Abstract:
BACKGROUND:In children with a history of significant obstructive sleep apnea who undergo adenotonsillectomy, postsurgical administration of opiates has been alleged to be associated with an increased risk for respiratory complications, including respiratory depression. The authors hypothesize that this association is due to an effect of recurrent hypoxemia that accompanies more severe obstructive sleep apnea on altered responsiveness to subsequent exogenous opiates. METHODS:The current study was designed to test the effect of recurrent hypoxia in the developing rat on respiratory responses to subsequent administration of the mu-opioid agonist fentanyl. Rats were exposed to 12% oxygen balance nitrogen for 7 h daily for 17 days, from postnatal day 17 to 33, a period equivalent to human childhood. After 17 additional days in room air, rats were given a fentanyl dose and tested for their respiratory response to fentanyl using a whole body plethysmograph. Rats undergoing similar protocols without recurrent hypoxia served as controls. RESULTS:As compared with controls, rats preexposed to recurrent hypoxia displayed a more profound depression with fentanyl in minute ventilation, respiratory frequency, tidal volume, and tidal volume divided by inspiratory time that represents respiratory drive. These results indicated an increased respiratory sensitivity to fentanyl after recurrent hypoxia. CONCLUSIONS:Previous recurrent hypoxia increases respiratory sensitivity to subsequent opiate agonists. If these findings are applicable to humans, opiate dosing in children must be adjusted depending on history of recurrent hypoxemia to avoid respiratory depression.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Moss IR,Brown KA,Laferrière Adoi
10.1097/00000542-200610000-00017subject
Has Abstractpub_date
2006-10-01 00:00:00pages
715-8issue
4eissn
0003-3022issn
1528-1175pii
00000542-200610000-00017journal_volume
105pub_type
杂志文章相关文献
ANESTHESIOLOGY文献大全abstract:BACKGROUND:Single lung transplantation has become a viable therapy for treatment of end-stage pulmonary disease. We previously observed that left lung autotransplantation (LLA) results in a chronic increase in pulmonary vascular resistance and enhanced pulmonary vascular reactivity to sympathetic alpha adrenoreceptor a...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199609000-00019
更新日期:1996-09-01 00:00:00
abstract::Interposition of activated carbon between a nitrogen analyzer needle valve and gas mixtures containing halothane, methoxyflurane, enflurane, or isoflurane eliminated the interfering effects of these agents, but added sampling delays. Placement of a carbon-filled Swinney adaptor in the sampling line between the needle ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197512000-00014
更新日期:1975-12-01 00:00:00
abstract:BACKGROUND:Systemic magnesium has been used to minimize postoperative pain with conflicting results by clinical studies. It remains unknown whether the administration of perioperative systemic magnesium can minimize postoperative pain. The objective of the current investigation was to evaluate the effect of systemic ma...
journal_title:Anesthesiology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/ALN.0b013e318297630d
更新日期:2013-07-01 00:00:00
abstract::Making good decisions in the era of Big Data requires a sophisticated approach to causality. We are acutely aware that association ≠ causation, yet untangling the two remains one of our greatest challenges. This realization has stimulated a Causal Revolution in epidemiology, and the lessons learned are highly relevant...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000003193
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Acute respiratory distress syndrome (ARDS) is a devastating condition with an estimated mortality exceeding 30%. There are data suggesting risk factors for ARDS development in high-risk populations, but few data are available in lower incidence populations. Using risk-matched analysis and a combination of cl...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3182794975
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:The authors evaluated optimal adrenergic support using norepinephrine, dopamine, and dobutamine in a clinically relevant model of septic shock. METHODS:Twenty-eight mature, female, anesthetized sheep (weight, 30.5 +/- 3.6 kg) underwent cecal ligation and perforation and were randomized into four groups of s...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200304000-00015
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Mild hypothermia is accompanied by metabolic changes. Epidural local anesthetic agents attenuate the surgical stress response, but it is not known whether they modulate thermal stress. METHODS:Thirty patients undergoing colorectal surgery, performed by one surgical team, received epidural 0.5% bupivacaine t...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199805000-00011
更新日期:1998-05-01 00:00:00
abstract::The goal of this randomized study of high-risk surgical patients was to determine whether intraoperative thoracic epidural anesthesia in combination with light general anesthesia alters postoperative morbidity when compared to a standard technique of "balanced" general anesthesia. A total of 173 patients scheduled for...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199110000-00010
更新日期:1991-10-01 00:00:00
abstract:BACKGROUND:Malignant hyperthermia is associated with mutations within the gene encoding the skeletal muscle ryanodine receptor, the calcium channel that releases Ca from sarcoplasmic reticulum stores triggering muscle contraction, and other metabolic activities. More than 200 variants have been identified in the ryanod...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181d69283
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Hypoalbuminemia may increase the risk of acute kidney injury (AKI). The authors investigated whether the immediate preoperative administration of 20% albumin solution affects the incidence of AKI after off-pump coronary artery bypass surgery. METHODS:In this prospective, single-center, randomized, parallel-...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0000000000001051
更新日期:2016-05-01 00:00:00
abstract::Operating room fires are rare but devastating events. Guidelines are available for the prevention and management of surgical fires; however, these recommendations are based on expert opinion and case series. The three components of an operating room fire are present in virtually all surgical procedures: an oxidizer (o...
journal_title:Anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/ALN.0000000000002598
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Impaired excitatory and inhibitory balance in the spinal dorsal horn has a crucial role in the pathophysiology of chronic pain. The authors addressed the therapeutic impact of increasing spinal glycine applied exogenously or via blockade of glycine transporter 1 using its selective inhibitors sarcosine and N...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e31816c9044
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Although previous studies have proposed that anesthetics may influence signal transduction systems, their effects on the beta-adrenoceptor-mediated system have not been fully characterized in vascular smooth muscle. The aim of this study was to determine how halothane and isoflurane affect beta-adrenoceptor-...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199811000-00022
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:To interpret correctly the results from studies performed during surgery and anesthesia it is necessary to dissect the separate effect of the anesthetic technique itself. The purpose of this study was to investigate the metabolic effects of epidural blockade (T7-S1) with bupivacaine 0.25% after 12 h fasting ...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200001000-00015
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Previous attempts at improving operating room utilization have generally emphasized more accurate scheduling, starting the first case on time, and reducing turnover time. Surgical case cancellations have largely been ignored except for recommendations for preoperative screening and good physician-patient com...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200604000-00029
更新日期:2006-04-01 00:00:00
abstract::Effects of lidocaine on arterial pressure, heart rate and electrocortical activity were studied in nine fetal lambs at 0.77 to 0.92 gestation (116 to 138 days of gestation; term in sheep is 150 days). Lidocaine was administered into a fetal femoral vein either as a continuous infusion or as a bolus injection. Epilepti...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197602000-00008
更新日期:1976-02-01 00:00:00
abstract::In order to determine whether or not irritation of the nasal passage with commonly used volatile anesthetics can elicit airway reflexes, we investigated respiratory, laryngeal, and tracheal responses to nasal insufflation of three volatile anesthetics (enflurane, isoflurane, and halothane) in 13 patients anesthetized ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199109000-00010
更新日期:1991-09-01 00:00:00
abstract::The authors have previously attributed the mechanism for the 50-67% decrease in the required dose of thiopental for induction of anesthesia in aged human patients to a decrease in the initial distribution volume for thiopental. Using a larger group of patients and volunteers studied in the laboratory, the authors have...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199003000-00003
更新日期:1990-03-01 00:00:00
abstract::Ropivacaine is an amide local anesthetic structurally related to, but appearing less cardiotoxic, than bupivacaine. The authors' investigation was designed in a randomized, double-blind fashion to compare the clinical effectiveness of ropivacaine and bupivacaine in patients undergoing lower-extremity surgery. Forty-fi...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199004000-00010
更新日期:1990-04-01 00:00:00
abstract::Propofol is a potent lipophilic anesthetic that was initially formulated in Cremophor El for human use. Because of the occurrence of Cremophor EL anaphylaxis and improvements in the quality of lipid emulsions, it was ultimately brought to market as 1% propofol formulated in 10% soybean oil emulsion. Emulsions represen...
journal_title:Anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/00000542-200510000-00026
更新日期:2005-10-01 00:00:00
abstract:INTRODUCTION:Spinal alpha2-adrenoceptor stimulation produces analgesia in neuropathic pain states, and this effect in animals is blocked by the inhibitors of brain-derived neurotrophic factor (BDNF) function. In rats, alpha2-adrenoceptor stimulation normally inhibits acetylcholine release, but it excites release after ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181de6d2c
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:The mechanisms of amino-amide local anesthetic agent-induced vasoconstriction remain unclear. The current study was designed to examine the roles of the protein kinase C (PKC), Rho kinase, and p44/42 mitogen-activated protein kinase (p44/42 MAPK) signaling pathways in calcium (Ca2+)-sensitization mechanisms ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200509000-00018
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Patients who are homozygous for the atypical mutation, compound heterozygous for atypical and silent mutations, or homozygous for silent mutations (SS) respond to mivacurium with extensively prolonged neuromuscular block. Although important, exact phenotyping of these patients is difficult. This article pres...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200109000-00010
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:General anesthetics modify airway responsiveness by several mechanisms, including direct effects on airway smooth muscle and reductions in neural reflex activity. Halothane has been shown to reduce responsiveness through both of these mechanisms. The airway effects of barbiturates are controversial, and the ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199308000-00014
更新日期:1993-08-01 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 analgesic activity of morphine-6-glucuronide (M-6-G) is well recognized for its contribution to the effects of morphine and its possible use as an opioid analgesic with a wider therapeutic range than morphine. The present study attempted to quantify the relative contribution of M-6-G to analgesia observe...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199712000-00014
更新日期:1997-12-01 00:00:00
abstract::Controversy persists about the cardiac toxicity of bupivacaine if accidentally administered intravenously during regional anesthesia. Using awake, unanesthetized sheep, we evaluated the cardiac effects of low and high equivalent doses of lidocaine and bupivacaine given intravenously over 10 s. All animals convulsed wi...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198401000-00004
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:Clonidine produces analgesia after spinal injection by activating alpha2-adrenergic receptors. Recently, clonidine has been demonstrated to increase spinal release of norepinephrine (NE) in vivo, in contrast to that anticipated by classic presynaptic autoinhibition. The purpose of the current study was to de...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200007000-00027
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Some patients develop recrudescence after a malignant hyperthermia (MH) reaction, but it is not clear which patients are at risk. The authors analyzed clinical variables associated with recrudescence after a clinical MH episode. METHODS:Data were obtained from Adverse Metabolic Reaction to Anesthesia report...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/01.anes.0000265148.86566.68
更新日期:2007-05-01 00:00:00
abstract::Low concentrations of ethanol (17 mM) inhibited development of spontaneous mechanical activity (vasomotion) in isolated rat portal veins. Low concentrations of ethanol potentiated, however, contractions induced by epinephrine, but not those induced by angiotensin or potassium. Higher concentrations of ethanol, such as...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197604000-00009
更新日期:1976-04-01 00:00:00