Abstract:
UNLABELLED:We investigated the effects of isoflurane-induced burst suppression, monitored with electroencephalography (EEG), on cerebral blood flow velocity (CBFV), cerebral oxygen extraction (COE), and autoregulation in 16 patients undergoing cardiac surgery. The experimental procedure was performed during nonpulsatile cardiopulmonary bypass (CPB) with mild hypothermia (32 degrees C) in fentanyl-anesthestized patients. Middle cerebral artery transcranial Doppler flow velocity, right jugular vein bulb oxygen saturation, and jugular venous pressure (JVP) were continuously measured. Autoregulation was tested during changes in mean arterial blood pressure (MAP) within a range of 40-80 mm Hg, induced by sodium nitroprusside and phenylephrine before (control) and during additional isoflurane administration to an EEG burst-suppression level of 6-9/min. Isoflurane induced a 27% decrease in CBFV (P < 0.05) and a 13% decrease in COE (P < 0.05) compared with control. The slope of the positive relationship between CBFV and cerebral perfusion pressure (CPP = MAP - JVP) was steeper with isoflurane (P < 0.05) compared with control, as was the slope of the negative relationship between CPP and COE (P < 0.05). We conclude that burst-suppression doses of isoflurane decrease CBFV and impair autoregulation of cerebral blood flow during mildly hypothermic CPB. Furthermore, during isoflurane administration, blood flow was in excess relative to oxygen demand, indicating a loss of metabolic autoregulation of flow. IMPLICATIONS:The effects of isoflurane on cerebral blood flow velocity (CBFV) and oxygen extraction (COE) as a function of perfusion pressure were studied. When added to fentanyl anesthesia, isoflurane induced a 27% and 13% decrease in CBFV and COE, respectively. CBFV became more pressure-dependent with isoflurane indicating an impaired autoregulation.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Reinsfelt B,Westerlind A,Houltz E,Ederberg S,Elam M,Ricksten SEdoi
10.1213/01.ane.0000086732.97924.besubject
Has Abstractpub_date
2003-11-01 00:00:00pages
1246-50issue
5eissn
0003-2999issn
1526-7598journal_volume
97pub_type
临床试验,杂志文章abstract:BACKGROUND:Statins reduce cardiac morbidity in nonsurgical populations, and may benefit surgical patients. We sought to examine cardiac outcome in patients who continued, compared with those who discontinued, statin therapy after major vascular surgery. METHODS:Prospectively collected data were examined for an associa...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000263029.72643.10
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Aspirin-resistant platelet activation in whole blood is attributable to a transcellular pathway not detected by isolated platelet aggregometry. Aspirin resistance as defined by urinary thromboxane levels is associated with increased risk for myocardial infarction or cardiac death. Whole blood point-of-care a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e318277de06
更新日期:2013-02-01 00:00:00
abstract:UNLABELLED:We performed in vitro studies to investigate the potential interaction of benzodiazepines with cloned human opioid receptor subtypes. Midazolam, chlordiazepoxide, and diazepam directly displaced [(3)H]-diprenorphine binding from kappa and delta receptors, but not mu receptors, whereas flumazenil was inactive...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200108000-00024
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:The arterial pulse oximeter, which was introduced clinically in the 1970s, is a convenient, useful, and now ubiquitous anesthesia monitor. Unfortunately, although percent saturation of arterial hemoglobin is, along with cardiac output and concentration of hemoglobin, one of 3 components of oxygen delivery, i...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3182166a26
更新日期:2011-06-01 00:00:00
abstract::In pregnant patients with myasthenia gravis and respiratory compromise, neuraxial anesthesia for lower abdominal surgery can risk further respiratory depression. We report the use of epidural anesthesia for dilation and curettage and tubal ligation in a 26-yr-old woman with a 12-wk intrauterine pregnancy with severe m...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000198335.89760.ed
更新日期:2006-03-01 00:00:00
abstract::Health care-associated infections are a hospital-wide concern associated with a significant increase in patient morbidity, mortality, and health care costs. Bacterial transmission in the anesthesia work area of the operating room environment is a root cause of 30-day postoperative infections affecting as many as 16% o...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000505
更新日期:2015-04-01 00:00:00
abstract::Regional anesthesia employing the spinal, epidural, or caudal approach was used to anesthetize 200 children, varying in age from 17 days to 15 years. Lidocaine in concentrations varying according to age was used. Ketamine (1 to 2 mg./kg.) was given in the majority of cases to ensure a quiet patient prior to block. No ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197505000-00034
更新日期:1975-05-01 00:00:00
abstract::To test the hypothesis that acute subarachnoid hemorrhage is associated with abnormal myocardial perfusion, we assessed myocardial blood flow with thallium scintigraphy in 19 patients with a confirmed subarachnoid hemorrhage and an abnormal electrocardiogram. A thallium scan was performed at the bedside of each patien...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199302000-00009
更新日期:1993-02-01 00:00:00
abstract::The extent and magnitude of sympathetic blockade during epidural anesthesia have previously been assessed only by indirect methods. In this study, direct intraneural recordings of muscle sympathetic activity (MSA) in the peroneal nerve was performed to determine the profundity of blockade of sympathetic fibers to the ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:Surgical site infiltration with local anesthetic reduces analgesic requests in various types of surgeries. Because thyroid surgery may induce severe postoperative pain, we tested the hypothesis that ropivacaine surgical site infiltration would significantly decrease postoperative administration of morphine i...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000001041
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:The incidence and implications of anti-heparin-platelet factor 4 (PF4) antibody seroconversion in the pediatric cardiac surgical population remain largely unexplored. We sought to prospectively characterize the incidence of seroconversion in two populations: neonates undergoing primary cardiac surgery and ch...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181734604
更新日期:2008-08-01 00:00:00
abstract::To compare the arterial and venous concentration differences of propofol, six healthy adult patients received a propofol infusion by the Bristol three-stage manual stepdown technique. Both the mean arterial and venous concentrations of propofol remained relatively stable during the 40-min infusion. Simultaneous blood ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199412000-00021
更新日期:1994-12-01 00:00:00
abstract:UNLABELLED:This study was performed to evaluate the ability of anesthesiologists to differentiate between sevoflurane, a newer, more expensive anesthetic, and halothane. A total of 113 assessments were made by 36 anesthesiologists on 58 children, aged 6 mo to 6 yr, scheduled for bilateral myringotomy and tube placement...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199712000-00004
更新日期:1997-12-01 00:00:00
abstract::The aim of the present study was to investigate the impact of isoflurane on regional neurogenic mechanisms in the control of vascular tone. Therefore, regional determinations of sympathetic activity and hemodynamics were made in chloralose-anesthetized swine before and during administration of 1.4% isoflurane. Sympath...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199501000-00023
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Isoflurane activates vascular adenosine triphosphate sensitive potassium (K(ATP)) channels, and may induce vasodilation. In the present study, we investigated whether hyperglycemia modifies isoflurane activation of vascular K(ATP) channel. METHODS:We used a cell-attached patch-clamp configuration to test th...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e318163fd5b
更新日期:2008-03-01 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:BACKGROUND:Endoscopic retrograde cholangiopancreatography (ERCP) patients typically receive either tubeless anesthesia or general endotracheal anesthesia (GETA). Patients receiving propofol-based total intravenous anesthesia (TIVA) are at higher risk of sedation-related adverse events (SRAEs) than patients receiving GE...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000005183
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Modulation of γ-aminobutyric acid type A receptors (GABAARs) by general anesthetics may contribute to their ability to produce amnesia. Receptors containing α5 subunits, which mediate tonic and slow synaptic inhibition, are co-localized with β3 and γ2 subunits in dendritic layers of the hippocampus and are s...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000423
更新日期:2014-12-01 00:00:00
abstract::The effects of isoflurane or halothane on cerebral blood flow (CBF) reactivity to changes in arterial carbon dioxide tension (PaCO2) during carotid endarterectomy were compared using the intravenous method of 133Xe-CBF determination. Patients, aged 65 +/- 3 yr (mean +/- SE), received O2 and N2O (1:1) and either 0.75% ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:
更新日期:1991-10-01 00:00:00
abstract::Cardiopulmonary bypass (CPB) impairs pulmonary endothelial injury in part by increasing expression of adhesion molecules that results in neutrophil influx. Although numerous proinflammatory cytokines up-regulate these responses, the extent to which systemic and pulmonary proinflammatory cytokines increase remains unkn...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200005000-00008
更新日期:2000-05-01 00:00:00
abstract::Evaluation of a new inhaled anesthetic requires determination of the anesthetic's potential to predispose to ventricular (and other) arrhythmias in an animal model. This need poses logistic and economic burdens if the effects of large numbers of new anesthetics are to be surveyed. We have devised a technique for deter...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199006000-00013
更新日期:1990-06-01 00:00:00
abstract::The present investigation explored the possibility that the commonly observed hypotension that occurs during induction of anesthesia with propofol might be related to its ability to produce venodilation. Thirty-six ASA I and II patients who received no premedication were studied. The first 20 patients were divided int...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199206000-00017
更新日期:1992-06-01 00:00:00
abstract:BACKGROUND:Aspects of intraoperative management (eg, hypotension) are associated with acute kidney injury (AKI) in noncardiac surgery patients. However, it is unclear if and how the addition of intraoperative data affects a baseline risk prediction model for postoperative AKI. METHODS:With institutional review board (...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000005057
更新日期:2021-02-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200101000-00021
更新日期:2001-01-01 00:00:00
abstract::The ex utero intrapartum treatment (EXIT) procedure provides time to secure the airway of the fetus while utero-placental circulation supplies the fetus with oxygen. We report the anesthetic management of a fetus with a large neck mass during an EXIT procedure in which the confirmation of correct endotracheal intubati...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000175206.91231.77
更新日期:2005-09-01 00:00:00
abstract::We assessed the efficacy of patient-controlled analgesia (PCA) techniques for extended femoral nerve sheath block after total hip arthroplasty. Forty-five patients were divided into three groups of 15. Over 48 h, all patients received 0.125% bupivacaine with clonidine 1 microg/mL and sufentanil 0.1 microg/mL via a fem...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200102000-00033
更新日期:2001-02-01 00:00:00
abstract::Fluid resuscitation is one of the most prevalent treatment in critical care. There is not definitive evidence about the best fluid for resuscitation. The aim of this review will be to asses the efficacy and safety of buffered solution versus saline. We will perform an electronic search in Medline, Embase, and Central....
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,meta分析,评审
doi:10.1213/ANE.0000000000001616
更新日期:2016-12-01 00:00:00
abstract::Attempted pulmonary artery catheterization via the left internal jugular vein resulted in a misdiagnosis of pulmonary hypertension before transesophageal echocardiography revealed the catheter positioned in the ascending aorta. Inadvertent aortic cannulation through an unusual type of partial anomalous pulmonary venou...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000296459.51820.64
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Acute lung injury is a recognized complication of lower limb ischemia-reperfusion that has been demonstrated experimentally and in the clinical setting of aortic surgery. The application of a tourniquet can cause lower limb ischemia-reperfusion in orthopedic surgery. We studied the effect of unilateral thigh...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3181e368d2
更新日期:2010-08-01 00:00:00
abstract::One of the most prevalent symptoms after major surgery is pain. When postoperative pain treatment is unsatisfactory, it can lead to poor surgical recovery, decreased quality of life, and increased health care costs. Current analgesics, single or in combination, have limited efficacy due to low potency, limited duratio...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000004767
更新日期:2020-06-01 00:00:00