Korean Journal of Anesthesiology

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Preemptive visceral analgesic effect of thoracic paravertebral block on postoperative opioid consumption in patients undergoing laparoscopic cholecystectomy: a prospective, randomized, assessor-blind study: Jong-Hyuk Lee, Chan-Sik Kim, Hyungtae Kim, Jae Moon Choi, Youngmu Kim, et al.; Korean J Anesthesiol. 2023;76(3):203-212.

Review Article

January 26, 2023

Mechanisms underlying lipid emulsion resuscitation for drug toxicity: a narrative review

Soo Hee Lee, Ju-Tae Sohn

Korean J Anesthesiol. 2023;76(3):171-182.

Currently, lipid emulsion (LE) is widely used to treat local anesthetic systemic toxicity (LAST). LE also ameliorates intractable cardiovascular collapse caused by lipid-soluble non-local anesthetic drug toxicity. This review aims to provide the underlying mechanism of LE resuscitation in drug toxicity (including LAST) and a detailed description of LE treatment and to discuss further research directions. We searched for relevant articles using the following keywords: “local anesthetic systemic toxicity or LAST or toxicity or intoxication or poisoning” and “Intralipid or lipid emulsion”. The underlying mechanisms of LE treatment can be classified into indirect and direct effects. One indirect effect known as the lipid shuttle is a commonly accepted mechanism of...

Clinical Research Article

November 15, 2022

Role of carotid corrected flow time and peak velocity variation in predicting fluid responsiveness: a systematic review and meta-analysis

Deepak Singla, Bhavna Gupta, Pragya Varshney, Mishu Mangla, Beeraling Ningappa Walikar, et al.

Korean J Anesthesiol. 2023;76(3):183-193.

Background: Dynamic parameters used for predicting fluid responsiveness require special equipment and are minimally invasive. Therefore, recent interest in the use of carotid artery ultrasound parameters, such as carotid corrected flow time (FTc) and peak velocity variation (ΔVpeak) has grown. Therefore, we performed this systematic review and meta-analysis to assess the ability of carotid FTc and/or ΔVpeak to accurately predict fluid responsiveness. Methods: We searched the PubMed and Embase databases for articles evaluating the diagnostic accuracy of carotid FTc or ΔVpeak for predicting fluid responsiveness. Two independent authors performed the search...

Clinical Research Article

October 24, 2022

Ultrasound-guided lumbar erector spinae plane block versus caudal block for postoperative analgesia in pediatric hip and proximal femur surgery: a randomized controlled study

Mohamed Elshazly, AbdelKhalek Shaban, Nevine Gouda, Mahitab Rashad, Sherif M. Soaida

Korean J Anesthesiol. 2023;76(3):194-202.

Background: According to previous research, 20% of infants experience prolonged postsurgical pain 6–12 months after major surgery, which is linked to functional impairment and a lower quality of life. The aim of our study is to evaluate whether the analgesic effect of the erector spinae plane block (ESPB) is superior to that of caudal epidural anesthesia (CEA) in pediatric patients undergoing hip or proximal femoral surgeries. Methods: Seventy-six children ranging in age from 1 to 7 years scheduled for hip or proximal femur surgery were randomly assigned to receive either a...

Clinical Research Article

December 21, 2022

Preemptive visceral analgesic effect of thoracic paravertebral block on postoperative opioid consumption in patients undergoing laparoscopic cholecystectomy: a prospective, randomized, assessor-blind study

Jong-Hyuk Lee, Chan-Sik Kim, Hyungtae Kim, Jae Moon Choi, Youngmu Kim, et al.

Korean J Anesthesiol. 2023;76(3):203-212.

Background: The preemptive visceral analgesic effect of regional nerve block has not been adequately investigated to date. We evaluated the preemptive visceral analgesic effect of thoracic paravertebral block (TPVB) in patients undergoing laparoscopic cholecystectomy (LC) in whom pre-incisional rectus sheath block (RSB) was used to minimize somatic surgical pain. Methods: In this prospective, randomized, assessor-blind study, 70 patients scheduled for elective LC were randomly assigned to the pre-TPVB (n = 35) or the post-TPVB (n = 35) group. Both groups received pre-incisional RSB, and patients in the pre-TPVB group received TPVB...

Clinical Research Article

November 2, 2022

Virtual reality simulator’s effectiveness on the spine procedure education for trainee: a randomized controlled trial

Ji Yeong Kim, Jong Seok Lee, Jae Hee Lee, Yoon Sun Park, Jaein Cho, et al.

Korean J Anesthesiol. 2023;76(3):213-226.

Background: Since the onset of the coronavirus disease 2019 pandemic, virtual simulation has emerged as an alternative to traditional teaching methods as it can be employed within the recently established contact-minimizing guidelines. This prospective education study aimed to develop a virtual reality simulator for a lumbar transforaminal epidural block (LTFEB) and demonstrate its efficacy. Methods: We developed a virtual reality simulator using patient image data processing, virtual X-ray generation, spatial registration, and virtual reality technology. For a realistic virtual environment, a procedure room, surgical table, C-arm, and monitor were created. Using...

Clinical Research Article

October 31, 2022

Impact of obesity on double-lumen endobronchial tube displacement after lateral decubitus positioning

Kyuho Lee, Jin Soo Park, Min-Soo Kim, Nayoung Tae, Dongwoo Lee, et al.

Korean J Anesthesiol. 2023;76(3):227-234.

Background: Double-lumen endobronchial tube (DLT) displacement, defined as migration of the DLT > 15 mm from optimal position, may threaten patient safety. Lateral decubitus positioning (LDP) of the patient can induce DLT displacement; however, little is known regarding the predictors for DLT displacement after this maneuver. Obesity may further aggravate DLT displacement by distorting mediastinal anatomy, but no comprehensive data exist concerning the impact of obesity on DLT displacement after LDP. Therefore, we evaluated the predictive value of preoperative risk factors, including obesity, for DLT displacement after LDP in patients who underwent pulmonary resection. Methods: Data of patients who underwent pulmonary resection between July 2020 and July 2021 were retrospectively reviewed....

Clinical Research Article

October 31, 2022

Effective concentration of remifentanil for successful i-gel insertion during remimazolam induction

Jung Ju Choi, Wol Seon Jung, Young Jin Chang, Seungbeom Yoo, Hyun Jeong Kwak

Korean J Anesthesiol. 2023;76(3):235-241.

Background: Remifentanil can be used as adjuvants during remimazolam induction without neuromuscular blockade. We evaluated the 95% effective concentration (EC) of remifentanil effect-site concentration (Ce) for the successful insertion of an i-gel using the biased-coin up-and-down method in adult patients during remimazolam induction. Methods: Forty 19–65 year-old patients scheduled to undergo surgery using i-gel were enrolled. Anesthesia was induced using remimazolam infusion (12 mg/kg/h). Simultaneously, remifentanil was infused at a predetermined Ce. After 5 min of anesthesia induction, the i-gel was inserted. The 95% EC (EC95) of remifentanil in each patient was determined using a biased-coin up-and-down method based on a successful insertion in a preceding patient. The step...

Clinical Research Article

December 23, 2022

Determination of optimal tip position of peripherally inserted central catheters using electrocardiography: a retrospective study

Ki Tae Jung, Linda Kelly, Alexandra Kuznetsov, A. Sassan Sabouri, Kichang Lee

Korean J Anesthesiol. 2023;76(3):242-251.

Background: Accurate tip positioning of a peripherally inserted central catheter (PICC) is crucial for optimal drug delivery and avoiding complications. The objective of this study was to evaluate the amplitude ratios of intravascular electrocardiography (ivECG) and external electrocardiography (exECG) according to the tip location. Methods: This retrospective study analyzed ivECG, exECG, and chest X-ray (CXR) of 278 patients who underwent a PICC procedure. The tip-to-carina distance (TCD) was measured using vertebral body units (VBU) on CXR. Tip locations were categorized as follows: Zone 1, malposition (TCD < 0.8 VBU); Zone 2, suboptimal (0.8 VBU ≤ TCD < 1.5 VBU); Zone 3, optimal (1.5 VBU ≤ TCD ≤ 2.4 VBU); Zone 4,...

Experimental Research Article

October 17, 2022

Anatomical study of the adductor canal: three-dimensional micro-computed tomography, histological, and immunofluorescence findings relevant to neural blockade

Shin Hyo Lee, Hee Jung Kim, Shin Hyung Kim, Tae-Hyeon Cho, Hyun-Jin Kwon, et al.

Korean J Anesthesiol. 2023;76(3):252-260.

Background: A precise anatomical understanding of the adductor canal (AC) and its neural components is essential for discerning the action mechanism of the AC block. We therefore aimed to clarify the detailed anatomy of the AC using micro-computed tomography (micro-CT), histological evaluation, and immunofluorescence (IF) assays. Methods: Gross dissections of 39 thighs provided morphometric data relevant to injection landmarks. Serial sectional images of the AC were defined using micro-CT and ultrasonography. The fascial and neural structures of the AC proper were histologically evaluated using Masson’s trichrome and Verhoeff-Van Gieson staining, and...

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Korean Journal of Anesthesiology1968 (v1 n1) to 2008 (v55 n6)

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Ultrasound-guided lumbar erector spinae plane block versus caudal block for postoperative analgesia in pediatric hip and proximal femur surgery: a randomized controlled study. Korean J Anesthesiol. 2023;76:194-202

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