Journal of anesthesia
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Journal of anesthesia · Apr 2013
ReviewThe recent progress in research on effects of anesthetics and analgesics on G protein-coupled receptors.
The exact mechanisms of action behind anesthetics and analgesics are still unclear. Much attention was focused on ion channels in the central nervous system as targets for anesthetics and analgesics in the 1980s. During the 1990s, major advances were made in our understanding of the physiology and pharmacology of G protein coupled receptor (GPCR) signaling. ⋯ There has been little work on G(s)- and G(i)-coupled receptors. In the last decade, a new assay system, using chimera G(i/o)-coupled receptor fused to Gq(i5), has been established and the effects of anesthetics and analgesics on the function of G(i)-coupled receptors is now more easily studied. This review highlights the recent progress of the studies regarding the effects of anesthetics and analgesics on GPCRs.
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Journal of anesthesia · Apr 2013
Factors affecting fetal bradycardia following combined spinal epidural for labor analgesia: a matched case-control study.
The combined spinal epidural (CSE) technique for labor analgesia has become increasingly popular owing to its rapid onset of analgesia. However, incidences of fetal bradycardia following CSE have been reported. This study aimed to identify predictors of fetal bradycardia post CSE, such as a decrease in pain scores, the block height, Prostin (dinoprostone; Pfizer) use, and dosage of oxytocin. ⋯ The difference between pre- and post-CSE pain scores, and a higher sensory block height, which are surrogates for a greater degree of sympatholysis, were found to be risk factors for fetal bradycardia post CSE.
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Journal of anesthesia · Apr 2013
Randomized Controlled TrialTramadol and levobupivacaine wound infiltration at cesarean delivery for postoperative analgesia.
The aim of the present study was to investigate whether levobupivacaine and tramadol wound infiltration decreases postoperative pain following Cesarean section and reduces the need for analgesics in the immediate post-delivery period. ⋯ We conclude that wound infiltration with tramadol and levobupivacaine in patients having Cesarean section under general anesthesia may be a good choice for postoperative analgesia.
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Journal of anesthesia · Apr 2013
A pilot study of the pleth variability index as an indicator of volume-responsive hypotension in newborn infants during surgery.
The aim of this pilot study was to evaluate the diagnostic value of pleth variability index (PVI) to predict fluid responsiveness in newborn infants during surgery. ⋯ This preliminary evaluation shows that PVI may indicate VRH in newborn infants during surgery.
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Journal of anesthesia · Apr 2013
Case ReportsThe use of inhaled nitric oxide and prone position in an ARDS patient with severe traumatic brain injury during spine stabilization.
The use of inhaled nitric oxide in patients with traumatic brain injury, intracranial hypertension, and acute respiratory distress syndrome (ARDS) has been reported in an intensive care unit setting only in a few case reports. The use of the prone position for patients with traumatic brain injury and lung impairment has been reported only in selected cases. Here we report our experience with the use of both inhaled nitric oxide and the prone position together in the operating room in a patient with head injury and ARDS who underwent column stabilization.