Pub Date : 2022-07-01DOI: 10.4103/2045-9912.330692
Yoshiharu Tanaka, Li Xiao, Nobuhiko Miwa
This study compared the effects of hydrogen-water (HW) bath on the oxygen radical absorption-based antioxidant capacity and the inflammatory indicator, C-reactive protein (CRP), in serum between healthy volunteers and inflammatory/collagen disease-patients. The HW bath apparatus supplied nano-bubbles with a diameter of 110 ± 10 nm and 338-682 μg/L of dissolved hydrogen after 120 minutes electrolysis, and nano-bubbles increased to 9.91 × 107/mL along with the increase of correlative dissolved hydrogen. Ten-minute HW bath increased the oxygen radical absorption-based antioxidant capacity to 110.9 ± 9.2% at post-bathing 120 minutes, although unaltered with 10-minute normal water bath at 40°C in healthy subjects. The CRP level was repressed to 70.2 ± 12.1% at 120 minutes after HW bath, although rather increased for normal water bath. In the patients with connective tissue diseases, the CRP level was repressed to 3-24% upon 9 days to 4 months of HW bathing. In another six patients with diverse autoimmune-related diseases, upon daily HW bathing as long as 2-25 months, the pre-bathing CRP level of 5.31 mg/dL decreased to 0.24 mg/dL being within the standard-range, with relief of visible inflammatory symptoms for some cases. Thus, the HW bath with high-density nano-bubbles has beneficial effects on serum antioxidant capacity, inflammation, and the skin appearance. The study was approved by the Committee of Ethics, Japanese Center of Anti-Aging Medical Sciences (Authorization No. H-15-03-2, on January 15, 2019), which was a non-profitable organization officially authenticated by the Hiroshima Prefecture Government of Japan.
{"title":"Hydrogen-rich bath with nano-sized bubbles improves antioxidant capacity based on oxygen radical absorbing and inflammation levels in human serum.","authors":"Yoshiharu Tanaka, Li Xiao, Nobuhiko Miwa","doi":"10.4103/2045-9912.330692","DOIUrl":"https://doi.org/10.4103/2045-9912.330692","url":null,"abstract":"<p><p>This study compared the effects of hydrogen-water (HW) bath on the oxygen radical absorption-based antioxidant capacity and the inflammatory indicator, C-reactive protein (CRP), in serum between healthy volunteers and inflammatory/collagen disease-patients. The HW bath apparatus supplied nano-bubbles with a diameter of 110 ± 10 nm and 338-682 μg/L of dissolved hydrogen after 120 minutes electrolysis, and nano-bubbles increased to 9.91 × 10<sup>7</sup>/mL along with the increase of correlative dissolved hydrogen. Ten-minute HW bath increased the oxygen radical absorption-based antioxidant capacity to 110.9 ± 9.2% at post-bathing 120 minutes, although unaltered with 10-minute normal water bath at 40°C in healthy subjects. The CRP level was repressed to 70.2 ± 12.1% at 120 minutes after HW bath, although rather increased for normal water bath. In the patients with connective tissue diseases, the CRP level was repressed to 3-24% upon 9 days to 4 months of HW bathing. In another six patients with diverse autoimmune-related diseases, upon daily HW bathing as long as 2-25 months, the pre-bathing CRP level of 5.31 mg/dL decreased to 0.24 mg/dL being within the standard-range, with relief of visible inflammatory symptoms for some cases. Thus, the HW bath with high-density nano-bubbles has beneficial effects on serum antioxidant capacity, inflammation, and the skin appearance. The study was approved by the Committee of Ethics, Japanese Center of Anti-Aging Medical Sciences (Authorization No. H-15-03-2, on January 15, 2019), which was a non-profitable organization officially authenticated by the Hiroshima Prefecture Government of Japan.</p>","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 3","pages":"91-99"},"PeriodicalIF":2.9,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/8c/MGR-12-91.PMC8690854.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39684774","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}
Medical effects of hydrogen have been reported in many studies. Due to difficulties in measuring hydrogen concentration in vivo after intake and high explosive risks of hydrogen, studies about dose-response relationships and tissue concentrations of hydrogen are few. Here, for the first time, we monitored real-time hydrogen concentrations in different tissues in rats including brain, liver, spleen, kidney, thigh muscle, inguinal white adipose tissue, and gonadal white adipose tissue after inhaling different concentrations of hydrogen (4%, 42%, and 67%) using an electrochemical sensor. Hydrogen concentrations in the same tissue showed a dose-dependent response. The equilibrium concentration values were highest in the brain and lowest in the thigh muscle. The saturation and desaturation curves changed more slowly in the thigh muscle and white adipose tissues than in other tissues. These results provide fundamental information for the selection of hydrogen dose applications in basic research and clinical trials. The experiments were approved by the Laboratory Animal Ethics Committee of Shandong First Medical University & Shandong Academy of Medical Sciences (No. 2020-1028) on March 18, 2020.
{"title":"<i>In vivo</i> microelectrode monitoring of real-time hydrogen concentration in different tissues of rats after inhaling hydrogen gas.","authors":"Bo-Yan Liu, Jun-Li Xue, Qian-Qian Gu, Min Zhao, Meng-Yu Zhang, Ming-Yue Wang, Yun Wang, Shu-Cun Qin","doi":"10.4103/2045-9912.330694","DOIUrl":"https://doi.org/10.4103/2045-9912.330694","url":null,"abstract":"<p><p>Medical effects of hydrogen have been reported in many studies. Due to difficulties in measuring hydrogen concentration in vivo after intake and high explosive risks of hydrogen, studies about dose-response relationships and tissue concentrations of hydrogen are few. Here, for the first time, we monitored real-time hydrogen concentrations in different tissues in rats including brain, liver, spleen, kidney, thigh muscle, inguinal white adipose tissue, and gonadal white adipose tissue after inhaling different concentrations of hydrogen (4%, 42%, and 67%) using an electrochemical sensor. Hydrogen concentrations in the same tissue showed a dose-dependent response. The equilibrium concentration values were highest in the brain and lowest in the thigh muscle. The saturation and desaturation curves changed more slowly in the thigh muscle and white adipose tissues than in other tissues. These results provide fundamental information for the selection of hydrogen dose applications in basic research and clinical trials. The experiments were approved by the Laboratory Animal Ethics Committee of Shandong First Medical University & Shandong Academy of Medical Sciences (No. 2020-1028) on March 18, 2020.</p>","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 3","pages":"107-112"},"PeriodicalIF":2.9,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fd/17/MGR-12-107.PMC8690855.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39685226","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}
Pub Date : 2022-07-01DOI: 10.4103/2045-9912.330696
Priyanka Bansal, Kunal Bansal
Dear Editor, As we find ourselves in the middle of a roller coaster ride of a pernicious pandemic, bearing the wrath of a deadly virus, I wish to bring forth a terminology which almost forgotten but may itself turnout to be a future pandemic especially among anesthesiologists – “Burnout.” Hyman1 in the article “Burnout: the ‘other’ pandemic” elucidated the definition and impact that burnout has on anesthesiologists. It is a common psychological disorder described first by Herbert J. Freudenberger2 that involves complete emotional detachment from oneself and surroundings or complete denial from reality.3 There are important risk factors that exhibited by a burnout patient emotional detachment, dissociation from reality (existentialism) or depersonalization, or a sense of dissatisfaction from personal accomplishments. A more explicit description of these risk factors has been mentioned by Afonso et al.’s recent study.4 The Facebook, Twitter and the so called oceans of information are flooded with zillions of research on incidence, risk factors, but the true need of the hour is therapy rather than problem because many unfortunates are already showing symptoms. The coronavirus disease 2019 (COVID-19) pandemic has deprived us of love, laugh attachment, physical touch, hugs, gigs over tea and all little human needs that we enjoy as a social being. Human mind already exists in a state of complete denial – we make future plans and deny death, the ultimate solace of all living beings. Humans are humane. We have become selfish as all social animals normally behave when confronted with a danger. Future research needs to be focused not only on the incidence but also on a solid reliable thorough solution to this menace. The syndrome is important to debate because it is directly linked to professionalism, quality of care to both colleagues and patients and efficiency of working. The major factor according to a study is workplace situation rather than personal factors. Lack of adequate workplace support, too many wee hours of working (a major factor for trainees, > 40 hours per week), and lack of a supportive mentor are some of very crucial factors responsible for burnout.4,5 Going not with the flow, we would like to focus more on the actions that can contribute to destress our much needed population. A feeling of support, good leadership at workplace, good mentor and also a healthy home environment bestow positive vibes. One pertinent point that really needs to be emphasized is that workplace environment is directly related to team leader. True leadership roles include being empathetic, passionate, resolute and having a true sympathetic nature towards colleagues harboring a culture of support.5 The anesthesiologists being at greater risk demand attention because we are “Swiss army knives” contributing truly to mankind and catering to a wide arena of services in our institute. We bequest patient care in most hostile circumstances (critical care, triage areas) a
{"title":"Anesthesiologists and burnout: what are we missing?","authors":"Priyanka Bansal, Kunal Bansal","doi":"10.4103/2045-9912.330696","DOIUrl":"https://doi.org/10.4103/2045-9912.330696","url":null,"abstract":"Dear Editor, As we find ourselves in the middle of a roller coaster ride of a pernicious pandemic, bearing the wrath of a deadly virus, I wish to bring forth a terminology which almost forgotten but may itself turnout to be a future pandemic especially among anesthesiologists – “Burnout.” Hyman1 in the article “Burnout: the ‘other’ pandemic” elucidated the definition and impact that burnout has on anesthesiologists. It is a common psychological disorder described first by Herbert J. Freudenberger2 that involves complete emotional detachment from oneself and surroundings or complete denial from reality.3 There are important risk factors that exhibited by a burnout patient emotional detachment, dissociation from reality (existentialism) or depersonalization, or a sense of dissatisfaction from personal accomplishments. A more explicit description of these risk factors has been mentioned by Afonso et al.’s recent study.4 The Facebook, Twitter and the so called oceans of information are flooded with zillions of research on incidence, risk factors, but the true need of the hour is therapy rather than problem because many unfortunates are already showing symptoms. The coronavirus disease 2019 (COVID-19) pandemic has deprived us of love, laugh attachment, physical touch, hugs, gigs over tea and all little human needs that we enjoy as a social being. Human mind already exists in a state of complete denial – we make future plans and deny death, the ultimate solace of all living beings. Humans are humane. We have become selfish as all social animals normally behave when confronted with a danger. Future research needs to be focused not only on the incidence but also on a solid reliable thorough solution to this menace. The syndrome is important to debate because it is directly linked to professionalism, quality of care to both colleagues and patients and efficiency of working. The major factor according to a study is workplace situation rather than personal factors. Lack of adequate workplace support, too many wee hours of working (a major factor for trainees, > 40 hours per week), and lack of a supportive mentor are some of very crucial factors responsible for burnout.4,5 Going not with the flow, we would like to focus more on the actions that can contribute to destress our much needed population. A feeling of support, good leadership at workplace, good mentor and also a healthy home environment bestow positive vibes. One pertinent point that really needs to be emphasized is that workplace environment is directly related to team leader. True leadership roles include being empathetic, passionate, resolute and having a true sympathetic nature towards colleagues harboring a culture of support.5 The anesthesiologists being at greater risk demand attention because we are “Swiss army knives” contributing truly to mankind and catering to a wide arena of services in our institute. We bequest patient care in most hostile circumstances (critical care, triage areas) a","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 3","pages":"115"},"PeriodicalIF":2.9,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/32/MGR-12-115.PMC8690853.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39685228","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}
Pub Date : 2022-07-01DOI: 10.4103/2045-9912.330693
Thalyta Dos Reis Furlani Zouain Ferreira Neves Dias, Francisco Ubiratan Ferreira de Campos, Cecilia Pedroso Turssi, Flávia Lucisano Botelho do Amaral, Fabiana Mantovani Gomes França, Roberta Tarkany Basting
There is a constant search for bleaching treatments that can offer greater safety with fewer adverse effects, especially in the techniques performed in the office, which usually employ hydrogen peroxide in high concentrations (35% to 40%) that are not recommended by some international control agencies. This in vitro study evaluated the color change after tooth bleaching with the use of ozone and a 10% ozonized carbamide peroxide bleaching treatment for in-office use. Thirty molars were allocated (n = 10): three applications of ozone (1 hour every 3 days); three applications of 10% ozonized carbamide peroxide (1 hour every 3 days); 10% carbamide peroxide agent (8 hours a day for 7 days). The teeth were mounted on a plaster model to simulate the dental arch, and trays made of silicone were used for the application of the bleaching agents and to allow ozone to enter through. The ozone concentration used was 60 μg/mL, with an oxygen flow of 0.25 L/min. The values of color change showed no significant differences among treatments. The variations in the parameters over time, as well as the values of ΔEab, ΔE00, and WID, showed that there was no significant difference among the three treatments. The use of ozone and 10% ozonized carbamide peroxide for in-office use was effective for tooth bleaching with clinically perceptible and acceptable color alterations. The study was approved on September 10, 2019 by the São Leopoldo Mandic Ethics Research Committee (CAAE No. 17711719.4.0000.5374).
{"title":"Color change after tooth bleaching with ozone and 10% ozonized carbamide peroxide for in-office use.","authors":"Thalyta Dos Reis Furlani Zouain Ferreira Neves Dias, Francisco Ubiratan Ferreira de Campos, Cecilia Pedroso Turssi, Flávia Lucisano Botelho do Amaral, Fabiana Mantovani Gomes França, Roberta Tarkany Basting","doi":"10.4103/2045-9912.330693","DOIUrl":"https://doi.org/10.4103/2045-9912.330693","url":null,"abstract":"<p><p>There is a constant search for bleaching treatments that can offer greater safety with fewer adverse effects, especially in the techniques performed in the office, which usually employ hydrogen peroxide in high concentrations (35% to 40%) that are not recommended by some international control agencies. This in vitro study evaluated the color change after tooth bleaching with the use of ozone and a 10% ozonized carbamide peroxide bleaching treatment for in-office use. Thirty molars were allocated (n = 10): three applications of ozone (1 hour every 3 days); three applications of 10% ozonized carbamide peroxide (1 hour every 3 days); 10% carbamide peroxide agent (8 hours a day for 7 days). The teeth were mounted on a plaster model to simulate the dental arch, and trays made of silicone were used for the application of the bleaching agents and to allow ozone to enter through. The ozone concentration used was 60 μg/mL, with an oxygen flow of 0.25 L/min. The values of color change showed no significant differences among treatments. The variations in the parameters over time, as well as the values of ΔE<sub>ab</sub>, ΔE<sub>00</sub>, and WI<sub>D</sub>, showed that there was no significant difference among the three treatments. The use of ozone and 10% ozonized carbamide peroxide for in-office use was effective for tooth bleaching with clinically perceptible and acceptable color alterations. The study was approved on September 10, 2019 by the São Leopoldo Mandic Ethics Research Committee (CAAE No. 17711719.4.0000.5374).</p>","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 3","pages":"100-106"},"PeriodicalIF":2.9,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0d/02/MGR-12-100.PMC8690856.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39685224","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}
Pub Date : 2022-04-17DOI: 10.4103/2045-9912.337993
Bing Li, Jian Xiong, Huijiang Liu, Di Li, Gang Chen
Stroke is one of the most important acute diseases that endanger human health and result in death, including acute cerebral hemorrhage and acute cerebral ischemia. Acute onset is its most prominent feature. Carbon monoxide (CO) is a colorless and odorless gas existing at room temperature. It is not only a common air pollutant, but also has been found to be closely related to stroke. A large amount of exogenous CO has an important impact on the incidence and prognosis of stroke, while endogenous CO as a gas signal also has an important impact on neuroprotection after stroke. Both low-dose CO inhalation and CO-releasing molecule-3 (a molecule that emits CO) treatment have shown the benefits of stroke, and perhaps the role of CO in stroke is one of the key areas for future research.
{"title":"Devil or angel: two roles of carbon monoxide in stroke","authors":"Bing Li, Jian Xiong, Huijiang Liu, Di Li, Gang Chen","doi":"10.4103/2045-9912.337993","DOIUrl":"https://doi.org/10.4103/2045-9912.337993","url":null,"abstract":"Stroke is one of the most important acute diseases that endanger human health and result in death, including acute cerebral hemorrhage and acute cerebral ischemia. Acute onset is its most prominent feature. Carbon monoxide (CO) is a colorless and odorless gas existing at room temperature. It is not only a common air pollutant, but also has been found to be closely related to stroke. A large amount of exogenous CO has an important impact on the incidence and prognosis of stroke, while endogenous CO as a gas signal also has an important impact on neuroprotection after stroke. Both low-dose CO inhalation and CO-releasing molecule-3 (a molecule that emits CO) treatment have shown the benefits of stroke, and perhaps the role of CO in stroke is one of the key areas for future research.","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 1","pages":"125 - 130"},"PeriodicalIF":2.9,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48292091","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}
Pub Date : 2022-04-17DOI: 10.4103/2045-9912.337994
T. Bansal, S. Singhal, Khushboo Kundu
Prevention and management of postoperative nausea and vomiting (PONV) is a fundamental part of anesthesia. Using sevoflurane and propofol in combination for maintenance of anesthesia has been found to reduce PONV compared to sevoflurane alone. However, there are limited studies comparing propofol with a combination of propofol and sevoflurane for the incidence of PONV after laparoscopic surgery. The prospective, randomized, double-blind study was planned to compare propofol and combination of propofol and sevoflurane as maintenance agents for the incidence of PONV. Seventy female patients of 18–60 years, of American Society of Anesthesiologists I or II, undergoing laparoscopic surgery were included. Propofol group (n = 35) included induction with propofol and maintenance with propofol infusion, and propofol + sevoflurane group (n = 35) included induction with propofol and maintenance with a combination of propofol infusion and sevoflurane inhalation. The objectives were to find the incidence of PONV and requirement of rescue antiemetic. In the propofol group, 11 patients (33%) experienced PONV and in the propofol + sevoflurane group, PONV was experienced by 12 patients (38.7%) [0.65]. In the propofol group, 11 patients required ondansetron and out of these 11 patients, 2 patients required metoclopramide. In the propofol + sevoflurane group, Ondansetron was required by 12 patients and 3 patients out of these 12 patients required metoclopramide. In the present study, the incidence of PONV was found to be similar in both groups. So, it can be suggested to add sevoflurane in smaller doses to infusion of propofol for maintenance of anesthesia.
{"title":"Prospective randomized double-blind study to evaluate propofol and combination of propofol and sevoflurane as maintenance agents in reducing postoperative nausea and vomiting in female patients undergoing laparoscopic surgery","authors":"T. Bansal, S. Singhal, Khushboo Kundu","doi":"10.4103/2045-9912.337994","DOIUrl":"https://doi.org/10.4103/2045-9912.337994","url":null,"abstract":"Prevention and management of postoperative nausea and vomiting (PONV) is a fundamental part of anesthesia. Using sevoflurane and propofol in combination for maintenance of anesthesia has been found to reduce PONV compared to sevoflurane alone. However, there are limited studies comparing propofol with a combination of propofol and sevoflurane for the incidence of PONV after laparoscopic surgery. The prospective, randomized, double-blind study was planned to compare propofol and combination of propofol and sevoflurane as maintenance agents for the incidence of PONV. Seventy female patients of 18–60 years, of American Society of Anesthesiologists I or II, undergoing laparoscopic surgery were included. Propofol group (n = 35) included induction with propofol and maintenance with propofol infusion, and propofol + sevoflurane group (n = 35) included induction with propofol and maintenance with a combination of propofol infusion and sevoflurane inhalation. The objectives were to find the incidence of PONV and requirement of rescue antiemetic. In the propofol group, 11 patients (33%) experienced PONV and in the propofol + sevoflurane group, PONV was experienced by 12 patients (38.7%) [0.65]. In the propofol group, 11 patients required ondansetron and out of these 11 patients, 2 patients required metoclopramide. In the propofol + sevoflurane group, Ondansetron was required by 12 patients and 3 patients out of these 12 patients required metoclopramide. In the present study, the incidence of PONV was found to be similar in both groups. So, it can be suggested to add sevoflurane in smaller doses to infusion of propofol for maintenance of anesthesia.","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 1","pages":"137 - 140"},"PeriodicalIF":2.9,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43333180","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}
Pub Date : 2022-04-17DOI: 10.4103/2045-9912.337998
Tanmay Tiwari, B. Sharma, Sachin Rajput
In cases with an unanticipated difficult airway, retrograde intubation can be used as an alternative procedure for airway management when a fiber optic bronchoscope is unavailable. We here report a case of successful management of an unanticipated difficult airway following a failed intubation in a 34-year-old 54 kg male patient with carcinoma lateral border of tongue using retrograde intubation guided technique. Maintaining oxygenation and minimizing airway trauma should be the priority following a failed intubation. Decisions seeking alternative techniques following failed intubation are easy, if valid and applicable techniques (as per anesthesiologist's skills and available resources) are discussed before induction of anesthesia.
{"title":"A case report of retrograde intubation as rescue procedure in unanticipated difficult airway: an old technique still relevant in low resource settings","authors":"Tanmay Tiwari, B. Sharma, Sachin Rajput","doi":"10.4103/2045-9912.337998","DOIUrl":"https://doi.org/10.4103/2045-9912.337998","url":null,"abstract":"In cases with an unanticipated difficult airway, retrograde intubation can be used as an alternative procedure for airway management when a fiber optic bronchoscope is unavailable. We here report a case of successful management of an unanticipated difficult airway following a failed intubation in a 34-year-old 54 kg male patient with carcinoma lateral border of tongue using retrograde intubation guided technique. Maintaining oxygenation and minimizing airway trauma should be the priority following a failed intubation. Decisions seeking alternative techniques following failed intubation are easy, if valid and applicable techniques (as per anesthesiologist's skills and available resources) are discussed before induction of anesthesia.","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 1","pages":"158 - 160"},"PeriodicalIF":2.9,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42809743","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}
Pub Date : 2022-04-17DOI: 10.4103/2045-9912.337995
Shruti Jain, N. Nazir, Saurav M Mustafi
Preemptive analgesia with intravenous ketamine has been utilized as a part of multi-modal analgesia for acute postoperative pain following laparoscopic cholecystectomy with mixed outcomes. We tested the effectiveness of low-dose ketamine for acute and chronic postoperative pain after laparoscopic cholecystectomy in a randomized controlled experiment. The study involved 50 individuals who had a laparoscopic cholecystectomy under general anesthesia. All the patients were separated into two equal groups. The ketamine and control groups were given 0.5 mg/kg ketamine and 2 mL of normal saline, respectively, at 15 minutes before incision. Patients in the ketamine group had a significantly lower numeric pain rating scale score at 0 minutes than those in the control group. The numeric pain rating scale score of the ketamine group was considerably greater than the control group after a half-hour interval. At other time periods, there was no significant difference in numeric pain rating scale scores between the two groups. The ketamine group had a greater duration of analgesia and sedation score than the control group. The cumulative tramadol demand at 24 hours and the incidence of chronic pain did not differ significantly across the groups. Substantial analgesic effect of intravenous ketamine lasted only up to 30 min postoperatively. There was no discernible effect in terms of chronic pain prevention.
{"title":"Preemptive low-dose intravenous ketamine in the management of acute and chronic postoperative pain following laparoscopic cholecystectomy: a prospective randomized control study","authors":"Shruti Jain, N. Nazir, Saurav M Mustafi","doi":"10.4103/2045-9912.337995","DOIUrl":"https://doi.org/10.4103/2045-9912.337995","url":null,"abstract":"Preemptive analgesia with intravenous ketamine has been utilized as a part of multi-modal analgesia for acute postoperative pain following laparoscopic cholecystectomy with mixed outcomes. We tested the effectiveness of low-dose ketamine for acute and chronic postoperative pain after laparoscopic cholecystectomy in a randomized controlled experiment. The study involved 50 individuals who had a laparoscopic cholecystectomy under general anesthesia. All the patients were separated into two equal groups. The ketamine and control groups were given 0.5 mg/kg ketamine and 2 mL of normal saline, respectively, at 15 minutes before incision. Patients in the ketamine group had a significantly lower numeric pain rating scale score at 0 minutes than those in the control group. The numeric pain rating scale score of the ketamine group was considerably greater than the control group after a half-hour interval. At other time periods, there was no significant difference in numeric pain rating scale scores between the two groups. The ketamine group had a greater duration of analgesia and sedation score than the control group. The cumulative tramadol demand at 24 hours and the incidence of chronic pain did not differ significantly across the groups. Substantial analgesic effect of intravenous ketamine lasted only up to 30 min postoperatively. There was no discernible effect in terms of chronic pain prevention.","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 1","pages":"141 - 145"},"PeriodicalIF":2.9,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48610961","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}
Pub Date : 2022-04-17DOI: 10.4103/2045-9912.337996
C. Kaya, N. Çelebi, S. Debbağ, O. Canbay, O. Onal
Dexmedetomidine is an α2 agonist and remifentanil is a short-acting μ opioid agonist. We aimed to compare the dexmedetomidine and remifentanil infusions used for conscious sedation in geriatric patients undergoing outpatient cataract surgery in terms of sedation quality, side effects, and surgeon satisfaction. Eighty patients were allocated into two groups as per the administration of dexmedetomidine (dexmedetomidine group) and remifentanil (remifentanil group) infusion in this randomized, prospective, double-blinded study. In dexmedetomidine group (n = 40), after a loading of 1 μg/kg dexmedetomidine in 10 minutes, 0.4 μg/kg/h infusion was administered. In the remifentanil group (n = 40), remifentanil at a dose of 0.05 μg/kg was administered for 10 minutes, and then 0.05 μg/kg/min infusion was continued. Observer Assessment Warning/Sedation Scale values evaluating sedation quality were lower in the dexmedetomidine group than in the remifentanil group, although it was not statistically significant (P > 0.05). Bispectral Index values evaluating sedation quality were lower in the dexmedetomidine group according to the remifentanil group (P < 0.05). The dexmedetomidine group had lower Verbal Rating Scale and Visual Analogue Scale scores evaluating pain intensity compared with the remifentanil group (P < 0.05). The nausea Visual Analogue Scale values evaluating the severity of postoperative nausea in the dexmedetomidine group were lower than those in the remifentanil group (P < 0.05). The surgeon satisfaction was found to be greater in the dexmedetomidine group compared with the remifentanil group (P = 0.015). In geriatric patients, the targeted sedation and analgesia levels were achieved more easily with dexmedetomidine infusion, without hemodynamic and respiratory side effects, compared to remifentanil infusion.
{"title":"Comparison of dexmedetomidine and remifentanil infusion in geriatric patients undergoing outpatient cataract surgery: a prospective, randomized, and blinded study","authors":"C. Kaya, N. Çelebi, S. Debbağ, O. Canbay, O. Onal","doi":"10.4103/2045-9912.337996","DOIUrl":"https://doi.org/10.4103/2045-9912.337996","url":null,"abstract":"Dexmedetomidine is an α2 agonist and remifentanil is a short-acting μ opioid agonist. We aimed to compare the dexmedetomidine and remifentanil infusions used for conscious sedation in geriatric patients undergoing outpatient cataract surgery in terms of sedation quality, side effects, and surgeon satisfaction. Eighty patients were allocated into two groups as per the administration of dexmedetomidine (dexmedetomidine group) and remifentanil (remifentanil group) infusion in this randomized, prospective, double-blinded study. In dexmedetomidine group (n = 40), after a loading of 1 μg/kg dexmedetomidine in 10 minutes, 0.4 μg/kg/h infusion was administered. In the remifentanil group (n = 40), remifentanil at a dose of 0.05 μg/kg was administered for 10 minutes, and then 0.05 μg/kg/min infusion was continued. Observer Assessment Warning/Sedation Scale values evaluating sedation quality were lower in the dexmedetomidine group than in the remifentanil group, although it was not statistically significant (P > 0.05). Bispectral Index values evaluating sedation quality were lower in the dexmedetomidine group according to the remifentanil group (P < 0.05). The dexmedetomidine group had lower Verbal Rating Scale and Visual Analogue Scale scores evaluating pain intensity compared with the remifentanil group (P < 0.05). The nausea Visual Analogue Scale values evaluating the severity of postoperative nausea in the dexmedetomidine group were lower than those in the remifentanil group (P < 0.05). The surgeon satisfaction was found to be greater in the dexmedetomidine group compared with the remifentanil group (P = 0.015). In geriatric patients, the targeted sedation and analgesia levels were achieved more easily with dexmedetomidine infusion, without hemodynamic and respiratory side effects, compared to remifentanil infusion.","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 1","pages":"146 - 152"},"PeriodicalIF":2.9,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46247700","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}
Pub Date : 2022-04-17DOI: 10.4103/2045-9912.337997
J. Schipke, Thomas E. Muth, Clark Pepper, J. Schneppendahl, Martin A. Hoffmanns, Sven Dreyer
Hyperoxia has been described to induce bradycardia by direct stimulation of the parasympathetic nervous system. Also, hyperoxia has been found to increase blood pressure by an elevation of vascular resistance. However, the latter effect itself would induce bradycardia by baroreceptor stimulation. This single-arm monocentric retrospective study aims to evaluate the correlation between these effects by investigating the relation between oxygen (O2) administration and heart rate over time. Data were collected from 23 patients without cardiovascular problems undergoing hyperbaric oxygen therapy (2.4 bar) retrospectively. During single oxygen bouts, transcutaneously measured partial pressure of O2 was increased. During this surge of oxygen pressure, the arterial blood pressure was increased while the heart rate was decreased. Respiration rate was maintained independently from breathing 100% O2 or air. During single oxygen bouts, the half-life of transcutaneously measured partial pressure of O2 was 5.4 ± 2.1 mmHg/s, and the half-life of heart rate was 0.45 ± 0.19 beats/min. It has been shown that hyperbaric oxygen therapy increases the transcutaneously measured partial pressure of O2. This increase was rather fast, followed by a rather slow decrease in HR. This finding does not support direct vagal activation. Heart rate is not decreased due to a direct vagal activation during hyperbaric oxygen therapy. Our single-arm, retrospective study has additionally confirmed that oxidative stress injures the endothelium, and the reduced endothelial-derived vasodilators cause vasoconstriction. As a consequence, blood pressure increases, and heart rate is then further decreased via the baroreceptor reflex.
{"title":"Hyperoxia and the cardiovascular system: experiences with hyperbaric oxygen therapy","authors":"J. Schipke, Thomas E. Muth, Clark Pepper, J. Schneppendahl, Martin A. Hoffmanns, Sven Dreyer","doi":"10.4103/2045-9912.337997","DOIUrl":"https://doi.org/10.4103/2045-9912.337997","url":null,"abstract":"Hyperoxia has been described to induce bradycardia by direct stimulation of the parasympathetic nervous system. Also, hyperoxia has been found to increase blood pressure by an elevation of vascular resistance. However, the latter effect itself would induce bradycardia by baroreceptor stimulation. This single-arm monocentric retrospective study aims to evaluate the correlation between these effects by investigating the relation between oxygen (O2) administration and heart rate over time. Data were collected from 23 patients without cardiovascular problems undergoing hyperbaric oxygen therapy (2.4 bar) retrospectively. During single oxygen bouts, transcutaneously measured partial pressure of O2 was increased. During this surge of oxygen pressure, the arterial blood pressure was increased while the heart rate was decreased. Respiration rate was maintained independently from breathing 100% O2 or air. During single oxygen bouts, the half-life of transcutaneously measured partial pressure of O2 was 5.4 ± 2.1 mmHg/s, and the half-life of heart rate was 0.45 ± 0.19 beats/min. It has been shown that hyperbaric oxygen therapy increases the transcutaneously measured partial pressure of O2. This increase was rather fast, followed by a rather slow decrease in HR. This finding does not support direct vagal activation. Heart rate is not decreased due to a direct vagal activation during hyperbaric oxygen therapy. Our single-arm, retrospective study has additionally confirmed that oxidative stress injures the endothelium, and the reduced endothelial-derived vasodilators cause vasoconstriction. As a consequence, blood pressure increases, and heart rate is then further decreased via the baroreceptor reflex.","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 1","pages":"153 - 157"},"PeriodicalIF":2.9,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46610173","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}
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