Anesthesia progress最新文献_第7页

Retrograde Intubation Over a Flexible Fiber-Optic Bronchoscope. 柔性纤维支气管镜逆行插管。

Anesthesia progress Pub Date : 2022-04-01 DOI: 10.2344/anpr-68-04-01

Ramanjot S Kang, Robert Hutnik, Ishu Kant, A. Zlatopolsky, Chamandeep Brar, Slawomir P. Oleszak

{"title":"Retrograde Intubation Over a Flexible Fiber-Optic Bronchoscope.","authors":"Ramanjot S Kang, Robert Hutnik, Ishu Kant, A. Zlatopolsky, Chamandeep Brar, Slawomir P. Oleszak","doi":"10.2344/anpr-68-04-01","DOIUrl":"https://doi.org/10.2344/anpr-68-04-01","url":null,"abstract":"Traditional retrograde intubation consists of tracheal intubation performed over a guide wire inserted into the trachea inferior to the vocal cords and then passed transorally or transnasally. This intubation technique is reserved for patients with a difficult airway when other methods such as blind nasal intubation or video laryngoscopy fail. A guide wire passed blindly in a retrograde fashion, however, is not without its own constraints. This case report presents the anesthetic management of a 23-year-old Duchenne muscular dystrophy patient with substantial scarring from a previous tracheostomy stoma and limited mouth opening. The patient underwent a retrograde fiber-optic transnasal intubation without the use of a guide wire for a tracheostomy revision procedure, followed by a second tracheostomy revision and retrograde fiber-optic transoral intubation 7.5 months later. This report demonstrates a novel technique for intubating patients with difficult airways. The use of a flexible fiber-optic bronchoscope for a retrograde intubation mitigates complications that can arise using traditional retrograde intubation over a guide wire and increases the likelihood of successful intubation.","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"69 1 1","pages":"42-45"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48168937","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

Severe Bradycardia Occurring After Assisted Mouth Opening: A Case Report. 辅助张口后发生严重心动过缓1例报告。

Anesthesia progress Pub Date : 2022-04-01 DOI: 10.2344/anpr-68-03-07

Yoshio Hayakawa, K. Fujii-Abe, T. Nakano, Masayuki Suzuki, H. Kawahara

引用次数: 1

Perioperative Dental Injury Associated With Intubated General Anesthesia. 围手术期牙齿损伤与插管全麻。

Anesthesia progress Pub Date : 2022-04-01 DOI: 10.2344/anpr-68-03-02

Taichi Kotani, Satoki Inoue, Masahiko Kawaguchi

{"title":"Perioperative Dental Injury Associated With Intubated General Anesthesia.","authors":"Taichi Kotani, Satoki Inoue, Masahiko Kawaguchi","doi":"10.2344/anpr-68-03-02","DOIUrl":"10.2344/anpr-68-03-02","url":null,"abstract":"Objective: Factors related to perioperative dental injury have likely changed as a variety of airway devices and preventive measures have been introduced. This retrospective chart review used data from an institutional registry to evaluate the incidence, timing, and contributing factors of patient self-reported dental injury and to assess the impact of dental injury on patient satisfaction.Methods: Multivariate logistic analysis was performed on the records of 14,820 patients using the incidence of dental injury as the dependent variable and covariates in the anesthesia registry and a postoperative questionnaire as independent variables to investigate factors significantly associated perioperative dental injury. In addition, satisfaction with the anesthesia service was compared between patients with and without injury using a matched-pair population.Results: A total of 101 dental injuries were identified. Of those, 25% were associated with intubation and extubation in the operating room, while most other injuries occurred postoperatively. Duration of anesthesia (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.00-1.03) and emergency surgery (OR, 1.92; 95% CI, 1.11-3.30) were independently associated with perioperative dental injury. Dental injury did not significantly decrease a patient's satisfaction with the anesthesia service (P = .441).Conclusion: Most perioperative dental injuries are unrelated to anesthesia procedures. However, the duration of anesthesia and emergency surgery were significantly associated with perioperative dental injury, while decreased patient satisfaction was not.","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"69 1 1","pages":"3-9"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8985457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42142033","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: The Next Evolutionary Step for Sedative-Hypnotics. 雷马唑仑:镇静催眠药的下一个进化步骤。

Anesthesia progress Pub Date : 2022-04-01 DOI: 10.2344/anpr-69-01-07

Kyle J. Kramer

引用次数: 1

Reversal Agents in Sedation and Anesthesia Practice for Dentistry. 牙科镇静和麻醉实践中的逆转剂。

Anesthesia progress Pub Date : 2022-04-01 DOI: 10.2344/anpr-69-01-09

M. Wong

引用次数: 1

A Review of Current Literature of Interest to the Office-Based Anesthesiologist. 对办公室麻醉师感兴趣的当前文献综述。

Anesthesia progress Pub Date : 2022-04-01 DOI: 10.2344/0003-3006-69.1.59

M. Saxen

引用次数: 0

Prospective Study on PDL Anesthesia as an Aide to Decrease Palatal Infiltration Pain. PDL麻醉辅助减轻腭部浸润性疼痛的前瞻性研究。

Anesthesia progress Pub Date : 2022-04-01 DOI: 10.2344/anpr-68-03-03

B. Crump, A. Reader, J. Nusstein, Melissa Drum, Sara Fowler, J. Draper

{"title":"Prospective Study on PDL Anesthesia as an Aide to Decrease Palatal Infiltration Pain.","authors":"B. Crump, A. Reader, J. Nusstein, Melissa Drum, Sara Fowler, J. Draper","doi":"10.2344/anpr-68-03-03","DOIUrl":"https://doi.org/10.2344/anpr-68-03-03","url":null,"abstract":"OBJECTIVE\u0000The purpose of this prospective randomized study was to assess using a periodontal ligament (PDL) injection as an aide to decrease palatal infiltration pain.\u0000\u0000\u0000METHODS\u0000A total of 133 subjects randomly received a PDL injection and alternative palatal infiltration or a mock PDL injection and conventional palatal infiltration at 2 separate appointments. PDL injection was given in the mid-palatal sulcus of the maxillary first molar. Mock PDL injection consisted of only needle insertion. All subjects then received a palatal infiltration administered into the blanched gingival tissue 3 mm (alternative palatal infiltration) or 7 mm (conventional palatal infiltration) from the gingival collar. Subjects recorded needle insertion and solution deposition pain using a Heft-Parker visual analog scale (VAS).\u0000\u0000\u0000RESULTS\u0000The combined PDL injection and alternative palatal infiltration had significantly decreased mean VAS ratings for needle insertion and solution deposition pain (P < .0001). Incidence of moderate/severe pain for needle insertion and solution deposition was reduced from 65% to 1% and from 65% to 2%, respectively.\u0000\u0000\u0000CONCLUSION\u0000Providing PDL anesthesia into the mid-palatal sulcus of the maxillary first molar and then administering an alternative palatal infiltration into the blanched collar around the PDL molar site led to significant reductions in needle insertion and solution deposition pain compared with a mock PDL and conventional palatal infiltration.","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"69 1 1","pages":"10-17"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48533744","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

Cross-sectional Study of PONV Risk Factors for Oral Surgery After Intubated General Anesthesia With Total Intravenous Anesthesia. 插管全麻加全静脉麻醉后口腔手术PONV危险因素的横断面研究。

Anesthesia progress Pub Date : 2022-04-01 DOI: 10.2344/anpr-68-03-12

Emi Ishikawa, Rie Iwamoto, Takayuki Hojo, Takahito Teshirogi, Keiji Hashimoto, M. Shibuya, Y. Kimura, T. Fujisawa

{"title":"Cross-sectional Study of PONV Risk Factors for Oral Surgery After Intubated General Anesthesia With Total Intravenous Anesthesia.","authors":"Emi Ishikawa, Rie Iwamoto, Takayuki Hojo, Takahito Teshirogi, Keiji Hashimoto, M. Shibuya, Y. Kimura, T. Fujisawa","doi":"10.2344/anpr-68-03-12","DOIUrl":"https://doi.org/10.2344/anpr-68-03-12","url":null,"abstract":"OBJECTIVE\u0000The incidence of postoperative nausea and vomiting (PONV) after general anesthesia with total intravenous anesthesia (TIVA) was reported to be significantly lower than with volatile inhalational agents (13.3% vs 25%). However, no investigation of PONV risk factors associated with TIVA has ever been reported. This cross-sectional retrospective study aimed to investigate whether known risk factors influenced PONV in intubated general anesthetics utilizing TIVA for dental or oral and maxillofacial surgery.\u0000\u0000\u0000METHODS\u0000Subjects were 761 patients who underwent dental or oral and maxillofacial surgery under TIVA with propofol, fentanyl, and remifentanil. Univariate and multivariable logistic regression analyses were performed using PONV (within 24 hours) as the dependent variable and previously reported risk factors as independent variables.\u0000\u0000\u0000RESULTS\u0000Age (odds ratio [OR]: 1.020 per year decrease; 95% confidence interval [CI]: 1.0002-1.0418; P = .047) and female sex (OR: 2.73; 95% CI: 1.60-4.84; P < .001) were positively associated with PONV. Sagittal split ramus osteotomy (SSRO) (OR: 2.28; 95% CI: 1.21-4.33; P = .011) and bimaxillary osteotomy (OR: 5.69; 95% CI: 2.09-15.99; P < .001) were more likely to be associated with PONV than operations that were neither bimaxillary osteotomy nor SSRO. Late PONV (2-24 hours) had an ∼2.7 times higher incidence than early PONV (0-2 hours).\u0000\u0000\u0000CONCLUSION\u0000These findings suggest further PONV countermeasures, aside from TIVA with propofol and prophylactic antiemetics for orthognathic surgeries especially bimaxillary osteotomy, are needed.","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"69 1 1","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48185430","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

Prolonged Washout Period for Avoiding Azilsartan-Induced Refractory Hypotension During General Anesthesia for a Patient With Renal Impairment. 延长洗脱期避免阿齐沙坦致肾功能损害患者全麻期间难治性低血压。

Anesthesia progress Pub Date : 2021-12-01 DOI: 10.2344/anpr-68-02-08

Takayuki Hojo, Yukifumi Kimura, Keiji Hashimoto, Takahito Teshirogi, Toshiaki Fujisawa

{"title":"Prolonged Washout Period for Avoiding Azilsartan-Induced Refractory Hypotension During General Anesthesia for a Patient With Renal Impairment.","authors":"Takayuki Hojo, Yukifumi Kimura, Keiji Hashimoto, Takahito Teshirogi, Toshiaki Fujisawa","doi":"10.2344/anpr-68-02-08","DOIUrl":"https://doi.org/10.2344/anpr-68-02-08","url":null,"abstract":"Angiotensin receptor blockers (ARBs) are widely used to treat hypertension, but severe refractory hypotension during general anesthesia is a well-known complication associated with the continuation of ARBs during the perioperative period. It has therefore been recommended that ARBs be withheld for 24 hours before induction of general anesthesia. However, impaired renal function affects the pharmacokinetics of each ARB differently. The half-life of azilsartan is prolonged in accordance with the degree of renal impairment. Herein, we describe a patient with chronic kidney disease grade 3B who experienced severe refractory hypotension after induction of general anesthesia requiring administration of dopamine following inadequate responses to ephedrine and phenylephrine despite a 24-hour azilsartan washout period. When the same patient underwent general anesthesia for a subsequent surgery, azilsartan was withheld for 48 hours before induction, resulting in mild intraoperative hypotension that responded adequately to phenylephrine. Severe refractory hypotension during general anesthesia cannot always be avoided by holding azilsartan for 24 hours in patients with significant renal impairment. Therefore, a longer washout period may be preferable for patients regularly taking azilsartan who also have concurrent substantial renal impairment.","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"68 4","pages":"220-223"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8674853/pdf/i0003-3006-68-4-220.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39816910","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: 2

Effects of Local Anesthetics With Vasoconstrictors on Dental Pulp Blood Flow and Oxygen Tension. 血管收缩剂局部麻醉剂对牙髓血流和氧张力的影响。

Anesthesia progress Pub Date : 2021-12-01 DOI: 10.2344/anpr-68-02-09

Keikoku Tachibana, Masataka Kasahara, Nobuyuki Matsuura, Tatsuya Ichinohe

{"title":"Effects of Local Anesthetics With Vasoconstrictors on Dental Pulp Blood Flow and Oxygen Tension.","authors":"Keikoku Tachibana, Masataka Kasahara, Nobuyuki Matsuura, Tatsuya Ichinohe","doi":"10.2344/anpr-68-02-09","DOIUrl":"https://doi.org/10.2344/anpr-68-02-09","url":null,"abstract":"Objective: The aim of this study was to investigate the changes in pulpal blood flow (PBF) and pulpal oxygen tension (PpulpO2) after injecting local anesthetics with vasoconstrictors.Methods: Under general anesthesia, male Japanese White rabbits were injected with 0.6 mL of 2% lidocaine with 1:80,000 epinephrine (LE) or 3% propitocaine (prilocaine) with 0.03 IU felypressin (PF) at the apical area of the lower incisor.Results: Relative to baseline, PBF and PpulpO2 significantly decreased 5 minutes after LE or PF injection as compared with saline. The decrease in PBF was significantly lower in the LE group than in the PF group. Although the LE group had a larger decrease in PpulpO2 relative to baseline than the PF group did, that difference was not significant. PBF and PpulpO2 recovered to baseline faster in the PF group than in the LE group.Conclusion: The injection of local anesthetic solutions containing vasoconstrictors (LE or PF) transiently caused significant decreases in PBF that resulted in significant decreases in PpulpO2. The recovery of PpulpO2 was faster than PBF regardless of the vasoconstrictor used.","PeriodicalId":7818,"journal":{"name":"Anesthesia progress","volume":"68 4","pages":"214-219"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8674846/pdf/i0003-3006-68-4-214.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39727908","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: 1