A Ram Doo, Jeongwoo Lee, Gwi Eun Yeo, Keun Hyeong Lee, Ye Sull Kim, Ju Han Mun, Young Jin Han, and Ji-Seon Son. Anesth Pain Med 2020;15:103-10. https://doi.org/10.17085/apm.2020.15.1.103

Although the quality of postoperative recovery may be affected by factors, there are few investigations whether the type of anesthesia also affects it. In this single-blinded, prospective, observational study, we compared the quality of postoperative recovery in patients undergoing orthopedic forearm surgery under general or regional anesthesia (brachial plexus block). Ninety-seven subjects, aged 18-65 years and American Society of Anesthesiologists physical status I or II, undergoing orthopedic forearm surgery, were allocated to general or regional anesthesia group. The quality of postoperative recovery was assessed using a validated Korean version of Quality of Recovery-40 (QoR-40K) questionnaire. Patients were surveyed three times, the day before surgery (baseline) and 1st and 7th day after the surgery, and the scores of both groups were compared. We analyzed 47 and 50 patients in general and regional anesthesia, respectively. The global QoR-40K score and those of each of its five dimensions were not significantly different between the two groups at baseline, 1st and 7th day postoperatively. In two-way RM ANOVA, the global QoR-40K score at postoperative 1st day was significantly lower than that of baseline (P < 0.001) and postoperative 7th day (P < 0.001), respectively, in both general and regional anesthesia groups. However, there was no significant difference at each timepoint between the two groups. The present study suggests that brachial plexus block with intravenous dexmedetomidine infusion does not improve the quality of postoperative recovery compared to sevoflurane inhalation anesthesia with remifentanil infusion in patients undergoing orthopedic forearm surgery.

BackgroundThis study aimed to evaluate the effects of hypercarbia on arterial oxygenation during one-lung ventilation (OLV).MethodsFifty adult patients undergoing elective video-assisted thoracoscopic lobectomy or pneumonectomy were enrolled. Group I patients (n = 25) were first maintained at normocarbia (PaCO2: 38‒42 mmHg) for 30 min and then at hypercarbia (45‒50 mmHg). In Group II patients (n = 25), PaCO2 was maintained in the reverse order. Arterial oxygen partial pressure (PaO2), respiratory variables, hemodynamic variables, and hemoglobin concentration were compared during normocarbia and hypercarbia. Arterial O2 content and O2 delivery were calculated.ResultsPaO2 values during normocarbia and hypercarbia were 66.5 ± 10.6 and 79.7 ± 17.3 mmHg, respectively (mean difference: 13.2 mmHg, 95% CI for difference of means: 17.0 to 9.3, P < 0.001). SaO2 values during normocarbia and hypercarbia were 92.5 ± 4.8% and 94.3 ± 3.1% (P = 0.009), respectively. Static compliance of the lung (33.0 ± 5.4 vs. 30.4 ± 5.3 ml/cmH2O, P < 0.001), arterial O2 content (15.4 ± 1.4 vs. 14.9 ± 1.5 ml/dl, P < 0.001) and O2 delivery (69.9 ± 18.4 vs. 65.1 ± 18.1 ml/min, P < 0.001) were significantly higher during hypercarbia than during normocarbia.ConclusionsHypercarbia increases PaO2 and O2 carrying capacity and improves pulmonary mechanics during OLV, suggesting that it may help manage oxygenation during OLV. Therefore, permissive hypercarbia may be a simple and valuable modality to manage arterial oxygenation during OLV.

A Ram Doo, Jin-Wook Choi, Ju-Hyung Lee, Ye Sull Kim, Min-Jong Ki, Young Jin Han, and Ji-Seon Son. Korean J Pain 2019;32:215-22. https://doi.org/10.3344/kjp.2019.32.3.215

Seon Woo Yoo, Min-Jong Ki, A Ram Doo, Cheol Jong Woo, Ye Sull Kim, and Ji-Seon Son. Korean J Pain 2021;34:339-45. https://doi.org/10.3344/kjp.2021.34.3.339

Several research studies suggest that obese patients are at a higher risk of developing lumbar spinal disorder, including degenerative lumbar spinal stenosis (LSS), compared to normal-weight individuals. However, there are few investigations of how obesity affects functional disability in activities of daily living (ADL) in patients who were diagnosed with LSS. This prospective observational study aimed to determine if an association exists between body composition parameters, such as body fat and skeletal muscle, and functional disability in ADL of LSS patients. In the results of the current study, there were significant differences in percent body fat between the mild/moderate and severe disability groups. However, there were no differences in skeletal muscle mass or index between the two groups. Furthermore, we found a positive linear relationship between percent body fat and functional disability in male sex. This study suggests that increased percent body fat predicts potential severe functional disability in ADL in LSS patients. Body composition analysis may provide useful information for predicting the disease severity of various lumbar spinal disorders in clinical practice.