Abstract:
:A recognized side effect of chemonucleolysis is life-threatening anaphylaxis to chymopapain. In the clinical trials of chymopapain, 13 cases of anaphylaxis were reported in 1585 administrations (0.82%). Two patients died. Data from a postmarketing survey (48,239 questionnaires) were reviewed to identify factors influencing the incidence and severity of anaphylaxis. The results indicate the incidence of anaphylaxis decreased to 0.44% in the 1983-1984 period (126/23,736), a level significantly (P less than or equal to 0.001) below the incidence of 0.82% observed in initial clinical trials. Only three deaths from complications related to anaphylaxis occurred in approximately 75,000 administrations (producing 252 anaphylactic episodes) reported since December 1982. The prophylactic use of antihistamines and pretreatment with intravenous fluids coincide with the dramatic reduction in mortality due to anaphylaxis. However, overdiagnosis of anaphylaxis in the clinical trials and avoidance of chemonucleolysis in patients with IgE antibodies to chymopapain may account, in part, for the reduction in incidence.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Moss J,Roizen MF,Nordby EJ,Thisted R,Apfelbaum JL,Schreider BD,McDermott DJsubject
Has Abstractpub_date
1985-12-01 00:00:00pages
1197-201issue
12eissn
0003-2999issn
1526-7598journal_volume
64pub_type
杂志文章abstract::There is precedent in medicine for recognizing and accepting intact decisional capacity and the subsequent ability to provide valid consent in one treatment domain, while simultaneously recognizing that the patient lacks decisional capacity in other domains. As such, obtaining consent for anesthesia for a surgical pro...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181c7eb12
更新日期:2010-02-01 00:00:00
abstract::The effects of continuous epidural anesthesia and of general anesthesia on the incidence of thromboembolism following total hip replacement were studied. Sixty patients were randomly allotted to one of two groups receiving either epidural or general anesthesia. Epidural anesthesia (N = 30) consisted of 0.5% bupivacain...
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:1983-02-01 00:00:00
abstract:UNLABELLED:This report describes treatment with cervical epidural blood patch of low cerebrospinal fluid (CSF) pressure headache resulting from spontaneous CSF leak via a tear in a cervical dural cuff. The leak was diagnosed by a dynamic computed tomography (CT)-myelography study followed by gadolinium enhanced magneti...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000117225.31416.36
更新日期:2004-06-01 00:00:00
abstract::The ability of opiates to be a complete anesthetic has been assessed in animals. These studies have investigated the serum levels of opiate required to produce a decrease in anesthetic requirement for a concomitantly administered inhalation anesthetic. A linear dose-response relation has been observed between opiate s...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1988-07-01 00:00:00
abstract::The purpose of this study was to compare the psychological effects of ketamine and thiopental anesthesia. In a double-blind comparison, 20 normal female volunteers were given 2.5 mg/kg ketamine intravenously and 20 were given 5.0 mg/kg thiopental intravenously. Subjects were assessed with a variety of objective and su...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:Several data suggest that both opioid and N-methyl-d-aspartate (NMDA) receptors are localized at the peripheral level, and drugs acting on these receptors may produce antinociception after topical administration; however, the antinociceptive effect of endogenous ligands at these receptors is poorly clarified...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181b21c5e
更新日期:2009-10-01 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:BACKGROUND:The analgesic efficacy of transversus abdominis plane (TAP) block has been established for patients undergoing abdominal surgery. We evaluated the efficacy of a novel approach to TAP block for postoperative analgesia after colorectal surgery. METHODS:Forty adult ASA physical status I to III patients undergo...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3182159bf8
更新日期:2011-06-01 00:00:00
abstract:IMPLICATIONS:Esophageal insufflation can occur simultaneously with venting from the drain tube during positive pressure ventilation with the ProSeal laryngeal mask airway. ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200204000-00050
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:The effect of interscalene block (ISB) on pulmonary function of obese participants has not been investigated. The goal of this study is to assess the association of obesity (body mass index [BMI] >29 kg/m vs BMI <25 kg/m) and change in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000002180
更新日期:2017-07-01 00:00:00
abstract:UNLABELLED:This study was performed to evaluate both the effects of pentobarbital on disruption of the blood-brain barrier (BBB) by hyperosmolar mannitol and the relationship between its effect on blood pressure and the integrity of the BBB. Under isoflurane anesthesia, rats in the control group were infused with 25% m...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199806000-00018
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:The extent to which insufflation of oxygen into the posterior pharynx during laryngoscopy prolongs adequate saturation in infants and small children remains unknown. Therefore, we compared oxygen saturation over time in preoxygenated small children with and without posterior pharynx oxygen insufflation. MET...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001189
更新日期:2016-04-01 00:00:00
abstract::Blood levels of many medications are acutely lowered by cardiopulmonary bypass (CPB). Because nifedipine is often used to provide protection from coronary ischemia, a determination of the effect of CPB on plasma nifedipine levels might help to determine the potential clinical benefit of nifedipine during and after byp...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/00000539-199010000-00016
更新日期:1990-10-01 00:00:00
abstract::We studied the performance of a target-controlled drug infusion device, computer-assisted continuous infusion (CACI). Forty-one volunteers received one of midazolam (n = 11), propofol (n = 10), thiopental (n = 10), or fentanyl (n = 10) in sedative concentrations. Concentrations were kept constant for 45-70 min at five...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199705000-00018
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:Nerve injury can generate neuropathic pain. The accompanying mechanical allodynia may be reduced by the intrathecal administration of adenosine. The neuroprotective effects of adenosine are mediated by the adenosine triphosphate (ATP)-sensitive potassium (K(ATP)) channel. We assessed the relationship between...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e318212b833
更新日期:2011-06-01 00:00:00
abstract::Only 1 in about 110 sex acts results in a conception and 1 in 270 in a live birth. Of all conceptions, 40% result in live births, 5% in stillbirths, and 55% never develop. 1/3 of all known conceptions ends in abortion, spontaneous or induced. It appears that the population problem depends on a small fraction of the...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1971-07-01 00:00:00
abstract::Although isoflurane can reduce ischemic neuronal injury after short postischemic recovery intervals, data from our laboratory have demonstrated that this neuroprotection is not sustained and that delayed apoptotic neuronal death, mediated in part by activation of caspases, contributes to the gradual increase in the si...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000202381.40516.8d
更新日期:2006-05-01 00:00:00
abstract:UNLABELLED:Diabetic patients are at increased risk of wound infection after major surgery, but the effect of perioperative glucose control on postoperative wound infection rates after surgery is uncertain. We tested the effect of an insulin infusion on perioperative neutrophil function in diabetic patients scheduled fo...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199905000-00008
更新日期:1999-05-01 00:00:00
abstract:UNLABELLED:We performed this study to assess the influence of endotracheal tube (ETT) tip design (Murphy-tip versus Magill-tip) on nasal trauma during nasotracheal intubation with a conventional polyvinyl chloride ETT. Patients were randomly allocated to one of four groups (n = 25 each): Magill-tipped ETT and Murphy-ti...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ane.0000169293.59514.28
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Chemical pleurodesis causes severe pain, prompting physicians to perform thoracoscopic talc poudrage under general or neuroleptanalgesia. We describe a novel method for pain control in five patients with pneumothoraces and severe chronic obstructive pulmonary disease. METHODS:Patients were premedicated with...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000249046.02025.ef
更新日期:2007-01-01 00:00:00
abstract::Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) are cardiac hormones with natriuretic, vasorelaxant, and aldosterone-inhibiting properties. We analyzed the plasma of 178 critically ill patients for ANP, BNP, aldosterone, and serum sodium concentration, as well as serum and urine osmolality and sod...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200109000-00029
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:Malignant hyperthermia (MH) is a pharmacogenetic disorder of skeletal muscle calcium regulation associated primarily, but not exclusively, with mutations in the skeletal muscle ryanodine receptor. Associated environmental factors, however, may also be important for expression of the syndrome. METHODS AND RE...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e31819240a5
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Postpartum depression (PPD) is associated with pain during and after delivery, with studies showing reduced rates among women delivering with labor epidural analgesia (LEA). We hypothesized that women who intend to deliver with LEA but do not receive it are at higher risk for PPD at 6 weeks due to the combin...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000002501
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Postoperative delirium is a major debilitating complication for patients and is associated with poor outcomes. Previous studies have suggested that excessive general anesthesia may lead to postoperative delirium. Electroencephalography (EEG)-based monitors have been administered in clinical practice in an at...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,meta分析
doi:10.1213/ANE.0000000000004746
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:In the perioperative period, anesthesiologists and postanesthesia care unit (PACU) nurses routinely prepare and administer small-volume IV injections, yet the accuracy of delivered medication volumes in this setting has not been described. In this ex vivo study, we sought to characterize the degree to which ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001976
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Patients with muscular dystrophy have been reported to experience a variety of life-threatening complications during and after general anesthesia. We performed a systematic analysis to define the spectrum of anesthetic-related complications in patients with muscular dystrophy, with an emphasis on malignant h...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ane.0b013e3181aa5cf6
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:We previously reported that the duration of hospitalization was not different between isoflurane and sevoflurane. But more plausible consequences of using soluble volatile anesthetics are delayed emergence from anesthesia and prolonged stays in the postanesthesia care unit (PACU). We therefore compared isofl...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/ANE.0000000000004093
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:In this study we sought to identify differences in risk factors and outcome of critically ill patients with Candida albicans and non-albicans candidemia. METHODS:Nonimmunosuppressed, nonneutropenic patients with candidemia diagnosed after intensive care unit (ICU) admission were included in a prospective obs...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181607262
更新日期:2008-02-01 00:00:00
abstract:UNLABELLED:Shoulder surgery is often performed with patients in the sitting position under interscalene block anesthesia. Vasovagal episodes, characterized by a sudden decrease in heart rate and/or blood pressure, have a reported incidence of 17%-24% in this setting. We performed a retrospective study to determine whet...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1999-02-01 00:00:00
abstract:UNLABELLED:Isoflurane reduces myocardial infarct size during early reperfusion by activating phosphatidylinositol-3-kinase (PI3K) signaling. We tested the hypothesis that this cardioprotection against reperfusion injury is enhanced by morphine and that a decrease in apoptosis plays a role in preservation of myocardial ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000171931.08371.a2
更新日期:2005-10-01 00:00:00