Ultrasound-guided spinal anaesthesia for a patient with severe scoliosis.

Ultrasound (US) guided spinal anaesthesia is gaining recognition for its ability to minimise technical difficulties encountered in patients with atypical spinal anatomy. Spinal anaesthesia is administered during a surgical procedure lithotripsy in patients with respiratory complications that can result from severe scoliosis or cerebral palsy. Here, we report a case in which US-guided spinal anaesthesia proved feasible and advantageous in a patient with cerebral paralysis and severe scoliosis.

Development and validation of a machine learning model to predict postoperative delirium using a nationwide database: A retrospective, observational study.

Study Objective: Postoperative delirium is a neuropsychological syndrome that typically occurs in surgical patients. Its onset can lead to prolonged hospitalization as well as increased morbidity and mortality. Therefore, it is important to promptly identify its signs.

Multicenter Prospective Cohort Study of Neoadjuvant Chemotherapy for Borderline Resectable Pancreatic Cancer (YPB-001).

Objectives: The present multicenter prospective observational study investigated the effectiveness and safety of neoadjuvant chemotherapy (NAC) for patients with borderline resectable pancreatic cancer (BRPC) and those with RPC contacting major vessels, with respect to a historical control of upfront surgery.

Materials And Methods: Patients with BRPC and RPC contacting major vessels were prospectively registered and administered NAC with durations and regimens determined by the corresponding treating physician. Our primary aim was to assess the R0 resection rate, and secondary aim was to evaluate safety, resection rate, time to treatment failure, overall survival, and response rate.

Association Between the Use of Midazolam During Cardiac Anesthesia and the Incidence of Postoperative Delirium: A Retrospective Cohort Study Using a Nationwide Database.

Objective: To evaluate the association between the intraoperative administration of midazolam and the incidence of postoperative delirium in patients undergoing cardiac surgery.

Design: Retrospective observational cohort study.

Setting: The Japanese Diagnosis Procedure Combination database.

Learning curve of i-gel insertion in novices using a cumulative sum analysis.

The i-gel, a popular second-generation supraglottic airway device, has been used in a variety of airway management situations, including as an alternative to tracheal intubation for general anesthesia, rescue in difficult airway settings, and out-of-hospital cardiac arrest resuscitation. We aimed to investigate the number of experiences needed to achieve a rapid, highly successful first attempt i-gel insertion in novices with a cumulative sum analysis. We also looked at how learning affected success rates, insertion time, and bleeding and reflex (limb movement, frowning face, or coughing) incidences.

Multidrug chemotherapy, whole-brain radiation and cytarabine therapy for primary central nervous system lymphoma in elderly patients with dose modification based on geriatric assessment: study protocol for a phase II, multicentre, non-randomised study.

Introduction: Multidrug chemoimmunotherapy with rituximab, high-dose methotrexate, procarbazine and vincristine (R-MPV) is a standard therapy for younger patients with primary central nervous system lymphoma (PCNSL); however, prospective data regarding its use in elderly patients are lacking. This multi-institutional, non-randomised, phase II trial will assess the efficacy and safety of R-MPV and high-dose cytarabine (HD-AraC) for geriatric patients with newly diagnosed PCNSL.

Methods And Analysis: Forty-five elderly patients will be included.

[Evaluation of Enhanced 3D Brain Image Using Ultrashort TE Sequence with Inversion Recovery for Preoperative Examination of Brain Tumor: Phantom Study Compared with MPRAGE].

It is important to obtain accurate anatomical information with little distortion in preoperative examination of brain tumors. Using PETRA, which is an ultrashort echo time (UTE) sequence that is less affected by magnetic susceptibility artifacts, we determined the optimal imaging conditions (radial views [RV] and inversion time [TI]) for IR-PETRA using the inversion recovery (IR) method and compared it with MPRAGE. IR-PETRA was found to be slightly inferior to MPRAGE in sharpness under the optimum conditions (RV=100,000 and TI=500 ms), but it was significantly improved by using a high RV value, and SNR and CNR were higher than or equal to MPRAGE.

Preoperative echocardiography predictive analytics for postinduction hypotension prediction.

Purpose: Hypotension is a risk factor for adverse perioperative outcomes. Preoperative transthoracic echocardiography has been extended for preoperative risk assessment before noncardiac surgery. This study aimed to develop a machine learning model to predict postinduction hypotension risk using preoperative echocardiographic data and compared it with conventional statistic models.

Comparison of total intravenous with inhalational anesthesia in terms of postoperative delirium and complications in older patients: a nationwide population-based study.

Purpose: Postoperative delirium incidences are increasing in older adults. A Cochrane Review found no significant difference in the incidence of postoperative delirium between total intravenous anesthesia (TIVA) and inhalational anesthesia (IA). This study evaluated the differences in postoperative delirium and morbidity between patients who underwent either TIVA or IA.

Comparing the effects of peripheral nerve block and general anesthesia with general anesthesia alone on postoperative delirium and complications in elderly patients: a retrospective cohort study using a nationwide database.

Introduction: The difference between the effects of peripheral nerve block (PNB) with general anesthesia (GA) and GA alone on the patients' postoperative clinical outcomes remains unknown. We assessed whether there is a difference in postoperative delirium and composite morbidity between patients receiving GA with PNB and GA alone using a national clinical database in Japan.

Methods: We compared the outcomes of patients receiving GA with PNB and GA alone from April 2016 to October 2019.

Comparison of Duodenal Stenting and Gastrojejunostomy for Duodenal Obstruction with Biliary Obstruction.

Background: The best palliation for double obstruction (duodenal obstruction with biliary obstruction) remains unclear. We aimed to compare outcomes of duodenal stenting (DuS) with gastrojejunostomy (GJ) and identify factors associated with survival time and time to recurrent biliary obstruction (TRBO).

Methods: Patients who underwent DuS or GJ combined with biliary stenting for double obstruction due to unresectable malignancy were retrospectively enrolled.

Efficacy and Safety Profile of Remimazolam for Sedation in Adults Undergoing Short Surgical Procedures.

Sedation for short-term procedures is increasingly being used in clinical practice. Selection of appropriate drugs is important for effective and safe sedation; however, an ideal sedative remains unavailable. Remimazolam is a novel, ultrafast-acting benzodiazepine with a shorter duration of action than other agents in this class.

Skin temperature changes after ultrasound-guided supra-inguinal fascia iliaca block: a prospective observational study.

Purpose: Ultrasound-guided supra-inguinal fascia iliaca block (SFIB) is widely used as regional anesthesia of the hip and thigh. It is difficult to judge the blocking effect and the spreading local anesthesia. We hypothesize that the effect and spread of the block could be proven objectively by a rise in the temperature.

The usefulness of Smart Pilot View for fast recovery from desflurane general anesthesia.

Introduction: Smart Pilot View (SPV) (Dräger Medical) provide information about the estimated drug effect of anesthetic drugs. We conducted a prospective randomized trial to evaluated the recovery time in SPV-guided general anesthesia compared with usual practice in patients with desflurane general anesthesia.

Method: Thirty-four American Society of Anesthesiologist's physical status I-II patients scheduled for elective surgery under general anesthesia were enrolled in the study.

Anesthetic management for a patient with myotonic dystrophy with remimazolam.

Background: Patients with myotonic dystrophy may have increased sensitivity to drugs used for anesthesia. We successfully managed general anesthesia in a patient with myotonic dystrophy using a novel intravenous anesthetic, remimazolam.

Case Presentation: The patient was a 46-year-old man, 169 cm in height, and weighing 60 kg.

Perseus A500 enables faster recovery from desflurane general anesthesia.

Purpose: The Dräger Perseus A500 (Perseus) anesthetic workstation has been designed with a lower internal volume. We evaluated the recovery time following general anesthesia using the Perseus workstation compared with that using the conventional Dräger Fabius Plus workstation.

Methods: Following approval by our institutional research ethics committee, 50 patients receiving elective surgery under general anesthesia were enrolled in the study.

Inflationary noninvasive blood pressure measurement reduces the incidence of subcutaneous hemorrhage.

Objective: We verified the hypothesis that in noninvasive blood pressure (NIBP) measurement, inflationary NIBP measurement using the new type of cuff (YP-71xT series, Nihon Koden, Tokyo, Japan) might be associated with a reduced risk of subcutaneous hemorrhage.

Methods: The study involved 30 healthy volunteers (15 males and 15 females). The blood pressure was measured by deflationary NIBP measurement + conventional cuff (control group), deflationary NIBP measurement + cuff (YP-71xT series) (deflationary measurement group), or inflationary NIBP measurement + cuff (YP-71xT series) (inflationary measurement group).