Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2009
Propofol and isoflurane enhancement of tonic gamma-aminobutyric acid type a current in cardiac vagal neurons in the nucleus ambiguus.
General anesthesia with propofol and isoflurane induces alterations of the cardiovascular system, including hypotension and changes in heart rate. The preganglionic cardiac vagal neurons (CVNs) are one of the major central components controlling heart rate and autonomic regulation. In this study, we examined whether propofol and isoflurane act on phasic or tonic gamma-aminobutyric acid type A (GABA(A)) receptor-mediated inhibition in CVNs. ⋯ The results demonstrate that the general anesthetics propofol and isoflurane enhance both phasic and tonic GABA(A) receptor-mediated inhibition of CVNs.
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Anesthesia and analgesia · Jan 2009
Randomized Controlled Trial Comparative StudyAirway scope and StyletScope for tracheal intubation in a simulated difficult airway.
Direct laryngoscopy is difficult when the cervical spine is immobilized. The Airway Scope and StyletScope are new laryngoscopes designed to facilitate intubation under these circumstances. Thus, in patients wearing a rigid cervical collar to simulate a difficult airway, we tested the hypothesis that the intubation success rates of the Airway Scope and StyletScope are similar, but that intubation with Airway Scope is faster. ⋯ Both the Airway Scope and StyletScope offer high success rates in a simulated difficult airway achieved by a rigid collar. However, the Airway Scope is faster and less likely to cause esophageal intubation.
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Anesthesia and analgesia · Jan 2009
An evaluation of the epidural catheter position by epidural nerve stimulation in conjunction with continuous epidural analgesia in adult surgical patients.
The epidural stimulation test to confirm epidural catheter position has been described as being simple, fast, and reliable. We evaluated the feasibility of the epidural stimulation test and its potential in contributing to effective postoperative continuous epidural analgesia. ⋯ The epidural stimulation test was often associated with technical difficulties and interpretation problems. The role of the repeated use of the epidural stimulation test for quality assurance in patients undergoing postoperative continuous epidural analgesia remains undetermined.
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Anesthesia and analgesia · Jan 2009
Review Case ReportsLeft ventricular assist device outflow cannula obstruction by the rare environmental fungus Myceliophthora thermophila.
Left ventricular assist devices are used to provide mechanical circulatory support during end-stage heart failure either as a destination therapy or as a bridge to heart transplantation. Perioperative transesophageal echocardiography is becoming an invaluable tool to investigate device function during implantation and in case of mechanical malfunction. ⋯ Here, we present a case of severe outflow conduit obstruction by a rare environmental fungus, Myceliophthora thermophila. After replacement of the infected device and intensive antifungal treatment, heart transplantation was performed 2 yr later.
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Anesthesia and analgesia · Jan 2009
Randomized Controlled TrialAlveolar recruitment and arterial desflurane concentration during bariatric surgery.
We investigated whether reversal of intraoperative atelectasis with the lung recruitment maneuver (RM) affects desflurane arterial concentrations during bariatric surgery. ⋯ Although the RM during bariatric surgery represents an effective method for improving intraoperative oxygenation, it does not significantly affect the desflurane blood concentrations during anesthesia or its elimination during emergence.