Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2008
Does the Pleth variability index indicate the respiratory-induced variation in the plethysmogram and arterial pressure waveforms?
Respiratory variations in the pulse oximeter plethysmographic waveform amplitude (deltaPOP) are sensitive to changes in preload and can predict fluid responsiveness in mechanically ventilated patients. However, they cannot be easily calculated from a bedside monitor. Pleth variability index (PVI, Masimo Corp., Irvine, CA) is a new algorithm that automatically calculates deltaPOP. The aim of our study was to test the ability of this new device to automatically and continuously monitor deltaPOP. ⋯ This study is the first to demonstrate the ability of PVI, an index automatically derived from the pulse oximeter waveform analysis, to automatically and continuously monitor deltaPOP. This new index has potential clinical applications for noninvasive fluid responsiveness monitoring.
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Anesthesia and analgesia · Apr 2008
Antiallodynic and antihyperalgesic effect of milnacipran in mice with spinal nerve ligation.
The antidepressant, milnacipran, has been reported to have antinociceptive, antiallodynic, and antihyperalgesic effects. In this study, we examined the mechanisms of the antiallodynic and antihyperalgesic effects of milnacipran in a model of neuropathic pain induced by spinal nerve ligation in mice. ⋯ We concluded that the antiallodynic and antihyperalgesic effects of milnacipran on neuropathic pain induced by spinal nerve ligation are principally mediated through action at supraspinal and spinal sites via activation of the spinal noradrenergic system.
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Anesthesia and analgesia · Apr 2008
Comment Letter Case ReportsCould this be malignant hyperthermia?
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Anesthesia and analgesia · Apr 2008
Randomized Controlled TrialChronic phantom limb pain: the effects of calcitonin, ketamine, and their combination on pain and sensory thresholds.
Calcitonin was effective in a study of acute phantom limb pain, but it was not studied in the chronic phase. The overall literature on N-methyl-D-aspartate antagonists is equivocal. We tested the hypothesis that calcitonin, ketamine, and their combination are effective in treating chronic phantom limb pain. Our secondary aim was to improve our understanding of the mechanisms of action of the investigated drugs using quantitative sensory testing. ⋯ Our results question the usefulness of calcitonin in chronic phantom limb pain and stress the potential interest of N-methyl-D-aspartate antagonists. Sensory assessments indicated that peripheral mechanisms are unlikely important determinants of phantom limb pain. Ketamine, but not calcitonin, affects central sensitization processes that are probably involved in the pathophysiology of phantom limb pain.
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Anesthesia and analgesia · Apr 2008
Randomized Controlled TrialStimulating catheters for continuous femoral nerve blockade after total knee arthroplasty: a randomized, controlled, double-blinded trial.
Continuous femoral nerve blockade (CFNB) is often used for postoperative analgesia after total knee arthroplasty (TKA). CFNB can be instituted using a variety of techniques. Stimulating catheters (SC) have the advantage of confirming placement of the catheter close to the nerve during advancement. ⋯ In this study, blind catheter advancement was as reliable as a SC technique for establishing and maintaining CFNB for postoperative analgesia as a part of multimodal analgesia technique after TKA.