Anesthesia and analgesia
-
Anesthesia and analgesia · May 2010
The effect of sex on the minimum local analgesic concentration of ropivacaine for caudal anesthesia in anorectal surgery.
Caudal anesthesia is routinely used in our hospital for most of ambulatory anorectal surgery; patients need to recover as quickly as possible. The dose of local anesthetic may be different for male and female patients. We designed this study to investigate the effect of sex on the minimum local anesthetic concentration (MLAC) of ropivacaine for caudal anesthesia. ⋯ We conclude that the ropivacaine MLAC for caudal anesthesia in female patients is 31% larger than in male patients.
-
Anesthesia and analgesia · May 2010
Adenosine-induced flow arrest to facilitate intracranial aneurysm clip ligation: dose-response data and safety profile.
Adenosine-induced transient flow arrest has been used to facilitate clip ligation of intracranial aneurysms. However, the starting dose that is most likely to produce an adequate duration of profound hypotension remains unclear. We reviewed our experience to determine the dose-response relationship and apparent perioperative safety profile of adenosine in intracranial aneurysm patients. ⋯ For intracranial aneurysms in which temporary occlusion is impractical or difficult, adenosine is capable of providing brief periods of profound systemic hypotension with low perioperative morbidity. On the basis of these data, a dose of 0.3 to 0.4 mg/kg ideal body weight may be the recommended starting dose to achieve approximately 45 seconds of profound systemic hypotension during a remifentanil/low-dose volatile anesthetic with propofol induced burst suppression.
-
Anesthesia and analgesia · May 2010
The link between intravenous multiple pump flow errors and infusion system mechanical compliance.
IV drug delivery in intensive care often takes the form of simultaneous multiple infusions from separate infusion devices via either shared or individual fluid pathways. Because of the potency of the drugs administered and the acuity of the patients, accurate drug delivery is required. ⋯ We describe a mathematical model of a simple infusion system used to investigate and verify results reported from a simple experimental multiple pump fault scenario. The results suggest that flow degradation is attributable to small changes in infusion system extracorporeal volume, referred to as "compliance." The model may, by expansion, be used to determine the nature of fluid flow within other multiple pump systems, be applied to the design of future IV systems, and explain the need for small-volume infusion systems with small mechanical compliance.
-
Anesthesia and analgesia · May 2010
Reversal of bupivacaine-induced cardiac electrophysiologic changes by two lipid emulsions in anesthetized and mechanically ventilated piglets.
Accidental IV administration of bupivacaine can compromise cardiovascular function by inducing lethal arrhythmias whose hemodynamic consequences may be alleviated by lipid emulsions. However, little is known about the electrophysiologic effects of lipid emulsions. In this study, we assessed whether 2 different lipid emulsions can reverse cardiac electrophysiologic impairment induced by the IV administration of bupivacaine in anesthetized and mechanically ventilated piglets. ⋯ LCT and LCT/MCT emulsions reversed the lengthening of His ventricle, QRS, atrial-His, and PQ intervals induced by the IV injection of 4 mg . kg(-1) bupivacaine.