Association between Intraoperative Electroencephalogram Burst Suppression and Postoperative Delirium: A Systematic Review and Meta-analysis.

Background: Electroencephalogram burst suppression can be associated with postoperative delirium; however, the results of relevant studies are discrepant. This systematic review and meta-analysis aimed to assess the association between intraoperative burst suppression and postoperative delirium in adult surgical patients.

Methods: PubMed, MEDLINE, Embase, Google Scholar, and the Cochrane Central Register of Controlled Trials were systematically searched and updated in May 2023.

A randomized comparison of three intubation techniques/tube materials for nasotracheal intubation.

Purpose: We sought to compare three intubation methods using different intubation techniques/tube materials for tube advancement from the nasal cavity into the oral cavity during nasotracheal intubation.

Methods: We conducted a randomized clinical trial with adult patients scheduled to undergo elective surgery requiring nasotracheal intubation for general anesthesia. Participants were randomly allocated to a polyvinyl chloride (PVC) tube group (group P), PVC tube attached to a rubber catheter group (group PR), or velvet-soft PVC tube group (group V).

Effect of analgesia nociception index monitor-based nociception control on perioperative stress responses during laparoscopic surgery in Trendelenburg position: a randomized controlled trial.

Introduction: The analgesia nociception index (ANI) monitor is a nociception monitoring device based on heart rate variability. We aimed to determine the effect of ANI monitor-based intraoperative nociception control on the perioperative stress response during laparoscopic surgery in the Trendelenburg position.

Methods: Altogether, 72 female patients who underwent total laparoscopic hysterectomy were randomized to either the control or ANI group.

Equal Ratio Ventilation Reduces Blood Loss During Posterior Lumbar Interbody Fusion Surgery.

Study Design: A prospective randomized double-blinded study.

Objective: The aim of this study was to compare the effect of two different ventilator modes (inspiratory to expiratory ratio [I:E ratio] of 1:1 and 1:2) on intraoperative surgical bleeding in patients undergoing posterior lumbar interbody fusion (PLIF) surgery.

Summary Of Background Data: During PLIF surgery, a considerable amount of blood loss is anticipated.

Utility of oxygen insufflation through working channel during fiberoptic intubation in apneic patients: a prospective randomized controlled study.

Background: Airway management is a part of routine anesthetic procedures; however, serious complications, including hypoxia and death, are known to occur in cases of difficult airways. Therefore, alternative techniques such as fiberoptic bronchoscope-assisted intubation (FOB intubation) should be considered, although this method requires more time and offers a limited visual field than does intubation with a direct laryngoscope. Oxygen insufflation through the working channel during FOB intubation could minimize the risk of desaturation and improve the visual field.

Efficacy of Single-Dose Dexmedetomidine Combined with Low-Dose Remifentanil Infusion for Cough Suppression Compared to High-Dose Remifentanil Infusion: A Randomized, Controlled, Non-Inferiority Trial.

Combination of dexmedetomidine and opioid may be an alternative to high-dose opioid in attenuating cough during emergence from anesthesia, while also reducing the adverse effects of high-dose opioid. We tested the hypothesis that a single-dose of dexmedetomidine combined with low-dose remifentanil infusion during emergence would not be inferior to high-dose remifentanil infusion alone in attenuating cough after thyroidectomy. One hundred sixty-nine patients undergoing thyroidectomy were enrolled and randomized in a 1:1 ratio into group DR or group R.

Nicardipine Effects on Renal Function During Spine Surgery.

Study Design: Single-center, prospective, randomized, and single-blinded clinical trial was conducted in patients (n=64) undergoing anterior or posterior spinal interbody fusion.

Objective: To investigate the renal protective effect of nicardipine during deliberate hypotension for spine surgery by measuring creatinine clearance (Ccr), serum cystatin C, urine output, and fractional excretion of sodium (FENa).

Summary Of Background Data: Deliberate hypotension during spine surgery may result in ischemic tissue damage of the kidney.

Incidence and risk factors of postoperative nausea and vomiting in patients with fentanyl-based intravenous patient-controlled analgesia and single antiemetic prophylaxis.

Purpose: We evaluated the incidence and risk factors of postoperative nausea and vomiting (PONV) in patients with fentanyl-based intravenous patient-controlled analgesia (IV-PCA) and single antiemetic prophylaxis of 5-hydroxytryptamine type 3 (5 HT₃)-receptor antagonist after the general anesthesia.

Materials And Methods: In this retrospective study, incidence and risk factors for PONV were evaluated with fentanyl IV-PCA during postoperative 48 hours after various surgeries.

Results: Four hundred-forty patients (23%) of 1878 had showed PONV.

Comparison of the efficacy of dexmedetomidine plus fentanyl patient-controlled analgesia with fentanyl patient-controlled analgesia for pain control in uterine artery embolization for symptomatic fibroid tumors or adenomyosis: a prospective, randomized study.

Purpose: To investigate whether dexmedetomidine infusion could reduce opioid consumption and opioid-related side effects after uterine artery embolization (UAE).

Materials And Methods: Fifty patients undergoing UAE for symptomatic leiomyomas or adenomyosis were randomized into two groups. In 25 patients, dexmedetomidine infusion was started at 0.

Effect-site concentration of remifentanil to prevent cough after laryngomicrosurgery.

Objectives/hypothesis: The aim of this study was to discover the optimal effect-site concentration of remifentanil for cough prevention that does not delay awakening or cause respiratory depression during emergence from anesthesia with propofol and remifentanil in laryngomicrosurgery patients.

Study Design: Prospective, randomized, controlled trial.

Methods: One hundred five patients were randomly assigned to maintain an effect-site concentration (Ce) of remifentanil at a predetermined value of 1 (R1), 1.

Medical simulation is needed in anesthesia training to achieve patient's safety.

Many medical schools and hospitals throughout the world are equipped with a simulation center for the purpose of training anesthesiologists to perform both technical and non-technical skills. Because induction, maintenance, and emergence of general anesthesia are critical to patient welfare, various simulation mannequins and tools are utilized for the purpose of training anesthesiologists for safer patient care. Traditionally, anesthesia residency training mostly consisted of didactic lectures and observations.

Increase in airway pressure resulting from prone position patient placing may predict intraoperative surgical blood loss.

Study Design: Prospective study on intraoperative blood loss during lumbar spine surgery.

Objective: To evaluate the relationship between airway pressure change due to the patient's prone position and intraoperative blood loss during lumbar spine surgery.

Summary Of Background Data: A prone position may increase abdominal pressure.

Effects of flashlight guidance on chest compression performance in cardiopulmonary resuscitation in a noisy environment.

Background: In real cardiopulmonary resuscitation (CPR), noise can arise from instructional voices and environmental sounds in places such as a battlefield and industrial and high-traffic areas. A feedback device using a flashing light was designed to overcome noise-induced stimulus saturation during CPR. This study was conducted to determine whether 'flashlight' guidance influences CPR performance in a simulated noisy setting.

Stress-induced cardiomyopathy after negative pressure pulmonary edema during emergence from anesthesia -A case report-.

Stress-induced cardiomyopathy (SICM) presenting as an acute myocardial dysfunction is characterized by transient left ventricular wall motion abnormality, which has been known to be associated with excessive catecholamine production caused due to various types of stress. Sympathetic hyperactivity is common during the perioperative period, and reports of SICM occurring during this period have actually increased. We present a case of SICM following negative pressure pulmonary edema due to upper airway obstruction during emergence from anesthesia.

Comparison of the trapezius squeezing test and jaw thrust as indicators for laryngeal mask airway insertion in adults.

Background: The purpose of this study was to compare the effectiveness of the trapezius squeezing test with that of the jaw thrust maneuver as clinical indicators of adequate conditions for laryngeal mask airway (LMA) insertion in adults under sevoflurane anesthesia.

Methods: One hundred adult patients of ASA physical status 1 or 2 undergoing minor surgical procedures were randomly allocated to the T (trapezius squeezing, n = 50) group or the J (jaw thrust, n = 50) group. The LMA was inserted immediately after the loss of response to trapezius squeezing or jaw thrust.

Effect of caudal block on sevoflurane requirement for lower limb surgery in children with cerebral palsy.

Background: Caudal block is a widely used technique for providing perioperative pain management in children. In this randomized double-blinded study, we evaluated the effects of preoperative caudal block on sevoflurane requirements in children with cerebral palsy (CP) undergoing lower limb surgery while bispectral index (BIS) values were maintained between 45 and 55.

Methods: 52 children undergoing Achilles-tendon lengthening were randomized to receive combined general-caudal anesthesia (caudal group, n = 27) or general anesthesia alone (control group, n = 25).

Cardiac arrest from acute hyperkalemia during liver surgery -A case report-.

We experienced a case of sudden onset of hyperkalemia during liver lobectomy and this was followed by ventricular tachycardia and cardiac arrest. The main cause of this fatality is assumed to be the wide range of surgical manipulation that induced reduced hepatic blood flow and ischemic necrosis of the hepatic cells. We report here on this case and we review the relevant medical literature.

Comparison of the laryngeal view during intubation using Airtraq and Macintosh laryngoscopes in patients with cervical spine immobilization and mouth opening limitation.

Background: For patients suspicious of cervical spine injury, a Philadelphia cervical collar is usually applied. Application of Philadelphia cervical collar may cause difficult airway. The aim of this study was to evaluate the laryngeal view and the success rate at first intubation attempt of the Airtraq and conventional laryngoscopy in patients with simulated cervical spine injury after application of a Philadelphia cervical collar.

Effects of propofol on beta-adrenoceptor-mediated signal transduction in cardiac muscle; role of cAMP.

Background: Propofol may decrease myocardial contractility via actions on the beta-adrenoceptor-mediated signal transduction. The aim of this study was to evaluate the effect of propofol via beta-adrenoceptor-mediated signal transduction by measuring the tissue levels of cAMP (cyclic adenosine monophosphate).

Methods: The effects of propofol on beta-adrenoceptor mediated cascades were measured with cAMP concentrations, which were stimulated by agonists (l-isoproterenol, GTPgammaS, and forskolin) of each step of beta-adrenoceptor-mediated cascades.

The displacement of the tracheal tube during robot-assisted radical prostatectomy.

Background And Objective: Robot-assisted prostatectomy requires pneumoperitoneum in a steep Trendelenburg position, which may induce endobronchial intubation or accidental extubation. The aim of the study was to evaluate the effect of pneumoperitoneum in 30 degrees Trendelenburg position on the displacement of the tracheal tube and to measure the changes in trachea length using fiberoptic bronchoscope.

Methods: Thirty male patients scheduled for robot-assisted radical prostatectomy were enrolled.

The usefulness of the laryngeal mask airway Fastrach for laryngeal surgery.

Background And Objective: Suspension laryngoscopy under general anaesthesia with a tracheal tube has been widely used for laryngeal microsurgery, but it has some limitations such as intense cardiovascular stimulation during anaesthesia of short duration, occasionally a poor surgical field, and the possibility of a mass being hampered by the tracheal tube. The aim of this study was to compare the usefulness of the laryngeal mask airway (LMA) Fastrach and fibreoptic bronchoscope with a conventional suspension laryngoscope in laryngeal microsurgery.

Methods: Forty patients scheduled for laryngeal microsurgery were enrolled in this prospective randomized study consecutively.

Spinal anesthesia with isobaric tetracaine in patients with previous lumbar spinal surgery.

Purpose: Previous lumbar spinal surgery (PLSS) is not currently considered as a contraindication for regional anesthesia. However, there are still problems that make spinal anesthesia more difficult with a possibility of worsening the patient's back pain. Spinal anesthesia using combined spinal-epidural anesthesia (CSEA) in elderly patients with or without PLSS was investigated and the anesthetic characteristics, success rates, and possible complications were evaluated.

Optimal conditions for Laryngeal Mask Airway insertion in children can be determined by the trapezius squeezing test.

Study Objective: To evaluate the trapezius squeezing test as a criterion of adequate anesthetic depth for Laryngeal Mask Airway (LMA) insertion in children without neuromuscular blocking agents.

Design: Prospective, randomized clinical trial.

Setting: Operating room of a university hospital.