Journal of anesthesia & clinical research最新文献

{"title":"Combined Styletubation with Videolaryngoscopy for Tracheal Intubation in Patients Undergoing Thyroidectomy with Intraoperative Neuromonitoring","authors":"Hui-Shan Pan, Tiffany Corey, Hsiang-Ning Luk, Jason Zhensheng Qu, Alan Shikani","doi":"10.3390/anesthres1010003","DOIUrl":"https://doi.org/10.3390/anesthres1010003","url":null,"abstract":"The purpose of this case series report is to demonstrate the current state of the art regarding tracheal intubation of an evoked electromyography-endotracheal tube (EMG-ET tube) for continuous intraoperative recurrent laryngeal nerve monitoring (IONM) in patients undergoing thyroid surgery. Both direct laryngoscopy (DL) and videolaryngoscopy (VL) are popular for routine tracheal intubation of an EMG-ET tube. A new intubating technique (styletubation), using a video-assisted intubating stylet (VS), provides less traumatic and swift intubation. Styletubation combined with VL ensures the precise placement of the EMG-ET tube. This novel intubation technique improves the outcome of intubating an EMG-ET tube for IONM.","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136096680","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":"Electrical Impedance Tomography (EIT) to Optimize Ventilatory Management in Critically Ill Patients: A Report of Two Cases","authors":"I. Cappellini, L. Campiglia, L. Zamidei, G. Consales","doi":"10.3390/anesthres1010002","DOIUrl":"https://doi.org/10.3390/anesthres1010002","url":null,"abstract":"Background: Electrical impedance tomography (EIT) is a non-invasive, radiation-free imaging method that enables the continuous bedside monitoring of regional ventilation and lung volume changes. The technique is based on the estimation of the resistivity changes that occur across the lungs with breathing. Methods: We present two case reports of patients affected by acute respiratory distress syndrome successfully managed with prone-positioning-based regional ventilation shown on EIT. Results: Both patients were submitted to cycles of prone-positioning-guided EIT and were successfully extubated and discharged from intensive care unit. Conclusions: EIT is a functional imaging method that has the potential to improve respiratory care by providing real-time, continuous monitoring of regional ventilation and lung volume changes at the bedside. Further research is needed to evaluate its efficacy in different clinical scenarios and to optimize its use in respiratory care.","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78040688","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":"Why a New Anesthesia Journal?","authors":"M. Ranucci","doi":"10.3390/anesthres1010001","DOIUrl":"https://doi.org/10.3390/anesthres1010001","url":null,"abstract":"Anesthesia Research (ISSN 2813-5806) is the new open-access journal published by MDPI [...]","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85949603","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":"Grading of Bag-Mask Ventilation Difficulty and Association with Unanticipated Difficult Laryngoscopy/Intubation in Children at a Training Center University Hospital: A Prospective Cohort Study","authors":"M. Oofuvong, Tidarut Sangkaew, Kanjana Nuanjun, E. McNeil","doi":"10.35248/2155-6148.20.11.937","DOIUrl":"https://doi.org/10.35248/2155-6148.20.11.937","url":null,"abstract":"Objective: In children, the grading of Bag-Mask Ventilation (BMV) difficulty and its association with difficult laryngoscopy/intubation has not been well established. This study aimed to evaluate the grading for BMV difficulty and determine its association with difficult laryngoscopy/intubation in a normal airway pediatric population. Methods: This prospective cohort study was conducted in children aged ≤9 years who underwent general anesthesia and oroendotracheal tube intubation between September 2008 and December 2012. Difficult laryngoscopy was defined as a Cormack–Lehane laryngoscopic view grade of 3 or 4. Difficult intubation was defined as the occurrence of at least two of the following: 1) at least three intubation attempts using direct laryngoscopy by experienced personnel (excluding first intubation attempts); 2) intubation time >300 s; and 3) occurrence of desaturation (SpO2<95%). The use of open airway maneuvers, including continuous positive airway pressure (CPAP), oropharyngeal airway (OPA), and two-person ventilation (TPV), or unsuccessful BMV were also considered. The association between BMV difficulty and difficult laryngoscopy/intubation was assessed using multivariate logistic regression with adjusted odds ratios (OR), 95% confidence intervals (CIs), and area under the receiver operating characteristic curve (AUC). Results: The incidence of difficult laryngoscopy/intubation was 6.4% (49/765). The categories of BMV difficulty were grade 0 (easy BMV without requiring an open airway maneuver, n=308), grade 1 (easy BMV after applying CPAP, n=368), grade 2 (successful BMV after inserting an OPA, n=16), grade 3 (successful BMV after applying TPV, n=71), and grade 4 (unsuccessful BMV after applying all airway maneuvers, n=2). Difficult BMV was defined as a BMV grade of 3 or 4 (v/s grades 0-2). After adjusting for age, body weight, history of snoring, type of operation, use of neuromuscular blocking agents, and first laryngoscopist, BMV difficulty was significantly associated with difficult laryngoscopy/intubation (adjusted OR [95% CI]=2.5 [1.1-5.5], sensitivity 0.59, specificity 0.74, AUC=0.70). Conclusion: A BMV grade of 3 (requiring TPV) or 4 (unsuccessful BMV) was associated with difficult laryngoscopy/ intubation in a pediatric population.","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81523731","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":"Vasovagal Attack during Insertion of Thoracic Paravertebral Catheter: A known but Rarely Reported Incident","authors":"S. Agarwal, S. Bharti, Wasimul Hoda","doi":"10.4172/2155-6148.1000872","DOIUrl":"https://doi.org/10.4172/2155-6148.1000872","url":null,"abstract":"Vasovagal syncope is defined as a sudden and transient loss of consciousness. We report a case of vasovagal attack during insertion of thoracic paravertebral cathether. A 28 year old male ASA I, case of bronchus Schwannomas was posted for left sided Pneumonectomy. Past history of 2 episodes of dizziness and fainting on visualization of blood. During insertion of the catheter through the needle, patient felt paraesthesia and complained of giddiness and became unconscious. The monitor showed sudden bradycardia and hypotension. The blood glucose was found to be 55 mg/dl. 25% dextrose 100 ml was given to correct hypoglycemia. Patient was resuscitated and surgery completed. Therefore, Vasovagal episodes along with regional anesthesia can be a significant hazard. Attention must be given to patients with history of vasovagal episodes. Adequate comfortable positioning, reassurance, adequate sedatives to relieve anxiety and preprocedure optimization of blood glucose may be useful in such patients.","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2155-6148.1000872","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70278810","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":"General Anesthesia for Elective Cesarean Section in a Patient with Moyamoya Disease","authors":"José Alexandre Colli Neto, Jefferson Ribeiro Zorzi Costa, Andreza Ribeiro Teixeira Barreta, Jose Helio Ribeiro Zen Jr, Fernando Eduardo Ribeiro Feres Junqueira, Maria Jose Ribeiro Nascimento Brandao","doi":"10.4172/2155-6148.1000879","DOIUrl":"https://doi.org/10.4172/2155-6148.1000879","url":null,"abstract":"","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2155-6148.1000879","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70279303","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":"High-Flow Oxygen Therapy for Peroperative Hypoxemia during One-lung Ventilation","authors":"A. Duwat, P. Courivaud, E. Dusart, G. Pavy, C. Pila","doi":"10.4172/2155-6148.1000880","DOIUrl":"https://doi.org/10.4172/2155-6148.1000880","url":null,"abstract":"Around 5-10% of patients develop hypoxemia during one-lung ventilation [1]. The change to one-lung ventilation is responsible for the development of intrapulmonary shunt and pulmonary vasoconstriction in response to hypoxia in the non-ventilated lung. The increase in blood flow towards the ventilated lung may also be accompanied by an increase in shunt as a result of hyperflow. However, these adaptive phenomena are sometimes insufficient and may lead to peroperative hypoxemia [2].","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2155-6148.1000880","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70279352","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":"Accuracy of a Novel Oxygen Mask Designed for Mainstream Capnometer in Non-intubated Pediatric Patients","authors":"I. Kondo, M. Kumemura, Tomoki Yamaguchi, K. Yamakawa, Yuichiro Nonaka, Masatoshi Iijima, S. Uezono","doi":"10.4172/2155-6148.1000877","DOIUrl":"https://doi.org/10.4172/2155-6148.1000877","url":null,"abstract":"Background: Capnography is useful for identifying postoperative apnea in non-intubated children. A Cap-ONE mask is a multi-functional face mask which can allow oxygen supply and simultaneous end-tidal CO2 (ETCO2) measurement in infant and pediatric as well as an adult patient. However, the accuracy of the ETCO2 measured via Cap-ONE has not been well evaluated especially in infant and pediatric patient. The aim of this study was to examine the correlation and level of agreement between ETCO2 obtained via Cap- ONE mask and arterial blood gas partial pressure of CO2 (PaCO2) in postoperative non-intubated pediatric patients in the intensive care unit (ICU). Methods: Postsurgical pediatric patients scheduled to admit to the ICU with invasive arterial pressure monitoring from April 2015 to March 2017 were enrolled. Patients with cardiac disease or facial abnormalities were excluded from the study. After arrival at the ICU, either small-sized (for 7-20 kg) or medium-sized (for 20-40 kg) Cap-ONE mask was installed on a patient face with oxygen supply at 5 L/min; then ETCO2 measurement was started. Once stabilized, the sample of arterial blood gas was analyzed to measure PaCO2. The relationship between ETCO2 and PaCO2 was examined by simple regression analysis. A Bland Altman plot was used to evaluate agreement between these two measurements. Results: A total of 77 ETCO2-PaCO2 paired values were obtained from 29 patients. In 23 (79.3%) patients, dexmedetomidine was administrated for sedation. The mean ± SD for ETCO2 and PaCO2 was 39.0 ± 8.5 mmHg and 41.5 ± 6.5 mmHg respectively (small group; 35.2 ± 8.7 mmHg and 37.8 ± 5.3 mmHg, medium group; 41.8 ± 7.3 mmHg and 44.2 ± 5.8 mmHg). Correlation coefficient (R2) was 0.554 (P<0.01) between ETCO2 and PaCO2 (small group; R2=0.431, medium group; R2=0.515). The mean bias ± SD between ETCO2 and PaCO2 was -2.38 ± 5.69 mmHg. The 95% level of agreement ranged from -13.54 to+8.78 mmHg (small group; -2.60 ± 6.55 mmHg, medium group; -2.40 ± 5.10 mmHg). Conclusion: ETCO2 obtained from Cap-ONE mask is correlated well with PaCO2 in postoperative non-intubated pediatric patients (aged 7 months to 14 years). The present study demonstrated that the Cap-ONE mask can provide a continuous, non-invasive, relatively reliable respiratory measurement in non-intubated, lightly sedated pediatric patients.","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2155-6148.1000877","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70279207","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":"Comparison of Accuracy of Different Methods for Detection of Postoperative Renal Impairment in Colorectal Surgery with Restrictive Fluid Strategy","authors":"K. Abdelrahman, E. Abdel-Allah, J. Sayed, N. Osman, M. Mostafa, Mohamed Ismail Seddiek, Y. Abbas, M. Mahmoud, Omar M. Soliman, A. Elkadi, M. AhmedMohamed, our, A. Thabet, Mustafa hassanian hassanian Bakr, A. M. Thabet","doi":"10.4172/2155-6148.1000873","DOIUrl":"https://doi.org/10.4172/2155-6148.1000873","url":null,"abstract":"Objective: Perioperative fluid restriction in major abdominal surgeries carries a potential risk of organ dysfunction such as acute kidney injury. Profound fluid restriction should be applied cautiously. The aim of this study is to compare the accuracy of (serum creatnine, urine output and KDIGO compared to NGAL for detection of postoperative AKI after colorectal surgery.Methods: Restrictive fluid strategy was applied to all patients with 5 mL/kg/h of lactated ringer (LR) and was administered intraoperatively starting from the induction of general anesthesia till the end of surgery and patient extubation. Data collected included incidence of AKI with three screening tools in addition to intra and postoperative complications.Results: None of the above tested AKI based criteria has satisfactory both sensitivity and specificity. The sensitivity of urine output for detection of AKI was 72.7 [39.0-94.0] while its specificity was 79.8 [69.9-87.6], for creatinine above 0.3 mg/dl; the sensitivity was 63.6 [30.8-89.1] and specificity was 98.9 [93.9-99.9], and for KDIGO the sensitivity was 81.8 % [95% CI 48.2-97.7] and specificity was 74.2% [95% CI 63.8-82.9].Conclusion: Despite use CVP for detection of hypovolemia, there is still high incidence of AKI. Creatinine based criteria, urine based criteria or combination of both are inaccurate when volume restriction is applied.","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2155-6148.1000873","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70278893","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":"Determination of Optimal PEEP by Carbon Dioxide Production (VCO2) in ARDS Patients","authors":"M. Abdelghafar, Zahretelwady Mohamed Salaheldin Mohamed","doi":"10.4172/2155-6148.1000874","DOIUrl":"https://doi.org/10.4172/2155-6148.1000874","url":null,"abstract":"Background: The use of PEEP is a corner stone in the management of ARDS. Several methods were investigated to determine the optimal PEEP. However, no method is considered gold standard. The study investigated whether the use of VCO2 to determine optimal PEEP value in ARDS patients improves oxygenation, alveolar ventilation and static compliance compared to ARDSNet FiO2-PEEP combination. Patients and methods: This prospective randomized controlled study was conducted at a tertiary university hospital ICU including sixty mechanically ventilated ARDS patients. Patients were randomized between two groups; group A, where PEEP was titrated using FiO2-PEEP combination and group B, where PEEP was titrated according to VCO2. In this group, PEEP was increased in increments of 2 cm H2O every 20 minutes with VCO2 monitoring. Once it failed to recover to baseline, the preceding PEEP value was considered optimum. Results: Group B received statistically significant higher values of PEEP 10.87 (± 2.35) vs. 9.20 (± 1.13) cm H2O; p <0.001 and lower values of FiO2 40 (± 0) vs. 57.00 (± 8.37) %; p <0.001, compared with group A. Significantly higher PaO2/FiO2 and static compliance were observed in group B compared with group A [216.27 (± 36.79) vs. 158.60 (± 42.65); p <0.001 and 57.80 (± 7.93) vs. 52.73 (± 4.98) mL/cm H2O; p <0.04, respectively]. While VA improved in both groups there was no associated impact of both interventions on VCO2 or MAP. Conclusion: Optimum PEEP determination using VCO2 resulted in improvement of oxygenation and lung compliance compared with FiO2-PEEP combination in ARDS patients. Higher PEEP used was not associated with increase in complications.","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2155-6148.1000874","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70279021","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}