Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2009
Randomized Controlled Trial Comparative StudyA comparison between sevoflurane and desflurane anesthesia in patients undergoing craniotomy for supratentorial intracranial surgery.
Desflurane in neurosurgery may be beneficial because it facilitates postoperative early neurologic evaluation. However, its use has been debated because of its capacity to promote cerebral vasodilatation. Sevoflurane has been extensively used in neurosurgical patients. In this prospective clinical trial, we compared early postoperative recovery and cognitive function in patients undergoing craniotomy for supratentorial expanding lesions and receiving sevoflurane or desflurane anesthesia. ⋯ Patients who received desflurane had a shorter extubation and recovery time but similar intraoperative and postoperative incidence of complications compared with those who received sevoflurane.
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Anesthesia and analgesia · Aug 2009
Randomized Controlled TrialThe effect of intravenous alanyl-glutamine supplementation on plasma glutathione levels in intensive care unit trauma patients receiving enteral nutrition: the results of a randomized controlled trial.
We sought to investigate the effect of IV alanyl-glutamine supplementation on plasma glutathione levels in severely traumatized patients receiving enteral nutrition. ⋯ This study demonstrates that IV alanyl-glutamine supplementation for 7 days increases total plasma glutathione levels in critically ill trauma patients receiving standard enteral nutrition.
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Anesthesia and analgesia · Aug 2009
Can the outcome of spinal cord stimulation in chronic complex regional pain syndrome type I patients be predicted by catastrophizing thoughts?
In this study, we examined whether pain catastrophizing is a predictor of spinal cord stimulation (SCS) outcome in patients with complex regional pain syndrome type I (CRPS-I). ⋯ This study showed that the efficacy of SCS in reduction of pain intensity, GPE, and QOL in a well-defined chronic CRPS-I population was not predicted by pain catastrophizing. Therefore, we conclude that a high level of pain catastrophizing in patients with CRPS-I is not a contraindication for SCS treatment.
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Anesthesia and analgesia · Aug 2009
Comparative StudyRat dorsal horn nociceptive-specific neurons are more sensitive than wide dynamic range neurons to depression by immobilizing doses of volatile anesthetics: an effect partially reversed by the opioid receptor antagonist naloxone.
The mechanism and site of action within the spinal cord by which volatile anesthetics produce immobility are not well understood. Little work has been done directly comparing anesthetic effects on neurons with specific functional characteristics that mediate transfer of nociceptive information within the spinal cord. ⋯ NS but not WDR neurons in the lumbar dorsal horn are depressed by peri-MAC increases of halothane and isoflurane. This depression, at least with halothane, can be partially reversed by the opioid antagonist naloxone. Given that opioid receptors are not likely involved in the mechanisms by which volatile anesthetics produce immobility, this suggests that, although the neuronal depression is of substantial magnitude and occurs concurrent to the production of immobility, it may not play a major role in the production of this anesthetic end point.
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Anesthesia and analgesia · Aug 2009
Comparative StudyA comparison of stroke volume variation measured by Vigileo/FloTrac system and aortic Doppler echocardiography.
The goal of this study was to compare stroke volume variation (SVV) assessed from a peripheral artery with the Vigileo/FloTrac system (SVV-FloTrac) with SVV derived close to the heart by aortic Doppler (SVV-Doppler). ⋯ SVV-FloTrac and SVV-Doppler measurements show acceptable bias and limits of agreement, and similar performance in terms of fluid responsiveness in patients undergoing liver transplantation.