Search results for "ANESTHESIA"

Increased pain and neurogenic inflammation in mice deficient of neutral endopeptidase

2009

The complex regional pain syndrome (CRPS) is characterized by enhanced neurogenic inflammation, mediated by neuropeptides. Neutral endopeptidase (NEP) is a key enzyme in neuropeptide catabolism. We used NEP knock out (ko) mice to investigate whether NEP deficiency leads to increased pain behavior and signs of neurogenic inflammation after soft tissue trauma with and without nerve injury. After chronic constriction injury (CCI) of the right sciatic nerve, NEP ko mice were more sensitive to heat, to mechanical stimuli, and to cold than wild type mice. Tissue injury without nerve injury produced no differences between genotypes. After CCI, NEP ko mice showed increased hind paw edema but lower …

Treatment of pulmonary hypertension in patients undergoing cardiac surgery with cardiopulmonary bypass: a randomized, prospective, double-blind study

2006

Pulmonary hypertension can already be present in patients undergoing cardiac surgery or can be exacerbated by cardiopulmonary bypass. Postoperative treatment is still a challenge for physicians. The aim of this study was to evaluate the effects of inhaled prostacyclin (iPGI2) and nitric oxide (iNO) compared with those of intravenous vasodilators.This prospective, randomized, double-blind study included 58 patients affected by severe mitral valve stenosis and pulmonary hypertension with high pulmonary vascular resistance (250 dynes x s x cm(-5)) and a mean pulmonary artery pressure25 mmHg. All patients were monitored by central venous, radial arterial and Swan-Ganz catheters. Data were recor…

Inhaled anesthesia in neurosurgery: Still a role?

2021

In patients undergoing craniotomy, general anesthesia should be addressed to warrant good hypnosis, immobility, and analgesia, to ensure systemic and cerebral physiological status and provide the best possible surgical field. Regarding craniotomies, it is unclear if there are substantial differences in providing general anesthesia using total intravenous anesthesia (TIVA) or balanced anesthesia (BA) accomplished using the third generation halogenates. New evidence highlighted that the last generation of halogenated agents has possible advantages compared with intravenous drugs: rapid induction, minimal absorption and metabolization, reproducible pharmacokinetic, faster recovery, cardioprote…

Interests of medical hypnosis during toxin botulinic injections: Preliminary study

2014

Intraoperative wound instillation of ropivacaine extraperitoneally subfascially fails to provide analgesia after remifentanil–isoflurane for abdomina…

2005

Summary Background Intraoperative local anaesthetic wound instillation has been shown previously to provide analgesia after abdominal surgery. This pain relief may be important, if remifentanil is used for general anaesthesia, because the rapid offset of action may mean that there is not enough analgesia at the end of surgery and in the recovery period. The aim of this randomized, placebo-controlled, double-blind study was to evaluate the analgesic efficacy of preventative wound instillation of ropivacaine after abdominal hysterectomy (AH). We hypothesized that this approach will significantly reduce postoperative morphine consumption. Patients and methods After ethics approval, 40 patients…

Anästhesiologisches Management bei der Versorgung von Mukoviszidose-Patienten1

2000

Objective: Improvements in the management of patients with cystic fibrosis (CF) result in increased life expectancy. Thus it is likely that anesthetists will see this patients with increasing frequency. This study describes our experiences in the anesthetic management of CF patients. Methods: We descriptively and retrospectively reviewed the records of all CF patients from 1981 until 1997 who underwent elective surgery in our department of ear, nose and throat and in whom general anesthesia was required. Results: 199 anesthetics in 53 patients were reviewed. Premedication with midazolam (0.4±0.07 mg/kg) were given orally in 163 of the 199 anesthetics (82%). In 45 anesthetics the induction w…

Cartridge syringe vs computer controlled local anesthetic delivery system: Pain related behaviour over two sequential visits - a randomized controlle…

2015

Background: Local anesthetic injection is one of the most anxiety provoking procedure in dentistry. Knowledge about change in pain related behaviour during consecutive visits helps in and scheduling of treatment procedures and management of children in dental clinic. Aim: To compare the pain perception, behavioural response and the associated change in physiological parameters while receiving local anesthesia injection with cartridge syringe and computer controlled local anesthetic delivery system (CCLAD) over two consecutive visits. Material and Methods: In this randomized controlled cross over trial, 120 children aged 7 – 11 years were randomly divided into group A: receiving injections w…

Intra-operative locally injected pharmacotherapy as a novel strategy for adhesion prophylaxis.

2012

Abstract Background Pharmacotherapy for peritoneal adhesion prophylaxis has been a focus for intensive research. Previous strategies included intravenous and intraperitoneal application of suitable pharmaceutical agents. However, success of these strategies in humans has been limited. Here we describe intra-operative local injection of pharmaceuticals as a novel strategy for adhesion prophylaxis. Methods N  = 208 peritoneal lesions were created in 26 adult Wistar rats. In each animal, lesions on one flank were randomly chosen for treatment with locally injected prednisolone whereas the contralateral side was injected with normal saline. Half of the animals were randomly selected for early a…

Should Reinke edema be considered a contributing factor to post-extubation failure?

2015

We read with interest the recently published review in Critical Care about post-extubation laryngeal edema and stridor by Pluijms et al. [1]. The review considers in detail the risk factors for post-extubation respiratory failure and describes a post-extubation algorithm for its prevention and reduction. We recently published a case report describing the occurrence of post-extubation stridor leading to post-extubation respiratory failure in a woman with a previously undiagnosed Reinke edema (RE) [2]. RE is a progressive laryngeal soft-tissue swelling. The condition typically manifests in female gender as hoarseness and as a gradually deepening voice in patients with a history of smoking, vo…

Pharmacokinetics of anidulafungin during albumin dialysis

2014

In the ICU setting, current guidelines recommend echi-nocandins as the first-line treatment for invasive candi-diasis [1]. Albumin dialysis (AD) has been used in theICU as supportive therapy for hepatic failure, but thistechnique can significantly enhance drug elimination [2].We prescribed anidulafungin for suspected invasivecandidiasis in a patient with severe liver failure treatedwith AD and measured the plasma concentrations of thedrug using high-performance liquid chromatography.This study (GEF-ANI-2010-02) was approved by thelocal ethics committee (INCLIVA, Institute of Research,Valencia, Spain) and written informed consent wasobtained from the patient’s next of kin. An adult patientwa…