Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2014
Multicenter StudyEpidural lysis of adhesions for failed back surgery and spinal stenosis: factors associated with treatment outcome.
Failed back surgery syndrome (FBSS) is a challenging problem. One treatment advocated to treat FBSS is epidural lysis of adhesions (LOA). The results of studies examining LOA for FBSS have been mixed, but are limited because no study has ever sought to identify factors associated with outcomes. ⋯ Considering our modest success rate, selecting patients for epidural LOA based on demographic and clinical factors may help better select treatment candidates. Procedural factors such as the use of hyaluronidase that increase risks and costs did not improve outcomes, so further research is needed before these become standard practice.
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Previous studies have shown that local anesthetics may induce apoptosis in some cell types. In this study, we investigated the apoptotic effects of local anesthetics in human breast tumor cells. ⋯ Lidocaine and bupivacaine induce apoptosis of breast tumor cells at clinically relevant concentrations. Our results reveal previously unrecognized beneficial actions of local anesthetics and call for further studies to assess the oncologic advantages of their use during breast cancer surgery.
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Anesthesia and analgesia · Jan 2014
Time-delay when updating infusion rates in the graseby 3400 pump results in reduced drug delivery.
Infusion pumps are commonly used for infusion of drugs for physiologic control, and infusion rate has been demonstrated to affect the parameters of pharmacokinetic models. In attempting to develop a model that explained this behavior, we examined the behavior of the Graseby 3400 syringe pump under a range of flow conditions and with variations in syringe characteristics. ⋯ These effects are influenced by syringe characteristics and vary sufficiently as to make it impossible to isolate this effect from the pharmacokinetic process being controlled. The implications of this for previous published results and clinical application of target-controlled infusions are discussed.
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Anesthesia and analgesia · Jan 2014
Hypergravity Exposure for 14 Days Increases the Effects of Propofol in Rats.
It is thought that the gravitational environment of space exploration alters the effects of anesthetics; however, no evidence has as yet been reported. In the present study, we sought to provide direct evidence showing that hypergravity exposure for 14 days increases anesthetic effects and to examine the possible causes. ⋯ The results provide evidence that hypergravity exposure for 14 days increases the effects of propofol. It is suggested that the results were not caused by differences in plasma propofol concentrations but by increased sensitivity, which was mediated via the vestibular system.