Abstract:
BACKGROUND:The perioperative assessment of right ventricular (RV) function remains a challenge. Tricuspid annular plane systolic excursion (TAPSE) using M-mode is a widely used measure of RV function. However, accurate alignment of the ultrasound beam with the direction of annular movement can be difficult with transesophageal echocardiography (TEE) to measure TAPSE, precluding effective use of M-mode to measure annular excursion. Tracking of specular reflectors in the myocardium may provide an angle-independent method to assess annular motion with TEE. We hypothesized that TEE speckle tracking of the lateral tricuspid annular motion represents a comparable measurement to the well-validated M-mode TAPSE on transthoracic echocardiogram (TTE), and may be considered as a reasonable alternative to TAPSE. METHODS:This is a prospective, observational cohort study. We included all patients, who were in sinus rhythm, with a preoperative TTE within 3 months of scheduled cardiac surgery that required intraoperative TEE. Tissue motion annular displacements (TMAD) of the lateral (L), septal (S), and midpoint (M) tricuspid annulus were measured (QLAB Cardiac Motion Quantification; Philips Medical, Andover, MA) after induction of general anesthesia. This was compared to the preoperative M-mode TAPSE on TTE. RESULTS:Seventy-two consecutive patients who met eligibility requirements were enrolled from September to November 2016. Twelve were excluded due to poor image quality, allowing TMAD to be analyzed in 60 patients. TMAD was analyzed offline and TMAD analysis was able to track tricuspid annular motion in all patients. The mean TMAD (L), TMAD (S), and TMAD (M) were 17.4 ± 5.2, 10.2 ± 4.8, and 14.2 ± 4.8 mm, respectively. TMAD (L) showed close correlation with M-mode TAPSE on TTE (r = 0.87, 95% confidence interval, 0.79-0.92; P < .01). All patients with a preoperative TAPSE <17 mm had a TMAD (L) <17 mm, while 71% of those with a TAPSE ≥ 17 mm had a TMAD (L) ≥ 17 mm. There was strong positive correlation between TMAD (L) and intraoperative RV fractional area change (r = 0.86, 95% confidence interval, 0.77-0.91; P < .01). Reproducibility analysis of TMAD within and across observers showed excellent correlation. CONCLUSIONS:TMAD is a quick and angle-independent method to quantitatively assess RV longitudinal function by TEE. It correlates strongly with M-mode TAPSE on TTE. Because TMAD and TAPSE were not simultaneously measured in this study, their correlation is subject to differences in loading conditions, general anesthesia, and changes in the disease process. TMAD may be easily applied in routine clinical settings and its role in the perioperative environment deserves to be further explored.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Shen T,Picard MH,Hua L,Burns SM,Andrawes MNdoi
10.1213/ANE.0000000000002614subject
Has Abstractpub_date
2018-01-01 00:00:00pages
62-67issue
1eissn
0003-2999issn
1526-7598journal_volume
126pub_type
杂志文章abstract::We designed a prospective, randomized, double-blind study to evaluate the efficacy of the combination of intrathecal sufentanil with a low dose of local anesthetic in an attempt to prolong analgesia in labor. Fifty-two patients received one of the following intrathecal study solutions: 2.5 mg of bupivacaine; 10 microg...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199508000-00017
更新日期:1995-08-01 00:00:00
abstract::This study evaluates the changes of oxygen saturation (SpO2) after intravenous administration of methylene blue in 103 patients undergoing open repair of thoracoabdominal aortic aneurysms. We found that SpO2 decreased by a median (interquartile range [IQR]) of 49% (37%-81%) <1 minute after methylene blue administratio...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000004325
更新日期:2019-11-01 00:00:00
abstract::Isoproterenol 5 micrograms may be an effective marker of accidental intravascular injection in women in labor; however, before isoproterenol can be incorporated in routinely used epidural test doses, the safety and usefulness should be determined in an animal model. This study was designed to examine the hemodynamic e...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199605000-00024
更新日期:1996-05-01 00:00:00
abstract::The Augustine Guide (AG) allows oral endotracheal intubations to be performed blindly; head and neck manipulation are unnecessary. It is a premolded device designed to fit in a lock and key fashion in the glottis, thus serving as a guide to allow blind laryngeal insertion of an endotracheal tube. Intubation success ra...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199405000-00026
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:There have been numerous studies published on the ProSeal laryngeal mask airway (PLMA). However, few have investigated its utility in a large practice setting. We sought to gather comprehensive data about the characteristics, efficacy, and safety of its use by a representative group of anesthesiologists work...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e318189ac84
更新日期:2008-12-01 00:00:00
abstract::The Brandt tube system can limit excessive cuff pressure during nitrous oxide (N(2)O) anesthesia, but there is a lack of data assessing whether the Brandt tube system avoids cuff deflation after cessation of N(2)O administration. In this study, we recorded air-filled cuff pressures of the Mallinckrodt Brandt or Hi-Con...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200302000-00055
更新日期:2003-02-01 00:00:00
abstract::Sufentanil is a new synthetic opiate analgesic that is 4520 times more potent than morphine in animal experiments. This study evaluated the cardiovascular effects of sufentanil, 15 micrograms/kg, and air/O2 used as a complete anesthetic with 50% inspired oxygen (air/O2 mixture) in 40 adult patients undergoing elective...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1982-02-01 00:00:00
abstract::The purpose of this study was to evaluate the influence of the volume of methylene blue-local anesthetic on the spread of the injectate along the costal pleura. Twenty patients undergoing elective thoracotomy were studied. Twelve patients received intercostal nerve injection with 10 mL of 0.5% bupivacaine with methyle...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199209000-00013
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:Anesthesia information management systems (AIMSs) have been effectively used to improve quality in anesthesia care, and have enabled the development of mandatory quality assurance (QA) reporting systems for adverse events (AEs). While this approach has been shown to increase event reporting over time, the lo...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究
doi:10.1213/ANE.0000000000002447
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Transversus abdominis plane (TAP) block and local anesthetic wound infiltration provide analgesia after cesarean delivery. Studies comparing the 2 techniques are scarce, with conflicting results. This double-blind, randomized controlled trial aimed to compare bilateral ultrasound-guided TAP block with single...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000001724
更新日期:2017-04-01 00:00:00
abstract:UNLABELLED:The purpose of this study was to determine if rates of telemetry events differ between patients whose monitoring is appropriately "indicated" versus "not indicated" by systematically applying rigorous criteria for appropriateness of electrocardiogram (ECG) telemetry usage. We performed a retrospective cohort...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000081720.49358.53
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:Transporting patients under anesthesia care incurs numerous potential risks, especially for those with critical illness. The purpose of this study is to identify and report all pediatric anesthesia transport-associated adverse events from a preexisting database of perioperative adverse events. METHODS:An ex...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000004433
更新日期:2020-07-01 00:00:00
abstract:IMPLICATIONS:Complications of IV mannitol administration resulting in compartment syndrome may warrant surgical intervention. Compartment syndrome is difficult to diagnose in the anesthetized patient. Infusing mannitol in an observed IV site permits discontinuation of mannitol before complications ensue. Early recognit...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200301000-00049
更新日期:2003-01-01 00:00:00
abstract:UNLABELLED:We investigated the physiological reaction to mobilization the first and second day after aortic valve replacement in an open, prospective study. Hemodynamic and oxygenation variables were recorded in 15 patients using a pulmonary artery oximetry catheter and bench oximetry. Serious intraoperative events occ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000096194.10459.7e
更新日期:2004-02-01 00:00:00
abstract::A response algorithm consists of a logical sequence of maneuvers to be performed in response to a specific condition. With the advent of alarm-equipped monitors that alert anesthesiologists to the presence of potentially hazardous clinical conditions, a need has arisen to develop the corresponding alarm-oriented respo...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::Prostaglandin E(2) receptors, subtype EP(1) (PGE(2)EP(1)) have been linked to several physiologic responses, such as fever, inflammation, and mechanical hyperalgesia. Local anesthetics modulate these responses, which may be due to direct interaction of local anesthetics with PGE(2)EP(1) receptor signaling. We sought t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200109000-00019
更新日期:2001-09-01 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:UNLABELLED:Postoperative pain is a common reason for the delayed discharge and unanticipated hospital admission of out-patients. In this study, we examined the pattern of pain in ambulatory surgical patients and determined those factors that predict postoperative pain. Ten thousand eight consecutive ambulatory surgical...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199710000-00017
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:QT interval prolongation is associated with torsades des pointes (TdP), but is a poor predictor of drug torsadogenicity. Susceptibility to TdP arises from increased transmural dispersion of repolarization (TDR) across the myocardial wall, rather than QT interval prolongation per se. TDR can be measured on th...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ane.0000252417.23986.6e
更新日期:2007-02-01 00:00:00
abstract:UNLABELLED:In the present study, we examined whether preincisional treatment with dextromethorphan (DM) provides preemptive analgesia. Ninety patients scheduled for laparoscopic cholecystectomy were included. Patients receiving chlorpheniramine maleate (CPM) 20 mg via an IM injection 30 min before skin incision were de...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199906000-00025
更新日期:1999-06-01 00:00:00
abstract::Aging and disease may make the elderly patient with cardiac disease particularly susceptible to hypotension during spinal anesthesia. We studied 15 men, 59-80 y old, with histories of prior myocardial infarction (n = 9), congestive heart failure (n = 2), and/or stable myocardial ischemia (n = 11) given spinal anesthes...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199707000-00018
更新日期:1997-07-01 00:00:00
abstract::Four patients underwent laryngoscopy and general anesthesia surgery without apparent perioperative complications. Within days of their procedure, throat and mouth pain were reported and intraoral examination in all cases revealed exposed bone in the posterior mandible. The sequestra were easily removed and healing was...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181e0cdcd
更新日期:2010-08-01 00:00:00
abstract:UNLABELLED:We tested the hypothesis that routine cleaning and autoclaving does not remove protein deposits from reusable laryngeal mask airways (LMAs). All previously used classic and flexible LMAs from a single hospital were tested. Each LMA was hand-washed in an enzymatic solution for 3 min, machine-washed with a dis...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000080154.76349.5b
更新日期:2003-10-01 00:00:00
abstract::When given for a sufficient time and dose intravenously, neuromuscular blocking drugs eventually can enter the cerebrospinal fluid (CSF). To study the potential pharmacologic consequences of neuromuscular blocking drugs in the CSF, a model was developed in the rat by using an intrathecal infusion of these drugs. A can...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199306000-00020
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:Performing key actions efficiently during crises can determine clinical outcomes, yet even expert clinicians omit key actions. Simulation-based studies of crises show that correct performance of key actions dramatically increases when emergency manuals (EMs) are used. Despite widespread dissemination of EMs,...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究
doi:10.1213/ANE.0000000000005012
更新日期:2020-12-01 00:00:00
abstract::A 19-year-old African American man with a T12 spinal cord lesion underwent a T4-L5 thoracolumbar spinal fusion. Intraoperatively, his arterial blood pressure acutely increased from 110/60 to 260/130 mm Hg without a change in heart rate. The patient did not have pheochromocytoma, carcinoid syndrome, or thyroid storm. T...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181f334b8
更新日期:2010-11-01 00:00:00
abstract::Different additives have been used to prolong regional blockade. We designed a prospective, randomized, double-blind study to evaluate the effect of dexamethasone added to lidocaine on the onset and duration of axillary brachial plexus block. Sixty patients scheduled for elective hand and forearm surgery under axillar...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ane.0000189055.06729.0a
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:We studied the effects of isoflurane on hippocampal synaptic transmission and paired-pulse plasticity, under in vivo intact interneuron circuitry. METHODS:Using rats chronically implanted with electrodes, excitatory postsynaptic potential (EPSP) and population spike amplitude (PSA) were measured in the hipp...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000281433.73260.8d
更新日期:2007-10-01 00:00:00
abstract::The purpose of this study was to investigate whether regression of sensory analgesia during constant epidural bupivacaine infusion was different in postoperative patients with acute pain than in patients with chronic nonsurgical pain. Sensory levels of analgesia (to pinprick) and pain (on a five-point scale) were asse...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1988-08-01 00:00:00
abstract::Two concentrations of etidocaine (1 and 1.5%) and of pH-adjusted bupivacaine (0.5 and 0.75%, pH 6.8), all fortified with hyaluronidase, were compared as local anesthetics in regional ophthalmic surgery for cataract extraction. The series comprised 160 patients assigned randomly to four groups (n = 40). Each patient re...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199307000-00026
更新日期:1993-07-01 00:00:00