Effectiveness of newborn infant parasympathetic evaluation (NIPE) index for guiding intraoperative fentanyl administration in children under 2 years: a randomized controlled trial.

Background: Assessing pain in infants and neonates is challenging due to their inability to communicate verbally. While validated subjective tools exist, they rely on interpreting the child's behavior, leading to potential inconsistencies and underestimation of pain. Based on heart rate variability, the newborn infant parasympathetic evaluation (NIPE) index offers a more objective approach to pain assessment in children under 2 years.

A comparison of the success rate of radial artery cannulation between the ultrasound-guided and conventional palpation techniques in elderly patients undergoing cardiothoracic surgery.

Background: Ultrasound-guided (USG) radial artery cannulation against the standard palpation technique increases the first attempt rate in both pediatric and adult patients. The objective of this study was to evaluate the benefits of USG versus the palpation technique in improving the first attempt rate in elderly patients.

Methods: The patients over 65 years of age were randomized to the USG or Palpation group.

Correlation and agreement of regional cerebral oxygen saturation measured from sensor sites at frontal and temporal areas in adult patients undergoing cardiovascular anesthesia.

Background: The function and viability of the brain depend on adequate oxygen supply. A decrease in cerebral blood supply causing cerebral desaturation may lead to many neurological complications. Direct measurement of regional cerebral oxygen saturation (rScO) assists in early detection and management.

Efficacy of early goal-directed therapy using FloTrac/EV1000 to improve postoperative outcomes in patients undergoing off-pump coronary artery bypass surgery: a randomized controlled trial.

Background: Early goal-directed therapy (EGDT) using FloTrac reduced length of stay (LOS) in intensive care (ICU) and hospital among patients undergoing coronary artery bypass graft (CABG) with a cardiopulmonary bypass. However, this platform in off-pump CABG (OPCAB) has received scant attention, so we evaluated the efficacy of EGDT using FloTrac/EV1000 as a modality for improving postoperative outcomes in patients undergoing OPCAB.

Methods: Forty patients undergoing OPCAB were randomized to the EV1000 or Control group.

Efficacy of Intraoperative Hemodynamic Optimization Using FloTrac/EV1000 Platform for Early Goal-Directed Therapy to Improve Postoperative Outcomes in Patients Undergoing Coronary Artery Bypass Graft with Cardiopulmonary Bypass: A Randomized Controlled Trial.

Purpose: Early goal-directed therapy (EGDT) using the FloTrac system reportedly improved postoperative outcomes among high-risk patients undergoing non-cardiac surgery. This study's objective was to evaluate the FloTrac/EV1000 platform's efficacy for improving postoperative outcomes in cardiac surgery.

Patients And Methods: Eighty-six adults undergoing coronary artery bypass graft (CABG) with cardiopulmonary bypass (CPB) in 2 tertiary referral centers were randomized to the EGDT or Control group.

Comparative study of analgesia nociception index (ANI) vs. standard pharmacokinetic pattern for guiding intraoperative fentanyl administration among mastectomy patients.

Background: The Analgesia Nociception Index (ANI) has been suggested as a non-invasive guide for analgesia. Our objective was to compare the efficacy of ANI vs. standard pharmacokinetic pattern for guiding intraoperative fentanyl administration.

1-1-8 one-step sevoflurane wash-in scheme for low-flow anesthesia: simple, rapid, and predictable induction.

Background: Sevoflurane is suitable for low-flow anesthesia (LFA). LFA needs a wash-in phase. The reported sevoflurane wash-in schemes lack simplicity, target coverage, and applicability.

Emergency Surgery Mortality (ESM) Score to Predict Mortality and Improve Patient Care in Emergency Surgery.

Background: Emergency surgery has poor outcomes with high mortality. Numerous studies have reported the risk factors for postoperative death in order to stratify risk and improve perioperative care; nevertheless, a predictive model based upon these risk factors is lacking.

Objective: We aimed to identify the risk factors of postoperative mortality and to construct a new model for predicting mortality and improving patient care.

Validation of Open-Heart Intraoperative Risk score to predict a prolonged intensive care unit stay for adult patients undergoing cardiac surgery with cardiopulmonary bypass.

Background: A prolonged stay in an intensive care unit (ICU) after cardiac surgery with cardiopulmonary bypass (CPB) increases the cost of care as well as morbidity and mortality. Several predictive models aim at identifying patients at risk of prolonged ICU stay after cardiac surgery with CPB, but almost all of them involve a preoperative assessment for proper resource management, while one - the Open-Heart Intraoperative Risk (OHIR) score - focuses on intra-operative manipulatable risk factors for improving anesthetic care and patient outcome.

Objective: We aimed to revalidate the OHIR score in a different context.

Comparative study of minimal fresh gas flow used in Lack-Plus and Lack's circuit in spontaneously breathing anesthetized adults.

Background: The Lack's circuit is a co-axial Mapleson A breathing system commonly used in spontaneously breathing anesthetized adults but still requires high fresh gas flow (FGF). The Lack-Plus circuit was invented with the advantage of lower FGF requirement. The authors compared the Lack-Plus and Lack's circuit for the minimal FGF requirement with no rebreathing in spontaneously breathing anesthetized adults.

A fatal adverse effect of cefazolin administration: severe brain edema in a patient with multiple meningiomas.

Cefazolin is commonly administered before surgery as a prophylactic antibiotic. Hypersensitivity to cefazolin is not uncommon, and the symptoms mostly include urticaria, skin reaction, diarrhea, vomiting, and transient neutropenia, which are rarely life threatening. We present a rare case of fatal cefazolin hypersensitivity in a female who was diagnosed with multiple meningiomas and scheduled for craniotomy and tumor removal.

1-1-12 one-step wash-in scheme for desflurane low flow anesthesia: performance without nitrous oxide.

Background: We reported a 1-1-12 wash-in scheme for desflurane-nitrous oxide (N2O) low flow anesthesia that is simple, rapid, and predictable. There remain some situations where N2O should be avoided, which limits the generalizability of this wash-in scheme. The objective of our study was to determine the performance of this scheme in contexts where N2O is not used.

Transdermal fentanyl patch for postoperative analgesia in total knee arthroplasty: a randomized double-blind controlled trial.

Purpose: To assess the efficacy of a transdermal fentanyl patch (TFP) (50 μg/hour) applied 10-12 hours before surgery versus placebo for postoperative pain control of total knee arthroplasty (TKA).

Materials And Methods: We enrolled 40 patients undergoing elective TKA under spinal anesthesia using isobaric or hyperbaric bupivacaine. Subjects were randomized to receive a TFP (Duragesic(®) 50 μg/hour) or placebo patch applied with a self-adhesive to the anterior chest wall 10-12 hours before spinal anesthesia.

1-1-12 one-step wash-in scheme for desflurane-nitrous oxide low-flow anesthesia: rapid and predictable induction.

Background: We propose a 1-1-12 wash-in scheme for desflurane-nitrous oxide (N2O) low-flow anesthesia. The objective of our study was to determine the time to achieve alveolar concentration of desflurane (FAD) at 1, 2, 3, 4, 5, and 6%.

Methods: We enrolled 106 patients scheduled for elective surgery under general anesthesia.

Development of an open-heart intraoperative risk scoring model for predicting a prolonged intensive care unit stay.

Background: Based on a pilot study with 34 patients, applying the modified sequential organ failure assessment (SOFA) score intraoperatively could predict a prolonged ICU stay, albeit with only 4 risk factors. Our objective was to develop a practicable intraoperative model for predicting prolonged ICU stay which included more relevant risk factors.

Methods: An extensive literature review identified 6 other intraoperative risk factors affecting prolonged ICU stay.

A comparison of spinal isobaric levobupivacaine and racemic bupivacaine for lower abdominal and lower extremity surgery.

Background: Levobupivacaine is a new long-acting local anesthetic, which is the isolated S-enantiomer of racemic bupivacaine with less cardiovascular and central nervous system toxicity than bupivacaine. Reports using levobupivacaine for epidural or brachial plexus anesthesia suggested equivalent clinical efficacy to bupivacaine. However, inadequate information for spinal anesthesia was found

Objective: To study the onset of motor block and other anesthetic efficacy of intrathecally administered racemic bupivacaine compared with levobupivacaine.

Less tachycardia in adults when using atropine 0.9 mg compared with 1.2 mg plus neostigmine 2.5 mg.

Objective: Compare the increase in heart rate in adults after 0.9 vs. 1.

Surveillance of anesthetic related complications at Srinagarind Hospital, Khon Kaen University, Thailand.

Objective: To identify the incidence of common anesthetic complications in 2003 at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand and find the strategies for prevention.

Material And Method: The study was part of a multi-center study conducted by the Thai Royal College of Anesthesiologists to survey anesthetic related complications in Thailand in 2003. The authors collected data from all the cases receiving anesthesia service at Srinagarind Hospital between January 1 and December 31, 2003, to report the incidence of common anesthetic complications and to assess the need to improve the quality of service.