Journal of anesthesia
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Journal of anesthesia · Feb 2013
No renal protection from volatile-anesthetic preconditioning in open heart surgery.
Acute kidney injury (AKI) is a common complication of open heart surgery (OHS). Preconditioning with volatile anesthetics is well proven to provide myocardial protection. Renal protection provided by volatile-anesthetic preconditioning has also been investigated; however, it is still controversial at the clinical level. This study aimed to investigate whether preconditioning with volatile anesthetics could mediate renal protection in OHS. ⋯ This study could not demonstrate volatile-anesthetic-mediated renal protection in OHS. Therefore, in practice, pharmacological preconditioning with volatile anesthetics did not seem to be beneficial.
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Journal of anesthesia · Feb 2013
The anesthetic urethane blocks excitatory amino acid responses but not GABA responses in isolated frog spinal cords.
The anesthetic urethane is commonly used in physiological experiments. We tested urethane's actions on GABA receptors on the primary afferents in the spinal cord, which are one of the few areas in the adult central nervous system (CNS) that are depolarized by GABA, and on ligand-gated excitatory amino acid (EAA) receptors located on motoneurons. Both receptor types are critically important during anesthetic immobilization. ⋯ Urethane appears to be selective for EAA-, sparing GABA responses at a clinical anesthetic concentration. Only a 10 % reduction of EAA activity seems to be necessary to induce anesthesia.
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Journal of anesthesia · Feb 2013
Day zero ambulation under modified femoral nerve block after minimally invasive surgery for total knee arthroplasty: preliminary report.
Ambulation in the early postoperative period of total knee arthroplasty is crucial, in order to avoid complications and obtain preferable outcomes. Although a femoral nerve block can provide enough postoperative analgesia after total knee arthroplasty, falling, or other accidents due to motor paresis, are potentially adverse events in patients who have received a conventional femoral nerve block. We devised a modified femoral nerve block to spare voluntary knee extension ability, and clinically applied it to patients who received total knee arthroplasty under minimally invasive surgery. ⋯ Patients were able to not only actively raise their extremities with their knee in extension, but also to flex the knee in the air without pain or aggravation. On day 0, the patients were able to walk around, with the leg that had been operated upon not giving way. Our anesthetic approach can provide better pain relief than a conventional femoral nerve block, while the patients achieve ambulation on the day of the procedure, following minimally invasive knee surgery.
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Journal of anesthesia · Feb 2013
Incidence of and risk factors for postoperative nausea and vomiting at a Japanese Cancer Center: first large-scale study in Japan.
The first purpose of this study was to determine the incidence of postoperative nausea and/or vomiting (PONV) 0-48 h after anesthesia at a Japanese cancer center. The second purpose of this study was to collect information on PONV risk factors, independently, in the categories of patient-related, anesthesia-related, and surgery-related factors. ⋯ The incidence of and risk factors for PONV at a Japanese cancer center according to this study are comparable to those reported elsewhere.
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Celiac plexus block (CPB) can be used for treating intra-abdominal visceral pain syndromes. The celiac plexus is the largest plexus of the sympathetic nervous system. Several nerve blocks have a marked effect on autonomic nervous activity. Furthermore, stellate ganglion block changes cardiac autonomic nervous activity. Thus, CPB could influence the sympathetic activity of the cardiac plexus. The aim of the present study was to see whether CPB modulated heart rate variability (HRV) in patients with pancreatic cancer. ⋯ CPB did not induce any significant changes in HRV or hemodynamics.