Cerebral oximeter based on near-infrared spectroscopy has been used as a continuous, noninvasive monitoring of regional cerebral oxygen saturation (rSO2). Although the absolute rSO2 values have a wide range of variability, the factors affecting a variability of rSO2 values have not been extensively investigated. The authors investigated the influence of patient variables and sensor location on rSO2 measured by the cerebral oximeter INVOS 4100 in 111 patients anesthetized with sevoflurane, fentanyl, and nitrous oxide in oxygen. The sensors for rSO2 measurements were applied on the right forehead (R), 1 cm lateral to R (R1), on the left forehead (L), 1 cm lateral to L (L1), and on the center of the forehead (C). The relationship between the rSO2 values and patient variables were also analyzed. Values of rSO2 at R1 and L1 were significantly lower than those at R and L, respectively. Values of rSO2 at C were significantly higher compared with those at other sites. There were no significant correlations between the rSO2 values and values of weight, height, and head size. Values of rSO2 were similar between males and females. A significant negative correlation between the rSO2 values and age and a positive correlation between the rSO2 values and hemoglobin concentration were observed. These data indicate that patient age, hemoglobin concentration at the measurement, and sensor location can affect rSO2 values.

Near-infrared spectroscopy (NIRS) has been proposed as a noninvasive clinical method for assessing cerebral oxygenation. The acceptable reliability and validity of NIRS values have not been established despite their widespread use. The INVOS 4100 and the NIRO 300 can display cerebral oxygen saturation as regional cerebral oxygen saturation and tissue oxygenation index, but they produce differing results.

Patients who have DLT malposition after placing the patient in the lateral position had more DLT malposition during OLV and hypoxaemia during OLV.

Background and Objectives: The sensory innervation of the hip joint includes the sensory articular branches of the obturator and femoral nerves. In this report, we retrospectively evaluated 14 cases in which hip joint pain was treated by percutaneous radiofrequency lesioning of sensory branches of obturator and/or femoral nerves.Methods: Fourteen patients who had hip joint pain and underwent percutaneous radiofrequency lesioning of sensory branches of obturator and/or femoral nerves were studied. In all cases, intra-articular hip joint block or articular branch block of obturator nerve with local anesthesia was transiently effective. Radiofrequency lesioning was performed at 75°C to 80°C for 90 seconds using an RFG-3B generator and Sluijter-Mehta cannulae kit (Radionics, Burlington, MA) for the obturator nerve in 9 patients and for both the obturator and femoral nerves in 5 patients. To assess pain intensity, a visual analog scale (VAS) was used.Results: The VAS scores before and after the radiofrequency lesioning were 6.8 Ϯ 0.9 and 2.7 Ϯ 1.3, respectively. Twelve patients (86%) reported at least 50% relief of pain for 1 to 11 months. There were no side effects or motor weakness observed.Conclusions: Percutaneous radiofrequency lesioning of sensory branches of the obturator and femoral nerves is an alternative treatment in patients with hip joint pain, especially in those where operation is not applicable. MethodsAfter institutional approval and informed consent, percutaneous radiofrequency lesioning of sen-From the

The results of the psychometric analysis indicated that the QoR-40J has characteristics of acceptable validity, reliability, and responsiveness in clinical practice in Japan. The QoR-40J may aid in evaluating the quality of recovery after surgery or the quality of methods of anesthesia.

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Ischemic neuronal injury is characterized by early death mediated by excitotoxicity and by delayed death caused by apoptosis. Current evidence indicates that volatile agents, barbiturates, and propofol can protect neurons against ischemic injury caused by excitotoxicity. In the case of volatile agents and propofol, neuroprotection may be sustained if the ischemic insult is relatively mild; however, with moderate to severe insults, this neuronal protection is not sustained after a prolonged recovery period. This suggests that volatile agents and propofol do not reduce delayed neuronal death caused by apoptosis. The long-term effects of barbiturates on ischemic cerebral injury are not yet defined. Cerebral ischemia is characterized by continued neuronal loss for a long time after the initial ischemic insult. Therefore, in investigations of cerebral ischemia, the duration of the recovery period should be taken into consideration in the analysis of the neuroprotective effects of anesthetic agents. A combination of different approaches that target specific stages of the evolution of ischemic injury may be required for sustained neuroprotection.