Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Dec 2011
Biphasic effects of chronic intrathecal gabapentin administration on the expression of protein kinase C gamma in the spinal cord of neuropathic pain rats.
Patients suffering from neuropathic pain are difficult to treat and many methods are used to resolve this issue. In this study, we used a model of neuropathic pain comprising rats with chronic constriction injury (CCI) on the left sciatic nerve to investigate the chronic effect of gabapentin via intrathecal administration. We also observed the expression of dorsal spinal protein kinase C gamma subunit (PKCγ) and other pain-related molecules in the spinal area which included cyclooxygenase 2 (COX2), c-Fos and cyclic AMP-dependent transcription factor (ATF3) in the neuropathic pain animals. ⋯ Our results indicate that chronic intrathecal gabapentin has beneficial effects on the behaviors of both thermal and mechanical stimulations in the neuropathic pain animals and the NMDA blocker can potentiate this effect. Furthermore, gabapentin has biphasic effect on the expression of PKCγ in the spinal cord on Day 7 and Day 14 for the model rats with CCI.
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Acta Anaesthesiol Taiwan · Dec 2011
Randomized Controlled Trial Comparative StudyUse of laryngeal mask airway in children with upper respiratory tract infection, compared with face mask: randomized, single blind, clinical trial.
The incidence of postoperative cough (primary outcome) and adverse respiratory events (secondary outcome) in children who received anesthesia by laryngeal mask airway (LMA) with children who received anesthesia by face mask (FM) was compared in a blind randomized trial with uncomplicated upper respiratory track infection (URI) undergoing general anesthesia. Previous studies of pediatric patients with URI receiving anesthesia by endotracheal tube have reported a greater number of anesthetic complications; however reports concerning adverse effects in pediatric patients with URI receiving anesthesia by LMA or FM are scanty. ⋯ In children with uncomplicated URI, the administration of inhalation anesthetics in general anesthesia by LMA is likely to cause fewer adverse events than the use of FM.
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Acta Anaesthesiol Taiwan · Dec 2011
Review Case ReportsIncidence of cardiac arrest increases with the indiscriminate use of dexmedetomidine: a case series and review of published case reports.
Dexmedetomidine has predictable, complex, and negative cardiovascular effects that lead to additional adverse effects such as bradycardia and hypotension in up to 42% of patients and might cause profound left ventricular dysfunction and refractory shock. Usually, these temporary effects can be successfully counteracted with atropine, ephedrine, and volume supplementation. ⋯ Here, we report the clinical characteristics of six patients who were scheduled for various neurosurgical procedures within a period of three months and suffered from cardiac arrest following dexmedetomidine administration. We urge clinicians to take caution against the negative effects of dexmedetomidine, especially when it is used in patients older than 50 years with underlying cardiac disease and in combination with cardiodepressant drugs.
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Acta Anaesthesiol Taiwan · Dec 2011
Randomized Controlled TrialClosed-loop isoflurane administration with bispectral index in open heart surgery: randomized controlled trial with manual control.
Improved anesthetic agent delivery system (IAADS), a modification of closed-loop anesthesia delivery system (CLADS), is designed to deliver inhalational anesthetics and propofol through closed-loop control with bispectral index (BIS) as target. We compared the performance of IAADS with the manual control isoflurane administration during cardiac surgery. ⋯ The present study proves the feasibility and efficacy of inhalation anesthetic administration through closed-loop control. This is the first system that has been developed to control intravenous and inhalational anesthetic agents in a closed-loop model using BIS.