Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2010
The influence of duration of fluid abstinence on hypotension during propofol induction.
Prolonged preoperative fasting might be expected to exacerbate hypotension during the induction of general anesthesia. We aimed to establish whether the duration of preoperative abstinence from fluids independently contributed to arterial blood pressure changes and dosage requirements during propofol induction. ⋯ When propofol is infused rapidly for induction of anesthesia in healthy adults younger than 65 years, the duration of preoperative fluid abstinence does not appear to affect MAP or propofol dose requirements.
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Hypertonic saline and/or norepinephrine infusion are routinely used to achieve a desired cerebral perfusion pressure (CPP) in the management of traumatic brain injury (TBI). We hypothesized that creatinine clearances (CrCls) would be significantly augmented in this setting. ⋯ Augmented CrCls are common in TBI patients receiving active management of CPP and persist even after discontinuation of such therapy. Further work is needed to clarify the impact of such clearances on renally excreted drugs in this setting.
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Anesthesia and analgesia · Dec 2010
The role of interleukin-1 in wound biology. Part II: In vivo and human translational studies.
In the accompanying paper, we demonstrate that genetic variation within Nalp1 could contribute to interstrain differences in wound chemokine production through altering the amount of interleukin (IL)-1 produced. We further investigate the role of IL-1 in incisional wound biology and its effect on wound chemokine production in vivo and whether this mechanism could be active in human subjects. ⋯ IL-1 plays a major role in regulating inflammatory mediator production in wounds through a novel mechanism; by stimulating the production of multiple cytokines and chemokines, it impacts clinically important aspects of wound biology. These data suggest that administration of an IL-1 receptor antagonist within the perioperative period could decrease postsurgical wound pain.