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BMC Anesthesiology

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https://www.readbyqxmd.com/read/27914476/lidocaine-relaxation-in-isolated-rat-aortic-rings-is-enhanced-by-endothelial-removal-possible-role-of-kv-katp-channels-and-a2a-receptor-crosstalk
#1
Aryadi Arsyad, Geoffrey P Dobson
BACKGROUND: Lidocaine is an approved local anesthetic and Class 1B antiarrhythmic with a number of ancillary properties. Our aim was to investigate lidocaine's vasoreactivity properties in intact versus denuded rat thoracic aortic rings, and the effect of inhibitors of nitric oxide (NO), prostenoids, voltage-dependent Kv and KATP channels, membrane Na(+)/K(+) pump, and A2a and A2b receptors. METHODS: Aortic rings were harvested from adult male Sprague Dawley rats and equilibrated in an organ bath containing oxygenated, modified Krebs-Henseleit solution, pH 7...
December 3, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27908275/does-standing-or-sitting-position-of-the-anesthesiologist-in-the-operating-theatre-influence-sevoflurane-exposure-during-craniotomies
#2
Péter Sárkány, Béla Tankó, Éva Simon, Judit Gál, Béla Fülesdi, Csilla Molnár
BACKGROUND: Exposure of the OR staff to inhalational anesthetics has been proven by numerous investigators, but its potential adverse effect under the present technical circumstances is a debated issue. The aim of the present work was to test whether using a laminar flow air conditioning system exposure of the team to anesthetic gases is different if the anesthetist works in the sitting as compared to the standing position. METHODS: Sample collectors were placed at the side of the patient and were fixed at two different heights: at 100 cm (modelling sitting position) and 175 cm (modelling standing position), whereas the third collector was placed at the independent corner of the OR...
December 1, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27894277/human-limb-skeletal-muscle-wasting-and-architectural-remodeling-during-five-to-ten-days-intubation-and-ventilation-in-critical-care-an-observational-study-using-ultrasound
#3
Peter Turton, Richard Hay, Jonathon Taylor, Jamie McPhee, Ingeborg Welters
BACKGROUND: Critically ill patients frequently suffer muscle weakness whilst in critical care. Ultrasound can reliably track loss of muscle size, but also quantifies the arrangement of the muscle fascicles, known as the muscle architecture. We sought to measure both pennation angle and fascicle length, as well as tracking changes in muscle thickness in a population of critically ill patients. METHODS: On days 1, 5 and 10 after admission to critical care, muscle thickness was measured in ventilated critically ill patients using bedside ultrasound...
November 29, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27884107/association-between-changes-in-cerebral-grey-matter-volume-and-postoperative-cognitive-dysfunction-in-elderly-patients-study-protocol-for-a-prospective-observational-cohort-study
#4
Nicolai Goettel, Panagiota Mistridis, Manfred Berres, Julia Reinhardt, Christoph Stippich, Andreas U Monsch, Luzius A Steiner
BACKGROUND: Cognitive decline is frequently observed in elderly patients after major surgery. The pathophysiology of postoperative cognitive dysfunction (POCD) remains unclear. The aim of our investigation is to identify potential associations between brain volume change and POCD in elderly patients undergoing major surgery. METHODS: This is a prospective observational cohort study approved by the regional ethics board. We intend to compare specific brain volumes (hippocampus, lateral ventricle, total grey matter volume, regional cortical thickness) on magnetic resonance imaging and cognitive functions determined by a neuropsychological assessment battery in 70 study participants aged ≥65 years before and 3 and 12 months after major noncardiac surgery...
November 25, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27871236/the-timing-of-administration-of-intravenous-dexmedetomidine-during-lower-limb-surgery-a-randomized-controlled-trial
#5
Eunsu Kang, Ki Hwa Lee, Sang Yoon Jeon, Kyu Won Lee, Myoung Jin Ko, Hyojoong Kim, Yong Han Kim, Jae-Wook Jung
BACKGROUND: Dexmedetomidine, a selective alpha-2 agonist, has sedative, analgesic, and anxiolytic effects without respiratory depression. Dexmedetomidine can cause a biphasic cardiovascular response, and induce transient hypertension. Hypotension is a common complication of spinal anesthesia. Decreasing anxiety of patients before procedure is important for high quality of procedure. This study aimed to compare the incidence of hypotension and patients' anxiety and comfort levels when dexmedetomidine was intravenously administered before and after spinal anesthesia...
November 21, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27871230/effect-of-the-ifenprodil-administered-into-rostral-anterior-cingulate-cortex-on-pain-related-aversion-in-rats-with-bone-cancer-pain
#6
Hao Feng, Zhaowei Chen, Gongming Wang, Xin Zhao, Zhonghao Liu
BACKGROUND: To assess the effect of rostral anterior cingulate cortex (rACC) administration with ifenprodil (NR2B receptor blocker) on bone cancer pain (BCP)-related aversion sentiment using the conditioned place avoidance experiments in rats. METHODS: A total of 30 male Wistar rats without place preference were randomly assigned to three groups: control group (Group C, n = 10), BCP group (Group P, n = 10) and ifenprodil group (Group Ifen, n = 10). Three microliter MADB-106 cells were inoculated into right tibia bone marrow cavity in group P and Ifen, while the same dose of normal saline in group C as a control...
November 21, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27855660/comparison-of-hemodynamic-response-to-tracheal-intubation-and-postoperative-pain-in-patients-undergoing-closed-reduction-of-nasal-bone-fracture-under-general-anesthesia-a-randomized-controlled-trial-comparing-fentanyl-and-oxycodone
#7
Yeon Sil Lee, Chong Wha Baek, Dong Rim Kim, Hyun Kang, Geun Joo Choi, Yong-Hee Park, Won-Joong Kim, Yong Hun Jung, Young Cheol Woo
BACKGROUND: The present study aimed to compare the intravenous bolus effect of oxycodone and fentanyl on hemodynamic response after endotracheal intubation and postoperative pain in patients undergoing closed reduction of nasal bone fracture. METHODS: In this prospective randomized double-blinded study, 64 patients undergoing closed reduction of nasal bone fracture were randomized into one of two groups: the fentanyl group (Group F) or the oxycodone group (Group O)...
November 17, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27852241/comparison-of-glottic-views-and-intubation-times-in-the-supine-and-25-degree-back-up-positions
#8
Raj M Reddy, Manish Adke, Pranava Patil, Irina Kosheleva, Saxon Ridley
BACKGROUND: We explored whether positioning patients in a 25° back-up sniffing position improved glottic views and ease of intubation. METHODS: In the first part of the study, patients were intubated in the standard supine sniffing position. In the second part, the back of the operating table was raised 25° from the horizontal by flexion of the torso at the hips while maintaining the sniffing position. The best view obtained during laryngoscopy was assessed using the Cormack and Lehane classification and Percentage of Glottic Opening (POGO) score...
November 16, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27852231/a-discrete-event-simulation-model-of-clinical-and-operating-room-efficiency-outcomes-of-sugammadex-versus-neostigmine-for-neuromuscular-block-reversal-in-canada
#9
Ralph P Insinga, Cédric Joyal, Alexandra Goyette, André Galarneau
BACKGROUND: The objective of this analysis is to explore potential impact on operating room (OR) efficiency and incidence of residual neuromuscular blockade (RNMB) with use of sugammadex (Bridion™, Merck & Co., Inc., Kenilworth, NJ USA) versus neostigmine for neuromuscular block reversal in Canada. METHODS: A discrete event simulation (DES) model was developed to compare ORs using either neostigmine or sugammadex for NMB reversal over one month. Selected inputs included OR procedure and turnover times, hospital policies for paid staff overtime and procedural cancellations due to OR time over-run, and reductions in RNMB and associated complications with sugammadex use...
November 16, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27852230/the-effect-of-preoperative-dexamethasone-on-pain-1%C3%A2-year-after-lumbar-disc-surgery-a-follow-up-study
#10
Rikke Vibeke Nielsen, Jonna Fomsgaard, Ole Mathiesen, Jørgen Berg Dahl
BACKGROUND: It has been hypothesized that dexamethasone can inhibit persistent postoperative pain, but data on humans is lacking and results from animal studies are conflicting. We explored the effect of 16 mg dexamethasone IV administered preoperatively on persistent pain 1 year after lumbar discectomy. METHODS: This is a prospective 1-year follow-up on a single-centre, randomized, and blinded trial exploring the analgesic effect of 16 mg IV dexamethasone or placebo after lumbar discectomy...
November 16, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27842511/comparative-assessment-of-two-frailty-instruments-for-risk-stratification-in-elderly-surgical-patients-study-protocol-for-a-prospective-cohort-study
#11
Daniel I McIsaac, Monica Taljaard, Gregory L Bryson, Paul E Beaule, Sylvain Gagne, Gavin Hamilton, Emily Hladkowicz, Allen Huang, John Joanisse, Luke T Lavallée, Hussein Moloo, Kednapa Thavorn, Carl van Walraven, Homer Yang, Alan J Forster
BACKGROUND: Frailty is an aggregate expression of susceptibility to poor outcomes, owing to age-, and disease-related deficits that accumulate within multiple domains. Older patients who are frail before surgery are at an increased risk of morbidity and mortality, and use a disproportionately high amount of healthcare resources. While frailty is now a well-established risk factor for adverse postoperative outcomes, the perioperative literature lacks studies that: 1) compare the predictive accuracy of different frailty instruments; 2) consider the impact of frailty on patient-reported outcome measures; and 3) consider the acceptability and feasibility of using frailty instruments in clinical practice...
November 14, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27842499/comparison-of-the-effect-of-continuous-intravenous-infusion-and-two-bolus-injections-of-remifentanil-on-haemodynamic-responses-during-anaesthesia-induction-a-prospective-randomised-single-centre-study
#12
Toyoaki Maruta, Yoshihumi Kodama, Ishie Tanaka, Tetsuro Shirasaka, Isao Tsuneyoshi
BACKGROUND: Remifentanil is an effective drug for protecting against adverse haemodynamic responses to tracheal intubation. We compared the haemodynamic responses during anaesthesia induction between continuous intravenous (IV) infusion and two bolus injections of remifentanil. METHODS: This prospective, randomised, open-label, single-centre study included patients with American Society of Anesthesiologists physical status I-II, scheduled to undergo elective surgery under general anaesthesia...
November 14, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27829366/anesthestic-management-of-kassabach-meritt-phenomenon-in-an-adult-case-report
#13
Abdelghafour Elkoundi, Mehdi Samali, Noureddine Kartite, Mohammed Tbouda, Mustapha Bensghir, Charki Haimeur
BACKGROUND: Kasabach-Merritt phenomenon (KMP) is characterized by a vascular tumor with profound thrombocytopenia and consumptive coagulopathy that may presents significant challenges for anesthesiologist. CASE PRESENTATION: An 87-year-old man presented with kaposiform hemangioendothelioma involving the right leg in critical condition due to massive bleeding. Hematology investigations indicated the presence of KMP. Association of this type of tumor with KMP in adults has never been reported...
November 9, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27821065/predictors-of-survival-in-critically-ill-patients-with-acute-respiratory-distress-syndrome-ards-an-observational-study
#14
Felix Balzer, Mario Menk, Jannis Ziegler, Christian Pille, Klaus-Dieter Wernecke, Claudia Spies, Maren Schmidt, Steffen Weber-Carstens, Maria Deja
BACKGROUND: Currently there is no ARDS definition or classification system that allows optimal prediction of mortality in ARDS patients. This study aimed to examine the predictive values of the AECC and Berlin definitions, as well as clinical and respiratory parameters obtained at onset of ARDS and in the course of the first seven consecutive days. METHODS: The observational study was conducted at a 14-bed intensive care unit specialized on treatment of ARDS. Predictive validity of the AECC and Berlin definitions as well as PaO2/FiO2 and FiO2/PaO2*Pmean (oxygenation index) on mortality of ARDS patients was assessed and statistically compared...
November 8, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27793105/assessment-of-risk-factors-for-cerebral-oxygen-desaturation-during-neonatal-and-infant-general-anesthesia-an-observational-prospective-study
#15
Ilona Razlevice, Danguole C Rugyte, Loreta Strumylaite, Andrius Macas
BACKGROUND: Cerebral oxygen saturation (rSO2c) decrease from baseline greater than 20 % during infant cardiac surgery was associated with postoperative neurologic changes and neurodevelopmental impairment at 1 year of age. So far, there is no sufficient evidence to support the routine monitoring of rSO2c during general surgical procedures in children. We aimed to find out the frequency of cerebral desaturation 20 % or more from baseline and to identify possible predictors of change in cerebral oxygen saturation during neonatal and infant general surgery...
October 28, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27776491/the-incidence-of-increased-icp-in-icu-patients-with-non-traumatic-coma-as-diagnosed-by-onsd-and-ct-a-prospective-cohort-study
#16
Nawal Salahuddin, Alaa Mohamed, Nadia Alharbi, Hamad Ansari, Khaled J Zaza, Qussay Marashly, Iqbal Hussain, Othman Solaiman, Torbjorn V Wetterberg, Khalid Maghrabi
BACKGROUND: Unexplained coma after critical illness can be multifactorial. We evaluated the diagnostic ability of bedside Optic Nerve Sheath Diameter [ONSD] as a screening test for non-traumatic radiographic cerebral edema. METHODS: In a prospective study, mixed medical-surgical intensive care units [ICU] patients with non-traumatic coma [GCS < 9] underwent bedside ultrasonographic ONSD measurements. Non-traumatic radiographic cerebral edema [NTRCE] was defined as > 5 mm midline shift, cisternal, sulcal effacement, or hydrocephalus on CT...
October 25, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27776488/midazolam-plasma-concentration-after-anesthesia-premedication-in-clinical-routine-an-observational-study-midazolam-plasma-concentration-after-anesthesia-premedication
#17
C Steiner, M P Steurer, D Mueller, M Zueger, A Dullenkopf
BACKGROUND: Midazolam is commonly used as a pre-anesthesia anxiolytic. It`s elimination may not be fast enough for short procedures. In orally premedicated patients we obtained midazolam plasma concentrations at the end of surgical procedures and compared those to concentrations at anesthesia induction. METHODS: The study was conducted prospectively with consent of the local ethics committee (Ethikkomission Kanton Thurgau, Switzerland) and carried out with written informed consent of each patient...
October 24, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27776485/the-antioxidant-n-acetyl-cysteine-suppresses-lidocaine-induced-intracellular-reactive-oxygen-species-production-and-cell-death-in-neuronal-sh-sy5y-cells
#18
Akihisa Okamoto, Masahiro Tanaka, Chisato Sumi, Kanako Oku, Munenori Kusunoki, Kenichiro Nishi, Yoshiyuki Matsuo, Keizo Takenaga, Koh Shingu, Kiichi Hirota
BACKGROUND: The local anesthetic lidocaine can affect intra- and extra-cellular signaling pathways in both neuronal and non-neuronal cells, resulting in long-term modulation of biological functions, including cell growth and death. Indeed, lidocaine was shown to induce necrosis and apoptosis in vitro. While several studies have suggested that lidocaine-induced apoptosis is mitochondrial pathway-dependent, it remains unclear whether reactive oxygen species (ROS) are involved in this process and whether the observed cell death can be prevented by antioxidant treatment...
October 24, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27770778/observational-study-on-patterns-of-neuromuscular-blockade-reversal
#19
Timur Dubovoy, Michelle Housey, Scott Devine, Sachin Kheterpal
BACKGROUND: Using electronic health record data, we hypothesized that larger reversal doses are used for patients with deeper levels of neuromuscular blockade (NMB) as evidenced by the last recorded TOF measurement. We also examined if dosing regimens reflect current practice guidelines of using ideal body weight (IBW) for NMB agents and total body weight (TBW) for neostigmine. METHODS: This is a retrospective observational study of adult, ASA 1-4 patients who underwent general anaesthesia and received non-depolarizing NMB agents between 01/01/2004 and 12/31/2013...
October 22, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27769172/randomized-controlled-trials-vs-observational-studies-why-not-just-live-together
#20
David Faraoni, Simon Thomas Schaefer
Randomized controlled trials (RCTs) are considered the gold standard for clinical research, thus having a high impact on clinical guidelines and our daily patients' care. However, various treatment strategies which we consider "evidence based" have never been subject to a prospective RCT, as we would rate it unethical to withheld an established treatment to individuals in an placebo controlled trial.In a recent BMC Anesthesiology publication, Trentino et al. analyzed the usefulness of observational studies in assessing benefit and risk of different transfusion strategies...
October 21, 2016: BMC Anesthesiology
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