Articles: anesthetics.
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Anaesth Intensive Care · Nov 2024
Promoting behavioural change by educating anaesthetists about the environmental impact of inhalational anaesthetic agents: A systematic review.
Of the total carbon footprint of Australia, 7% is attributed to healthcare. In the UK, inhalational agents make up 5% of the healthcare carbon footprint. This systematic review aims to determine which methods of education about the environmental impact of inhalational anaesthetic agents can be utilised to promote behaviour change, reducing the anaesthetic-related carbon footprint. ⋯ The most common teaching techniques utilised in education curricula were didactic lectures (85%), visual prompts (54%), emails (46%), and conversation forums (31%). All but one study reported a positive relationship between teaching sessions and behavioural change resulting in lower inhalational anaesthetic use by participants and their organisations, reducing healthcare-associated emissions. This systematic review has demonstrated that single education sessions as well as multi-focused, multimodal education curricula on the topic of greener anaesthesia can be beneficial in promoting behavioural change.
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Int J Obstet Anesth · Nov 2024
Case ReportsNeuraxial labor analgesia in a parturient with carnitine palmitoyl transferase type II deficiency: a case report.
Carnitine Palmitoyl Transferase Type II (CPT II) deficiency is a disorder of fatty acid beta oxidation that causes decreased adenosine triphosphate (ATP) and ketone production during periods of fasting or high energy requirements. Labor and delivery can precipitate attacks for parturients with this disorder, causing hypoglycemia, muscle weakness, rhabdomyolysis, and kidney failure. Anesthetic management considers the delivery mode and anesthetic medications available to reduce these risks. We present the case of a pregnant patient with CPT II deficiency with labor epidural analgesia and a vaginal delivery, with alternative plans had a different delivery mode been required.
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J. Cardiothorac. Vasc. Anesth. · Nov 2024
Observational StudySerum Levels of Bupivacaine After Bilateral Ultrasound-Guided Deep Parasternal Intercostal Plane Block in Cardiac Surgery with Median Sternotomy.
To evaluate systemic levels of bupivacaine after bilateral ultrasound-guided deep parasternal intercostal plan (PIP) block in cardiac surgical patients undergoing median sternotomy. ⋯ Bilateral PIP placed at the end of cardiac surgery resulted in low systemic bupivacaine levels. The inclusion of additives shortened Tmax without improving outcome.
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Anesthesia and analgesia · Nov 2024
A Behavioral and Electroencephalographic Study of Anesthetic State Induced by MK-801 Combined with Haloperidol, Ketamine and Riluzole in Mice.
Ketamine is an intravenous anesthetic that acts as a channel blocker on the N-methyl- d -aspartate (NMDA) receptor, a glutamate receptor subtype. MK-801 is the most potent compound among noncompetitive NMDA receptor antagonists. Ketamine induces loss of the righting reflex (LORR) in rodents, which is one of the indicators of unconsciousness, whereas high doses of MK-801 produce ataxia, but not LORR. In contrast, we previously reported that MK-801 combined with a low dose of the dopamine receptor antagonist haloperidol-induced LORR in mice. To assess a neurophysiologically distinct brain state and demonstrate unconsciousness, electroencephalograms (EEG) need to be examined together with LORR. Therefore, we herein investigated EEG changes after the systemic administration of MK-801 alone or in combination with haloperidol, and compared them with those induced by ketamine, the glutamate release inhibitor riluzole, and the γ-aminobutyric acid type A receptor agonist propofol. ⋯ This study revealed differences in EEG changes induced by various sedatives. The results obtained on MK-801 alone and MK-801 plus haloperidol suggest the importance of dopamine transmission in maintaining the righting reflex.