Search results for "Anesthesiology and Pain Medicine"
showing 10 items of 1004 documents
Personalized intraoperative positive end-expiratory pressure: a further step in protective ventilation
2017
Human surrogate models of neuropathic pain.
2005
Neuropathic pain is defined as pain initiated or caused by a primary lesion or dysfunction in the nervous system (Merskey and Bogduk, 1994). Current efforts to refine this definition focus on the terms ‘dysfunction’ and ‘nervous system’ with the intention to clarify that there has to be an identifiable lesion or disease process affecting the somatosensory system. Experimental models of neuropathic pain according to either one of these definitions are expected to imitate mechanisms of nerve damage within the peripheral or central parts of the somatosensory system and the ensuing processes of degeneration and regeneration. Whereas this approach to model the etiology and pathophysiology of the…
Hipertensión endocraneal asociada a la sedación con sevoflurano mediante el dispositivo AnaConDa®en un paciente con traumatismo craneoencefálico seve…
2013
Sedation in neurocritical patients remains a challenge as there is no drug that meets all the requirements. Since the appearance of the AnaConDa® device, and according to the latest recommendations, sevoflurane has become an alternative for patients with brain injury. The use of AnaConDa® produces an increase in the anatomical dead space that leads to a decrease in alveolar ventilation. If the decrease in the alveolar ventilation is not offset by an increase in minute volume, there will be an increase in PaCO2. We report the case of a patient with severe traumatic brain injury who suffered an increase in intracranial pressure as a result of increased PaCO2 after starting sedation with the A…
Injection pressure mapping of intraneural vs. perineural injections: further lessons from cadaveric studies.
2018
Background The aim of the study was to investigate the difference between intraneural and perineural injection pressures in human cadavers. Targeted nerves included the cervical roots, the supraclavicular and infraclavicular brachial plexus, the sciatic-subgluteal nerve and the common peroneal and tibial nerves. Methods Ten readings were obtained for each nerve location. Over ten seconds, 1 mL of 0.9% NaCl was injected - deliberately slower than in clinical practice to eliminate the risk of aberrant readings relating to the speed of injection. Perineural injections occurred at least 1 mm outside the epineurium. After pressure recordings were completed 0.1mL of dye was injected, and dissecti…
The evidence of neuraxial administration of analgesics for cancer-related pain: a systematic review
2015
Background The present systematic review analysed the existing evidence of analgesic efficacy and side effects of opioids without and with adjuvant analgesics delivered by neuraxial route (epidural and subarachnoid) in adult patients with cancer. Methods Search strategy was elaborated with words related to cancer, pain, neuraxial route, analgesic and side effects. The search was performed in PubMed, EMBASE, and Cochrane for the period until February 2014. Studies were analysed according to methods, results, quality of evidence, and strength of recommendation. Results The number of abstracts retrieved was 2147, and 84 articles were selected for full reading. The final selection comprised nin…
Ventilation/perfusion ratios measured by multiple inert gas elimination during experimental cardiopulmonary resuscitation
2014
Background During cardiopulmonary resuscitation (CPR) the ventilation/perfusion distribution (VA/Q) within the lung is difficult to assess. This experimental study examines the capability of multiple inert gas elimination (MIGET) to determine VA/Q under CPR conditions in a pig model. Methods Twenty-one anaesthetised pigs were randomised to three fractions of inspired oxygen (1.0, 0.7 or 0.21). VA/Q by micropore membrane inlet mass spectrometry-derived MIGET was determined at baseline and during CPR following induction of ventricular fibrillation. Haemodynamics, blood gases, ventilation distribution by electrical impedance tomography and return of spontaneous circulation were assessed. Inter…
Wache Videolaryngoskopie
2016
Introduction Awake video laryngoscopy is a novel option in airway management that is drawing more and more attention as an alternative to awake endoscopic guided intubation.Main issues: Intubation under preserved spontaneous breathing is the safest method to secure the expected difficult airway. In direct comparisons to awake flexible endoscopic intubation, awake video laryngoscopy achieves satisfactory intubation times and a high acceptance of patients and anesthesiologists. Specific cases, in particular very limited mouth opening or sub-glottic masses, require awake flexible endoscopic intubation. Sufficient topical anesthesia and a sophisticated sedation protocol are prerequisites for su…