Anesthesiology
-
The authors devised a new method, the hyomental distance ratio (HMDR), for preoperatively identifying patients with a reduced occipitoatlantoaxial extension capacity, which was defined as the ratio of the hyomental distance in head extension position to that in the neutral position. They compared the accuracy of the HMDR with that of the Bellhouse test in 40 patients with rheumatoid arthritis. ⋯ The HMDR was a good predictor of a reduced occipitoatlantoaxial extension capacity in patients with rheumatoid arthritis, but the Bellhouse test was not a clinically reliable method.
-
Comparative Study
Comparison of arginine vasopressin, terlipressin, or epinephrine to correct hypotension in a model of anaphylactic shock in anesthetized brown Norway rats.
Arginine vasopressin (AVP) and terlipressin were proposed as alternatives to catecholamines in shock states characterized by decreased plasma AVP concentrations. The endogenous plasma AVP profile in anaphylactic shock is unknown. In an ovalbumin-sensitized anesthetized anaphylactic shock rat model, the authors investigated (1) plasma AVP concentrations and (2) the dose versus mean arterial pressure response for exogenous AVP and terlipressin and compared them with those of epinephrine. ⋯ In a rat model, anaphylactic shock is associated with inadequately low plasma AVP concentrations. For clinically relevant doses, AVP and epinephrine had comparable effects on mean arterial pressure and heart rate values, whereas, unexpectedly, terlipressin was ineffective. These results are consistent with reports in humans experiencing anaphylaxis where AVP injection restored arterial pressure.