Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2010
Case ReportsUltrasonography as a preoperative assessment tool: predicting the feasibility of central neuraxial blockade.
A woman with severe ankylosing spondylitis presented to the preanesthetic clinic before total hip arthroplasty. She had required general anesthesia with fiberoptic intubation after failed attempts at spinal anesthesia for previous hip surgery. ⋯ Dural puncture with a single needle pass was subsequently achieved with the aid of preprocedural ultrasound imaging. Ultrasound may be a useful preoperative assessment tool for assessing the feasibility of central neuraxial blockade when technical difficulty is anticipated.
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Anesthesia and analgesia · Jan 2010
The effect of preoperative heart rate and anxiety on the propofol dose required for loss of consciousness.
Conflicting results have been reported on the effect of anxiety on the propofol dose required for inducing loss of consciousness (LOC). The hemodynamic effects of anxiety, increased heart rate (HR), and cardiac output may account for these discrepancies. We therefore designed this study to address, first, the effect of perioperative HR on propofol dose required for LOC and, second, the effect of perioperative anxiety on HR. ⋯ Increased perioperative HR is associated with increased propofol dose required for LOC. Perioperative anxiety accounts for increased HR.
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Anesthesia and analgesia · Jan 2010
The effects of resiniferatoxin in an experimental rat thoracotomy model.
Chronic pain after thoracotomy has been reproduced in a rat model that allows investigation of drugs that might reduce the incidence of allodynia after thoracotomy. Previous studies suggest that morphine, clonidine, neostigmine, gabapentin, and bupivacaine reduce the incidence of allodynia in the rat postthoracotomy pain model. One purpose of this study was to test whether intercostal injection of resiniferatoxin (RTX) decreased the amount of allodynia in an animal model of chronic postthoracotomy pain. We also tested whether RTX induced a transient mechanical hyperalgesic response in uninjured animals. ⋯ The current results suggest that intercostal RTX causes a transient hyperalgesic response in uninjured animals and is ineffective in reducing the mechanical allodynia after thoracotomy.
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Although cold hypersensitivity is a well-documented phenomenon in animals and humans with inflammatory and neuropathic pain, little is known about the presence of cold hyperalgesia after surgery. Therefore, we studied primary cold hyperalgesia after a surgical incision in mice. ⋯ The present data give strong evidence that a surgical incision does not cause cold hyperalgesia. Furthermore, a lack of cold hyperalgesia in unrestrained male and female mice after incision was not due to increased skin temperature after incision. Finally, we demonstrated that in contrast to a surgical incision, inflammation and nerve injury generate intense cold hyperalgesia and an increase in skin temperature, suggesting that different mechanisms are involved in surgical and inflammatory or neuropathic pain.