Abstract:
BACKGROUND:Occasionally, emergency perioperative pacing is necessary. Transcutaneous cardiac pacing is noninvasive, safe, and readily available. Its feasibility and hemodynamic effects during thoracic surgery and one-lung ventilation have not been established. METHODS:Twenty anesthetized patients (aged 25-70 yr) without cardiac disease undergoing elective pulmonary resection (right n = 10, left n = 10) were studied in normal sinus rhythm and during transcutaneous cardiac pacing. Patients were paced in supine and lateral decubitus positions (with closed and opened chest) at the minimal current necessary to produce ventricular capture. Invasive arterial monitoring permitted calculation of mean arterial pressure, and transesophageal echocardiography was used to assess atrial and ventricular wall motion and the evaluation of transmitral flow. Twelve patients underwent Doppler analysis of pulmonary venous flow. RESULTS:Pacing was achieved in all patients, with a mean threshold of 86.9 +/- 20.6 mA for the right thoracotomy group, and 106.7 +/- 16.2 mA for the left thoracotomy group. The mean paced heart rates for the right and left thoracotomy groups were 101.6 +/- 18.2 and 105.4 +/- 11.5 beats/min, respectively. During pacing, all patients sustained reversible transient decrements in mean arterial pressure (9-19%) from baseline, the loss of AV synchrony, and the development of paradoxical ventricular septal wall motion. No patient had significant mitral regurgitation during sinus or paced rhythms. Decreased systolic pulmonary venous flow velocity and abnormal systolic flow reversal were seen during pacing in 11 of the 12 patients studied. CONCLUSIONS:Transcutaneous cardiac pacing is effective in patients undergoing thoracotomy and one-lung ventilation. Its use in patients in normal sinus rhythm induces reversible decrements in mean arterial pressure because of the effects of altered atrioventricular association, ventricular wall motion, and pulmonary venous return.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Amar D,Gross JN,Burt M,Schwinger ME,Rusch VW,Reinsel RAdoi
10.1097/00000542-199310000-00013subject
Has Abstractpub_date
1993-10-01 00:00:00pages
715-23issue
4eissn
0003-3022issn
1528-1175journal_volume
79pub_type
临床试验,杂志文章相关文献
ANESTHESIOLOGY文献大全abstract:BACKGROUND:Rocuronium, like other steroidal nondepolarizing muscle relaxants, may in part be eliminated by the liver. To determine the influence of liver disease on its neuromuscular blocking effect, we studied the pharmacokinetics and pharmacodynamics of rocuronium in patients with cirrhosis. METHODS:Eighteen patient...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199406000-00011
更新日期:1994-06-01 00:00:00
abstract::The slow positive (P2) wave of the evoked electrospinogram was recorded from the dorsal epidural space in man. The waveform characteristics of the P2 wave were similar to those of the dorsal cord positive wave (P wave), which is believed to be caused by the primary afferent depolarization (PAD) and to be related to pr...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197510000-00003
更新日期:1975-10-01 00:00:00
abstract:BACKGROUND:Awareness during anesthesia is foremost assessed with postoperative interviews, which may underestimate its incidence. On-line monitors such as the Bispectral Index and patient response to verbal command are not necessarily commonly used. This study investigated response to command during deep sedation (Bisp...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200309000-00011
更新日期:2003-09-01 00:00:00
abstract::Alterations in platelet receptors critical to adhesion may play a role in the pathogenesis of the qualitative platelet defect associated with cardiopulmonary bypass. Using flow cytometry, we measured changes in the following platelet surface adhesive proteins: the von Willebrand factor receptor, glycoprotein Ib; the f...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199110000-00004
更新日期:1991-10-01 00:00:00
abstract:BACKGROUND:Mutations in the methylenetetrahydrofolate reductase (MTHFR) gene (677C>T, 1298A>C) cause elevated plasma homocysteine concentrations and have been linked to fatal outcomes after nitrous oxide anesthesia. This study tested the hypothesis that patients with common MTHFR 677C>T or 1298A>C mutations develop hig...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e318178820b
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:The surface membrane Ca(2+)-adenosine triphosphatase and Na(+)-Ca(2+) exchanger transport Ca(2+) out of the ventricular myocyte, competing for cytosolic Ca(2+) with the Ca(2+)-adenosine triphosphatase located in the sarcoplasmic reticulum. In this study the authors examined the effects of halothane, isoflura...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200206000-00027
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Postoperative nausea and vomiting continue to be a significant problem for pediatric ambulatory surgery patients. Although ondansetron has been demonstrated to be effective in the prophylactic treatment of postoperative nausea and vomiting (surrogate end point) no one has demonstrated a benefit of antiemetic...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199511000-00007
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:Age is often the sole criterion for determining the need for preoperative electrocardiograms. However, screening electrocardiograms have not been shown to add value above clinical information. This study was designed to determine whether it is possible to target electrocardiograms ordering to patients most l...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e31819fb139
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Studies using transthoracic thermodilution have demonstrated increased extravascular lung water (EVLW) measurements attributed to progression of edema and flooding during sepsis and acute lung injury. The authors hypothesized that redistribution of pulmonary blood flow can cause increased apparent EVLW secon...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181bc99cf
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:The authors sought to understand neural correlates of anesthetic-induced unconsciousness. Cortical gamma oscillations have been associated with neural processes supporting conscious perception, but the effect of general anesthesia on these oscillations is controversial. In this study, the authors examined th...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200505000-00012
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Mortality after noncardiac surgery has been associated with the "triple low state," a combination of low mean arterial blood pressure (<75 mmHg), low bispectral index (<45), and low minimum alveolar concentration of volatile anesthesia (<0.70). The authors set out to determine whether duration of a triple lo...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000281
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:The mechanism by which barbiturates protect neurons against ischemia is unclear, particularly when they are given after ischemia or reperfusion begins. Because an excess release of excitatory neurotransmitters causes postsynaptic membrane depolarization, which triggers neuronal damage in ischemia, the effect...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199612000-00024
更新日期:1996-12-01 00:00:00
abstract::The proclamation, "Gentlemen! this is no humbug," attributed to John Collins Warren, M.D., was not identified in any contemporaneous eyewitness report of William T. G. Morton's October 16, 1846, demonstration of ether at Massachusetts General Hospital. The earliest known documentation of the proclamation is in Nathan ...
journal_title:Anesthesiology
pub_type: 传,历史文章,杂志文章
doi:10.1097/ALN.0000000000000944
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:During muscular exercise, a negative correlation has been demonstrated between the value of mixed venous oxygen saturation (SvO2) and the level of muscular work, expressed at each level as the ratio of oxygen uptake (VO2) to each subject's maximal oxygen uptake (VO2max). Because the immediate postoperative p...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199402000-00007
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:In vitro studies have shown that isoflurane, enflurane, and halothane inhibit the hypoxic pulmonary vasoconstriction (HPV) with essentially the same potency. The aim of this study is to compare the effects of sevoflurane and isoflurane on HPV in constant-flow perfused rabbit lungs. METHODS:Constant-flow per...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199312000-00026
更新日期:1993-12-01 00:00:00
abstract::The effect of neuromuscular blockade with vecuronium on the hemodynamic responses to a noxious stimulus was investigated in male Sprague-Dawley rats. The rats were anesthetized with either halothane (group 1, n = 10), or isoflurane (group 2, n = 10). The maximum values for heart rate and mean arterial pressure during ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198908000-00009
更新日期:1989-08-01 00:00:00
abstract:BACKGROUND:Perfluorocarbon liquids are being used experimentally and in clinical trials for the treatment of acute lung injury. Their resemblance to inhaled anesthetic agents suggests the possibility of application by vaporization. The authors' aim was to develop the technical means for perfluorocarbon vaporization and...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199908000-00021
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Because ephedrine infusion (2 mg/min) does not adequately prevent spinal hypotension during cesarean delivery, the authors investigated whether adding phenylephrine would improve its efficacy. METHODS:Thirty-nine parturients with American Society of Anesthesiologists physical status I-II who were scheduled ...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200109000-00020
更新日期:2001-09-01 00:00:00
abstract::The blood flow in the sciatic nerve of the rabbit was estimated from the wash out of intraneurally injected 133Xe. To avoid diffusion of the tracer into the surrounding muscular tissue, the nerve was covered by a gas-tight plastic film. Using this technique, the basal blood flow in the sciatic nerve was estimated to 3...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198501000-00002
更新日期:1985-01-01 00:00:00
abstract::The neonatal neurobehavioral effects of bupivacaine, mepivacaine, and 2-chloroprocaine used in random sequence for pudendal block anesthesia were studied. The neurobehavioral status of 54 infants was studied 4 and 24 hours after delivery. Except for a significant difference in the responses to pinprick, there was no s...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-198004000-00004
更新日期:1980-04-01 00:00:00
abstract::The relationship of train-of-four (TOF) ratio to the depression of the first twitch (TD) was investigated in 16 patients given pancuronium in doses insufficient to eliminate the fourth response in the train. In ten patients the block was allowed to spontaneously recover (Group 1) and in six it was reversed with neosti...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198612000-00003
更新日期:1986-12-01 00:00:00
abstract:BACKGROUND:The practice of chronic pain management has grown steadily in recent years. The purpose of this study was to identify and describe issues and trends in liability related to chronic pain management by anesthesiologists. METHODS:Data from 5,475 claims in the American Society of Anesthesiologists Closed Claims...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200401000-00018
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine whether progressive levels of hypothermia (37, 34, 31, or 28 degrees C) during cardiopulmonary bypass (CPB) in pigs reduce the physiologic and metabolic consequences of global cerebral ischemia. METHODS:Sagittal sinus and cortical microdialysis catheters were inserted ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199802000-00018
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Deep hypothermia has been associated with an increased incidence of postoperative neurologic dysfunction after cardiac surgery in children. Recent studies suggest an excitotoxic mechanism involving overstimulation of glutamate receptors. Extracellular glutamate uptake occurs primarily by astrocytes. Astrocyt...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199912000-00030
更新日期:1999-12-01 00:00:00
abstract::The effects of epinephrine 1/200,000 as an adjuvant to epidural morphine were investigated in three healthy male volunteers, during 26-h observation sessions. Peak blood concentrations of morphine were 44 +/- 12.9 ng/ml after plain morphine and 13.7 +/- 6.7 ng/ml after epinephrine-morphine. Cutaneous hypalgesia was mo...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198303000-00010
更新日期:1983-03-01 00:00:00
abstract::Opioid receptors have been targeted for the treatment of pain and related disorders for thousands of years and remain the most widely used analgesics in the clinic. Mu (μ), kappa (κ), and delta (δ) opioid receptors represent the originally classified receptor subtypes, with opioid receptor like-1 (ORL1) being the leas...
journal_title:Anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/ALN.0b013e318238bba6
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:The authors previously reported that the pulmonary vasodilator response to the sympathetic beta-adrenoreceptor agonist isoproterenol is potentiated during isoflurane anesthesia compared with the conscious state. In the present in vivo study, the authors tested the hypothesis that halothane and enflurane anes...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200208000-00027
更新日期:2002-08-01 00:00:00
abstract::The treatment of venous air embolism by aspiration from central venous catheters is well established. However, some anesthesiologists prefer to use a pulmonary artery catheter to monitor patients undergoing a neurosurgical procedure in the sitting position. While offering certain advantages, pulmonary artery catheters...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198801000-00017
更新日期:1988-01-01 00:00:00
abstract::Because propofol has cerebral effects similar to those observed for barbiturates, we postulated that it too might offer protection against a focal cerebral ischemic insult. Spontaneously hypertensive male rats were anesthetized with halothane (in 50% O2/balance N2), and their tracheas were intubated and their lungs me...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199205000-00020
更新日期:1992-05-01 00:00:00
abstract:WHAT WE ALREADY KNOW ABOUT THIS TOPIC:WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Hypotension is a risk factor for adverse perioperative outcomes. Machine-learning methods allow large amounts of data for development of robust predictive analytics. The authors hypothesized that machine-learning methods can prov...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002374
更新日期:2018-10-01 00:00:00