Journal of anesthesia
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The nociceptin system comprises the nociceptin receptor (NOP) and the ligand nociceptin/orphanin FQ (N/OFQ) that binds to the receptor. The archetypal role of the system is in pain processing but the NOP receptor is also expressed on immune cells. ⋯ As there is a loss of regulation of inflammatory responses during sepsis, the nociceptin system could be a target for therapies aimed at modulating sepsis. This review details the known effects of NOP activation on leucocytes and the vascular endothelium and discusses the most recent human and animal data on the role of the nociceptin system in sepsis.
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Journal of anesthesia · Oct 2014
Clinical evaluation of hyponatremia and hypovolemia in critically ill adult neurologic patients: contribution of the use of cumulative balance of sodium.
Knowledge of the cumulative balance of sodium (CBS) is important for the diagnosis of salt disorders and water homeostasis and has the potential to predict hypovolemic status in acute neurological patients. However, an extensive application of the use of CBS is still lacking in the intensive care setting, where salt and water homeostasis represents a priority. ⋯ CBS is likely to be a useful parameter in the diagnosis of CSWS and a surrogate parameter for estimating hypovolemia in acute neurological patients.
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Journal of anesthesia · Oct 2014
Incidence and predictors of difficult nasotracheal intubation with airway scope.
The airway scope (AWS) improves views of the larynx during orotracheal intubation. However, the role of the AWS in routine nasotracheal intubation has not been studied adequately. ⋯ The AWS achieves a high success rate for nasotracheal intubation with cuff inflation in patients undergoing dental and maxillofacial surgery.
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Journal of anesthesia · Oct 2014
Preventive effects of multisensory rehabilitation on development of cognitive dysfunction following systemic inflammation in aged rats.
Systemic inflammation can trigger transient or longer-lasting cognitive impairments, particularly in elderly patients. However, its pathogenesis has not been sufficiently clarified. In this study, we explored the potential effects of multisensory rehabilitation on cognitive dysfunction following systemic inflammation using an animal model. ⋯ These memory deficits were positively correlated with the levels of both tumor necrosis factor (TNF)-α and interleukin (IL)-1β in the hippocampus. On the other hand, in the LPS-treated ER group, neither cognitive impairment nor an increase in hippocampal levels of both TNF-α and IL-1β was found. These results imply that early rehabilitation (ER) intervention may be effective in preventing cognitive dysfunction following systemic inflammation via its anti-neuroinflammatory effects.
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Journal of anesthesia · Oct 2014
Effects of a simulation-based sedation training course on non-anesthesiologists' attitudes toward sedation and analgesia.
The purpose of this study was to conduct a survey of emergency or complication during sedation and change of attitude toward sedation by simulation-based sedation training course (SEDTC) hosted by the Japanese Association of Medical Simulation. We used a questionnaire survey to non-anesthesiologists who participated in the 1st to 13th SEDTCs from 2011 to 2012. Survey contents included emergencies or complications during sedation and impressions of the Sedation and Analgesia guidelines for non-anesthesia doctors developed by the American Society of Anesthesiologists. ⋯ Non-anesthesiologists largely accepted the guidelines. SEDTC attendance improved significantly 13 points of 18 important suggestions. As non-anesthesiologists experience several complications during sedation, SEDTC may be useful for the improvement of their attitude toward the safety management of sedation.