Abstract:
BACKGROUND:Transcranial motor-evoked potentials (TcMEPs) monitor spinal cord motor tract integrity. Using a swine model, the authors studied the effects of vasodilatory hypotension, hemorrhage, and various resuscitation efforts on TcMEP responses. METHODS:Twelve pigs were anesthetized with constant infusions of propofol, ketamine, and fentanyl. Animals were incrementally hemorrhaged, until bilateral tibialis anterior TcMEP amplitude decreased to less than 40% of baseline or until 50% of the blood volume was removed. Mean arterial pressure (MAP), cardiac output (CO), and oxygen delivery (DO2) were examined. Resuscitation with phenylephrine, epinephrine, and colloid were evaluated. In seven animals, vasodilatory hypotension was examined. Paired comparisons and multivariate analysis were performed. RESULTS:Hemorrhage significantly reduced (as a percentage of baseline, mean±SD) TcMEPs (left, 33±29%; right, 26±21%), MAP (60±17%), CO (49±12%), and DO2 (43±13%), P value less than 0.001 for all. Vasodilation reduced MAP comparably, but TcMEPs, CO, and DO2, were not significantly lowered. After hemorrhage, restoration of MAP with phenylephrine did not improve TcMEPs, CO, or DO2, but similar restoration of MAP with epinephrine restored (to percentage of baseline) TcMEPs (59±40%), and significantly increased CO (81±17%) and DO2 (72±19%) compared with both hemorrhage and phenylephrine, P value less than 0.05 for all. Resuscitation with colloid did not improve TcMEPs. Multivariate analysis revealed that changes in TcMEPs were more closely associated with changes in CO and DO2 as compared with MAP. CONCLUSIONS:Hypotension from hemorrhage, but not vasodilation, is associated with a decrease in TcMEP amplitude. After hemorrhage, restoration of TcMEPs with epinephrine but not phenylephrine indicates that CO and DO2 affect TcMEPs more than MAP. Monitoring CO may be beneficial in major spine surgery when using TcMEP monitoring.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Lieberman JA,Feiner J,Lyon R,Rollins MDdoi
10.1097/ALN.0b013e31829d4a92subject
Has Abstractpub_date
2013-11-01 00:00:00pages
1109-19issue
5eissn
0003-3022issn
1528-1175journal_volume
119pub_type
杂志文章相关文献
ANESTHESIOLOGY文献大全abstract:BACKGROUND:Acid aspiration into one lung causes contralateral lung injury and systemic organ injury; this injury is thought to be mediated by the sequestration of activated neutrophils. Recombinant human soluble complement receptor 1 (sCR1) inhibits both the classical and alternative complement pathways; this study inv...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199611000-00021
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Ketamine is a potent bronchodilator that, in clinically used concentrations, relaxes airway smooth muscle in part by a direct effect. This study explored the role of calcium concentration (Ca2+) in this relaxation. METHODS:Canine trachea smooth muscle strips were loaded with the fluorescent probe fura-2 and...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199705000-00014
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine is only approved for use in humans as an intravenous medication. An oral formulation may broaden the use and benefits of dexmedetomidine to numerous care settings. The authors hypothesized that oral dexmedetomidine (300 mcg to 700 mcg) would result in plasma concentrations consistent with sed...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000003568
更新日期:2020-12-01 00:00:00
abstract::The authors studied the influence of locally administered isoflurane anesthesia on the pulmonary vascular response to regional alveolar hypoxia (hypoxic pulmonary vasoconstriction [HPV]) over a range of cardiac outputs (COs) in seven mechanically ventilated, closed-chest dogs. The right lung was ventilated with 100% O...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198604000-00002
更新日期:1986-04-01 00:00:00
abstract::Postoperative adrenocortical function was compared in 23 out-patients receiving either thiopental, 4 mg/kg, for induction and a thiopental infusion, 0.26 mg . kg-1 . min-1, in combination with nitrous oxide 70% for maintenance of anesthesia (control); etomidate, 0.4 mg/kg, for induction followed by an etomidate infusi...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198412000-00003
更新日期:1984-12-01 00:00:00
abstract::The effects of the neodymium-yttrium aluminum garnet (Nd-YAG) laser on several commonly used endotracheal tubes were examined. Six different types of tubes were tested for flammability. Three tubes were clear, transparent polyvinylchloride with black lettering on the surface. One was yellow-green silicone rubber with ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198611000-00010
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:Deep hypothermia has been associated with an increased incidence of postoperative neurologic dysfunction after cardiac surgery in children. Recent studies suggest an excitotoxic mechanism involving overstimulation of glutamate receptors. Extracellular glutamate uptake occurs primarily by astrocytes. Astrocyt...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199912000-00030
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:This series investigated the quality of analgesia and the incidence and severity of side effects of intrathecal morphine for post-cesarean analgesia administered over a dose range of 0.0-0.5 mg. METHODS:ONE hundred eight term parturients undergoing cesarean delivery at term and given spinal anesthesia were ...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199902000-00018
更新日期:1999-02-01 00:00:00
abstract::In the absence of data on the anatomic localization of the cuff of the laryngeal mask airway (LMA) in children, radiologic images were obtained from 50 infants and children (aged 1 month to 15 yr) undergoing diagnostic radiologic procedures during halothane and N2O:O2 anesthesia. In 46 patients, the cuff of the LMA wa...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199212000-00007
更新日期:1992-12-01 00:00:00
abstract::The metabolism of alfentanil was studied in three healthy subjects after a 1-h infusion of 2.5 mg alfentanil-3H. One of the subjects was a poor hydroxylator of debrisoquine. Pharmacokinetic parameters were similar in the three subjects and were in the same range as those reported for volunteers. The majority of the ad...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198810000-00012
更新日期:1988-10-01 00:00:00
abstract:BACKGROUND:During muscular exercise, a negative correlation has been demonstrated between the value of mixed venous oxygen saturation (SvO2) and the level of muscular work, expressed at each level as the ratio of oxygen uptake (VO2) to each subject's maximal oxygen uptake (VO2max). Because the immediate postoperative p...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199402000-00007
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:We previously described the use of the nematode Caenorabditis elegans as a genetic model for studying the mechanism of action of volatile anesthetics. All previous strains of C. elegans with altered responses to anesthetics have been identified by screening the response to halothane. The current study was de...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199410000-00016
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:The Neurologic and Adaptive Capacity Score (NACS) is a multi-item scale that was published in 1982 to measure the effects of intrapartum drugs on the neonate. Although this scoring system has been widely used in obstetric anesthesia research, studies confirming its reliability have not been published. The pu...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-200106000-00007
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:Inhaled nitric oxide (NO) may be useful in the treatment of adult respiratory distress syndrome and other diseases characterized by pulmonary hypertension and hypoxemia. NO is rapidly converted to nitrogen dioxide (NO2) in oxygen (O2) environments. We hypothesized that in patients whose lungs are mechanicall...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199505000-00020
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:The current study was performed to determine whether volatile anesthetics may include as part of their action in the central nervous system the depression of presynaptic transmitter release by alteration in intrasynaptic [Ca2+] ([Ca2+]i). METHODS:Guinea pig cerebrocortical synaptosomes were studied at 37 de...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199509000-00019
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Little is known about the influence of liver transplantation on the pharmacokinetics of most anesthetic drugs. The authors determined the pharmacokinetics of rocuronium during liver transplantation and examined whether variability in pharmacokinetics could explain variability in recovery of neuromuscular fun...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-199706000-00012
更新日期:1997-06-01 00:00:00
abstract::Anesthesia and surgery are a risk for all, the healthy as well as the sick. While the prevention of adverse outcomes in healthy patients is paramount, enhancement of safety for critically ill patients is also essential, since they are more likely to suffer a SNO after a critical incident. Dangers originate from a vari...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:
更新日期:1987-05-01 00:00:00
abstract::Fourteen cases of sudden cardiac arrest in healthy patients who received spinal anesthesia were discovered in a preliminary review of 900 closed insurance claims for major anesthetic mishaps. All patients were resuscitated from the intraoperative cardiac arrest, but six suffered such severe neurologic injury that they...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198801000-00003
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:An animal experimental model of acute lung injury after intratracheal instillation of acidified milk products has been recently demonstrated. Exogenous administration of surfactant has proved to be successful treatment for acute lung injury induced by many causes including acid aspiration. The authors conduc...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199907000-00033
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Fluid resuscitation in hemorrhagic shock aims to restore hemodynamics and repair altered microcirculation. Hemodynamic coherence is the concordant performance of macro- and microcirculation. The present study on fluid therapy in hemorrhagic shock hypothesized that the choice of fluid (0.9% sodium chloride [s...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002998
更新日期:2020-01-01 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:BACKGROUND:The study was designed to compare the effects of equimolar concentrations of racemic bupivacaine, levobupivacaine, and ropivacaine on ventricular conduction, anisotropy, duration and homogeneity of refractoriness, and wavelengths, and to provide a potency ratio for effects on conduction velocity. METHODS:Is...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200203000-00021
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:We aimed to assess the clinical effectiveness of intravenous exenatide compared to insulin in perioperative blood glucose control in coronary artery bypass grafting surgery patients. METHODS:Patients more than 18 yr old admitted for elective coronary artery bypass grafting were included in a phase II/III no...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0000000000001838
更新日期:2017-11-01 00:00:00
abstract::[This corrects the article on p. 1281 in vol. 121, issue 6, PMID: 25072223.]. ...
journal_title:Anesthesiology
pub_type: 已发布勘误
doi:10.1097/01.anes.0000470960.33159.09
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:The most sensitive diagnostic criterion of myasthenia gravis is a decrement in the muscular response to repetitive stimulation. The authors hypothesized that myasthenia gravis patients who show a train-of-four ratio (T4/T1) < 0.9 in the preanesthetic period will have increased sensitivity to nondepolarizing ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200008000-00011
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:The use of nicotinic agonists for analgesia is limited by their unacceptable side effects. Sazetidine-A is a new partial agonist nicotinic ligand that has very high selectivity for beta2-containing nicotinic acetylcholine receptors. It potently and selectively desensitizes alpha4beta2 nicotinic acetylcholine...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181834490
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Optimal risk adjustment is a requisite precondition for monitoring quality of care and interpreting public reports of hospital outcomes. Current risk-adjustment measures have been criticized for including baseline variables that are difficult to obtain and inadequately adjusting for high-risk patients. The a...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e318219d5f9
更新日期:2011-06-01 00:00:00
abstract::To study the cerebral protective effects of hypothermia in arterial hypoxia, anesthetized (70% N2O), mechanically ventilated rats were cooled to a body temperature of 27 C. Hypoxia was induced by decreasing the oxygen content in the inspired gas mixture either to 6-7 per cent or to 2.5-3 per cent. This reduced mean Pa...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197601000-00006
更新日期:1976-01-01 00:00:00
abstract:BACKGROUND:Procedure times are important variables that often are included in studies of quality and efficiency. However, due to the need for costly chart review, most studies are limited to single-institution analyses. In this article, the authors describe how well the anesthesia claim from Medicare can estimate chart...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200702000-00024
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:Load-dependent impairment of left ventricular (LV) function was observed after leg elevation in a subgroup of coronary surgery patients. The present study investigated underlying mechanisms by comparing hemodynamic effects of an increase in LV systolic pressures with leg elevation to effects of a similar inc...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199908000-00011
更新日期:1999-08-01 00:00:00