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Airway; pharmacology anaesthetics

Christina H Shin, Sebastian Zaremba, Scott Devine, Milcho Nikolov, Tobias Kurth, Matthias Eikermann
INTRODUCTION: Obstructive sleep apnoea (OSA), the most common type of sleep-disordered breathing, is associated with significant immediate and long-term morbidity, including fragmented sleep and impaired daytime functioning, as well as more severe consequences, such as hypertension, impaired cognitive function and reduced quality of life. Perioperatively, OSA occurs frequently as a consequence of pre-existing vulnerability, surgery and drug effects. The impact of OSA on postoperative respiratory complications (PRCs) needs to be better characterised...
January 13, 2016: BMJ Open
M Mahmoud, K P Mason
Despite lack of paediatric labelling, contributions to the literature on paediatric applications of dexmedetomidine have increased over recent years. Dexmedetomidine possesses many properties that are advantageous for a sedative and anaesthetic; it has been reported to provide sedation that parallels natural sleep, anxiolysis, analgesia, sympatholysis, and an anaesthetic-sparing effect with minimal respiratory depression. In addition, there is increasing evidence supporting its organ-protective effects against ischaemic and hypoxic injury...
August 2015: British Journal of Anaesthesia
Christoph Curths, Judy Wichmann, Sarah Dunker, Horst Windt, Heinz-Gerd Hoymann, Hans D Lauenstein, Jens Hohlfeld, Tamara Becker, Franz-Josef Kaup, Armin Braun, Sascha Knauf
Animal models with a high predictive value for human trials are needed to develop novel human-specific therapeutics for respiratory diseases. The aim of the present study was to examine lung-function parameters in marmoset monkeys (Callithrix jacchus) that can be used to detect pharmacologically or provocation-induced AHR (airway hyper-responsiveness). Therefore a custom-made lung-function device that allows application of defined aerosol doses during measurement was developed. It was hypothesized that LPS (lipopolysaccharide)-challenged marmosets show AHR compared with non-challenged healthy subjects...
January 2014: Clinical Science (1979-)
G V Cammu, V Smet, K De Jongh, D Vandeput
Six years ago, a study performed in our department reported that the incidence of postoperative residual curarisation (PORC) was 39%. The reassessment of neuromuscular monitoring and reversal of neuromuscular block in routine anaesthetic practice is relevant now that sugammadex has become available. The incidence of PORC, defined by a train-of-four (TOF) <90%, was evaluated at post-anaesthesia care unit (PACU) arrival in patients whose neuromuscular block had been reversed with neostigmine or sugammadex and those in whom reversal was felt unnecessary (adequate spontaneous recovery)...
November 2012: Anaesthesia and Intensive Care
Munasib Khan, Arif-ullah Khan, Najeeb-ur-Rehman, Anwarul-Hassan Gilani
ETHNOPHARMACOLOGICAL RELEVANCE: Carum roxburghianum is traditionally used in hyperactive gastrointestinal and respiratory disorders. The present study was carried out to investigate the possible gut and airways relaxant potential of Carum roxburghianum to rationalize its folk uses. MATERIALS AND METHODS: Crude extract of Carum roxburghianum (Cr.Cr) was studied in in vivo and in vitro techniques. RESULTS: Cr.Cr exhibited protective effect against castor oil-induced diarrhea in mice at 100-1000 mg/kg...
June 14, 2012: Journal of Ethnopharmacology
J Jakobsson
Available volatile anaesthetics are safe and efficacious; however, their varying pharmacology provides small but potentially clinically important differences. Desflurane is one of the third-generation inhaled anaesthetics. It is the halogenated inhaled anaesthetic with the lowest blood and tissue solubilities, which promotes its rapid equilibration and its rapid elimination following cessation of administration at the end of anaesthesia. The low fat solubility of desflurane provides pharmacological benefits, especially in overweight patients and in longer procedures by reducing slow compartment accumulation...
April 2012: Acta Anaesthesiologica Scandinavica
Venkateswaran Ramkumar
Awake intubation is usually performed electively in the presence of a difficult airway. A detailed airway examination is time-consuming and often not feasible in an emergency. A simple 1-2-3 rule for airway examination allows one to identify potential airway difficulty within a minute. A more detailed airway examination can give a better idea about the exact nature of difficulty and the course of action to be taken to overcome it. When faced with an anticipated difficult airway, the anaesthesiologist needs to consider securing the airway in an awake state without the use of anaesthetic agents or muscle relaxants...
September 2011: Indian Journal of Anaesthesia
Munasib Khan, Arif-ullah Khan, Najeeb-ur-Rehman, Anwarul-Hassan Gilani
Crude extract of Juniperus excelsa (JeExt), which tested positive for the presence of anthraquinone, flavonoids, saponins, sterols, terpenes and tannin, exhibited a protective effect against castor oil-induced diarrhoea in mice at 100-1000 mg/kg. In rabbit jejunum preparations, JeExt (0.01-1.0 mg/mL) caused relaxation of spontaneous and K(+) (80 mM)-induced contractions at similar concentrations to papaverine, whereas verapamil was relatively more potent against K(+). JeExt (0.03-0.3 mg/mL) shifted Ca(2+) concentration-response curves to the right, like papaverine or verapamil...
April 2012: Journal of Natural Medicines
Durga Prasada Rao, Venkateswara A Rao
The purpose of this article is to review the fundamental aspects of obesity, pregnancy and a combination of both. The scientific aim is to understand the physiological changes, pathological clinical presentations and application of technical skills and pharmacological knowledge on this unique clinical condition. The goal of this presentation is to define the difficult airway, highlight the main reasons for difficult or failed intubation and propose a practical approach to management Throughout the review, an important component is the necessity for team work between the anaesthesiologist and the obstetrician...
November 2010: Indian Journal of Anaesthesia
Adrian Reber
The risk factors for respiratory complications can broadly be classified as patient-related or procedure-related factors. Knowledge about pathophysiological and pharmacological aspects of the patients' condition is essential for their safe care during preoperative assessment, intra-operative management and, if necessary, postoperative intensive care. A good understanding of the risk factors leading to the development of postoperative respiratory complications should result in the implementation of perioperative strategies designed to prevent their occurrence and reduce severity...
July 2009: Therapeutische Umschau. Revue Thérapeutique
Michael A Insko, Thomas L Deckwerth, Paul Hill, Christopher F Toombs, Csaba Szabo
BACKGROUND AND PURPOSE: Sodium sulphide (Na(2)S) disassociates to sodium (Na(+)) hydrosulphide, anion (HS(-)) and hydrogen sulphide (H(2)S) in aqueous solutions. Here we have established and characterized a method to detect H(2)S gas in the exhaled breath of rats. EXPERIMENTAL APPROACH: Male rats were anaesthetized with ketamine and xylazine, instrumented with intravenous (i.v.) jugular vein catheters, and a tube inserted into the trachea was connected to a pneumotach connected to a H(2)S gas detector...
July 2009: British Journal of Pharmacology
K J Coote, H Atherton, A Young, R Sugar, R Burrows, N J Smith, J-M Schlaeppi, P J Groot-Kormelink, M Gosling, H Danahay
BACKGROUND AND PURPOSE: The epithelial sodium channel (ENaC) is a key regulator of airway mucosal hydration and mucus clearance. Negative regulation of airway ENaC function is predicted to be of clinical benefit in the cystic fibrosis lung. The aim of this study was to develop a small animal model to enable the direct assessment of airway ENaC function in vivo. EXPERIMENTAL APPROACH: Tracheal potential difference (TPD) was utilized as a measure of airway epithelial ion transport in the guinea-pig...
December 2008: British Journal of Pharmacology
Yousuf M Al Suleimani, Ying Dong, Michael J A Walker
Different drugs from various pharmacological classes were compared for their ability to protect against the nasal effects of acute allergen challenge in a guinea pig model. In the model, sneezing and nose rubbing were recorded after an initial allergen challenge in guinea pigs previously sensitized to egg albumin. Four days later the same guinea pigs were re-challenged a second time when anesthetised. In these anaesthetized animals, nasal airway pressure, pulmonary inflation pressure and cellular infiltration into nasal lavage fluid were measured...
2008: Pulmonary Pharmacology & Therapeutics
S M Burburan, D G Xisto, P R M Rocco
Anaesthetic management in asthmatic patients has been focused on avoiding bronchoconstriction and inducing bronchodilation. However, the definition of asthma has changed over the past decade. Asthma has been defined as a clinical syndrome characterized by an inflammatory process that extends beyond the central airways to the distal airways and lung parenchyma. With this concept in mind, and knowing that asthma is a common disorder with increasing prevalence rates and severity worldwide, a rational choice of anaesthetic agents and procedures is mandatory...
June 2007: Minerva Anestesiologica
A Rudra, M Mondal, A Acharya, S Nayak, S Mukherjee
Complications of anaesthesia leading to death in young pregnant women might be prevented if more experienced personnel could be entrusted with the job. The contribution of anaesthesia to maternal mortality in the United Kingdom is 1.7 per million pregnancies with almost similar incidence from United States. The commonest single factor responsible for anaesthesia-related death is difficult or failed intubation. A pregnant woman with a potentially difficult airway should receive aspiration prophylaxis (mechanical or pharmacological) as soon as operative delivery is anticipated...
June 2006: Journal of the Indian Medical Association
Kai Goldmann
PURPOSE OF THE REVIEW: During the last two years, several studies have enhanced our knowledge about the influence of pharmacological agents and routine airway management manoeuvres on the airway of paediatric patients. New supraglottic airway devices have been introduced into routine paediatric anaesthesia practice, and the design of paediatric endotracheal tubes has been modified. This review summarizes the most recent and relevant scientific developments in paediatric airway management...
June 2006: Current Opinion in Anaesthesiology
Gino Villetti, Marco Bergamaschi, Franco Bassani, Pier Tonino Bolzoni, Selena Harrison, Paolo M Gigli, Alberto Janni, Pierangelo Geppetti, Maurizio Civelli, Riccardo Patacchini
1. Our study was aimed at investigating the duration of the bronchodilator action of the antimuscarinc drug glycopyrrolate compared to tiotropium and ipratropium. In the guinea-pig isolated trachea, the time (t1/2) necessary for a contractile response to carbachol (0.3 microM) to return to 50% recovery after washout of the antagonist was studied. The offset of the antagonist effect of glycopyrrolate, tiotropium and ipratropium (10 nM each) was t1/2 = 4.0 +/- 0.5, > 4.5 and 0.5 +/- 0.1 h, respectively. At 4...
June 2006: British Journal of Pharmacology
Michael J Carr
Local anesthetics are among the most effective peripherally acting antitussives. A complete understanding of their pharmacological properties in airway afferent neurons associated with the cough reflex has been hampered by an incomplete understanding of the contribution of various classes of afferent neuron to cough. The aim of this study was to evaluate the influence of the antitussive local anesthetic mexiletine on nodose ganglion-derived vagal afferent Adelta-fibers innervating guinea pig trachea. This distinct subtype of airway sensory neuron was recently shown to be involved in evoking cough in anaesthetized guinea pigs...
2006: Pulmonary Pharmacology & Therapeutics
Getúlio Rodrigues de Oliveira Filho, Leonardo Schonhorst
The authors describe the implementation of problem-based learning (PBL) in an introductory course to anaesthesiology (ICA) traditionally administered in teacher-centred formats. The study was performed during the 2003 and 2004 courses. Seven residents participated in ICA2003 and 5 in ICA2004. Courses covered pre- and post-anaesthesia care, airway management, pharmacology of anaesthetics, and neuraxial blocks. Lectures, demonstrations and PBL were used in ICA2003. Only PBL was used in ICA2004. ICA2003 residents' perceptions of the contribution of learning formats to solving post-tests were assessed on 100-millimetre visual analogue scales (VASs)...
June 2005: Medical Teacher
A Reber
In obese patients, perioperative pulmonary complications have an increased frequency and are associated with higher morbidity and mortality compared with non-obese patients. The management of surgical procedures in these patients is a challenge for the anaesthetist. Knowledge of pathophysiological and pharmacological aspects of the obese patients' condition is essential for their care during preoperative assessment, intra-operative management and, if necessary, postoperative intensive care. Special information on airway and lung protection as well as cases involving laparoscopic surgery, obstetric and paediatric anaesthesia in obese patients are also discussed...
July 2005: Der Anaesthesist
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