Abstract:
BACKGROUND:Aprotinin has been reported to reduce blood loss and transfusion requirements in patients having major orthopedic operations. Data on whether epsilon amino-caproic acid (EACA) is effective in this population are sparse. METHODS:Sixty-nine adults with malignancy scheduled for either pelvic, extremity or spine surgery during general anesthesia entered this randomized, double-blind, placebo-controlled trial, and received either intravenous aprotinin (n = 23), bolus of 2 x 10(6) kallikrein inactivator units (KIU), followed by an infusion of 5 x 10(5) KIU/h, or EACA (n = 22), bolus of 150 mg/kg, followed by a 15 mg/kg/h infusion or saline placebo (n = 24) during surgery. Our goal was to determine whether prophylactic EACA or aprotinin therapy would reduce perioperative blood loss (intraoperative + first 48h) >30% when compared to placebo. RESULTS:The mean age of the study population was 52 +/- 17 yr. The groups did not differ in age, duration of surgery, perioperative blood loss or number of packed erythrocyte units transfused. When compared to the placebo group, the two treated groups had a significantly lower D-Dimer level immediately after surgery, P < 0.01. CONCLUSIONS:Under the conditions of this study, we were unable to find a clinical benefit to using aprotinin or EACA to reduce perioperative blood loss or transfusion requirements during major orthopedic surgery in cancer patients.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Amar D,Grant FM,Zhang H,Boland PJ,Leung DH,Healey JAdoi
10.1097/00000542-200302000-00011subject
Has Abstractpub_date
2003-02-01 00:00:00pages
337-42issue
2eissn
0003-3022issn
1528-1175pii
00000542-200302000-00011journal_volume
98pub_type
临床试验,杂志文章,随机对照试验相关文献
ANESTHESIOLOGY文献大全abstract::The present study was designed to determine changes in hepatic oxygen supply in guinea pigs during halothane or isoflurane anesthesia. Twenty-seven guinea pigs were randomly divided into three equal groups: control (no anesthesia) group, and animals anesthetized with halothane or isoflurane to decrease mean arterial p...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198711000-00014
更新日期:1987-11-01 00:00:00
abstract:BACKGROUND:The value of exercise electrocardiography in the prediction of perioperative cardiac risk has yet to be defined. This study was performed to determine the predictive value of exercise electrocardiography as compared with clinical parameters and resting electrocardiography. METHODS:A total of 204 patients at...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200101000-00011
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:In 2001, the Centers for Medicare and Medicaid Services issued a rule allowing U.S. states to "opt out" of the regulations requiring physician supervision of nurse anesthetists in an effort to increase access to anesthesia care. Whether "opt out" has successfully achieved this goal remains unknown. METHODS:...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000001504
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:Insufficient data exist on the production of compound A during closed-system sevoflurane administration with newer carbon dioxide absorbents. METHODS:A modified PhysioFlex apparatus (Dräger, Lübeck, Germany) was connected to an artificial test lung (inflow at the top of the bellow approximately/= 160 ml/min...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200109000-00030
更新日期:2001-09-01 00:00:00
abstract::This study was performed to determine the potency of succinylcholine using the single-dose technique, and to test the ability of the cumulative dose technique for generating dose-response data. Thirty-eight adult patients received single doses (n = 18), cumulative doses (n = 10), or cumulative doses of succinylcholine...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:The long-term use of opioids for analgesia carries significant risk for tolerance, addiction, and diversion. These adverse effects are largely mediated by μ-opioid receptors in the central nervous system. Based on the authors' previous observation that morphine and δ-opioid receptor agonists synergize in spi...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002840
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Factors determining renal function at organ recovery in deceased kidney donors are not well established. METHODS:The authors studied the prevalence and risk factors associated with elevated prerecovery creatinine and calculated glomerular filtration rate in 458 deceased organ donors identified through the C...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e318194ca8a
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Anesthetic drugs administered to immature animals may cause neurohistopathologic changes and alterations in behavior. The authors studied association between anesthetic exposure before age 4 yr and the development of reading, written language, and math learning disabilities (LD). METHODS:This was a populati...
journal_title:Anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/01.anes.0000344728.34332.5d
更新日期:2009-04-01 00:00:00
abstract::Critically ill patients must often breathe spontaneously through an endotracheal tube that acts as a fixed inspiratory and expiratory tubular airway resistor. Although this practice is common, its effect on the pattern of breathing is not known. The mean breathing patterns of seven normal, healthy male subjects and ei...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-198603000-00009
更新日期:1986-03-01 00:00:00
abstract::Assessment of competency in traditional graduate medical education has been based on observation of clinical care and classroom teaching. In anesthesiology, this has been relatively easy because of the high volume of care provided by residents under the direct observation of faculty in the operating room. With the mov...
journal_title:Anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/01.anes.0000264778.02286.4d
更新日期:2007-04-01 00:00:00
abstract::To determine whether administration of nitrous oxide, 50% and 70%, could provide analgesia and anxiolysis during venous cannulation in pediatric patients, 165 ASA Physical Status 1 patients scheduled for elective surgery were studied. Children, 3 weeks to 18 yr of age, were randomly assigned either to receive nitrous ...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199002000-00010
更新日期:1990-02-01 00:00:00
abstract:BACKGROUND:The dorsal horn of the spinal cord is a pivotal point for transmission of neuronal pain. During spinal and epidural anesthesia, the neurons of the dorsal horn are exposed to local anesthetics. Unfortunately, little is known about the action of local anesthetics on the major ionic conductances in dorsal horn ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199801000-00025
更新日期:1998-01-01 00:00:00
abstract::Although it generally is agreed that halothane is a pulmonary vasodilator, its effect on venous admixture and hypoxic pulmonary vasoconstriction are more controversial. The effects of 2.4% halothane on pulmonary vascular resistance and venous admixture were investigated in an isolated canine lobe made atelectatic. Hal...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199208000-00013
更新日期:1992-08-01 00:00:00
abstract:BACKGROUND:Combining a hypnotic and an analgesic to produce sedation, analgesia, and surgical immobility required for clinical anesthesia is more common than administration of a volatile anesthetic alone. The aim of this study was to apply response surface methods to characterize the interactions between remifentanil a...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/00000542-200608000-00009
更新日期:2006-08-01 00:00:00
abstract::In order to elucidate the possible mechanism(s) by which opiates may affect cerebral and spinal circulation, and cerebral metabolism, cerebral blood flow (CBF) and spinal cord blood flow (SCBF) were measured simultaneously following intravenous or subarachnoid administration of morphine in dogs lightly anesthetized wi...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:
更新日期:1983-09-01 00:00:00
abstract:BACKGROUND:Compared to other perioperative complications, failure to rescue (i.e., death after suffering a complication) is highest after perioperative myocardial infarction (a myocardial infarction that occurs intraoperatively or within 30 days after surgery). The purpose of this study was to identify patient and surg...
journal_title:Anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/ALN.0000000000003330
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Animal studies have provided considerable evidence to support a role of histamine in the central nervous system in thermoregulation, and premedication with a histamine H2 receptor antagonist before general anesthesia is used to reduce the risk of acid aspiration. The authors investigated whether premedicatio...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199512000-00008
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:The noble gas xenon (Xe) has been used as an inhalational anesthetic agent in clinical trials with little or no physiologic side effects. Like nitrous oxide, Xe is believed to exert minimal unwanted cardiovascular effects, and like nitrous oxide, the vapor concentration to achieve 1 minimum alveolar concentr...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200002000-00035
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine is only approved for use in humans as an intravenous medication. An oral formulation may broaden the use and benefits of dexmedetomidine to numerous care settings. The authors hypothesized that oral dexmedetomidine (300 mcg to 700 mcg) would result in plasma concentrations consistent with sed...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000003568
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Repetitive C-fiber stimulation induces a state of facilitated processing of sensory information in the dorsal horn, while chronic nerve compression gives rise to a hyperalgesic state, characterized by spontaneous neuronal activity generated by voltage-sensitive sodium channels, as well as spinal facilitation...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:We describe the anesthetic management for a new surgical procedure: laser ablation of emphysematous bullae via thoracoscope. Although thoracoscopy is not new, this is the first description of a series of patients with bilateral, chronic lung disease who underwent long periods of one-lung ventilation (OLV) du...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199301000-00008
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:In animals, systemic and intrathecal administration of the alpha2 -adrenergic receptor agonist dexmedetomidine results in robust antinociceptive effects in models of heat pain. In humans, systemically administered dexmedetomidine is approved for sedating patients in the intensive care unit. However, whether ...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200409000-00024
更新日期:2004-09-01 00:00:00
abstract::Rats were given standardized injections of 3H-L-proline into the trigeminal ganglion and 14C-lidocaine hydrochloride at the infraorbital foramen. The 3H-L-proline was always injected 2.5 h before removal of the nerve. Lidocaine, 1, 2, and 4%, produced a concentration-related inhibition of entry of 3H-labeled rapid axo...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197602000-00009
更新日期:1976-02-01 00:00:00
abstract:BACKGROUND:Hydroxyethyl starch (HES) 130/0.4 may impair blood coagulation less than other HES solutions and, thus, may be used at larger doses without increasing the risk of postoperative bleeding. This study tested the hypothesis that volume replacement with 6% HES 130/0.4 at a dose of up to 50 ml/kg does not increase...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200307000-00010
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:The tuberomammillary histaminergic neurons are involved in the sedative component of anesthetic action. The nucleus basalis magnocellularis (NBM) in the basal forebrain receives dense excitatory innervation from the tuberomammillary nucleus and is recognized as an important site of sleep-wake regulation. Thi...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181b061a0
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:The Atenolol study of 1996 provided evidence that perioperative β-blockade reduced postsurgical mortality. In 1998, the indications for perioperative β-blockade were codified as the Perioperative Cardiac Risk Reduction protocol and implemented at the San Francisco Veterans Affairs Medical Center. The current...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3182110e83
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:This propensity score-matched cohort study evaluates the effect of anesthetic technique on a 30-day mortality after total hip or knee arthroplasty. METHODS:All patients who had hip or knee arthroplasty between January 1, 2003, and December 31, 2014, were evaluated. The principal exposure was spinal versus g...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000001248
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Knowledge of normal front teeth-to-carina distance (FT-C) might prevent accidental bronchial intubation. The aim of the current study was to measure FT-C and to examine whether the Morgan formula for oral intubation depth, i.e., endotracheal tube (ETT) position at front teeth (cm) = 0.10 x height (cm) + 5, g...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181730288
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:We have previously shown that intralipid (lipid emulsion) protects the heart against ischemia/reperfusion injury and bupivacaine-induced cardiotoxicity. However, the precise underlying mechanisms are not fully understood. Here we explored the hypothesis that free fatty acid receptor-1 or G-protein-coupled re...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002195
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Initial anesthetic-induced hypothermia results largely from core-to-peripheral redistribution of heat. Nifedipine administration may minimize hypothermia by inducing vasodilation well before induction of anesthesia. Although vasodilation would redistribute heat to peripheral tissues, thermoregulatory respons...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199401000-00019
更新日期:1994-01-01 00:00:00