Abstract:
UNLABELLED:Fentanyl reduces the amount of propofol necessary to prevent responses to surgical stimuli. However, opioids have relatively little effect on consciousness. We, therefore, tested the hypothesis that fentanyl minimally alters the effect-site concentration of propofol associated with awakening. Fifty women having gynecologic laparotomy with propofol anesthesia were randomly allocated into the following target effect-site fentanyl concentrations: 0.8, 1.0, 1.4, 2.0, and 3.0 ng/mL. Fentanyl was continued at the designated rate through the initial postoperative phase. The propofol effect-site concentration associated with eye opening in response to verbal command was regarded as the awakening concentration. The estimated propofol effect-site concentrations at awakening did not differ significantly among the groups and were 1.9 +/- 0.5 micro g/mL with a fentanyl effect-site concentration of 0.8 ng/mL; 1.6 +/- 0.4 micro g/mL with 1.0 ng/mL of fentanyl; 1.6 +/- 0.2 micro g/mL with 1.4 ng/mL of fentanyl; 1.7 +/- 0.4 micro g/mL with 2.0 ng/mL of fentanyl; and 1.6 +/- 0.34 micro g/mL with 3.0 ng/mL of fentanyl (mean +/- SD). Seventy percent of the subjects in the 0.8 ng/mL fentanyl group spontaneously complained of pain, whereas none of the patients in the 2 or 3 ng/mL groups did. Five (56%) of 9 women in the 3 ng/mL group had a postoperative respiratory rate <6 breaths/min. Heart rate in one of these women decreased to <40 bpm. These data suggest that the optimal fentanyl effect-site concentration in patients recovering from gynecologic laparoscopy is between 1.4 and 2.0 ng/mL. IMPLICATIONS:The effect-site concentration for propofol at awakening was virtually independent of the fentanyl effect-site concentration over the range of 0.8 to 3.0 ng/mL; however, 0.8 ng/mL of fentanyl was associated with inadequate postoperative analgesia, and 3.0 ng/mL of fentanyl was associated with respiratory toxicity. The optimal postoperative fentanyl effect-site concentration during recovery from propofol general anesthesia for laparotomy thus appears to be near 2 ng/mL.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Iwakiri H,Nagata O,Matsukawa T,Ozaki M,Sessler DIdoi
10.1213/01.ane.0000062772.28479.2bsubject
Has Abstractpub_date
2003-06-01 00:00:00pages
1651-5, table of contentsissue
6eissn
0003-2999issn
1526-7598journal_volume
96pub_type
临床试验,杂志文章,随机对照试验abstract:IMPLICATIONS:Postoperative management of sedation and analgesia in pediatric cardiac patients presents many challenges. This case report describes a child who experienced dramatic clinical improvement with the postoperative use of caudal morphine and clonidine after conventional therapy had failed. ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200301000-00019
更新日期:2003-01-01 00:00:00
abstract::Epidural anesthesia may be performed as a single injection or by staged doses. Thirty patients undergoing primary total hip replacement were randomly assigned to have epidural anesthesia using a single injection or a staged technique with 25 mL of 0.75% bupivacaine. Arterial plasma bupivacaine concentrations were sign...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199408000-00019
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:The impact of physiological adjustments throughout pregnancy on maternal vital signs and laboratory values has yet to be fully defined. The present study was designed to determine the normal range of these parameters among healthy pregnant women during the peripartum period. METHODS:This is a retrospective ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000003866
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Detection of ongoing spontaneous pain behaviors in laboratory animals remains a research challenge. Most preclinical pain studies measure elicited behavioral responses to an external noxious stimulus; however, ongoing spontaneous pain in humans and animals may be unrelated to hypersensitivity, and likely dim...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000119
更新日期:2014-04-01 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 efficiency of a gravity-dependent autotransfusion system (ATS) for filtering tumor cells from blood was examined under laboratory and clinical conditions. In laboratory studies, reconstituted whole blood was seeded with known numbers of cultured A431 human vulva carcinoma cells then filtered through the ATS. Cance...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199406000-00017
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:Severe exacerbation of chronic neuropathic pain often requires morphine in patients already treated with drugs such as tricyclic antidepressants, carbamazepine and gabapentin. However, it is unclear if a combination of these drugs intensifies the effects of morphine on the respiratory system and, if so, whet...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e31817e6e53
更新日期:2008-10-01 00:00:00
abstract:UNLABELLED:In this retrospective cohort study, we compared adverse cardiac outcomes after noncardiac surgery among patients with prior percutaneous transluminal coronary angioplasty (PTCA), patients with nonrevascularized coronary artery disease (CAD), and normal controls. Inpatient hospital discharge abstracts from al...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199909000-00003
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:Volatile inhaled anesthetics exert a differential protective effect against bronchospasm development after cholinergic stimulation. However, their ability to inhibit the adverse respiratory consequences of an anaphylactic reaction after exposure to an allergen has not been characterized. We therefore compare...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31828e5ccf
更新日期:2013-06-01 00:00:00
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
更新日期:1998-09-01 00:00:00
abstract::Tracheal temperature--the temperature of the tracheal wall--is believed to reflect the core temperature. The trachea reacts quickly to temperature changes because it is surrounded by various large arteries and veins. Using the blood temperature from the cardiopulmonary bypass (CPB) and the jugular vein temperature as ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/00000539-199304000-00020
更新日期:1993-04-01 00:00:00
abstract::Few anesthesia studies have explored perioperative continuous epidural infusion of neostigmine. We examined such a regimen in thoracotomy patients. Ninety patients were randomized to one of three groups in this double-blind trial. Before anesthesia induction, an epidural catheter was inserted in all patients at T5-8 l...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ane.0000184812.94185.b3
更新日期:2006-01-01 00:00:00
abstract::Catecholamine-induced desensitization of beta-adrenergic receptors resulting in hyporesponsiveness to further stimulation has been frequently reported after an increase in endogenous catecholamines. To examine the possibility of beta-adrenoceptor desensitization due to intraoperative adrenergic activation (surgical st...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199007000-00001
更新日期:1990-07-01 00:00:00
abstract:BACKGROUND:Manikins are widely used in airway management training; however, simulation of realism and interpatient variability remains a challenge. We investigated whether cadavers embalmed with the novel Fix for Life (F4L) embalmment method are a suitable and realistic model for teaching 3 basic airway skills: facemas...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000003678
更新日期:2018-10-01 00:00:00
abstract::Despite the exhaustive search for an acceptable substitute to erythrocyte transfusion, neither chemical-based products such as perfluorocarbons nor hemoglobin-based oxygen carriers have succeeded in providing a reasonable alternative to allogeneic blood transfusion. However, there remain scenarios in which blood trans...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000003957
更新日期:2021-01-01 00:00:00
abstract::Isoflurane-oxygen was given for induction and maintenance of anesthesia to ten patients having coronary artery bypass grafts. All had preserved ventricular function without hypertension or other cardiac lesions; treatment with beta-blocking drugs was maintained until the operation in all patients. Cardiac output, arte...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:UNLABELLED:Nitric oxide (NO) may play an important role in central and peripheral nociceptive processes. However, its contribution to peripheral antinociception is still not clear. In the present study, we investigated the effect of peripherally administered FK409, a spontaneous NO releaser, and its interaction with pe...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199802000-00028
更新日期:1998-02-01 00:00:00
abstract::Repeated conventional tracheal intubation attempts may contribute to patient morbidity. Critically-ill patients (n = 2833) suffering from cardiovascular, pulmonary, metabolic, neurologic, or trauma-related deterioration were entered into an emergency intubation quality improvement database. This practice analysis was ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000122825.04923.15
更新日期:2004-08-01 00:00:00
abstract:UNLABELLED:Recent reports have discussed the potential risk of transient radicular irritation (TRI) after spinal anesthesia with lidocaine. Because we have not encountered such neurologic sequelae with the high incidence reported, we prospectively examined the incidence of TRI after spinal anesthesia with lidocaine. On...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199805000-00022
更新日期:1998-05-01 00:00:00
abstract::The role of succinylcholine in the precipitation of malignant hyperthermia (MH) necessitates the testing of new neuromuscular relaxants for their ability to trigger MH in MH-susceptible swine before general human use. We tested doxacurium and mivacurium, two new nondepolarizing bis-benzylisoquinolinium neuromuscular r...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199009000-00012
更新日期:1990-09-01 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:BACKGROUND:Many new mechanical ventilation modes are proposed without any clinical evaluation. "Dual-controlled" modes, such as AutoFlow™, are supposed to improve patient- ventilator interfacing and could lead to fewer alarms. We performed a long-term clinical evaluation of the efficacy and safety of AutoFlow during as...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3181f00015
更新日期:2010-10-01 00:00:00
abstract:UNLABELLED:Incorrect positioning of central venous catheters (CVC) in infants and children may lead to serious complications such as perforation of the heart or great vessels. CVC position is not usually assessed until the first postoperative chest radiograph, potentially leaving malposition undetected for several hour...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200110000-00016
更新日期:2001-10-01 00:00:00
abstract::Patients referred to the Pain Clinic at the University of Virginia Medical Center with genuine phantom pain rather than stump pain have been treated by a variety of technics. Simple revision of drug therapy has proved helpful in some instances, as has repeated injection of trigger areas or neuromata, though surgical e...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197711000-00019
更新日期:1977-11-01 00:00:00
abstract:BACKGROUND:Chemical pleurodesis causes severe pain, prompting physicians to perform thoracoscopic talc poudrage under general or neuroleptanalgesia. We describe a novel method for pain control in five patients with pneumothoraces and severe chronic obstructive pulmonary disease. METHODS:Patients were premedicated with...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000249046.02025.ef
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:N-methyl-D-aspartate receptor (NMDARs)-dependent central sensitization plays an important role in cancer pain. Binding of NMDAR subunit 2B (NR2B) by postsynaptic density protein-95 (PSD-95) can couple NMDAR activity to intracellular enzymes, such as neuronal nitric oxide synthase (nNOS), facilitate downstrea...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000202
更新日期:2014-06-01 00:00:00
abstract::Agreement between estimated fibrinogen concentration via thromboelastography and traditional assays is not established in the parturient. We therefore recruited 56 parturients and performed Clauss and functional fibrinogen level (FLEV) tests. Mean difference of measurements was 36.8 mg/dL (95% CI, 21.8-51.9) with a st...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000003301
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Drugs such as propofol and ketamine are used alone or in combination to provide sedation for medical procedures in children. The purpose of this systematic review was to compare the safety and effectiveness of propofol and ketamine to other drug regimens. METHODS:We searched Medline, Embase, Cochrane Centra...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000004967
更新日期:2020-07-07 00:00:00
abstract:UNLABELLED:The nonhalogenated anesthetic alkanes, cyclopropane and butane, do not enhance gamma-aminobutyric acid-elicited GABAergic currents, suggesting that these agents produce anesthesia via interactions with other molecular targets. Perhalogenated nonimmobilizing alkanes, such as 1,2-dichlorohexafluorocyclobutane ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200209000-00015
更新日期:2002-09-01 00:00:00
abstract::This study was conducted to assess the learning function of murine progeny born of mothers that had received either 1% or 2% halothane or 2% or 4% enflurane, on days 6 and 10 or days 14 and 17 or gestation. Their timed performance at the age of 6 to 7 weeks was compared in a maze with that of control mice of similar a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1981-11-01 00:00:00