Anesthesia and analgesia
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Anesthesia and analgesia · Sep 2009
An anatomical study of the transversus abdominis plane block: location of the lumbar triangle of Petit and adjacent nerves.
The transversus abdominis plane (TAP) block is a new technique for providing analgesia to the anterior abdominal wall. Most previous studies have used the lumbar triangle of Petit as a landmark for the block. In this cadaveric study, we determined the exact position and size of the lumbar triangle of Petit and identified the nerves affected by the TAP block. ⋯ The lumbar triangles of Petit found in the specimens in this study were more posterior than the literature suggests. The position of the lumbar triangle of Petit varies largely and the size is relatively small. The relevant nerves to be blocked had not entered the TAP in the specimens in this study at the point of the lumbar triangle of Petit. At the midaxillary line, however, all the nerves were in the TAP.
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Anesthesia and analgesia · Sep 2009
Low tidal volume ventilation in a porcine model of acute lung injury improves cerebral tissue oxygenation.
In study, we investigated the effects of different tidal volumes on cerebral tissue oxygenation and cerebral metabolism in a porcine model of acute lung injury (ALI). We hypothesized that mechanical ventilation with low tidal (LT) volumes improves cerebral tissue oxygenation and metabolism after experimentally induced ALI. ⋯ Protective ventilation with LT yielded a significant improvement in cerebral tissue oxygenation and metabolism compared to HT ventilation in a porcine model of ALI. There was dissociation between arterial and cerebral tissue oxygenation. Cerebral oxygenation and metabolism might have possibly been impaired by a more distinctive inflammatory response in the HT group.
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Anesthesia and analgesia · Sep 2009
Ketamine inhibits maturation of bone marrow-derived dendritic cells and priming of the Th1-type immune response.
Dendritic cells (DCs) play a key role as antigen-presenting cells and growing evidence suggests that DCs influence T-cell activation and regulate the polarity of the immune response. Ketamine has been reported to have immunomodulatory properties that affect immune cells, including macrophages and natural killer cells. However, the effect of ketamine on DCs has not been characterized. We examined the immunomodulation of DCs by ketamine. ⋯ Our findings suggest that ketamine inhibits the functional maturation of DCs and interferes with DC induction of Th1 immunity in the whole animal. These novel findings provide new insight into the immunopharmacological role of ketamine.
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Anesthesia and analgesia · Sep 2009
The effect of a peripheral block on inflammation-induced prostaglandin E2 and cyclooxygenase expression in rats.
Peripheral inflammatory pain is associated with an upregulation of spinal cord COX-2 (cyclooxygenase-2), with a subsequent increase in central prostaglandin E2 (PGE2) levels associated with the development of hyperalgesia. In this study, we evaluated the effect of bupivacaine administered via a nerve block or via a systemic route on the spinal expression of PGE2 and COX in a model of peripheral inflammation in rats. ⋯ These results constitute a key element strongly suggesting that local anesthetics act at a different level when administered systematically or via a nerve block.
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Anesthesia and analgesia · Sep 2009
Editorial CommentSpend time on patients and families or on documentation?