Journal of anesthesia
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Journal of anesthesia · Oct 2018
Randomized Controlled Trial Comparative StudyUltrasound-guided lumbar plexus block using three different techniques: a comparison of ultrasound image quality.
The purpose of this study was to compare the ultrasound image quality at three different transducer positions for ultrasound-guided lumbar plexus block (LPB). ⋯ Under the conditions of this study, the contrast between LP and PMM is significantly higher at paravertebral position than at medial position and at the abdominal transverse flank (shamrock position). LP and PMM at the shamrock position appear significantly brighter among the three probe positions in sonograms.
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Neuropathic pain is a common health problem that affects millions of people worldwide. Despite being studied extensively, the cellular and molecular events underlying the central immunomodulation and the pathophysiology of neuropathic pain is still controversial. The idea that 'glial cells are merely housekeepers' is incorrect and with respect to initiation and maintenance of neuropathic pain, microglia and astrocytes have important roles to play. ⋯ Inhibition of astrocytes before and after induction of neuropathic pain has been found to prevent and reverse neuropathic pain, respectively. Moreover, microglial inhibitors have been found to prevent (but not to reverse) neuropathic pain. As they are expressed by glia, opioid receptors are expected to have a role to play in neuropathic pain.
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Journal of anesthesia · Oct 2018
Multicenter Study Observational StudyHypotension after induction of general anesthesia: occurrence, risk factors, and therapy. A prospective multicentre observational study.
Hypotension after induction of general anesthesia (GAIH) is common in anesthesiology practice and can impact outcomes. ⋯ GAIH rate depends on age, degree of blood pressure decompensation prior the surgery, and presence of diabetes mellitus type II.
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Journal of anesthesia · Oct 2018
Randomized Controlled Trial Comparative StudyAnalgesic effects of methadone and magnesium following posterior spinal fusion for idiopathic scoliosis in adolescents: a randomized controlled trial.
To provide optimal conditions for neurophysiological monitoring and rapid awakening, remifentanil is commonly used during pediatric spinal surgery. However, remifentanil may induce hyperalgesia and increase postoperative opioid requirements. We evaluated the potential of methadone or magnesium to prevent remifentanil-induced hyperalgesia. ⋯ With the dosing regimens in the current study, the only benefit noted with methadone was a decrease in perioperative opioid requirements. However, given the potential for hyperalgesia with the intraoperative use of remifentanil, adjunctive use of methadone appears warranted.