BackgroundSerratus plane block is a thoracic truncal block that has been proposed as alternatives for analgesia such as epidural anesthesia and paravertebral block for the anterolateral chest wall. Previously, we performed the clinical study about optimal volume of the local anesthetic in serratus plane block. The primary aim of this study was to assess the pattern of distribution of dye into the serratus plane of cadavers after ultrasound-guided serratus plane injection.FindingsUltrasound-guided serratus plane injection was performed at the level of the fourth rib on the mid-axillary line in nine adult Thiel-embalmed cadavers. In each cadaver, one side was injected with 20 ml of methylene blue dye and the contralateral side with 40 ml. Dissections of the thoracic walls were performed 20 min after the injection. The spread of the dye to intercostal nerves, lateral and medial pectoral nerves, long thoracic nerve, and thoracodorsal nerves was assessed. All T2–T5 intercostal nerves in the 40-ml group and all T3–T4 nerves in the 20-ml group were stained with the dye. A larger number of intercostal nerves was stained in the 40-ml group than that in the 20-ml group. Medial and lateral pectoral nerves were not frequently stained in either group.ConclusionsThe range of craniocaudal spread of the injectate was wider in the 40-ml group than that in the 20-ml group after ultrasound-guided serratus plane injection in Thiel-embalmed cadavers.
Background:
Emergence agitation for pediatric patients after general anesthesia is one of the postoperative complications. The relationship between consciousness at tracheal extubation and emergence agitation is not clear.
Aim:
The aim of the present study was to determine whether tracheal extubation of anesthetized pediatric patients with heart disease by propofol decreases the incidence of emergence agitation.
Settings and Design:
This was a retrospective case-control study conducted at a children's hospital.
Materials and Methods:
Pediatric patients with heart disease aged 0-14 years who underwent cardiac catheterization under general anesthesia by propofol between October 2014 and September 2018 were enrolled. The incidence of emergence agitation by anesthetized extubation was compared with that by awake extubation.
Statistical Analysis Used:
Logistic regression analysis was performed.
Results:
Anesthetized extubation was performed in 202 patients and awake extubation was performed in 56 patients. The incidence of emergence agitation was significantly lower in patients who underwent anesthetized extubation than in patients who underwent awake extubation (25.2% vs. 69.6%,
P
= 0.000). In logistic regression analysis, anesthetized extubation [odds ratio (OR): 0.075, 95% confidence interval (CI): 0.034-0.165,
P
= 0.000] and older age (OR: 0.808, 95% CI: 0.728-0.897,
P
= 0.000) were associated with a decreased incidence of emergence agitation, and preoperative anxiety (OR: 2.220, 95% CI: 1.060-4.660,
P
= 0.03) was associated with an increased incidence of emergence agitation.
Conclusions:
Tracheal extubation under anesthesia by propofol decreases the incidence of emergence agitation in pediatric patients with heart disease.
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