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Physiology and anesthesia

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https://www.readbyqxmd.com/read/28099786/labor-intervention-and-outcomes-in-women-who-are-nulliparous-and-obese-comparison-of-nurse-midwife-to-obstetrician-intrapartum-care
#1
Nicole S Carlson, Elizabeth J Corwin, Nancy K Lowe
BACKGROUND: Women who are obese have slower labors than women of normal weight, and show reduced response to interventions designed to speed labor progress like oxytocin augmentation and artificial rupture of membranes. The optimal labor management for these women has not been described. METHODS: This retrospective cohort study compared 2 propensity score-matched groups of women (N = 360) who were healthy, nulliparous, spontaneously laboring, and obese (body mass index ≥ 30 kg/m(2) )...
January 18, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28099321/preoxygenation-physiologic-basis-benefits-and-potential-risks
#2
Usharani Nimmagadda, M Ramez Salem, George J Crystal
Preoxygenation before anesthetic induction and tracheal intubation is a widely accepted maneuver, designed to increase the body oxygen stores and thereby delay the onset of arterial hemoglobin desaturation during apnea. Because difficulties with ventilation and intubation are unpredictable, the need for preoxygenation is desirable in all patients. During emergence from anesthesia, residual effects of anesthetics and inadequate reversal of neuromuscular blockade can lead to hypoventilation, hypoxemia, and loss of airway patency...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28097611/assessing-nitrous-oxide-effect-using-electroencephalographically-based-depth-of-anesthesia-measures-cortical-state-and-cortical-input
#3
Levin Kuhlmann, David T J Liley
Existing electroencephalography (EEG) based depth of anesthesia monitors cannot reliably track sedative or anesthetic states during n-methyl-D-aspartate (NMDA) receptor antagonist based anesthesia with ketamine or nitrous oxide (N2O). Here, a physiologically-motivated depth of anesthesia monitoring algorithm based on autoregressive-moving-average (ARMA) modeling and derivative measures of interest, Cortical State (CS) and Cortical Input (CI), is retrospectively applied in an exploratory manner to the NMDA receptor antagonist N2O, an adjuvant anesthetic gas used in clinical practice...
January 17, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28096570/tourniquet-application-during-anesthesia-what-we-need-to-know
#4
REVIEW
Kamal Kumar, Craig Railton, Qutaiba Tawfic
Tourniquets are routinely and safely used in limb surgeries throughout the world. Tourniquet application alters normal physiology. Healthy patients tolerate these physiological changes well, but the physiological changes may not be well-tolerated by patients with poor cardiac function. This review discusses the physiological changes associated with tourniquet use, safe practice and provides the latest updates regarding tourniquet use. A systematic literature search of PubMed, MEDLINE, ScienceDirect, and Google Scholar was done...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28078857/effects-of-sevoflurane-on-cardiopulmonary-function-in-patients-undergoing-coronary-artery-bypass
#5
J Zhang, S Wang
The objective of the current study was to investigate effects of sevoflurane on cardiopulmonary function in patients undergoing coronary artery bypass grafting (CABG). In this study, 60 cases of patients with coronary heart disease (CHD) were selected and randomly divided into the sevoflurane group (group S) and the control group C (group C) with 30 cases in each group. The two groups received intravenous anesthesia. The patients of group C were only given oxygen mask and physiological saline to keep vein open; while the patients of group S were administered with 1% sevoflurane immediately after the beginning of cardiopulmonary bypass (CPB) until the end of the treatment...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28074820/airway-management-of-the-cardiac-surgical-patients-current-perspective
#6
REVIEW
Arindam Choudhury, Nishkarsh Gupta, Rohan Magoon, Poonam Malhotra Kapoor
The difficult airway (DA) is a common problem encountered in patients undergoing cardiac surgery. However, the challenge is not only just establishment of airway but also maintaining a definitive airway for the safe conduct of cardiopulmonary bypass from initiation to weaning after surgical correction or palliation, de-airing of cardiac chambers. This review describes the management of the DA in a cardiac theater environment. The primary aims are recognition of DA both anatomical and physiological, necessary preparations for (and management of) difficult intubation and extubation...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28070330/the-approximated-cardiovascular-reserve-index-complies-with-haemorrhage-related-hemodynamic-deterioration-pattern-a-swine-exsanguination-model
#7
Roy Nadler, Elon Glassberg, Itay E Gabbay, Linn Wagnert-Avraham, Gal Yaniv, David Kushnir, Arik Eisenkraft, Ben-Zion Bobrovsky, Uri Gabbay
BACKGROUND: To estimate the cardiovascular reserve we formulated the Cardiovascular Reserve Index (CVRI) based on physiological measurements. The aim of this study was to evaluate the pattern of CVRI in haemorrhage-related haemodynamic deterioration in an animal model simulating combat injury. METHODS: Data were collected retrospectively from a research database of swine exsanguination model in which serial physiological measurements were made under anesthesia in 12 swine of haemorrhagic injury and 5 controls...
February 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28068994/spatiotemporal-changes-of-optical-signals-in-the-somatosensory-cortex-of-neuropathic-rats-after-electroacupuncture-stimulation
#8
Myeounghoon Cha, Younbyoung Chae, Sun Joon Bai, Bae Hwan Lee
BACKGROUND: Peripheral nerve injury causes physiological changes in primary afferent neurons. Neuropathic pain associated with peripheral nerve injuries may reflect changes in the excitability of the nervous system, including the spinothalamic tract. Current alternative medical research indicates that acupuncture stimulation has analgesic effects in various pain symptoms. However, activation changes in the somatosensory cortex of the brain by acupuncture stimulation remain poorly understood...
January 10, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28056235/-a-novel-open-chest-method-of-right-ventricular-hemodynamics-measurement-in-pulmonary-hypertensive-mice
#9
A H Yuan, Y Y He, S H Yang, S Q Li, J Ye, S Hu, J Y Qiu, Z C Jing, X J Wang
Objective: Right heart catheterization is the gold-standard for measurement of right ventricular hemodynamics. However, it is difficult to perform in mice. We thus aimed to establish a new open chest method to record and analyze the right ventricular hemodynamic parameters in intubated mice connected to a respirator under anesthesia. Methods: Eight-week old male C57BL/6 mice were divided into the control group, and the hypoxia group using completely random method. Mice in the hypoxia group were exposed in low pressure oxygen chamber, which simulated the environment of plateau (5 500 m altitude, 10% oxygen) for 3 weeks...
December 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28046175/acute-effects-of-general-anesthesia-with-propofol-pentobarbital-or-isoflurane-plus-propofol-on-plasma-metabolites-and-hormones-in-adult-pigs
#10
G Daş, A Vernunft, S Görs, E Kanitz, J M Weitzel, K-P Brüssow, C C Metges
Experimental setups for physiological research, in which acute operative interventions need to be performed, can require inclusion of general anesthesia (GA), which may interfere or confound with the effects of the experimental factors of interest on measured variables. It was recently shown that the most commonly used sedatives/anesthetics in pigs (e.g., ketamine, xylazine, azaperone) affect physiological responses and thus the primary metabolic readouts have the potential to be confounded. To extend the search for a physiologically-friendly anesthesia regime for such studies, we investigated effects of GA induced by propofol (Prop) or pentobarbital (Pent) or propofol plus isoflurane (Prop + Isof) on plasma concentrations of commonly measured metabolites and hormones...
December 2016: Journal of Animal Science
https://www.readbyqxmd.com/read/28031981/drug-delivery-biomaterials-and-nanomedicine-an-interview-with-daniel-s-kohane
#11
Daniel S Kohane
Daniel Kohane speaks to Francesca Lake, Managing Editor: Obtaining his MD and PhD in Physiology from Boston University (MA, USA), Dan Kohane went on to complete residencies in Pediatrics at Boston Children's Hospital (MA, USA) and Anesthesiology at Massachusetts General Hospital (USA), followed by a fellowship in Pediatric Critical Care at Boston Children's Hospital. He is currently a Professor of Anesthesia at Harvard Medical School (MA, USA) and a Senior Associate in Pediatric Critical Care at Boston Children's Hospital, where he directs the Laboratory for Biomaterials and Drug Delivery...
September 2016: Future Science OA
https://www.readbyqxmd.com/read/28030956/effects-of-long-duration-administration-of-1-isoflurane-on-resting-cerebral-blood-flow-and-default-mode-network-in-macaque-monkeys
#12
Chunxia Li, Xiaodong Zhang
Isoflurane is an inhalational anesthetic widely used in medical procedures or biomedical researches. The duration of anesthesia administration varies from minutes to hours. It is known isoflurane has dose-dependent effects on brain functionality and physiology and long-duration anesthesia administration could cause neurocognitive decline in animals and humans. However, the duration effect of isoflurane on the brain physiology and functionality still remains poorly understood. In the present study, cerebral blood flow (CBF) and functional connectivity of adult rhesus monkeys (maintained with 1% isoflurane for four hours) was examined using MRI...
December 28, 2016: Brain Connectivity
https://www.readbyqxmd.com/read/28017922/noise-and-non-neuronal-contributions-to-the-bold-signal-applications-to-and-insights-from-animal-studies
#13
Shella D Keilholz, Wen-Ju Pan, Jacob Billings, Maysam Nezafati, Sadia Shakil
The BOLD signal reflects hemodynamic events within the brain, which in turn are driven by metabolic changes and neural activity. However, the link between BOLD changes and neural activity is indirect and can be influenced by a number of non-neuronal processes. Motion and physiological cycles have long been known to affect the BOLD signal and are present in both humans and animal models. Differences in physiological baseline can also contribute to intra- and inter-subject variability. The use of anesthesia, common in animal studies, alters neural activity, vascular tone, and neurovascular coupling...
December 22, 2016: NeuroImage
https://www.readbyqxmd.com/read/28010998/comparison-of-multimodal-intraoperative-neurophysiological-monitoring-efficacy-in-early-childhood-and-school-aged-children-undergoing-spinal-surgery
#14
Alpaslan Şenköylü, Murat Zinnuroğlu, Alp Börçek, Erdem Aktaş, İrfan Güngör, Mehmet Beyazova
OBJECTIVE: The aim of this study was to compare the performance of multimodal intraoperative neurophysiological monitoring (MIONM) in children below and over 6 years of age. METHODS: 43 children, diagnosed with spinal pathologies were divided into two cohorts according to their age and enrolled in the study. Those under the age of 6 consisted group A, whereas those between the age of 6 and 11 consisted group B. All patients underwent spinal surgical procedures according to their diagnosis...
December 20, 2016: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28006891/the-efficacy-of-nasal-tip-hold-press-on-venous-cannulation-pain-in-children-a-prospective-randomize-controlled-study
#15
Behzad Maghsoudi, Mehrdad Jookar, Hosein Haddad, Zahra Zoonobi, Mahnaz Rakhshan
BACKGROUND: Venipuncture is a common and quiet unpleasant experience for pediatric patients. The pain associated with venous cannulation disturbs the children. Different methods have been used to minimize the pain. The present study evaluated the efficacy of holding and pressing the tip of the nose on the venipuncture pain in pediatric patients. METHODS: A prospective randomize controlled study carried out using the Visual analogue scale (YAS) for assessment cannulation pain and the Yale preoperative anxiety scale (YPAS) for the assessment of anxiety before cannulation...
December 22, 2016: Minerva Pediatrica
https://www.readbyqxmd.com/read/28005566/anesthesia-for-functional-endoscopic-sinus-surgery
#16
Daniel A Carlton, Satish Govindaraj
PURPOSE OF REVIEW: The present article summarizes anesthetic techniques used during functional endoscopic sinus surgery to decrease bleeding and aid in creating a clear surgical field. The applicable physiology behind these anesthetic techniques is reviewed with emphasis on the effect on bleeding and the surgical field. Deliberate hypotension, reverse Trendelenburg positioning, regional anesthesia, and cerebral monitoring are discussed. RECENT FINDINGS: There are mixed data as to whether traditional inhalation anesthesia or total intravenous anesthesia is superior with respect to better surgical fields and decreased blood loss...
February 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27999879/-perioperative-patient-management-in-orthogeriatrics
#17
P Moldzio, J Peters
The management of major orthopedic surgery in the elderly prototypically reflects the perioperative risks of geriatric, often very frail patients reflecting an aging population. To improve outcome, the risks of anesthesia and surgery as well as of patient comorbidities must be thoroughly assessed and balanced using a multidisciplinary approach. Particular risks include cardiopulmonary morbidity, anemia, risk of hemorrhage and the management by anticoagulation, cerebral impairments as well as frailty and limited physiological reserves in general...
December 20, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27989360/complications-in-neonatal-surgery
#18
Mauricio A Escobar, Michael G Caty
Neonatal surgery is recognized as an independent discipline in general surgery, requiring the expertise of pediatric surgeons to optimize outcomes in infants with surgical conditions. Survival following neonatal surgery has improved dramatically in the past 60 years. Improvements in pediatric surgical outcomes are in part attributable to improved understanding of neonatal physiology, specialized pediatric anesthesia, neonatal critical care including sophisticated cardiopulmonary support, utilization of parenteral nutrition and adjustments in fluid management, refinement of surgical technique, and advances in surgical technology including minimally invasive options...
December 2016: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/27984669/the-influence-of-ringer-s-lactate-or-hes-130-0-4-administration-on-the-integrity-of-the-small-intestinal-mucosa-in-a-pig-hemorrhagic-shock-model-under-general-anesthesia
#19
Ana Liza Ortiz, Helena Vala, Carlos Venâncio, João Mesquita, Aura Silva, Jose Manuel Gonzalo-Orden, David Ferreira
OBJECTIVE: To determine the effect of fluid resuscitation with 2 different physiological solutions, Ringer's lactate (RL) and hydroxyethyl starch (HES) 130/0.4, on histological lesions of the small intestinal mucosa in anesthetized pigs subjected to severe acute bleeding. DESIGN: Prospective experimental study. SETTING: University teaching hospital. ANIMALS: Twenty-eight healthy Large White pigs, 3 months of age. INTERVENTIONS: Pigs were subjected to severe acute bleeding (30 mL/kg) under total intravenous anesthesia with propofol and remifentanil...
December 16, 2016: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/27973934/patients-with-type-2-diabetes-anesthetic-management-in-the-ambulatory-setting-part-1-pathophysiology-and-associated-disease-states
#20
Bryant W Cornelius
The increasing prevalence of diabetes mellitus in the general population has many implications for the ambulatory anesthesia provider. Complications, particularly associated with poor glycemic control, can affect multiple organ systems and jeopardize the safety of any planned anesthetic. It is essential that anesthesiologists and sedation providers have in-depth knowledge of the pathophysiology of diabetes mellitus and the comorbid conditions that commonly accompany it. Anesthesiologists and sedation providers must also understand certain surgical and anesthetic considerations when planning an effective and safe anesthetic for diabetic patients...
2016: Anesthesia Progress
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