Journal of Anesthesia and Clinical Research最新文献

{"title":"Emergency Management of Unexpected Life-Threatening Septic Shock in a Patient Undergoing Ureteroscopic Stone Removal","authors":"N. R. Tripathy, S. Tripathy","doi":"10.4172/2155-6148.1000807","DOIUrl":"https://doi.org/10.4172/2155-6148.1000807","url":null,"abstract":"We present a case of life-threatening septic shock undergoing ureteroscopic stone removal in the operation theatre just after the surgery. Patient was symptomatically diagnosed on the operation table and intensively managed to stabilize quickly without wasting time and later it was confirmed by investigations that it was a septic shock resulted due to Gram negative bacilli E-coli.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"7 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78778829","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}

{"title":"Potassium Concentration in Cardioplegic Solutions in Pediatric Patients Undergoing Tetralogy of Fallot Repair: Impact on Myocardial Protection","authors":"M. A. Ali, S. Elshafy, A. Mandour, K. Kassem, M. Sherif, H. Elmorabaa, A. A. A. Glalah, A. Sleem","doi":"10.4172/2155-6148.1000851","DOIUrl":"https://doi.org/10.4172/2155-6148.1000851","url":null,"abstract":"Objective: We investigated the cardioprotective effects of two different potassium concentrations in crystalloid cardioplegic solutions in pediatric patients undergoing tetralogy of Fallot (TOF) repair under cardiopulmonary bypass (CPB). Methods: Eighty seven pediatric patients with Tetralogy of Fallot (TOF) were randomly allocated into two groups according to the type of cardioplegic solution. Group L received large volume with low potassium concentration (K+ 10 mmol/L) cardioplegia; 30 ml/kg for induction of arrest and repeated every 20 min at a dose of 15 ml/kg. Group S received small volume with high potassium concentration (K+ 30 mmol/L) cardioplegia; 10 ml/kg for induction of arrest and repeated every 20 min at a dose of 5 ml/kg. Results: Group L showed earlier return of cardiac rhythm (33.8 ± 4.9 sec) compared to 38.9 ± 5.6 sec in group S with most of the cases had sinus rhythm. The maximum Inotropic Score in the first 24 h was lower in group L; 13 (5) compared to group S; 15 (10). Less increase in cardiac troponin I (cTnI) in all postoperative readings, shorter duration of mechanical ventilation, ICU length, and hospital stay in group L. No changes in hemodynamic parameters between both groups. Conclusion: Better myocardial protection in pediatric cardiac patients perfused by cardioplegia with low potassium concentration.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89823155","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}

{"title":"Emergency Caesarean Section in Systemic Sclerosis: Multidisciplinary Management","authors":"Murabito Paolo, L. Valeria, Scarpinati Giuseppe, Bonsignore Christian, Tringali Eleonora, M. Carmelo, P. Sofia, A. Marinella","doi":"10.4172/2155-6148.1000864","DOIUrl":"https://doi.org/10.4172/2155-6148.1000864","url":null,"abstract":"Systemic sclerosis (Ss) is a rare autoimmune disease, it is associated with abnormal deposition of extracellular collagen in visceral organs and skin. Another feature of Systemic sclerosis is vascular dysfunction, causing distal amputation secondary to multiple Raynaud’s Phenomenon. Ss it is an anaesthetic challenge from different point of views, patients usually show poor oral aperture and consequently difficult airway management. Moreover they may even be affected by restrictive pulmonary disease, representing an obstacle for adequate mechanical ventilation. Ss it is also associated with cardiovascular and respiratory comorbidities. Management of systemic sclerosis involved many different specialties such as: paediatrician and gynecologist who gave 32 weeks of pregnancy as an acceptable moment to perform caesarean delivery if needed. Also thoracic surgeon was engaged to help us in managing difficult airways by flexible bronchoscopy if general anesthesia would have been necessary. Patients affected by Ss, are usually young woman, so we should expect to manage pregnancy in this rare pathology also because the immunosuppressant therapies are more effective now than in the past. In this case report, a pregnant women affected by Ss was managed even in emergency situation. In order to reduce mistake and to manage any possible condition such as elective caesarean section or emergency one, we decided to adopt an anesthesiologic protocol to manage our patient. Our protocol established three attempt for each anesthesia technique, first line anesthesia was epidural anesthesia, then spinal anesthesia and as last chance general anesthesia. As a result of non-reassuring fetal heart rate, patient underwent an emergency caesarean section, we had to perform spinal anesthesia because it was difficult to place epidural catheter. Patient was stable after spinal anesthesia and surgery, so our case report strongly recommends to plan carefully anesthesia, in this case spinal anesthesia is a viable solution for women with Scleroderma undergoing caesarean section.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79603242","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}

{"title":"Adductor Canal vs. Femoral Continuous Peripheral Nerve Blocks for Knee Arthroplasty: A One-year Follow-up Pilot Study of 2 Randomized, Controlled Clinical Trials","authors":"E. Davidson, Anthony T Machi, Jacklynn F. Sztain, Nicholas J. Kormylo, S. Madison, Wendy B. Abramson, Amanda M. Monahan, Bahareh Khatibi, S. Ball, Francis B. Gonzales, D. Sessler, B. Ilfeld","doi":"10.4172/2155-6148.1000838","DOIUrl":"https://doi.org/10.4172/2155-6148.1000838","url":null,"abstract":"Author(s): Davidson, Evan N. | Abstract: For patients undergoing tricompartment or unicompartment knee arthroplasty, previous studies have shown that a continuous femoral block provides superior analgesia in various circumstances compared with a continuous adductor canal block during the local anesthetic infusion. However, the long-term outcomes of these two approaches remains unknown. We thus evaluated functional outcomes with each approach 1, 4, and 12 months after surgery.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"6 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80775974","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}

{"title":"Evaluation of Ventilator-induced Diaphragmatic Dysfunction by Diaphragmatic Excursion During Spontaneous Breathing Trials","authors":"Y. Nassar, M. Elbanna, Moamen Arafa, A. Hussein","doi":"10.4172/2155-6148.1000824","DOIUrl":"https://doi.org/10.4172/2155-6148.1000824","url":null,"abstract":"Introduction: Ventilator-induced diaphragmatic dysfunction (VIDD) leads to difficulties in weaning. Diaphragmatic excursion assessment by ultrasonography is a feasible bedside assessment of the diaphragm in the ICU. Our primary aim was to identify the presence of VIDD using US in patients undergoing Spontaneous breathing trials (SBT). Our secondary aim was to assess the impact of VIDD impact on weaning outcome. Methods: This study was conducted in the Critical Care Department of Cairo University Hospital between March 2014 and March 2015. All consecutive subjects who required MV for ≥ 72 h and were ready for SBT were prospectively recruited. Exclusion criteria: Any history of aminoglycoside use, paralytics, central or neuromuscular disease, chemotherapy, cachexia, severe electrolyte imbalance or intra-abdominal pressure (IAP)>7 mmHg Thirty minutes from the start of SBT, each hemi-diaphragm was evaluated by M-mode sonography with the patient in the supine position. Five measurements were recorded and averaged. Ventilator Induced diaphragmatic dysfunction (VIDD) was diagnosed if diaphragmatic excursion (DE) was 0.05). Successful weaning was present in [18/26 (69%) vs. 13/24 (54.2%), p=0.06] and weaning time was shorter [29 ± 18 vs. 43 ± 28 h, p=0.02] in the NDD group versus the VIDD group respectively. The median DE was higher in successfully weaned vs. failed weaning subjects [14.4 (1.9-40) vs. 9.2 (6.6-35.1), p=0.01]. The receiver operator characteristic curves (ROC) showed a cut-off for weaning DE 14 mm for right hemi-diaphragm with an area under the curve (AUC) 0.8. Conclusions: VIDD is present in nearly half of our mechanically ventilated patients ≥ 72 h. VIDD is associated with lower DE and longer weaning time. Diaphragmatic excursion may serve as a valuable tool for predicting weaning outcome as traditional volumetric respiratory indices.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"9 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":"75289027","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}

{"title":"Anaesthetic Management in a Case of Wilson's Disease in Pregnancy","authors":"B. Mohanty","doi":"10.4172/2155-6148.1000845","DOIUrl":"https://doi.org/10.4172/2155-6148.1000845","url":null,"abstract":"Wilson’s disease (WD) is an inherited autosomal recessive disease results due to deficiency of ceruloplasmin leading to copper deposition mainly liver, brain and cornea. This accumulation can cause liver cirrhosis, ataxia and kayser Fleischer ring (KF) in cornea. I present a case of 21-year-old primigravida diagnosed WD 3 years back on treatment with Zinc was referred to our hospital for elective caesarean section (CS). She had thrombocytopenia, extrahepatic portal vein obstruction with hypersplenism and mild ascites. She has undergone CS under general anaesthesia (GA) with successful outcome. The anaesthetic management in presence of hepatic dysfunction and thrombocytopenia was challenging and there are only few case reports on WD patients undergoing CS under GA.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"12 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78369569","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}

{"title":"Mental Nerve and Field Blocks for Lip Cancer Radiotherapy: A Case Report","authors":"S. Saraf, Ravikiran Nikhade","doi":"10.4172/2155-6148.1000869","DOIUrl":"https://doi.org/10.4172/2155-6148.1000869","url":null,"abstract":"","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80106034","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}

{"title":"Behavioral changes in children receiving anesthesia","authors":"pHany Mohamed Elzahabyp","doi":"10.4172/2155-6148-c2-004","DOIUrl":"https://doi.org/10.4172/2155-6148-c2-004","url":null,"abstract":"","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83952038","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}

{"title":"Neurologic Dysfunction after Aortic Dissection Surgery: Different Cerebral Hypothermic Antegrade Perfusion Techniques","authors":"C. Bassano, P. Nardi, D. Colella, E. Bovio, M. Pugliese, M. Russo, P. Prati, A. Tartaglione, R. Scaini, A. Scafuri, G. Ruvolo","doi":"10.4172/2155-6148.1000813","DOIUrl":"https://doi.org/10.4172/2155-6148.1000813","url":null,"abstract":"Introduction: Neurologic dysfunction remains one of the most disabling complications of emergency aortic arch surgery. Many cerebral protection techniques are described, but their comparison has always been hampered by the wide spectrum of preoperative conditions, pathologic anatomies, complications, and surgical procedures. The aim of our study was to evaluate the incidence of early permanent neurologic injury and in-hospital mortality after emergency aortic arch surgery splitted by different antegrade cerebral perfusion techniques combined with hypothermic circulatory arrest (HCA). Methods: Between January 2005 and December 2015, 249 patients underwent emergent surgery for acute, type A aortic dissection. Of these, 112 (45%) (Mean age 63.8 ± 12.8 years, 82 males) received cerebral protection through antegrade perfusion of the supra-aortic vessels. Unilateral perfusion (UACP) was performed in 55 (49.1%) patients, while bilateral perfusion (BACP) was achieved via right axillary artery cannulation alone in 25 (22.3%) cases or with the Kazui technique in 32 (28.6%). Permanent neurologic injury was defined as the post-operative onset of focal stroke or lethal coma. Results: In-hospital mortality was 17.9% (UACP 20% vs. BACP 15.8%; p=0.56). The global rate of the early permanent neurologic injury was 12.3% (UACP 10.9% vs. BACP 15.8%; p=0.45). Conclusion: There is no evidence that BACP combined with HCA is superior to UACP combined with HCA for emergency aortic arch surgery in preventing early permanent neurologic injury and in-hospital mortality.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"1 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":"84293765","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}

{"title":"Effect of Preoperative Pregabalin on Induced Hypotension and Postoperative Analgesia with Functional Endoscopic Sinus Surgery","authors":"Hesham M. Marouf, N. Khalil","doi":"10.4172/2155-6148.1000789","DOIUrl":"https://doi.org/10.4172/2155-6148.1000789","url":null,"abstract":"Background: Our target was to estimate the effect of pregabalin as premedication on deliberate hypotension and quality of the surgical site during functional endoscopic surgery for nasal sinuses (FESS) and its postoperative analgesic effect.Materials and methods: Eighty patients ASA I-II prepared for FESS were included in this randomized research. The study encompassed 2 groups [control group (C) and pregabalin group (P)]. Patients were given either placebo capsule [group (C)] or pregabalin capsule 150 mg [group (P)] 1 h preoperatively. During surgery mean arterial blood pressure (MAP) was maintained between 55-60 mmHg by intravenous infusion of nitroglycerin (NTG) at a rate of 0.5-10 μg/kg/min. We recorded quality of surgical site [using average category scale (ACS)], the overall dose of NTG used, postoperative pain, the overall dose of morphine used postoperatively, and number of patients requesting analgesia.Results: Pregabalin group (P) showed better ACS, lower overall dose of NTG used, less postoperative pain, lower overall dose of morphine, and less number of patients requesting analgesia than control group (C).Conclusion: Preoperative oral pregabalin improved the quality of the surgical site during FESS, and decreased the required dose of intraoperative hypotensive agent and postoperative morphine with better postoperative analgesia.","PeriodicalId":15000,"journal":{"name":"Journal of Anesthesia and Clinical Research","volume":"49 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76788357","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}