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) inhibitor may, when nebulized and inhaled, cause selective pulmonary vasodilation and potentiate the vasodilation by inhaled prostacyclin (iPGI(2)). Consequently, we investigated the hemodynamic effects of inhaled milrinone or the combination iPGI(2) + inhaled milrinone in cardiac surgical patients with postoperative mean pulmonary arterial pressure (MPAP) >25 mm Hg and PVR >200 dynes. s(-1). cm(-5). During mechanical ventilation and using a conventional nebulizing system, 9 patients inhaled incremental concentrations of milrinone (0.25, 0.5 and 1 mg/mL) in subsequent 10-min periods (Study Part 1). In the same manner, 11 patients received iPGI(2) (10 microg/mL) followed by the combination of iPGI(2) (10 microg/mL) and inhaled milrinone (1 mg/mL) (Study Part 2). Inhaled milrinone reduced PVR with a maximal effect (-20%, P < 0.001) at the largest concentration. As compared with iPGI(2) alone, iPGI(2) + inhaled milrinone caused a further and prolonged reduction of PVR (-8%, P < 0.05) and increased stroke volume (+5%, P < 0.05). Systemic vascular resistance or mean arterial pressure was not affected by inhalation of either drug(s). The authors conclude that inhalation of the cAMP-selective PDE-inhibitor milrinone selectively dilates the pulmonary vasculature without systemic effects in cardiac surgical patients with pulmonary hypertension. Furthermore, inhaled milrinone appears to potentiate and prolong the pulmonary selective vasodilatory effect of iPGI(2). Inhaled milrinone alone or combined with iPGI(2) may be an important therapeutic option in the treatment of patients with pulmonary hypertension and right ventricular failure. IMPLICATIONS:Pulmonary hypertension may cause or aggravate right heart failure. IV vasodilators reduce systemic blood pressure and might thereby further impair coronary perfusion and right heart performance. In the present study of cardiac surgical patients with pulmonary hypertension, selective pulmonary vasodilation without systemic effects was induced by nebulized, inhaled vasodilators.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Haraldsson s A,Kieler-Jensen N,Ricksten SEdoi
10.1097/00000539-200112000-00018subject
Has Abstractpub_date
2001-12-01 00:00:00pages
1439-45, table of contentsissue
6eissn
0003-2999issn
1526-7598journal_volume
93pub_type
临床试验,杂志文章abstract::Twenty-four male patients scheduled for elective pulmonary resection were studied to determine whether continuous insufflation of oxygen to the nonventilated lung would reduce intrapulmonary shunting (Qs/Qt) and arterial oxygen desaturation. Measurements of physiologic variables were made using pulmonary arterial and ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1982-06-01 00:00:00
abstract::The nucleus raphe magnus (NRM) is an important descending pain inhibitory system. We postulated that the analgesic action of supraspinally administered opiates results from increased descending inhibitory control of the NRM. We tested whether fentanyl activates NRM neurons in the rat slice preparation using extra-cell...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199505000-00007
更新日期:1995-05-01 00:00:00
abstract::The Bonfils Retromolar Intubation Fiberscope is a rigid, straight fiberoptic device with a 40-degree curved tip, which facilitates targeted intubation. Bonfils, using a retromolar approach to intubate tracheas of children with Pierre Robin syndrome, was first described in 1983. After an initial steep learning curve, t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0b013e318265bae2
更新日期:2012-10-01 00:00:00
abstract::Cerebral computer tomography is a recently introduced neuroradiologic procedure involving tomographic x-rays of horizontal brain sections. Although most adults undergo the procedure without anesthesia, children and uncooperative adults must be given general anesthesia for absolute immobility. Of 84 procedures under ge...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197705000-00005
更新日期:1977-05-01 00:00:00
abstract::Tranexamic acid (TA) is a synthetic drug that inhibits fibrinolysis. It has been administered to decrease the use of blood products during cardiac surgery and orthotopic liver transplantation when infused in larger doses. A small-dose infusion of aprotinin causes a reduction in fibrinolysis and blood product requireme...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199708000-00007
更新日期:1997-08-01 00:00:00
abstract::A new mode of pulmonary ventilation called intratracheal pulmonary ventilation (ITPV) was studied. Briefly, a continuous flow of air/oxygen is introduced through a small catheter, the tip of which is positioned at the carina, with a diffuser mounted at its distal end. A timed expiration valve, when closed, provides fo...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199403000-00006
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:Postoperative nausea (PON) is a common complication of anesthesia and surgery. Antiemetic medication for higher-risk patients may reduce but does not reliably prevent PON. We examined aromatherapy as a treatment for patients experiencing PON after ambulatory surgery. Our primary hypothesis was that in compar...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e31824a0b1c
更新日期:2013-09-01 00:00:00
abstract:UNLABELLED:We compared bronchial mucus transport velocity (BTV), an index of mucociliary clearance, between the laryngeal mask airway (LMA) and the tracheal tube (TT). Forty patients were studied during propofol anesthesia and muscle relaxation with rocuronium. BTV was measured 10 and 60 min after insertion of the airw...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199806000-00028
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:A potential physicochemical interaction between epidural local anesthetics and extended-release epidural morphine (EREM) could negate the sustained release. In this study, we sought to determine the pharmacokinetic and drug effects of prior epidural lidocaine administration on EREM. METHODS:Thirty healthy w...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e318222f59c
更新日期:2011-08-01 00:00:00
abstract::This consensus statement was commissioned in 2012 by the Board of Directors of the Society for Obstetric Anesthesia and Perinatology to improve maternal resuscitation by providing health care providers critical information (including point-of-care checklists) and operational strategies relevant to maternal cardiac arr...
journal_title:Anesthesia and analgesia
pub_type: 指南,杂志文章,评审
doi:10.1213/ANE.0000000000000171
更新日期:2014-05-01 00:00:00
abstract:IMPLICATIONS:This case describes the impact of argatroban and off-pump coronary revascularization on hemostasis as assessed by conventional hemostatic measures and Thrombelastography in a patient with heparin-induced thrombocytopenia. ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000052381.47101.a2
更新日期:2003-04-01 00:00:00
abstract::Although convective warming therapy is effective in preventing hypothermia in anesthetized patients, little is known concerning the potential risks of its use. Hence, this balanced cross-over study was designed to determine if the use of convective warming therapy increased the risk of wound contamination. For 4 h, ei...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199301000-00009
更新日期:1993-01-01 00:00:00
abstract::This study investigated the use of propofol in swine genetically susceptible to malignant hyperthermia (MH). Thirteen animals were exposed to 2% halothane in inspired air, a propofol infusion of 12 mg.kg-1.hr-1 for up to 45 min, or a combination of both. When MH was triggered the animals were treated with dantrolene. ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1989-06-01 00:00:00
abstract::In Japan, an ever-present problem in the preoperative evaluation of patients with ischemic heart disease is that although such evaluations are based on Western data, these data serve as the basis for determining perioperative risk in Japanese patients. To remedy this problem, the Cardiac Ischemia and Anesthesia Resear...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000152009.49024.F1
更新日期:2005-05-01 00:00:00
abstract::Both epidural and general anesthetics alter autonomic balance. However, the relative differences between epidural (EA) and general anesthetics (GA) with regard to cardiac and peripheral sympathovagal balance have not been described. Twenty consecutive patients scheduled for radical retropubic prostatectomy were random...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199407000-00031
更新日期:1994-07-01 00:00:00
abstract::General anesthesia is best avoided in cases of Klippel-Feil syndrome where tracheal intubation is potentially difficult. The syndrome features severe abnormalities of the neck and upper thoracic spine, which may also lead to difficulties with neuraxial blockade. We describe the use of epidural anesthesia for bilateral...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200102000-00043
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:The diagnosis of myocardial infarction (MI) after noncardiac surgery has traditionally relied on using relatively insensitive contemporary cardiac troponin (cTn) assays. We hypothesized that using a recently introduced novel high-sensitivity cTnT (hscTnT) assay would increase the detection rate of perioperat...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000002240
更新日期:2017-11-01 00:00:00
abstract::Hypertonic saline improves organ perfusion and animal survival during hemorrhagic shock because it expands plasma volume and increases tissue oxygenation. Because both decreased and increased myocardial performance have been reported with hypertonic saline, the effects of hyperosmolarity and the mechanism accounting f...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199510000-00021
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:To prevent reflex-induced bronchoconstriction in patients with asthma, local anesthetics are commonly administered by aerosol or IV as adjunct medication. Lidocaine attenuates responsiveness to a neurally active stimulus that increases tone, but there is scant information about the effect of lidocaine on bas...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000260638.57139.87
更新日期:2007-05-01 00:00:00
abstract::Delirium is an acute change in cognition and attention, which may include alterations in consciousness and disorganized thinking. Although delirium may affect any age group, it is most common in older patients, especially those with preexisting cognitive impairment. Patients with delirium after surgery recover more sl...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0b013e3182147f6d
更新日期:2011-05-01 00:00:00
abstract::The purpose of this study was to evaluate the effects of preemptive and postlesion sympathectomy in the sciatic cryoneurolysis (SCN) model of neuropathic pain in rats. SCN in rats produces a prolonged significant mechanical allodynia (hypersensitivity to previously non-noxious mechanical stimuli) with no thermal hyper...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199509000-00021
更新日期:1995-09-01 00:00:00
abstract::This study defines some characteristics of a standard anesthetic circuit that may impede anesthetic induction and recovery with I-653, sevoflurane, isoflurane, and halothane. Partition coefficients for anesthetic circuit components (masks, bellows, bags, airways, and circuit tubes) consistently ranked halothane greate...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1989-08-01 00:00:00
abstract:UNLABELLED:Forty-eight healthy parturients scheduled for elective cesarean delivery were randomly allocated to receive intrathecally either 12 mg of hyperbaric bupivacaine plus 12.5 microg of fentanyl (n = 23) or bupivacaine alone (n = 25). In the latter group, IV 12.5 microg of fentanyl was administered immediately af...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200207000-00037
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Postoperative sore throat (POST) is not uncommon after general anesthesia with a supraglottic airway (SGA) device. Although it was reported that some pharmacological and nonpharmacological measures can reduce POST, because of limitations and variable success rates, we need to find a simpler and more effectiv...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000004664
更新日期:2020-12-01 00:00:00
abstract:UNLABELLED:We present the case of a 57-yr-old patient who suffered an unexplained cerebrovascular event 3 days after being struck by a motor vehicle. Workup demonstrated a previously unknown patient foramen ovale. The etiologies of paradoxical embolism in trauma are discussed. IMPLICATIONS:Paradoxical embolism after m...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000102069.59203.a4
更新日期:2004-04-01 00:00:00
abstract::Fifty patients undergoing colonic surgery received combined thoracic epidural and general anesthesia followed by continuous epidural bupivacaine 0.25% and morphine 0.05 mg/mL, 4 mL/h, for 96 h postoperatively plus oral tenoxicam 20 mg daily. Heart rate (HR) and arterial blood pressure (BP) were measured at supine rest...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199611000-00022
更新日期:1996-11-01 00:00:00
abstract::The acute central nervous and cardiovascular effects of the local anesthetics ropivacaine and bupivacaine were compared in 12 volunteers in a randomized double-blind manner with use of intravenous infusions at a rate of 10 mg/min up to a maximal dose of 150 mg. The volunteers were all healthy men. They were familiariz...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1989-11-01 00:00:00
abstract:UNLABELLED:We assessed the role of vasopressin (VP) for the hemodynamic response to pneumoperitoneum in pigs. Four groups of anesthetized pigs were investigated. Nine pigs were intraabdominally insufflated with CO2 and eight were intraabdominally insufflated with argon; eight pigs received an i.v. injection of 1 mg/kg ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199908000-00003
更新日期:1999-08-01 00:00:00
abstract::Postoperative sensitivity to tactile stimuli differs as a function of age. In this study, we hypothesized that preoperative sciatic nerve block (SNB), by providing preemptive analgesia, would result in better analgesia than postoperative SNB in the young rat. With the paw incision model of postoperative pain, male Spr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000114181.69204.72
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Cell-free hemoglobin (Hb) forms in stored red blood cells (RBCs) as a result of hemolysis. Studies suggest that this cell-free Hb may decrease nitric oxide (NO) bioavailability, potentially leading to endothelial dysfunction, vascular injury, and multiorgan dysfunction after transfusion. We tested the hypoth...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001392
更新日期:2016-08-01 00:00:00