Journal of anesthesia
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Journal of anesthesia · Aug 2012
Calcium channel blockers are inadequate for malignant hyperthermia crisis.
Malignant hyperthermia (MH) results from disordered calcium (Ca(2+)) homeostasis in skeletal muscle during general anesthesia. Although Ca(2+) channel blockers may be given to treat the tachycardia and circulatory instability, coadministration of Ca(2+) channel blockers and dantrolene is contraindicated during MH crisis. We evaluated the effect of Ca(2+) channel blockers on Ca(2+) homeostasis and their interactions with dantrolene in human skeletal muscle. ⋯ Ca(2+) channel blockers led to increased [Ca(2+)](i) in human skeletal muscle cells. The increase is thus scarcely affected by dantrolene treatment. Data provide a greater physiologic basis for avoiding the use of Ca(2+) channel blockers during MH crisis.
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Journal of anesthesia · Aug 2012
Effects of tidal volume and PEEP on arterial blood gases and pulmonary mechanics during one-lung ventilation.
The main problem of one-lung ventilation (OLV) is hypoxemia. The use of a high tidal volume for preventing hypoxemia during OLV is controversial. We compared the effects of a high tidal volume versus a low tidal volume with or without PEEP on arterial oxygen tension (PaO(2)) and pulmonary mechanics during OLV. ⋯ During OLV, mechanical ventilation with a low tidal volume with or without PEEP increased hypoxemia as compared to that when performing OLV with a high tidal volume.
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Journal of anesthesia · Aug 2012
Case ReportsPerioperative management of a patient with thyroid hormone resistance who underwent total thyroidectomy for thyroid cancer.
Resistance to thyroid hormone (RTH) is a rare, predominantly inherited syndrome that involves impaired tissue responsiveness to thyroid hormones. We describe the perioperative management of a patient with RTH who underwent total thyroidectomy. ⋯ Moreover, thyroid function even after discharge remained unstable despite replacement therapy. We suggest that the parathyroid and thyroid function of patients with RTH be followed very closely and that nociceptive stimulus of the surgery and postoperative pain be reduced as much as possible.
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Journal of anesthesia · Aug 2012
Effects of TrkA inhibitory peptide on cancer-induced pain in a mouse melanoma model.
Tropomyosin receptor kinase (Trk) A, a high-affinity receptor of nerve growth factor, is a therapeutic target for both noxious and neuropathic pain. The present study examined the effects of an inhibitory peptide of Trk activity (IPTRK) 3 that inhibits TrkA activity on cancer-induced pain in a mouse melanoma model. ⋯ These results suggest that TrkA inhibitory peptide likely suppress melanoma-induced pain with concomitant reduction in the increased paw volume in a mouse skin cancer pain model.
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Journal of anesthesia · Aug 2012
Risk factors for gastric distension in patients with acute appendicitis: a retrospective cohort study.
There has been no report on risk factors for gastric distension (GD) when inducing general anesthesia in an emergency situation. The aim of this study was to clarify the risk factors for GD in patients with acute appendicitis at their hospital visit. ⋯ Younger appendicitis patients with acute abdominal pain for 1 or more days should be treated as patients with high risk for GD.