Asian journal of anesthesiology最新文献

{"title":"Feasibility and Safety of Using Supraglottic Airway Devices for Pediatric Patients Undergoing Magnetic Resonance Imaging: A Case Series of High-Risk Patients.","authors":"Jia-Jing Wu,&nbsp;Yueh-Hsun Chuang,&nbsp;Chun-Yu Wu","doi":"10.6859/aja.202109_59(3).0003","DOIUrl":"https://doi.org/10.6859/aja.202109_59(3).0003","url":null,"abstract":"<p><strong>Background: </strong>General anesthesia or sedation is commonly required for pediatric patients undergoing magnetic resonance imaging (MRI) scans, and airway management during the procedure is the highest concern for anesthesiologists owing to the limited access to the patient in the MRI unit. The use of supraglottic airway devices (SADs) has recently become more popular than endotracheal tubes; however, the feasibility of using SADs for children in MRI suites was reported only in a few studies that involved healthy patients.</p><p><strong>Methods: </strong>We present a successful case series of 30 pediatric patients, and the majority are high-risk patients, including patients with aromatic L-amino acid decarboxylase (AADC) deficiency, mitochondrial disease, and tuberous sclerosis, using either i-gel or laryngeal masks for airway maintenance during MRI examination.</p><p><strong>Results: </strong>A total of 38 MRI exams were conducted; the patients' median age was 4 (range 1.6-17.0 years), and the mean examination time was 50.87 minutes. No patient experienced oxygen desaturation, and only 1 patient with AADC deficiency had an episode of hypotension. The MRI scans were completed without interruption with an adequate image quality according to a specialized radiologist.</p><p><strong>Conclusion: </strong>From the clinical point of view, this case series demonstrated a broader application of SADs for airway maintenance during MRI scans for pediatric patients with a high risk during anesthesia rather than only for a healthy patient population.</p>","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"59 3","pages":"96-101"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39187195","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":"Point of Care Supraglottic Airway Devices for Safe Percutaneous Tracheostomy in Patients With Coronavirus Disease 2019.","authors":"Taichi Kotani,&nbsp;Satoki Inoue,&nbsp;Keiko Uemura,&nbsp;Masahiko Kawaguchi","doi":"10.6859/aja.202109_59(3).0006","DOIUrl":"https://doi.org/10.6859/aja.202109_59(3).0006","url":null,"abstract":"","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"59 3","pages":"115-116"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39188318","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":"Submental Intubation in Patients With Complex Facial Bone Fractures.","authors":"Yung-Lin Hsieh, Po-Chih Hsu, Cay-huyen Chen, M. Kao","doi":"10.6859/aja.202109/PP.0001","DOIUrl":"https://doi.org/10.6859/aja.202109/PP.0001","url":null,"abstract":"Yung-Lin Hsieh, Po-Chih Hsu, Cay-Huyen Chen, Ming-Chang Kao Department of Anesthesiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan Department of Oral and Maxillofacial Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan Department of Anesthesiology, New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City, Taiwan","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43675906","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":"Plastic Sheet and Video Intubating Stylet: A Technical Note.","authors":"P. B. Tsai, H. Luk","doi":"10.6859/aja.202109/PP.0003","DOIUrl":"https://doi.org/10.6859/aja.202109/PP.0003","url":null,"abstract":"Received: 3 July 2021; Received in revised form: 14 July 2021; Accepted: 23 July 2021. Corresponding Author: Hsiang-Ning Luk, MD, MS, PhD, Department of Anesthesia, Hualien Tzu-Chi Medical Center, No. 707, Sec. 3, Zhongyang Rd., Hualien City, Hualien County 970473, Taiwan (lukairforce@gmail.com). This is a technical note for tracheal intubators for performing tracheal intubation during the COVID-19 pandemic and beyond. Up until July 2, 2021, there have been 182,319,261 confirmed cases and 3,954,324 deaths. Unfortunately, it has been estimated that thousands of healthcare workers have died from the disease. It is not easy to know exactly how many airway managers contracted COVID-19 while fulfilling their vital duties of airway management during the pandemic. All the relevant principles have been referenced in all available consensus guidelines for airway management in patients with COVID-19. However, the scarcity of medical resources and exhausted capacity in the real world might require alternative strategies at the scene. We need to fi nd an affordable, accessible and available strategy to accomplish the goals of tracheal intubation during the pandemic (e.g., safe, accurate, and smooth). Here, we present our experiences of applying a plastic sheet as an ancillary physical barrier against contagious droplets and secretions from the patient’s airway in Taiwan. Meanwhile, we use a video-assisted intubating stylet technique to perform tracheal intubation. A brief description of how to prepare such a plastic sheet is shown in Figure 1, and how to apply it with various intubating tools is shown in Figure 2. First, we prepared a transparent and soft plastic sheet (e.g., excised from a plastic trash bag made of ethylene vinyl acetate, 0.05–0.10 mm in thickness; 50 × 80 cm in size). We marked two small areas on the plastic sheet (Figure 1A) and cut a small cross with a surgical blade in the center of each marked area (Figure 1B). Then, we covered the marked area with a small transparent adhesive fi lm dressing (e.g., Tegaderm, Figure 1C). Finally, we used a large bore needle to make a small nick at the center of the cross on each fi lm (Figure 1D). Then, it was ready for applying intubating tools, shown in Figure 2. If the intubating stylet technique was preferred (Figure 2A and 2B), one hole was used for passage of the stylet, and the other hole was for various suction tubes. On the other hand, if video laryngoscopy was the preference, one hole was used to introduce the laryngoscope, and the other hole was for passing the endotracheal tube (Figure 2C ad 2D). During the laryngoscope setup, in order not to damage the adhesive fi lm, which functions to minimize the defect in the plastic sheet and to prevent contamination from the patient, we recommend the following technique. First, the laryngoscope camera module is inserted through the hole (Figure 2C). Then, the disposable blade is mounted over the module from the inner side of the sheet (Figure 2D). In ","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"1 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45000667","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 Intramuscular Dexmedetomidine Administration Before Extubation on Post-Extubation Haemodynamics, Postoperative Sedation, and Analgesic Requirements: A Double Blind Placebo Controlled Study.","authors":"S P Ambesh,&nbsp;Madhulika Dubey","doi":"10.6859/aja.202109_59(3).0004","DOIUrl":"https://doi.org/10.6859/aja.202109_59(3).0004","url":null,"abstract":"<p><strong>Background: </strong>Dexmedetomidine, an α2-adrenoreceptor agonist has been successfully used for attenuating stress response to laryngoscopy. The present study was designed to evaluate the effects of intramuscular dexmedetomidine 30 minutes before extubation on hemodynamic response in patients undergoing laminectomy for prolapsed intervertebral disc (PIVD) under endotracheal intubation and general anesthesia.</p><p><strong>Methods: </strong>Present double-blinded randomized placebo-controlled study, included 100 patients from either sex with American Society of Anesthesiologists grades I and II and age from 18 to 60 years undergoing laminectomy for PIVD under general anesthesia. Patients were randomly divided into two groups of 50 each based on computer generated random numbers. The study group received dexmedetomidine (2.0 μg/ kg, i.m.) in 2.5 mL saline, and the control group received normal saline (placebo, i.m.) 2.5 mL. Drugs had been administered 30 minutes before anticipated time of extubation intramuscularly at the deltoid region. Comparison of continuous variables between two groups was done by using student's unpaired t-test. Categorical data were analyzed by using chi-square test and Fischer Exact test as applicable.</p><p><strong>Results: </strong>Heart rate was found to be significantly lower in the study group, 15 minutes before extubation (P = 0.003), during and after extubation (P ＜ 0.0001). The systolic and diastolic blood pressure was significantly lower in the study group during and after extubation (P ＜ 0.05). Cough was significantly lower in the study group during extubation. No significant difference was observed in other complications (respiratory stridor, incidence of laryngospasm or bronchospasm and reintubation) between the two groups. Pain score at 5 minutes, 2 hours, and 4 hours post-extubation was significantly lower in the study group (P ＜ 0.01). P-value ＜ 0.05 was considered statistically significant.</p><p><strong>Conclusions: </strong>Dexmedetomidine provides haemodynamic stability during extubation and post-extubation. It also provides post-operative calmness and reduces analgesic requirement and post-extubation complications.</p>","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"59 3","pages":"102-110"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39627061","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":"Plastic Sheet and Video Intubating Stylet: A Technical Note.","authors":"Phil B Tsai,&nbsp;Hsiang-Ning Luk","doi":"10.6859/aja.202109_59(3).0007","DOIUrl":"https://doi.org/10.6859/aja.202109_59(3).0007","url":null,"abstract":"","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"59 3","pages":"117-121"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39393033","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":"COVID-19: Regional Anesthesia, Benefits, and Practical Recommendations.","authors":"Gabriel Enrique Mejía-Terrazas,&nbsp;Eunice López-Muñoz,&nbsp;Juan Salvador Vilchis-Rentería,&nbsp;Alexis Janet Muñoz-García,&nbsp;María Del Rocío Angelica Alcántara-Muñoz","doi":"10.6859/aja.202109_59(3).0002","DOIUrl":"https://doi.org/10.6859/aja.202109_59(3).0002","url":null,"abstract":"<p><p>During coronavirus disease 2019 (COVID-19) pandemic, efforts have been made to rethink the health system and provide various recommendations to the best care of patients and for the protection of health personnel. In patients with suspicion or confirmation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who require surgical intervention and anesthetic management, strategies must be established to minimize aerosol-generating procedures. Regional anesthesia (RA) is not considered an aerosol-generating procedure per se and is currently proposed such as a safe strategy and part of comprehensive perioperative care. However, the preoperative evaluation has undergone changes in the context of the COVID-19 pandemic, so in addition to routine preoperative evaluation, a patient-oriented history, clinical, laboratory, and radiologic evaluation should be performed, and a series of general recommendations should be taken into account before, during, and after the performance of RA procedure. A search of PubMed/MEDLINE, Web of Science, and Google Scholar databases was performed until August 22, 2020, using the words: 〞regional anesthesia or nerve block or peripheral nerve block or spinal anesthesia or epidural anesthesia and SARS-CoV-2 or COVID-19 or MERS or SARS-CoV-1 or influenza.〞 We included in this review all articles, regardless of design, published in the English language. Given the benefits reported with the use of RA techniques, both for the patient and for healthcare personnel, it has recently been suggested that RA should be considered as the first choice. However, it is important to generate more precise and homogeneous management guidelines based on the evidence obtained every day during the care of patients with COVID-19.</p>","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"59 3","pages":"83-95"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39393031","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":"All Is Not Well in COVID-19 Recovered Patients: Anesthesiologist Viewpoint.","authors":"Prakash K Dubey,&nbsp;Kunal Singh","doi":"10.6859/aja.202109_59(3).0005","DOIUrl":"https://doi.org/10.6859/aja.202109_59(3).0005","url":null,"abstract":"","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"59 3","pages":"111-114"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39187194","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":"COVID-19 Pandemic: Taiwan Society of Anesthesiologists' Response to the Ethical Aspects of Health and Safety in Operating Room Management.","authors":"Shao-Chun Wu,&nbsp;Ming-Hui Hung,&nbsp;Chien-Kun Ting,&nbsp;Amina Mohamed Illias,&nbsp;Chueng-He Lu,&nbsp;Mei-Yung Tsou","doi":"10.6859/aja.202109_59(3).0001","DOIUrl":"https://doi.org/10.6859/aja.202109_59(3).0001","url":null,"abstract":"","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"59 3","pages":"81-82"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39627060","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":"COVID-19: Regional Anesthesia, Benefits, and Practical Recommendations.","authors":"G. E. Mejía-Terrazas, E. López-Muñoz, Juan Salvador Vilchis-Rentería, A. J. Muñoz-García, M. R. A. Alcántara-Muñoz","doi":"10.6859/aja.202109/PP.0002","DOIUrl":"https://doi.org/10.6859/aja.202109/PP.0002","url":null,"abstract":"During coronavirus disease 2019 (COVID-19) pandemic, efforts have been made to rethink the health system and provide various recommendations to the best care of patients and for the protection of health personnel. In patients with suspicion or confirmation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who require surgical intervention and anesthetic management, strategies must be established to minimize aerosol-generating procedures. Regional anesthesia (RA) is not considered an aerosol-generating procedure per se and is currently proposed such as a safe strategy and part of comprehensive perioperative care. However, the preoperative evaluation has undergone changes in the context of the COVID-19 pandemic, so in addition to routine preoperative evaluation, a patient-oriented history, clinical, laboratory, and radiologic evaluation should be performed, and a series of general recommendations should be taken into account before, during, and after the performance of RA procedure. A search of PubMed/MEDLINE, Web of Science, and Google Scholar databases was performed until August 22, 2020, using the words: 〞regional anesthesia or nerve block or peripheral nerve block or spinal anesthesia or epidural anesthesia and SARS-CoV-2 or COVID-19 or MERS or SARS-CoV-1 or influenza.〞 We included in this review all articles, regardless of design, published in the English language. Given the benefits reported with the use of RA techniques, both for the patient and for healthcare personnel, it has recently been suggested that RA should be considered as the first choice. However, it is important to generate more precise and homogeneous management guidelines based on the evidence obtained every day during the care of patients with COVID-19.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"1 1","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48635186","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}