Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2013
Communication latencies of wireless devices suitable for time-critical messaging to anesthesia providers.
Rapid and reliable methods of text communication to mobile anesthesia care providers are important to patient care and to efficient operating room management. Anesthesia departments are implementing automated methods to send text messages to mobile devices for abnormal vital signs, clinical recommendations, quality of care, and compliance or billing issues. The most time-critical communications determine maximum acceptable latencies. We studied the reliability of several alphanumeric messaging systems to identify an appropriate technology for such use. ⋯ Developers of anesthesia communication systems need to measure latencies of proposed communication pathways and devices used to deliver urgent messages to mobile users. Similar evaluation is relevant for text pagers used on an ad hoc basis for delivery of time-critical notifications. Testing over a period of hours to days is adequate only for disqualification of a candidate paging system, because acceptable results are not necessarily indicative of long-term performance. Rather, weeks of testing are required, with appropriate batching of pages for analysis.
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Anesthesia and analgesia · Apr 2013
The antinociceptive and antihyperalgesic effects of topical propofol on dorsal horn neurons in the rat.
Propofol (2,6-diisopropylphenol) is an IV anesthetic used for general anesthesia. Recent evidence suggests that propofol-anesthetized patients experience less postoperative pain, and that propofol has analgesic properties when applied topically. We presently investigated the antinociceptive effects of topical propofol using behavioral and single-unit electrophysiological methods in rats. ⋯ The results indicate that topical propofol inhibits responses of WDR neurons to noxious heat consistent with analgesia, and reduced AITC sensitization of WDR neurons consistent with an antihyperalgesic effect. These results are consistent with clinical studies demonstrating reduced postoperative pain in surgical patients anesthetized with propofol. The mechanism of analgesic action of topical propofol is not clear, but may involve desensitization of TRPV1 or TRPA1 receptors expressed in peripheral nociceptive nerve endings, engagement of endocannabinoids, or activation of peripheral γ-aminobutyric acid A receptors.
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Anesthesia and analgesia · Apr 2013
Characterization and quantification of isoflurane-induced developmental apoptotic cell death in mouse cerebral cortex.
Accumulating evidence indicates that isoflurane and other, similarly acting anesthetics exert neurotoxic effects in neonatal animals. However, neither the identity of dying cortical cells nor the extent of cortical cell loss has been sufficiently characterized. We conducted the present study to immunohistochemically identify the dying cells and to quantify the fraction of cells undergoing apoptotic death in neonatal mouse cortex, a substantially affected brain region. ⋯ Prolonged exposure to isoflurane increased neuronal apoptotic cell death in 7-day-old mice, eliminating approximately 2% of cortical neurons, of which some were identified as GABAergic interneurons. Moreover, isoflurane exposure interfered with the inhibitory nervous system by downregulating the central enzymes GAD65 and GAD67. Conversely, at this age, only a minority of degenerating cells were identified as astrocytes. The clinical relevance of these findings in animals remains to be determined.