Journal of anesthesia
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Journal of anesthesia · Jan 2007
Cardiac output increases the rate of carbon monoxide elimination in hyperpneic but not normally ventilated dogs.
The very high solubility of carbon monoxide (CO) in blood suggests that its elimination depends predominantly on ventilation and not perfusion. Nevertheless, hyperventilation is not used for CO elimination because of the adverse effects of hypocapnia. With isocapnic hyperpnea (IH), ventilation can be increased considerably without hypocapnia. This raises the issue of whether CO elimination is limited by perfusion during IH. We studied the effect of increasing cardiac output on t1/2, the half-time of decline of blood carboxyhemoglobin concentration ([COHb]), during normal ventilation (NV) and during IH. ⋯ These findings suggest that CO elimination during IH treatment is limited at least partly by pulmonary blood flow and may therefore be further augmented by increasing cardiac output.
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Journal of anesthesia · Jan 2007
Randomized Controlled Trial Comparative StudyEffect of narcotic pretreatment on pain after rocuronium injection: a randomized, double-blind controlled comparison with lidocaine.
Various strategies have been studied to reduce the discomfort of rocuronium pain. These studies have shown fentanyl and lidocaine to be effective in reducing the incidence of pain on rocuronium injection. This prospective, randomized, and double-blind study was carried out on 80 neurosurgical patients for whom pain on rocuronium injection was assessed after pretreatment with lidocaine, fentanyl, sufentanil, or normal saline. ⋯ In the sufentanil group, 85% of patients reported pain, of whom 25% fell into the severe to very severe group. We found that lidocaine was best at decreasing the incidence of pain on intravenous (i.v.) injection of rocuronium. Although the incidence of pain on injection of rocuronium with both fentanyl and sufentanil was high, the intensity was definitely reduced, with most patients falling in the mild pain group.
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Journal of anesthesia · Jan 2007
Randomized Controlled Trial Comparative StudyHeparin anticoagulation in patients undergoing off-pump and on-pump coronary bypass surgery.
The authors analyzed the coagulation data of patients who underwent on-pump coronary artery bypass graft (CABG) or off-pump coronary artery bypass surgery (OPCAB) in a randomized prospective trial. ⋯ We have shown that the heparin anticoagulation regimen in OPCAB patients does not lead to an immediate hypercoagulable state. Total doses of heparin and protamine were lower in the OPCAB group compared with the CABG group, and there was a residual heparin effect on TEG and PTT in the early postoperative period in the OPCAB group.