical Research Pub Date : 2020-06-02 DOI: 10.31487/j.acr.2020.01.02

C. Motamed, L. Bordenave, S. Suria

引用次数: 0

Role and Advantageousness of Ketamine in Obese and Non-Obese Patients: Peri-Interventional Considerations 氯胺酮在肥胖和非肥胖患者中的作用和优势:围介入期考虑

Journal of Anesthesia and Clinical Research Pub Date : 2018-11-06 DOI: 10.4172/2155-6148.1000827

A. Weinbroum

{"title":"Role and Advantageousness of Ketamine in Obese and Non-Obese Patients: Peri-Interventional Considerations","authors":"A. Weinbroum","doi":"10.4172/2155-6148.1000827","DOIUrl":"https://doi.org/10.4172/2155-6148.1000827","url":null,"abstract":"Obese and morbidly obese patients are a growing group of individuals that generates medical, social and economic problems worldwide. They undergo various interventions that require anesthesia and/or analgesia. Despite their healthy look, these individuals are graded at high ASA physical status, mainly because of their impaired respiratory and cardiovascular conditions, and the metabolic changes their body undergoes. Opioids are the default drugs for perioperative analgesia. Nevertheless, their use has reached a frightening epidemic-like condition worldwide. Multimodal analgesia regimens have been recommended as a perioperative standard of care, particularly for the obese. These regimens employ combinations of opioids and non-opioid compounds that augment the formers' analgesic potencies, thus providing superior pain relief at rest, movement, or on effort, while reducing opioid consumption and their concerned adverse effects. The most important perioperative IV adjuvant currently employed is ketamine that sees resurgence among physicians from diverse medical specialties. After summarizing obese patients' perioperative drawbacks, this review will illustrate ketamine’s neuropharmacology, and will describe its therapeutic usefulness as an analgesic adjuvant. Since data regarding the use of the drug in obese patients is scarce, brief examplifications of its benefits in non-obese cohorts will be portrayed as well.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"30 1","pages":"1-17"},"PeriodicalIF":0.0,"publicationDate":"2018-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83090728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Demanding Truth is not a Witch-Hunt 要求真相不是政治迫害

Journal of Anesthesia and Clinical Research Pub Date : 2018-06-21 DOI: 10.4172/2155-6148.1000836

Tuan-Yen Wu

引用次数: 0

Anaesthetic Challenging in Microsurgical Flap Reconstruction: A Systematic Review 显微外科皮瓣重建中的麻醉挑战:系统回顾

Journal of Anesthesia and Clinical Research Pub Date : 2018-01-29 DOI: 10.4172/2155-6148.1000806

Lauretta Mp, L. Caporali, S. Manera, Melotti Rm, Prucher Gm

{"title":"Anaesthetic Challenging in Microsurgical Flap Reconstruction: A Systematic Review","authors":"Lauretta Mp, L. Caporali, S. Manera, Melotti Rm, Prucher Gm","doi":"10.4172/2155-6148.1000806","DOIUrl":"https://doi.org/10.4172/2155-6148.1000806","url":null,"abstract":"Background: Anaesthetic management for microvascular reconstructive surgery is challenging and clearly affects the risk of major complications such as flap hypo-perfusion. \u0000In this systematic review we explore recent (last 7 years) clinical evidences related to perioperative management and anaesthetic controversy of patients undergoing microvascular reconstructive surgery, especially focused on head and neck surgery with free flaps (FF) and breast reconstructive surgery with deep inferior epigastric perforator flap (DIEP-flap).Methods: A literature search of published clinical studies between 2011 and 2018 was conducted, yielding a total of 4307 papers. Only 150 were eligible, according inclusion and exclusion criteria.Results: 62 studies were selected for this review and categorized in 3 groups: preoperative-intraoperativepostoperative anaesthetic management and areas of controversy for patients undergoing head and neck surgery with FF and breast reconstructive surgery with DIEP-flap.Discussion: Anaesthetic management for flap reconstructive surgery remains an open field of interest with limited evidences regarding a standard care. Main components of research currently are: the need to join standard multidisciplinary enhanced recovery pathways, as well as the necessity to develop a standard intraoperative management. In theatre, the recent hemodynamic parameter “Hypotension Probability Indicator” (HPI) is promising: the advantage to predict a drop in the mean arterial pressure can be more effective than a fluid therapy titrated to maintain SVV less than 13%. Prospective studies are necessary to clarify.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"44 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2018-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76148985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Alternative Airway Means for Endotracheal Intubation in Adult Patients for Cervical Discectomy. Comparison between Airtraq, King Vision Video Laryngoscope and Macintosh Laryngoscope: A Prospective Randomized Study 成人颈椎间盘切除术患者气管内插管的替代气道方法。Airtraq、King Vision视频喉镜和Macintosh喉镜的比较:一项前瞻性随机研究

Journal of Anesthesia and Clinical Research Pub Date : 2018-01-01 DOI: 10.4172/2155-6148.1000858

S. Arafa, A. Sayed

{"title":"Alternative Airway Means for Endotracheal Intubation in Adult Patients for Cervical Discectomy. Comparison between Airtraq, King Vision Video Laryngoscope and Macintosh Laryngoscope: A Prospective Randomized Study","authors":"S. Arafa, A. Sayed","doi":"10.4172/2155-6148.1000858","DOIUrl":"https://doi.org/10.4172/2155-6148.1000858","url":null,"abstract":"Objectives: A prospective randomized study to demonstrate the ease of intubation between Airtraq, King Vision video laryngoscope, and Macintosh laryngoscope, to compare the different laryngeal views and the need for assisted maneuvers, and hemodynamic changes during intubation in patients scheduled for one level cervical discectomy. Materials & Methods: Ninety patients ASA I&II scheduled for one level cervical discectomy were randomly assigned into three groups to perform endotracheal intubation with Airtraq (group I; 30 patients), King Vision laryngoscope (group II; 30 patients), and Macintosh laryngoscope (group III; 30 patients). Intubation time and success rate for intubation were recorded. Also, observation and recording of vocal cord visualization using Cormack-Lehane grading and intubation difficulty score (IDS), complications and hemodynamic changes occurred with each aid. Results: There were statistically significant differences between the three groups as regard the time needed for successful intubation, the need for assist maneuvers, quality of glottis view, and the incidence of complications during airways manipulations, with better results (less time taken for intubation, better glottis view, less IDS and less complications with more stable hemodynamics during intubation) for king Vision group compared with Airtraq and Macintosh laryngoscope groups. Conclusion: King Vision laryngoscope had advantages of short time for intubation, almost, no complications occurred with it contrary to Airtraq or Macintosh laryngoscope and almost, no significant alterations in hemodynamics during intubation. It might give self-confidence to the anesthesiologist to use it easily, ensures intubation and permits many assistant doctors or trained residents to visualize the field during intubation.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74802055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of the Effect of Dexmedetomidine on the Suppression of the Adrenergic Response to Laryngoscopy and Intubation 右美托咪定对喉镜及插管后肾上腺素能反应抑制作用的评价

Journal of Anesthesia and Clinical Research Pub Date : 2018-01-01 DOI: 10.4172/2155-6148.1000828

D. Nava, J. Núñez, B. Hernandez, Andilay Pota Barito, A. Diab

{"title":"Evaluation of the Effect of Dexmedetomidine on the Suppression of the Adrenergic Response to Laryngoscopy and Intubation","authors":"D. Nava, J. Núñez, B. Hernandez, Andilay Pota Barito, A. Diab","doi":"10.4172/2155-6148.1000828","DOIUrl":"https://doi.org/10.4172/2155-6148.1000828","url":null,"abstract":"Objectives: Dexmedetomidine is a potent agonist of α-2 receptors with sympatholytic, sedative and analgesic properties. Direct laryngoscopy and endotracheal intubation are associated with hemodynamic changes due to reflex sympathetic discharge; causing hypertension, tachycardia and arrhythmias. Several drugs have been used to control this haemodynamic response however, none harmless. Materials and methods: Sample of 60 patients, divided into two groups, the DM1 group received a dexmedetomidine dose of 0.5 μg/kg, and the DM2 group received a dose of 1 μg/kg of the same drug diluted in 100 cc of solution, which it was administered in 10 min. The hemodynamic variables (HR, SBP, DBP and MAP) and sedation during two periods were verified. Results: In the first stage there was a decrease in the SBP in the DM1 group of 9 and 11% with respect to the baseline at 5 and 10 min (p=0.8443 and p=0.1650). Similar trends were found with the DBP and the PAM. In the second stage, SBP, DBP and MAP showed statistically significant differences. Conclusion: Dexmedetomidine at an intravenous loading dose of 0.5 μg/kg presents hemodynamic stability before and after intubation, with no evidence of adverse effects.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"3 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73627138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Conscious Sedation with Dexmedetomidine in Awake Surgery 右美托咪定在清醒手术中的镇静作用

Journal of Anesthesia and Clinical Research Pub Date : 2018-01-01 DOI: 10.4172/2155-6148.1000812

R. Altieri, F. Zenga, A. Melcarne, C. Junemann, Emanuela Faccoli, A. Rivera, S. Atlante, Andrea Lavorato, Giuseppe Palmieri, M. Minardi, F. Cofano, A. Ducati, D. Garbossa, R. Savastano

{"title":"Conscious Sedation with Dexmedetomidine in Awake Surgery","authors":"R. Altieri, F. Zenga, A. Melcarne, C. Junemann, Emanuela Faccoli, A. Rivera, S. Atlante, Andrea Lavorato, Giuseppe Palmieri, M. Minardi, F. Cofano, A. Ducati, D. Garbossa, R. Savastano","doi":"10.4172/2155-6148.1000812","DOIUrl":"https://doi.org/10.4172/2155-6148.1000812","url":null,"abstract":"Background: It is well demonstrated that awake surgery for brain tumours is the gold standard to achieve the maximal safe resection. On the other hand, many surgeons prefer general anesthesia in order to avoid useless stress for patients. The aim of our paper is to investigate if there are clinical and biochemical findings demonstrating a different stress level in patients who underwent awake craniotomy compared to those who underwent totally asleep surgery. Methods: We compared our awake craniotomy series performed with conscious sedation using Dexmedetomidine to a group of patients treated in general anesthesia settings in terms of patient stress, rated by blood pressure, heart rate, glycaemia, lactate values, post-operative ischemia or bleeding at the MRI. We also compared the duration of surgeries in the two groups and the relations between time and other parameters. Results: We found that preoperative heart rate was higher in the awake group (63.00 (SD13.58) vs. 76.5 (SD 14.34) p value 0.025) together with preoperative systolic blood pressure 122 (SD 12.95 vs. 135.1 SD (11.78) p value 0.044). However there were no clinical, biochemical and radiological differences in post-operative period in the two groups, suggesting the efficacy of Dexmedetomidine in stress control. It is demonstrated a cause-effect relation between the duration of surgery and the raising of blood pressure, suggesting that conscious sedation can reduce useless anesthesiological time in the awake surgery setting. Conclusions: We showed that the two anesthetic settings are similar in terms of stress parameters after surgery. This finding could be confirmed in a prospective study with a higher number of patients.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"90 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76759053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Magnitude and Associated Factors of Immediate Postoperative Hypoxemia among Elective Surgical Procedures at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia 埃塞俄比亚亚的斯亚贝巴Tikur Anbessa专科医院择期外科手术术后立即低氧血症的程度及相关因素

Journal of Anesthesia and Clinical Research Pub Date : 2018-01-01 DOI: 10.4172/2155-6148.1000821

Getahun Dendir Wolde, M. A. Awol, M. S. Obsa, Naol Gorde Wesene, Ashebir Debalike Gemechu, Ephrem Nigussie Tadesse

{"title":"Magnitude and Associated Factors of Immediate Postoperative Hypoxemia among Elective Surgical Procedures at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia","authors":"Getahun Dendir Wolde, M. A. Awol, M. S. Obsa, Naol Gorde Wesene, Ashebir Debalike Gemechu, Ephrem Nigussie Tadesse","doi":"10.4172/2155-6148.1000821","DOIUrl":"https://doi.org/10.4172/2155-6148.1000821","url":null,"abstract":"Background: Definition of Hypoxemia is insufficient amount of oxygen in the blood. There are different contributing risk factors for occurrence of post-operative hypoxemia which may lead to myocardial ischemia, organ dysfunction, wound infection, hospital stay and increase cost for the hospital and patient. Objectives: To assess the magnitude and associated factors of immediate post-operative hypoxemia in elective surgical procedures at Tikur Anbessa specialized Hospital from January 30, 2017 to March 31, 2017 G.C. Methods: Institutional based cross-sectional study design was conducted. Using Systemic random sampling technique and structured questioners data was collected from sampled elective surgical patients’ age ≥ 18 that came during the 2 months period. Data was entered into Epi info version 7 computer software by investigators and transported to SPSS version 20 computer program for analysis. Variables that demonstrated a significant relationship on bivariate analysis (p-value<0.2) were included Multivariate regression analysis was applied to evaluate independent variable relationships with a dependent variable that was continuous. A p-value<0.05 was considered to represent a statistically significant relationship. Results: Among sampled 238 elective surgical patients magnitude of hypoxemia was 54 (22.7%).Frequency of hypoxemia was high in first 10 min after admission to post anesthesia care unit. The independent predictors of hypoxemia were who had Respiratory co morbidity [(AOR=8.8; CI 2.264, 34.117)] (p=0.002) and cardiothoracic surgery [AOR=4.904; CI1.385, 17.368] (p=0.014). Conclusion and recommendation: Magnitude of hypoxemia was high and so specials consideration should give co morbid diseases patients by pre-operative optimization of patient that has other factors additional to the surgical procedure.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"106 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79186680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2