Abstract：
STUDY OBJECTIVE:To test the feasibility and efficacy of a new approach to paravertebral catheter placement in patients undergoing major surgery of the breast. DESIGN:Single-group, single-center observational study. SETTING:Operating room, postoperative recovery area, and normal ward of a university hospital. PATIENTS:25 ASA physical status 1, 2, 3, and 4 patients undergoing major unilateral surgery of the breast. INTERVENTIONS:Paravertebral catheters for intraoperative and postoperative anesthesia and analgesia were applied using the recently described lamina technique. This technique is performed at a more medial puncture site, avoiding the pleura. MEASUREMENTS:Additional opioid requirements were recorded to assess effectiveness of regional anesthesia. At the time of catheter withdrawal, patients, staff nurses, and anesthesiologists who provided postoperative pain management were asked to rate their satisfaction with paravertebral catheter effectiveness. MAIN RESULTS:All patients successfully received a paravertebral catheter using the lamina technique. During the surgical procedure, 84% of patients received no additional opioids after intubation. No patient required opioids as rescue medication postoperatively (visual analog scale rating > 30 mm) or during the rest of the hospital stay. Postoperative analgesia provided with paravertebral catheters was rated very high by patients, staff nurses, and anesthesiologists involved in postoperative care. CONCLUSIONS:The lamina technique for placement of a paravertebral catheter is a feasible and effective technique for intraoperative and postoperative analgesia in patients scheduled for major breast surgery with or without axillary lymph node resection.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Jüttner T,Werdehausen R,Hermanns H,Monaca E,Danzeisen O,Pannen BH,Janni W,Winterhalter Mdoi
10.1016/j.jclinane.2010.12.015subject
Has Abstractpub_date
2011-09-01 00:00:00pages
443-50issue
6eissn
0952-8180issn
1873-4529pii
S0952-8180(11)00203-0journal_volume
23pub_type
杂志文章abstract：:Placement of a central venous catheter into an internal thoracic vein occurs in approximately 2% of all catheterizations. A case in which a pulmonary artery catheter was trapped within the internal thoracic vein during orthotopic heart transplantation is presented. ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2010.03.010
更新日期：2011-05-01 00:00:00
abstract：STUDY OBJECTIVES:To determine which monetary value patients place on decreasing or eliminating common side effects of anesthesia and surgery. DESIGN:Prospective questionnaire with visual analog scales. SETTING:Preoperative holding area of a tertiary care hospital. PATIENTS:60 adult patients scheduled for general ane...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章
doi：10.1016/s0952-8180(00)00178-1
更新日期：2000-08-01 00:00:00
abstract：STUDY OBJECTIVE:To identify the maximally effective dolasetron dose (i.e., maximum efficacy with minimum adverse events) for prevention of postoperative nausea and vomiting (PONV) using the statistical power generated in a pooled patient sample from three large, nearly identical clinical trials. DESIGN:Three randomize...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1016/s0952-8180(99)00123-3
更新日期：2000-02-01 00:00:00
abstract：:The case of a patient with hereditary angioedema (HAE), a rare, life-threatening disorder caused by reduced activity of the C1 esterase inhibitor, and requiring off-pump coronary artery bypass graft (OP-CABG) surgery, is presented. Perioperative management of patients with HAE who undergo complex cardiac surgical proc...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2009.04.007
更新日期：2010-06-01 00:00:00
abstract：:We report a series of successful awake fiberoptic intubations in patients with critical (unstable, difficult) airways using the alpha(2)-agonist, dexmedetomidine. Dexmedetomidine has several desirable pharmacologic properties, including sedation, anxiolysis, hypnosis, analgesia, amnesia, antisialagogue effects, and a ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2006.09.006
更新日期：2007-08-01 00:00:00
abstract：:This case describes a postoperative complication after single-lung ventilation in a 10-year-old patient scheduled for scoliosis repair. This patient underwent an anterior thoracoscopic excision of several vertebral discs followed by a posterior double-rod fixation of her spine. The postoperative course was complicated...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/s0952-8180(02)00482-8
更新日期：2003-03-01 00:00:00
abstract：STUDY OBJECTIVE:To establish the analgesic effective doses as defined as a visual analog pain scale (VAS) of at least 10 for 95% of parturients (ED95) receiving either epidural fentanyl or sufentanil with bupivacaine 0.125% for labor analgesia. DESIGN:Double-blind, randomized controlled study. SETTING:Two tertiary-ca...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0952-8180(98)00113-5
更新日期：1998-12-01 00:00:00
abstract：:"A professor is a gentleman with a different point of view." This characteristic and sarcastic statement was often recited by August Bier (1861-1949) and can also be aptly applied to him. As the father of spinal and intravenous regional neural blockade, Bier had a tremendous impact on surgery and anesthesia. It took h...
journal_title：Journal of clinical anesthesia
pub_type： 传,历史文章,杂志文章
doi：10.1016/s0952-8180(00)00202-6
更新日期：2000-11-01 00:00:00
abstract：OBJECTIVE:When dexmedetomidine is used in patients undergoing spinal anesthesia, high incidence of bradycardia in response to parasympathetic activation is reported. Therefore, we aimed to evaluate the effectiveness of atropine premedication for preventing the incidence of bradycardia and the hemodynamic effect on pati...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2016.07.012
更新日期：2016-12-01 00:00:00
abstract：STUDY OBJECTIVE:Perioperative fasting guidelines differ in their approaches to chewing gum in the preoperative period. Current recommendations range from canceling the surgery to proceeding with it. Given this lack of consensus, we performed gastric ultrasound assessments in healthy volunteers before and after a standa...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2019.01.021
更新日期：2019-09-01 00:00:00
abstract：:This is a case of systemic ropivacaine toxicity from a sciatic nerve catheter. A 20-year-old patient after heart transplant with poor systemic perfusion on hemodialysis and multiple medications experienced local anesthetic systemic toxicity 72 hours after placement of a peripheral nerve catheter. The case demonstrates...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2015.03.021
更新日期：2015-06-01 00:00:00
abstract：:Multiple drugs are used to provide anesthesia. Volatile anesthetics are commonly combined with opioids. Several studies have demonstrated that small doses of opioid (i.e., within the analgesic range) result in a marked reduction in minimum alveolar concentration (MAC) of the volatile anesthetic that will prevent purpo...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/s0952-8180(97)00122-0
更新日期：1997-09-01 00:00:00
abstract：STUDY OBJECTIVE:To test the hypothesis that emotional intelligence, as measured by the Bar-On Emotional Quotient Inventory (EQ-I) 125 (Multi Health Systems, Toronto, Ontario, Canada) personal inventory, would correlate with resident performance. DESIGN:Prospective survey. SETTING:University-affiliated, multiinstituti...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2007.12.008
更新日期：2008-03-01 00:00:00
abstract：:We present a case of abrupt hemodynamic and mental status changes that occurred during shoulder surgery. During interscalene anesthesia for rotator cuff repair, there was abrupt onset of altered mental status and hemodynamic changes, which had a variety of possible contributing causes. Complete recovery occurred durin...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/s0952-8180(01)00314-2
更新日期：2001-11-01 00:00:00
abstract：STUDY OBJECTIVES:To examine the effect of timing of an intravenous (i.v.) dose (intraoperative vs. postoperative) of ketorolac tromethamine on pain scores and overall outcome after total abdominal hysterectomy (TAH) and myomectomy. DESIGN:Prospective, randomized, placebo-controlled study. PATIENTS:248 ASA physical st...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1016/s0952-8180(97)00062-7
更新日期：1997-08-01 00:00:00
abstract：:The anesthetic management of a parturient with a circulating lupus anticoagulant and an anticardiolipin antibody presenting to the obstetric suite taking heparin and aspirin is discussed. Issues concerning placement of a regional anesthetic with recent aspirin ingestion and heparin therapy are discussed. Documentation...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(95)00175-1
更新日期：1996-02-01 00:00:00
abstract：:Spinal cord injuries continue to be a devastating medical problem. By impairing voluntary and involuntary nervous system function, virtually every body system function is affected. However, pulmonary function alteration and respiratory complications continue to be the major causes of morbidity and mortality in patient...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/s0952-8180(03)00105-3
更新日期：2003-08-01 00:00:00
abstract：:We describe the anesthetic management of a morbidly obese patient with obstructive sleep apnea who underwent awake craniotomy. The patient's personal continuous positive airway pressure (CPAP) machine was used to support ventilation intraoperatively. Dexmedetomidine was used as the primary sedative. During cortical ma...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2007.10.015
更新日期：2008-06-01 00:00:00
abstract：STUDY OBJECTIVES:To evaluate if using regional anesthesia for post-operative pain control for patients who underwent ankle ORIF is associated with a decrease in length of stay. DESIGN:Multicenter retrospective cohort study. SETTING:Inpatient perioperative. PATIENTS:12,468 inpatients (2007 to 2016) who received ankle...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2020.110008
更新日期：2020-12-01 00:00:00
abstract：:Over a 12-month period, 1,743 patients were retrospectively evaluated for anaphylactic/anaphylactoid reactions during cardiac surgery. Reactions to protamine, vancomycin, blood, and metocurine were observed in eight patients (0.46%). Baseline to reaction mean arterial pressures decreased from 81 +/- 9 mmHg to 50 +/- 7...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(89)90005-6
更新日期：1989-01-01 00:00:00
abstract：:We report an 11-year-old male with undiagnosed myopathy, who developed cardiac arrest secondary to severe rhabdomyolysis and hyperkalemia following succinylcholine administration. The patient required extracorporeal membrane oxygenation support from which he was eventually weaned successfully. He died eleven days afte...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2003.09.020
更新日期：2004-09-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate perioperative dual antiplatelet therapy management in patients with previously placed coronary stents. DESIGN:Retrospective medical record review. SETTING:Academic medical center. PATIENTS:A total of 1891 surgical cases performed at Vanderbilt University Medical Center in 2012 were evalua...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2016.01.030
更新日期：2016-09-01 00:00:00
abstract：:A parturient presented at 35 weeks' gestation with worsening neurological symptoms caused by syringomyelia. She underwent urgent cesarean delivery. The etiology and anesthetic considerations for an obstetrical patient with syringomyelia are discussed. ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2011.03.007
更新日期：2011-12-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the significance of pain and other symptoms on the recovery process after ambulatory surgery, by surveying pain, analgesic use, and related aspects of recovery in the first 48 hours after discharge from an ambulatory surgery unit. DESIGN:Prospective, observational, surveillance survey. PA...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2003.08.004
更新日期：2004-05-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the effect-site target concentration (C(et)) of remifentanil that provides optimal conditions for patients and operators during cataract surgery during monitored anesthesia care using a target controlled infusion (TCI) of propofol and remifentanil. DESIGN:Prospective, randomized, double-bl...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2010.02.007
更新日期：2010-11-01 00:00:00
abstract：BACKGROUND:Postoperative nausea and vomiting (PONV) is one of the common complications in patients who have undergone surgery with general anesthesia. The association of intraoperative use of remifentanil with PONV has remained controversial. The aim of the current study was to determine the association of dose of intr...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2016.04.018
更新日期：2016-11-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the consequences of opioid use for postoperative pain management and the degree to which these consequences may be reduced or minimized with opioid-sparing or opioid-replacement techniques. DESIGN:Literature review relating to the economics of postoperative pain management. Comparisons betw...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/s0952-8180(02)00372-0
更新日期：2002-08-01 00:00:00
abstract：:Myotonic dystrophy (DM), though rare, can significantly complicate anesthesia due to muscular and extra-muscular involvement. When this condition is compounded by a pheochromocytoma, anesthetizing such patients becomes extra challenging. We present a case report of a 61-year-old lady with congenital DM, with the whole...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2016.03.035
更新日期：2016-11-01 00:00:00
abstract：:A 13-year-old girl with Goltz's (Goltz-Gorlin) syndrome (focal dermal hypoplasia) and cloacal exstrophy underwent day surgery cystoscopy. During the administration of inhalation anesthesia by mask, persistent partial upper airway obstruction was noted. Direct laryngoscopy unexpectedly showed variously sized verrucous ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(91)90190-x
更新日期：1991-09-01 00:00:00
abstract：STUDY OBJECTIVE:To confirm the relationship between bevel orientation, catheter direction, and radiopaque contrast spread in the lumbar region. DESIGN:Pilot cadaver study. SETTING:Anatomy laboratory of a university hospital. MEASUREMENTS:Cadavers were randomized to two groups of 4 cadavers each. In Group 1, needle b...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2014.04.004
更新日期：2014-12-01 00:00:00
