Anesthesia and analgesia
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Anesthesia and analgesia · Feb 2009
The impact of aprotinin on postoperative renal dysfunction in neonates undergoing cardiopulmonary bypass: a retrospective analysis.
Recent concern about the safety of aprotinin administration to adults has led to its suspension from worldwide markets. However, few studies have examined its safety in pediatric patients. Studies in children evaluating aprotinin's safety have been hindered by the heterogeneity of pediatric patients and the inconsistency of clinical protocols. In this investigation, we retrospectively reviewed 200 neonatal cardiac surgical cases performed at our institution to examine the safety of aprotinin, focusing on postoperative renal dysfunction, using a consistent aprotinin dosing protocol. ⋯ The occurrence of postoperative renal dysfunction in neonates was more significantly predicted by the duration of CPB than by the intraoperative administration of aprotinin. CPB times of more than 100 min appeared to be a critical marker for the development of postoperative renal dysfunction. Randomized prospective trials are needed to confirm the validity of our retrospective findings.
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Anesthesia and analgesia · Feb 2009
The effects of multiple infusion line extensions on occlusion alarm function of an infusion pump.
For anesthesia or conscious sedation of patients undergoing diagnostic or therapeutic procedures in computed tomography or magnetic resonance imaging scans, an extension of infusion lines for continuous drug delivery of anesthetics or vasopressors is often necessary. In this study, we tried to determine if the length of the infusion line influenced the time until an alarm sounded after occlusion at the end of the infusion line. ⋯ When simulating low flow rate infusions (5 mL/h) as for vasopressor support, occlusion alarm time was critically prolonged, especially with an increased length of infusion lines.
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Anesthesia and analgesia · Feb 2009
Orexin A decreases ketamine-induced anesthesia time in the rat: the relevance to brain noradrenergic neuronal activity.
Orexins (OXs) regulate wakefulness, and a lack of OX Type-I receptors cause narcolepsy. OX selectively increases norepinephrine (NE) release from rat cerebral cortical slices, and brain noradrenergic neurons are involved in the sleep-wakefulness cycle. Ketamine increases NE release from the rat cerebral cortex. We hypothesized that OX would affect ketamine anesthesia's interactions with brain noradrenergic neuronal activity. ⋯ Orexinergic neurons may be an important target for ketamine. OXA antagonized ketamine anesthesia via Orexin-1 receptor with noradrenergic neurons.
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Anesthesia and analgesia · Feb 2009
The preconditioning effect of sevoflurane on the oxygen glucose-deprived hippocampal slice: the role of tyrosine kinases and duration of ischemia.
The neuroprotective efficacy of anesthetics observed in experimental models remains unproven in the clinical setting. The nonreceptor tyrosine kinase focal adhesion kinase (FAK) has been suggested to be involved in the neuroprotective effect of anesthetics observed experimentally. In the present work, we investigated whether FAK and the duration of ischemia play a role in the preconditioning effect of sevoflurane on brain tissue. ⋯ In the OGD rat acute hippocampal slice, the preconditioning effect of a clinically relevant concentration of sevoflurane was very likely to involve FAK and was observed only for periods of ischemia