Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2006
The effect of electroencephalogram-targeted high- and low-dose propofol infusion on histopathological damage after traumatic brain injury in the rat.
Propofol is commonly used to sedate patients after traumatic brain injury. However, the dose-dependent neuroprotective effects of propofol after head trauma are unknown. We compared histopathological damage after 6 h of electroencephalogram-targeted high- and low-dose propofol infusion in rats subjected to controlled cortical impact (CCI). ⋯ Despite different levels of cortical neuronal function, there were no relevant differences in the short-term histopathological damage. These results challenge the view that the neuroprotective effect of propofol relates to the suppression of cerebral metabolic demand.
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Anesthesia and analgesia · Dec 2006
Case ReportsThe effect of too much intravenous lidocaine on bispectral index.
Systemic local anesthetics have beneficial perioperative properties and have an anesthetic-sparing effect. To assess depth of anesthesia during lidocaine infusion, it would be important to know the effect of systemic local anesthetics on bispectral index (BIS). ⋯ We report an inadvertent overdose of i.v. lidocaine in a patient monitored with BIS. BIS decreased to 0 for approximately 15 min, indicating that lidocaine and sevoflurane interact to decrease BIS.
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Anesthesia and analgesia · Dec 2006
Randomized Controlled Trial Comparative StudyThe posterior approach to the sciatic nerve in the popliteal fossa: a comparison of single- versus double-injection technique.
We compared single-injection and double-injection of the sciatic nerve with nerve stimulation in the posterior popliteal approach using mepivacaine 1% in a prospective, randomized and single-blind study to evaluate effectiveness, delay of onset, and complications in patients undergoing foot and ankle surgery. In the single-injection group (Group S, n = 30), 25 mL of mepivacaine 1% was administered after eliciting foot inversion or plantar flexion. In the double-injection group (Group D, n = 30), 12.5 mL of the solution was injected after eversion or dorsiflexion and 12.5 mL after plantar flexion of the foot. ⋯ Complete analgesia of the deep peroneal nerve was achieved in 80% and 97% in Group S and D, respectively; P < 0.05. There were more paresthesias during block procedure in Group D (17% vs 40%) (P < 0.05). We conclude that double-nerve stimulation of the sciatic nerve gives similar complete onset times and overall success rate to single-nerve stimulation and more paresthesias during block performance.
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Anesthesia and analgesia · Dec 2006
Randomized Controlled Trial Comparative StudyCombined spinal epidural does not cause a higher sensory block than single shot spinal technique for cesarean delivery in laboring women.
The combined spinal epidural (CSE) technique has been shown to result in a higher sensory block than an equivalent single shot spinal (SSS) in women undergoing elective cesarean delivery. We tested whether this is true also in laboring women who may have variable epidural pressures. ⋯ As compared with previous reports in nonlaboring parturients, the block characteristics of CSE in our study were indistinguishable from those of SSS in laboring parturients for cesarean delivery.