Journal of anesthesia
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Journal of anesthesia · Jan 2007
Comparative StudyEarly neuropsychological dysfunction in elderly high-risk patients after on-pump and off-pump coronary bypass surgery.
Advanced age is associated with systemic atherosclerosis and is a risk factor for neurological dysfunction after coronary artery bypass grafting (CABG). However, few studies have investigated early neurological dysfunction after off-pump CABG in elderly patients. ⋯ Off-pump CABG reduced postoperative NP dysfunction in elderly patients with severe systemic atherosclerosis compared to on-pump CABG.
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Journal of anesthesia · Jan 2007
Clinical TrialPain-relieving effects of intravenous ATP in chronic intractable orofacial pain: an open-label study.
Chronic orofacial pain is often refractory to conventional pain therapies. We conducted an open-label study to determine whether adenosine 5'-triphosphate (ATP) could alleviate chronic intractable orofacial pain, and if so, which type of pain could respond to ATP. ⋯ Intravenous ATP did not relieve non-neuropathic orofacial pain. However, it exerted slowly expressed but long-lasting analgesic and anti-allodynic effects in patients with neuropathic orofacial pain, especially in those suffering from neuropathic pain following pulpectomy and/or tooth extraction.
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Journal of anesthesia · Jan 2007
Comparative StudyPrognostic value of serum myoglobin in patients after cardiac surgery.
Serum myoglobin as a marker of myocardial damage and injury has been shown to be of prognostic value in patients with cardiovascular events. In this study, we analyzed the prognostic value of serum myoglobin in comparison to other parameters of muscle damage and renal function in patients after cardiac surgery. ⋯ Serum myoglobin is associated with outcome in patients after cardiac surgery. Prediction of ICU mortality and need for RRT was comparable for myoglobin and creatinine, while both were significantly superior to CK.
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Journal of anesthesia · Jan 2007
Case ReportsAnesthetic management of a patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) during laparotomy.
A 53-year-old man with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) underwent a gastrectomy. We administered bicarbonated Ringer's solution, which has a physiological concentration of bicarbonate. ⋯ Aggressive warming was needed to maintain normothermia, presumably because the mitochondrial respiratory chain, which is responsible for thermogenesis, is impaired in MELAS patients. It is important to maintain normothermia in MELAS patients in order to avoid further mitochondrial metabolic depression.
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The dose and time course of propofol infusion required to induce rapid sedation without oversedation during spinal anesthesia were investigated. ⋯ Propofol infusion, starting with 10 mg.kg(-1).h(-1), decreasing to 5 mg.kg(-1).h(-1) after 1 minute, and then decreasing to 2.5 mg.kg(-1).h(-1) after another min induced rapid onset of sedation and kept the OAAS score at 3 or 4 during spinal anesthesia.