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Anesthesiology

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https://www.readbyqxmd.com/read/28520576/editor-s-note-anesthesiology-2017-expanding-the-richness-and-reach
#1
Evan D Kharasch
No abstract text is available yet for this article.
May 18, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28514242/risks-of-cardiovascular-adverse-events-and-death-in-patients-with-previous-stroke-undergoing-emergency-noncardiac-nonintracranial-surgery-the-importance-of-operative-timing
#2
Mia N Christiansen, Charlotte Andersson, Gunnar H Gislason, Christian Torp-Pedersen, Robert D Sanders, Per Føge Jensen, Mads E Jørgensen
BACKGROUND: The outcomes of emergent noncardiac, nonintracranial surgery in patients with previous stroke remain unknown. METHODS: All emergency surgeries performed in Denmark (2005 to 2011) were analyzed according to time elapsed between previous ischemic stroke and surgery. The risks of 30-day mortality and major adverse cardiovascular events were estimated as odds ratios (ORs) and 95% CIs using adjusted logistic regression models in a priori defined groups (reference was no previous stroke)...
May 17, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28514241/phrenic-nerve-palsy-and-regional-anesthesia-for-shoulder-surgery-anatomical-physiologic-and-clinical-considerations
#3
Kariem El-Boghdadly, Ki Jinn Chin, Vincent W S Chan
Regional anesthesia has an established role in providing perioperative analgesia for shoulder surgery. However, phrenic nerve palsy is a significant complication that potentially limits the use of regional anesthesia, particularly in high-risk patients. The authors describe the anatomical, physiologic, and clinical principles relevant to phrenic nerve palsy in this context. They also present a comprehensive review of the strategies for reducing phrenic nerve palsy and its clinical impact while ensuring adequate analgesia for shoulder surgery...
May 17, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28514240/raising-the-alarm-on-brain-attacks-in-surgical-patients-are-we-doing-enough-to-prevent-and-treat-postoperative-strokes
#4
Laurent G Glance, Robert G Holloway
No abstract text is available yet for this article.
May 17, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28489614/validation-of-innovative-techniques-for-monitoring-nociception-during-general-anesthesia-a-clinical-study-using-tetanic-and-intracutaneous-electrical-stimulation
#5
Sandra Funcke, Sven Sauerlaender, Hans O Pinnschmidt, Bernd C Saugel, Kai Bremer, Daniel A Reuter, Rainer Nitzschke
BACKGROUND: This study compares the analgesic indices Analgesia Nociception Index (heart rate variability), Surgical Pleth Index (photoplethysmography), and pupillary dilatation, to heart rate, mean arterial pressure, and bispectral index, with regard to diagnostic accuracy and prediction probability for nociceptive response. The primary endpoint was the correlation between Δ values and the remifentanil dose administered. METHODS: We anesthetized 38 patients with propofol and increasing doses of remifentanil and applied standardized tetanic and intracutaneous electrical painful stimulations on each analgesic level...
May 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28486269/neurophysiologic-correlates-of-ketamine-sedation-and-anesthesia-a-high-density-electroencephalography-study-in-healthy-volunteers
#6
Phillip E Vlisides, Tarik Bel-Bahar, UnCheol Lee, Duan Li, Hyoungkyu Kim, Ellen Janke, Vijay Tarnal, Adrian B Pichurko, Amy M McKinney, Bryan S Kunkler, Paul Picton, George A Mashour
BACKGROUND: Previous studies have demonstrated inconsistent neurophysiologic effects of ketamine, although discrepant findings might relate to differences in doses studied, brain regions analyzed, coadministration of other anesthetic medications, and resolution of the electroencephalograph. The objective of this study was to characterize the dose-dependent effects of ketamine on cortical oscillations and functional connectivity. METHODS: Ten healthy human volunteers were recruited for study participation...
May 9, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28486268/medical-student-in-the-operating-room
#7
Rebekka DePew
No abstract text is available yet for this article.
May 9, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28475557/understanding-potential-drug-side-effects-can-we-translate-molecular-mechanisms-to-clinical-applications
#8
Andreas Koster, Jerrold H Levy
No abstract text is available yet for this article.
May 5, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28475556/high-concentrations-of-tranexamic-acid-inhibit-ionotropic-glutamate-receptors
#9
Irene Lecker, Dian-Shi Wang, Kirusanthy Kaneshwaran, C David Mazer, Beverley A Orser
BACKGROUND: The antifibrinolytic drug tranexamic acid is structurally similar to the amino acid glycine and may cause seizures and myoclonus by acting as a competitive antagonist of glycine receptors. Glycine is an obligatory co-agonist of the N-methyl-D-aspartate (NMDA) subtype of glutamate receptors. Thus, it is plausible that tranexamic acid inhibits NMDA receptors by acting as a competitive antagonist at the glycine binding site. The aim of this study was to determine whether tranexamic acid inhibits NMDA receptors, as well as α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid and kainate subtypes of ionotropic glutamate receptors...
May 5, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28475555/epidural-neostigmine-versus-fentanyl-to-decrease-bupivacaine-use-in-patient-controlled-epidural-analgesia-during-labor-a-randomized-double-blind-controlled-study
#10
Jessica L Booth, Vernon H Ross, Kenneth E Nelson, Lynnette Harris, James C Eisenach, Peter H Pan
BACKGROUND: The addition of opioids to epidural local anesthetic reduces local anesthetic consumption by 20% but at the expense of side effects and time spent for regulatory compliance paperwork. Epidural neostigmine also reduces local anesthetic use. The authors hypothesized that epidural bupivacaine with neostigmine would decrease total hourly bupivacaine use compared with epidural bupivacaine with fentanyl for patient-controlled epidural analgesia. METHODS: A total of 215 American Society of Anesthesiologists physical status II, laboring parturients requesting labor epidural analgesia consented to the study and were randomized to receive 0...
May 5, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28459735/frequency-and-type-of-situational-awareness-errors-contributing-to-death-and-brain-damage-a-closed-claims-analysis
#11
Christian M Schulz, Amanda Burden, Karen L Posner, Shawn L Mincer, Randolph Steadman, Klaus J Wagner, Karen B Domino
BACKGROUND: Situational awareness errors may play an important role in the genesis of patient harm. The authors examined closed anesthesia malpractice claims for death or brain damage to determine the frequency and type of situational awareness errors. METHODS: Surgical and procedural anesthesia death and brain damage claims in the Anesthesia Closed Claims Project database were analyzed. Situational awareness error was defined as failure to perceive relevant clinical information, failure to comprehend the meaning of available information, or failure to project, anticipate, or plan...
May 1, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28459734/a-systematic-review-and-meta-analysis-examining-the-impact-of-incident-postoperative-delirium-on-mortality
#12
Gavin M Hamilton, Kathleen Wheeler, Joseph Di Michele, Manoj M Lalu, Daniel I McIsaac
BACKGROUND: Delirium is an acute and reversible geriatric syndrome that represents a decompensation of cerebral function. Delirium is associated with adverse postoperative outcomes, but controversy exists regarding whether delirium is an independent predictor of mortality. Thus, we assessed the association between incident postoperative delirium and mortality in adult noncardiac surgery patients. METHODS: A systematic search was conducted using Cochrane, MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature, and Embase...
May 1, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28459733/a-phase-1-single-center-double-blind-placebo-controlled-study-in-healthy-subjects-to-assess-the-safety-tolerability-clinical-effects-and-pharmacokinetics-pharmacodynamics-of-intravenous-cyclopropyl-methoxycarbonylmetomidate-abp-700-after-a-single-ascending
#13
Michel M R F Struys, Beatrijs I Valk, Douglas J Eleveld, Anthony R Absalom, Peter Meyer, Sascha Meier, Izaak den Daas, Thomas Chou, Kai van Amsterdam, Jason A Campagna, Steven P Sweeney
BACKGROUND: Cyclopropyl-methoxycarbonylmetomidate (ABP-700) is a new "soft" etomidate analog. The primary objectives of this first-in-human study were to describe the safety and efficacy of ABP-700 and to determine its maximum tolerated dose. Secondary objectives were to characterize the pharmacokinetics of ABP-700 and its primary metabolite (cyclopropyl-methoxycarbonyl acid), to assess the clinical effects of ABP-700, and to investigate the dose-response and pharmacokinetic/pharmacodynamic relationships...
May 1, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28459732/goal-directed-fluid-therapy-does-not-reduce-primary-postoperative-ileus-after-elective-laparoscopic-colorectal-surgery-a-randomized-controlled-trial
#14
Juan C Gómez-Izquierdo, Alessandro Trainito, David Mirzakandov, Barry L Stein, Sender Liberman, Patrick Charlebois, Nicolò Pecorelli, Liane S Feldman, Franco Carli, Gabriele Baldini
BACKGROUND: Inadequate perioperative fluid therapy impairs gastrointestinal function. Studies primarily evaluating the impact of goal-directed fluid therapy on primary postoperative ileus are missing. The objective of this study was to determine whether goal-directed fluid therapy reduces the incidence of primary postoperative ileus after laparoscopic colorectal surgery within an Enhanced Recovery After Surgery program. METHODS: Randomized patient and assessor-blind controlled trial conducted in adult patients undergoing laparoscopic colorectal surgery within an Enhanced Recovery After Surgery program...
May 1, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28452806/perioperative-steroid-management-approaches-based-on-current-evidence
#15
Melanie M Liu, Andrea B Reidy, Siavosh Saatee, Charles D Collard
No abstract text is available yet for this article.
April 28, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28437360/dna-hydroxymethylation-by-ten-eleven-translocation-methylcytosine-dioxygenase-1-and-3-regulates-nociceptive-sensitization-in-a-chronic-inflammatory-pain-model
#16
Zhiqiang Pan, Zhou-Ya Xue, Guo-Fang Li, Meng-Lan Sun, Ming Zhang, Ling-Yun Hao, Qian-Qian Tang, Li-Jiao Zhu, Jun-Li Cao
BACKGROUND: Ten-eleven translocation methylcytosine dioxygenase converts 5-methylcytosine in DNA to 5-hydroxymethylcytosine, which plays an important role in gene transcription. Although 5-hydroxymethylcytosine is enriched in mammalian neurons, its regulatory function in nociceptive information processing is unknown. METHODS: The global levels of 5-hydroxymethylcytosine and ten-eleven translocation methylcytosine dioxygenase were measured in spinal cords in mice treated with complete Freund's adjuvant...
April 24, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28430694/iron-loading-exaggerates-the-inflammatory-response-to-the-toll-like-receptor-4-ligand-lipopolysaccharide-by-altering-mitochondrial-homeostasis
#17
Konrad Hoeft, Donald B Bloch, Jan A Graw, Rajeev Malhotra, Fumito Ichinose, Aranya Bagchi
BACKGROUND: Perioperative and critically ill patients are often exposed to iron (in the form of parenteral-iron administration or blood transfusion) and inflammatory stimuli, but the effects of iron loading on the inflammatory response are unclear. Recent data suggest that mitochondrial reactive oxygen species have an important role in the innate immune response and that increased mitochondrial reactive oxygen species production is a result of dysfunctional mitochondria. We tested the hypothesis that increased intracellular iron potentiates lipopolysaccharide-induced inflammation by increasing mitochondrial reactive oxygen species levels...
April 21, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28422819/gnaq-tt-695-694-gc-polymorphism-is-associated-with-increased-gq-expression-vascular-reactivity-and-myocardial-injury-after-coronary-artery-bypass-surgery
#18
Ulrich H Frey, Stefanie Klenke, Anna Mitchell, Tim Knüfermann, Heinz Jakob, Matthias Thielmann, Winfried Siffert, Jürgen Peters
BACKGROUND: Angiotensin II receptor type 1-mediated activation of the α-subunit of the heterotrimeric Gq protein evokes increased vasoconstriction and may promote hypertrophy-induced myocardial damage. The authors recently identified a TT(-695/-694)GC polymorphism in the human Gq promoter, the GC allele being associated with an increased prevalence of cardiac hypertrophy. In this article, the authors tested whether the TT(-695/-694)GC polymorphism is associated with differences in (1) myocardial Gq protein expression, (2) vascular reactivity, and (3) myocardial damage after coronary artery bypass grafting...
April 19, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28422818/inhibition-of-metabotropic-glutamate-receptor-subtype-1-alters-the-excitability-of-the-commissural-pyramidal-neuron-in-the-rat-anterior-cingulate-cortex-after-chronic-constriction-injury-to-the-sciatic-nerve
#19
Shi-Hao Gao, Lin-Lin Shen, Hui-Zhong Wen, Yan-Dong Zhao, Huai-Zhen Ruan
BACKGROUND: Inhibition of the metabotropic glutamate receptor subtype 1 in the anterior cingulate cortex has an analgesic effect during sustained nociceptive hypersensitivity. However, the specific changes in different subtypes of anterior cingulate cortex layer 5 pyramidal neurons, as well as the distinct effect of metabotropic glutamate receptor subtype 1 inhibition on different neuronal subtypes, have not been well studied. METHODS: Retrograde labeling combined with immunofluorescence, whole cell clamp recording, and behavioral tests combined with RNA interference were performed in a rat model of chronic constriction injury to the sciatic nerve...
April 19, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28410273/up-regulation-of-intracellular-calcium-handling-underlies-the-recovery-of-endotoxemic-cardiomyopathy-in-mice
#20
Justin C Morse, Joanne Huang, Natasha Khona, Edward J Miller, Deborah A Siwik, Wilson S Colucci, Ion A Hobai
BACKGROUND: In surviving patients, sepsis-induced cardiomyopathy is spontaneously reversible. In the absence of any experimental data, it is generally thought that cardiac recovery in sepsis simply follows the remission of systemic inflammation. Here the authors aimed to identify the myocardial mechanisms underlying cardiac recovery in endotoxemic mice. METHODS: Male C57BL/6 mice were challenged with lipopolysaccharide (7 μg/g, intraperitoneally) and followed for 12 days...
April 14, 2017: Anesthesiology
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