Active inspiratory impedance and load compensation: effects of duration of anesthesia.

Abstract:

:General anesthesia results in increases in respiratory elastance and flow resistance within 10-15 min after induction. Stabilization (compensation) of the respiratory system in the face of this added load is related to the addition of active (contractile) force-length and force-velocity properties to its internal impedance during inspiration. The difference between active (inspiratory) and passive (relaxation-exhalation) values of elastance and resistance can be used as an index of load compensation. We therefore evaluated the effects of duration of anesthesia on respiratory impedance and stabilization by comparing active elastance (E'rs) and flow resistance (R'rs) to their corresponding passive values (Ers, Rrs) at the beginning and end of steady-state breathing in ten young, healthy anesthetized adults undergoing orthopedic surgery (anesthesia approximately 1.5 MAC of a halogenated anesthetic in 60% N2O-40% O2). Occlusion pressure (P0.1) and components of ventilation also were measured. Duration of anesthesia did not correlate with changes in active or passive mechanics or with control of ventilation. Mean Rrs increased by 76% (P less than 0.025), probably due to a decline of atropine effect; however, R'rs increased by only 17%, indicating near-maximum stabilization of flow-resistive properties at the end. Passive elastance increased 6%, whereas E'rs increased 3.8%, indicating essentially constant volume-elastic stabilization throughout. Occlusion pressure increased 20% and VT/TI 22%, probably due to a decline in effects of sedation and neuromuscular blockade. We conclude that after induction of anesthesia, the reserve available to overcome flow resistance (intrinsic plus equipment) diminishes but is not related to duration of anesthesia. The reserve available to overcome elastic properties remains essentially constant throughout anesthesia.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Baydur A,Sassoon CS,Stiles CM

subject

Has Abstract

pub_date

1986-01-01 00:00:00

pages

1-8

issue

1

eissn

0003-2999

issn

1526-7598

journal_volume

65

pub_type

杂志文章
  • The effect of GP683, an adenosine kinase inhibitor, on the desflurane anesthetic requirement in dogs.

    abstract:UNLABELLED:The availability of an analgesic compound devoid of the side effects associated with the commonly used opioid and nonsteroidal antiinflammatory drugs would be useful during the perioperative period. Although adenosine has analgesic and anesthetic-sparing properties, it also produces dose-dependent cardiovasc...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199709000-00035

    authors: Wang B,Tang J,White PF,Foster AC,Grettenberger HM,Kopcho J,Wender RH

    更新日期:1997-09-01 00:00:00

  • A comparison of lighted stylet (Surch-Lite) and direct laryngoscopic intubation in patients with high Mallampati scores.

    abstract:BACKGROUND:A lighted stylet is an effective alternative to a direct laryngoscope and has been reported to be particularly useful in patients with difficult airways. A high Mallampati class indicates poor visibility of the oropharyngeal structures. Because a lighted stylet does not require direct oropharyngeal visualiza...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ane.0b013e3181994fba

    authors: Rhee KY,Lee JR,Kim J,Park S,Kwon WK,Han S

    更新日期:2009-04-01 00:00:00

  • The Efficacy of Eslicarbazepine Acetate in Models of Trigeminal, Neuropathic, and Visceral Pain: The Involvement of 5-HT1B/1D Serotonergic and CB1/CB2 Cannabinoid Receptors.

    abstract:BACKGROUND:Many clinical pain states that are difficult to treat share a common feature of sensitization of nociceptive pathways. Drugs that could normalize hyperexcitable neural activity (e.g., antiepileptic drugs) may be useful in relieving these pain states. Eslicarbazepine acetate (ESL) is a novel antiepileptic dru...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000000953

    authors: Tomić MA,Pecikoza UB,Micov AM,Stepanović-Petrović RM

    更新日期:2015-12-01 00:00:00

  • The relationship between cardiac output measured by the thermodilution method and that measured by the carbon dioxide rebreathing technique during laparoscopic surgery.

    abstract::Carbon dioxide insufflation during laparoscopic surgery may interfere with the accuracy of the cardiac output value measured by the NICO2 system. The authors simultaneously measured cardiac output by the thermodilution method and by the carbon dioxide rebreathing technique during laparoscopic adrenalectomy in a patien...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000148697.28380.D5

    authors: Suzuki M,Koda S,Nakamura Y,Kawamura N,Shimada Y

    更新日期:2005-05-01 00:00:00

  • Cardiovascular effects of morphine in patients with coronary arterial disease.

    abstract::Large doses of morphine sulfate have been reported to cause myocardial lactate production and reduction in coronary blood flow in animals. Similar effects with clinical doses in man would significantly alter the management of cardiac patients. Eleven adult patients with significant coronary arterial disease and normal...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Sethna DH,Moffitt EA,Gray RJ,Bussell J,Raymond M,Conklin C,Shell WE,Matloff JM

    更新日期:1982-02-01 00:00:00

  • Performance validation of a modified magnetic resonance imaging-compatible temperature probe in children.

    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

    authors: Nasr VG,Schumann R,Bonney I,Diaz L,Ahmed I

    更新日期:2012-06-01 00:00:00

  • Synergy between pairs of competitive antagonists at adult human muscle acetylcholine receptors.

    abstract:BACKGROUND:Synergistic neuromuscular blocking effects have been observed clinically with certain pairs of nicotinic acetylcholine receptor (nAChR) competitive antagonists. The mechanism for synergy has not been elucidated. We tested the hypothesis that synergy arises from a differential selectivity of antagonists for t...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e31817b4469

    authors: Liu M,Dilger JP

    更新日期:2008-08-01 00:00:00

  • The effect of cerebral monitoring on recovery after general anesthesia: a comparison of the auditory evoked potential and bispectral index devices with standard clinical practice.

    abstract:UNLABELLED:The use of cerebral monitoring may improve the ability of anesthesiologists to titrate anesthetic drugs. However, there is controversy regarding the impact of the alleged anesthetic-sparing effects of cerebral monitoring on the recovery process and patient outcome. We designed this prospective double-blinded...

    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.0000087041.63034.8c

    authors: Recart A,Gasanova I,White PF,Thomas T,Ogunnaike B,Hamza M,Wang A

    更新日期:2003-12-01 00:00:00

  • The effect of graded hypothermia (36 degrees C-32 degrees C) on hemostasis in anesthetized patients without surgical trauma.

    abstract:UNLABELLED:The isolated effects of hypothermia on hemostasis have not been investigated in healthy humans. We cooled 16 anesthetized patients scheduled for elective intracranial surgery to 32 degrees C body core temperature and assessed prothrombin time (PT), activated partial thromboplastin time, thrombelastogram (TEG...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/01.ane.0000062520.65192.c9

    authors: Kettner SC,Sitzwohl C,Zimpfer M,Kozek SA,Holzer A,Spiss CK,Illievich UM

    更新日期:2003-06-01 00:00:00

  • Testing anal sphincter tone predicts the effectiveness of caudal analgesia in children.

    abstract:UNLABELLED:In this study, we examined the effectiveness of caudal blocks and correlated it with the laxity of the patients' anal sphincter before emergence from anesthesia in 178 children undergoing inguinal and/or penile surgery. Bupivacaine 0.25% in a volume of 0.6-1.25 mL/kg was used in all patients. The presence of...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200205000-00019

    authors: Verghese ST,Mostello LA,Patel RI,Kaplan RF,Patel KM

    更新日期:2002-05-01 00:00:00

  • Height, weight, and the spread of subarachnoid hyperbaric bupivacaine in the term parturient.

    abstract::Using a standardized technique, spinal anesthesia was induced in 50 term parturients to study the correlation between patient height, weight, and body mass index (BMI) and the spread of sensory blockade. All patients received 12 mg hyperbaric bupivacaine while in the right lateral decubitus position on a horizontal op...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Norris MC

    更新日期:1988-06-01 00:00:00

  • The quality of randomized controlled trials in major anesthesiology journals.

    abstract::Increased attention has been directed at the quality of randomized controlled trials (RCTs) and how they are being reported. We examined leading anesthesiology journals to identify if there were specific areas for improvement in the design and analysis of published clinical studies. All RCTs that appeared between Janu...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000150612.71007.A3

    authors: Greenfield ML,Rosenberg AL,O'Reilly M,Shanks AM,Sliwinski MJ,Nauss MD

    更新日期:2005-06-01 00:00:00

  • Patient preferences for early discharge after laparoscopic cholecystectomy.

    abstract:UNLABELLED:Patients may have concerns about their ability to manage postoperative symptoms at home after ambulatory surgery. We assessed patients' attitudes toward postoperative care at home or in the hospital after laparoscopic cholecystectomy. Thirty-eight patients undergoing elective laparoscopic cholecystectomy wer...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199906000-00015

    authors: Lehmann HP,Fleisher LA,Lam J,Frink BA,Bass EB

    更新日期:1999-06-01 00:00:00

  • Incidence, Prediction, and Causes of Unplanned 30-Day Hospital Admission After Ambulatory Procedures.

    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

    authors: Teja B,Raub D,Friedrich S,Rostin P,Patrocínio MD,Schneider JC,Shen C,Brat GA,Houle TT,Yeh RW,Eikermann M

    更新日期:2020-08-01 00:00:00

  • One hundred percent incidence of hemidiaphragmatic paresis associated with interscalene brachial plexus anesthesia as diagnosed by ultrasonography.

    abstract::Interscalene brachial plexus anesthesia for shoulder surgery routinely includes sensory anesthesia of the fourth and fifth cervical nerves. The authors reasoned that some degree of diaphragm paralysis should result from interscalene blocks that produce surgical C3-C5 sensory anesthesia. In this investigation, ultrason...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199104000-00014

    authors: Urmey WF,Talts KH,Sharrock NE

    更新日期:1991-04-01 00:00:00

  • The in vivo effects of general and epidural anesthesia on human immune function.

    abstract:UNLABELLED:Impaired in vivo immunity is often observed after major surgery and is multifactorial. We conducted a randomized clinical study to determine the independent effects of general anesthesia (GA) and of lumbar epidural anesthesia (LEA) on human immune function in the absence of surgical trauma. Nineteen healthy ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200108000-00044

    authors: Procopio MA,Rassias AJ,DeLeo JA,Pahl J,Hildebrandt L,Yeager MP

    更新日期:2001-08-01 00:00:00

  • Special article: mandragora: anesthetic of the ancients.

    abstract::Initial attempts at surgical anesthesia began many centuries ago, with the plants of antiquity. The mandragora, or mandrake, was used as a sedative and to induce pain relief for surgical procedures. It has been depicted in tablets and friezes since the 16th century before the common era (BCE) and used for its sedative...

    journal_title:Anesthesia and analgesia

    pub_type: 历史文章,杂志文章,评审

    doi:10.1213/ANE.0b013e318259ee4d

    authors: Chidiac EJ,Kaddoum RN,Fuleihan SF

    更新日期:2012-12-01 00:00:00

  • Population pharmacokinetics of dexmedetomidine in infants after open heart surgery.

    abstract:BACKGROUND:Dexmedetomidine is a highly selective alpha(2)-agonist with hypnotic, analgesic, and anxiolytic properties. In adults, it provides sedation while preserving respiratory function facilitating extubation. Only limited pharmacokinetic data are available for pediatric patients. The primary aim of this study was ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3181d783c8

    authors: Su F,Nicolson SC,Gastonguay MR,Barrett JS,Adamson PC,Kang DS,Godinez RI,Zuppa AF

    更新日期:2010-05-01 00:00:00

  • Droperidol causes a dose-dependent prolongation of the QT interval.

    abstract::To further investigate possible prolongation of the frequency-corrected QT interval (QTc interval) after administration of droperidol (DRO), we studied 40 surgical patients who were randomly assigned to one of three groups, receiving an intravenous (IV) injection of either 0.1 mg/kg (Group 1, n = 10), 0.175 mg/kg (Gro...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/00000539-199411000-00028

    authors: Lischke V,Behne M,Doelken P,Schledt U,Probst S,Vettermann J

    更新日期:1994-11-01 00:00:00

  • The volatile anesthetic isoflurane inhibits the histamine-induced Ca2+ influx in primary human endothelial cells.

    abstract:UNLABELLED:Although isoflurane is a known vasodilator, the mechanism of isoflurane-induced vasodilation is not clear. One of the most important systems in this context is the nitric oxide (NO)-mediated vasodilation. The activity of this system is regulated by the agonist-induced Ca(2+) influx rather than Ca(2+) release...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000068826.97781.ce

    authors: Tas PW,Stöbetael C,Roewer N

    更新日期:2003-08-01 00:00:00

  • The effects of general anesthesia and surgery on basal and interferon stimulated natural killer cell activity of humans.

    abstract:UNLABELLED:Natural killer (NK) cells can lyse certain tumor cells as well as virally infected cells without prior sensitization. Animal studies have shown that general anesthesia (GA) alone or GA followed by surgery decreases both basal NK cytotoxicity and enhancement of NK activity by interferon (IFN). The purpose of ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199710000-00037

    authors: Kutza J,Gratz I,Afshar M,Murasko DM

    更新日期:1997-10-01 00:00:00

  • The Diagnostic Accuracy of Noninvasive Methods to Measure the Intracranial Pressure: A Systematic Review and Meta-analysis.

    abstract:BACKGROUND:Although invasive monitoring is the standard method for intracranial pressure (ICP) measurement, it is not without potential for serious complications. Noninvasive methods have been proposed as alternatives to invasive ICP monitoring. The study aimed to investigate the diagnostic accuracy of the currently av...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000005189

    authors: Sallam A,Abdelaal Ahmed Mahmoud M Alkhatip A,Kamel MG,Hamza MK,Yassin HM,Hosny H,Younis MI,Ramadan E,Algameel HZ,Abdelhaq M,Abdelkader M,Mills KE,Mohamed H

    更新日期:2020-09-24 00:00:00

  • Plasma concentrations of bupivacaine in neonates after continuous epidural infusion.

    abstract::This study reports plasma bupivacaine concentrations in 13 neonates who received lumbar epidural anesthesia during major abdominal surgery. A bolus of 1.8 mg/kg of bupivacaine (2.5 mg/mL) was administered after induction of anesthesia, followed by a continuous infusion of 0.2 mg.kg-1.h-1 (1.25 mg/mL). Plasma concentra...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000539-199703000-00006

    authors: Larsson BA,Lönnqvist PA,Olsson GL

    更新日期:1997-03-01 00:00:00

  • Large-dose intrathecal sufentanil prevents the hormonal stress response during major abdominal surgery: a comparison with intravenous sufentanil in a prospective randomized trial.

    abstract::We studied the effect of large-dose intrathecal sufentanil (ITS) for major abdominal surgery on the hormonal stress response. Forty patients were randomly allocated to receive either IV sufentanil (IVS) or 150 microg of ITS as part of general anesthesia. In the IVS group, adrenocorticotropic hormone (ACTH) and cortiso...

    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.0000131728.68125.4E

    authors: Borgdorff PJ,Ionescu TI,Houweling PL,Knape JT

    更新日期:2004-10-01 00:00:00

  • The effects of ketamine on the temporal summation (wind-up) of the R(III) nociceptive flexion reflex and pain in humans.

    abstract:UNLABELLED:Animal studies have suggested that the temporal summation of nociceptive inputs might play a significant role in the development of central sensitization (i.e., hyperexcitability of central nociceptive neurons) and hyperalgesia via the activation of N-methyl-D-aspartate receptors. To further analyze these pr...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200002000-00031

    authors: Guirimand F,Dupont X,Brasseur L,Chauvin M,Bouhassira D

    更新日期:2000-02-01 00:00:00

  • The additive pulmonary vasodilatory effects of inhaled prostacyclin and inhaled milrinone in postcardiac surgical patients with pulmonary hypertension.

    abstract:UNLABELLED:Selective pulmonary vasodilation is an advantageous therapeutic strategy for cardiac surgical patients with increased pulmonary vascular resistance (PVR) and right ventricular failure. We hypothesized that milrinone, an adenosine-3',5'-cyclic monophosphate (cAMP)-selective phosphodiesterase enzyme (PDE) inhi...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000539-200112000-00018

    authors: Haraldsson s A,Kieler-Jensen N,Ricksten SE

    更新日期:2001-12-01 00:00:00

  • Assessment of vaporizer performance in low-flow and closed-circuit anesthesia.

    abstract::The performance of five of the most commonly used halothane vaporizers and three enflurane vaporizers was tested under conditions encountered in low-flow and closed-circuit anesthesia. Anesthetic gas concentrations were measured continuously with a mass spectrometer connected to a circle system. The results indicated ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Lin CY

    更新日期:1980-05-01 00:00:00

  • Buffered Solutions Versus Isotonic Saline for Resuscitation in Nonsurgical Critically Ill: Protocol for Cochrane Review.

    abstract::Fluid resuscitation is one of the most prevalent treatment in critical care. There is not definitive evidence about the best fluid for resuscitation. The aim of this review will be to asses the efficacy and safety of buffered solution versus saline. We will perform an electronic search in Medline, Embase, and Central....

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,meta分析,评审

    doi:10.1213/ANE.0000000000001616

    authors: Barea-Mendoza JA,Antequera AM,Plana MN,Chico-Fernández M,Muriel A,Sáez I,Estrada-Lorenzo JM,Montejo-González JC

    更新日期:2016-12-01 00:00:00

  • Glymphatic System Function in Relation to Anesthesia and Sleep States.

    abstract::The brain is one of the most metabolically active organs in the body. The brain's high energy demand associated with wakefulness persists during rapid eye movement sleep, and even during non-rapid eye movement sleep, cerebral oxygen consumption is only reduced by 20%. The active bioenergetic state parallels metabolic ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000004069

    authors: Benveniste H,Heerdt PM,Fontes M,Rothman DL,Volkow ND

    更新日期:2019-04-01 00:00:00

  • Emerging techniques in the management of acute pain: epidural analgesia.

    abstract::Epidural analgesia, often using opioids intraoperatively and postoperatively, is widely accepted as a valuable modality for perioperative pain management. In this review I present data from meta-analyses and recently published trials that evaluate the perioperative use of opioids administered epidurally or parenterall...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/01.ane.0000179686.73009.2b

    authors: Viscusi ER

    更新日期:2005-11-01 00:00:00