Anesthesia and analgesia
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Anesthesia and analgesia · May 2012
Prevention of paclitaxel-induced neuropathy through activation of the central cannabinoid type 2 receptor system.
Peripheral neuropathy is a major dose-limiting toxicity of chemotherapy, especially after multiple courses of paclitaxel. The development of paclitaxel-induced neuropathy is associated with the activation of microglia followed by the activation and proliferation of astrocytes, and the expression and release of proinflammatory cytokines in the spinal dorsal horn. Cannabinoid type 2 (CB(2)) receptors are expressed in the microglia in neurodegenerative disease models. ⋯ Our findings suggest an innovative therapeutic approach to prevent chemotherapy-induced neuropathy and may permit more aggressive use of active chemotherapeutic regimens with reduced long-term sequelae.
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Anesthesia and analgesia · May 2012
ReviewThe current status of continuous noninvasive measurement of total, carboxy, and methemoglobin concentration.
Intraoperative early detection of anemia, identifying toxic levels of carboxyhemoglobin after carbon monoxide exposure and titrating drug dosage to prevent toxic levels of methemoglobin are important goals. The pulse oximeter works by illuminating light into the tissue and sensing the amount of light absorbed. ⋯ Currently there are 2 commercial pulse oximeters (Masimo Rainbow SET and OrSense NBM-200MP) that measure total hemoglobin concentration and one (Masimo) that also measures methemoglobin and carboxyhemoglobin. In this review, we describe the peer-reviewed literature addressing the accuracy of these monitors.
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Drug waste has been implicated as a significant contributor to environmental contamination and unnecessary health care costs. ⋯ Propofol does not degrade in nature, accumulates in body fat, and is toxic to aquatic life. We reduced wastage by removing 50 and 100 mL vials of propofol from the pharmacy, retaining only the smallest size (20 mL).