Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2013
Randomized Controlled TrialResponse to succinylcholine in patients carrying the K-variant of the butyrylcholinesterase gene.
Succinylcholine is usually metabolized quickly by the butyrylcholinesterase enzyme (BChE) but genetic variants of BChE may prolong the duration of action. The Kalow (K) variant is the most common mutation in the butyrylcholinesterase gene (BCHE), being present in 25% of Caucasians. The significance of the K-variant for the duration of action of succinylcholine has not been well studied. Our hypothesis was that the duration of action of succinylcholine would be prolonged in patients heterozygous for the K-variant genotype compared with the normal genotype (wild-type). ⋯ We conclude that the mean duration of action of succinylcholine is prolonged for the patient heterozygous for the K-variant allele by at most 4 minutes relative to the wild-type, but this difference is small relative to the wide variability and overlap in recovery times among all patients.
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Anesthesia and analgesia · Mar 2013
Randomized Controlled Trial Comparative StudyA randomized comparison of ropivacaine 0.1% and 0.2% for continuous interscalene block after shoulder surgery.
The optimal concentration of ropivacaine for continuous interscalene block after shoulder surgery is currently unknown. ⋯ These results suggest that ropivacaine 0.2% provides more effective analgesia than ropivacaine 0.1% during the first 24 hours for continuous interscalene block after shoulder surgery.
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Anesthesia and analgesia · Mar 2013
Differential involvement of central and peripheral α2 adrenoreceptors in the antinociception induced by aerobic and resistance exercise.
Several studies have demonstrated antinociception induced by exercise; however, the specific mechanisms for this effect are not well understood. Thus, we investigated the involvement of α2-adrenergic receptors (α2-ARs) in the antinociceptive effect produced by exercise in rats and mice. ⋯ These results suggest a peripheral involvement of α2-ARs in the antinociception induced by aerobic and resistance exercise.
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Anesthesia and analgesia · Mar 2013
Case ReportsA feasibility study using the VivaSight Single Lumen™ to intubate the trachea through the Fastrach laryngeal mask airway: a preliminary report of 50 cases.
The VivaSight Single Lumen™ (SL) is new endotracheal tube with a video camera and a light source in the tip allowing continuous visual observation of the airway. In this study, we checked the feasibility of endotracheal intubation with a VivaSight-SL through the Fastrach Laryngeal Mask Airway(®) (FT-LMA). ⋯ The high first-attempt intubation success rate using the VivaSight-SL to intubate the trachea through a FT-LMA makes this technique an attractive and promising concept.
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Anesthesia and analgesia · Mar 2013
Medication and volume delivery by gravity-driven micro-drip intravenous infusion: potential variations during "wide-open" flow.
Gravity-driven micro-drip infusion sets allow control of medication dose delivery by adjusting drops per minute. When the roller clamp is fully open, flow in the drip chamber can be a continuous fluid column rather than discrete, countable, drops. We hypothesized that during this "wide-open" state, drug delivery becomes dependent on factors extrinsic to the micro-drip set and is therefore difficult to predict. We conducted laboratory experiments to characterize volume delivery under various clinically relevant conditions of wide-open flow in an in vitro laboratory model. ⋯ Laboratory simulation of clinical situations with gravity-driven micro-drip infusion sets under wide-open flow conditions revealed that infusion rate (drug and/or volume delivery) can vary widely depending on extrinsic factors including catheter size, fluid column height, and carrier flow. The variable resistance implies nonlaminar flow in the micro-drip model that cannot be easily predicted mathematically. These findings support the use of mechanical pumps instead of gravity-driven micro-drips to enhance the precision and safety of IV infusions, especially for vasoactive drugs.