Search results for "Anesthesia"

Milrinone is preferred to levosimendan for mesenteric perfusion in hypoxia-reoxygenated newborn piglets treated with dopamine

2012

INTRODUCTION There is little information regarding the comparative hemodynamic effects of adding milrinone or levosimendan to dopamine infusion in hypoxia-reoxygenated (H-R) newborns. RESULTS Severely hypoxic piglets had cardiogenic shock with depressed cardiac index (CI) and mean arterial pressure (MAP). The hemodynamics deteriorated gradually after initial recovery upon reoxygenation. Heart rate and CI improved with milrinone (D+M) and levosimendan (D+L) administration (P < 0.05 vs. control). Both regimens improved carotid arterial flow and carotid vascular resistance; D+M additionally improved superior mesentric arterial flow (all P < 0.05 vs. control). No effect was found on renal arter…

Initiation of high-frequency oscillatory ventilation and its effects upon cerebral circulation in pigs: an experimental study

2006

BACKGROUND: Current practice at high-frequency oscillatory ventilation (HFOV) initiation is a stepwise increase of the constant applied airway pressure to achieve lung recruitment. We hypothesized that HFOV would lead to more adverse cerebral haemodynamics than does pressure controlled ventilation (PCV) in the presence of experimental intracranial hypertension (IH) and acute lung injury (ALI) in pigs with similar mean airway pressure settings. METHODS: In 12 anesthetized pigs (24-27 kg) with IH and ALI, mean airway pressure (P(mean)) was increased (to 20, 25, 30 cm H(2)O every 30 min), either with HFOV or with PCV. The order of the two ventilatory modes (cross-over) was randomized. Mean art…

Epidural anesthesia: Simulated intravascular test dose with S(+) ketamine, lidocaine and adrenaline. A prospective, randomized, double blind and plac…

2015

Abstract Objective The use of a test dose in epidural anesthesia is a safety recommendation. However, specificity and sensitivity of the drugs used with this indication have not been conclusive. The main objective of this study was to compare the effectiveness and the adverse effects of a simulated intravascular test dose of adrenaline, lidocaine and S(+)-ketamine. Material and methods A prospective, randomized, double blinded, placebo controlled study was designed. ASA I patients scheduled for elective surgery were included. These were randomized to the following study groups: S(+)-ketamine 0.5 mg kg −1 (S+K group), 5% lidocaine 1.5 mg kg −1 (L5% group), adrenaline 15 μg (ADR group), and p…

High dose naloxone does not improve cerebral or myocardial blood flow during cardiopulmonary resuscitation in pigs

1997

In a prospective, randomized, placebo-controlled, double-blind trial we tested the hypothesis that naloxone given during cardiopulmonary resuscitation (CPR) enhances cerebral and myocardial blood flow. Twenty-one anesthetized, normoventilated pigs were instrumented for measurements of right atrial and aortic pressures, and regional organ blood flow (radiolabeled microspheres). After 5 min of untreated fibrillatory arrest, CPR was commenced using a pneumatic chest compressor/ventilator. With onset of CPR, an i.v. bolus of 40 micrograms/kg b.w. of epinephrine was given, followed by an infusion of 0.4 micrograms/kg per min. After 5 min of CPR, either naloxone, 10 mg/kg b.w. (group N, n = 11) o…

The effect of the type of colloid on the efficacy of hypertonic saline colloid mixtures in hemorrhagic shock: dextran versus hydroxyethyl starch

1993

Colloids increase and prolong the efficacy of hypertonic saline solutions in hemorrhagic shock. We compared the efficacy of dextran 60 and hydroxyethyl starch (HES) 200,000/0.5 at iso-oncotic concentrations of 6.5 or 6% in a 7.5% NaCI solution. Thirty-two rabbits were bled to maintain a mean arterial pressure at 35 mmHg. Twenty-five percent of the shed blood volume was replaced after 40 min by bolus infusion either with hypertonic dextran (HS-DEX) (n = 16) or with hypertonic hydroxyethyl starch (HS-HES) (n = 16). The animals were then observed for a 120-min period. In both groups immediate and complete restoration of cardiovascular function was achieved in up to 30 min and adequate restorat…

2006

The objective was to study the effects of a lung recruitment procedure by stepwise increases of mean airway pressure upon organ blood flow and hemodynamics during high-frequency oscillatory ventilation (HFOV) versus pressure-controlled ventilation (PCV) in experimental lung injury. Lung damage was induced by repeated lung lavages in seven anesthetized pigs (23–26 kg). In randomized order, HFOV and PCV were performed with a fixed sequence of mean airway pressure increases (20, 25, and 30 mbar every 30 minutes). The transpulmonary pressure, systemic hemodynamics, intracranial pressure, cerebral perfusion pressure, organ blood flow (fluorescent microspheres), arterial and mixed venous blood ga…

Retracted: Cerebral effects and blood sparing efficiency of sodium nitroprusside-induced hypotension alone and in combination with acute normovolaemi…

2001

The combined reduction of oxygen-carrying capacity and perfusion pressure during the combination of acute normovolaemic haemodilution (ANH) and controlled hypotension (CH) raises concerns of hypoperfusion and ischaemic injury to the brain. Forty-two patients undergoing radical prostatectomy were prospectively allocated to receive CH induced by sodium nitroprusside (mean arterial pressure (MAP) 50 mm Hg), a combination of CH+ANH (post-ANH haematocrit 29%; intraoperative MAP 50 mm Hg), or standard anaesthesia (control). Serum levels of the brain-originated proteins neuron-specific enolase (NSE) and protein S-100, blood loss, transfusion requirements, adverse effects, and postoperative recover…

Intraoperative clonidine modulates sympathetic tone in the early postoperative period after remifentanil. A double blind, placebo-controlled study

1999

Abstract Aim of the study : Severe pain following major surgery can impair the control of the cardiovascular system (CVS) by causing sympathetic stimulation, possibly leading to myocardial ischaemia. In this study we examine the influence of intraoperative intravenous (i.v.) clonidine infusion on postoperative analgesia and blood concentrations of noradrenaline and adrenaline after major gynaecological surgery. Methods : All patients underwent an abdominal hysterectomy under balanced general anaesthesia using the new opioid remifentanil. The patients were randomised to receive either 5 μg kg −1 of i.v. clonidine intraoperatively ( n =20), or placebo ( n =20). Over a period of 240 minutes po…

Spontaneous Cortical Spreading Depression and Intracranial Pressure Following Acute Subdural Hematoma in a Rat

2012

Acute subdural hemorrhage (ASDH) is a frequent and devastating consequence of traumatic brain injury. Tissue damage develops rapidly and makes treatment even more difficult. Management of increased intracranial pressure (ICP) due to extravasated blood volume and brain swelling is often insufficient to control all adverse effects of ASDH. In addition to sheer volume, spontaneously triggered cortical spreading depression (CSD) that leads to cell death following ischemia or trauma may contribute to injury development after ASDH. Therefore, we explored the occurrence of CSD by tissue impedance (IMP) measurement in a rat model subjected to ASDH. IMP and intraventricular and mean arterial pressur…

Ventilación mecánica no invasiva en el postoperatorio. Revisión clínica

2015

Non-invasive ventilation (NIV) is a method of ventilatory support that is increasing in importance day by day in the management of postoperative respiratory failure. Its role in the prevention and treatment of atelectasis is particularly important in the in the period after thoracic and abdominal surgeries. Similarly, in the transplanted patient, NIV can shorten the time of invasive mechanical ventilation, reducing the risk of infectious complications in these high-risk patients. It has been performed A systematic review of the literature has been performed, including examining the technical, clinical experiences and recommendations concerning the application of NIV in the postoperative per…