IMPLICATIONS: The trials that achieve the most effective control of heart rate are associated with a reduced incidence of postoperative myocardial infarction, suggesting that effective control of heart rate is important for achieving cardioprotection. This meta-analysis, however, demonstrates that administration of {beta}-blockers does not reliably decrease heart rates, and may be associated with increased side effects.
IMPLICATIONS: Maintenance of mitochondrial matrix volume due to potassium influx has been implicated in cardioprotection via KATP channel opening. Here, we show that sevoflurane increases mitochondrial matrix volume by opening KATP channels. These findings add to our understanding of the intracellular mechanisms of volatile anesthetics as cardioprotective drugs.
IMPLICATIONS: We found a positive correlation between hemoglobin levels on discharge and quality of life in elderly patients after primary hip arthroplasty. This should direct us to reconsider the appropriateness of a restrictive transfusion policy in this subgroup of patients.
IMPLICATIONS: A rapid and large transfusion of red blood cells (RBC) can result in hyperkalemia and cardiac arrest. Various conditions associated with hemorrhagic shock may worsen hyperkalemia and/or increase potassium cardiotoxicity during large RBC transfusions.
IMPLICATIONS: Using a porcine model, this study showed that treatment with a prothrombin complex concentrate improves coagulation after dilutional coagulopathy and reduces time to hemostasis with both venous and arterial bleeding.
IMPLICATIONS: When compared with fluid resuscitation using 6% hydroxyethyl starch (HES) 130/0.4 or 4% gelatin solution, small-volume resuscitation using 4 mL/kg hypertonic saline-HES might be preferable because the net effects of limited intravascular volume load and the preserved clot formation seem to reduce further blood loss.
IMPLICATIONS: During extracorporeal membrane oxygenation (ECMO), anticoagulation therapy is usually achieved with unfractionated heparin. We report on an ECMO with danaparoid sodium for a patient with massive pulmonary embolism and suspected type 2 heparin-induced thrombocytopenia.
IMPLICATIONS: In a study comparing plasma concentrations and target-controlled concentrations of propofol in children and young adults, the relationship between propofol and bispectral index in children appears to be less sensitive than in young adults.
IMPLICATIONS: Oral disintegrating tablets decrease at-home emesis in children undergoing tonsillectomy with or without adenoidectomy.
IMPLICATIONS: This study demonstrates that the end-tidal sevoflurane concentration needed for removal of a laryngeal mask airway and a laryngeal tube in children are similar.
IMPLICATIONS: During 1 yr of mandatory urine pregnancy testing on the day of elective orthopedic surgery, three unrecognized pregnancies and one unrecognized ectopic pregnancy were detected. Patient history would not have been a reliable screening mechanism. There was also one false positive and three false "weak positive" tests, all in perimenopausal patients.
IMPLICATIONS: We investigated what anatomical elements were associated with difficult intubation. Using the intubation difficulty scale, thyromental distance, increasing neck circumference, body mass index, and a Mallampati score >= 3 were associated with a higher incidence of a difficult intubation. Neck circumference should be included when assessing patients preoperatively to predict difficult intubation.
IMPLICATIONS: The i-gel is a new single-use supraglottic airway device with a noninflatable cuff and an esophageal vent. This first clinical study demonstrates a first insertion success rate of 97%, a mean leak pressure 30 {+/-} 7 cm H2O, average peak pressure 11 {+/-} 3 cm H2O, and a low morbidity rate.
IMPLICATIONS: After toll-like receptor 2 stimulation with peptidoglycan, morphine inhibits tumor necrosis factor and interleukin (IL)-6 production in human monocytes via the {micro} opioid receptors pathway. IL-10 is not a factor for this inhibition.
IMPLICATIONS: Our data suggest that sevoflurane and isoflurane are specific inducers of the ASK1-, MKK3/MKK6-p38 MAP kinase cascade in Jurkat T-cells. Sevoflurane-induced p38 activation and sevoflurane-mediated apoptosis are two uncorrelated phenomena. Since these changes are only induced by supra-clinical concentrations, their clinical relevance is uncertain.
IMPLICATIONS: Droperidol potently blocks human-ether-a-go-go-related gene potassium channels in the open and inactivated state. Aromatic residue at position 656 may participate in droperidol binding, and inactivation gating can induce a conformational state that optimizes droperidol binding to the channel. This finding provides a molecular mechanism for the previously reported QT interval prolongation under clinical administration of droperidol.
IMPLICATIONS: A pharmacokinetic/pharmacodynamic model with two sigmoidal curves connected by a intervening plateau describes the effect of sevoflurane on Bispectral Index and Narcotrend indices better than the classical Emax model with a single sigmoid curve. This new model might have advantages in studies where higher doses could result in electroencephalographic burst suppression.
IMPLICATIONS: A vibrotactile display can enhance information transfer to the anesthesiologist and improve response times to a simulated clinical critical incident.
IMPLICATIONS: The pleth variability index (Masimo Corp., Irvine, CA) is an automated method for calculating the respiratory-induced variation in the plethysmogram and follows similar changes in the arterial pulse pressure.
IMPLICATIONS: Automated estimation of the magnitude of arterial blood pressure change due to respiratory variation agrees with manual estimation, and supports identifying patients who are likely to respond to fluid administration.
IMPLICATIONS: Automatic calculation and real-time monitoring of arterial pulse pressure variation induced by mechanical ventilation is possible using a bedside monitor and, in contrast to the measurement of cardiac filling pressures, can reliably predict the hemodynamic effects of intravascular fluid administration during the immediate postoperative period of cardiac surgery.
IMPLICATIONS: This pharmacokinetic model provides a simplified dosage scheme for administering liquid sevoflurane using the AnaConDa anesthetic-conserving device to sedate mechanically ventilated intensive care patients.
IMPLICATIONS: Five cases are presented in which the Bonfils Retromolar Intubation FiberscopeTM was used for awake orotracheal intubation.
IMPLICATIONS: Anesthetic management for insertion of a Dumon stent to seal a large tracheoesophageal fistula is difficult because of the care needed to prevent aspiration of esophageal contents and diversion of oxygen through the fistula into the stomach from the trachea when patients are under mechanical ventilation. Our method of sealing a large tracheoesophageal fistula with a Sengstaken-Blakemore tube was performed successfully, and seems to be simple but effective for this purpose.
IMPLICATIONS: We report three cases of successful bilateral, ultrasound-guided, continuous ilioinguinal-iliohypogastric nerve block for pain relief after cesarean delivery.
IMPLICATIONS: Current and predicted increases in age-adjusted population are often used to justify expansion of healthcare facilities to satisfy expected future demand. Analysis of operative data from three hospitals showed that annual changes in local population can be of no value in predicting their annual increases in anesthesia workload. At one hospital, operating room time increased despite a decline in the local population, including elderly.
IMPLICATIONS: Previous statistical analyses of operating room (OR) information systems databases have shown the importance of estimating OR case durations using a combination of scheduled procedure(s), surgeon, and type of anesthetic. A systematic review of general thoracic surgery articles identified those same data to be the principal predictors of case duration, emphasizing the importance of relying on all of these data.
IMPLICATIONS: We investigated the effect of treatment with two concentrations of desflurane on the properties of mitochondria isolated from rats subjected to forebrain ischemia and compared it with the effect of halothane. Better preservation of mitochondrial function was observed in the desflurane group when compared with the halothane group, which was assessed at 4 h after reperfusion.
IMPLICATIONS: A single, preoperative IV dose of dexamethasone 40 mg has a prolonged suppressive effect on the inflammatory response and dynamic pain after total hip arthroplasty. Single-dose glucocorticoids may be a useful addition to multimodal postoperative analgesia.
IMPLICATIONS: The perioperative administration of celecoxib, a cyclooxygenase (COX)-2 inhibitor, reduces postoperative pain and opioid consumption after major orthopedic surgery. In addition, this COX-2 inhibition has important long-term outcome benefits after total knee arthroplasty, including improved knee function scores and less time to achieve effective joint range of motion.
IMPLICATIONS: We found that ketamine, but not calcitonin, reduced the intensity of chronic phantom limb pain compared to placebo. This study confirms the potential usefulness of N-methyl-d-aspartate-antagonists in the treatment of this difficult pain condition and suggests further research for the translation of this knowledge into benefits for patients.
IMPLICATIONS: Real-time fluoroscopy with contrast enhancement should be performed during the lumbar medial branch block procedure to increase diagnostic and therapeutic values and to avoid complications.
IMPLICATIONS: The function of the lumbosacral nerve roots is altered in patients with a sacralized L5 or lumbarized S1. Therefore, in patients receiving epidurals or selective nerve root injections, one should be aware of a transitional segment before initiating the injection.
IMPLICATIONS: We describe a patient who experienced repeated episodes of transient global amnesia as an adverse effect of intrathecal baclofen. Although such profound memory loss due to baclofen may be unique, this case draws the attention of clinicians to mild memory impairment as an occasional adverse effect. The discovery of exacerbating and alleviating factors may provide insight into the rare and poorly understood phenomenon of transient global amnesia.
IMPLICATIONS: Deep surgical wounds can produce spinal upregulation of both cyclooxygenase-1 and -2 in selective cell types coincident with postoperative pain.
IMPLICATIONS: This study evaluated the effect of the benzodiazepine, midazolam, on thermal hyperalgesia in a neuropathic pain model. Our results suggested that {gamma}-aminobutyric acid (GABA) inhibition may be attenuated after peripheral nerve injury and that this may contribute to resulting hyperalgesia. Our results imply that systemic administration of benzodiazepines prevents loss of the GABA transporter protein and that this class of drugs could be of help in alleviating symptoms of neuropathic pain.
IMPLICATIONS: The noxious-induced withdrawal model combined with spinal Fos-immunoreactivity is a useful model for evaluating the differential effects of inhaled anesthetics and opioids on nociceptive processing during general anesthesia in rats.
IMPLICATIONS: Milnacipran showed antinociceptive, antiallodynic, and antihyperalgesic effects in mice with spinal nerve ligation. The analgesic effects may be mediated by an action at a supraspinal and spinal site via an activation of spinal noradrenaline and serotonin neurons.
IMPLICATIONS: Continuous femoral nerve blockade for postoperative analgesia after total knee arthroplasty was established with a stimulating or a nonstimulating catheter technique. We found no difference in opioid requirements, sensory blockade, and pain scores using these two techniques. The nonstimulating technique may be preferable because of its simplicity of insertion.
IMPLICATIONS: Serotonin is an essential central nociceptive-modulating neurotransmitter. Blockade of 5-HT3 receptors after IV administration of granisetron is associated with a faster regression of sensory blockade after spinal bupivacaine.
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.