Anesthesiology
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Previous studies have reported a greater frequency of sensitization to latex in the female population and a higher incidence of anaphylactic reactions to latex during cesarean section. In this study, the authors investigated the prevalence of latex sensitization in obstetric patients compared with nonpregnant subjects. ⋯ The authors report a higher prevalence of latex sensitization in the obstetric population than in nonpregnant subjects undergoing gynecologic surgery.
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Cortical γ oscillations are thought to play a role in conscious cognitive functions. Suppression of 40-Hz γ activity was implicated in the loss of consciousness during general anesthesia. However, several experimental studies found that γ oscillations were preserved in anesthesia. The authors investigated the concentration-dependent effect of isoflurane on spontaneous γ oscillations in two frequency bands and three distinct brain regions in the rat. ⋯ Distinction between high- and low-frequency γ bands is important when evaluating the effect of general anesthetics on brain electrical activity. Spontaneous 40-Hz γ power does not indicate the state of consciousness. The attenuation and interregional desynchronization of high-frequency γ oscillations appear to correlate with the loss of consciousness.
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Neuropathic pain alters opioid self-administration in rats. The brain regions altered in the presence of neuropathic pain mediating these differences have not been identified, but likely involve ascending pain pathways interacting with the limbic system. The amygdala is a brain region that integrates noxious stimulation with limbic activity. ⋯ μ-Opioid receptors in the lateral amygdala partially meditate heroin's antiallodynic effects and self-administration after peripheral nerve injury. The lack of effect of β-funaltrexamine on heroin self-administration in sham-operated subjects suggests that opioids maintain self-administration through a distinct mechanism in the presence of pain.
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Vasopressors, such as norepinephrine, are frequently used to treat perioperative hypotension. Increasing perfusion pressure with norepinephrine may increase blood flow in regions at risk. However, the resulting vasoconstriction could deteriorate microcirculatory blood flow in the intestinal tract and kidneys. This animal study was designed to investigate the effects of treating perioperative hypotension with norepinephrine during laparotomy with low fluid volume replacement. ⋯ In this model of abdominal surgery in which clinical conditions were imitated as close as possible, treatment of perioperative hypotension with norepinephrine had no adverse effects on microcirculatory blood flow or tissue oxygen tension in the intestinal tract.