Abstract:
BACKGROUND:Neuromuscular blocking drugs have been implicated in intraoperative bronchoconstrictive episodes. We examined the effects of clinically relevant doses of cisatracurium and rocuronium on the lung mechanics of pediatric subjects. We hypothesized that cisatracurium and rocuronium would have bronchoconstrictive effects. METHODS:We studied ASA physical status I and II pediatric subjects having elective dental or urological procedures, requiring general anesthesia with endotracheal intubations with either cisatracurium or rocuronium. Pulmonary function tests were performed before and after neuromuscular blocking drug dosing and again after albuterol administration. Using forced deflation and passive deflation techniques, forced vital capacity (FVC) and maximum expiratory flow rate at 10% (MEF10) of FVC were obtained. Fractional changes from the baseline were used to compare subjects. Changes in MEF10 of >30% were considered clinically significant. A Shapiro-Wilk test, paired t test, and Wilcoxon rank sum test were used to analyze the data. RESULTS:Twenty-five subjects (median age = 5.25 years; range = 9 months-9.9 years) were studied; 12 subjects received cisatracurium and 13 subjects received rocuronium. Data are shown as mean proportional change ± SD or, in the case of not normally distributed, median proportional change (first, third quartile) with P values. In the cisatracurium group, there were no differences between baseline and postneuromuscular blocker administration in the fractional change from the baselines of FVC (1.00 ± 0.04, P = 0.5), but there was a significant decrease in MEF10 (0.80 ± 0.18, P = 0.002). In the rocuronium group, there were small yet significant decreases of FVC (0.99 [first quartile 0.97, third quartile 1], P = 0.02) and significant decreases in MEF10 (0.78 ± 0.26, P = 0.008). After administration of albuterol in the cisatracurium group, FVC increased slightly but significantly from baseline values (1.02 ± 0.02, P = 0.005). MEF10 increased significantly beyond baseline values (1.24 ± 0.43, P =0.04). In the rocuronium group, there were also significant differences between baseline and postalbuterol administration from the baseline value of FVC (1.02 ± 0.02, P = 0.004) and MEF10 (1.23 ± 0.29, P = 0.01). CONCLUSIONS:At clinically relevant doses, both cisatracurium and rocuronium caused changes in lung function, indicating constriction of smaller airways. In general, these changes were mild and not clinically detectable. However, in the rocuronium group, 3 of 13 patients showed more noticeable decreases in MEF10 (≤50%), demonstrating the potential for significant broncho-bronchiolar constriction in susceptible patients.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Yang CI,Fine GF,Jooste EH,Mutich R,Walczak SA,Motoyama EKdoi
10.1213/ANE.0b013e3182a6d191subject
Has Abstractpub_date
2013-12-01 00:00:00pages
1393-400issue
6eissn
0003-2999issn
1526-7598pii
00000539-201312000-00020journal_volume
117pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Pulmonary hypertension and resulting right ventricular (RV) dysfunction are associated with significant perioperative morbidity and mortality. Although echocardiography permits real-time, noninvasive assessment of RV function, objective and comparative measures are underdeveloped, and appropriate animal mode...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001215
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Increasing evidence links postoperative cognitive dysfunction (POCD) to surgery and anesthesia. POCD is recognized as an important neuropsychological adverse outcome in surgical patients, particularly the elderly. This prospective cohort study aimed to investigate whether POCD is associated with impaired int...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001803
更新日期:2017-03-01 00:00:00
abstract::The original 1858 edition of John Snow's On Chloroform and Other Anaesthetics, from which came the Wood Library-Museum of Anesthesiology reprints in 1971 and 1989, was donated to the Wood Library-Museum by Ralph Waters of Madison, Wisconsin, in 1967. The book contains a message of appreciation to Waters, dated October...
journal_title:Anesthesia and analgesia
pub_type: 历史文章,杂志文章
doi:10.1213/00000539-199009000-00013
更新日期:1990-09-01 00:00:00
abstract::The effects of narcotic agents and two inhalation anesthetics on intrabiliary pressure (IBP) were measured before and after morphine (0.2 mg/kg), meperidine (2 mg/kg), fentanyl (0.002 mg/kg), or pentazocine (1 mg/kg) given intramuscularly to guinea pigs, and after halothane (0.5, 1.0, 1.5, or 2.0 MAC) or enflurane (sa...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1979-03-01 00:00:00
abstract::To determine whether nalbuphine might replace fentanyl as the principal opioid for anesthesia during coronary artery bypass surgery, 20 patients undergoing myocardial revascularization were anesthetized with flunitrazepam and with a continuous infusion of either nalbuphine (an opioid agonist-antagonist) or fentanyl (a...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/00000539-199111000-00002
更新日期:1991-11-01 00:00:00
abstract:UNLABELLED:Propofol and thiopental have been used clinically in combination for induction of anesthesia. Studies suggest that this mixture has synergistic activity, recovery characteristics similar to propofol alone, and bactericidal effects on multiple organisms. It may therefore be both clinically useful and cost-eff...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199802000-00038
更新日期:1998-02-01 00:00:00
abstract::It has been proposed that propofol has antiemetic effects even in nonsedative doses. The aim of this study was to investigate whether propofol influences vomiting induced by the dopamine agonist apomorphine. Ten healthy male volunteers received apomorphine infusion (1 mg/min) until vomiting was induced on four differe...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199505000-00019
更新日期:1995-05-01 00:00:00
abstract::The purpose of this study was to examine the effects of dexmedetomidine, an alpha 2-adrenergic agonist, on cerebral blood flow and metabolic rate in dogs anesthetized with 0.64% isoflurane. After intubation and institution of mechanical ventilation, arterial, venous, pulmonary artery, and sagittal sinus catheters were...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199006000-00008
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abstract:BACKGROUND:As the use of pulse oximeters increases, the needs for higher performance and wider applicability of pulse oximetry have increased. To realize the full potential of pulse oximetry, it is indispensable to increase the number of optical wavelengths. To develop a multiwavelength oximetry system, a physical theo...
journal_title:Anesthesia and analgesia
pub_type: 历史文章,杂志文章
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更新日期:2007-12-01 00:00:00
abstract::A 53-yr-old man undergoing laparoscopic cholecystectomy experienced cardiac arrest intraoperatively. Patient state index values decreased to single digits during the cardiac arrest and returned to baseline after successful cardiopulmonary resuscitation. ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000140247.16106.75
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abstract:BACKGROUND:The status of neuropathic pain alters the responsiveness to formalin injection in rats. However, the mechanism by which this alteration occurs is unknown. METHODS:We used immunocytochemistry to examine the expression of brain-derived neurotrophic factor (BDNF) and calcitonin gene-related peptide (CGRP) in t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000258762.22607.15
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abstract:BACKGROUND:The wide need for analgesia, anesthesia, and sedation in children and the lack of pediatric labeling leads to widespread off-label use of medications for pain and sedation in children. Any attempt to address the lack of labeling will require national estimates of the numbers of children using each medication...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31825b6fb2
更新日期:2012-11-01 00:00:00
abstract:INTRODUCTION:During magnetic resonance imaging (MRI), children are at risk for body temperature variations. The cold MRI environment that preserves the MRI magnet can cause serious hypothermia. On the other hand, hyperthermia may also develop because of radiofrequency-induced heating of the tissues, particularly in pro...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31824b003e
更新日期:2012-06-01 00:00:00
abstract::Hospitals rely on pagers and ordinary telephones to reach staff members in emergency situations. New telecommunication technologies such as General Packet Radio Service (GPRS), the third generation mobile phone system Universal Mobile Telecommunications System (UMTS), and Wireless Local Area Network (WLAN) might be ab...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000180216.83554.00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000255208.96685.2e
更新日期:2007-03-01 00:00:00
abstract::Common practice during local anesthetic injection is to warn the patient using words such as: "You will feel a big bee sting; this is the worst part." Our hypothesis was that using gentler words for administration of the local anesthetic improves pain perception and patient comfort. One hundred forty healthy women at ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3181cc5727
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Previous studies have demonstrated that Homer 1b/c, a postsynaptic molecular scaffolding protein that binds and clusters metabotropic glutamate receptors at neuronal synapses, has an important role in the metabotropic glutamate receptor signaling process. In the current study, we investigated the possible in...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
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abstract:UNLABELLED:A cohort of seven patients receiving intrathecal analgesic drug therapy for chronic intractable pain underwent radiocontrast myelography and computed tomography (CT) scanning to screen for catheter-associated intrathecal masses. Three of seven patients examined had intraspinal masses associated with the tip ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200301000-00039
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abstract:BACKGROUND:Regional anesthesia is increasingly used in pediatric patients to provide postoperative analgesia and to supplement intraoperative anesthesia. The Pediatric Regional Anesthesia Network was formed to obtain highly audited data on practice patterns and complications and to facilitate collaborative research in ...
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abstract::We describe the treatment of two patients with hemorrhagic shock unresponsive to volume replacement and catecholamines. Both patients responded to a small-dose infusion of vasopressin, which allowed tapering off of the catecholamines. The possible role of small-dose infusions of vasopressin in fluid- and catecholamine...
journal_title:Anesthesia and analgesia
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journal_title:Anesthesia and analgesia
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abstract:BACKGROUND:In this study, we evaluated the feasibility and accuracy of Univent tube (Fuji Systems, Tokyo, Japan) placement with the aid of auscultation (AUS) or as guided by a lighted stylet (LS) compared with placement guided by the fiberoptic bronchoscope (FOB) or the blind intubation technique as recommended by the ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3181c5ed18
更新日期:2010-02-01 00:00:00
abstract::Reactive oxygen species (ROS) are central to cardiac ischemic and reperfusion injury. They contribute to myocardial stunning, infarction and apoptosis, and possibly to the genesis of arrhythmias. Multiple laboratory studies and clinical trials have evaluated the use of scavengers of ROS to protect the heart from the e...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
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更新日期:2005-11-01 00:00:00
abstract::Despite the wide use of droperidol to reduce nausea and vomiting in children, its pharmacokinetics have not been described in pediatric patients. Twelve ASA Class I-II children, undergoing tonsillectomy and adenoidectomy, received standardized anesthesia; none of the children received premedication. After induction of...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199306000-00010
更新日期:1993-06-01 00:00:00
abstract::Tissue Doppler Imaging (TDI) provides information on systolic function through its systolic mitral annulus velocity wave (Sm), reflecting the peak velocity of shortening of the myocardial fibers oriented in the longitudinal direction. In this study, we evaluated the effect of load changes on Sm. Forty-two cardiac surg...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ANE.0000131972.99804.28
更新日期:2004-08-01 00:00:00
abstract::The epidural administration of morphine and fentanyl delay the regression of sensory anesthesia in postoperative patients receiving epidural bupivacaine. This study was performed to determine any differential effects of two lipid-soluble opioids upon regression of sensory anesthesia during coadministration with epidur...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199312000-00017
更新日期:1993-12-01 00:00:00
abstract::Artificial intelligence-driven anesthesiology and perioperative care may just be around the corner. However, its promises of improved safety and patient outcomes can only become a reality if we take the time to examine its technical, ethical, and moral implications. The aim of perioperative medicine is to diagnose, tr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000004728
更新日期:2020-05-01 00:00:00
abstract:UNLABELLED:As medical costs continue to escalate, there is willingness to consider the role played by nontraditional factors in health. We investigated the usefulness of tape-recorded hypnosis instruction on perioperative outcome in surgical patients in a prospective, randomized, and partially blinded study. Sixty pati...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200001000-00016
更新日期:2000-01-01 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::Delirium is an acute change in cognition and attention, which may include alterations in consciousness and disorganized thinking. Although delirium may affect any age group, it is most common in older patients, especially those with preexisting cognitive impairment. Patients with delirium after surgery recover more sl...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0b013e3182147f6d
更新日期:2011-05-01 00:00:00