Thromboelastography for monitoring prolonged hypercoagulability after major abdominal surgery.

Abstract:

UNLABELLED:Despite clinical and laboratory evidence of perioperative hypercoagulability, there are no consistent data evaluating the extent, duration, and specific contribution of platelets and procoagulatory proteins by in vitro testing. We tested the hypothesis that the parallel use of standard and abciximab-cytochalasin D-modified thromboelastography (TEG) can assess 7 days' postoperative hypercoagulability and can estimate the independent contribution of procoagulatory proteins and platelets. Thromboelastograms were performed before surgery, at the end of surgery, 6 h after surgery, and on postoperative days 1, 2, 3, and 7; they were analyzed for the reaction time and the maximal amplitude (MA). We calculated the elastic shear modulus of standard MA (G(t)) and modified MA (G(c)), which reflect total clot strength and procoagulatory protein component, respectively. The difference was an estimate of the platelet component (G(p)). There was a 10% perioperative increase of standard MA, corresponding to a 50% increase of G(t) (P < 0.0001) and an 86%-90% contribution of the calculated G(p) to G(t). We conclude that serial standard and modified thromboelastography may reveal prolonged postoperative hypercoagulability and the independent contribution of platelets and procoagulatory proteins to clot strength. IMPLICATIONS:Postoperative hypercoagulability, occurring for at least 1 wk after major abdominal surgery, may be demonstrated by standard and modified thromboelastography. This hypercoagulability is not reflected by standard coagulation monitoring and seems to be predominantly caused by increased platelet reactivity.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Mahla E,Lang T,Vicenzi MN,Werkgartner G,Maier R,Probst C,Metzler H

doi

10.1097/00000539-200103000-00004

subject

Has Abstract

pub_date

2001-03-01 00:00:00

pages

572-7

issue

3

eissn

0003-2999

issn

1526-7598

journal_volume

92

pub_type

杂志文章
  • Incorporating simulation-based objective structured clinical examination into the Israeli National Board Examination in Anesthesiology.

    abstract::We describe the unique process whereby simulation-based, objective structured clinical evaluation (OSCE) has been incorporated into the Israeli board examination in anesthesiology. Development of the examination included three steps: a) definition of clinical conditions that residents are required to handle competentl...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000194934.34552.ab

    authors: Berkenstadt H,Ziv A,Gafni N,Sidi A

    更新日期:2006-03-01 00:00:00

  • The breaking of an intrathecally-placed epidural catheter during extraction.

    abstract:IMPLICATIONS:Misplacement of an epidural catheter into the subarachnoid space is a recognized complication. However, breakage of an intrathecal epidural catheter during removal presents a dilemma. Appropriate imaging, a neurosurgical consultation, and aggressive surgical exploration and extraction of the retained piece...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200210000-00055

    authors: Ugboma S,Au-Truong X,Kranzler LI,Rifai SH,Joseph NJ,Salem MR

    更新日期:2002-10-01 00:00:00

  • Vocalization assessed by electrolaryngography is unaffected by topical lidocaine anesthesia: a prospective, crossover, randomized, double-blind placebo-controlled study.

    abstract:BACKGROUND:Topical anesthesia of the upper airway is often recommended when difficulty in airway management is anticipated. There are published reports, however, of administration of topical anesthesia resulting in complete loss of airway control. Adverse effects are mostly attributed to interference with involuntary p...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e3182455b71

    authors: Maxwell MJ,English JD,Moppett IK,McGlashan JA,Norris AM

    更新日期:2012-04-01 00:00:00

  • The pronociceptive effect of ondansetron in the setting of P-glycoprotein inhibition.

    abstract::Ondansetron is a potent antiemetic drug that acts through inhibition of the 5HT3 receptors for serotonin. Minimum alveolar concentration (MAC) for isoflurane is not affected by systemic ondansetron; however ondansetron is a substrate of P-glycoprotein, a transport pump expressed in the blood-brain barrier. Thus, we hy...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000228861.80314.22

    authors: Scott JA,Wood M,Flood P

    更新日期:2006-09-01 00:00:00

  • Paravertebral blockade for day-case breast augmentation: a randomized clinical trial.

    abstract:BACKGROUND:Bilateral breast augmentation is an increasingly popular day-case procedure. Local infiltration with sedation is routinely used for its ease of application compared with the more complex and potentially riskier paravertebral blockade (PVB). We hypothesized that ropivacaine injected by experienced anesthesia ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e318264ba33

    authors: Gardiner S,Rudkin G,Cooter R,Field J,Bond M

    更新日期:2012-11-01 00:00:00

  • Postoperative pain in ambulatory surgery.

    abstract:UNLABELLED:Postoperative pain is a common reason for the delayed discharge and unanticipated hospital admission of out-patients. In this study, we examined the pattern of pain in ambulatory surgical patients and determined those factors that predict postoperative pain. Ten thousand eight consecutive ambulatory surgical...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199710000-00017

    authors: Chung F,Ritchie E,Su J

    更新日期:1997-10-01 00:00:00

  • Spinal anesthesia with hyperbaric levobupivacaine and ropivacaine for outpatient knee arthroscopy: a prospective, randomized, double-blind study.

    abstract::To compare unilateral spinal block produced with small doses of hyperbaric ropivacaine with that produced by 2 doses of hyperbaric levobupivacaine, we randomly allocated 91 ASA physical status I-II outpatients undergoing knee arthroscopy to receive unilateral spinal anesthesia with 7.5 mg of hyperbaric ropivacaine 0.5...

    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.0000155265.79673.56

    authors: Cappelleri G,Aldegheri G,Danelli G,Marchetti C,Nuzzi M,Iannandrea G,Casati A

    更新日期:2005-07-01 00:00:00

  • Effect of dexmedetomidine, a selective and potent alpha 2-agonist, on cerebral blood flow and oxygen consumption during halothane anesthesia in dogs.

    abstract::The effect of the alpha 2-agonist dexmedetomidine on the cerebral blood flow (CBF) and the metabolic rate for oxygen was studied by a sagittal sinus outflow technique in dogs during halothane anesthesia. Dexmedetomidine was given in a dose (10 micrograms/kg) reported to reduce the anesthetic requirement of halothane b...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199008000-00003

    authors: Karlsson BR,Forsman M,Roald OK,Heier MS,Steen PA

    更新日期:1990-08-01 00:00:00

  • Differences in production of reactive oxygen species and mitochondrial uncoupling as events in the preconditioning signaling cascade between desflurane and sevoflurane.

    abstract:BACKGROUND:Signal transduction cascade of anesthetic-induced preconditioning has been extensively studied, yet many aspects of it remain unsolved. Here, we investigated the roles of reactive oxygen species (ROS) and mitochondrial uncoupling in cardiomyocyte preconditioning by two modern volatile anesthetics: desflurane...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e3181a93ad9

    authors: Sedlic F,Pravdic D,Ljubkovic M,Marinovic J,Stadnicka A,Bosnjak ZJ

    更新日期:2009-08-01 00:00:00

  • The Mechanism of Mitral Regurgitation Influences the Temporal Dynamics of the Vena Contracta Area as Measured with Color Flow Doppler.

    abstract:BACKGROUND:In patients with mitral regurgitation (MR), the effective regurgitant orifice area can be estimated by measuring the vena contracta area (VCA). We hypothesize that the VCA has characteristic temporal dynamics related to the underlying mechanism of functional mitral regurgitation (FMR) versus degenerative mit...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000001056

    authors: Cobey FC,Ashihkmina E,Edrich T,Fox J,Shook D,Bollen B,Breeze JL,Ursprung WW,Shernan SK

    更新日期:2016-02-01 00:00:00

  • The out-of-hospital esophageal and endobronchial intubations performed by emergency physicians.

    abstract:BACKGROUND:Rapid establishment of a patent airway in ill or injured patients is a priority for prehospital rescue personnel. Out-of-hospital tracheal intubation can be challenging. Unrecognized esophageal intubation is a clinical disaster. METHODS:We performed an observational, prospective study of consecutive patient...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000253523.80050.e9

    authors: Timmermann A,Russo SG,Eich C,Roessler M,Braun U,Rosenblatt WH,Quintel M

    更新日期:2007-03-01 00:00:00

  • Severity of baseline pain and degree of analgesia in the third molar post-extraction dental pain model.

    abstract:UNLABELLED:The purpose of this study was to determine whether different levels of pain would respond similarly to analgesia. We compared the analgesic response to ibuprofen in subjects with moderate versus severe baseline pain in clinical trials using the third molar post-extraction dental pain model. We performed a po...

    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.0000063827.97392.5e

    authors: Averbuch M,Katzper M

    更新日期:2003-07-01 00:00:00

  • The effects of perioperative pain management techniques on food consumption and body weight after laparotomy in rats.

    abstract:UNLABELLED:We examined the effects of two perioperative pain management techniques on recovery after laparotomy, as assessed by body weight (BW) and food consumption (FC). All rats received a preoperative intrathecal mixture of morphine plus bupivacaine combined with one of two treatments: (a) injection of slow-release...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000167771.98680.a7

    authors: Shavit Y,Fish G,Wolf G,Mayburd E,Meerson Y,Yirmiya R,Beilin B

    更新日期:2005-10-01 00:00:00

  • Perioperative Diabetes Insipidus Caused by Anesthetic Medications: A Review of the Literature.

    abstract::Diabetes insipidus (DI) is an uncommon perioperative complication that can occur secondary to medications or surgical manipulation and can cause significant hypovolemia and electrolyte abnormalities. We reviewed and evaluated the current literature and identified 24 cases of DI related to medications commonly used in ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000005344

    authors: Van Decar LM,Reynolds EG,Sharpe EE,Harbell MW,Kosiorek HE,Kraus MB

    更新日期:2021-01-06 00:00:00

  • Exposure to sevoflurane and nitrous oxide during four different methods of anesthetic induction.

    abstract:UNLABELLED:The National Institute for Occupational Safety and Health-recommended exposure levels for nitrous oxide exposure are 25 ppm as a time-weighted average over the time of exposure. The exposure limit for halogenated anesthetics (without concomitant nitrous oxide exposure) is 2 ppm. Inhaled sevoflurane provides ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199904000-00045

    authors: Hoerauf KH,Wallner T,Akça O,Taslimi R,Sessler DI

    更新日期:1999-04-01 00:00:00

  • Readability, Content, and Quality Assessment of Web-Based Patient Education Materials Addressing Neuraxial Labor Analgesia.

    abstract:BACKGROUND:Studies in a variety of disciplines have shown that the readability of Web-based patient education materials is above that of the sixth grade reading level recommended by the U.S. Department of Health and Human Services. The aim of this study was to evaluate the readability, content, and quality of English- ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,多中心研究

    doi:10.1213/ANE.0000000000000888

    authors: Patel SK,Gordon EJ,Wong CA,Grobman WA,Goucher H,Toledo P

    更新日期:2015-11-01 00:00:00

  • Continuous gastric decompression for postoperative nausea and vomiting after coronary revascularization surgery.

    abstract::Postoperative nausea and vomiting is common after cardiac surgery and may contribute to significant morbidity. Gastric decompression during anesthesia has been used for postoperative nausea and vomiting prophylaxis in shorter duration noncardiac surgery with conflicting results. We tested the hypothesis that gastric d...

    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.0000143567.51304.1A

    authors: Burlacu CL,Healy D,Buggy DJ,Twomey C,Veerasingam D,Tierney A,Moriarty DC

    更新日期:2005-02-01 00:00:00

  • Influence and relative sensitivities of 50-Hz and 100-Hz tetanic stimuli on subsequent tetanic fade ratios in patients receiving vecuronium.

    abstract::We studied the possible effects of repetitive (1-min interval) 50- and 100-Hz tetanic stimuli on 50-Hz and 100-Hz tetanic fade ratios (RF50HZ and RF100HZ). We also evaluated the sensitivity of the recorded responses to these two tests to assess residual neuromuscular block (isometric adductor pollicis mechanical activ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199601000-00025

    authors: Baurain MJ,Hoton F,Dernovoi BS,d'Hollander AA

    更新日期:1996-01-01 00:00:00

  • Reliability of the transient hyperemic response test in detecting changes in cerebral autoregulation induced by the graded variations in end-tidal carbon dioxide.

    abstract:UNLABELLED:The transient hyperemic response (THR) in the middle cerebral artery (MCA) after the release of brief compression of the ipsilateral common carotid artery has been used to study cerebral autoregulation. We conducted the present study to evaluate the reliability of THR to detect changes in cerebral autoregula...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199810000-00018

    authors: Mahajan RP,Cavill G,Simpson EJ

    更新日期:1998-10-01 00:00:00

  • Protocolized intensive care unit management of analgesia, sedation, and delirium improves analgesia and subsyndromal delirium rates.

    abstract:BACKGROUND:Sedatives and analgesics, in doses that alter consciousness in the intensive care unit (ICU), contribute to delirium and mortality. Pain, agitation, and delirium can be monitored in ICU patients. These symptoms were noted before (PRE) and after (POST) a protocol to alleviate undesirable symptoms. Analgesia a...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3181d7e1b8

    authors: Skrobik Y,Ahern S,Leblanc M,Marquis F,Awissi DK,Kavanagh BP

    更新日期:2010-08-01 00:00:00

  • Ultrasound-guided epidural catheter insertion in children.

    abstract:UNLABELLED:Epidural catheters (EC) are often used in pediatric patients for intraoperative and postoperative pain relief. The small anatomical structures and catheter insertion under general anesthesia make it more difficult to perform EC and to prevent damage. In this study we investigated the use of ultrasound (US) i...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000156579.11254.D1

    authors: Rapp HJ,Folger A,Grau T

    更新日期:2005-08-01 00:00:00

  • Beta-adrenergic blockers and vasovagal episodes during shoulder surgery in the sitting position under interscalene block.

    abstract:UNLABELLED:Shoulder surgery is often performed with patients in the sitting position under interscalene block anesthesia. Vasovagal episodes, characterized by a sudden decrease in heart rate and/or blood pressure, have a reported incidence of 17%-24% in this setting. We performed a retrospective study to determine whet...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Kahn RL,Hargett MJ

    更新日期:1999-02-01 00:00:00

  • A comparison of the effect on dispersion of repolarization of age-adjusted MAC values of sevoflurane in children.

    abstract:BACKGROUND:QT interval prolongation is associated with torsades des pointes (TdP), but is a poor predictor of drug torsadogenicity. Susceptibility to TdP arises from increased transmural dispersion of repolarization (TDR) across the myocardial wall, rather than QT interval prolongation per se. TDR can be measured on th...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/01.ane.0000252417.23986.6e

    authors: Whyte SD,Sanatani S,Lim J,Booker PD

    更新日期:2007-02-01 00:00:00

  • Local anesthetics induce apoptosis in human breast tumor cells.

    abstract:BACKGROUND:Previous studies have shown that local anesthetics may induce apoptosis in some cell types. In this study, we investigated the apoptotic effects of local anesthetics in human breast tumor cells. METHODS:Human breast cancer (MCF-7) and mammary epithelial (MCF-10A) cell lines were treated with lidocaine and/o...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3182a94479

    authors: Chang YC,Liu CL,Chen MJ,Hsu YW,Chen SN,Lin CH,Chen CM,Yang FM,Hu MC

    更新日期:2014-01-01 00:00:00

  • The effects of desflurane on cardiac function as measured by conductance volumetry in swine.

    abstract:UNLABELLED:The purpose of the investigation was to assess the effects of desflurane (DES) on left ventricular heart function during basal barbiturate anesthesia in a closed-pericardium, closed-chest acute swine model. The study was performed in 11 normoventilated adult pigs. Hemodynamic measurements were obtained using...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199809000-00003

    authors: Sundeman H,Haney M,Broomé M,Häggmark S,Johansson G,Winsö O,Biber B

    更新日期:1998-09-01 00:00:00

  • Long-term pain vulnerability after surgery in rats: prevention by nefopam, an analgesic with antihyperalgesic properties.

    abstract:BACKGROUND:Tissue damage associated with surgery often produces peripheral and central sensitization that may outlast the stimuli, leading to exaggerated postoperative pain. Paradoxically, the use of opioid analgesia, which is essential for surgical pain management may induce pain sensitization leading to enhanced post...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e3181aa956b

    authors: Laboureyras E,Chateauraynaud J,Richebé P,Simonnet G

    更新日期:2009-08-01 00:00:00

  • Postoperative epidural analgesia and oral anticoagulant therapy.

    abstract::The relative safety of epidural catheter placement with subsequent heparinization has been well documented. However, what is the risk of neurologic sequelae in such patients who receive warfarin perioperatively? This study retrospectively evaluates the risk of spinal hematoma in patients receiving postoperative epidur...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199407000-00017

    authors: Horlocker TT,Wedel DJ,Schlichting JL

    更新日期:1994-07-01 00:00:00

  • A comparison of costs and efficacy of ondansetron and droperidol as prophylactic antiemetic therapy for elective outpatient gynecologic procedures.

    abstract::Ondansetron and droperidol are both effective prophylactic antiemetics for gynecologic outpatient procedures. However, increased drowsiness, delayed discharge, and postdischarge restlessness may occur with droperidol, and ondansetron is costly. In this prospective, randomized, double-blind, placebo-controlled study in...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199608000-00018

    authors: Tang J,Watcha MF,White PF

    更新日期:1996-08-01 00:00:00

  • The intrathoracic blood volume index as an indicator of fluid responsiveness in critically ill patients with acute circulatory failure: a comparison with central venous pressure.

    abstract:BACKGROUND:The intrathoracic blood volume index (ITBVI) and central venous pressure (CVP) are routinely used to predict fluid responsiveness in critically ill patients with acute circulatory failure (systolic blood pressure < 90 mm Hg or vasopressor requirement). However, they have never been compared. METHODS:In this...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e31817e6618

    authors: Muller L,Louart G,Bengler C,Fabbro-Peray P,Carr J,Ripart J,de La Coussaye JE,Lefrant JY

    更新日期:2008-08-01 00:00:00

  • Heart block after coronary artery bypass--effect of chronic administration of calcium-entry blockers and beta-blockers.

    abstract::We evaluated risk of heart block after cardiopulmonary by-pass (CPB) in patients with normal conduction undergoing coronary artery bypass grafting who chronically received calcium-entry blockers, beta-blockers, or combined therapy. Before CPB, calcium-entry blockers alone produced an increase in P-R intervals but no c...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Henling CE,Slogoff S,Kodali SV,Arlund C

    更新日期:1984-05-01 00:00:00