Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2008
The influence of age on the dynamic relationship between end-tidal sevoflurane concentrations and bispectral index.
Age is an important determinant of the pharmacokinetic profile of inhaled anesthetics. The influence of age on the dynamic profile of sevoflurane's effect has not been well described. We performed this study to characterize the influence of age and other covariates on the dynamic relationship between sevoflurane end-tidal concentration (C(ET)) and its effect measured by bispectral index (BIS). ⋯ Age significantly affects the dynamic relationship between sevoflurane C(ET) and its effect measured with BIS.
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Anesthesia and analgesia · Nov 2008
Case ReportsEndobrochial blockade through a tracheostomy tube for lung isolation.
We present an alternative technique for one-lung ventilation as safe way of treating patients with tracheostomy using a fiberoptic bronchoscope and a Fogarty catheter.
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Anesthesia and analgesia · Nov 2008
Case ReportsA rapidly enlarging neck mass: the role of the sitting position in fiberoptic bronchoscopy for difficult intubation.
Difficult airway management is a dilemma for any anesthesiologist. Although practice guidelines and algorithms may help in such situations, the anesthesiologist's judgment and vigilance remain the primary means to save lives. ⋯ Therefore, there were few safe strategies for airway management for general anesthesia. We reiterate the role of awake fiberoptic intubation in such circumstances.
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Anesthesia and analgesia · Nov 2008
The effects of volatile aromatic anesthetics on voltage-gated Na+ channels expressed in Xenopus oocytes.
Many inhaled anesthetics inhibit voltage-gated sodium channels at clinically relevant concentrations, and suppression of neurotransmitter release by these anesthetics results, at least partly, from decreased presynaptic sodium channel activity. Volatile aromatic anesthetics can inhibit N-methyl-D-aspartate (NMDA) receptor function and enhance gamma-amino butyric acid A receptor function, but these effects depend strongly on the chemical properties of the aromatic compounds. In the present study we tested whether diverse aromatic anesthetics consistently inhibit sodium channel function. ⋯ Aromatic compounds vary in their actions on the kinetics of sodium channel gating and this may underlie their variable inhibition. The range of inhibition produced by minimum alveolar anesthetic concentration concentrations of inhaled anesthetics indicates that sodium channel inhibition may underlie the action of some of these anesthetics, but not others.