Abstract：
BACKGROUND:Local anesthetics (LA) work by blocking sodium conductance through voltage-gated sodium channels. Complete local anesthetic resistance is infrequent, and the cause is unknown. Genetic variation in sodium channels is a potential mechanism for local anesthetic resistance. A patient with a history of inadequate loss of sensation following LA administration underwent an ultrasound-guided brachial plexus nerve block with a complete failure of the block. We hypothesized that LA resistance is due to a variant form of voltage-gated sodium channel. METHODS:Whole-Exome Sequencing. The patient and her immediate family provided consent for exome sequencing, and they were screened with a questionnaire to identify family members with a history of LA resistance. Exome sequencing results for four individuals were referenced to the 1000 Genomes Project and the NHLBI ESP to identify variants associated with local anesthetic resistance present in less than 1% of the general population and located in functional regions of the genome. RESULTS:Exome sequencing of the four family members identified one genetic variant in the voltage-gated sodium channel shared by the three individuals with LA resistance but not present in the unaffected family member. Specifically, we noted the A572D mutation in the SCN5A gene encoding for Nav1.5. CONCLUSIONS:We identified a genetic variant that is associated with LA resistance in the gene encoding for Nav1.5. We also demonstrate that Nav1.5 is present in human peripheral nerves to support the plausibility that an abnormal form of the Nav1.5 protein could be responsible for the observed local anesthetic resistance.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Clendenen N,Cannon AD,Porter S,Robards CB,Parker AS,Clendenen SRsubject
Has Abstractpub_date
2016-10-01 00:00:00pages
1089-1097issue
10eissn
0375-9393issn
1827-1596pii
R02Y9999N00A16053101journal_volume
82pub_type
杂志文章abstract：:The case of a woman of 27 affected by the Prader-Willi syndrome who underwent general anaesthesia for dental surgery is reported. The patient presented severe mental retardation, small stature, moderate muscular hypotonia, hyperphagia, obesity, and diabetes mellitus. Premedication consisted of diazepam and atropine; a...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1996-10-01 00:00:00
abstract：:Coagulopathy associated with massive operative blood loss is an intricate, multicellular and multifactorial event. Massive bleeding can either be anticipated (during major surgery with high risk of bleeding) or unexpected. Management requires preoperative risk evaluation and preoperative optimization (discontinuation ...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：2007-07-01 00:00:00
abstract：:The paper reports the case of a young male which was severely poisoned by anilyne shoe black. After a few hours, he was in a semicomatose state, accompanied by "very dark" arterial blood gases with oxygen tension in excess of 100 mmHg. Following the administration of intravenous methylene blue (2 mg/kg), methemoglobin...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1990-12-01 00:00:00
abstract：:The anaesthetic technique chosen for a laparohysterectomy in a woman affected by Apert's acrocephalosyndactilia is described. Difficulties in performing tracheal intubation were overcome by mean of loco-regional anesthesia (LRA). In order to minimize the anaesthetic risk, a standardised preoperative evaluation and ass...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1997-05-01 00:00:00
abstract：: ...
journal_title：Minerva anestesiologica
pub_type： 信件
doi：10.23736/S0375-9393.19.13663-2
更新日期：2019-09-01 00:00:00
abstract：BACKGROUND:Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is an effective rescue therapy for improving oxygenation in selected severe acute respiratory distress syndrome (ARDS). Prone position (PP) is usually considered before vvECMO and few data are available on the association of PP during VV-ECMO. Thus, w...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2014-03-01 00:00:00
abstract：:Known for two centuries, positive pressure non invasive mechanical ventilation (VMNPP) has been widely applied in acute respiratory failure (IRA) only in the last ten years. The fact that VMNPP is able to improve gas exchange by avoiding endotracheal intubation and its complications is the most attractive aspect in bo...
journal_title：Minerva anestesiologica
pub_type： 历史文章,杂志文章,评审
doi：
更新日期：2000-10-01 00:00:00
abstract：: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...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：2007-06-01 00:00:00
abstract：:Pulse-oximeter is described as the most important technological proceeding for monitoring the patients' safety during anesthesia, after surgery and in emergency. This opinion was widely confirmed in the 1990s when pulse-oximeter has been definitively introduced in the standard for base monitoring in the OR and has bee...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：2002-05-01 00:00:00
abstract：:Intubating laryngeal mask airway (ILMA) is a very useful device for difficult airway management. The use of this device has not yet been studied in otorhinolaryngology surgery. The case of a 52-year-old man, weighing 104 kg, anesthetized for microlaryngoscopy due to aphonia occurred 6 months before, is reported. Tradi...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2001-10-01 00:00:00
abstract：BACKGROUND:Pneumonia is the primary source of sepsis and is significantly associated with mortality. However, only a few studies focus on its clinical characteristics and outcomes. METHODS:We evaluated 500 intensive care unit patients who met severe sepsis or septic shock criteria, dividing them into two distinct grou...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,多中心研究
doi：
更新日期：2013-12-01 00:00:00
abstract：BACKGROUND:Trapeziectomy is one of the most painful procedures in ambulatory surgery. This prospective randomized trial aimed to compare postoperative pain control using distal peripheral nerve blocks (dPNB) with a low concentration of a long-acting local anesthetic versus conventional systemic analgesia. METHODS:Fift...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,随机对照试验
doi：10.23736/S0375-9393.18.12291-7
更新日期：2018-11-01 00:00:00
abstract：:Pulmonary gas exchange is regularly impaired during general anaesthesia with mechanical ventilation. This results in decreased oxygenation of blood. Major causes are collapse of lung tissue (atelectasis) and airway closure. Collapsed lung tissue is present in 90% of all subjects, both during spontaneous breathing and ...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：2002-05-01 00:00:00
abstract：BACKGROUND:Multiple patient and clinical characteristics contribute to the variable outcome of spinal anesthesia (SPA). Acute reduction of cerebrospinal fluid (CSF) volume may alter the effect of SPA. The objective of the present study was to test if aspiration of 10 mL CSF immediately prior to SPA is associated with h...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：10.23736/S0375-9393.20.14138-5
更新日期：2020-06-01 00:00:00
abstract：AIM:The authors have evaluated remifentanil for intraoperative analgesia in endonasal endoscopic surgery for pituitary lesions. METHODS: EXPERIMENTAL DESIGN:a perspective, randomized and comparative study between remifentanil and fentanyl for intraoperative analgesia was performed in an operating room of the neurosur...
journal_title：Minerva anestesiologica
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：2003-03-01 00:00:00
abstract：:The successful management of 2 cases of rare myopathies, who underwent hemithyroidectomy, is here reported. Anaesthesia was induced with TPS and fentanyl, and maintained with isoflurane. Neuromuscular blockade was achieved by atracurium; neuromuscular monitoring by Neurostar-Medeleck was performed. This intraoperative...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1991-07-01 00:00:00
abstract：BACKGROUND:The use of propofol often results in pain upon injection. Various strategies can be used to reduce this pain, ranging from the administration of analgesics to modification of the propofol emulsion. However, basic premedication protocol aimed at peri- and postoperative pain reduction could also sufficiently r...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,随机对照试验
doi：
更新日期：2010-09-01 00:00:00
abstract：AIM:Inguinal herniorrhaphy (IH) is a common surgical procedure that can be successfully performed by using general, regional or local anesthesia and is usually performed in an outpatient setting. In this study, recovery profile, incidence of adverse effects, postoperative pain scores and patient satisfaction between pa...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,随机对照试验
doi：
更新日期：2009-12-01 00:00:00
abstract：:Humoral immunity (immunoglobulins and C3) as well as nutritional conditions (serum albumin, transferrin) have been investigated in 23 patients in the acute phase after surgery and/or trauma. Immunoglobulin deficiency, well correlated with the severity of trauma, was observed in the most critically ill patients in the ...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：1981-08-01 00:00:00
abstract：:In patients with strong suspicion of SAH, CT is the initial diagnostic procedure of choice. A lumbar puncture (LP) should be done if a CT is not available. If the patient has no focal deficit or papilloedema there is a little risk in LP. When a CT is negative there can be indication to do a LP: small leaks can be over...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：1998-04-01 00:00:00
abstract：:Over the past 15 years, there have been dramatic changes in the management of blunt hepatic trauma, specifically in the imaging techniques, and in the non-operative management. Actually, in more than 80% of blunt hepatic trauma, non operative management is used. In the last 20% the surgical option has to be taken with...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：2002-04-01 00:00:00
abstract：BACKGROUND:We prospectively evaluated the effect of insertion angle on the visibility of echogenic and nonechogenic needles in phantoms and in axillary nerve blocks in patients. METHODS:Conventional and echogenic needles were studied in phantoms at insertion angles of 0-30°, 30-45°, and ≥ 45°. Operators rated comfort ...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,随机对照试验
doi：
更新日期：2015-04-01 00:00:00
abstract：BACKGROUND:Combined epidural/general anaesthesia might theoretically emphasise the cardiovascular effects of epidural block alone. The goal of the present investigation was to evaluate the incidence of both hypotension and bradycardia during integrated epidural/general anaesthesia in a multicentric, observational study...
journal_title：Minerva anestesiologica
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1998-07-01 00:00:00
abstract：BACKGROUND:Anaesthesia drugs cause the cutaneous vasodilatation that produces core temperature lowering at the beginning of general anaesthesia; when the thermal threshold for vasoconstriction is reached the cutaneous heat losses are decreased. Furthermore, the soda lime begins to produce water and heat after 40 minute...
journal_title：Minerva anestesiologica
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1995-09-01 00:00:00
abstract：:Fifteen to 30% of patients develop acute renal failure (ARF) following rhabdomyolysis and rhabdomyolysis accounts for 5 to 9% of all ARF. Experimental studies revealed two critical factors that predispose to myoglobinuric ARF: hypovolemia/dehydration and aciduria. At the nephron level, three basic mechanisms underlie ...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,评审
doi：
更新日期：1999-05-01 00:00:00
abstract：:A 74-year-old patient was submitted to urgent surgery for intestinal occlusion. After the induction of the anaesthesia, tracheal intubation failed since no progression of Eshmann tracheal tube introducer was possible. The ventilation was difficult and a laryngeal mask was inserted. After oxygenation, the tracheal tube...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2012-02-01 00:00:00
abstract：BACKGROUND:Labile iron is important in the pathogenesis of acute kidney injury (AKI). Neutrophil gelatinase-associated lipocalin (NGAL) and hepcidin control iron metabolism and are upregulated during renal stress. However, higher levels of urinary NGAL are associated with AKI severity whereas higher urinary hepcidin le...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2015-11-01 00:00:00
abstract：BACKGROUND:Today, most of the pre-emptive hemodynamic optimization algorithms are based on variables associated with invasive techniques like arterial cannulation. The non-invasive Nexfin™ technology is able to estimate continuous Cardiac Index (CI) and pulse pressure variation (PPV). However, the efficiency of an earl...
journal_title：Minerva anestesiologica
pub_type： 杂志文章,随机对照试验
doi：
更新日期：2016-11-01 00:00:00
abstract：BACKGROUND:The coronary sinus oxygen saturation (SO2) can affect the oxygen saturation of the superior vena cava (superior cava SO2) and the pulmonary artery (pulmonary artery SO2), causing a gradient between the latter two (ΔSO2), as has been observed in different physiological and pathological conditions. The objecti...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2011-06-01 00:00:00
abstract：AIM:Heat shock proteins (HSPs), induced by thermal stress, make the cells more resistant to following stress. We aimed to verify if rats heating reduces the production of TNF-alpha in a model of acute respiratory distress syndrome (ARDS). METHODS:We divided 34 Wistar rats in Group A and Group B. The rats of Group A re...
journal_title：Minerva anestesiologica
pub_type： 杂志文章
doi：
更新日期：2005-10-01 00:00:00
