IMPLICATIONS: Hemolysis as a consequence of cardiopulmonary bypass can increase the risk of cyanide toxicity from sodium nitroprusside administration in cardiac surgical patients because free hemoglobin in the plasma reacts directly with sodium nitroprusside to generate free cyanide anion.
IMPLICATIONS: We studied the hemodynamic consequences of epidural injection of adrenaline-added bupivacaine in infants weighing <10 kg. Arterial blood pressure, heart rate, and systemic vascular resistance decreased, stroke volume increased, and cardiac output was unchanged after lumbar epidural injection of adrenaline and bupivacaine.
IMPLICATIONS: This study demonstrates that changes in dynamic pulmonary compliance are an accurate test of endobronchial intubation in children and are more reliable than changes in peak airway pressures or auscultation of breath sounds.
IMPLICATIONS: Remifentanil decreases the propofol requirements by half for the insertion of the laryngeal mask way or laryngeal tube airway devices in children.
IMPLICATIONS: Assessment of recovery after ambulatory surgery has become a remarkable outcome in many clinical studies. Through a systematic review, the published evidence related to postoperative recovery outcome measurement within 1 wk after ambulatory surgery was identified and validity, reliability, and responsiveness to change and clinical applicability of the instruments analyzed.
IMPLICATIONS: We measured two concentrations of morphine and its two glucuronide metabolites in patients suffering from severe postoperative pain. We also measured pain intensity during the first postoperative day. Morphine-6-glucuronide appeared to be a potent opioid agonist and morphine-3-glucuronide a mild opioid antagonist. Both are poorly excreted in patients with renal failure. Because of the long transfer half-life for from blood to effect compartment, the effects of the metabolites appear after an important delay.
IMPLICATIONS: Hypercapnia with hyperventilation is an alternative to using less soluble drugs to shorten recovery times.
IMPLICATIONS: This study demonstrates that exposure of aged rats to 4 h of 70% nitrous oxide impairs acquisition of a spatial memory task when testing begins 2 days later, and suggests that subanesthetic concentrations of anesthetics may lead to persistent changes in the aged brain.
IMPLICATIONS: We tested the hypothesis that the protein kinase signaling pathway may regulate ethanol's neurobehavioral action. Our results suggest that PKA pathways participate in ethanol-induced neurobehavioral changes and the possible involvement of N-methyl-d-aspartate receptors in PKA regulation of ethanol's actions.
IMPLICATIONS: Isoflurane, at clinically relevant concentrations, inhibits angiotensin II-induced vasoconstriction, but by a mechanism that differs from that of sevoflurane. Unlike sevoflurane, the inhibitory effect of isoflurane on vascular contraction is mainly mediated by an attenuation of the increase in intracellular Ca2+ in response to angiotensin II.
IMPLICATIONS: Increasing concentrations of CO2 rectilinearly decrease the MAC of halothane, isoflurane, and desflurane with no threshold to this effect. MAC of CO2 in the rat is approximately 50% of 1 atm.
IMPLICATIONS: Pulse contour-derived cardiac output does not agree well with continuous and bolus pulmonary artery derived cardiac output measurements during conditions of hemorrhage and resuscitation with norepinephrine unless frequent recalibration is performed.
IMPLICATIONS: Chronic pain-related economic evaluations were reviewed. More researchers and clinicians should be trying to incorporate cost-utility analyses in their clinical trial designs, but while doing so include sensitivity analyses, cost data to permit international comparisons, and the long time horizons relevant to treating often recurrent chronic pain conditions.
IMPLICATIONS: The uncoordinated ordering of cases by multiple surgeons is sufficiently random to yield a nearly uniform rate of patient admissions to the postanesthesia care unit. As a result, there is little to be gained by implementing formal case ordering algorithms.
IMPLICATIONS: A simple calculation using historical data can provide an estimate of when patients should be ready on the day of surgery that minimizes scheduling delays while also reducing excessive waiting times for patients.
IMPLICATIONS: Normal and hypertonic salines have similar hemodynamic effects, but no effect on renal blood flow.
IMPLICATIONS: A new cricothyroidotomy device may shorten the time required to secure an emergency airway.
IMPLICATIONS: Large-dose propofol infusion induces multiple organ failure in rabbits. This effect is related to propofol itself, and not to its lipid vehicle.
IMPLICATIONS: Sedative doses of remifentanil increase blood flow in the cingulated, while reducing it in the hippocampus and amygdala. These changes do not occur in the presence of Apolipoprotein E4 polymorphism.
IMPLICATIONS: This randomized, controlled study compared single-dose, extended-release epidural morphine (EREM) with conventional epidural morphine for postoperative analgesia after Cesarean delivery. EREM 10 mg significantly improved analgesia and decreased supplemental opioid medication usage for 48 h post-Cesarean delivery versus conventional epidural morphine 4 mg.
IMPLICATIONS: We describe the management of a pregnant patient with visual loss, mental status changes, and severe preeclampsia, who was diagnosed as having posterior reversible encephalopathy syndrome. This syndrome is associated with symmetric hypodensities of the posterior gray and white matter and is usually reversible with prompt treatment.
IMPLICATIONS: Based on a three-dimensional computed tomographic investigation, the authors propose a novel supraclavicular approach to the right subclavian vein. A pilot study suggests the proposed approach works well.
IMPLICATIONS: The perioperative administration of celecoxib as part of a preventive multimodal analgesic technique results in a decrease in postoperative pain, opioid use, postoperative nausea and vomiting, and recovery room length of stay after anterior cruciate ligament surgery.
IMPLICATIONS: The administration of celecoxib as a component of a multimodal analgesic technique reduces long-term persistent pain and patellofemoral complications after anterior cruciate ligament reconstruction. Further, patients receiving celecoxib were more likely to return to their preinjury level of activity.
IMPLICATIONS: Perioperative oral controlled-release oxycodone reduces postoperative IV morphine consumption after lumbar discectomy, while providing good analgesia with a few side effects.
IMPLICATIONS: In this double-blind, randomized study, patients treated with thoracic epidural analgesia using ropivacaine and sufentanil had less impaired lung function after pulmonary lobectomy when compared with those using IV morphine analgesia.
IMPLICATIONS: Intraarticular administration of fadolmidine effectively suppressed experimental arthritic pain in the rat due to its action on peripheral {alpha}2-adrenoceptors and downstream, peripheral opioid-receptors. This finding suggests that intraarticular administration of fadolmidine may suppress arthritic pain with few, if any, central side effects.
IMPLICATIONS: Epidural droperidol, administered as a single bolus, continuous infusion, or combined bolus infusion, reduced pruritus, and postoperative nausea and vomiting, regardless of the method of administration.
IMPLICATIONS: In patients undergoing total knee arthroplasty with combined femoral and sciatic nerve blocks, continuous infusion of ropivacaine 0.2% provided similar analgesia compared with ropivacaine 0.3%, while 0.1% did not provide adequate analgesia.
IMPLICATIONS: Eliciting a tibial motor response predicts a higher success rate than eliciting a peroneal motor response with parasacral sciatic nerve block.
IMPLICATIONS: Glossopharyngeal nerve block (GNB) is a useful method for the palliation of posttonsillectomy pain. An obtunded gag reflex response may be a clinical indicator for analgesia from GNB.
IMPLICATIONS: We describe the first real-time application of three-dimensional ultrasound reconstruction for guiding the insertion of a popliteal nerve catheter for ankle surgery. Three-dimensional ultrasound technology may provide substantially better guidance during placement of peripheral nerve blocks than is possible with conventional two-dimensional ultrasound.
IMPLICATIONS: We report a case of pneumothorax in a patient after an otherwise uneventful coracoid infraclavicular brachial plexus block. Subtleties in landmark identification and measurement may affect the risk of pneumothorax.
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