IMPLICATIONS: Maintaining adequate systemic oxygen delivery after the Norwood procedure by balancing pulmonary and systemic blood flows is critical to improved early postoperative mortality. This review discusses the role of the {alpha}-adrenergic blocking drug, phenoxybenzamine, in helping to achieve this balance.
IMPLICATIONS: The results of this study support the hypothesis that exposure to sevoflurane during the early minutes of reperfusion (anesthetic postconditioning) attenuates reperfusion injury resulting in preservation of myocardial function and decreased infarct size comparable to anesthetic preconditioning. The combination of anesthetic preconditioning and postconditioning offered no additional benefit over either intervention alone.
IMPLICATIONS: Sphingosylphosphorylcholine induces coronary vasocontriction via activation of Rho kinase. Sevoflurane, but not propofol, inhibits this pathway, resulting in prevention of vasoconstriction.
IMPLICATIONS: Airway management of a patient undergoing right upper-lobe surgery after left pneumonectomy was accomplished using a left-sided endobronchial tube placed in the bronchus intermedius.
IMPLICATIONS: The frequency of anesthesia-related cardiac arrests is increased in patients with congenital heart disease undergoing cardiac surgery, but is not associated with an increase in mortality. Neonates and infants are at higher risk.
IMPLICATIONS: The Pediatric Perioperative Cardiac Arrest (POCA) registry is a voluntary database that records the incidence of cardiac arrest in children undergoing anesthesia. We analyzed the incidence of cardiac arrest from the POCA Registry from the years 1998 through 2004.
IMPLICATIONS: Neonatal-onset multi-system inflammatory disease (NOMID) is a rare autosomal dominantly inherited autoinflammatory disease characterized by seemingly unprovoked episodes of inflammation, recurrent fever, chronic aseptic meningitis, developmental delay, papilledema, and sensory organ involvement. An understanding of its clinical manifestations and respective implications are important for the anesthetic care of children with NOMID.
IMPLICATIONS: Many children have poor understanding of assent information for research. This study suggests that use of an informational form that considers the age and reading abilities of the child participant results in improved understanding and acceptance of the information.
IMPLICATIONS: In patients with bidirectional Glenn shunts, the size of the right internal jugular vein is not affected by liver compression or the Trendelenberg position.
IMPLICATIONS: The removal of dentures in edentate patients before their entering the operating room has been a well-honored tradition for decades. The authors demonstrate that bag-mask ventilation is easier and more successful if dentures are left in place.
IMPLICATIONS: This study evaluated the sedative, anxiolytic, analgesic, and hemodynamic effects of 1 and 1.5 {micro}g/kg dexmedetomidine administered intranasally in healthy volunteers. Both doses produced significant sedation. The intranasal route is effective, well tolerated, and convenient for the administration of dexmedetomidine.
IMPLICATIONS: The minimum alveolar concentration (MAC) of isoflurane is a quantitative trait because it varies continuously in a population. Using two mouse strains differing in isoflurane MAC, we identified a quantitative trait loci for isoflurane MAC on mouse chromosome 7. This chromosome contains genetic elements influencing the MAC of isoflurane.
IMPLICATIONS: Neurotransmitters that are coreleased onto anesthetic-sensitive receptors may modulate the function of receptors for which they are not the native agonist via an anesthetic-like mechanism.
IMPLICATIONS: The plasticizer di(2-ethylhexyl) phthalate modulates the function of both {gamma}-amino butyric acid type A and glycine receptors.
IMPLICATIONS: None of the monitors used today has proved effective for the early detection of one-lung intubation. In this study, one-lung ventilation sounds were collected from anesthetized patients during induction in order to investigate the efficacy of a new Auto-Regressive model of acoustic analysis for the detection of one-lung intubation.
IMPLICATIONS: A survey of 18 institutions using anesthesia information management systems revealed that, in many cases, system configurations may increase exposure to billing denial, Centers for Medicare and Medicaid Services noncompliance, security breeches, and medical legal defense difficulties. Configuration standards are needed to address these problems and to provide guidance for institutions using this technology.
IMPLICATIONS: Continuous patient monitoring by pulse oximetry and capnometry during narcotic administration via patient-controlled analgesia suggests that the incidence of desaturation and bradypnea exceeds that documented by intermittent monitoring. Continuous monitoring may be important to prevent adverse events related to narcotic administration, but additional research is needed to reduce the rate of false positive alarms and to understand the true incidence of this problem.
IMPLICATIONS: For cultural and social reasons, anesthesia providers make decisions that increase personal clinical work load, even though such decisions may be economically unsound and increase patient and surgeon waiting times. Command displays showed promise in mitigating this tendency.
IMPLICATIONS: Anesthesiologists made managerial decisions that increased the clinical work per unit time at each operating room (OR) to which they were assigned. Although sound for decisions involving individual ORs, this heuristic (i.e., simplified, rule-of-thumb approach) was then applied to decisions involving multiple ORs resulting in unnecessary overutilized OR time, unpredictable work hours, etc.
IMPLICATIONS: Inpatient satisfaction can be improved by an organization in which there are surgical suite nurses dedicated only to anesthesia (e.g., in holding area, for regional blocks, and upon operating room entrance); a written anesthesia information leaflet is given during the preoperative visit, and there are two postoperative visits.
IMPLICATIONS: A hospital implemented a policy such that when a major error in patient readiness for anesthesia and surgery was found in the holding area, the patient was always returned to the parent department and the surgical procedure delayed. The result was a progressive reduction in the incidence of such errors.
IMPLICATIONS: Pulse oximeter plethysmography wave forms can be used to predict fluid responsiveness. This observational study of fully sedated and ventilated patients after cardiac surgery shows that the change in plethysmographic wave forms induced by ventilation acts as a more accurate variable of fluid responsiveness than the more classic nondynamic variables such as central venous pressure and pulmonary artery occlusion pressure.
IMPLICATIONS: Thoracic epidural analgesia partly restores pulmonary vasoreactivity in acute experimental pancreatitis.
IMPLICATIONS: Distention of the epidural space before epidural catheter placement was associated with fewer intravascular catheter insertions and fewer unblocked segments.
IMPLICATIONS: Despite inducing hypercoagulability with liberal intravascular fluid administration, overall functional recovery was not dependent on the amount of fluid administered in knee arthroplasty surgery.
IMPLICATIONS: Advances in endourology using laser technology have resulted in procedures for prostate reduction that are as effective as classic transurethral resection of the prostate (TURP) but that nearly eliminate the risk for TURP syndrome. More options for anesthetic management may now be available, including general anesthesia and the ability to perform these procedures on an outpatient basis.
IMPLICATIONS: Dexamethasone improves postoperative analgesia as a component of a multimodal regimen that includes rofecoxib, fentanyl, and bupivacaine.
IMPLICATIONS: Although some patients may benefit from repeating the intradiscal electrothermal therapy procedure, pain reduction may be less pronounced and shorter-lived than after the initial procedure.
IMPLICATIONS: Through the use of functional magnetic resonance imaging, we found that propofol-based general anesthesia suppresses acupuncture-induced blood oxygenation level-dependant signals in several areas of the brain.
IMPLICATIONS: This study suggests that ropivacaine at 0.05% with 4 {micro}g/mL fentanyl is sufficient for preserving gastrointestinal motility, analgesia, and motor function for patients undergoing gynecologic lower abdominal surgery.
IMPLICATIONS: The patients who received EMLA(R) cream had less pain with needle puncture as well as throughout the performance of humeral block.
IMPLICATIONS: In adolescents, clonidine 1 {micro}g/kg prolonged the duration of sensory block achieved with bupivacaine by 30 min and postoperative analgesia by 120 min without severe adverse events.
IMPLICATIONS: The ED50 and ED95 for spinal ropivacaine in lower limb surgery of 50 min duration or less were 7.6 and 11.4 mg, respectively. This provides a useful guide for clinicians to choose the optimal dose of spinal ropivacaine under different clinical situations.
IMPLICATIONS: Tramadol has dose- and time-dependent bactericidal activity against Escherichia coli and Staphylococcus epidermidis as well as antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa. The antibacterial properties of tramadol may be useful for reducing the risk of bacterial infection after local or regional anesthesia.
IMPLICATIONS: Tibial evoked motor response predicts a better success rate than common peroneal response for the mid-femoral sciatic nerve block with a single injection.
IMPLICATIONS: The duration of spinal blockade is decreased in patients who are chronic opium abusers compared with nonabusers.
To see an article, click its [Full Text] or [PDF] link. To review many abstracts, check the boxes to the left of the titles you want, and click the 'Get All Checked Abstract(s)' button. To see one abstract at a time, click its [Abstract] link.