Anesthesia and analgesia
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Nerve stimulators are widely used to assist with peripheral nerve blocks but do not eliminate the risk of nerve injury. We evaluated the histologic findings 6 h after sciatic nerve block with bupivacaine in pigs. ⋯ No signs of inflammation were observed when the muscle contraction was achieved with a current between 0.3 and 0.5 mA (P = 0.03). In conclusion, the current required to elicit a motor response, the position of the needle tip, and the subsequent likelihood of nerve damage merit further evaluation.
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Anesthesia and analgesia · Dec 2005
The relationship between salivary biomarkers and state-trait anxiety inventory score under mental arithmetic stress: a pilot study.
Measurement of stress hormones is a common objective method for assessment of mental stress. However, the stress of blood sampling alone may also increase stress hormone levels. ⋯ The STAI-s was significantly correlated to salivary alpha-amylase (r = 0.589; P < 0.01) but not to salivary chromogranin-A or cortisol. Therefore, salivary alpha-amylase is a useful indicator of psychosocial stress.
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Anesthesia and analgesia · Dec 2005
Randomized Controlled TrialCardiac output measurement using the transesophageal Doppler method is less accurate than the thermodilution method when changing PaCO2.
Cardiac output (CO) determination using transesophageal Doppler is based on the measurement of descending aortic blood flow. Because cerebral blood flow is dependent on PaCO2, an increase in PaCO2 would result in an increase of CO because of the increase in cerebral blood flow and vice versa. We enrolled 30 patients undergoing off-pump coronary artery graft surgery in the study. ⋯ On the other hand, there were no significant differences in CO by transesophageal Doppler: 3.85 +/- 0.76 L/min at PaCO2 of 40 mmHg and 3.77 +/- 0.74 at 30 mmHg. Bland-Altman analysis yielded bias and precision of -0.32 and 0.49 L/min at PaCO2 of 40 mmHg, and -0.01 and 0.34 L/min at 30 mmHg. These results indicate that both methods of CO measurement are in agreement at 30 mmHg of PaCO2, but the thermodilution method provides higher values at 40 mmHg of PaCO2.
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Anesthesia and analgesia · Dec 2005
Inhibition of mitochondrial permeability transition enhances isoflurane-induced cardioprotection during early reperfusion: the role of mitochondrial KATP channels.
Inhibition of the mitochondrial permeability transition pore (mPTP) mediates the protective effects of brief, repetitive ischemic episodes during early reperfusion after prolonged coronary artery occlusion. Brief exposure to isoflurane immediately before and during early reperfusion also produces cardioprotection, but whether mPTP is involved in this beneficial effect is unknown. We tested the hypothesis that mPTP mediates isoflurane-induced postconditioning and also examined the role of mitochondrial KATP (mKATP) channels in this process. ⋯ Neither atractyloside nor 5-HD alone affected infarct size, but these drugs abolished protection by 1.0 MAC isoflurane, 10 mg/kg CsA, and 0.5 MAC isoflurane plus 5 mg/kg CsA. The results indicate that mPTP inhibition enhances, whereas opening abolishes, isoflurane-induced postconditioning. This isoflurane-induced inhibition of mitochondrial permeability transition is dependent on activation of mitochondrial KATP channels in vivo.
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Anesthesia and analgesia · Dec 2005
Case ReportsThe Cohen flexitip endobronchial blocker: an alternative to a double lumen tube.
One-lung ventilation (OLV) is usually achieved by the use of a double-lumen tubes (DLTs). With increasing need for use of OLV for video-assisted thoracoscopic procedures, the limitations of traditional DLT's, including difficult insertion and positioning, have become evident. This has led to renewed interest in devising alternative methods of achieving lung separation, such as the Univent tube or Arndt endobronchial blocker. This report describes the technical features and clinical use of a new tip-deflecting endobronchial blocker.