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
An instrument designed for faculty supervision evaluation by anesthesia residents and its psychometric properties.
We aimed 1) to develop a valid and reliable instrument for faculty supervision evaluation by anesthesia residents and 2) to disclose the sources of error in residents' ratings. ⋯ The nine-item instrument produced valid and reliable measures of faculty supervision. However, a significant amount of halo effect biased such measures. G-studies may help identify the type and magnitude of rater biases affecting resident-generated faculty supervision evaluations, and can be useful for interpreting their results, especially if personnel decisions (e.g., tenure, promotion) rely on such measures.
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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.
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Anesthesia and analgesia · Oct 2008
Randomized Controlled Trial Comparative StudyA randomized double-blinded comparison of phenylephrine and ephedrine infusion combinations to maintain blood pressure during spinal anesthesia for cesarean delivery: the effects on fetal acid-base status and hemodynamic control.
Phenylephrine and ephedrine are both used to maintain arterial blood pressure during spinal anesthesia for cesarean delivery. Usually, either drug is given alone but several previous studies have described combining the drugs. However, the effect of varying the proportion of vasopressors in such combinations has not been reported. ⋯ When varying combinations of phenylephrine and ephedrine were given by infusion to maintain arterial blood pressure during spinal anesthesia for cesarean delivery, as the proportion of phenylephrine decreased and the proportion of ephedrine increased, hemodynamic control was reduced and fetal acid-base status was less favorable. Combinations of phenylephrine and ephedrine appear to have no advantage compared with phenylephrine alone when administered by infusion for the prevention of hypotension associated with spinal anesthesia for cesarean delivery.
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Anesthesia and analgesia · Oct 2008
Randomized Controlled TrialThe effect of dexmedetomidine on perioperative hemodynamics in patients undergoing craniotomy.
The perioperative course of patients undergoing intracranial surgery is frequently complicated by hypertensive episodes. Dexmedetomidine (DEX), an alpha-2 adrenoreceptor agonist, is gaining popularity in neuroanesthesia, because its sympatholytic and antinociceptive properties may improve hemodynamic stability at critical moments of surgery. We designed this study to assess the efficacy of DEX in controlling hypertensive responses in patients undergoing intracranial surgery. ⋯ By using indices, which assess a global hemodynamic stability of the anesthetic, we determined that intraoperative DEX infusion was effective for blunting the increases in SBP perioperatively. The use of DEX did not increase the incidence of hypotension or bradycardia, common side effects of the drug.