IMPLICATIONS: Sevoflurane and desflurane precondition isolated human myocardium through production of reactive oxygen species.
IMPLICATIONS: This observational study substantiated the clinical value of once-daily 2.5 mg fondaparinux given for 4 {+/-} 1 wk after major orthopedic lower limb surgery. The clinical value of fondaparinux was also observed in patients in whom specific recommendations for neuraxial/deep peripheral indwelling catheter removal were applied.
IMPLICATIONS: In primary amyloidosis, proliferation of plasma cells lead to an increased production of monoclonal immunoglobulins, some of which can form amyloid chains. We describe a patient who developed periorbital blistering purpura under the adhesive tape that was attributed to capillary fragility associated with deposition of amyloid.
IMPLICATIONS: Ketamine did not exacerbate pulmonary vascular resistance in children with pulmonary hypertension who were anesthetized with sevoflurane in air and breathing spontaneously.
IMPLICATIONS: This study evaluates the ability to administer positive pressure support ventilation through a laryngeal mask airway to anesthetized, spontaneously breathing children.
IMPLICATIONS: This evaluation trial suggests that the POVOC score for the prediction of postoperative vomiting (PV) in children allows for the risk for PV to be estimated in various patient populations and in different settings with acceptable accuracy.
IMPLICATIONS: Central venous oxygen saturation (ScvO2) accurately reflects cardiocirculatory function. However, venous catheters do not allow continuous measurement of ScvO2 in pediatric patients. Using an experimental and clinical approach, we determined the accuracy of a novel pediatric central venous catheter with integrated fiberoptic oximetry, correlated ScvO2 to periprocedural vital variables, and tested its feasibility in pediatric cardiac surgery patients.
IMPLICATIONS: Peripheral nerve blocks performed in pediatric patients under general anesthesia with a higher stimulation threshold (0.5 1 mA) have a similar success rate to those performed with lower stimulation thresholds (<=0.5 mA).
IMPLICATIONS: We present reference values for kaolin-activated thromboelastography (TEG(R)) in healthy children. Accurate interpretation of pediatric TEG results requires comparison to reference values that are age-, analyzer-, and activator-specific.
IMPLICATIONS: Evidence-based guidelines developed by an international multidisciplinary panel of experts and endorsed by Society for Ambulatory Anesthesia for the management of postoperative nausea and vomiting.
IMPLICATIONS: Bispectral Index-guided closed-loop administration of propofol could be optimized by implementing Bayesian technology. We applied simulations to select the Bayesian variances yielding the optimal closed-loop control system for propofol administration and found that this technique resulted in stable control and can be introduced safely into clinical testing.
IMPLICATIONS: Hemorrhagic shock decreased the minimum alveolar concentration of isoflurane depending on the severity of the shock, although the hypnotic effect shows great resistance to hemorrhagic shock. We propose that activation of the endogenous opioid system during hemorrhagic shock explains these phenomena.
IMPLICATIONS: Etomidate has structural and clinical similarities to {alpha}2-adrenoceptor agonists. Atipamezole, an {alpha}2-adrenoceptor agonist, significantly increased the half-maximal effective concentration of etomidate in tadpoles. In contrast, the sedative effects of etomidate were not reduced in wild-type or transgenic mice lacking the {alpha}2-adrenoceptor subtype. Thus the interaction between etomidate and {alpha}2-adrenoceptors is species-specific.
IMPLICATIONS: Findings in the present study indicate that targeting spinal CaMKII{alpha} might effectively reduce spinal-mediated pain behavior during the immediate postoperative period.
IMPLICATIONS: Compartmented neuron cultures allow for axon and soma to be selectively incubated. We provide first, albeit indirect, evidence that cell death after local anesthetic application may be caused by different processes, depending upon whether the entire cell, or only the axon, is incubated.
IMPLICATIONS: Windup of sacral dorsal horn neurons is a N-methyl-d-aspartate receptor-dependent increase in progressive response to repetitive C-fiber stimulation that is enhanced by increasing stimulus frequency and intensity. Windup is dose-dependently reduced by isoflurane in a manner that parallels the influence of temporal and spatial summation of noxious stimuli on anesthetic requirements.
IMPLICATIONS: The low aqueous solubility of nonpolar groups (hydrophobicity) is a powerful thermodynamic force determining the conformation, and thus the function, of macromolecules such as proteins. The inhaled anesthetic isoflurane does not affect the aqueous solubility of two simple nonpolar molecules (methane and toluene) in concentrations used for clinical anesthesia. These results argue against alteration in the aqueous solubility of nonpolar groups on macromolecules as a primary component of the mechanism of action of inhaled anesthetics.
IMPLICATIONS: Rewarming anesthetized volunteers from a core temperature of 34{degrees}C 36{degrees}C was accomplished 25% more rapidly using Kimberly Clark energy transfer pads than with the Allon circulating-water garment and twice as fast as with a forced-air warming system.
IMPLICATIONS: An earphone-type infrared tympanic thermometer was compared with esophageal temperature measurements in both general and cardiac surgery patients and found to agree within clinically acceptable limits for continuous core temperature monitoring.
IMPLICATIONS: For outpatients undergoing anterior cruciate ligament reconstruction and receiving regional anesthesia, the SF-8 is sufficient to assess postoperative pain, physical function, and mental function. Only the Quality of Recovery from Anesthesia (QoR)-40 physical comfort composite, but not the remainder of the QoR-40, was additionally helpful when compared with the SF-8.
IMPLICATIONS: An anesthesia department implemented scheduling of anesthetics outside of operating rooms by clerks and nurses from other departments using its hospital's enterprise-wide scheduling system. Experiments showed that improvements in the consistency and accuracy of patient instructions were sensitive both to the user interface and to the probabilities of anesthetics starting earlier than scheduled.
IMPLICATIONS: The frequency of intraoperative blood testing for noncardiothoracic cases was 13% before and after installation of point-of-care testing devices at a hospital.
IMPLICATIONS: The effects of arginine vasopressin in vascular KATP channels are enhanced by extracellular acidification, hence arginine vasopressin-induced vasoconstriction may be enhanced in shock.
IMPLICATIONS: The gum-elastic bougie can be used for retrogade intubation when the trachea is open.
IMPLICATIONS: The intracerebroventricular administration of dexmedetomidine to conscious rats results in a reduction in arterial blood pressure through sympathetic inhibition and a decrease in heart rate by sympathetic inhibition and vagal stimulation.
IMPLICATIONS: In this in vitro study using mouse hippocampus, the proseizure effect of morphine was mediated by {micro} and {kappa} opioid receptors.
IMPLICATIONS: Estimation of blood loss after simulated vaginal delivery using noncalibrated drapes was inaccurate, and the inaccuracy worsened as blood loss volume increased. Calibration of the vaginal delivery drape improved the accuracy of estimated blood loss.
IMPLICATIONS: Bibliometric analysis of clinical research publications from anesthesiology departments over a 6-yr period found that the United States leads in overall research productivity, whereas European countries have higher per capita research productivity.
IMPLICATIONS: In the hyperlordotic position, the patient's hips are above the feet and head. A case of bilateral femoral and sciatic neuropathies caused by this position is presented.
IMPLICATIONS: This report demonstrates the complications of extremely high levels of CO2 when the CO2 used for peritoneal insufflation cannot be removed through increased ventilation.
IMPLICATIONS: The laryngeal mask airway may be used as a bridge, in lieu of endotracheal intubation, in microdirect laryngoscopy cases in which ventilation during emergence may be difficult and the insertion of an endotracheal tube would disrupt the surgical procedure.
IMPLICATIONS: The ability of diagnostic spinal injections to improve surgical outcomes remains unproven. There is strong evidence for selective nerve root blocks, although the evidence supporting the use of preoperative discography is weak. There is no evidence to support the use of facet blocks or sacroiliac joint injections before spinal fusion.
IMPLICATIONS: In response to experimental pain, subjects reported subjective analgesia and demonstrated reductions in pain-related brain activity with either opioid administration or virtual reality distraction, whereas combining the two interventions further improved the two analgesic end points. These results provide preliminary data to support the clinical use of multimodal (e.g., combined pharmacologic and nonpharmacologic) analgesic techniques.
IMPLICATIONS: Postsurgical pain is associated with increased brain activity in regions usually identified with acute pain.
IMPLICATIONS: African Americans and people of low socioeconomic standing may be less likely to accept, and thus benefit from, perioperative epidural analgesia.
IMPLICATIONS: The cardiovascular adverse effects of nonselective nonsteroidal antiinflammatory drugs and cyclooxygenase-2 selective inhibitors will likely continue to be controversial. In the meantime, careful risk/benefit assessment should be undertaken and these drugs should be used with caution in patients with cardiovascular risks.
IMPLICATIONS: This report demonstrates the complexity of treating patients with long-term continuous intrathecal opioids when modest adjustment of the intrathecal cocktail results in a paradoxical clinical course.
IMPLICATIONS: Needlestick distal nerve injury in rats models several clinical and pathological features of human chronic regional pain syndrome, suggesting that even minor distal nerve injury can cause some of the abnormalities associated with chronic regional pain syndrome.
IMPLICATIONS: The present study aimed to assess the effects of spinal cyclic adenosine monophosphate (cAMP) on the nociceptive processing in a chronic neuropathic pain model. Our results showed that blockade of the cAMP pathway within 3 days could partially reverse the increase in phosphorylated cAMP response element-binding protein to partial sciatic nerve ligation-induced tactile allodynia and thermal hyperalgesia. Modulation of the cAMP pathway may be of clinical importance if there is early intervention in patients with chronic neuropathic pain.
IMPLICATIONS: Using a specific p38 mitogen-activated protein kinase inhibitor (MAPK), we demonstrated that p38 MAPK activation is part of the signaling cascade in the spinal cord that leads to synthesis of tumor necrosis factor-alpha and contributes to mechanical allodynia in a rat chronic constriction injury model of neuropathic pain.
IMPLICATIONS: This series of four cases describes the use of intraoperative ultrasonography performed by an anesthesiologist to facilitate surgical dissection of peripheral nerve tumors.
IMPLICATIONS: A multilevel paravertebral block provides good analgesia for breast surgery, but the duration of analgesia is briefer than described in previous studies.
IMPLICATIONS: Preclinical administered femoral nerve blockade effectively decreases pain, anxiety, and heart rate in patients after femoral trauma. Regional blockade is an option to be considered for out of hospital analgesia in the hands of the trained physician.
IMPLICATIONS: After a single attempt, the paramedian approach is associated with an increased success rate, compared with the midline approach, during continuous spinal anesthesia in elderly patients.
IMPLICATIONS: This report describes a piezoelectric needle and catheter design that permits distal tip visualization using color flow Doppler ultrasound. This method may be useful to confirm the location of the needle or catheter tip when performing regional anesthesia.
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