Anesthesia and analgesia
-
Anesthesia and analgesia · Oct 2007
The influence of venovenous renal replacement therapy on measurements by the transpulmonary thermodilution technique.
Use of the transpulmonary thermodilution technique has been suggested for extended hemodynamic monitoring in critically ill patients. However, many of these patients also require renal replacement therapy (RRT). Therefore, we analyzed the influence of venovenous RRT on measurement of cardiac index (CI), intrathoracic blood volume index (ITBVI), and extravascular lung water index (EVLWI). ⋯ RRT had no clinically relevant effect on measurement of CI, ITBVI, and EVLWI in patients with sepsis and maintained cardiac output. Furthermore, the dialysis catheter tip position had no significantly different influence under these conditions.
-
Anesthesia and analgesia · Oct 2007
Intravenous infusion of dexmedetomidine can prevent the degeneration of spinal ventral neurons induced by intrathecal morphine after a noninjurious interval of spinal cord ischemia in rats.
In recent studies, we demonstrated that neuraxial morphine after noninjurious spinal cord ischemia in the rat could induce spastic paraplegia and degeneration of selective spinal ventral neurons. Our objective was to investigate the impact of dexmedetomidine infusion on the degeneration of spinal ventral neurons induced by intrathecal (IT) morphine after spinal cord ischemia. ⋯ These data show that repetitive administration of IT morphine can induce paraplegia with degeneration of spinal ventral neurons, which can be attenuated by IV dexmedetomidine at a sedative dose. The use of dexmedetomidine may provide beneficial effects on neurological outcome after IT morphine after spinal cord ischemia in rats.
-
Anesthesia and analgesia · Oct 2007
Opioid-induced sedation in the postanesthesia care unit does not insure adequate pain relief: a case-control study.
Sedation can occur during intravenous titration of morphine for acute pain control in the postanesthesia care unit (PACU). We designed this case-control study to evaluate the relationship between opioid-induced sedation in the PACU and adequacy of early postoperative analgesia. ⋯ Clinically significant opioid-induced sedation in the PACU does not insure adequate self-reported pain relief.
-
Anesthesia and analgesia · Oct 2007
Editorial CommentFibrinogen and bleeding: old molecule--new ideas.