Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2009
Multicenter StudyThe incidence of intraoperative awareness in children: childhood awareness and recall evaluation.
There is a considerable discrepancy between the reported incidences of awareness under anesthesia in children (0.2%-2.7%). In this prospective, observational, cohort study we evaluated 1) the incidence of awareness during general anesthesia in children across three settings, 2) factors contributing to awareness, and 3) short-term psychological effects of awareness. ⋯ Although 0.8% of children experienced possible/probable awareness in this study, none experienced short-term psychological distress.
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Anesthesia and analgesia · Nov 2009
Comparative StudyAn in vitro analysis of central venous drug delivery by continuous infusion: the effect of manifold design and port selection.
Central venous catheters are used extensively in anesthesia and critical care. Multiport manifolds allow for simultaneous administration of multiple medication infusions into a common central venous catheter lumen. The structures of such manifolds vary considerably. In this study, we quantitatively compared, in a laboratory model of continuous drug infusion, the drug delivery dynamics of a traditional stopcock manifold and a microinfusion manifold constructed to minimize dead volume. ⋯ Using a traditional stopcock manifold, port selection significantly affects drug delivery dynamics for continuous infusions. The findings provide quantitative support for the concept that the most critical infusion should join the system at the manifold port closest to the patient. Port selection was less important for the microinfusion manifold and dynamics were faster compared with the second and fourth ports of the stopcock manifold. The smaller dead volumes of the microinfusion manifold minimize unwanted delays in drug delivery onset and offset allowing more precise control over drug delivery by continuous infusion.
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Anesthesia and analgesia · Nov 2009
Comparative StudyInotropic support during experimental endotoxemic shock: part II. A comparison of levosimendan with dobutamine.
We compared the association of levosimendan or dobutamine with norepinephrine for the maintenance of systemic and hepatosplanchnic perfusion during early endotoxemic shock. ⋯ In volume-resuscitated endotoxemic pigs, the association of either levosimendan or dobutamine with norepinephrine preserved systemic blood flow, oxygen delivery, and VO(2). However, only dobutamine-norepinephrine maintained portal blood flow, which was associated with preservation of splanchnic and hepatic oxygen homeostasis and stable lactate concentrations.
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Anesthesia and analgesia · Nov 2009
Comparative StudyAcute methadone treatment reduces myocardial infarct size via the delta-opioid receptor in rats during reperfusion.
Methadone is an opioid agonist often given to manage acute and chronic pain. We sought to determine whether methadone compared with morphine dose dependently reduces myocardial infarct size (IS) and whether the mechanism is delta-opioid receptor mediated. Furthermore, we examined whether myocardial IS reduction varies with the timing of methadone administration or duration of induced ischemia. ⋯ These findings demonstrate that methadone and morphine produce similar myocardial IS-sparing effects that are delta-opioid receptor mediated and that are dependent on the duration of myocardial ischemia.
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Anesthesia and analgesia · Nov 2009
Randomized Controlled TrialRopivacaine spinal anesthesia is not antagonized by ondansetron pretreatment.
We investigated a possible effect of ondansetron on the duration of sensory and motor block produced by ropivacaine. ⋯ Ondansetron had no effect on the subarachnoid sensory or motor block produced by ropivacaine.