Abstract：
BACKGROUND:Lipid infusion reverses systemic local anesthetic toxicity. The acceptable upper limit for lipid administration is unknown and has direct bearing on clinical management. We hypothesize that high volumes of lipid could have undesirable effects and sought to identify the dose required to kill 50% of the animals (LD(50)) of large volume lipid administration. METHODS:Intravenous lines and electrocardiogram electrodes were placed in anesthetized, male Sprague-Dawley rats. Twenty percent lipid emulsion (20, 40, 60, or 80 mL/kg) or saline (60 or 80 mL/kg), were administered over 30 mins; lipid dosing was assigned by the Dixon "up-and-down" method. Rats were recovered and observed for 48 hrs then euthanized for histologic analysis of major organs. Three additional rats were administered 60 mL/kg lipid emulsion and euthanized at 1, 4, and 24 hrs to identify progression of organ damage. RESULTS:The maximum likelihood estimate for LD(50) was 67.72 (SE, 10.69) mL/kg. Triglycerides were elevated immediately after infusion but returned to baseline by 48 hrs when laboratory abnormalities included elevated amylase, aspartate aminotransferase, and serum urea nitrogen for all lipid doses. Histologic diagnosis of myocardium, brain, pancreas, and kidneys was normal at all doses. Microscopic abnormalities in lung and liver were observed at 60 and 80 mL/kg; histopathology in the lung and liver was worse at 1 hr than at 4 and 24 hrs. CONCLUSIONS:The LD(50) of rapid, high volume lipid infusion is an order of magnitude greater than doses typically used for lipid rescue in humans and supports the safety of lipid infusion at currently recommended doses for toxin-induced cardiac arrest. Lung and liver histopathology was observed at the highest infused volumes.
journal_name
Reg Anesth Pain Medjournal_title
Regional anesthesia and pain medicineauthors
Hiller DB,Di Gregorio G,Kelly K,Ripper R,Edelman L,Boumendjel R,Drasner K,Weinberg GLdoi
10.1097/aap.0b013e3181c6f5aasubject
Has Abstractpub_date
2010-03-01 00:00:00pages
140-4issue
2eissn
1098-7339issn
1532-8651journal_volume
35pub_type
杂志文章abstract：:The development of chronic pain is a complex mechanism that is still not fully understood. Multiple somatic and visceral afferent pain signals, when experienced over time, cause a strengthening of certain neural circuitry through peripheral and central sensitization, resulting in the physical and emotional perceptual ...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章,评审
doi：10.1136/rapm-2020-101273
更新日期：2020-07-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Demand is growing for objective assessment of manual skills and competencies of invasive procedures. The aim of this study was to validate an objective tool for assessing residents' skill in performing epidural anesthesia by use of a global assessment scale and a 3-scale, 27-stage checklist. W...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
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journal_title：Regional anesthesia and pain medicine
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journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章,随机对照试验
doi：10.1097/AAP.0b013e31828b25bc
更新日期：2013-05-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Paresthesia occasionally occurs during dural puncture or injection of local anesthetic for spinal anesthesia. Although the incidence of neurologic complications after spinal anesthesia is extremely low, the significance of paresthesia is unknown. The influence of known lumbar spine pathology o...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1016/s1098-7339(98)90081-5
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journal_title：Regional anesthesia and pain medicine
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doi：10.1053/rapm.2002.29244
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journal_title：Regional anesthesia and pain medicine
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doi：10.1136/rapm-2018-100036
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abstract：BACKGROUND:Robotic and hand-assisted laparoscopic nephrectomies are often associated with moderate to severe postoperative pain. The aim of the current study was to investigate the analgesic efficacy of the transmuscular quadratus lumborum (TQL) block for patients undergoing robotic or hand-assisted laparoscopic nephre...
journal_title：Regional anesthesia and pain medicine
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doi：10.1136/rapm-2020-101745
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journal_title：Regional anesthesia and pain medicine
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doi：10.1016/j.rapm.2008.04.007
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journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1016/AAP.0b013e3181933a53
更新日期：2009-01-01 00:00:00
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journal_title：Regional anesthesia and pain medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s1098-7339(98)90055-4
更新日期：1998-05-01 00:00:00
abstract：:This article provides a brief overview of earlier work of our group on the peripheral signaling of pain, summarizes more recent studies on the role of opioids in chronic neuropathic pain, and speculates on the future of gene-based therapies as novel strategies to enhance the peripheral modulation of pain. Neurophysiol...
journal_title：Regional anesthesia and pain medicine
pub_type：
doi：10.1097/AAP.0b013e31823b145f
更新日期：2012-03-01 00:00:00
abstract：BACKGROUND:Ivor-Lewis esophagectomy is associated with significant postoperative analgesic requirements and perioperative complications. A dual-epidural technique may improve perioperative outcomes compared with single thoracic epidural analgesia. METHODS:This study identified all cases of Ivor-Lewis esophagectomy ove...
journal_title：Regional anesthesia and pain medicine
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doi：10.1097/AAP.0b013e318276a714
更新日期：2013-01-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Hematoma is typically cited as one mechanism of nerve injury following axillary block. However, documented cases of this are lacking. METHODS:A healthy 38-year-old man was scheduled for surgical removal of a tumor of the hand. A transarterial axillary block was performed with a 22-gauge short...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：
更新日期：1999-05-01 00:00:00
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journal_title：Regional anesthesia and pain medicine
pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：2001-09-01 00:00:00
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journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1136/rapm-2019-101139
更新日期：2020-08-01 00:00:00
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journal_title：Regional anesthesia and pain medicine
pub_type： 传,历史文章,杂志文章
doi：10.1016/j.rapm.2008.04.011
更新日期：2008-09-01 00:00:00
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journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1016/s1098-7339(03)00182-2
更新日期：2003-07-01 00:00:00
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journal_title：Regional anesthesia and pain medicine
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journal_title：Regional anesthesia and pain medicine
pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：1998-01-01 00:00:00
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journal_title：Regional anesthesia and pain medicine
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doi：10.1136/rapm-2019-100806
更新日期：2019-11-02 00:00:00
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journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1136/rapm-2019-100904
更新日期：2019-12-10 00:00:00
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journal_title：Regional anesthesia and pain medicine
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doi：10.1136/rapm-2018-000005
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journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章,多中心研究
doi：10.1016/j.rapm.2008.01.016
更新日期：2008-09-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Peripheral nerve blocks can be successfully utilized in infants for neurosurgical procedures. Our objective was utilizing a series of peripheral nerve blocks for a neurosurgical procedure in a very low-birth-weight neonate. CASE REPORT:We report the use of supraorbital, great auricular, and g...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1016/j.rapm.2003.09.008
更新日期：2004-01-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Gabapentin is an anticonvulsant that has been shown to be effective in the treatment of neuropathic and inflammatory pain in animal and human studies. The analgesic effect of its perioperative use has not been fully elucidated. METHODS:This systematic review (meta-analysis) included 12 random...
journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章,meta分析
doi：10.1016/j.rapm.2006.01.005
更新日期：2006-05-01 00:00:00
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journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
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更新日期：2015-05-01 00:00:00
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journal_title：Regional anesthesia and pain medicine
pub_type： 杂志文章
doi：10.1016/s1098-7339(99)90105-0
更新日期：1999-07-01 00:00:00
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journal_title：Regional anesthesia and pain medicine
pub_type： 临床试验,杂志文章,随机对照试验
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journal_title：Regional anesthesia and pain medicine
pub_type： 临床试验,杂志文章,随机对照试验
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