Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2008
The endothelin receptor antagonist tezosentan improves renal microcirculation in a porcine model of endotoxemic shock.
Impaired renal microcirculation has been suggested as a factor contributing to the development of renal dysfunction in sepsis. This study was conducted to elucidate the role of endothelin-1 (ET-1)in mediating reductions in renal microcirculatory blood flow during endotoxemic shock. ⋯ These results indicate that treatment with the dual endothelin receptor tezosentan in endotoxemic shock attenuates the reduction of renal microcirculation and total renal blood flow independently of plasma changes in the renin-angiotensin-aldosterone system or early plasma cytokine response.
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Acta Anaesthesiol Scand · Nov 2008
Randomized Controlled Trial Comparative StudyEpidural sufentanil provides better analgesia from 24 h after surgery compared with epidural fentanyl in children.
Studies comparing epidural fentanyl and sufentanil in adults reported a similar analgesic effect with variable side effects. We hypothesized that epidural fentanyl and sufentanil will have a similar analgesic effect in children undergoing urological surgery. ⋯ Epidural sufentanil provides better analgesia from 24 h after surgery compared with epidural fentanyl in infants and children undergoing urological surgery. The incidence of pruritus in the sufentanil group was higher than that in the fentanyl group.
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Acta Anaesthesiol Scand · Nov 2008
Randomized Controlled TrialHigh-volume infiltration analgesia in total knee arthroplasty: a randomized, double-blind, placebo-controlled trial.
High-volume infiltration analgesia may be effective with a low risk of side effects in hip and knee arthroplasty. The present placebo-controlled study was carried out to evaluate the analgesic effect of high-volume infiltration analgesia in bilateral total knee arthroplasty, along with a detailed description of the infiltration technique. ⋯ High-volume infiltration analgesia is effective in knee arthroplasty and, due to its simplicity, may be preferable compared with other analgesic techniques in knee arthroplasty.
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Acta Anaesthesiol Scand · Nov 2008
Randomized Controlled TrialItraconazole, a potent inhibitor of P-glycoprotein, moderately increases plasma concentrations of oral morphine.
Individual variation in opioid response is considerable, partly due to pharmacokinetic factors. Transporter proteins are becoming increasingly interesting also in the pharmacokinetics of opioids. The efflux transporter P-glycoprotein can affect gastrointestinal absorption and tissue distribution, particularly brain access of many opioids. The aim of this study was to evaluate whether itraconazole, which is a potent inhibitor of P-glycoprotein and CYP3A4, would change the pharmacokinetics or the pharmacodynamics of oral morphine. ⋯ Itraconazole moderately increases plasma concentrations of oral morphine, probably by enhancing its absorption by inhibiting intestinal wall P-glycoprotein. A possible improvement of morphine penetration to the brain could not be observed.