Abstract:
UNLABELLED:Suppression of nitric oxide (NO) production alters the toxicity of cocaine and bupivacaine. We undertook this study to determine whether the systemic toxicity of two other local anesthetics that differ in antiarrhythmic activity, plasma clearance, and biotransformation are similarly affected by nitric oxide synthase (NOS) inhibition. Sprague-Dawley rats anesthetized with 70% N2O and 0.5% halothane mixed with O2 were pretreated with saline (0.2 mL x kg(-1) x min(-1) i.v.) or N(omega)-nitro-L-arginine methyl ester (L-NAME; a competitive inhibitor of NOS) (2 mg x kg(-1) x min(-1) i.v.) for 30 min. The animals were then given tetracaine (3 mg x kg(-1) x min(-1) i.v.) or lidocaine (8 mg x kg(-1) x min(-1) i.v.) until cardiac arrest (asystole). Doses of lidocaine or tetracaine that produced arrhythmias, seizures, isoelectric encephalogram, and asystole were determined. Hemodynamic recordings were performed throughout the experiments, and plasma was collected to measure the concentration of lidocaine or tetracaine. L-NAME decreased tetracaine and lidocaine doses that produced arrhythmias (> or = 2 degrees atrioventricular conduction block) (tetracaine 14 +/- 2 mg/kg; lidocaine 102 +/- 9 mg/kg) versus saline treatment (tetracaine 28 +/- 2 mg/kg; lidocaine 136 +/- 9 mg/kg; P < 0.05). The tetracaine and lidocaine doses required to produce asystole were also smaller in animals with L-NAME pretreatment than those in saline-pretreated animals. L-NAME reduced the arrhythmia dose of tetracaine more than the arrhythmia dose of lidocaine (28 of 14 = 2.0 fold and 136 of 102 = 1.3-fold). The plasma concentration of lidocaine, but not tetracaine, was significantly higher at each sample time in L-NAME-pretreated animals than in saline-pretreated animals. Inhibition of NOS by L-NAME enhances the cardiotoxicity of lidocaine and tetracaine, with a greater effect on tetracaine than on lidocaine. Altered drug clearance by L-NAME was insufficient to explain these findings because L-NAME pretreatment increased the plasma levels of only lidocaine, not tetracaine. IMPLICATIONS:Inhibition of nitric oxide production in rats markedly enhances the cardiovascular toxicity of lidocaine and tetracaine. Altered drug clearance by N(omega)-nitro-L-arginine methyl ester was insufficient to explain these findings because N(omega)-nitro-L-arginine methyl ester pretreatment increased the plasma levels of only lidocaine, not tetracaine.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Heavner JE,Shi B,Pitkänen Mdoi
10.1097/00000539-199904000-00003subject
Has Abstractpub_date
1999-04-01 00:00:00pages
717-22issue
4eissn
0003-2999issn
1526-7598journal_volume
88pub_type
杂志文章abstract::Adrenomedullin is a potent vasodilatory peptide. Plasma adrenomedullin (AM) concentrations increase during and after cardiopulmonary bypass (CPB). However, the cause of this increase and its site of production have not been identified. We investigated the role of the hepatosplanchnic and cerebral circulations in the i...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000072543.78106.aa
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000002499
更新日期:2017-11-01 00:00:00
abstract::There are quantitative deficiencies in the coagulation system for at least the first 6 mo of life. Clinical experience, however, does not indicate an increased risk of excessive bleeding during surgical procedures. Thrombelastography, a test providing a functional evaluation of coagulation, was used to assess the hemo...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199704000-00008
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:Intercostal nerve blocks with liposomal bupivacaine are commonly used for thoracic surgery pain management. However, dose scheduling is difficult because the pharmacokinetics of a single-dose intercostal injection of liposomal bupivacaine has never been investigated. The primary aim of this study was to asse...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000005115
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Statins reduce cardiac morbidity in nonsurgical populations, and may benefit surgical patients. We sought to examine cardiac outcome in patients who continued, compared with those who discontinued, statin therapy after major vascular surgery. METHODS:Prospectively collected data were examined for an associa...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000263029.72643.10
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Musculoskeletal deformities in mucopolysaccharidoses (MPSs) patients pose unique challenges when patients present for surgery, especially nonspinal surgery. MPS patients have developed postsurgical neurological deficits after nonspinal surgery. While the incidence of neurological deficits after nonspinal sur...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000004215
更新日期:2020-06-01 00:00:00
abstract::Nicardipine is used in the treatment of premature labor. There are no previous reports in the anesthesia literature of serious side effects associated with this drug. We report a case of pulmonary edema induced by nicardipine therapy for tocolysis in a pregnant 27-yr-old patient admitted to our hospital for preterm la...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000135182.79774.A0
更新日期:2004-09-01 00:00:00
abstract::The effects of anesthetics on intracranial pressure (ICP) may be different in preterm neonates than in adults because the neonate's cranial sutures are not yet fused. The authors monitored changes in anterior fontanel pressure (AFP), a noninvasive indicator of ICP, during anesthesia in 44 preterm neonates without neur...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-198705000-00011
更新日期:1987-05-01 00:00:00
abstract:UNLABELLED:We conducted a prospective, randomized study to determine the efficacy of conjugated estrogen in reducing blood product transfusion during orthotopic liver transplantation (OLT). Patients undergoing OLT were included in the study. Only those having a reaction time of more than 30 mm or 15 min (19 -28 mm) on ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199806000-00008
更新日期:1998-06-01 00:00:00
abstract::The purpose of this study was to examine the effects of alfentanil applied to the surface of the spinal cord and the effects of intravenously administered alfentanil on noxiously evoked activity of dorsal horn neurons. Extracellular single neuron recordings were obtained from wide dynamic range neurons in 26 decerebra...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1986-02-01 00:00:00
abstract::Combinations of nonsteroidal antiinflammatory drugs (NSAIDs) and opioids are widespread in the management of pain, allowing better analgesia with reduced side effects. Cannabinoids are promising analgesic drugs that have pharmacological properties similar to those of opioids. However, the beneficial effects of cannabi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000194587.94260.1d
更新日期:2006-02-01 00:00:00
abstract::Despite the wide use of droperidol to reduce nausea and vomiting in children, its pharmacokinetics have not been described in pediatric patients. Twelve ASA Class I-II children, undergoing tonsillectomy and adenoidectomy, received standardized anesthesia; none of the children received premedication. After induction of...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199306000-00010
更新日期:1993-06-01 00:00:00
abstract::A 50-micrograms/kg dose of fentanyl, given intravenously in divided doses to dogs under enflurane-nitrous oxide anesthesia caused sharp decreases in heart rate (HR), arterial blood pressure (AP), left ventricular dP/dt, and plasma levels of catecholamines. Naloxone, 20 micrograms/kg given 65-70 min later, completely a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1983-03-01 00:00:00
abstract:UNLABELLED:Intrathecal (IT) sufentanil provides effective analgesia for extracorporeal shock wave lithotripsy. However, the optimal dose of sufentanil has not been established. We designed a prospective, randomized, double-blinded study to determine the optimal dose of IT sufentanil. Sixty men were randomized to receiv...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199910000-00013
更新日期:1999-10-01 00:00:00
abstract:UNLABELLED:Flurbiprofen, a nonsteroidal antiinflammatory drug (NSAID), has been used to treat rheumatic and osteoarthritic pain and to reduce postoperative pain. Although other NSAIDs, such as indomethacin, reduce cerebral blood flow (CBF), the effect of flurbiprofen on CBF is unknown. In the present study, we investig...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/01.ane.0000099755.97885.3c
更新日期:2004-02-01 00:00:00
abstract::We measured arterial plasma concentrations of lidocaine by enzyme immunoassay when 10 ml of 2% lidocaine without epinephrine was injected into the cervical, thoracic, or lumbar epidural spaces in 30 patients. There was no difference in the time courses of plasma levels of lidocaine. Peak concentrations were achieved 1...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1983-06-01 00:00:00
abstract:UNLABELLED:Selective pulmonary vasodilation is an advantageous therapeutic strategy for cardiac surgical patients with increased pulmonary vascular resistance (PVR) and right ventricular failure. We hypothesized that milrinone, an adenosine-3',5'-cyclic monophosphate (cAMP)-selective phosphodiesterase enzyme (PDE) inhi...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200112000-00018
更新日期:2001-12-01 00:00:00
abstract::Aprotinin, a potent antifibrinolytic drug, reduces the proportion of adults who receive blood transfusions during cardiac surgery, although the effect in children remains unclear. We performed a systematic review of the literature to identify all English language, randomized controlled trials of aprotinin involving ch...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,meta分析
doi:10.1213/01.ane.0000194954.64293.61
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Patients with chronic pain frequently suffer affective disorders, particularly anxiety and depression. Although clinical research on the relationship between pain and depressive symptoms has been done, it is not clear whether pain causes depression or depression exaggerates pain. To investigate the relation ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000261514.19946.66
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:The relatively short duration of effect of local anesthetics has been addressed by encapsulation in drug delivery systems. Codelivery with a single compound that produces an adjuvant effect on nerve block but without intrinsic local anesthetic properties can further prolong the nerve block effect. Here, we i...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000002719
更新日期:2018-04-01 00:00:00
abstract::While a large number of studies has examined the efficacy of opioid-sparing analgesics in adult surgical populations, fewer studies are available to guide postoperative pain treatment in pediatric patients. We systematically reviewed available publications on the use of systemic nonopioid agents for postoperative anal...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000002434
更新日期:2017-11-01 00:00:00
abstract:UNLABELLED:There is concern that the environment in which consent for anesthesia research is sought may be coercive. We therefore designed this study to determine the factors that parents consider in consenting to their child's participation in clinical anesthesia research. The study sample consisted of 246 parents who...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199801000-00010
更新日期:1998-01-01 00:00:00
abstract::We studied 49 patients of ASA physical status I to determine cerebral anesthetic concentration on awakening calculated with end-tidal anesthetic concentration, when the end-tidal concentration decreased spontaneously. We also attempted to explain the difference in the average of the bracketing alveolar anesthetic conc...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199311000-00024
更新日期:1993-11-01 00:00:00
abstract::A response algorithm consists of a logical sequence of maneuvers to be performed in response to a specific condition. With the advent of alarm-equipped monitors that alert anesthesiologists to the presence of potentially hazardous clinical conditions, a need has arisen to develop the corresponding alarm-oriented respo...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::If there is a genetic predisposition to excessive bleeding, there should be an association in excessive blood loss between multiple cardiac surgeries. We retrospectively determined in 174 patients the association of excessive bleeding between 2 cardiac surgeries with cardiopulmonary bypass between January 19, 1990 and...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000198563.28246.00
更新日期:2006-04-01 00:00:00
abstract::We assessed the efficacy of patient-controlled analgesia (PCA) techniques for extended femoral nerve sheath block after total hip arthroplasty. Forty-five patients were divided into three groups of 15. Over 48 h, all patients received 0.125% bupivacaine with clonidine 1 microg/mL and sufentanil 0.1 microg/mL via a fem...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200102000-00033
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:The analgesic efficacy of transversus abdominis plane (TAP) block has been established for patients undergoing abdominal surgery. We evaluated the efficacy of a novel approach to TAP block for postoperative analgesia after colorectal surgery. METHODS:Forty adult ASA physical status I to III patients undergo...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3182159bf8
更新日期:2011-06-01 00:00:00
abstract:UNLABELLED:The enhancing action of propofol on gamma-amino-n-butyric acid subtype A (GABA(A)) receptors purportedly underlies its anesthetic effects. However, a recent study found that a GABA(A) antagonist did not alter the capacity of propofol to depress the righting reflex. We examined whether the noncompetitive GABA...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000048821.23225.3a
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Transesophageal echocardiography (TEE) is a valuable monitor for patients undergoing cardiac and noncardiac surgery as it allows for evaluation of cardiovascular compromise in the perioperative period. It is challenging for anesthesiology residents and medical students to learn to use and interpret TEE in th...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000002004
更新日期:2017-05-01 00:00:00
abstract::One-hundred and eight-five pairs of gas samples were collected from inspired gas (10 cm behind the head at nose level) and end-tidal gas of persons administering anesthesia in 3 operating rooms during daily routine anesthesia. Mean operating-room N2O concentrations from 22 to 144 ppm (volume/volume [V/V]) were measure...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197803000-00012
更新日期:1978-03-01 00:00:00