Abstract:
:Epidural analgesia, often using opioids intraoperatively and postoperatively, is widely accepted as a valuable modality for perioperative pain management. In this review I present data from meta-analyses and recently published trials that evaluate the perioperative use of opioids administered epidurally or parenterally (as-needed or by patient-controlled analgesia) and their effect on outcome. Published effects of perioperative epidural techniques on cardiac and pulmonary function are reviewed. Clinical and practical issues associated with epidural anesthesia and analgesia include the existence of analgesic gaps (often related to technical difficulties with the pump or use of an indwelling catheter), the occurrence of hypotension, and compatibility with anticoagulation therapy. A new treatment option, a single epidural injection of morphine for continuous perioperative analgesia (DepoDur; Endo Pharmaceuticals Inc, Chadds Ford, PA), may reduce some of these problems. Data from recent clinical studies are presented.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Viscusi ERdoi
10.1213/01.ane.0000179686.73009.2bsubject
Has Abstractpub_date
2005-11-01 00:00:00pages
S23-9issue
5 Suppleissn
0003-2999issn
1526-7598journal_volume
101pub_type
杂志文章,评审abstract::Previous perfluorocarbon (PFC) emulsions have been associated with transient adverse events (i.e., platelet activation, decreased platelet count, febrile responses, changes in hemodynamic function). The Phase I studies described in this report were parallel, randomized, double-blinded, placebo-controlled studies condu...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200010000-00008
更新日期:2000-10-01 00:00:00
abstract::The dorsal raphe (DR) nucleus is a system of nuclei in the midline of the lower brainstem, which is considered one of the most important nuclei in the modulation of pain in the central nervous system. Central noradrenergic systems play an important role in the control of cardiovascular regulation and pain transmission...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199408000-00009
更新日期:1994-08-01 00:00:00
abstract:UNLABELLED:There is concern that the environment in which consent for anesthesia research is sought may be coercive. We therefore designed this study to determine the factors that parents consider in consenting to their child's participation in clinical anesthesia research. The study sample consisted of 246 parents who...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199801000-00010
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:There have been numerous studies published on the ProSeal laryngeal mask airway (PLMA). However, few have investigated its utility in a large practice setting. We sought to gather comprehensive data about the characteristics, efficacy, and safety of its use by a representative group of anesthesiologists work...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e318189ac84
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:Postoperative delirium is an important problem for surgical inpatients and was the target of a multidisciplinary quality improvement project at our institution. We developed and tested a semiautomated delirium risk stratification instrument, Age, WORLD backwards, Orientation, iLlness severity, Surgery-specif...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000005085
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Paravertebral analgesia is useful for breast surgery. Patient controlled analgesia by IV or epidural routes is well established for delivering postoperative analgesia. Our objective was to apply patient control to paravertebral analgesia and evaluate the efficacy and tolerability of two distinct dosing regim...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ane.0b013e31817b7f01
更新日期:2008-08-01 00:00:00
abstract:UNLABELLED:Intravenous and volatile general anesthetics inhibit norepinephrine (NE) release from sympathetic neurons and other neurosecretory cells. However, the actions of general anesthetics on NE release from central nervous system (CNS) neurons are unclear. We investigated the effects of representative IV and volat...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200211000-00032
更新日期:2002-11-01 00:00:00
abstract:UNLABELLED:Several factors are responsible for hypercarbia during laparoscopic procedures. This study was undertaken because we observed a sudden increase in PaCO(2) in children with portal hypertension (PHT), which was unusual in healthy children undergoing laparoscopic procedures. Fifty-seven children underwent lapar...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200211000-00022
更新日期:2002-11-01 00:00:00
abstract:UNLABELLED:This study was performed to evaluate both the effects of pentobarbital on disruption of the blood-brain barrier (BBB) by hyperosmolar mannitol and the relationship between its effect on blood pressure and the integrity of the BBB. Under isoflurane anesthesia, rats in the control group were infused with 25% m...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199806000-00018
更新日期:1998-06-01 00:00:00
abstract:UNLABELLED:In adult patients, the creation of pneumoperitoneum (PP) by means of carbon dioxide (CO(2)) insufflation leads to an increase in cerebral blood flow velocity (CBFV), which is thought to be caused by hypercapnia. We evaluated whether PP leads to an increase of CBFV in children, and whether this increase is di...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200202000-00005
更新日期:2002-02-01 00:00:00
abstract:IMPLICATIONS:This case report shows that atelectasis of the left lung-induced by extrinsic compression of the left main bronchus by an aortic aneurysm and persisting despite aggressive conservative treatment-may be effectively treated by bronchial stenting and high-frequency percussive ventilation. ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200211000-00012
更新日期:2002-11-01 00:00:00
abstract:PURPOSE:Some severe complications during percutaneous dilatational tracheostomy (PDT) may be related to poor visualization of tracheal structures. Subjectively, the bronchoscopical view obtained via a laryngeal mask airway (LMA) seems to be better than that obtained with an endotracheal tube (ETT). In this prospective,...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3181d27fb4
更新日期:2010-04-01 00:00:00
abstract:UNLABELLED:The aim of this study was to investigate modern and classical electroencephalographic (EEG) variables in response to remifentanil and propofol infusions. We hypothesized that modern EEG variables may indicate the effects of propofol but not of remifentanil. Twenty-five patients were included in the study aft...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200211000-00042
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:Frailty, a state of decreased physiological reserve, is strongly associated with perioperative mortality in older adults. However, the mechanism by which frailty is associated with mortality is not yet understood. Autonomic dysfunction in the form of decreased intraoperative hemodynamic variability has been ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000004085
更新日期:2019-06-01 00:00:00
abstract::Two hundred twenty-two spinal anesthesias were administered with 10 mg. of tetracaine and 1 ml. of 10 percent dextrose to investigate the effects of vasopressors, patients age, and pH of cerebrospinal fluid on the onset and duration of spinal anesthesia. Neither the differences in overall age, cerebrospinal fluid pH, ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1975-07-01 00:00:00
abstract::Patients receiving metoprolol before cardiac revascularization surgery were randomly divided into those in whom metoprolol was discontinued before the operation (N = 10) and those in whom metoprolol was continued up to the time of operation (N = 10). Cardiovascular responses to neuroleptanesthesia and sternotomy were ...
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:1983-04-01 00:00:00
abstract:UNLABELLED:An IM combination of meperidine, promethazine, and chlorpromazine (DPT) has been given as sedation for pediatric procedures for more than 40 years. We compared this IM combination to oral (PO) ketamine/midazolam in children having cardiac catheterization. A total of 51 children, ages 9 mo to 10 yr, were enro...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200002000-00011
更新日期:2000-02-01 00:00:00
abstract::Intravenous lidocaine has been reported previously to inhibit postoperative pain when given either as single injections or as short infusions in amounts usually causing adverse reactions. To determine the efficacy of a continuous low-dose (2 mg/kg) intravenous infusion of lidocaine, postoperative pain (visual analogue...
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:1985-10-01 00:00:00
abstract:OBJECTIVE:Through the Australian and New Zealand Haemostasis Registry, we report on the Australian and New Zealand experience with recombinant activated factor VII (rFVIIa) in obstetric patients. METHODS:The role of rFVIIa for off-label indications, including trauma, cardiac surgery, and severe postpartum hemorrhage, ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181c039e6
更新日期:2009-12-01 00:00:00
abstract::Patients undergoing potentially painful interventional radiological procedures generally require a combination of analgesia and sedation. This sedation/analgesia should allow the patient to communicate while also remaining calm. Bispectral index (BIS) monitoring could be useful in achieving this. The primary end-point...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ane.0000223681.77120.ca
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:IV infusion systems can be configured with manifolds connecting multiple drug infusion lines to transcutaneous catheters. Prior in vitro studies suggest that there may be significant lag times for drug delivery to reflect changes in infusion rates set at the pump, especially with low drug and carrier flows a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3182a76f3b
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Intrathecal neostigmine not only produces analgesia but also severe nausea. In contrast, epidural neostigmine enhances opioid and local anesthetic analgesia without causing nausea. Previous studies examined only single epidural neostigmine bolus administration and did not assess the efficacy of continuous ep...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ane.0b013e31819518e4
更新日期:2009-08-01 00:00:00
abstract::The ideal choice of a priming solution of the cardiopulmonary bypass (CPB) and its influence on the hemostatic system are not clear. Addition of albumin was reported to inhibit platelet damaging by blood-surface interactions ("coating"). To explore this possibility in 60 consecutive male patients undergoing elective a...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验,收录出版
doi:10.1213/00000539-199202000-00008
更新日期:1992-02-01 00:00:00
abstract::Although isoflurane can reduce ischemic neuronal injury after short postischemic recovery intervals, data from our laboratory have demonstrated that this neuroprotection is not sustained and that delayed apoptotic neuronal death, mediated in part by activation of caspases, contributes to the gradual increase in the si...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000202381.40516.8d
更新日期:2006-05-01 00:00:00
abstract:UNLABELLED:In the present study, we investigated the effect of remifentanil on cerebral blood flow velocity (CBFV). We investigated 20 patients (ASA physical status III) scheduled for elective coronary artery bypass graft surgery. Anesthesia was induced with remifentanil 5 microg/kg IV (Group 1, n = 10) or 2 microg/kg ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-199809000-00013
更新日期:1998-09-01 00:00:00
abstract::A recognized side effect of chemonucleolysis is life-threatening anaphylaxis to chymopapain. In the clinical trials of chymopapain, 13 cases of anaphylaxis were reported in 1585 administrations (0.82%). Two patients died. Data from a postmarketing survey (48,239 questionnaires) were reviewed to identify factors influe...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1985-12-01 00:00:00
abstract::Aging and disease may make the elderly patient with cardiac disease particularly susceptible to hypotension during spinal anesthesia. We studied 15 men, 59-80 y old, with histories of prior myocardial infarction (n = 9), congestive heart failure (n = 2), and/or stable myocardial ischemia (n = 11) given spinal anesthes...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199707000-00018
更新日期:1997-07-01 00:00:00
abstract::Rapid sequence induction and intubation (RSII) and awake tracheal intubation are commonly used anesthetic techniques in patients at risk of pulmonary aspiration of gastric or esophageal contents. Some of these patients may have a gastric tube (GT) placed preoperatively. Currently, there are no guidelines regarding whi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0b013e3182917f11
更新日期:2014-03-01 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:IMPLICATIONS:Chronic hiccups may be a serious therapeutic problem. Pharmacological treatment with increasing dosages of baclofen, carbamazepine, or gabapentin is not always successful. In this paper, the use of general anesthesia with positive-pressure ventilation and muscle relaxation for the termination of chronic hi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200208000-00050
更新日期:2002-08-01 00:00:00