Anesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of auditory evoked potential index monitoring on anesthetic drug requirements and recovery profile after laparoscopic surgery: a clinical utility study.
The auditory evoked potential (AEP) monitor provides an electroencephalogram-derived index (AAI) that has been reported to correlate with the central nervous system depressant effects of anesthetic drugs. This clinical utility study was designed to test the hypothesis that AAI-guided administration of the maintenance anesthetics and analgesics would improve their titration and thereby provide a faster recovery from general anesthesia. ⋯ Use of AEP monitoring as an adjunct to standard clinical monitors improved titration of anesthetic drugs, thereby facilitating the early recovery process after laparoscopic surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Sevoflurane provides greater protection of the myocardium than propofol in patients undergoing off-pump coronary artery bypass surgery.
Sevoflurane, like other halogenated anesthetics, has been shown to have a protective effect on the myocardium at risk after an ischemic injury. The current study tested the hypothesis that such beneficial effects, so far mainly seen in the laboratory, are reproducible in humans. ⋯ Patients receiving sevoflurane for off-pump coronary artery surgery had less myocardial injury during the first 24 postoperative hours than patients receiving propofol. The results further support cardioprotective effects of sevoflurane.
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Comparative Study
Orally administered paracetamol does not act locally in the rat formalin test: evidence for a supraspinal, serotonin-dependent antinociceptive mechanism.
The mechanism of action of paracetamol (acetaminophen) remains elusive because it is still under discussion as to whether it acts locally and/or centrally. The primary aim of this study was to clarify its site(s) of action (central and/or local) using the rat formalin test. ⋯ Orally administered paracetamol does not seem to exert any relevant local action in the formalin model of tonic pain in rats, but it might activate the serotonergic bulbospinal pathways via a supraspinal site of action that remains to be elucidated.
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Comparative Study
Comparative neurotoxicity of intrathecal and epidural lidocaine in rats.
Although there is a considerable difference in the number of clinical reports of neurologic injury between spinal anesthesia and other regional techniques, there are no animal data concerning a difference in the local anesthetic neurotoxicity between intrathecal and epidural administration. In the current study, the functional and morphologic effects of lidocaine administered intrathecally and epidurally were compared in rats. ⋯ Persistent functional impairment occurred only after intrathecal lidocaine. Histologic damage in the nerve roots and the spinal cord was less severe after epidural lidocaine than after intrathecal lidocaine. The current results substantiate the clinical impression that neurologic complications are less frequent after epidural anesthesia than after spinal anesthesia.
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Comparative Study
The neuroprotective effect of xenon administration during transient middle cerebral artery occlusion in mice.
Xenon has been shown to be neuroprotective in several models of in vitro and in vivo neuronal injury. However, its putative neuroprotective properties have not been evaluated in focal cerebral ischemia. The purpose of this study was to determine if xenon offers neuroprotection in a mouse model of middle cerebral artery occlusion. ⋯ In this model of transient focal cerebral ischemia, xenon administration improved both functional and histologic outcome.