Pub Date : 2022-06-01DOI: 10.6859/aja.202206_60(2).0006
Mohamad Ali Barada, Omar Rajab, Ahmad Salah Naja, Pier Semaan, Loubna Sinno, Zoher Naja
Background: Several anesthetic techniques have been used for pilonidal sinus surgery such as general, spinal, and local anesthesia infiltration. However, the most effective technique remains controversial. The aim of this study was to assess the effectiveness of sacrococcygeal local anesthesia for complicated pilonidal cysts in terms of postoperative analgesic consumption.
Methods: This was a retrospective cohort study conducted by collecting data from medical records for male patients who underwent pilonidal surgery using sacrococcygeal local anesthesia from 2008 to 2018. Patients' demographics, operative data, and postoperative outcomes such as pain, nausea, as well as analgesic consumption at 0 and 3 hours were analyzed. Pain scores at rest and upon pressure were recorded using the Visual Analogue Scale. The length of complicated pilonidal sinus was considered to be greater than or equal to 7 cm with multiple openings.
Results: A total of 394 patients were included in the study, 173 patients (43.9%) had complicated cysts while 221 patients (56.1%) had uncomplicated cysts. The majority of patients were males (85.5% vs. 76.9% in the complicated and uncomplicated groups respectively). Patients' weight was significantly higher in the complicated cyst group (87.12 ± 17.07 vs. 82.43 ± 20.30 kg, P value = 0.02). Around 41% of the patients in the complicated group were obese (body mass index ≥ 30 kg/m^2) compared to 32.0% of the patients in the uncomplicated group. Mean arterial pressure and heart rate at baseline, intraoperatively and at the end of the operation were similar between the two groups. Pain scores at rest and upon pressure were low in both groups. Analgesic consumption was similar between the two groups. Eight patients (4.6%) in the complicated group required acetaminophen at 0 hour compared to 6 patients (2.7%) in the uncomplicated group. Three patients (1.7%) received ketoprofen at 0 hour in the complicated group and 3 patients (1.4%) in the other group. Three patients, 2 (1.2%) in the complicated group and 1 (0.5%) in the second group required tramadol hydrochloride.
Conclusions: Sacrococcygeal local anesthetic technique for complex pilonidal sinus surgery provided intra-operative hemodynamic stability as well as low post-operative pain and analgesic consumption.
背景:多种麻醉技术已被应用于毛窦手术，如全身、脊柱和局部麻醉浸润。然而，最有效的技术仍然存在争议。本研究的目的是评估骶尾椎局部麻醉对复杂毛鞘囊肿术后镇痛消耗的有效性。方法:回顾性队列研究，收集2008 - 2018年骶尾椎局部麻醉行脊髓膜手术的男性患者的病历资料。分析患者的人口统计学、手术数据和术后0和3小时的疼痛、恶心、镇痛药消耗等结果。使用视觉模拟量表记录休息和按压时的疼痛评分。复杂的毛窦长度大于等于7cm，有多个开口。结果:共纳入394例患者，其中合并囊肿173例(43.9%)，无合并囊肿221例(56.1%)。男性患者居多(并发症组为85.5%，无并发症组为76.9%)。合并囊肿组患者体重明显增高(87.12±17.07 vs. 82.43±20.30 kg, P值= 0.02)。并发症组约41%的患者为肥胖(体重指数≥30 kg/m^2)，而非并发症组为32.0%。两组患者基线、术中及术后平均动脉压和心率相似。两组休息时和受压时的疼痛评分均较低。两组镇痛药用量相似。并发症组8例患者(4.6%)在0小时需要对乙酰氨基酚，而非并发症组6例患者(2.7%)。并发症组3例(1.7%)患者在0小时接受酮洛芬治疗，其他组3例(1.4%)患者接受酮洛芬治疗。合并组2例(1.2%)，合并组1例(0.5%)需要盐酸曲马多。结论:骶尾骨局麻技术用于复杂毛窦手术，术中血流动力学稳定，术后疼痛和镇痛消耗低。
{"title":"Sacrococcygeal Local Anesthesia for Complicated Versus Uncomplicated Pilonidal Sinus Surgery: A Single Center Study.","authors":"Mohamad Ali Barada, Omar Rajab, Ahmad Salah Naja, Pier Semaan, Loubna Sinno, Zoher Naja","doi":"10.6859/aja.202206_60(2).0006","DOIUrl":"https://doi.org/10.6859/aja.202206_60(2).0006","url":null,"abstract":"<p><strong>Background: </strong>Several anesthetic techniques have been used for pilonidal sinus surgery such as general, spinal, and local anesthesia infiltration. However, the most effective technique remains controversial. The aim of this study was to assess the effectiveness of sacrococcygeal local anesthesia for complicated pilonidal cysts in terms of postoperative analgesic consumption.</p><p><strong>Methods: </strong>This was a retrospective cohort study conducted by collecting data from medical records for male patients who underwent pilonidal surgery using sacrococcygeal local anesthesia from 2008 to 2018. Patients' demographics, operative data, and postoperative outcomes such as pain, nausea, as well as analgesic consumption at 0 and 3 hours were analyzed. Pain scores at rest and upon pressure were recorded using the Visual Analogue Scale. The length of complicated pilonidal sinus was considered to be greater than or equal to 7 cm with multiple openings.</p><p><strong>Results: </strong>A total of 394 patients were included in the study, 173 patients (43.9%) had complicated cysts while 221 patients (56.1%) had uncomplicated cysts. The majority of patients were males (85.5% vs. 76.9% in the complicated and uncomplicated groups respectively). Patients' weight was significantly higher in the complicated cyst group (87.12 ± 17.07 vs. 82.43 ± 20.30 kg, P value = 0.02). Around 41% of the patients in the complicated group were obese (body mass index ≥ 30 kg/m^2) compared to 32.0% of the patients in the uncomplicated group. Mean arterial pressure and heart rate at baseline, intraoperatively and at the end of the operation were similar between the two groups. Pain scores at rest and upon pressure were low in both groups. Analgesic consumption was similar between the two groups. Eight patients (4.6%) in the complicated group required acetaminophen at 0 hour compared to 6 patients (2.7%) in the uncomplicated group. Three patients (1.7%) received ketoprofen at 0 hour in the complicated group and 3 patients (1.4%) in the other group. Three patients, 2 (1.2%) in the complicated group and 1 (0.5%) in the second group required tramadol hydrochloride.</p><p><strong>Conclusions: </strong>Sacrococcygeal local anesthetic technique for complex pilonidal sinus surgery provided intra-operative hemodynamic stability as well as low post-operative pain and analgesic consumption.</p>","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":" ","pages":"76-82"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40574265","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 : 2022-06-01DOI: 10.6859/aja.202206_60(2).0001
Wei-Zen Sun, James L Reynolds
{"title":"Resilience in a Storm: Typhoon Omicron Hits Taiwan.","authors":"Wei-Zen Sun, James L Reynolds","doi":"10.6859/aja.202206_60(2).0001","DOIUrl":"https://doi.org/10.6859/aja.202206_60(2).0001","url":null,"abstract":"","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":" ","pages":"43-45"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40574262","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 : 2022-06-01DOI: 10.6859/aja.202206_60(2).0008
R Sripriya, G Prabavathy
{"title":"Horner's Syndrome Following Thoracic Paravertebral Block-Radiological Evidence of Spread to Stellate Ganglion and Fascial Anatomy Facilitating the Spread.","authors":"R Sripriya, G Prabavathy","doi":"10.6859/aja.202206_60(2).0008","DOIUrl":"https://doi.org/10.6859/aja.202206_60(2).0008","url":null,"abstract":"","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":" ","pages":"87-88"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40574266","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 : 2022-05-04DOI: 10.6859/aja.202204/PP.0003
Po-Jen Yun, Zhi-Fu Wu, Tsai-Wang Huang, W. Tseng
Po-Jen Yun, Zhi-Fu Wu, Tsai-Wang Huang, Wei-Cheng Tseng Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Anesthesiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
{"title":"Unilateral Negative-Pressure Pulmonary Edema Following One-Lung Ventilation for Thoracic Surgery.","authors":"Po-Jen Yun, Zhi-Fu Wu, Tsai-Wang Huang, W. Tseng","doi":"10.6859/aja.202204/PP.0003","DOIUrl":"https://doi.org/10.6859/aja.202204/PP.0003","url":null,"abstract":"Po-Jen Yun, Zhi-Fu Wu, Tsai-Wang Huang, Wei-Cheng Tseng Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Anesthesiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47868341","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 : 2022-05-04DOI: 10.6859/aja.202204/PP.0002
Y. Yamamoto, Yusuke Naito, H. Nakatani, M. Ida, M. Kawaguchi
BACKGROUND Patients with alcohol drinking habits have less nausea and vomiting during chemotherapy because of cytochrome P450 enzyme induction. However, few studies have examined the effect of alcohol consumption on postoperative nausea and vomiting (PONV). We conducted a study to clarify the relationship between alcohol drinking habits and PONV. METHODS Data of patients undergoing hepatectomy under general anesthesia between 2016 and 2020 were retrospectively collected. Since alcohol drinking habits vary by gender, age, and comorbidities, propensity score matching was performed to adjust patient background before multivariate logistic regression analysis. RESULTS Seventy-eight patients in the alcohol consumption and non-consumption groups were matched by propensity matching. Univariate analysis showed that alcohol consumption (P = 0.04) and male (P ＜ 0.001) were the factors that significantly reduced PONV. Multiple logistic regression analysis including intraoperative factors showed that alcohol consumption (odds ratio, 0.36; 95% confidence interval [CI], 0.15-0.90) and female (odds ratio, 5.34; 95% CI, 2.0-14.2) were associated with PONV as factors affecting PONV. CONCLUSION Patients with no alcohol drinking habits may be at higher risk of PONV.
{"title":"Relationship Between Preoperative Alcohol Consumption and Postoperative Nausea and Vomiting in Liver Resection: A Propensity Score Matched Analysis in a Single Institute.","authors":"Y. Yamamoto, Yusuke Naito, H. Nakatani, M. Ida, M. Kawaguchi","doi":"10.6859/aja.202204/PP.0002","DOIUrl":"https://doi.org/10.6859/aja.202204/PP.0002","url":null,"abstract":"BACKGROUND\u0000Patients with alcohol drinking habits have less nausea and vomiting during chemotherapy because of cytochrome P450 enzyme induction. However, few studies have examined the effect of alcohol consumption on postoperative nausea and vomiting (PONV). We conducted a study to clarify the relationship between alcohol drinking habits and PONV.\u0000\u0000\u0000METHODS\u0000Data of patients undergoing hepatectomy under general anesthesia between 2016 and 2020 were retrospectively collected. Since alcohol drinking habits vary by gender, age, and comorbidities, propensity score matching was performed to adjust patient background before multivariate logistic regression analysis.\u0000\u0000\u0000RESULTS\u0000Seventy-eight patients in the alcohol consumption and non-consumption groups were matched by propensity matching. Univariate analysis showed that alcohol consumption (P = 0.04) and male (P ＜ 0.001) were the factors that significantly reduced PONV. Multiple logistic regression analysis including intraoperative factors showed that alcohol consumption (odds ratio, 0.36; 95% confidence interval [CI], 0.15-0.90) and female (odds ratio, 5.34; 95% CI, 2.0-14.2) were associated with PONV as factors affecting PONV.\u0000\u0000\u0000CONCLUSION\u0000Patients with no alcohol drinking habits may be at higher risk of PONV.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49292883","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 : 2022-05-04DOI: 10.6859/aja.202204/PP.0001
A. Alrefaey, Sherine A Bakrey
BACKGROUND The hemodynamic consequences of sympathetic blockade under spinal anesthesia remains a major concern especially in elderly frail patients. The baricity of the injected solution remains the principal factor controlling the diffusion of spinal anesthetics and the resulting sympathetic blockade. In this study, the sequential administration of isobaric and hyperbaric bupivacaine (HB) is evaluated regarding the incidence of hypotension during orthogeriatric surgery. METHODS Fifty elderly patients (age ＞ 60), scheduled for lower limb orthopedic surgery were randomly divided into two groups. In group HIB (n = 25), sequential injection of two syringes, 1.5 mL of 0.5% HB with 15 μ of fentanyl was injected, followed immediately by 1.5 mL of 0.5% isobaric bupivacaine, and in group HB (n = 25), 3 mL of 0.5% HB mixed with 15 μ of fentanyl citrate (0.3 mL of fentanyl 50 μg/mL) were used for spinal anesthesia. RESULTS No statistical difference was found between the two groups regarding patient demographics, comorbidities, or preoperative laboratory data. The absolute incidence of hypotension (16% vs. 44%, P = 0.03) was statistically lower in the HIB group than the HB group. Also, the total number of hypotensive episodes and the need for vasopressor medications were statistically lower in the HIB group than the HB group (P = 0.02 vs. P = 0.01). CONCLUSIONS Our results show a better hemodynamic profile of the sequentially injected mixture with a lower incidence of intraoperative hypotension and subsequent lower vasopressor requirements.
背景:脊髓麻醉下交感神经阻滞的血流动力学后果仍然是一个主要问题，特别是在老年体弱患者中。注射溶液的比重仍然是控制脊髓麻醉药扩散和由此产生的交感神经阻滞的主要因素。在这项研究中，顺序给药等压和高压布比卡因(HB)评估关于低血压的发生率在骨科手术。方法50例拟行下肢骨科手术的老年患者(年龄50 ~ 60岁)随机分为两组。HIB组(n = 25)连续注射2支注射器，先注射含15 μ芬太尼的0.5% HB 1.5 mL，然后立即注射0.5%异重布比卡因1.5 mL, HB组(n = 25)分别用3 mL 0.5% HB与15 μ枸橼酸芬太尼混合(50 μg/mL芬太尼0.3 mL)进行脊髓麻醉。结果两组在患者人口统计学、合并症或术前实验室数据方面无统计学差异。HIB组低血压的绝对发生率(16% vs. 44%， P = 0.03)低于HB组。此外，HIB组低血压发作的总次数和血管加压药物的需求在统计学上低于HB组(P = 0.02比P = 0.01)。结论:顺序注射的混合液具有较好的血流动力学特征，术中低血压发生率较低，随后的血管加压药物需求较低。
{"title":"Sequential Intrathecal Injection of Hyperbaric and Isobaric Bupivacaine in Orthogeriatric Lower Limb Surgery, a Prospective Randomized Study.","authors":"A. Alrefaey, Sherine A Bakrey","doi":"10.6859/aja.202204/PP.0001","DOIUrl":"https://doi.org/10.6859/aja.202204/PP.0001","url":null,"abstract":"BACKGROUND\u0000The hemodynamic consequences of sympathetic blockade under spinal anesthesia remains a major concern especially in elderly frail patients. The baricity of the injected solution remains the principal factor controlling the diffusion of spinal anesthetics and the resulting sympathetic blockade. In this study, the sequential administration of isobaric and hyperbaric bupivacaine (HB) is evaluated regarding the incidence of hypotension during orthogeriatric surgery.\u0000\u0000\u0000METHODS\u0000Fifty elderly patients (age ＞ 60), scheduled for lower limb orthopedic surgery were randomly divided into two groups. In group HIB (n = 25), sequential injection of two syringes, 1.5 mL of 0.5% HB with 15 μ of fentanyl was injected, followed immediately by 1.5 mL of 0.5% isobaric bupivacaine, and in group HB (n = 25), 3 mL of 0.5% HB mixed with 15 μ of fentanyl citrate (0.3 mL of fentanyl 50 μg/mL) were used for spinal anesthesia.\u0000\u0000\u0000RESULTS\u0000No statistical difference was found between the two groups regarding patient demographics, comorbidities, or preoperative laboratory data. The absolute incidence of hypotension (16% vs. 44%, P = 0.03) was statistically lower in the HIB group than the HB group. Also, the total number of hypotensive episodes and the need for vasopressor medications were statistically lower in the HIB group than the HB group (P = 0.02 vs. P = 0.01).\u0000\u0000\u0000CONCLUSIONS\u0000Our results show a better hemodynamic profile of the sequentially injected mixture with a lower incidence of intraoperative hypotension and subsequent lower vasopressor requirements.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"15 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41268694","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 : 2022-03-01DOI: 10.6859/aja.202203_60(1).0001
Chi Te Chou, Sung-Wei Yu, Ting-Chun Lin
Obturator nerve block (ONB) has been widely applied in transurethral resection of bladder tumor and knee surgery to prevent serious complications such as bladder perforation or to improve the quality of anesthesia during knee surgery. The classic/pubic and inguinal ONB methods are the two primary approaches used. The classic and inguinal ONB methods are two techniques for anesthetizing the obturator nerve, and each method may result in different respective outcomes. We aimed to compare the efficacy of the classic and inguinal methods. We presumed the inguinal approach to be an overall superior technique because it was recently invented and has been reported to provide numerous benefits. This study included randomized controlled trials comparing classic and inguinal approaches to ONB. Two independent investigators extracted study-level data for a random-effects meta-analysis of the comparison between the classic approach and inguinal approaches. We identified five studies comprising 312 patients. The pooled results revealed a higher success rate (risk ratio, 1.15; 95% confidence interval [CI], 1.04-1.27), fewer puncture attempts (mean difference, -0.84; 95% CI, -1.55 to -0.12), and shorter procedure time (mean difference, -28.87; 95% CI, -47.19 to -10.54) for patients given inguinal ONB. The inguinal approach is, overall, the superior method for performing the ONB procedure. The inguinal method resulted in a higher success rate, fewer puncture attempts, and shorter procedure time.
{"title":"Systematic Review and Meta-Analysis of Inguinal Versus Classic Obturator Nerve Block.","authors":"Chi Te Chou, Sung-Wei Yu, Ting-Chun Lin","doi":"10.6859/aja.202203_60(1).0001","DOIUrl":"https://doi.org/10.6859/aja.202203_60(1).0001","url":null,"abstract":"Obturator nerve block (ONB) has been widely applied in transurethral resection of bladder tumor and knee surgery to prevent serious complications such as bladder perforation or to improve the quality of anesthesia during knee surgery. The classic/pubic and inguinal ONB methods are the two primary approaches used. The classic and inguinal ONB methods are two techniques for anesthetizing the obturator nerve, and each method may result in different respective outcomes. We aimed to compare the efficacy of the classic and inguinal methods. We presumed the inguinal approach to be an overall superior technique because it was recently invented and has been reported to provide numerous benefits. This study included randomized controlled trials comparing classic and inguinal approaches to ONB. Two independent investigators extracted study-level data for a random-effects meta-analysis of the comparison between the classic approach and inguinal approaches. We identified five studies comprising 312 patients. The pooled results revealed a higher success rate (risk ratio, 1.15; 95% confidence interval [CI], 1.04-1.27), fewer puncture attempts (mean difference, -0.84; 95% CI, -1.55 to -0.12), and shorter procedure time (mean difference, -28.87; 95% CI, -47.19 to -10.54) for patients given inguinal ONB. The inguinal approach is, overall, the superior method for performing the ONB procedure. The inguinal method resulted in a higher success rate, fewer puncture attempts, and shorter procedure time.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"60 1 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41480620","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 : 2022-03-01DOI: 10.6859/aja.202202/PP.0004
Y. Koyama, Y. Morimoto, Y. Osaka, Yoshihiro Aoi, K. Tsuzaki
Coronavirus disease 2019 (COVID-19) has rapidly spread globally ever since the virus was first identified in December 2019 in Wuhan, China. Despite efforts to accelerate the supply of COVID-19 vaccines worldwide, the global pandemic has continued. Polymerase chain reaction (PCR) test is currently considered the gold standard for the diagnosis of COVID-19. However, the rate of false-negative PCR for COVID-19 has been reported to be over 10%. Furthermore, an asymptomatic period can last up to 14 days following the infection. Under these circumstances, standard anesthetic practice, surgery scheduling, and approaches to appropriate management of the operating room to protect both patients and medical personnel against COVID-19 transmission need to be reviewed and appropriately modified. In this review, based on our institutional experiences along with the guidelines reported elsewhere, we propose safer and more effective perioperative management amidst the COVID-19 pandemic.
{"title":"Perioperative Management During the COVID-19 Pandemic: Strategies at Three General Hospitals in Japan and a Narrative Review.","authors":"Y. Koyama, Y. Morimoto, Y. Osaka, Yoshihiro Aoi, K. Tsuzaki","doi":"10.6859/aja.202202/PP.0004","DOIUrl":"https://doi.org/10.6859/aja.202202/PP.0004","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) has rapidly spread globally ever since the virus was first identified in December 2019 in Wuhan, China. Despite efforts to accelerate the supply of COVID-19 vaccines worldwide, the global pandemic has continued. Polymerase chain reaction (PCR) test is currently considered the gold standard for the diagnosis of COVID-19. However, the rate of false-negative PCR for COVID-19 has been reported to be over 10%. Furthermore, an asymptomatic period can last up to 14 days following the infection. Under these circumstances, standard anesthetic practice, surgery scheduling, and approaches to appropriate management of the operating room to protect both patients and medical personnel against COVID-19 transmission need to be reviewed and appropriately modified. In this review, based on our institutional experiences along with the guidelines reported elsewhere, we propose safer and more effective perioperative management amidst the COVID-19 pandemic.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47486062","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 : 2022-03-01DOI: 10.6859/aja.202203_60(1).0006
M. Fromentin, M. Barat, J. Ricard, D. Roux
Internal jugular vein (IJV) cannulation is a stan-dard procedure for critically ill patients that should be performed under ultrasound (US) guidance. The use of two-dimensional US was found to decrease the risk of total adverse events by 71% in a recent review that included 35 studies and 5,108 participants. 1 Major complications such as hemothorax, mediastinal hematoma, cardiac tamponade, or chylothorax. 2 Accidental arterial puncture and hematoma are the two most re-duced complications by pre-procedure US location of vessels. 1 Several techniques with their specific complications are described. Common the most
{"title":"Ultrasound Guidance for Internal Jugular Vein Catheterization: Don't Forget the Basics.","authors":"M. Fromentin, M. Barat, J. Ricard, D. Roux","doi":"10.6859/aja.202203_60(1).0006","DOIUrl":"https://doi.org/10.6859/aja.202203_60(1).0006","url":null,"abstract":"Internal jugular vein (IJV) cannulation is a stan-dard procedure for critically ill patients that should be performed under ultrasound (US) guidance. The use of two-dimensional US was found to decrease the risk of total adverse events by 71% in a recent review that included 35 studies and 5,108 participants. 1 Major complications such as hemothorax, mediastinal hematoma, cardiac tamponade, or chylothorax. 2 Accidental arterial puncture and hematoma are the two most re-duced complications by pre-procedure US location of vessels. 1 Several techniques with their specific complications are described. Common the most","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"60 1 1","pages":"41-42"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45634316","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 : 2022-03-01DOI: 10.6859/aja.202203_60(1).0004
Vikas Kumar, Sanjeev Kumar, A. Bharti, R. Avinash, K. H. Raghwendra
BACKGROUND Hemodynamic changes are the most common predicted response after laryngoscopy and intubation during general anesthesia. We compared the efficacy of buprenorphine with fentanyl to attenuate this stress response. METHODS One hundred and thirty patients of either sex between the age group of 18-70 years, admitted for the routine surgical procedure under general anesthesia were enrolled in this double blind, randomized, clinical study. Patients were randomly assigned into two equal groups (60 patients in each group): group F received fentanyl 2 μg/kg, and group B received buprenorphine 2.5 μg/kg; both via intravenous route. Each group received a total volume of 10 mL by adding normal saline to the total drug volume, given over 60 seconds, 5 minutes before intubation. Thereafter patients were induced using routine balanced anesthesia technique, and the hemodynamic parameters were observed at baseline (0 minute), 1, 3, and 5 minutes after the administration of the study drug and again at 1, 3, 5, 7, and 10 minutes after intubation. Continuous variables were presented as mean with an 80% confidence interval, and a t-test was applied for comparing the difference of means between two groups after we checked the normality condition. Chi-square test was applied to test the independence of attributes of categorical variables. Repeated measures two-way analysis of variance was performed to compare the outcome variables between the two groups. RESULTS In both groups, mean arterial blood pressure (MAP) and heart rate (HR) were statistically insignificant up to 5 minutes after study drug, thereafter mean HR and MAP at 1, 3, 5, 7, and 10 minutes after intubation, were statistically significant between the two groups, and P value was less than 0.05. CONCLUSIONS The dose of 2.5 μg/kg buprenorphine is an effective alternative to fentanyl 2 μg/kg for attenuating the hemodynamic response accompanying laryngoscopy and tracheal intubation without causing any hemodynamic adverse effect.
{"title":"Comparative Study of Efficacy of Buprenorphine and Fentanyl on Attenuation of Hemodynamic Changes to Laryngoscopy and Intubation: A Prospective, Randomized Double-Blind Study.","authors":"Vikas Kumar, Sanjeev Kumar, A. Bharti, R. Avinash, K. H. Raghwendra","doi":"10.6859/aja.202203_60(1).0004","DOIUrl":"https://doi.org/10.6859/aja.202203_60(1).0004","url":null,"abstract":"BACKGROUND\u0000Hemodynamic changes are the most common predicted response after laryngoscopy and intubation during general anesthesia. We compared the efficacy of buprenorphine with fentanyl to attenuate this stress response.\u0000\u0000\u0000METHODS\u0000One hundred and thirty patients of either sex between the age group of 18-70 years, admitted for the routine surgical procedure under general anesthesia were enrolled in this double blind, randomized, clinical study. Patients were randomly assigned into two equal groups (60 patients in each group): group F received fentanyl 2 μg/kg, and group B received buprenorphine 2.5 μg/kg; both via intravenous route. Each group received a total volume of 10 mL by adding normal saline to the total drug volume, given over 60 seconds, 5 minutes before intubation. Thereafter patients were induced using routine balanced anesthesia technique, and the hemodynamic parameters were observed at baseline (0 minute), 1, 3, and 5 minutes after the administration of the study drug and again at 1, 3, 5, 7, and 10 minutes after intubation. Continuous variables were presented as mean with an 80% confidence interval, and a t-test was applied for comparing the difference of means between two groups after we checked the normality condition. Chi-square test was applied to test the independence of attributes of categorical variables. Repeated measures two-way analysis of variance was performed to compare the outcome variables between the two groups.\u0000\u0000\u0000RESULTS\u0000In both groups, mean arterial blood pressure (MAP) and heart rate (HR) were statistically insignificant up to 5 minutes after study drug, thereafter mean HR and MAP at 1, 3, 5, 7, and 10 minutes after intubation, were statistically significant between the two groups, and P value was less than 0.05.\u0000\u0000\u0000CONCLUSIONS\u0000The dose of 2.5 μg/kg buprenorphine is an effective alternative to fentanyl 2 μg/kg for attenuating the hemodynamic response accompanying laryngoscopy and tracheal intubation without causing any hemodynamic adverse effect.","PeriodicalId":8482,"journal":{"name":"Asian journal of anesthesiology","volume":"60 1 1","pages":"26-32"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47032581","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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