Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2008
Biography Historical ArticleGaston Labat's Regional Anesthesia: the missing years.
Gaston Labat's textbook Regional Anesthesia: Its Technique and Clinical Application was one of the earliest regional anesthesia texts, and certainly one of the most successful. Although Dr. Labat was working on a third edition at the time of his death, its fate and the reason for a more than 30-year delay in publishing a third edition have often been speculated upon. ⋯ Lundy Archive revealed communications between Dr. Lundy and Labat's widow which help explain the delay. Further searches into the collections of John Adriani, MD, help explain how he came to be the one to publish the long-awaited third edition.
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Anesthesia and analgesia · Oct 2008
Etomidate has no effect on hypoxia reoxygenation and hypoxic preconditioning in isolated human right atrial myocardium.
We examined the effects of etomidate on recovery of contractile function after hypoxia reoxygenation and hypoxic preconditioning in vitro using isolated human myocardium. ⋯ Etomidate did not modify the in vitro FoC of human myocardium exposed to HR. Furthermore, etomidate did not modify the protective effect of hypoxic preconditioning.
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Anesthesia and analgesia · Oct 2008
Randomized Controlled Trial Comparative StudyPlanning for early emergence in neurosurgical patients: a randomized prospective trial of low-dose anesthetics.
For early detection of a cerebral complication, rapid awakening from anesthesia is essential after craniotomy. Systemic hypertension is a major drawback associated with fast tracking, which may predispose to formation of intracranial hematoma. Although various drugs have been widely evaluated, there are limited data with regards to use of anesthetics to blunt emergence hypertension. We hypothesized that use of low-dose anesthetics during craniotomy closure facilitates early emergence with a decrease in hemodynamic consequences. ⋯ Pain during surgical closure may be an important cause of sympathetic stimulation leading to emergence hypertension. The use of low-doses of fentanyl during craniotomy closure is more advantageous than propofol or isoflurane for early emergence in neurosurgical patients and is the most effective technique for preventing early postoperative hypertension.
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IV lidocaine (1.5 mg/kg) administered to facilitate endotracheal intubation was associated with transient bronchospasm in a 17-month-old-female with mild intermittent asthma. Immediately after lidocaine administration, the patient developed diffuse bilateral expiratory wheezes and dramatic increases in peak inspiratory pressure. ⋯ This is consistent with recent clinical studies suggesting that IV lidocaine may cause airway narrowing in asthmatics. Practitioners should be aware of this potential complication.
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Anesthesia and analgesia · Oct 2008
Production of endothelin-1 and reduced blood flow in the rat kidney during lung-injurious mechanical ventilation.
The mechanisms by which mechanical ventilation (MV) can injure remote organs, such as the kidney, remain poorly understood. We hypothesized that upregulation of systemic inflammation, as reflected by plasma interleukin-6 (IL-6) levels, in response to a lung-injurious ventilatory strategy, ultimately results in kidney dysfunction mediated by local endothelin-1 (ET-1) production and renal vasoconstriction. ⋯ Lung-injurious MV for 4 h in healthy rats results in significant production of renal ET-1 and in decreased RBF, independent of IL-6. Decreased RBF has no observable effect on kidney function or histology.