Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2012
Biography Historical ArticleSpecial article: Francis Hoeffer McMechan, MD: creator of modern anesthesiology?
If one person can be credited with the creation of the infrastructure of modern anesthesiology, that individual would be Francis Hoeffer McMechan. He has been largely forgotten since his death in 1939 despite his remarkable and enduring accomplishments. ⋯ His accomplishments are even more amazing given the severe arthritis that left him wheelchair-bound for almost his entire professional life and denied him the ability to practice anesthesia. Our specialty owes an incredible debt to this largely unknown and unsung hero.
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Anesthesia and analgesia · Dec 2012
The local peripheral antihyperalgesic effect of levetiracetam and its mechanism of action in an inflammatory pain model.
We have recently shown that levetiracetam, administered systemically, exerts an antihyperalgesic effect in a rat inflammatory pain model. In this study, we examined whether levetiracetam has local peripheral antihyperalgesic/anti-edematous effects in the same model of localized inflammation and whether opioidergic, adrenergic, purinergic, 5-HTergic, and GABAergic receptors are involved in its antihyperalgesic action. ⋯ Our results show that levetiracetam produces local peripheral antihyperalgesic and anti-edematous effects in a rat model of localized inflammation. Antihyperalgesia is at least in part mediated by peripheral μ-opioid, α2A,C-adrenergic, A1 adenosine, and 5-HT1B/1D receptors, but not by GABAA receptors. These findings could contribute toward a better understanding of the analgesic effects of levetiracetam, and improved treatments of inflammatory pain with a lower incidence of systemic side effects and drug interactions of levetiracetam.
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Anesthesia and analgesia · Dec 2012
Intraoperative hydroxyethyl starch 70/0.5 is not related to acute kidney injury in surgical patients: retrospective cohort study.
Although high-molecular-weight hydroxyethyl starch (HES) has been reported to cause acute kidney injury (AKI), it is not clear whether low-molecular-weight HES (6% HES 70/0.5) can be a risk for AKI or not. We hypothesized that intraoperative 6% HES 70/0.5 administration is not related to postoperative AKI. ⋯ In this uncontrolled retrospective chart review, intraoperative 6% HES 70/0.5 in a low dose was not related to postoperative AKI in patients with major intraoperative blood loss. Randomized controlled trials are warranted to further evaluate the safety and efficacy of low-molecular-weight HES.
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Anesthesia and analgesia · Dec 2012
A case series of recombinant platelet factor 4 for heparin reversal after cardiopulmonary bypass.
Platelet factor 4 (PF4) is released by activated platelets and has a strong affinity for heparin. Recombinant PF4 (rPF4) has been previously considered as an alternative to protamine for heparin reversal. However, it has been demonstrated that antibodies directed against the PF4/heparin moiety are important in the pathophysiologic development of heparin-induced thrombocytopenia, a prothrombotic complication for which cardiac bypass patients are at increased risk. ⋯ Our case series demonstrates that heparin anticoagulation was effectively reversed by the administration of rPF4 without serious complications. Additional studies are needed to further validate the safety and efficacy of exogenous rPF4 administration.
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Anesthesia and analgesia · Dec 2012
Biography Historical ArticleSpecial article: Laurette McMechan (1878-1970): "mother of anesthetists".
Laurette van Varseveld McMechan (1878-1970) was married to Francis Hoeffer McMechan (1879-1939), who organized the International Anesthesia Research Society and was the editor of the first journal for physician and dentist anesthetists. Although she was not a physician, she made vital contributions to the development of worldwide organized anesthesia and its journals. ⋯ Her life was dedicated to the profession of anesthesia. A memorial tribute labeled her "the mother of anesthetists," a title she deserved.