Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2000
Comparative StudyThe comparative toxicity of ropivacaine and bupivacaine at equipotent doses in rats.
We compared the toxicity of systemic local anesthetics bupivacaine and ropivacaine administered at equivalent and equipotent doses. In the first experiments, 18 male Wistar rats were anesthetized with thiopental and maintained under positive controlled ventilation. Electrocardiogram, electroencephalogram, and invasive arterial blood pressure were continuously recorded. ⋯ In awake rats, all the animals intoxicated by ropivacaine easily recovered. In the bupivacaine group, two animals required cardiopulmonary resuscitation before any seizure activity could be detected, and only three rats survived. We conclude that, in the model used, ropivacaine, even at an equipotent dose, is less toxic than bupivacaine.
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Anesthesia and analgesia · Dec 2000
Clinical TrialCognition after coronary artery surgery is not related to postoperative jugular bulb oxyhemoglobin desaturation.
During the early postoperative period after coronary artery bypass grafting (CABG) surgery, many patients experience jugular bulb oxyhemoglobin desaturation (SjO(2) < 50%). We sought to determine whether SjO(2) during cardiopulmonary bypass and the early postoperative period influenced long-term cognitive performance after CABG surgery. One hundred two patients completed a battery of cognitive tests the day before and 3 mo after CABG surgery. ⋯ Intraoperatively, SjO(2) was determined by intermittent blood sampling, and postoperatively, the area under the curve of SjO(2) < 50% and time was calculated from continuous reflectance oximetry. No significant correlations between cognitive performance and either intra- or postoperative SjO(2) were found. Preoperative cognitive performance was the main determinant of cognition at 3 mo (r(2) = 0.83, P<0.001), and palpable atheroma of the ascending aorta made a small, but significant, contribution to a decline in cognition (r(2) = 0.018, P = 0.001).
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Anesthesia and analgesia · Dec 2000
Case ReportsAnesthesia for fetoscopic fetal surgery: twin reverse arterial perfusion sequence and twin-twin transfusions syndrome.
Twin reversed arterial perfusion sequence and twin-twin transfusion syndrome can be managed by fetoscopic fetal surgery. It is important to consider the fetal, uteroplacental, and maternal issues when choosing an anesthetic technique. We report on three patients with differing anesthetic issues using fetoscopic surgery for umbilical cord coagulation.
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Anesthesia and analgesia · Dec 2000
Aspiration in transtracheal oxygen insufflation with different insufflation flow rates during cardiopulmonary resuscitation in dogs.
We investigated whether transtracheal insufflation of oxygen with different insufflation flow rates protects against aspiration of gastric contents during cardiopulmonary resuscitation (CPR). Its ventilation and oxygenation effects were also evaluated. Cardiac arrest was induced in anesthetized and paralyzed 18 mongrel dogs. ⋯ We conclude that transtracheal oxygen insufflation, but not chest compression alone, was able to maintain oxygenation for 20 min during CPR in dogs with cardiac arrest. Mild hypercapnia was noted in all groups. Chest compression alone caused pulmonary aspiration, whereas insufflation of 10 L O(2)/min provided better protection against pulmonary aspiration than that of 4 L O(2)/min.
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Anesthesia and analgesia · Dec 2000
Xenon administration during early reperfusion reduces infarct size after regional ischemia in the rabbit heart in vivo.
The noble gas xenon can be used as an anesthetic gas with many of the properties of the ideal anesthetic. Other volatile anesthetics protect myocardial tissue against reperfusion injury. We investigated the effects of xenon on reperfusion injury after regional myocardial ischemia in the rabbit. ⋯ Xenon reduced infarct size from 51%+/-3% of the area at risk in controls to 39%+/-5% (P<0.05). Infarct size in relation to the area at risk size was smaller in the xenon-treated animals, indicated by a reduced slope of the regression line relating infarct size to the area at risk size (Control: 0.70+/-0.08, r = 0.93; Xenon: 0.19+/-0.09, r = 0.49, P<0.001). In conclusion, inhaled xenon during early reperfusion reduced infarct size after regional ischemia in the rabbit heart in vivo.