Anesthesia and analgesia
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Anesthesia and analgesia · May 2013
Ryanodine receptor type 1 gene variants in the malignant hyperthermia-susceptible population of the United States.
Mutations in the ryanodine receptor type 1 gene (RYR1) that encodes the skeletal muscle-specific intracellular calcium (Ca(2+)) release channel are a cause of malignant hyperthermia (MH). In this study, we examined RYR1 mutations in a large number of North American MH-susceptible (MHS) subjects without prior genetic diagnosis. ⋯ The identification of novel RYR1 variants and previously observed RYR1 variants of uncertain significance in independent MHS families is necessary for demonstrating the significance of these variants for MH susceptibility and supports the need for functional studies of these variants. Continued reporting of the clinical phenotypes of MH is necessary for interpretation of genetic findings, especially because the pathogenicity of most of these genetic variants associated with MHS remains to be elucidated.
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Anesthesia and analgesia · May 2013
Review Meta AnalysisPreventive analgesia by local anesthetics: the reduction of postoperative pain by peripheral nerve blocks and intravenous drugs.
Barreveld et al. show that LA administered either IV or via block; before, during or after surgery, significantly reduces postoperative pain and opioid consumption.
Specifically in:
- Total knee arthroplasty (femoral, sciatic and lumbar plexus b., single-shot or continuous)
- Total hip arthroplasty (continuous lumbar plexus; intra-articular LA)
- Knee arthroscopy (single-shot lumbar plexus; IA LA; single-shot femoral nerve ± sciatic).
- Arthroscopic shoulder surgery - interscalene b., single-shot or continuous. IA is not beneficial.
- Hand & forearm surgery - axillary b. offers analgesic benefits only on day of surgery.
- TAP block is beneficial for laparoscopic, open appendectomy, abdominal surgery, cesarean section, and TAH.
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Anesthesia and analgesia · May 2013
Case ReportsCase report: Three-dimensional high-resolution ultrasound-guided nerve blocks: a new panoramic vision of local anesthetic spread and perineural catheter tip location.
We report in 3 patients that high-frequency ultrasound 3-dimensional imaging enabled us to analyze anatomic variations, evaluate local anesthetic spread, and optimize a perineural catheter location by withdrawing it until its tip was appropriately positioned. This innovative technology may provide answers to different problems facing the operator performing ultrasound-guided nerve blocks. It may enhance predictability and safety aspects of peripheral nerve blocks.
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Anesthesia and analgesia · May 2013
Editorial CommentComparing apples to oranges: just say no to N2O?