Journal of anesthesia
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Journal of anesthesia · Apr 2013
ReviewAnesthesia for children with mitochondrial disorders: a national survey and review.
Mitochondrial diseases are a heterogeneous group of disorders. Patients with such diseases often need general anesthesia for diagnostic procedures and surgery; guidelines are lacking for the anesthetic care of these patients. ⋯ Although the response rate was low, the majority of the responders provide care to these children routinely, so it can be inferred that the results of this survey are the closest published results to the true trend.
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Journal of anesthesia · Apr 2013
ReviewThe recent progress in research on effects of anesthetics and analgesics on G protein-coupled receptors.
The exact mechanisms of action behind anesthetics and analgesics are still unclear. Much attention was focused on ion channels in the central nervous system as targets for anesthetics and analgesics in the 1980s. During the 1990s, major advances were made in our understanding of the physiology and pharmacology of G protein coupled receptor (GPCR) signaling. ⋯ There has been little work on G(s)- and G(i)-coupled receptors. In the last decade, a new assay system, using chimera G(i/o)-coupled receptor fused to Gq(i5), has been established and the effects of anesthetics and analgesics on the function of G(i)-coupled receptors is now more easily studied. This review highlights the recent progress of the studies regarding the effects of anesthetics and analgesics on GPCRs.
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Journal of anesthesia · Apr 2013
Randomized Controlled TrialMagnesium sulfate attenuates tourniquet pain in healthy volunteers.
Preoperative administration of an N-methyl-D-aspartate (NMDA) receptor antagonist has been shown to attenuate tourniquet-induced blood pressure increase under general anesthesia, suggesting that the mechanism of this blood pressure increase includes NMDA receptor activation. The attenuation of this increase may be associated with the pain relief induced by NMDA receptor antagonism. We tested the hypothesis that magnesium sulfate, an NMDA receptor antagonist, attenuates tourniquet pain. ⋯ Magnesium sulfate, 4 g, significantly attenuated tourniquet pain in healthy awake volunteers, suggesting that NMDA receptor activation is involved in tourniquet pain.
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Journal of anesthesia · Apr 2013
Comparative StudyAnalysis of expert consultation referrals to the Korean Society of Anesthesiologists (KSA): a comparison of procedural sedation and general anesthesia.
Procedural sedation during diagnostic or therapeutic procedures is currently widely used by clinicians across a broad range of specialties. However, procedural sedation is a poorly controlled practice in many countries, often performed in potentially unsafe environments. ⋯ Our analysis of procedural sedation based on anesthesia-related adverse events compiled in the national database revealed a high severity of patient injury similar to that due to general anesthesia. Most procedural sedations were shown to be poorly controlled without adequate pre-procedural patient evaluation or intraoperative monitoring. Thus, it is essential to establish proper practical guidelines for procedural sedation and ensure strict adherence to these guidelines, especially during the NAAP.
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Journal of anesthesia · Apr 2013
Randomized Controlled Trial Comparative StudyDexmedetomidine versus remifentanil sedation during awake fiberoptic nasotracheal intubation: a double-blinded randomized controlled trial.
Awake fiberoptic nasotracheal intubation is usually performed in patients with an anticipated difficult airway. This study compares dexmedetomidine and remifentanil for conscious sedation during fiberoptic intubation. ⋯ Both dexmedetomidine and remifentanil were effective as sedatives in patients undergoing awake fiberoptic nasotracheal intubation. Compared with remifentanil, dexmedetomidine offered better endoscopy scores, lower recall of intubation, and greater patient satisfaction, with minor hemodynamic side effects.