Anesthesia and analgesia
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Anesthesia and analgesia · Sep 2009
Sciatic nerve catheter placement: success with using the Raj approach.
Continuous regional analgesia has increased in popularity and is becoming standard of care for many painful surgical procedures. Various approaches of sciatic catheter insertion have been proposed, each with attributes and disadvantages. We investigated whether the Raj approach that uses a simple midpoint landmark between the ischial tuberosity and greater trochanter will facilitate sciatic catheter placement. ⋯ Use of a simple landmark between easily identifiable bony structures enhances the simplicity and placement of a sciatic nerve catheter and is recommended for use in clinical practice.
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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.