Abstract:
:Interscalene brachial plexus anesthesia for shoulder surgery routinely includes sensory anesthesia of the fourth and fifth cervical nerves. The authors reasoned that some degree of diaphragm paralysis should result from interscalene blocks that produce surgical C3-C5 sensory anesthesia. In this investigation, ultrasonography was used to study the incidence of ipsilateral hemidiaphragmatic paresis during routine interscalene block, as it is a practical, sensitive, and low-risk method for diagnosing hemidiaphragmatic function without radiation exposure. Thirteen healthy patients received interscalene blocks using a paresthesia technique with 34-52 mL 1.5% mepivacaine with added epinephrine and bicarbonate. All developed cervical sensory anesthesia. Data were collected before and 2, 5, and 10 min after injection, and, when possible (11 of 13 patients), at hourly intervals after surgery. Changes from normal to paradoxical motion of the ipsilateral hemidiaphragm were seen in all 13 patients during sniff and Mueller maneuvers within 5 min (in 11 of 13 patients at 2 min). Diaphragmatic motion returned to normal in 10 of 11 patients between 3 and 4 h after injection and in the remaining patient by the fifth hour after injection. Diaphragmatic paresis appears to be an inevitable consequence of interscalene brachial plexus block when providing anesthesia sufficient for shoulder surgery.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Urmey WF,Talts KH,Sharrock NEdoi
10.1213/00000539-199104000-00014subject
Has Abstractpub_date
1991-04-01 00:00:00pages
498-503issue
4eissn
0003-2999issn
1526-7598journal_volume
72pub_type
杂志文章abstract::Waste anesthetic gas scavenging technology has not changed appreciably in the past 30 years. Open reservoir systems entrain high volumes of room air and dilute waste gases before emission into the atmosphere. This process requires a large vacuum pump, which is both costly to install and, although efficient, operates c...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31822c9a2c
更新日期:2011-11-01 00:00:00
abstract::If there is a genetic predisposition to excessive bleeding, there should be an association in excessive blood loss between multiple cardiac surgeries. We retrospectively determined in 174 patients the association of excessive bleeding between 2 cardiac surgeries with cardiopulmonary bypass between January 19, 1990 and...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000198563.28246.00
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:The therapeutic use of opioids has been associated with altered cognition and impaired psychomotor function. Several studies have demonstrated the impact of opioid therapy on psychomotor performance and cognition, but there are no data about the effect of long-term treatment with transdermal buprenorphine on...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000281078.65585.1e
更新日期:2007-11-01 00:00:00
abstract::The purpose of this canine study was to examine the cerebral vascular and metabolic effects of adding nitrous oxide to isoflurane from 1.4% expired (1 MAC) up to a concentration giving an isoelectric electroencephalogram (EEG). Cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRO2) were determined us...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199101000-00013
更新日期:1991-01-01 00:00:00
abstract::This consensus statement was commissioned in 2012 by the Board of Directors of the Society for Obstetric Anesthesia and Perinatology to improve maternal resuscitation by providing health care providers critical information (including point-of-care checklists) and operational strategies relevant to maternal cardiac arr...
journal_title:Anesthesia and analgesia
pub_type: 指南,杂志文章,评审
doi:10.1213/ANE.0000000000000171
更新日期:2014-05-01 00:00:00
abstract:UNLABELLED:It is generally accepted that major surgery is associated with severe alterations of the host-defense mechanisms. We investigated the effect of surgical stress on the immune system. Specifically, we studied the relationship between perioperative lipopolysaccharide (LPS) hyporesponsiveness and monocyte human ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200105000-00046
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Hypoxemia, as measured by pulse oximetry (SpO2), is common in postanesthesia care unit (PACU) patients. The temporal distribution of desaturation has managerial implications because treatment may necessitate the presence of an anesthesiologist. METHODS:We retrieved SpO2 values recorded electronically every ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000410
更新日期:2014-12-01 00:00:00
abstract::We studied the feasibility of recording motor evoked responses to transcranial electrical stimulation (tce-MERs) during partial neuromuscular blockade (NMB). In 11 patients, compound muscle action potentials were recorded from the tibialis anterior muscle in response to transcranial electrical stimulation during vario...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199210000-00021
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:Percutaneous cannulation of the femoral vein, in the pediatric age group, can be technically challenging, especially when performed by residents in training. We examined whether the use of real-time ultrasound guidance is superior to a landmark technique for femoral vein catheterization in children undergoin...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3181e9c475
更新日期:2010-09-01 00:00:00
abstract::Roentgenograms of iothalamate meglumine 60% (Conray) injected bilaterally into the intercostal grooves of the ninth or tenth ribs in 30 surgical patients showed extensive spread of the contrast central and peripherally from the site of injection within 30 seconds, with almost complete absorption within 10 minutes 30 s...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1980-11-01 00:00:00
abstract::The routine preoperative evaluation of pediatric patients often includes a history, physical examination, complete blood count, and urinalysis (UA). We retrospectively reviewed the records of 486 elective surgeries in children to determine the role of abnormal preoperative laboratory test results in perioperative mana...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1990-02-01 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::Virchow's triad is traditionally invoked to explain pathophysiologic mechanisms leading to thrombosis, alleging concerted roles for abnormalities in blood composition, vessel wall components, and blood flow in the development of arterial and venous thrombosis. Given the tissue-specific bleeding observed in hemophilia ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0b013e31823a088c
更新日期:2012-02-01 00:00:00
abstract:UNLABELLED:C-fos and Fos expression, frequently used as a neural nociceptive marker, is altered by many drugs. The effects of histamine receptor antagonists on c-fos messenger (m)RNA expression are unknown. We examined the effect of local and systemic administration of pyrilamine (H(1) receptor antagonist) and cimetidi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000068883.63751.f8
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Variations in the butyrylcholinesterase (BCHE) gene can prolong neuromuscular block after the administration of the neuromuscular blocking drugs succinylcholine and mivacurium. The most frequent variations in the BCHE gene are the atypical (A) and Kalow (K) variants. We, therefore, developed a detection appr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000296455.31211.bd
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Intercostal nerve blocks with liposomal bupivacaine are commonly used for thoracic surgery pain management. However, dose scheduling is difficult because the pharmacokinetics of a single-dose intercostal injection of liposomal bupivacaine has never been investigated. The primary aim of this study was to asse...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000005115
更新日期:2020-12-01 00:00:00
abstract:UNLABELLED:Uptake of inhaled anesthetics may be measured as the amount of anesthetic infused to maintain a constant alveolar concentration of anesthetic. This method assumes that the patient absorbs all of the infused anesthetic, and that none is lost to circuit components. Using a standard anesthetic circuit with a 3-...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199805000-00032
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:Transversus abdominis plane (TAP) block and local anesthetic wound infiltration provide analgesia after cesarean delivery. Studies comparing the 2 techniques are scarce, with conflicting results. This double-blind, randomized controlled trial aimed to compare bilateral ultrasound-guided TAP block with single...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000001724
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Sepsis is currently the leading cause of direct maternal death in the United Kingdom. In this study, we aimed to determine frequency, temporal trends, and independent associations for severe sepsis during hospitalization for delivery in the United States. METHODS:Data were obtained from the Nationwide Inpat...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3182a009c3
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Safe and effective alternatives are required in labor when epidural analgesia is not appropriate. We hypothesized that patient-controlled IV remifentanil labor analgesia would not be inferior to patient-controlled epidural labor analgesia. METHODS:This randomized nonblinded controlled noninferiority study i...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3182a7cd1b
更新日期:2014-03-01 00:00:00
abstract::Patients referred to the Pain Clinic at the University of Virginia Medical Center with genuine phantom pain rather than stump pain have been treated by a variety of technics. Simple revision of drug therapy has proved helpful in some instances, as has repeated injection of trigger areas or neuromata, though surgical e...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197711000-00019
更新日期:1977-11-01 00:00:00
abstract:UNLABELLED:The calcium channel blocker nifedipine has analgesic properties that are enhanced by nicotine. Although it is not known how this analgesic state might affect the awareness of anginal pain and impending myocardial infraction, recent studies have shown an increased mortality associated with the use of large do...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199811000-00023
更新日期:1998-11-01 00:00:00
abstract::These experiments investigated the effect of halothane or fentanyl anesthesia on plasma atrial natriuretic polypeptide (ANP) and angiotensin II (AII) concentrations and the response to a 30% blood volume load in rats. Halothane (1.1% and 2.2% inspired) or fentanyl (50 and 200 micrograms/kg) anesthesia alone produced l...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract::To improve operating room workflow, an internal transfer pricing system (ITPS) for anesthesia services was introduced in our hospital in 2001. The basic principle of the ITPS is that the department of anesthesia receives reimbursement only for the surgically controlled time, not for anesthesia-controlled time (ACT). A...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000154187.47998.60
更新日期:2005-07-01 00:00:00
abstract::The purpose of the present study was to assess patients' anxiety level and information requirement in the preoperative phase. During routine preoperative screening, 320 patients were asked to assess their anxiety and information requirement on a six-item questionnaire, the Amsterdam Preoperative Anxiety and Informatio...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199603000-00002
更新日期:1996-03-01 00:00:00
abstract::Pregnancy is associated with an increased sensitivity to both general and local anesthetics. The exact reason is uncertain, but increased concentrations of progesterone and endogenous opiates have been implicated. Therefore, we tested the ability of intrathecally administered progesterone to produce analgesia and to p...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199304000-00010
更新日期:1993-04-01 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:BACKGROUND:Insufficient fixation of an epidural catheter may result in migration of the catheter and eventual catheter failure. However, the best fixation method remains to be established. Aron Alpha A (2-ethyl cyanoacrylate) adhesive is approved for clinical use and can be used for surgical adhesion to both skin and b...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000003326
更新日期:2019-07-01 00:00:00
abstract::The effect of enflurane anesthesia on bronchomotor tone was studied in 15 dogs, using isolated tracheal segments in situ. In six animals, the changes of tracheal tension in response to changing enflurane concentration were continuously measured while keeping tidal volume, respiratory frequency, and end-tidal PCO2 cons...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1989-07-01 00:00:00
abstract::Propofol is associated with a low incidence of postoperative nausea and vomiting. In a prospective, randomized, double-blind, placebo-controlled study, we investigated the possible direct antiemetic properties of a subhypnotic dose of propofol. Fifty-two ASA physical status I or II patients, aged 15-60 yr with nausea ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199204000-00013
更新日期:1992-04-01 00:00:00