The influence of inspired oxygen fraction and end-tidal carbon dioxide on post-cross-clamp cerebral oxygenation during carotid endarterectomy under general anesthesia.


BACKGROUND:Ten to fifteen percent of awake patients develop neurological deficits secondary to cerebral hypoperfusion after carotid artery cross-clamping. The reversal of such deficits by increasing the inspired oxygen fraction (Fio(2)) has been demonstrated, and regional cerebral oxygenation (rSO(2)) has been shown to improve during carotid cross-clamping in awake patients by increasing Fio(2). Paradoxical improvements in cerebral blood flow during carotid endarterectomy (CEA) at the time of cross-clamping and normalization of post-cross-clamp electroencephalographic abnormalities have been induced by hypocapnia. We performed this study to determine the influence of Fio(2) and end-tidal carbon dioxide (Petco(2)) on rSO(2) in patients undergoing CEA with general anesthesia during carotid cross-clamping. METHODS:Twenty patients were recruited. Ten underwent elective shunting. Patients received standardized general anesthesia. rSO(2) was measured using the INVOS 5100B monitor (Somanetics Corporation, Troy, MI). After carotid cross-clamping, Fio(2) and minute ventilation were sequentially adjusted: 1) Fio(2) 30%, Petco(2) 30-35 mm Hg; 2) Fio(2) 100%, Petco(2) 30-35 mm Hg; and 3) Fio(2) 100%, Petco(2) 40-45 mm Hg. At each point, rSO(2) was recorded from both operative and nonoperative sides, and arterial blood gas analysis was performed. RESULTS:Results from shunted and unshunted patients were analyzed separately. Increasing Fio(2): Administration of 100% oxygen while maintaining Petco(2) in the range 30-35 mm Hg in unshunted patients resulted in an 8% increase (P = 0.008) in rSO(2) on the operative side and a 6% increase (P = 0.011) on the nonoperative side compared with an Fio(2) of 30%. In shunted patients, administration of 100% oxygen while maintaining the Petco(2) in the range 30-35 mm Hg resulted in a 4% increase in rSO(2) on both the operative side (P = 0.008) and the nonoperative side (P = 0.011) compared with an Fio(2) of 30%. Increasing Petco(2): In unshunted patients, there was a 6% (P = 0.008) increase in rSO(2) on the operative side and a 5% increase (P = 0.024) on the nonoperative side at Petco(2) 40-45 mm Hg compared with Petco(2) 30-35 mm Hg maintaining Fio(2) at 100%. In shunted patients, there was a 3% increase (P = 0.018) in rSO(2) on the operative side and a 4% increase (P = 0.007) on the nonoperative side at Petco(2) 40-45 mm Hg compared with Petco(2) 30-35 mm Hg maintaining Fio(2) at 100%. CONCLUSION:rSO(2) is reliably improved during carotid cross-clamping by increasing Fio(2) in patients undergoing CEA with general anesthesia. Additional improvement in rSO(2) may be gained by increasing Petco(2).


Anesth Analg


Anesthesia and analgesia


Picton P,Chambers J,Shanks A,Dorje P




Has Abstract


2010-02-01 00:00:00














  • Systemic ondansetron antagonizes the sensory block produced by intrathecal lidocaine.

    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


    authors: Fassoulaki A,Melemeni A,Zotou M,Sarantopoulos C

    更新日期:2005-06-01 00:00:00

  • Marked mixed venous desaturation during early mobilization after aortic valve surgery.

    abstract:UNLABELLED:We investigated the physiological reaction to mobilization the first and second day after aortic valve replacement in an open, prospective study. Hemodynamic and oxygenation variables were recorded in 15 patients using a pulmonary artery oximetry catheter and bench oximetry. Serious intraoperative events occ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章


    authors: Kirkeby-Garstad I,Sellevold OF,Stenseth R,Skogvoll E,Karevold A

    更新日期:2004-02-01 00:00:00

  • Droperidol causes a dose-dependent prolongation of the QT interval.

    abstract::To further investigate possible prolongation of the frequency-corrected QT interval (QTc interval) after administration of droperidol (DRO), we studied 40 surgical patients who were randomly assigned to one of three groups, receiving an intravenous (IV) injection of either 0.1 mg/kg (Group 1, n = 10), 0.175 mg/kg (Gro...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Lischke V,Behne M,Doelken P,Schledt U,Probst S,Vettermann J

    更新日期:1994-11-01 00:00:00

  • The pulmonary absorption-excretion volume effect.

    abstract::An in-vitro experiment demonstrated the concentration effect of N2O (3% versus 75%) during elimination and during uptake. Other pulmonary absorption-excretion phenomena also occur simultaneously, as paired events during uptake and then during elimination:diffusion hyperoxia and diffusion anoxia; alveolar concentration...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Rackow H,Salanitre E

    更新日期:1976-01-01 00:00:00

  • Electrocerebral silence by intracarotid anesthetics does not affect early hyperemia after transient cerebral ischemia in rabbits.

    abstract:UNLABELLED:Evidence suggests that early postischemic hyperemia is mediated by both neurological and vascular mechanisms. We hypothesized that if neuronal activity were primarily responsible for reperfusion hyperemia, then electrocerebral silence induced by intracarotid anesthetics (propofol and pentothal) would attenua...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Joshi S,Wang M,Nishanian EV,Emerson RG

    更新日期:2004-05-01 00:00:00

  • To do or not to do a preinduction check-up of the anesthesia machine.

    abstract::The anesthesia machine check is an integral part of the anesthesiologist's daily routine. It is standard operating procedure to check the high- and low-pressure systems of the machine as well as other integral parts that are accessible. Many new anesthesia machines offer a self-testing capability, but older ones with ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Ianchulev SA,Comunale ME

    更新日期:2005-09-01 00:00:00

  • A comparison of peripheral skin blood flow and temperature during endoscopic thoracic sympathotomy.

    abstract::The assessment of sympathetic denervation to the upper extremities during surgery for hyperhidrosis is essential in predicting postoperative outcome, particularly for endoscopic thoracic chain sympathotomy, a recently described, minimally destructive technique that minimizes postoperative compensatory hyperhidrosis. T...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章


    authors: Eisenach JH,Pike TL,Wick DE,Dietz NM,Fealey RD,Atkinson JL,Charkoudian N

    更新日期:2005-01-01 00:00:00

  • Ketamine potentiates nondepolarizing neuromuscular relaxants in a primate.

    abstract::Ketamine has many neuromuscular effects in vitro. Its neuromuscular effects in vivo have been controversial and inconsistent. To systematically examine its neuromuscular effects over a wide dose range and its interaction with all popular nondepolarizing neuromuscular relaxants, the effects of ketamine 2, 5, and 10 mg/...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Tsai SK,Lee C

    更新日期:1989-01-01 00:00:00

  • Central administration of minocycline and riluzole prevents morphine-induced tolerance in rats.

    abstract:BACKGROUND:Long-term exposure to opiates induces tolerance to the analgesic effect. The neurobiological mechanism of this phenomenon is not completely clear. In this study, we evaluated the effects of central administration of minocycline (a tetracycline derivative) and riluzole (an antiglutamatergic drug) on morphine-...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Habibi-Asl B,Hassanzadeh K,Charkhpour M

    更新日期:2009-09-01 00:00:00

  • Nonhalogenated anesthetic alkanes and perhalogenated nonimmobilizing alkanes inhibit alpha(4)beta(2) neuronal nicotinic acetylcholine receptors.

    abstract:UNLABELLED:The nonhalogenated anesthetic alkanes, cyclopropane and butane, do not enhance gamma-aminobutyric acid-elicited GABAergic currents, suggesting that these agents produce anesthesia via interactions with other molecular targets. Perhalogenated nonimmobilizing alkanes, such as 1,2-dichlorohexafluorocyclobutane ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Raines DE,Claycomb RJ,Forman SA

    更新日期:2002-09-01 00:00:00

  • The peripheral antinociceptive effects of endomorphin-1 and kynurenic acid in the rat inflamed joint model.

    abstract:BACKGROUND:Several data suggest that both opioid and N-methyl-d-aspartate (NMDA) receptors are localized at the peripheral level, and drugs acting on these receptors may produce antinociception after topical administration; however, the antinociceptive effect of endogenous ligands at these receptors is poorly clarified...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Mecs L,Tuboly G,Nagy E,Benedek G,Horvath G

    更新日期:2009-10-01 00:00:00

  • Accidental intraneural injection into the musculocutaneous nerve visualized with ultrasound.

    abstract::Ultrasound has become a widely used tool within the practice of regional anesthesia, offering real-time visualization of the nerves, needle, and local anesthetic during performance of a block. A successful ultrasound-guided axillary block was performed on a healthy adult male undergoing wrist surgery. Postoperative re...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Russon K,Blanco R

    更新日期:2007-11-01 00:00:00

  • Muscle weakness and paresthesia associated with epidural analgesia in a patient with an intrathecal neurofibrolipoma as part of a tethered cord syndrome.

    abstract::We report a case of a 75-yr-old female patient in whom motor deficits and paresthesias occurred after lumbar epidural analgesia. These symptoms were eventually found to be due to a tethered cord syndrome. An epidural catheter was inserted for analgesia after colon surgery. The postoperative course was characterized by...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Jetzek-Zader M,Peterschulte G,Ludwig U,Lipfert P

    更新日期:2004-07-01 00:00:00

  • Anesthetic management of pulmonary lavage in adults.

    abstract::A 6-year experience in the anesthetic management of 34 successful whole-lung lavages on 11 adult patients with pulmonary alveolar proteinosis is described. All patients were radiographically, physiologically, and symptomatically improved after the procedures. The anesthetic protocol for lung lavage includes: (1) unila...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Lippmann M,Mok MS

    更新日期:1977-09-01 00:00:00

  • Macroscopic postmortem findings in 235 surgical intensive care patients with sepsis.

    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


    authors: Torgersen C,Moser P,Luckner G,Mayr V,Jochberger S,Hasibeder WR,Dünser MW

    更新日期:2009-06-01 00:00:00

  • Biotransformation of halothane, enflurane, isoflurane, and desflurane to trifluoroacetylated liver proteins: association between protein acylation and hepatic injury.

    abstract::In susceptible patients, halothane, enflurane, isoflurane, and desflurane can produce severe hepatic injury by an immune response directed against reactive anesthetic metabolites covalently bound to hepatic proteins. The incidence of hepatotoxicity appears to directly correlate with anesthetic metabolism catalyzed by ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Njoku D,Laster MJ,Gong DH,Eger EI 2nd,Reed GF,Martin JL

    更新日期:1997-01-01 00:00:00

  • Thiopental and epinephrine-induced dysrhythmias in dogs anesthetized with enflurane or isoflurane.

    abstract::Epinephrine-induced dysrhythmias were studied in 19 dogs anesthetized with 1.25 MAC enflurane or isoflurane, or the same preceded by thiopental (20 mg/kg). In 11 (group 1) dogs, thiopental reduced the dose of epinephrine required for production of ventricular ectopy, bigeminy and tachycardia with enflurane, and only v...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Atlee JL 3rd,Roberts FL

    更新日期:1986-05-01 00:00:00

  • Preoperative local infiltration with ropivacaine for postoperative pain relief after cholecystectomy.

    abstract::In a randomized, double-blind, placebo-controlled trial, we evaluated the use of preoperative local anesthesia with regard to postoperative pain. Before surgery in 66 patients scheduled for cholecystectomy, the abdominal wall along the proposed line of incision was infiltrated with 70 mL of 0.25% ropivacaine, 70 mL of...

    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


    authors: Johansson B,Glise H,Hallerbäck B,Dalman P,Kristoffersson A

    更新日期:1994-02-01 00:00:00

  • The Cognitive Science of Learning: Concepts and Strategies for the Educator and Learner.

    abstract::Education is the fundamental process used to develop and maintain the professional skills of physicians. Medical students, residents, and fellows are expected to learn considerable amounts of information as they progress toward board certification. Established practitioners must continue to learn in an effort to remai...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审


    authors: Weidman J,Baker K

    更新日期:2015-12-01 00:00:00

  • The direction dependence of thermoregulatory vasoconstriction during isoflurane/epidural anesthesia in humans.

    abstract::We tested the hypothesis that once thermoregulatory vasoconstriction is triggered at a given core temperature during isoflurane anesthesia, redilation starts at a substantially higher core temperature. To avoid direct perception of cutaneous cooling and warming, we used epidural anesthesia and limited our thermal mani...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Ozaki M,Sessler DI,McGuire J,Blanchard D,Schroeder M,Moayeri A

    更新日期:1993-10-01 00:00:00

  • A characterization of motion affecting pulse oximetry in 350 patients.

    abstract::As part of an oximetry research effort in which plethysmographic data were collected from moving patients, a wide variety of patient motion affecting pulse oximetry was observed and characterized by the clinical incidence, type, severity and duration of patient motion. 350 patients were observed for movement in clinic...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Tobin RM,Pologe JA,Batchelder PB

    更新日期:2002-01-01 00:00:00

  • Long-term pain vulnerability after surgery in rats: prevention by nefopam, an analgesic with antihyperalgesic properties.

    abstract:BACKGROUND:Tissue damage associated with surgery often produces peripheral and central sensitization that may outlast the stimuli, leading to exaggerated postoperative pain. Paradoxically, the use of opioid analgesia, which is essential for surgical pain management may induce pain sensitization leading to enhanced post...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Laboureyras E,Chateauraynaud J,Richebé P,Simonnet G

    更新日期:2009-08-01 00:00:00

  • Fenoldopam mesylate and renal function in patients undergoing liver transplantation: a randomized, controlled pilot trial.

    abstract::To test the relative effects on serum creatinine (CRE), blood urea nitrogen (BUN), and urine output of small-dose dopamine and fenoldopam in patients undergoing liver transplantation, we randomized 43 patients to 1 of 2 continuous infusions over 48 h, starting with anesthesia induction: fenoldopam, 0.1 microg . kg(-1)...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Della Rocca G,Pompei L,Costa MG,Coccia C,Scudeller L,Di Marco P,Monaco S,Pietropaoli P

    更新日期:2004-12-01 00:00:00

  • Using skin surface temperature to differentiate between complex regional pain syndrome type 1 patients after a fracture and control patients with various complaints after a fracture.

    abstract:OBJECTIVE:In this study, we assessed the validity of skin surface temperature recordings, based on various calculation methods applied to the thermographic data, to diagnose acute complex regional pain syndrome type 1 (CRPS1) fracture patients. METHODS:Thermographic recordings of the palmar/plantar side and dorsal sid...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,多中心研究


    authors: Niehof SP,Beerthuizen A,Huygen FJ,Zijlstra FJ

    更新日期:2008-01-01 00:00:00

  • Barbiturate-benzodiazepine interactions at the gamma-aminobutyric acidA receptor in rat cerebral cortical synaptoneurosomes.

    abstract::Combinations of benzodiazepines (midazolam and diazepam) with barbiturates (pentobarbital and phenobarbital) exhibit synergistic (supra-additive) hypnotic interactions in rats. Because both benzodiazepines and barbiturates interact with the gamma-aminobutyric acidA (GABAA) receptor complex, we have tested the hypothes...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: DeLorey TM,Kissin I,Brown P,Brown GB

    更新日期:1993-09-01 00:00:00

  • Anatomical landmarks for femoral nerve block: a comparison of four needle insertion sites.

    abstract:UNLABELLED:The site for needle insertion in femoral nerve block varies significantly among various descriptions of the technique. To determine the site with the highest likelihood of needle-femoral nerve contact, femoral nerve block was simulated in a human cadaver model (17 femoral triangles from 9 adult cadavers). Fo...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Vloka JD,Hadzić A,Drobnik L,Ernest A,Reiss W,Thys DM

    更新日期:1999-12-01 00:00:00

  • Fentanyl-air-oxygen anesthesia for ligation of patent ductus arteriosus in preterm infants.

    abstract::In 10 premature infants (1123 +/- 263 g), fentanyl citrate (30 to 50 microgram/kg) was used in conjunction with pancuronium (0.1 mg/kg) as the sole anesthetic for transthoracic ligation of patent ductus arteriosus. Ventilation was controlled with air and oxygen in concentrations sufficient to maintain transcutaneous P...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Robinson S,Gregory GA

    更新日期:1981-05-01 00:00:00

  • Perioperative Diabetes Insipidus Caused by Anesthetic Medications: A Review of the Literature.

    abstract::Diabetes insipidus (DI) is an uncommon perioperative complication that can occur secondary to medications or surgical manipulation and can cause significant hypovolemia and electrolyte abnormalities. We reviewed and evaluated the current literature and identified 24 cases of DI related to medications commonly used in ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Van Decar LM,Reynolds EG,Sharpe EE,Harbell MW,Kosiorek HE,Kraus MB

    更新日期:2021-01-06 00:00:00

  • Epidural ropivacaine anesthesia decreases the bispectral index during the awake phase and sevoflurane general anesthesia.

    abstract::The sedative effects of epidural anesthesia without volatile and IV anesthetics and quantification of the degree of epidural anesthesia-induced sedation have not been investigated. In the current study we evaluated the effects of epidural anesthesia on the bispectral index (BIS) during the awake phase and during gener...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Ishiyama T,Kashimoto S,Oguchi T,Yamaguchi T,Okuyama K,Kumazawa T

    更新日期:2005-03-01 00:00:00

  • Gallamine administered by combined bolus and infusion.

    abstract::A technique combining an intravenous bolus and intravenous infusion regimen of gallamine based on its pharmacokinetics was developed to produce continuous relaxation during surgery. The combination of a bolus dose of gallamine, 2.5 mg/kg, and infusion, 0.8 mg/kg/hr, was tested in 11 patients. In 10 patients, surgery c...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章


    authors: Shanks CA,Funk DI,Avram MJ,Henthorn TK

    更新日期:1982-10-01 00:00:00