Abstract:
:Women in labor who receive epidural analgesia are more likely to experience hyperthermia and overt clinical fever. The gradual development of modest hyperthermia observed in laboring women with epidural analgesia is not seen in those electing other forms of analgesia or unmedicated labor. Clinical fever is also far more likely in women laboring with epidural analgesia. It is possible that the observed slow increase in mean temperature is an artifact of averaging the temperature curves of a small group of women who eventually develop fever with a larger group who remain afebrile throughout labor. Selection bias confounds the association between epidural analgesia and fever, because women at risk for fever-due to longer duration of ruptured membranes, longer labor, more frequent cervical examinations, and other interventions-are also more likely to select epidural analgesia. However, even randomized trials have confirmed a higher incidence of fever in epidural-exposed women, suggesting a causal relationship. The mechanisms of epidural-associated fever remain incompletely understood. Altered thermoregulation and an antipyretic effect of opioids given to women without epidural analgesia may explain part of the phenomenon, but the most likely etiology is inflammation, most commonly in the placenta and membranes (chorioamnionitis). The consequences of maternal fever are diverse. Obstetricians are more likely to intervene surgically in laboring women with fever, and neonatologists are more likely to evaluate neonates of febrile women for sepsis. More ominously, maternal inflammatory fever is associated with neonatal brain injury, manifest as cerebral palsy, encephalopathy, and learning deficits in later childhood. At present, there are no safe and effective means to inhibit epidural-associated fever. Future research should define the etiology of this fever and search for safe and effective interventions to prevent it and to inhibit its potential adverse effects on the neonatal brain.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Segal Sdoi
10.1213/ANE.0b013e3181f713d4subject
Has Abstractpub_date
2010-12-01 00:00:00pages
1467-75issue
6eissn
0003-2999issn
1526-7598pii
ANE.0b013e3181f713d4journal_volume
111pub_type
杂志文章,评审abstract::Bolus doses of propofol in patients for cardioversion often produce hypotension and apnea. Etomidate provides cardiovascular stability in these patients, but myoclonus may interfere with electrocardiographic interpretation. This study was designed to demonstrate whether propofol, when given as a low-dose infusion, can...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199310000-00006
更新日期:1993-10-01 00:00:00
abstract::Drug dosages, length of stay (LOS), and incidence of psychological side effects of fentanyl and nalbuphine were compared in a randomized, double-blind study using unpremedicated female day-surgery patients undergoing diagnostic laparoscopy. Patients received either fentanyl 1.5 micrograms/kg (F group; n = 142), low-do...
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:1987-12-01 00:00:00
abstract:BACKGROUND:Obstructive sleep apnea (OSA) is a commonly encountered comorbid condition in patients undergoing surgery and is associated with a greater risk of postoperative adverse events. Our objective in this review was to investigate the effectiveness of continuous positive airway pressure (CPAP) in reducing the risk...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,meta分析,评审
doi:10.1213/ANE.0000000000000634
更新日期:2015-05-01 00:00:00
abstract::We studied 60 children undergoing elective surgery to evaluate the effect of interactions between vecuronium and isoflurane or halothane on the potency and duration of neuromuscular blockade, as measured by electromyography. Vecuronium was first administered by a logarithm-based cumulative method (14, 22, 35, 56, 89 m...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199003000-00003
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:Isoflurane activates vascular adenosine triphosphate sensitive potassium (K(ATP)) channels, and may induce vasodilation. In the present study, we investigated whether hyperglycemia modifies isoflurane activation of vascular K(ATP) channel. METHODS:We used a cell-attached patch-clamp configuration to test th...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e318163fd5b
更新日期:2008-03-01 00:00:00
abstract::The effect of ketamine on intraocular pressure (IOP) was studied in 10 children. Control IOP values were determined prior to induction of anesthesia, following premedication with atropine alone or in combination with pentobarbital and meperidine. After the IM injection of 8 mg/kg of ketamine, the IOP was determined at...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197611000-00005
更新日期:1976-11-01 00:00:00
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
doi:
更新日期:1982-10-01 00:00:00
abstract:UNLABELLED:N-methyl-D-aspartate receptor antagonism probably accounts for most of ketamine's anesthetic effects; its analgesic properties are mediated partly via N-methyl-D-aspartate and partly via opioid receptors. We assessed the involvement of the mu-opioid receptor in S(+) ketamine-induced respiratory depression an...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200112000-00031
更新日期:2001-12-01 00:00:00
abstract:UNLABELLED:Genitofemoral neuritis, which occurs when the neurolytic solution spreads into the psoas muscle, is the most common complication after neurolytic lumbar sympathetic block. We developed a transdiscal approach for neurolytic lumbar sympathetic block to reduce the danger of genitofemoral neuritis by making a sy...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199712000-00024
更新日期:1997-12-01 00:00:00
abstract::Elevated serum ammonia may play a role in central nervous system derangement after transurethral resection of the prostate. Glycine used as a surgical irrigant for prostate resection produces ammonia as a by-product after liver and renal metabolism. The presence of liver dysfunction often leads to an inability to remo...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:Hyperkalemia poses serious hazards to patients undergoing orthotopic liver transplantation (OLT), and its predictors have not been thoroughly examined. METHODS:We retrospectively studied 1124 consecutive adult patients who underwent OLT. Hyperkalemia was defined as serum K+ > or =5.5 mmol/L. A total of 47 r...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000271914.54261.17
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Paravertebral analgesia is useful for breast surgery. Patient controlled analgesia by IV or epidural routes is well established for delivering postoperative analgesia. Our objective was to apply patient control to paravertebral analgesia and evaluate the efficacy and tolerability of two distinct dosing regim...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ane.0b013e31817b7f01
更新日期:2008-08-01 00:00:00
abstract::Although clonidine has been shown to increase the duration of local anesthetic action and prolong postoperative analgesia when included in single-injection nerve blocks, the only controlled investigation of the efficacy of this practice to improve analgesia for continuous perineural local anesthetic infusion failed to...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.ASN.0000145571.41015.D5
更新日期:2005-04-01 00:00:00
abstract::Sevoflurane reduces autonomic neural control, which plays a significant role in cerebral autoregulation. Therefore, we hypothesized that sevoflurane influences cerebral autoregulation. We investigated the effects of sevoflurane on dynamic cerebral blood flow (CBF) autoregulation by using spectral and transfer function...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000189056.96273.48
更新日期:2006-02-01 00:00:00
abstract::Preoperative anxiety may increase gastric fluid acidity and volume. To pursue this possibility we evaluated the relationship between peroral premedication, preoperative anxiety, and gastric content in 246 consecutive patients presenting for elective gynecologic surgery. All patients fasted overnight and received eithe...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199207000-00017
更新日期:1992-07-01 00:00:00
abstract::Nicardipine is used in the treatment of premature labor. There are no previous reports in the anesthesia literature of serious side effects associated with this drug. We report a case of pulmonary edema induced by nicardipine therapy for tocolysis in a pregnant 27-yr-old patient admitted to our hospital for preterm la...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000135182.79774.A0
更新日期:2004-09-01 00:00:00
abstract::A new single injection procedure, the fascia iliaca compartment block, is described for blocking the femoral, lateral cutaneous, and obturator nerves. The technique consists of injecting a local anesthetic immediately behind the fascia iliaca at the union of the lateral with the two medial thirds of the inguinal ligam...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1989-12-01 00:00:00
abstract::Atelectasis is common after cardiac surgery and may result in impaired gas exchange. Continuous positive airway pressure (CPAP) is often used to prevent or treat postoperative atelectasis. We hypothesized that noninvasive pressure support ventilation (NIPSV) by increasing tidal volume could improve the evolution of at...
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.0000130621.11024.97
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:District-level hospitals (DLHs) are the main providers of surgical services for rural populations in Sub-Saharan Africa (SSA). Skilled teams are essential for surgical care, and gaps in anesthesia impact negatively on surgical capacity and outcomes. This study, from a baseline of a project scaling-up access ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000004363
更新日期:2020-04-01 00:00:00
abstract::The intracranial and systemic hemodynamic effects of sufentanil (20 micrograms/kg) were studied in 10 mongrel dogs. Baseline anesthesia was maintained with 0.7% end-tidal isoflurane and 50% nitrous oxide in oxygen. Catheters were inserted for blood pressure measurement, arterial and sagittal sinus blood sampling, radi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199102000-00006
更新日期:1991-02-01 00:00:00
abstract::Anesthesia information systems (AIS) record data from patient monitors and create a detailed electronic anesthesia record. Because the anesthesia record is a primary piece of evidence used in court during a malpractice proceeding, the ability to create an anesthesia record has fostered considerable debate concerning t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000130259.52838.3B
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:With health care practice consolidation, the increasing geographic scope of health care systems, and the advancement of mobile telecommunications, there is increasing interest in telemedicine-based health care consultations. Anesthesiology has had experience with telemedicine consultation for preoperative ev...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000005208
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Signal transduction cascade of anesthetic-induced preconditioning has been extensively studied, yet many aspects of it remain unsolved. Here, we investigated the roles of reactive oxygen species (ROS) and mitochondrial uncoupling in cardiomyocyte preconditioning by two modern volatile anesthetics: desflurane...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181a93ad9
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Improving perioperative efficiency and throughput has become increasingly important in the modern practice of anesthesiology. Fast-track surgery represents a multidisciplinary approach to improving perioperative efficiency by facilitating recovery after both minor (i.e., outpatient) and major (inpatient) sur...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/01.ane.0000263034.96885.e1
更新日期:2007-06-01 00:00:00
abstract::A series of 50 combat-injured patients given crash intubation for rapid induction of anesthesia is presented. The technic consisted of injection of 3 mg of d-tubocurarine and 0.4 mg of atropine IV, preoxygenation by face mask for 3 minutes, and then injection of sodium thiopental or ketamine, followed immediately by 6...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract:BACKGROUND:Risk of intraoperative hypothermia is relatively high in middle-aged and elderly patients undergoing curative resection of esophageal cancer, which may cause myocardial ischemia during the early postoperative period. The objective of this study was to compare aggressive or standard body temperature managemen...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000004022
更新日期:2019-08-01 00:00:00
abstract::Ocular microtremor (OMT) is a fine physiologic tremor of the eye related to neuronal activity in the reticular formation of the brainstem. The frequency of OMT is suppressed by propofol and sevoflurane and predicts the response to command at emergence from anesthesia. Previous studies have relied on post hoc computer ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究
doi:10.1213/01.ANE.0000133145.98702.C0
更新日期:2004-09-01 00:00:00
abstract::To compare the arterial and venous concentration differences of propofol, six healthy adult patients received a propofol infusion by the Bristol three-stage manual stepdown technique. Both the mean arterial and venous concentrations of propofol remained relatively stable during the 40-min infusion. Simultaneous blood ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199412000-00021
更新日期:1994-12-01 00:00:00
abstract:UNLABELLED:Dichloroacetate (DCA) stimulates pyruvate dehydrogenase (PDH), accelerating recovery of the postischemic heart. Because DCA also stimulates hepatic PDH, it may facilitate graft recovery during liver transplantation (OLT). Hepatic removal and replacement during OLT produce major changes in O2 consumption (VO2...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199710000-00007
更新日期:1997-10-01 00:00:00
abstract:UNLABELLED:Postoperative pain management after cardiac surgery has been mainly based on parenteral opioids. However, because opioids have numerous side effects, coadministration of non-opioid analgesics has been introduced as a method of reducing opioid dose. In this prospective, randomized, double-blinded study, we ev...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200210000-00005
更新日期:2002-10-01 00:00:00