Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2012
Comparative StudyUniversity of Queensland vital signs dataset: development of an accessible repository of anesthesia patient monitoring data for research.
Data recorded from the devices used to monitor a patient's vital signs are often used in the development of displays, alarms, and information systems, but high-resolution, multiple-parameter datasets of anesthesia monitoring data from patients during anesthesia are often difficult to obtain. Existing databases have typically been collected from patients in intensive care units. However, the physical state of intensive care patients is dissimilar to those undergoing surgery, more frequent and marked changes to cardiovascular and respiratory variables are seen in operating room patients, and additional and highly relevant information to anesthesia (e.g., end-tidal agent monitoring, etc.) is omitted from these intensive care databases. We collected a set of high-quality, high-resolution, multiple-parameter monitoring data suitable for anesthesia monitoring research. ⋯ The present dataset provides clinical anesthesia monitoring data from entire surgical cases where patients underwent anesthesia, includes a wide range of vital signs variables that are commonly monitored during surgery, and is published in accessible, user-friendly file formats. The text and image file formats let researchers without engineering or computer science backgrounds easily access the data using standard spreadsheet and image browsing software. In future work, monitoring data should be collected from a wider range and larger number of cases, and software tools are needed to support searching and navigating the database.
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Anesthesia and analgesia · Mar 2012
Comparative StudySystemic lidocaine does not attenuate hepatic dysfunction after liver surgery in rats.
Lidocaine has been shown to attenuate ischemia-reperfusion (I/R) injury in the heart, lung, and brain, potentially due to modulation of inflammatory responses and apoptotic signaling pathways. Because hepatic I/R injury after liver surgery still poses a significant risk for postoperative liver dysfunction or even failure, we investigated whether systemic lidocaine would also positively affect hepatocellular damage and overall liver function after hepatic I/R injury. In addition the potential underlying mechanisms of action were studied. ⋯ Systemic lidocaine in therapeutic concentrations neither attenuated hepatocellular damage nor improved postoperative liver function after hepatic I/R injury.
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Anesthesia and analgesia · Mar 2012
Case Reports Comparative StudyMicropuncture needles combined with ultrasound guidance for unusual central venous cannulation: desperate times call for desperate measures--a new trick for old anesthesiologists.
Central vascular access can be a very challenging task in patients with skeletal deformities such as ankylosing spondylitis, kyphosis, and chin-on-chest deformity. The use of traditional methods of accessing the central venous circulation in these patients can require multiple attempts and may lead to significant complications such as bleeding, pneumothorax, and vascular injury. Ultrasound-guided central venous access has become a very common procedure in the United States and Europe; its efficacy and safety have been demonstrated, and together with the use of micropuncture needles, the technique can facilitate central venous access in complicated cases.
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Anesthesia and analgesia · Mar 2012
Comparative StudyAngiotensin converting enzyme inhibitors are not associated with respiratory complications or mortality after noncardiac surgery.
General use of angiotensin-converting enzyme inhibitors (ACEIs) is associated with upper-airway complications such as cough, angioedema, and bronchospasm; furthermore, preoperative use is associated with increased morbidity or mortality. Our primary goal in this study was thus to evaluate the association of ACEI therapy with perioperative respiratory morbidity in adult noncardiac surgical patients. Our secondary goals were to evaluate the association between preoperative use of ACEI and 30-day mortality, as well as to a composite outcome of in-hospital morbidity and mortality in adult noncardiac surgical patients having general anesthesia. ⋯ We did not find any association between use of ACEIs and intraoperative or postoperative upper-airway complications. Furthermore, ACEI use was not associated with in-hospital complications or increased 30-day mortality.