Anesthesia and analgesia
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Anesthesia and analgesia · Oct 1994
Randomized Controlled Trial Clinical TrialPrevention of endotracheal tube-induced coughing during emergence from general anesthesia.
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Anesthesia and analgesia · Oct 1994
Prevention of occupational transmission of human immunodeficiency virus and hepatitis B virus among anesthesiologists: a survey of anesthesiology practice.
In light of the increasing prevalence of the human immunodeficiency virus (HIV) and hepatitis B virus (HBV), anesthesiologists are now likely to see more patients who are at high risk for these viruses. Therefore, it is important that they adopt infection control policies aimed at preventing occupational transmission of these and other pathogens during their clinical practice. This study was designed, using a questionnaire format, to evaluate anesthesiologist compliance with Centers for Disease Control (CDC) guidelines for the prevention of occupational transmission of HIV and HBV. ⋯ However, anesthesiologists who reported recapping needles using the one-handed technique were less likely to sustain a needlestick injury than those who recapped using the two-handed technique. Thirty-one percent and 72% of respondents respectively reported a clean or contaminated needlestick within the preceeding 12 mo. Only 45.4% of those receiving a contaminated needlestick sought treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Oct 1994
Comparative StudyIntracranial volume/pressure relationship during desflurane anesthesia in dogs: comparison with isoflurane and thiopental/halothane.
Desflurane-induced increase of intracranial pressure (ICP) does not appear to be completely explained by desflurane-induced changes in cerebral blood flow, cerebrospinal fluid (CSF) formation and reabsorption, or brain tissue water content. The present study was designed to determine whether desflurane alters intracranial volume/pressure relationships sufficiently to account for desflurane-induced increase of ICP. In 24 dogs, infusions of mock CSF were used to determine the CSF pressure increase due to increase of CSF volume, and the capacity of CSF pressure to return to baseline after a CSF pressure increase (CSF pressure normalization). ⋯ However, desflurane and isoflurane had no consistent effect on the other measures of CSF pressure increase caused by increase of CSF volume. Isoflurane also decreased the capacity for CSF pressure normalization at normal CSF pressure as indicated by decreased S1 and increased delta Ps. It is concluded that, under conditions of normal ICP, desflurane may decrease Ce, favoring an increase of ICP.
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Anesthesia and analgesia · Oct 1994
Comparative StudyProlonged analgesia and decreased toxicity with liposomal morphine in a mouse model.
Inadequate control of postoperative pain remains a major clinical problem. A reliable method of providing long-lasting postoperative analgesia with a single dose would be very useful. We synthesized a liposomal morphine formulation and compared it to free morphine with regard to duration of analgesia in the mouse. ⋯ In vitro experiments showed a slow release rate of morphine from the liposome depot. Prolonged analgesia and decreased systemic toxicity for liposomal morphine are explained by sustained release of morphine from the liposomal depot. These results suggest that liposomal narcotic formulations may provide prolonged analgesia with single-dose administration.
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Anesthesia and analgesia · Oct 1994
The difference of isoflurane and halothane in ventriculoarterial coupling in dogs.
Effective arterial elastance (Ea) and left ventricular end-systolic elastance (Ees) are used as indices of cardiac afterload and cardiac contractility, respectively. We compared the effects of two volatile anesthetics, halothane and isoflurane, on ventriculoarterial coupling using an index of Ea/Ees in 20 mongrel dogs. Ees was obtained using a single-beat estimation technique. ⋯ The decreases in cardiac output and Ees were not significantly different between halothane and isoflurane. Halothane increased Ea/Ees from 0.83 +/- 0.05 to 1.22 +/- 0.13, whereas isoflurane maintained the Ees/Es at a constant level. Our results suggest that mechanical efficiency is well maintained during isoflurane anesthesia because it has an equivalent effect on left ventricular contractility and arterial properties, whereas halothane can impair mechanical efficiency by depressing left ventricular contractility more than the arterial system.