Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2008
Randomized Controlled TrialThe effects of prehydration on the properties of cerebrospinal fluid and the spread of isobaric spinal anesthetic drug.
In a two-part clinical study, we investigated the effect of the administration of fluids "prehydration" on the physical properties of cerebrospinal fluid (CSF) and intrathecal spread of local anesthetics. ⋯ Rapid crystalloid prehydration can affect CSF flow in the lumbar region, reducing cephalic spread of 0.5% isobaric tetracaine and delaying the time to reach the peak sensory level.
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Anesthesia and analgesia · Mar 2008
Comparative StudyImproved clot formation by combined administration of activated factor VII (NovoSeven) and fibrinogen (Haemocomplettan P).
Recombinant activated factor VII (rFVIIa) is increasingly used for treating refractory bleeding after cardiac surgery. However, hemostasis also depends on coagulation factors, including fibrinogen, which stabilizes platelet plugs at sites of vascular injury. We compared the hemostatic effects of rFVIIa, fibrinogen, or their combination. ⋯ The onset of fibrin formation and thrombin generation were shortened after rFVIIa addition, but fibrin clot strength was only increased after fibrinogen supplementation. In vitro clot formation was most improved by using both rFVIIa and fibrinogen in whole blood after CPB.
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Anesthesia and analgesia · Mar 2008
Comparative StudyA comparison of preoperative anxiety in female patients with mothers of children undergoing surgery.
We compared anxiety in mothers of children undergoing ambulatory surgery with female patients undergoing surgery themselves. We found that mothers were as anxious as patients undergoing major abdominal surgery and more anxious than patients undergoing minor surgery. Predictors of maternal anxiety were child age and maternal monitoring coping.
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Anesthesia and analgesia · Mar 2008
Comparative StudyMeasurement of blood flow index during antegrade selective cerebral perfusion with near-infrared spectroscopy in newborn piglets.
Neonates with complex congenital heart defects have traditionally undergone surgery during deep hypothermic cardiac arrest (HCA). Selective cerebral perfusion (SCP) is thought to minimize ischemic brain injury by providing adequate cerebral blood flow. We investigated SCP with different flow rates compared with HCA with respect to cerebral perfusion and tissue oxygenation as assessed by near-infrared spectroscopy. ⋯ Both BFI and FV(mean) suggested increased cerebral perfusion in the SCP 50 group compared with the HCA and SCP 25 groups. TOI was significantly higher in both the SCP 25 and SCP 50 groups compared with HCA. SCP at 25 mL x kg(-1) x min(-1) may be most appropriate for cerebral protection.
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Anesthesia and analgesia · Mar 2008
Comparative StudyImmobilizing doses of halothane, isoflurane or propofol, do not preferentially depress noxious heat-evoked responses of rat lumbar dorsal horn neurons with ascending projections.
The spinal cord is an important site where volatile anesthetics decrease sensation and produce immobility. Beyond this knowledge, our understanding of a site of anesthetic action is limited. Previous evidence suggests that dorsal horn neurons with ascending projections may be more susceptible to depression by general anesthetics than local spinal interneurons. In this study we evaluated the effects of volatile and injectable general anesthetics on lumbar dorsal horn neurons with and without ascending projections. ⋯ Our findings suggest, at peri-MAC concentrations, these general anesthetics do not preferentially depress lumbar dorsal horn neurons with ascending projections compared to those with no identifiable ascending projections.