Anesthesia and analgesia
-
Anesthesia and analgesia · May 2007
Case ReportsUltrasound-guided infraclavicular block in an anticoagulated and anesthetized patient.
The author describes the use of ultrasound to facilitate a continuous infraclavicular brachial plexus block in a patient who had been anticoagulated with 5000 U of heparin. The procedure was done 2 h after the patient was anticoagulated, and his activated clotting time was 203 s. The patient had vascular checks with a laser Doppler monitor every hour and neurological checks every 12 h.
-
Anesthesia and analgesia · May 2007
Case ReportsCerebral oxygen desaturation after cardiopulmonary bypass in a patient with raynaud's phenomenon detected by near-infrared cerebral oximetry.
Raynaud's phenomenon is characterized by episodes of arterial vasospasm precipitated by cold stress, usually affecting the digits of the hands. There is controversy about the occurrence of vasospasm in internal organ systems. In this report, we present a case of Raynaud's peripheral vasospasm accompanied by cerebral oxygen desaturation as detected by near infrared cerebral oximetry after separation from cardiopulmonary bypass.
-
Anesthesia and analgesia · May 2007
Comparative StudyDisruption of attention and working memory traces in individuals with chronic pain.
Research has found that chronic pain disrupts attention and that this disruption can lead to significant functional impairment and decreased quality of life. We conducted the present study to examine how attention and memory are disrupted by chronic pain. ⋯ These findings point to a specific cognitive mechanism, the maintenance of the memory trace, that is affected by chronic pain during task performance. Cognitive function was not improved by short-term local analgesia.
-
Anesthesia and analgesia · May 2007
Comparative StudyLack in effects of therapeutic concentrations of dexmedetomidine and clonidine on the neuromuscular blocking action of rocuronium in isolated rat diaphragms.
We investigated the effects of the alpha-2 adrenoceptor agonists clonidine and dexmedetomidine on the neuromuscular blocking effect of rocuronium in vitro. ⋯ These results indicate that very high, but not therapeutic, concentrations of clonidine and dexmedetomidine enhance the neuromuscular blocking action of rocuronium, but this is not mediated by an agonist action on alpha-2 adrenoceptors.
-
Anesthesia and analgesia · May 2007
The "axillary tunnel": an anatomic reappraisal of the limits and dynamics of spread during brachial plexus blockade.
Various anatomic factors have been described as affecting the distribution of a solution injected around the brachial plexus. Using computerized axial tomography dye studies, we introduce a new concept. ⋯ We conclude that the brachial plexus is contained within a rigid-walled tunnel of variable dimensions, which we call the "axillary tunnel." The scapula/subscapularis complex, related to the subcoracoid point of resistance, may account for the differing patterns of dye distribution observed.