Abstract:
:A 91-yr-old man (57 kg, 156 cm, ASA III) received an infraclavicular brachial plexus block for surgery of bursitis of the olecranon. Twenty minutes after infraclavicular injection of 30 mL of mepivacaine 1% (Scandicain) and 5 min after supplementation of 10 mL of prilocaine 1% (Xylonest) using an axillary approach, the patient complained of agitation and dizziness and became unresponsive to verbal commands. In addition, supraventricular extrasystole with bigeminy occurred. Local anesthetic toxicity was suspected and a dose of 200 mL of a 20% lipid emulsion was infused. Symptoms of central nervous system and cardiac toxicity disappeared within 5 and 15 min after the first lipid injection, respectively. Plasma concentrations of local anesthetics were determined before, 20, and 40 min after lipid infusion and were 4.08, 2.30, and 1.73 microg/mL for mepivacaine and 0.92, 0.35, and 0.24 microg/mL for prilocaine. These concentrations are below previously reported thresholds of toxicity above 5 microg/mL for both local anesthetics. Signs of toxicity resolved and the patient underwent the scheduled surgical procedure uneventfully under brachial plexus blockade.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Litz RJ,Roessel T,Heller AR,Stehr SNdoi
10.1213/ane.0b013e3181683dd7subject
Has Abstractpub_date
2008-05-01 00:00:00pages
1575-7, table of contentsissue
5eissn
0003-2999issn
1526-7598pii
106/5/1575journal_volume
106pub_type
杂志文章abstract::Intraocular pressure (IOP) measurements in children are usually performed under nitrous oxide and halothane anesthesia. We studied the effects of both time and end-tidal halothane concentration on IOP in 80 children (mean age +/- SD = 4.5 +/- 2.9 yr), to determine the most optimal time to make such measurements in ane...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199008000-00011
更新日期:1990-08-01 00:00:00
abstract:BACKGROUND:Even though current perception threshold (CPT) has been used for evaluating the effectiveness of sensory block in patients before surgery, its reliability under controlled conditions has not been investigated. Two independent investigations were performed. The primary objective of the first study was to dete...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1213/ANE.0000000000000575
更新日期:2015-03-01 00:00:00
abstract::Cimetidine blunts the increase in cerebral blood flow (CBF) normally observed during hypoxia. It is important, therefore, to know whether other H2-blockers also affect the cerebral circulation adaptation to hypoxia. Cerebral blood flow was measured in 24 awake dogs after an intravenous injection of either saline (cont...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199104000-00020
更新日期:1991-04-01 00:00:00
abstract:UNLABELLED:We compared, in a double-blinded manner, the anesthetic maintenance and recovery properties of remifentanil with a clinically comparable fentanyl-based anesthetic technique in pediatric ambulatory surgical patients. Anesthesia was induced with either halothane or sevoflurane and nitrous oxide and oxygen. Pat...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000539-200004000-00017
更新日期:2000-04-01 00:00:00
abstract::Dantrolene effectively treats malignant hyperthermia (MH) hut the current form, Dantrium, must be dissolved to a 0.33 mg/mL, pH 9.5 solution. This study describes lecithin-coated microcrystal formulations of sodium dantrolene (MC-NaD) and neutral dantrolene (MC-D) which reconstitute to 200 mg/mL within 1 min. In rats,...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199604000-00021
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:The cerebral perfusion pressure that denotes the lower limit of cerebral blood flow autoregulation (LLA) is generally considered to be equivalent for reductions in arterial blood pressure (ABP) or increases in intracranial pressure (ICP). However, the effect of decreasing ABP at different levels of ICP has n...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181964848
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Local anesthetics cause reversible block of pain and robustly inhibit TWIK-related K channel (TREK-1) currents. Before local anesthesia onset, injection of local anesthetics can cause unwanted transient pain. TREK-1 is an anesthetic-sensitive potassium channel that when inhibited produces pain. A disordered ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000004216
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine, an α(2)-receptor agonist, prolongs analgesia when used in neuraxial and IV blocks. We evaluated the effect of dexmedetomidine added to ropivacaine for tibial nerve block on the duration of the sensory blockade. METHODS:For this prospective, randomized, controlled, double-blind, crossover tr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e318265bab7
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Unicondylar knee arthroplasty (UKA) is a commonly performed procedure with significant expected postoperative pain. Peripheral nerve blocks are 1 analgesic option, but some approaches may decrease quadriceps motor strength and interfere with early ambulation. In this study, we compared the analgesia provided...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000001162
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Unanticipated hospital admission is regarded as a measure of adverse perioperative patient care. However, previously published studies for risk prediction after ambulatory procedures are sparse compared to those examining readmission after inpatient surgery. We aimed to evaluate the incidence and reasons for...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究
doi:10.1213/ANE.0000000000004852
更新日期:2020-08-01 00:00:00
abstract::The renal effects of pulsatile (pulse pressure 18.0 +/- 1.5 mm Hg [mean +/- SEM]) or nonpulsatile perfusion (mean pulse pressure 1.9 +/- 0.4 mm Hg) during either alpha-stat (mean PaCO2 41.2 +/- 0.9 mm Hg measured at 37 degrees C) or pH-stat (mean PaCO2 60.6 +/- 1.7 mm Hg measured at 37 degrees C) pH management of hypo...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199211000-00007
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Recombinant activated factor VII (rFVIIa) is increasingly used for treating refractory bleeding after cardiac surgery. However, hemostasis also depends on coagulation factors, including fibrinogen, which stabilizes platelet plugs at sites of vascular injury. We compared the hemostatic effects of rFVIIa, fibr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e318163fc76
更新日期:2008-03-01 00:00:00
abstract::Seven anesthetized patients were studied to determine the interaction between pancuronium and lincomycin and the ability of neostigmine and 4-aminopyridine to antagonize the block. Lincomycin 600 mg given IV alone did not decrease twitch tension. An 8 to 10% decrease in twitch tension occurred when lincomycin was give...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197805000-00007
更新日期:1978-05-01 00:00:00
abstract::We studied the time to postoperative micturition and the duration of analgesia in 82 children aged 6 mo to 10 yr undergoing herniorrhaphy or orchiopexy under general anesthesia with N2O and halothane. All received D5 lactate Ringer's solution equivalent to 6 h maintenance intraoperatively, and oral fluids postoperativ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199301000-00029
更新日期:1993-01-01 00:00:00
abstract::Informed consent for pediatric anesthesia challenges practitioners to navigate complex ethical, medical, and legal ambiguities. A patient's status as a minor does not negate the importance of his or her participation in the decision-making process but, rather, necessitates a nuanced evaluation of age and development t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000003705
更新日期:2018-12-01 00:00:00
abstract::This randomized double-blind study compared the hemodynamic and metabolic effects of pancuronium and vecuronium during treatment of shivering after cardiac surgery with hypothermic cardiopulmonary bypass. Thirty sedated and pain-free patients who shivered after cardiac surgery were treated with pancuronium (n = 15) or...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199409000-00012
更新日期:1994-09-01 00:00:00
abstract::Recent determinations of the minimum alveolar anesthetic concentration (MAC) for nitrous oxide in rats yield values of 1.51-1.55 atm. When combined with results from other reports, these results suggest a deviation from linear additivity, and call into question the unitary theory of narcosis. The present report provid...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199410000-00016
更新日期:1994-10-01 00:00:00
abstract::The effects of narcotic agents and two inhalation anesthetics on intrabiliary pressure (IBP) were measured before and after morphine (0.2 mg/kg), meperidine (2 mg/kg), fentanyl (0.002 mg/kg), or pentazocine (1 mg/kg) given intramuscularly to guinea pigs, and after halothane (0.5, 1.0, 1.5, or 2.0 MAC) or enflurane (sa...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1979-03-01 00:00:00
abstract:BACKGROUND:Although detailed analyses of the postmortem findings of various critically ill patient groups have been published, no such study has been performed in patients with sepsis. In this retrospective cohort study, we reviewed macroscopic postmortem examinations of surgical intensive care unit (ICU) patients who ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e318195e11d
更新日期:2009-06-01 00:00:00
abstract:UNLABELLED:The purpose of this animal investigation was to compare behavioral responses with spinal Fos-like immunoreactivity (FLI) after pre-versus postformalin administration of anesthetic doses of IV ketamine or alfentanil. Preformalin and postformalin injection (1.5% subcutaneously) treatment groups included IV sal...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199907000-00022
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Although invasive monitoring is the standard method for intracranial pressure (ICP) measurement, it is not without potential for serious complications. Noninvasive methods have been proposed as alternatives to invasive ICP monitoring. The study aimed to investigate the diagnostic accuracy of the currently av...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000005189
更新日期:2020-09-24 00:00:00
abstract:BACKGROUND:Many of the complications of mechanical ventilation are related to inappropriate endotracheal tube (ETT) cuff pressure. The aim of the current study was to evaluate the effectiveness of automatic cuff pressure closed-loop control in patients under prolonged intubation, where presence of carbon dioxide (CO2) ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1213/ANE.0000000000002358
更新日期:2017-10-01 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:BACKGROUND:A potential physicochemical interaction between epidural local anesthetics and extended-release epidural morphine (EREM) could negate the sustained release. In this study, we sought to determine the pharmacokinetic and drug effects of prior epidural lidocaine administration on EREM. METHODS:Thirty healthy w...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e318222f59c
更新日期:2011-08-01 00:00:00
abstract:UNLABELLED:The optimal dose and timing of 5-HT(3) antagonist administration for prophylaxis against postoperative nausea and vomiting (PONV) remains controversial. Although 5-HT(3) antagonists seem to be most effective when administered near the end of surgery, there are no data on the comparative efficacy or costs ass...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200006000-00017
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:Transcutaneous vagus nerve stimulation (TVNS) is a promising treatment for acute and chronic pain. However, experimental studies yielded controversial results. We examined if TVNS reduces the perceived intensity of repetitive painful heat stimulation and temporal summation of pain (TSP) in healthy volunteers...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000002820
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Predicting blood product transfusion requirements during orthotopic liver transplantation (OLT) remains difficult. Our primary aim in this study was to determine which patient variables best predict recipient risk for large blood transfusion requirements during OLT. The secondary aim was to determine whether...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3182a76f19
更新日期:2014-02-01 00:00:00
abstract:UNLABELLED:As medical costs continue to escalate, there is willingness to consider the role played by nontraditional factors in health. We investigated the usefulness of tape-recorded hypnosis instruction on perioperative outcome in surgical patients in a prospective, randomized, and partially blinded study. Sixty pati...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200001000-00016
更新日期:2000-01-01 00:00:00
abstract::A previous demonstration that the ratio of analgesic to anesthetic endpoints is not constant across inhalation anesthetic agents implies that more than one mechanism of action may be operant in general anesthesia. We hypothesized that the endogenous opiate systems might account for this observed disparity in ratios. T...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1986-04-01 00:00:00
abstract:BACKGROUND:Recent attention to adverse effects of intensive care unit (ICU) sedation has led to the use of strategies that target a "lighter" depth of sedation. Among these strategies are "analgosedation" protocols, which prioritize pain management and preferentially use IV opioids before administration of continuously...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001393
更新日期:2016-10-01 00:00:00