Abstract:
BACKGROUND:Use of high-dose inhalational anesthesia during open fetal surgery may induce maternal-fetal hemodynamic instability and fetal myocardial depression. The authors' preliminary human retrospective study demonstrated less fetal bradycardia and left ventricular systolic dysfunction with lower dose desflurane supplemented with propofol and remifentanil IV anesthesia (SIVA). In this animal study, the authors compare maternal-fetal effects of high-dose desflurane anesthesia (HD-DES) and SIVA. METHODS:Of 26 instrumented midgestational ewes, data from 11 animals exposed to both SIVA and HD-DES in random sequences and six animals exposed to HD-DES while maternal normotension was maintained were analyzed. Maternal electroencephalography was used to guide comparable depths of anesthesia in both techniques. Hemodynamic parameters, blood gas, and fetal cardiac function from echocardiography were recorded. RESULTS:Compared with SIVA, HD-DES resulted in significant maternal hypotension (mean arterial pressure difference, 19.53 mmHg; 95% CI, 17.6-21.4; P < 0.0001), fetal acidosis (pH 7.11 vs. 7.24 at 150 min, P < 0.001), and decreased uterine blood flow. In the HD-DES group with maternal normotension, uterine blood flow still declined and fetal acidosis persisted, with no statistically significant difference from the group exposed to HD-DES that had maternal hypotension. There was no statistically significant difference in fetal cardiac function. CONCLUSION:In sheep, SIVA affects maternal hemodynamics less and provides better fetal acid/base status than high-dose desflurane. Fetal echocardiography did not reflect myocardial dysfunction in this model.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Ngamprasertwong P,Michelfelder EC,Arbabi S,Choi YS,Statile C,Ding L,Boat A,Eghtesady P,Holland K,Sadhasivam Sdoi
10.1097/ALN.0b013e318283c954subject
Has Abstractpub_date
2013-04-01 00:00:00pages
796-808issue
4eissn
0003-3022issn
1528-1175journal_volume
118pub_type
杂志文章相关文献
ANESTHESIOLOGY文献大全abstract::In view of evidence suggesting possible participation of cobalamin in cyanide metabolism, the effects of sodium nitroprusside (SNP) infusion on blood cyanide and plasma thiocyanate levels and serum vitamin B12 levels were examined in ten patients undergoing major orthopedic procedures. Whole blood cyanide concentratio...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198104000-00009
更新日期:1981-04-01 00:00:00
abstract:BACKGROUND:The authors hypothesized that low tidal volume (VT) would minimize ventilator-induced lung injury regardless of the degree of mechanical power. The authors investigated the impact of power, obtained by different combinations of VT and respiratory rate (RR), on ventilator-induced lung injury in experimental m...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002143
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Cerebral embolization is a primary cause of cardiac surgical neurologic morbidity. During cardiopulmonary bypass (CPB), there are well-defined periods of embolic risk. In theory, cerebral embolization might be reduced by an increase in pump flow during these periods. The purpose of this study was to determin...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199911000-00031
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Diaphragm and psoas are affected during sepsis in animal models. Whether diaphragm or limb muscle is preferentially affected during sepsis in the critically ill remains unclear. METHODS:Retrospective secondary analysis study including 40 patients, comparing control (n = 17) and critically ill patients, with...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000201
更新日期:2014-05-01 00:00:00
abstract::To determine whether neuronal firing is affected by anesthetics, the behavior of neurons in the mesencephalic reticular formation in response to repetitive somatosensory stimulation at 2/sec was studied during wakefulness and during nitrous oxide, halothane, and thiopental anesthesia in the cat. With clinical doses of...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197710000-00005
更新日期:1977-10-01 00:00:00
abstract:BACKGROUND:Cerebral injury is among the most common and disabling complications of open heart surgery. Attempts to provide neuroprotection have yielded conflicting results. We assessed the potential of propofol-induced burst suppression during open heart surgery to provide cerebral protection as determined by postopera...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000542-199905000-00006
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:Elimination of daily-routine chest radiographs (CXRs) may influence chest computed tomography (CT) and ultrasound practice in critically ill patients. METHODS:This was a retrospective cohort study including all patients admitted to a university-affiliated intensive care unit during two consecutive periods o...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/01.anes.0000296069.00566.16
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Although the use of an anesthesiology "airway" rotation to train the nonanesthesiologist is commonly employed, little data exist on the utility, clinical exposure, and outcomes of these programs. METHODS:A prospectively collected observational dataset of airway procedures completed by trainees in a 4-week, ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000064
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Buprenorphine, a partial μ-opioid receptor agonist and κ-opioid receptor antagonist, is an effective analgesic. The effects of buprenorphine on sleep have not been well characterized. This study tested the hypothesis that an antinociceptive dose of buprenorphine decreases sleep and decreases adenosine concen...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e31822e9f85
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Postoperative nausea and vomiting continue to be a significant problem for pediatric ambulatory surgery patients. Although ondansetron has been demonstrated to be effective in the prophylactic treatment of postoperative nausea and vomiting (surrogate end point) no one has demonstrated a benefit of antiemetic...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199511000-00007
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:Volatile anesthetics inhibit presynaptic voltage-gated sodium channels to reduce neurotransmitter release, but their effects on excitatory neuron excitability by sodium current inhibition are unclear. The authors hypothesized that inhibition of transient and persistent neuronal sodium currents by the volatil...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002753
更新日期:2019-07-01 00:00:00
abstract::The neonatal neurobehavioral effects of bupivacaine, mepivacaine, and 2-chloroprocaine used in random sequence for pudendal block anesthesia were studied. The neurobehavioral status of 54 infants was studied 4 and 24 hours after delivery. Except for a significant difference in the responses to pinprick, there was no s...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-198004000-00004
更新日期:1980-04-01 00:00:00
abstract:BACKGROUND:The authors compare three techniques for insertion of the ProSeal laryngeal mask airway. METHODS:Two hundred forty healthy patients aged 18-80 yr were randomly allocated for ProSeal laryngeal mask airway insertion using the digital, introducer tool (IT), or gum elastic bougie (GEB)-guided techniques. The di...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200401000-00008
更新日期:2004-01-01 00:00:00
abstract::The effects of continuous positive airway pressure (CPAP) on cardiovascular dynamics and pulmonary shunt (QS/QT) were investigated in 12 dogs before and during sodium nitroprusside infusion that decreased mean arterial blood pressure 40-50 per cent. Before nitroprusside infusion, 5 cm H2O CPAP significantly, P less th...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197705000-00008
更新日期:1977-05-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate a new, physiologically inspired method for the analysis of the electroencephalogram during propofol-remifentanil anesthesia. Based on fixed-order autoregressive moving-average modeling, this method was hypothesized to be capable of dissociating the effects that hypno...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e3181e3d8a6
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Because ephedrine infusion (2 mg/min) does not adequately prevent spinal hypotension during cesarean delivery, the authors investigated whether adding phenylephrine would improve its efficacy. METHODS:Thirty-nine parturients with American Society of Anesthesiologists physical status I-II who were scheduled ...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200109000-00020
更新日期:2001-09-01 00:00:00
abstract::The thermoregulatory threshold for vasoconstriction has been studied in infants and children given isoflurane, but not in those given halothane anesthesia. More importantly, the effect of vasoconstriction on central temperature in pediatric patients remains unknown. Also unknown is the effect of caudal analgesia on va...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199203000-00011
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Sevoflurane is a volatile general anesthetic that differs in chemical nature from the gaseous anesthetic nitrous oxide. In a controlled laboratory setting, the authors characterized the subjective, psychomotor, and analgesic effects of sevoflurane and nitrous oxide at two equal minimum alveolar subanesthetic...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-199711000-00012
更新日期:1997-11-01 00:00:00
abstract::Deliberate hypotension was induced with isoflurane (mean inspired concentration 2.3 +/- 1.0%) in 12 patients undergoing craniotomy for clipping of cerebral aneurysms. Global cerebral blood flow (CBF) was measured before, during, and after hypotension. Arterio-venous O2 content difference was measured concomitantly, an...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198603000-00001
更新日期:1986-03-01 00:00:00
abstract:BACKGROUND:Both pain and the pharmacologic management of pain can cause the undesirable effect of sleep disruption. One goal of basic and clinical neuroscience is to facilitate rational drug development by identifying the brain regions and neurochemical modulators of sleep and pain. Adenosine is thought to be an endoge...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200212000-00036
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Anesthetic potency is assessed by determination of the anesthetic concentration that prevents gross, purposeful movement in response to noxious stimulation. It is unclear whether anesthetics cause a progressive decrease in the number and force of limb movements evoked by noxious stimulation, or a step decrea...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199910000-00027
更新日期:1999-10-01 00:00:00
abstract::To examine the effects of cardiac surgery and cardiopulmonary bypass (CPB) on the lung, functional residual capacity (FRC) and lung-thorax compliance were measured at four stages during open heart surgery in 15 children. The patients were anesthetized with fentanyl/droperidol and N2O/O2, paralyzed, and ventilated with...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract:BACKGROUND:Factors determining renal function at organ recovery in deceased kidney donors are not well established. METHODS:The authors studied the prevalence and risk factors associated with elevated prerecovery creatinine and calculated glomerular filtration rate in 458 deceased organ donors identified through the C...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e318194ca8a
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Alveolar overdistension and repetitive derecruitment-recruitment contribute to ventilator-induced lung injury (VILI). The authors investigated (1) whether inflammatory cell activation due to VILI was assessable by positron emission tomography and (2) whether cell activation due to dynamic overdistension alon...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/01.anes.0000264748.86145.ac
更新日期:2007-04-01 00:00:00
abstract::Positive pressure ventilation can affect hemodynamic stability by neuroreflex-mediated activity. Inhalational anesthesia is known to attenuate the arterial baroreflex function; however, little information is known about the effect of volatile anesthetics on the lung inflation reflex. The influence of isoflurane on sta...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199206000-00017
更新日期:1992-06-01 00:00:00
abstract:BACKGROUND:Drugs that block spinal excitatory amino acid receptor activation may prevent pain after surgery. The authors previously studied the effect of excitatory amino acid receptor antagonists after incision. In the present study, we examined the role of N-methyl-d-aspartate (NMDA), non-NMDA, and metabotropic gluta...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200008000-00029
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Rocuronium, like other steroidal nondepolarizing muscle relaxants, may in part be eliminated by the liver. To determine the influence of liver disease on its neuromuscular blocking effect, we studied the pharmacokinetics and pharmacodynamics of rocuronium in patients with cirrhosis. METHODS:Eighteen patient...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199406000-00011
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:In the event of trauma, emergency reversal of anticoagulation therapy may be required. However, no specific reversal agents are routinely available for the direct oral anticoagulants such as dabigatran. The authors investigated four-factor prothrombin complex concentrate (PCC) for treating dabigatran-induced...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000863
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Chronic neck pain after whiplash injury is caused by cervical zygapophysial joints in 50% of patients. Diagnostic blocks of nerves supplying the joints are performed using fluoroscopy. The authors' hypothesis was that the third occipital nerve can be visualized and blocked with use of an ultrasound-guided te...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/00000542-200602000-00016
更新日期:2006-02-01 00:00:00
abstract::The slow positive (P2) wave of the evoked electrospinogram was recorded from the dorsal epidural space in man. The waveform characteristics of the P2 wave were similar to those of the dorsal cord positive wave (P wave), which is believed to be caused by the primary afferent depolarization (PAD) and to be related to pr...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197510000-00003
更新日期:1975-10-01 00:00:00