Abstract:
BACKGROUND:Severe exacerbation of chronic neuropathic pain often requires morphine in patients already treated with drugs such as tricyclic antidepressants, carbamazepine and gabapentin. However, it is unclear if a combination of these drugs intensifies the effects of morphine on the respiratory system and, if so, whether these effects are due to pharmacokinetic or pharmacodynamic interaction. METHODS:We gave rabbits (n=6 per group) the following drugs daily for 4 days: subcutaneous normal saline 1 mL (control); amitriptyline subcutaneously 7 mg/kg; carbamazepine orally 100 mg/kg; gabapentin subcutaneously 25 mg/kg; and all three drugs concurrently (combination). On the fifth day, morphine 5 mg/kg was given IV, and Paco2, Pao2 and pH were measured. Morphine, morphine 3-glucoronide and morphine 6-glucoronide concentrations were measured in the plasma over the 4 h period after morphine injection. RESULTS:Compared with controls, premorphine baseline Paco2 was significantly higher (P<0.05) in the amitriptyline group. Postmorphine Paco2 was significantly higher in the amitriptyline and combination groups at all time points over the 240 min, and in the gabapentin group at 10 and 30 min after morphine injection (P<0.05). Peak Paco2 was significantly higher in the amitriptyline group (58.4+/-1.6 mm Hg; mean SD, P<0.005) and in the combination group (57.4+/-1.0 mm Hg, P<0.02) than in the control group (50.2+/-5.2 mm Hg). Similarly, the area under the curve of Paco2 from zero to 240 min was significantly higher in the amitriptyline and combination groups than in the control (P<0.001). There were no significant differences among the groups in plasma concentrations of morphine and its metabolites. CONCLUSIONS:We conclude that pretreatment with amitriptyline increases morphine- induced hypercarbia through pharmacodynamic processes. The effects of carbamazepine or gabapentin were not obvious in this model.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Kozer E,Levichek Z,Hoshino N,Kapur B,Leombruno J,Taguchi N,Garcia-Bournissen F,Koren G,Ito Sdoi
10.1213/ane.0b013e31817e6e53subject
Has Abstractpub_date
2008-10-01 00:00:00pages
1216-22issue
4eissn
0003-2999issn
1526-7598pii
107/4/1216journal_volume
107pub_type
杂志文章abstract:UNLABELLED:Untreated pain during the transportation of patients after minor trauma is a common problem in emergency medicine. Because paramedics usually are not allowed to perform invasive procedures or to give drugs for pain treatment, a noninvasive, nondrug-based method would be helpful. Acupressure is a traditional ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200209000-00035
更新日期:2002-09-01 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::Halothane, enflurane, isoflurane, and fentanyl were examined for their potential to exacerbate liver dysfunction in rats with preexisting cirrhosis. Male Wistar rats given sodium phenobarbital for 2 weeks are assigned randomly to two groups. One group (cirrhotic) was exposed by inhalation to carbon tetrachloride (CCl4...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1985-12-01 00:00:00
abstract:UNLABELLED:Ketamine, a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, has psychotomimetic activity. NMDA receptor antagonists cause morphological damage in the posterior cingulate cortex, which may be the brain region responsible for their psychotomimetic effects. Benzodiazepines are effective in preve...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199812000-00040
更新日期:1998-12-01 00:00:00
abstract:UNLABELLED:Previous investigations of the effects of potent opioid analgesics on the heart have concentrated on effects on contraction magnitude and time course, but little is known about their effects on cytosolic Ca(2+) regulation in cardiac tissue. In this study, we sought to assess the effects of alfentanil on cont...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000104481.20813.35
更新日期:2004-04-01 00:00:00
abstract::The purpose of this study was to compare meperidine to meperidine with bupivacaine when used for patient-controlled epidural analgesia (PCEA) after thoracotomy. For 3 days after thoracotomy patients received thoracic PCEA with meperidine 0.1% plain or with added bupivacaine 0.1% or 0.01%. No background infusion was us...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199607000-00014
更新日期:1996-07-01 00:00:00
abstract::Previous studies have shown that the anesthetic potency of organic compounds increases as a given halogen is replaced with successively larger halogens. These studies often are limited in the accuracy of determination of potency, rarely correlate potency with physical properties, and usually fail to include ether comp...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1989-05-01 00:00:00
abstract::This study reports plasma bupivacaine concentrations in 13 neonates who received lumbar epidural anesthesia during major abdominal surgery. A bolus of 1.8 mg/kg of bupivacaine (2.5 mg/mL) was administered after induction of anesthesia, followed by a continuous infusion of 0.2 mg.kg-1.h-1 (1.25 mg/mL). Plasma concentra...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-199703000-00006
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Early hyperglycemia is associated with multiple organ failure (MOF) after traumatic injury; however, few studies have considered the contribution of depth of clinical shock. We hypothesize that when considered simultaneously, glucose and lactate are associated with MOF in severely injured blunt trauma patien...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000002626
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:IV lipid emulsion has demonstrated to be effective therapy for bupivacaine-induced cardiotoxicity. However, the role of epinephrine when coadministered with lipid emulsion in toxin-induced cardiac arrest is unclear. We postulated superior resuscitation outcome in the absence of epinephrine in a rabbit model ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181e66050
更新日期:2010-09-01 00:00:00
abstract::In in vitro pharmacological experiments, determination of effective concentration values for various anesthetics depends on understanding the exact concentration of the drugs dissolved in physiological solutions. Actual anesthetic concentration may differ from expectations because of drug adsorption, absorption or oth...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000142112.30807.5C
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:The recommended treatment of suspected tension pneumothorax is immediate needle decompression. Recommended sites and needle sizes for this procedure vary, and there are published reports of failed decompression as well as iatrogenic hemothorax. We investigated the optimal needle length and relative safety of...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000282827.86345.ff
更新日期:2007-11-01 00:00:00
abstract::Continuous positive airway pressure (CPAP) of 5 and 10 cm H2O applied to the nonventilated lung is effective in improving arterial oxygenation during one-lung ventilation (1-LV). The effectiveness of lower levels of CPAP on improving oxygenation, however, has not been reported, possibly because of limitations of previ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199408000-00029
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:The analgesic efficacy of transversus abdominis plane (TAP) block has been established for patients undergoing abdominal surgery. We evaluated the efficacy of a novel approach to TAP block for postoperative analgesia after colorectal surgery. METHODS:Forty adult ASA physical status I to III patients undergo...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3182159bf8
更新日期:2011-06-01 00:00:00
abstract::We investigated the characteristics of hypoxemic fetoplacental vasoconstriction (HFPV) in the dual perfused, single isolated human placental cotyledon. Fetal arterial blood pressures (FAP) were measured in four cotyledons (Group 1) equilibrated with 21% oxygen (O2), 5% carbon dioxide (CO2), and nitrogen (N2) [control]...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000222468.76942.d8
更新日期:2006-08-01 00:00:00
abstract:UNLABELLED:Shoulder surgery is often performed with patients in the sitting position under interscalene block anesthesia. Vasovagal episodes, characterized by a sudden decrease in heart rate and/or blood pressure, have a reported incidence of 17%-24% in this setting. We performed a retrospective study to determine whet...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1999-02-01 00:00:00
abstract::The effects of gestational age (GA) and plasma protein concentrations on the plasma protein binding of fentanyl and alfentanil were studied in preterm and term neonates. Binding experiments were performed using split-cell equilibrium dialysis. Fentanyl and alfentanil concentrations were measured using specific radioim...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199702000-00013
更新日期:1997-02-01 00:00:00
abstract::The purpose of this study was to evaluate the influence of the volume of methylene blue-local anesthetic on the spread of the injectate along the costal pleura. Twenty patients undergoing elective thoracotomy were studied. Twelve patients received intercostal nerve injection with 10 mL of 0.5% bupivacaine with methyle...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199209000-00013
更新日期:1992-09-01 00:00:00
abstract:UNLABELLED:Nonsteroidal antiinflammatory drugs (NSAIDs) provide effective postoperative analgesia after arthroscopic knee surgery. Some investigators have suggested that the preemptive administration of NSAIDs may reduce postoperative analgesic requirements and hypersensitivity. We evaluated the analgesic effect of adm...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200201000-00010
更新日期:2002-01-01 00:00:00
abstract::Spontaneous ventilation may offer advantages over controlled mechanical ventilation (CMV), but increase in work of breathing may diminish its usefulness. During general anesthesia, respiratory depression and increased work of breathing often preclude spontaneous ventilation, and patients then receive CMV. We compared ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199208000-00003
更新日期:1992-08-01 00:00:00
abstract::To determine the incidence of atrioventricular (A-V) block, 86 patients, aged 58.9 +/- 10.4 yr, undergoing elective coronary artery bypass grafting (CABG) during aortic cross-clamping (ACC) and cold potassium cardioplegia were investigated. The incidence and duration of complete A-V block after release of the aortic c...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199501000-00009
更新日期:1995-01-01 00:00:00
abstract::Prostaglandin E(2) receptors, subtype EP(1) (PGE(2)EP(1)) have been linked to several physiologic responses, such as fever, inflammation, and mechanical hyperalgesia. Local anesthetics modulate these responses, which may be due to direct interaction of local anesthetics with PGE(2)EP(1) receptor signaling. We sought t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200109000-00019
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:Hydroxyethyl starch (HES) solution is characterized by its mean molecular weight (MW), concentration, and degree of substitution (DS). This character varies worldwide. METHODS:After binding fluorescein-isothiocyanate (FITC-HES), we evaluated the retention rate of three types of 6% HES in the A2 and V2 blood...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000275198.84094.ad
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Adverse effects of hydroxyethyl starches (HESs) have been verified in patients suffering from sepsis or kidney disease, but not in surgical patients at large. The investigation aimed to determine whether the use of HES 130/0.4 was associated with the incidence of acute postinterventional adverse events compa...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000002778
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:We studied the effects of isoflurane on hippocampal synaptic transmission and paired-pulse plasticity, under in vivo intact interneuron circuitry. METHODS:Using rats chronically implanted with electrodes, excitatory postsynaptic potential (EPSP) and population spike amplitude (PSA) were measured in the hipp...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000281433.73260.8d
更新日期:2007-10-01 00:00:00
abstract::The nucleus raphe magnus (NRM) is an important descending pain inhibitory system. We postulated that the analgesic action of supraspinally administered opiates results from increased descending inhibitory control of the NRM. We tested whether fentanyl activates NRM neurons in the rat slice preparation using extra-cell...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199505000-00007
更新日期:1995-05-01 00:00:00
abstract::The effects of three anesthetic techniques on liver function were compared in patients with mild alcoholic hepatitis who required surgery, both peripheral and superficial. Thirty patients were randomly assigned to receive one of three anesthetics: thiopental, nitrous oxide and oxygen, enflurane, plus muscle relaxant; ...
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:1985-05-01 00:00:00
abstract:UNLABELLED:We designed this study to assess the efficacy of dolasetron compared with clonidine and placebo in prophylaxis of postanesthetic shivering. We included 90 patients undergoing elective abdominal or urologic surgery. The patients were randomly assigned to one three groups (each group n = 30) using a double-bli...
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:10.1097/00000539-200201000-00020
更新日期:2002-01-01 00:00:00
abstract:UNLABELLED:New neurological deficit after spinal surgery is a rare complication that requires a quick diagnostic and therapeutic approach to reduce the risk of permanent neurological disabilities. We report a patient who presented with transient neurologic deficit after surgery for lumbar disk herniation resulting from...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000083371.57228.64
更新日期:2003-11-01 00:00:00
abstract::The effect of laparoscopy on cardiac function is controversial. We hypothesized that cardiac dysfunction related to increased afterload could be predominant in patients undergoing elective abdominal aortic repair. To test this hypothesis, we conducted a transesophageal echocardiographic study in 15 patients during lap...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000202473.17453.79
更新日期:2006-05-01 00:00:00