Abstract:
:In this review, we summarize the clinical implications of residual neuromuscular block. Data suggest that residual neuromuscular block is a common complication in the postanesthesia care unit, with approximately 40% of patients exhibiting a train-of-four ratio <0.9. Volunteer studies have demonstrated that small degrees of residual paralysis (train-of-four ratios 0.7-0.9) are associated with impaired pharyngeal function and increased risk of aspiration, weakness of upper airway muscles and airway obstruction, attenuation of the hypoxic ventilatory response (approximately 30%), and unpleasant symptoms of muscle weakness. Clinical studies have also identified adverse postoperative events associated with intraoperative neuromuscular management. Large databased investigations have identified intraoperative use of muscle relaxants and residual neuromuscular block as important risk factors in anesthetic-related morbidity and mortality. Furthermore, observational and randomized clinical trials have demonstrated that incomplete neuromuscular recovery during the early postoperative period may result in acute respiratory events (hypoxemia and airway obstruction), unpleasant symptoms of muscle weakness, longer postanesthesia care unit stays, delays in tracheal extubation, and an increased risk of postoperative pulmonary complications. These recent data suggest that residual neuromuscular block is an important patient safety issue and that neuromuscular management affects postoperative outcomes.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Murphy GS,Brull SJdoi
10.1213/ANE.0b013e3181da832dsubject
Has Abstractpub_date
2010-07-01 00:00:00pages
120-8issue
1eissn
0003-2999issn
1526-7598pii
ANE.0b013e3181da832djournal_volume
111pub_type
杂志文章,评审abstract::Total knee arthroplasty (TKA) may result in severe pain, and single-injection femoral nerve blocks (SFNB) have been demonstrated to have a limited duration of analgesia. Continuous femoral nerve blocks (CFNB) can prolong the analgesic duration of SFNB. We prospectively randomized 36 patients undergoing TKA to CFNB ver...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ane.0000198675.20279.81
更新日期:2006-04-01 00:00:00
abstract::Hypertonic saline improves organ perfusion and animal survival during hemorrhagic shock because it expands plasma volume and increases tissue oxygenation. Because both decreased and increased myocardial performance have been reported with hypertonic saline, the effects of hyperosmolarity and the mechanism accounting f...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199510000-00021
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:Hyperventilation has been an integral, but poorly validated part of neuroanesthetic practice. We conducted a two-period, crossover, randomized trial to evaluate surgeon-assessed brain bulk and measured intracranial pressure (ICP) in patients undergoing craniotomy for removal of supratentorial brain tumors du...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1213/01.ane.0000295804.41688.8a
更新日期:2008-02-01 00:00:00
abstract:UNLABELLED:Fentanyl reduces the amount of propofol necessary to prevent responses to surgical stimuli. However, opioids have relatively little effect on consciousness. We, therefore, tested the hypothesis that fentanyl minimally alters the effect-site concentration of propofol associated with awakening. Fifty women hav...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/01.ane.0000062772.28479.2b
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Obesity causes multiorgan dysfunction, specifically metabolic abnormalities in the liver. Obese patients are opioid-sensitive and have high rates of respiratory complications after surgery. Obesity also has been shown to cause resistance to leptin, an adipose-derived hormone that is key in regulating hunger,...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001578
更新日期:2016-12-01 00:00:00
abstract::A quest for a systems-level neuroscientific basis of anesthetic-induced loss and return of consciousness has been in the forefront of research for the past 2 decades. Recent advances toward the discovery of underlying mechanisms have been achieved using experimental electrophysiology, multichannel electroencephalograp...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000001353
更新日期:2016-11-01 00:00:00
abstract:UNLABELLED:Pain management has become a notable feature of public health policy and mass media communication in France over the past few years. To assess the evolution of the knowledge and attitudes of the French population with respect to pain management and morphine use, telephone surveys using similar questionnaires...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199909000-00023
更新日期:1999-09-01 00:00:00
abstract::We studied whether N-terminal pro brain natriuretic peptide (NT-pro BNP) measured at intensive care unit admission is an independent predictor of mortality in critically ill patients. We conducted a prospective observational cohort study enrolling 78 patients with APACHE II scores more than 12. Serum NT-pro BNP and ca...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000217202.55909.5d
更新日期:2006-06-01 00:00:00
abstract::In this multicenter, randomized, controlled trial, we sought to determine whether patient-controlled epidural analgesia (PCEA) for labor affected the incidence of cesarean delivery when compared with patient-controlled IV opioid analgesia (PCIA). Healthy, term nulliparous patients in 4 Canadian institutions were rando...
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:10.1213/01.ANE.0000136850.08972.07
更新日期:2004-11-01 00:00:00
abstract::Asymptomatic anemia in healthy patients undergoing low risk surgery is rare. In this retrospective study, we examined the records of 9584 ASA class I-II patients scheduled for elective low risk surgery who had a preoperative hemoglobin (hgb) test for the presence of anemia. Hgb <9 g/dL was detected in 75 patients (0.8...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000180836.02142.E6
更新日期:2005-11-01 00:00:00
abstract::The International Standards for a Safe Practice of Anesthesia were developed on behalf of the World Federation of Societies of Anaesthesiologists (WFSA), a nonprofit organization representing anesthesiologists in 150 countries, and the World Health Organization (WHO). The recommendations have been approved by WHO and ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000002927
更新日期:2018-06-01 00:00:00
abstract::The influence of preoxygenation in the supine (n = 10) versus the 45 degrees head-up (n = 10) position on the duration of apnea leading to a decrease in arterial oxygen saturation to 95%, as monitored by pulse oximetry, was investigated in 20 women undergoing elective cesarean section at term of pregnancy. The results...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199211000-00018
更新日期:1992-11-01 00:00:00
abstract:IMPLICATIONS:Carney's complex is characterized by cardiac myxomas, adrenocortical disease, growth hormone-secreting adenomas, and other types of tumors. Its prevalence and incidence are unknown. The anesthesiologist must examine the patient or order tests to exclude cardiac tumors, signs of excess cortisol secretion, a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200210000-00015
更新日期:2002-10-01 00:00:00
abstract::Regional anesthesia employing the spinal, epidural, or caudal approach was used to anesthetize 200 children, varying in age from 17 days to 15 years. Lidocaine in concentrations varying according to age was used. Ketamine (1 to 2 mg./kg.) was given in the majority of cases to ensure a quiet patient prior to block. No ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197505000-00034
更新日期:1975-05-01 00:00:00
abstract:UNLABELLED:The dose-response curve for the effect of volatile anesthetics on the somatosensory evoked potential (SEP) is well described, but for propofol, the large dose segment of the curve is undefined. We describe the effect of increasing plasma concentrations of propofol on cortical SEPs in 18 rats. After surgical ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000090318.16879.a8
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:The clinical utility of focused transthoracic echocardiography (TTE) is increasingly recognized in perioperative medicine. However its use is limited among anesthesiologists because of a lack of training. The most efficient training methods have not been determined. We hypothesized that simulation-based TTE ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e318265408f
更新日期:2012-11-01 00:00:00
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
doi:10.1213/01.ANE.0000152616.57107.F6
更新日期:2005-06-01 00:00:00
abstract:UNLABELLED:The effect of opioid administration on the bispectral index (BIS) during general anesthesia is controversial. Several investigators have reported BIS to be insensitive to opioid addition, whereas others have found a hypnotic response. We designed this study to examine the effect of remifentanil on BIS during...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200206000-00028
更新日期:2002-06-01 00:00:00
abstract::Hemodynamic responses to physostigmine were evaluated in eight patients with coma due to overdose with mainly anticholinergic drugs (AC) and in five patients with coma due to overdose with nonanticholinergic drugs (NAC). After correction of hypovolemia, but before administration of physostigmine, AC patients had signi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1983-10-01 00:00:00
abstract::Activity of methionine synthetase was measured in liver biopsies of seven patients who had received 50% to 70% nitrous oxide supplemented by a combination of a narcotic and/or barbiturate with or without a volatile anesthetic, and from seven patients who were anesthetized without nitrous oxide (control group). Methion...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1982-02-01 00:00:00
abstract::Early tracheal extubation has been safely performed after large operative procedures, questioning the need for routine postoperative ventilation. Because immediate postoperative tracheal extubation of liver transplantation patients has not been previously reported, we performed preliminary studies at two institutions ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199702000-00003
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:Lung-protective ventilation (LPV) has been demonstrated to improve clinical outcomes in surgical patients. There are very limited data on the current use of LPV for patients undergoing 1-lung ventilation (1LV) despite evidence that 1LV may be a particularly important setting for its use. In this multicenter ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究
doi:10.1213/ANE.0000000000002642
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Transporting patients under anesthesia care incurs numerous potential risks, especially for those with critical illness. The purpose of this study is to identify and report all pediatric anesthesia transport-associated adverse events from a preexisting database of perioperative adverse events. METHODS:An ex...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000004433
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Pro- and anti-inflammatory cytokines (adipokines) associated with adipose tissue can modulate inflammatory processes and lead to systemic inflammatory conditions such as metabolic syndrome. In the present pilot study, we investigated 3 major adipokines (leptin, adiponectin, and resistin) and 2 nonspecific pr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000003363
更新日期:2019-03-01 00:00:00
abstract::A new mode of pulmonary ventilation called intratracheal pulmonary ventilation (ITPV) was studied. Briefly, a continuous flow of air/oxygen is introduced through a small catheter, the tip of which is positioned at the carina, with a diffuser mounted at its distal end. A timed expiration valve, when closed, provides fo...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199403000-00006
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:The possibility that μ opioid agonists can influence cancer recurrence is a subject of recent interest. Epidemiologic studies suggested that there were differences in cancer recurrence in breast and prostate cancer contingent on anesthetic regimens. In this study, we identify a possible mechanism for these e...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31820568af
更新日期:2011-03-01 00:00:00
abstract::The existence of a dose-response relation between nitrous oxide concentration and regional dysfunction in compromised myocardium, and whether or not halothane-induced myocardial depression alleviated this regional dysfunction was examined. Nitrous oxide was administered to eight dogs with experimentally induced left a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::Saphenous vein rings mounted in organ chambers containing Krebs-Ringer solution were used to determine if the venodilator effects of morphine, nalbuphine, and butorphanol are the result of interference with adrenergic neurotransmission or are caused by direct depressant actions on venous smooth muscle cells. Morphine ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::The mechanisms of succinylcholine-induced cardiac effects have not been fully elucidated. Accordingly, we studied the effects of succinylcholine on atrial rate and contractile force in the isolated canine atrium perfused with donor blood. The sinus node artery was perfused with heparinized blood from the common caroti...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199212000-00019
更新日期:1992-12-01 00:00:00
abstract:UNLABELLED:We studied the in vitro effects of sevoflurane, isoflurane, and propofol anesthesia on platelet function. Thirty patients undergoing minor surgical procedures were divided into three groups (n = 10 each). Induction of anesthesia was achieved by using 5 mg/kg thiopental i.v., and 0.1 mg/kg vecuronium i.v. was...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199902000-00039
更新日期:1999-02-01 00:00:00