Anesthesia and analgesia
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We developed an IV regional anesthesia (IVRA) model using the tails of rats to allow preclinical evaluation of the safety and efficacy of drugs used in IVRA and analgesia. ⋯ A reliable model for studying IVRA and analgesia has been developed in rats.
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Anesthesia and analgesia · Apr 2010
Accuracy of preoperative electrocardiographic and chest radiographic screening for prediction of left ventricular dysfunction in patients with suspected neuromuscular disorders.
We sought to determine the reliability of electrocardiography (ECG) and chest radiography (CXR) in predicting left ventricular (LV) dysfunction in patients with suspected neuromuscular disorders (NMDs) undergoing preanesthetic evaluation for muscle biopsy. ⋯ In patients with suspected neuromuscular disease, CXR and ECG provided low independent diagnostic prediction for the presence or absence of LV dysfunction. The combination of both tests can identify cardiomyopathy with relatively high accuracy in children with suspected NMDs independent of age and gender, particularly in patients with moderate to severe LV dysfunction. Although our findings suggest that combination ECG and CXR screening is a reliable means of detecting LV dysfunction, this approach fails to differentiate the severity or type of cardiomyopathy that may exist. Therefore, the decision to obtain a perioperative Echo before muscle biopsy should involve careful consideration of the disease suspected, ECG and CXR results, laboratory studies, patient age, physical examination, and family history.
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Anesthesia and analgesia · Apr 2010
Influence of procedure classification on process variability and parameter uncertainty of surgical case durations.
Predictive variability of operating room (OR) times influences decision making on the day of surgery including when to start add-on cases, whether to move a case from one OR to another, and where to assign relief staff. One contributor to predictive variability is process variability, which arises among cases of the same procedure(s). Another contributor is parameter uncertainty, which is caused by small sample sizes of historical data. ⋯ For procedures with few historic data, the Bayesian method allows for effective case duration prediction, permitting use of detailed procedure descriptions. Although fine resolution of scheduling procedures increases the chance of performed procedure(s) differing from scheduled procedure(s), this does not increase process variability. Future studies need both to address differences in process variability among specialties and accept the limitation that findings from one may not apply to others.
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Anesthesia and analgesia · Apr 2010
Reversible conduction block in isolated toad sciatic nerve by emulsified isoflurane.
Studies have shown that the local use of volatile anesthetics can produce local anesthetic effects. We designed this study to evaluate the characteristics of nerve conduction block of emulsified isoflurane (EI) and compare its nerve blockade with 1%lidocaine, by measuring compound nerve action potential (CNAP) parameters in isolated toad sciatic nerve. ⋯ EI produced completely reversible and dose-dependent nerve conduction inhibition, which had slower onset and faster recovery compared with those produced by lidocaine.