Abstract:
BACKGROUND:There is little information concerning the carbon dioxide-related effects on respiratory mechanics in anesthetized, paralyzed subjects; however, hypocapnia or hypercapnia is often permitted in patients with severe brain injury or acute respiratory distress syndrome. Therefore, the carbon dioxide dependence of respiratory mechanics in healthy anesthetized, paralyzed subjects was investigated. METHODS:Interrupter resistance (Rint), additional tissue viscoelastic resistance (deltaR), and quasi-static elastance (Est) of lung (L) and chest wall were assessed by means of the rapid end-inspiratory occlusion method in two groups of seven healthy paralyzed subjects anesthetized with diazepam or isoflurane. They underwent ventilation with a fixed pattern and hyperoxic gas mixtures with different fractions of inspired carbon dioxide (FICO2) to produce a partial pressures of arterial carbon dioxide (PaCO2) of 24.4 +/- 3.4, 39.6 +/- 3.2, and 62 +/- 4.1 (SD) mmHg. RESULTS:Chest wall mechanics and Est,L were unaffected by PaCO2 changes. With diazepam anesthesia, Rint,L decreased linearly, with increasing PaCO2, from 2.3 to 1.4 cm H2O.s.l(-1), whereas deltaR,L decreased from 2 to 1.7 cm H2O.s.l(-1), though not significantly. With isoflurane anesthesia, the decrease of Rint,L (0.2 +/- 0.5 cm H2O.s.l(-1)) was not significant, and deltaRL remained unchanged. With diazepam, Rint,L was 45 (hypercapnia) to 110% (hypocapnia) greater than with isoflurane. CONCLUSIONS:Changes of PaCO2 from 20-65 mmHg cause increasing bronchodilation in anesthetized, paralyzed subjects, this effect being attenuated or abolished by drugs (e.g., halogenated anesthetics) that depress smooth muscle tone substantially. The carbon dioxide bronchodilating effects are probably direct for peripheral structures and are paralleled by a tendency of lung tissue resistance to decrease. Because local PaCO2-related changes in bronchomotor tone promote VA/Q matching, this mechanism should be impaired by anesthetics that cause bronchodilation.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
D'Angelo E,Calderini IS,Tavola Mdoi
10.1097/00000542-200104000-00013subject
Has Abstractpub_date
2001-04-01 00:00:00pages
604-10issue
4eissn
0003-3022issn
1528-1175journal_volume
94pub_type
杂志文章相关文献
ANESTHESIOLOGY文献大全abstract:BACKGROUND:Perfluorocarbon liquids are being used experimentally and in clinical trials for the treatment of acute lung injury. Their resemblance to inhaled anesthetic agents suggests the possibility of application by vaporization. The authors' aim was to develop the technical means for perfluorocarbon vaporization and...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199908000-00021
更新日期:1999-08-01 00:00:00
abstract::The relationship between neuroleptic malignant syndrome (NMS) and malignant hyperthermia (MH) was investigated using the in vitro skeletal muscle contracture test to screen for MH-susceptibility in NMS patients. The maximum contracture tension which developed following exposure to halothane (1-3%), and incremental dos...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198707000-00004
更新日期:1987-07-01 00:00:00
abstract:BACKGROUND:Mask ventilation is an essential element of airway management that has rarely been studied as the primary outcome. The authors sought to determine the incidence and predictors of difficult and impossible mask ventilation. METHODS:A four-point scale to grade difficulty in performing mask ventilation (MV) is ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200611000-00007
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Preanesthesia medical examination is a common procedure performed before ophthalmic surgery. The frequency and characteristics of new medical issues and unstable medical conditions revealed by ophthalmic preanesthesia medical examination are unknown. We conducted a prospective observational study to estimate...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e31828ea5b2
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Conflicting opinions are present in the literature regarding the origin of the negative inotropic effect of propofol on the myocardium. This study aims to resolve these discrepancies by investigating the inotropic effects of propofol the L-type calcium channels and the sodium-calcium exchanger (NCX). METHOD...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200211000-00019
更新日期:2002-11-01 00:00:00
abstract::Postoperative itching is an important problem in the postoperative care unit. Pruritus after surgery may be drug induced (including intrathecal opioids) or secondary to a preexisting systemic disease. Mechanisms of itching are complex and not completely understood. The purpose of this review is to highlight new discov...
journal_title:Anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/00000542-200507000-00025
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Occasionally, emergency perioperative pacing is necessary. Transcutaneous cardiac pacing is noninvasive, safe, and readily available. Its feasibility and hemodynamic effects during thoracic surgery and one-lung ventilation have not been established. METHODS:Twenty anesthetized patients (aged 25-70 yr) witho...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-199310000-00013
更新日期:1993-10-01 00:00:00
abstract:BACKGROUND:The mechanism by which barbiturates protect neurons against ischemia is unclear, particularly when they are given after ischemia or reperfusion begins. Because an excess release of excitatory neurotransmitters causes postsynaptic membrane depolarization, which triggers neuronal damage in ischemia, the effect...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199612000-00024
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Halothane and isoflurane have been shown to differentially effect mechanisms of contraction in working myocardial fibers. The aim of this study was to compare effects of halothane and isoflurane on contractile force (CF) and Ca2+ transients in canine cardiac Purkinje fiber preparations. METHODS:Fiber prepar...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199406000-00024
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:This study compared two insertion techniques of ProSeal laryngeal mask airway. METHODS:A total of 160 female patients (American Society of Anesthesiologists physical status I or II; age 18-80 yrs) undergoing gynecologic surgery were randomly allocated to the standard or rotational technique groups. In the s...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e31819b5d40
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Recent evidences have documented that several pharmacologic actions of alpha2-adrenoceptor agonists are mediated via activation of not only alpha2-adrenoceptors, but also by imidazoline receptors, which are nonadrenergic receptors in the central nervous system. However, the effect of imidazoline receptors on...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199710000-00032
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:Propofol is an intravenous anesthetic agent that may impair host defense system. The aim of this study was to evaluate the effects of propofol on macrophage functions and its possible mechanism. METHODS:Mouse macrophage-like Raw 264.7 cells were exposed to propofol, at 3, 30 (a clinically relevant concentra...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200305000-00021
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Intrathecal sufentanil (ITS) is frequently used to provide analgesia during labor. Decreases in blood pressure and sensory changes in this circumstance suggest that ITS may have a local anesthetic effect and thus cause a sympathectomy. To determine whether ITS given to laboring women causes a sympathectomy, ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199710000-00022
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to determine the relationship of four postanesthesia care unit (PACU) cardiovascular events to long-term outcomes (unplanned critical care admission or mortality) and to evaluate the contribution of anesthetic management compared with other perioperative factors in predicting th...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199604000-00003
更新日期:1996-04-01 00:00:00
abstract::The slow positive (P2) wave of the evoked electrospinogram was recorded from the dorsal epidural space in man. The waveform characteristics of the P2 wave were similar to those of the dorsal cord positive wave (P wave), which is believed to be caused by the primary afferent depolarization (PAD) and to be related to pr...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197510000-00003
更新日期:1975-10-01 00:00:00
abstract::The effect of liposome encapsulation on the analgesia produced by intrathecally administered alfentanil was examined in the rat. In rats prepared with chronic intrathecal catheters, alfentanil in doses of 1-50 micrograms was administered intrathecally in either saline or in multilamellar liposomes (dipalmitoylphosphat...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199209000-00019
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:The authors sought to determine whether subjects with pathophysiological conditions that are characterized by increased concentrations of aldosterone have increased susceptibility to the side effects of neonatal anesthesia with sevoflurane. METHODS:Postnatal day 4-20 (P4-P20) rats were exposed to sevofluran...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e318266c62d
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:The most sensitive diagnostic criterion of myasthenia gravis is a decrement in the muscular response to repetitive stimulation. The authors hypothesized that myasthenia gravis patients who show a train-of-four ratio (T4/T1) < 0.9 in the preanesthetic period will have increased sensitivity to nondepolarizing ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200008000-00011
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Clinically used general anesthetics, alone or in combination, are damaging to the developing mammalian brain. In addition to causing widespread apoptotic neurodegeneration in vulnerable brain regions, exposure to general anesthesia at the peak of synaptogenesis causes learning and memory deficiencies later i...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3182303a63
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Excessive bleeding often occurs during pediatric scoliosis surgery and is attributed to numerous factors, including accelerated fibrinolysis. The authors hypothesized that administration of tranexamic acid would reduce bleeding and transfusion requirements during scoliosis surgery. METHODS:Forty-four patien...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200504000-00006
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Optimal management of anesthesia-induced respiratory depression requires identification of the neural pathways that are most effective in maintaining breathing during anesthesia. Lesion studies point to the brainstem retrotrapezoid nucleus. We therefore examined the respiratory effects of common anesthetic/a...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002675
更新日期:2019-06-01 00:00:00
abstract::This study examined whether pain or stress can enhance the analgesic effects of spinally administered opiates. The experiments determined the effects of mechanically produced pain and of the stress of being restrained on the analgesic effects of 0.63 microgram of epidural sufentanil in rats using a tail-withdrawal pro...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198807000-00004
更新日期:1988-07-01 00:00:00
abstract::Inorganic fluoride (F-) production and renal function were assessed in six groups of Fischer 344 rats administered either methoxyflurane (MOF) or deuterated methoxyflurane (d4-MOF). One untreated and one phenobarbital (PB)-treated group were exposed for two hours to either air, 0.5 per cent (V/v) MOF, or 0.5 per cent ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198203000-00009
更新日期:1982-03-01 00:00:00
abstract:BACKGROUND:Sevoflurane is a volatile general anesthetic that differs in chemical nature from the gaseous anesthetic nitrous oxide. In a controlled laboratory setting, the authors characterized the subjective, psychomotor, and analgesic effects of sevoflurane and nitrous oxide at two equal minimum alveolar subanesthetic...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-199711000-00012
更新日期:1997-11-01 00:00:00
abstract:WHAT WE ALREADY KNOW ABOUT THIS TOPIC:WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Craniotomy for brain tumor displays significant morbidity and mortality, and no score is available to discriminate high-risk patients. Our objective was to validate a prediction score for postoperative neurosurgical complications...
journal_title:Anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/ALN.0000000000002426
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Ketamine is an anesthetic drug. Subanesthetic doses of ketamine have been shown to reduce interleukin-6 concentrations after surgery and to reduce mortality and the production of tumor necrosis factor alpha and interleukin 6 in septic animals. Similarly, adenosine was shown to reduce tumor necrosis factor al...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200506000-00017
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine, a highly selective alpha 2-adrenergic agonist, increases perioperative hemodynamic stability in healthy patients but decreases blood pressure and heart rate. The goal of this study was to evaluate, in a preliminary manner, the hemodynamic effects of perioperatively administered dexmedetomidi...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199503000-00003
更新日期:1995-03-01 00:00:00
abstract::Blood from 20 ASA physical status I patients collected before and after induction of anesthesia was used in vitro to reexamine the effects of nitrous oxide on the oxyhemoglobin dissociation curve and the response of the oxygen electrode. The preinduction P50 values with and without 70% N2O were 28.4 +/- 0.1 mmHg and 2...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198702000-00015
更新日期:1987-02-01 00:00:00
abstract::The authors had previously observed a deleterious cerebrovascular effect of prolonged hypothermia in primates and cats. In this study they examined the systemic as well as cerebral hemodynamic and metabolic effects of 24 hours of hypothermia in the dog. With decreases in temperature to 29 C, cardiac output (Q) and who...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198003000-00007
更新日期:1980-03-01 00:00:00
abstract:BACKGROUND:Nonsteroidal antiinflammatory drugs are commonly used to treat postoperative and chronic pain. Animal studies suggest that these drugs act, in part, by blocking prostaglandin production in the spinal cord. The authors tested intrathecal ketorolac in patients with chronic or postoperative pain. METHODS:After...
journal_title:Anesthesiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/ALN.0b013e3181d94dc0
更新日期:2010-05-01 00:00:00