Journal of anesthesia
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Journal of anesthesia · Sep 1996
Effects of spinal naloxone and naltrindole on the antinociceptive action of intrathecally administered dexmedetomidine.
Intrathecally administered alpha-2 adrenoceptor and opioid agonists are well known to exert antinociceptive effects in humans and various animals. To examine the interaction of these two groups of agents in the spinal cord, we tested the effect of the opioid antagonists naloxone or naltrindole on the antinociceptive action of an intrathecally administered alpha-2 agonist, dexmedetomidine, using a formalin test in rats. 19 groups of Sprague-Dawley rats (250-300 g) were prepared with chronic intrathecal catheters and examined for the effects of agents on the formalin test. Each group contained 6 animals. 50 μl of 5% formalin was injected subcutaneously in the plantar surface of one hind paw. ⋯ Intrathecal dexmedetomidine (1 μg) maximally depressed the behavioral changes in both phase 1 and phase 2 of the formalin test, which was antagonized by the alpha-2 adrenoceptor selective antagonist atipamezole (0.3 μg). Naloxone (0.1-10 μg) or naltrindole (1-10 μg), when coadministered with dexmedetomidine, showed a dose-dependent antagonism to the effect of dexmedetomidine, whereas naloxone, naltrindole, or atipamezole alone showed no effect on the nocieptive behavior due to formalin injection. These results indicate that the antinociceptive effect of intrathecally administered alpha-2 adrenoceptor agonists may involve opioid receptors in the spinal cord.
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We report a case of femoral neuropathy caused by retractors used during operation. The patient (a 74-year-old woman) was scheduled for right hemicolectomy for cecum cancer, and anesthesia was maintained with nitrous oxide and sevoflurane in oxygen plus extradural anesthesia. After operation, the patient complained of hypesthesia in the anterolateral and medial area governed by the femoral nerve. ⋯ After 2 months, the patient had completely recovered from the neurological symptoms. These manifestations were indicative of femoral neuropathy resulting from the pressure of large-bladed self-retraining retractors. It is important to include femoral neuropathy in the differential diagnosis of postoperative paralysis of the lower limb.
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Journal of anesthesia · Sep 1996
Clinical evaluation of a new continuous intraarterial blood gas monitoring system in the intensive care setting.
The present study was designed to evaluate a new continuous intraarterial blood gas monitoring system under routine clinical intensive care conditions. Nine mechanically ventilated adult patients were enrolled in this study. A multiparameter intravascular sensor was inserted into the radial or dorsalis pedis artery through a 20-gauge cannula in each patient. ⋯ In clinically important ranges of Po2, less than 200 mmHg in particular, the bias and precision values were -2.25±6.48 mmHg in the range of less than 100mmHg, and 0.98±14.38 mmHg in the range of 100-200 mmHg. Variations of sensor accuracy as a function of elapsed time were within the clinically acceptable range throughout the study period. These findings suggest that this new device is sufficiently useful for routine clinical settings.
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Journal of anesthesia · Sep 1996
Cervical sympathectomy affects adrenocorticotropic hormone and thyroid-stimulating hormone in rats.
To examine the effects of bilateral cervical sympathectomy on the secretion of adrenocorticotropic hormone (ACTH), thyroid-stimulating hormone (TSH), growth hormone (GH), and prolactin (PRL), 18 male rats were divided into three groups: control (Cont), sham operation (Sham), and bilateral cervical sympathectomy (Symp). All rats were kept under a normal circadian rhythm for 2 weeks. Subsequently, blood was collected and plasma ACTH as well as serum TSH, GH, and PRL levels were measured. ⋯ The present results suggest that cervical sympathectomy in the rat increases ACTH secretion and decreases TSH secretion in the pituitary. These effects seem to be due to a mildly increased secretion of melatonin in the pineal body that probably in turn increases corticotropin-releasing factor (CRF) secretion and decreases thyrotropin-releasing hormone (TRH) secretion in the hypothalamus. Extrapolation of these findings to humans suggests that longterm and repeated stellate ganglion block would affect the pituitary secretions of ACTH and TSH.
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Journal of anesthesia · Sep 1996
RETRACTED ARTICLE: Dibutyryl cyclic AMP increases the contractility of fatigued diaphragm in dogs.
The effects of dibutyryl cyclic AMP (DBcAMP) on the contractility of nonfatigued and fatigued diaphragms were studied in 36 anesthetized and mechanically ventilated dogs. The animals were divided into four groups. In group C1 (n=8), dogs without fatigue received only Ringer's lactate solution. ⋯ In group D2, Pdi at both stimuli increased significantly with an infusion of DBcAMP compared with the fatigue values (20 Hz; 13.3±3.3vs 9.3±2.1, 100 Hz; 23.4±3.6vs 21.3±3.2;P<0.05). In group C2, the speed of recovery from fatigue was relatively slower at 20-Hz stimulation than at 100-Hz stimulation. It is concluded that DBcAMP increases the contractility of fatigued diaphragm, but that this agent does not affect the contractility of nonfatigued diaphragm.