Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2012
Clinical TrialCardiovascular effects of dexmedetomidine sedation in children.
Dexmedetomidine (DEX) affects heart rate (HR), mean arterial blood pressure, cardiac index (CI), stroke index (SI), and systemic vascular resistance index (SVRI) in adults. In this study we sought to determine whether similar effects occur in children undergoing DEX sedation. ⋯ DEX decreases CI in children and has a cumulative effect. For patients undergoing prolonged procedures HR and CI remained decreased at the time of discharge together with a decrease in SI and an increase in SVRI.
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Anesthesia and analgesia · Jan 2012
Salvinorin A pretreatment preserves cerebrovascular autoregulation after brain hypoxic/ischemic injury via extracellular signal-regulated kinase/mitogen-activated protein kinase in piglets.
Cerebral hypoxia/ischemia during infant congenital heart surgery is not uncommon and may induce devastating neurologic disabilities persistent over the lifespan. Hypoxia/ischemia-induced cerebrovascular dysfunction is thought to be an important contributor to neurological damage. No pharmacological agents have been found to prevent this. Mitogen activated protein kinase (MAPK), including extracellular signal regulated kinase (ERK), c-Jun-N-terminal kinase, and p38, is thought to contribute to ischemic preconditioning. We investigated whether pretreatment with salvinorin A, the only natural nonopioid κ receptor agonist, could preserve autoregulation of the pial artery via MAPK. ⋯ Salvinorin A pretreatment preserves autoregulation of the pial artery to hypotension and hypercapnia after hypoxia/ischemia via ERK in a piglet model.
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Anesthesia and analgesia · Jan 2012
Intravenous infusion of remifentanil induces transient withdrawal hyperalgesia depending on administration duration in rats.
Recent studies suggest that remifentanil, similar to other μ-opioid agonists, may induce hyperalgesia. We performed animal experiments to determine whether IV remifentanil infusion, the mode of administration used in clinical practice, induces hyperalgesia and the conditions in which this phenomenon occurs. We also determined whether remifentanil-induced hyperalgesia is related to extracellular signal-regulated protein kinase 1/2 (ERK1/2) phosphorylation. ⋯ IV remifentanil induces transient withdrawal hyperalgesia soon after its termination. This hyperalgesia is strongly associated with the duration of exposure to remifentanil. Contrary to our hypothesis, ERK1/2 by itself was not the essential factor involved in the induction of the hyperalgesia.
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Anesthesia and analgesia · Jan 2012
Editorial Historical ArticleEducation in anesthesia: then & now.