Abstract:
BACKGROUND:Cardiac surgery for carcinoid heart disease is complicated by hemodynamic instability secondary to carcinoid crises, cardiovascular dysfunction, and blood loss. The safety of vasopressors and the benefit of aprotinin during concomitant octreotide administration are uncertain. METHODS:We reviewed the effects of vasopressors and aprotinin on octreotide administration and mortality by univariate analysis in 100 consecutive cases of cardiac surgery for carcinoid heart disease from 1985 to 2003. Because mortality declines were temporally related to the introduction of aprotinin, bivariate analyses were performed to identify other factors associated with mortality. RESULTS:Carcinoid symptoms and hypotension were treated with octreotide (n = 89) and/or vasopressors (n = 93). Vasopressors were not associated with increased octreotide administration. Patients requiring epinephrine had higher mortality but also had worse preoperative New York Heart Association class, higher urinary 5-hydroxyindoleacetic acid levels, and increased blood transfusion requirements. Aprotinin (n = 54) was associated with decreased blood transfusion requirements, increased octreotide administration, but not mortality. Overall mortality was 13%, declining from 28% between 1985 and 1994 to 6% between 1995 and 2003. Mortality was associated with greater blood transfusion requirements and longer duration of cardiopulmonary bypass. CONCLUSIONS:Vasopressors may be used in conjunction with octreotide in carcinoid patients. The increased mortality associated with epinephrine likely reflects selection bias rather than a primary adverse effect. The improved survival over time in carcinoid patients is multifactorial and unrelated to aprotinin administration, suggesting further inhibition of the kallikrein-kinin system has little added benefit for this outcome in the presence of octreotide.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Weingarten TN,Abel MD,Connolly HM,Schroeder DR,Schaff HVdoi
10.1213/01.ane.0000284704.57806.0bsubject
Has Abstractpub_date
2007-11-01 00:00:00pages
1192-9, table of contentsissue
5eissn
0003-2999issn
1526-7598pii
105/5/1192journal_volume
105pub_type
杂志文章abstract:BACKGROUND:Central poststroke pain (CPSP) is a disabling morbidity occurring in 8%-14% of patients with stroke. It is infrequently recognized and difficult to manage. OBJECTIVE:We systematically reviewed the pathophysiology and treatment of CPSP. METHODS:We conducted a Medline search using the key words "central post...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ane.0b013e31819d644c
更新日期:2009-05-01 00:00:00
abstract:UNLABELLED:When opioids are used for postoperative pain control, it is useful to define the dose-response relationship for analgesia and respiratory depression. We studied 20 chronically opioid-consuming patients having elective multilevel spine fusion. Preoperatively, each patient received a fentanyl infusion of 2 mic...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000156563.25878.19
更新日期:2005-08-01 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::Forty neonates delivered by cesarean section were studied, half being delivered of mothers in whom anesthesia was induced with midazolam (0.3 mg/kg intravenously) and half of mothers given thiopental (4 mg/kg). At delivery, blood samples from mother and the umbilical vein were drawn for determination of plasma concent...
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:1989-03-01 00:00:00
abstract::In certifying competence of anesthesiologists who have finished residency training, knowledge and judgment are evaluated objectively using written and oral examinations. Clinical motor skills, however, are not routinely assessed by objective techniques. This implicitly assumes that knowledge and judgment correlate wit...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
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更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:The diagnosis of myocardial infarction (MI) after noncardiac surgery has traditionally relied on using relatively insensitive contemporary cardiac troponin (cTn) assays. We hypothesized that using a recently introduced novel high-sensitivity cTnT (hscTnT) assay would increase the detection rate of perioperat...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000002240
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Recent research suggests that 6% hydroxyethyl starch (HES) 130/0.4 is one of the most frequently used resuscitation fluids worldwide. The retraction of studies evaluating its use necessitates a reevaluation of available evidence regarding its safety and efficacy. METHODS:We performed a systematic review and...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,meta分析,评审
doi:10.1213/ANE.0b013e318236b4d6
更新日期:2012-01-01 00:00:00
abstract:UNLABELLED:Symptoms of orthostatic intolerance are common after general anesthesia and are associated with an increased risk of postoperative morbidity. The contribution of orthostatic hypotension (OH) has not been well defined. We conducted a head-up tilt test on patients after general anesthesia for minor surgery to ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000093388.17298.90
更新日期:2004-01-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199108000-00008
更新日期:1991-08-01 00:00:00
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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:1986-08-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000003740
更新日期:2019-02-01 00:00:00
abstract::In this prospective randomized, double-blind study, we investigated the effect of ondansetron on the lidocaine subarachnoid block. Fifty-four male patients scheduled for transurethral surgery under subarachnoid anesthesia received oral ondansetron 4 mg the evening before surgery and 4 mg IV 15 min before subarachnoid ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2005-06-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31827fe77e
更新日期:2013-04-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001729
更新日期:2017-06-01 00:00:00
abstract::The performance of five of the most commonly used halothane vaporizers and three enflurane vaporizers was tested under conditions encountered in low-flow and closed-circuit anesthesia. Anesthetic gas concentrations were measured continuously with a mass spectrometer connected to a circle system. The results indicated ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1980-05-01 00:00:00
abstract:BACKGROUND:A decremental positive end-expiratory pressure (PEEP) trial after full lung recruitment allows for the adjustment of the lowest PEEP that prevents end-expiratory collapse (open-lung PEEP). For a tidal volume (Vt) approaching zero, the PEEP of minimum respiratory system elastance (PEEP(minErs)) is theoretical...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31824a95ca
更新日期:2013-03-01 00:00:00
abstract:UNLABELLED:We tested the hypothesis that, under relatively low tidal volume (VT) mechanical ventilation, continuing lung decruitment induced by negative end-expiratory pressure (NEEP) would increase the lung cytokine response, potentially contributing to lung injury. Mouse lungs were excised and randomly assigned to on...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200206000-00038
更新日期:2002-06-01 00:00:00
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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
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199305000-00006
更新日期:1993-05-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2004-09-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199709000-00035
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:Vascular access is often technically difficult in children because of the small caliber and impalpability of the veins. In this study, we sought to determine if use of the Vein Entry Indicator Device (VEIDtrade mark) in children facilitates peripheral venous access. METHODS:Two-hundred-two healthy (ASA grad...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ane.0b013e318185cdab
更新日期:2008-11-01 00:00:00
abstract::Dr. Paul Janssen was the founder of Janssen Pharmaceutica and the developer of over 80 pharmaceutical compounds that proved useful in human, botanical, and veterinary medicine. He and his coworkers synthesized the fentanyl family of drugs, many other potent analgesics, droperidol, etomidate, and numerous other importa...
journal_title:Anesthesia and analgesia
pub_type: 传,历史文章,杂志文章
doi:10.1213/ane.0b013e3181605add
更新日期:2008-02-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e31818e0d34
更新日期:2009-01-01 00:00:00
abstract::Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the contin...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000002280
更新日期:2017-11-01 00:00:00
abstract::The effects of intravenously administered lidocaine on cough suppression in elderly patients over the age of 60 yr during tracheal intubation under general anesthesia were evaluated in two studies. In the first study, 100 patients received a placebo of either 0.5, 1.0, 1.5, or 2.0 mg/kg lidocaine intravenously 1 min b...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199308000-00016
更新日期:1993-08-01 00:00:00
abstract::In a laboratory experiment, the expected analgesic action of 33% nitrous oxide was reversed by creating the expectancy of heightened awareness of bodily sensations. Pain threshold and tolerance of electrical tooth-pulp stimulation were significantly reduced. Results from a control study gave us a basis for comparison ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1983-12-01 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:IMPLICATIONS:The performance of regional blockade on a patient with a preexisting neurologic condition or a history of neurologic complications after regional anesthesia is controversial. We present a case of recurring brachial plexus neuropathy in a diabetic patient after two shoulder procedures performed 4 mo apart. ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200009000-00035
更新日期:2000-09-01 00:00:00