Abstract:
:A pharmacokinetic evaluation of bupivacaine was carried out after intercostal nerve blocks performed on 28 occasions in 27 children varying in age from 3 months to 16 yr. Bupivacaine HCl, 0.5%, with epinephrine 1:200,000 was employed. Doses of 2 mg/kg, 3 mg/kg, and 4 mg/kg resulted in peak whole blood arterial bupivacaine (base) concentrations (mean +/- SD) of 0.77 +/- 0.25 microgram/ml, 1.37 +/- 0.23 microgram/ml, and 1.87 +/- 0.53 microgram/ml, respectively. Calculated pharmacokinetic parameters (mean +/- SD) were the following: apparent volume of distribution (VD beta), 2.8 +/- 0.8 L/kg; steady-state volume of distribution (VDss), 2.7 +/- 0.7 L/kg; elimination half-life (t1/2 beta), 147 +/- 80 min; and total body clearance (Cl), 16.0 +/- 7.4 ml X min-1 X kg-1, or 382 +/- 201 ml X min-1 X m-2. Compared with data reported for adult patients, our data indicate that the volume of distribution is greater and clearance is more rapid in children than in adults. The absorption of local anesthetic from the intercostal space appears to be more rapid in children than adults. In an additional group of 11 children, the relationship of the bupivacaine blood:plasma concentration ratio (lambda) to hematocrit was investigated. Hematocrit in this group ranged from 30 to 59, and lambda varied from 0.47 to 0.82. There was a significant relationship between lambda and hematocrit defined by the equation lambda = -0.0079 Hct + 1.028 (r = 0.72, P less than 0.05). Reporting bupivacaine concentration in terms of plasma concentration may introduce an artifact that is dependent on the hematocrit, and we therefore suggest that whole blood concentration values be reported by investigators in the future.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Rothstein P,Arthur GR,Feldman HS,Kopf GS,Covino BGsubject
Has Abstractpub_date
1986-06-01 00:00:00pages
625-32issue
6eissn
0003-2999issn
1526-7598journal_volume
65pub_type
杂志文章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::Phenomena seen in axons exposed to subblocking doses serve as the basis for interpreting clinical and behavioral observations during onset and recovery of peripheral nerve block. To delineate the changes in excitability and in impulse conduction caused by subblocking concentrations of local anesthetics (LAs) in myelin...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199212000-00008
更新日期:1992-12-01 00:00:00
abstract:UNLABELLED:Opioid medication is the mainstay of therapy for severe acute and chronic pain. Unfortunately, the side effects of these medications can affect patient comfort and safety, thus limiting their proven therapeutic potential. Whereas the main analgesic effects of opioids are centrally mediated, many of the commo...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/01.ane.0000090147.97636.77
更新日期:2004-01-01 00:00:00
abstract::Ten volunteers were studied during six stages of propofol sedation, namely awake (no propofol), light sedation (small dose of propofol), deep sedation (large dose), deep sedation with stimulation of the ulnar nerve, then light sedation again (small dose), and awake (recovery). Light and deep sedation were defined in t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199612000-00026
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Visual estimation and gravimetric methods are commonly used to quantify the volume of blood loss during cesarean delivery (CD). However, the correlation between blood loss and post-CD hemoglobin (Hb) is poorly studied, and it is unclear whether the correlation varies according to how blood loss is measured. ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000003449
更新日期:2019-05-01 00:00:00
abstract:UNLABELLED:Combined spinal-epidural anesthesia (CSE) is a popular technique for cesarean delivery. Regional blocks in obstetrics are often performed with the parturient in the sitting position because the midline may be recognized more easily than in the lateral decubitus position. When conventional spinal anesthesia i...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199809000-00023
更新日期:1998-09-01 00:00:00
abstract::In chloralose-anesthetized dogs the hypotensive and reflex cardiovascular responses to infusions of sodium nitroprusside were studied before and during halothane and enflurane, and before after divided doses of cryptenamine. The latter drug, a mixture of hypotensive veratrum alkaloids, lowers blood pressure reflexly b...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1980-12-01 00:00:00
abstract::The sensitivity, specificity, and accuracy of the cobalt blue and ninhydrin sweat tests were compared with the sympathogalvanic response (SGR) in assessment of complete sympathetic blockade. Patients were randomly assigned to receive epidural administration of either preservative-free physiologic saline solution and 8...
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:1985-04-01 00:00:00
abstract::Organ transplantation is a multidisciplinary specialty that has seen remarkable advances in the past two decades, in the tireless pursuit of providing life-saving therapy for patients suffering from end-stage organ failure. As the scientific basis and clinical practice of organ transplantation continues to evolve, it ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/00000539-199005000-00014
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:Unanticipated hospital admission is regarded as a measure of adverse perioperative patient care. However, previously published studies for risk prediction after ambulatory procedures are sparse compared to those examining readmission after inpatient surgery. We aimed to evaluate the incidence and reasons for...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究
doi:10.1213/ANE.0000000000004852
更新日期:2020-08-01 00:00:00
abstract::The role of succinylcholine in the precipitation of malignant hyperthermia (MH) necessitates the testing of new neuromuscular relaxants for their ability to trigger MH in MH-susceptible swine before general human use. We tested doxacurium and mivacurium, two new nondepolarizing bis-benzylisoquinolinium neuromuscular r...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199009000-00012
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:We have shown previously that either echocardiographic indices of diastolic dysfunction or increased preoperative brain natriuretic peptide (BNP) predict postoperative atrial fibrillation (POAF). Because these 2 predictors of POAF have not been evaluated together, our goal was to further elucidate their conc...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001471
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Gabapentin is an adjuvant analgesic and may enhance the spread of subarachnoid block. We investigated the effects of pretreatment with gabapentin on subarachnoid block characteristics and hemodynamics. METHODS:Seventy patients undergoing transurethral procedures under subarachnoid anesthesia with 2.2 mL of ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ane.0000295786.66822.60
更新日期:2008-01-01 00:00:00
abstract::We investigated the appropriateness of the somatosensory evoked potentials (SSEPs) as an objective monitor of sensory blockade of the ulnar nerve by comparing the effects of saline and lidocaine infiltration of the ulnar nerve at the elbow, with and without epinephrine. The four treatments were administered in random ...
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:1986-08-01 00:00:00
abstract::Inferential statistics relies heavily on the central limit theorem and the related law of large numbers. According to the central limit theorem, regardless of the distribution of the source population, a sample estimate of that population will have a normal distribution, but only if the sample is large enough. The rel...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000002741
更新日期:2018-02-01 00:00:00
abstract::The effects of thoracic epidural anesthesia on the performance of the parasternal intercostal muscles were investigated by measuring electromyographic activity and length changes of the parasternals (EMG activities and length, respectively, of the parasternals) in seven pentobarbital anesthetized, spontaneously breath...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199309000-00013
更新日期:1993-09-01 00:00:00
abstract::In pediatric practice, complications due to the laryngeal mask airway (LMA) have been studied with size 2 LMA, but not with size 1 LMA. We, therefore, compared prospectively the complications induced by LMA size 1 and 2 in 141 children aged 21 days to 11 yr. Intraoperative and lowest SpO2 values after removal of LMA w...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199303000-00012
更新日期:1993-03-01 00:00:00
abstract:UNLABELLED:Labor epidural analgesia (LEA) is allegedly associated with maternal fever and an increase in the newborn sepsis work-up (SWU) rate. In this study, we evaluated whether LEA causes an increase in the SWU rate compared with a Control group given parenteral narcotics for labor pain. Maternal and neonatal data w...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200110000-00038
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:Whether intraoperative analgesics have an impact on postoperative cancer recurrence is unknown. Some investigations suggest that the opioids could favor relapse and that regional analgesia and nonsteroidal antiinflammatory drugs could improve cancer prognosis. We retrospectively reviewed our series of breast...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181d2ad07
更新日期:2010-06-01 00:00:00
abstract:UNLABELLED:Nasotracheal intubation is often required during dental and maxillofacial surgery. The complications of nasotracheal intubation are well documented, but there have been few systematic attempts to find methods for their prevention. We examined intubation-related carriage of bacteria, especially methicillin-re...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/01.ane.0000066258.20778.06
更新日期:2003-07-01 00:00:00
abstract:UNLABELLED:Percutaneous tracheostomy with single-step dilation technique using Griggs' guidewire dilating forceps (GWDF) is a well-recognized procedure. Recently, Ciaglia has introduced a one-step dilation technique using a curved, gradually tapered dilator, the Ciaglia Blue Rhino (CBR). In a prospective, randomized st...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200212000-00050
更新日期:2002-12-01 00:00:00
abstract:UNLABELLED:Pressure infusion devices are often used to administer fluids in the operating room, but they may rarely be associated with serious venous air embolism. We studied the performance of the Level 1 and the Ranger Pressure Infusor in the laboratory. The Ranger delivered less air and delivered fluid faster than t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000082492.38765.74
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:We have developed a proportional-integral-derivative controller allowing the closed-loop coadministration of propofol and remifentanil, guided by a Bispectral Index (BIS) monitor, during induction and maintenance of general anesthesia. The controller was compared with manual target-controlled infusion. METH...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1213/ANE.0b013e318205680b
更新日期:2011-03-01 00:00:00
abstract::After Fontan repair in children, we performed a prospective, open-label study to evaluate the effect of amrinone on pulmonary vascular resistance (PVRI). Eight patients who underwent the Fontan repair had baseline arterial pressure, left atrial pressure, central venous pressure, and cardiac output measured postoperati...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199602000-00004
更新日期:1996-02-01 00:00:00
abstract:UNLABELLED:Using a randomized, double-blind protocol design, we compared a new lower-lipid emulsion of propofol (Ampofol) containing propofol 1%, soybean oil 5%, and egg lecithin 0.6% with the most commonly used formulation of propofol (Diprivan) with respect to onset of action and recovery profiles, as well as intraop...
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.0000103184.36451.d7
更新日期:2004-03-01 00:00:00
abstract:UNLABELLED:Propofol (Diprivan(TM); AstraZeneca, Wilmington, DE) is a commonly used drug for the induction of general anesthesia in the ambulatory setting. With the availability of a new bisulfite-containing generic formulation of propofol, questions have arisen regarding its cost effectiveness and safety compared with ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200010000-00019
更新日期:2000-10-01 00:00:00
abstract:UNLABELLED:We evaluated the blood-sparing effects of intraoperative moderate acute normovolemic hemodilution (ANH) combined with intraoperative tranexamic acid treatment and shed blood reinfusion in patients undergoing off-pump coronary artery bypass (OPCAB). One-hundred consecutive OPCAB patients (baseline hematocrit ...
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.0000113238.35409.fe
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Surveys suggest that, consistent with a high smoking prevalence, Chinese smokers in the general population report little interest in quitting. In other cultures, surgery is a powerful teachable moment for smoking cessation, increasing the rate of spontaneous quitting. We determined the perioperative tobacco ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31828e5cf0
更新日期:2013-06-01 00:00:00
abstract::The antifibrinolytic drug, tranexamic acid, decreases blood loss in adult patients undergoing cardiac surgery. However, its efficacy has not been extensively studied in children. Using a prospective, randomized, double-blind study design, we examined 41 children undergoing repeat sternotomy for repair of congenital he...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199705000-00008
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:Multiple interventions have been tested in models of cardiopulmonary resuscitation (CPR) to optimize drug use, chest compressions, and ventilation. None has studied the effects of positive end-expiratory pressure (PEEP) on outcome. We hypothesized that because PEEP can reverse pulmonary atelectasis, lower pu...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181b278a3
更新日期:2009-10-01 00:00:00