Abstract:
:The local anesthetic effects of opioids have been demonstrated in both clinical and laboratory studies. Clinically, both meperidine and sufentanil can produce segmental sensory anesthesia. However, previous studies of the effects of opioids on nerve conduction have all made use of peripheral nerve preparations and yielded conflicting results. In the present study we describe the local anesthetic effects of phenylpiperidine opioids on individual dorsal root axons, the probable target for intrathecal local anesthetics. Dorsal roots were removed from anesthetized adult male rats and maintained in vitro. Standard single fiber recording techniques were used to isolate activity in the individual axons. Drug exposure was accomplished by perfusing the isolated dorsal root with an artificial cerebrospinal fluid containing the study drug at a clinically relevant concentration. Steady-state drug effects were measured after 15-30 min of exposure and compared to control measurements in the same preparation. Meperidine (705 microM) blocked conduction in 61.5% of 39 myelinated and unmyelinated axons, and significantly reduced conduction velocity in the remaining unblocked axons. These effects were not naloxone reversible. Fentanyl (0.6 microM and 3 microM) and sufentanil (1.04 microM) failed to affect the nerve conduction in any dorsal root axon. The discrepancy between laboratory and clinical observations is discussed. We suggest that the site of conduction block may occur at the proximal end of the dorsal root as it passes through the dorsal root entry zone, an anatomically unique segment of the primary sensory pathway with decreased conduction safety for action potential propagation.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Jaffe RA,Rowe MAdoi
10.1097/00000539-199610000-00021subject
Has Abstractpub_date
1996-10-01 00:00:00pages
776-81issue
4eissn
0003-2999issn
1526-7598journal_volume
83pub_type
杂志文章abstract::Morphine anesthesia is often recommended in patients with reduced cardiac reserve. As the effect of morphine on the balance between myocardial oxygen supply and demand is not well understood, the effect of large doses of morphine (3 mg/kg, subcutaneously) on experimental myocardial infarction size in the rat was evalu...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1982-10-01 00:00:00
abstract::Because of its slow onset of action, intrathecal morphine may not be the optimal drug for intraoperative analgesia during short cases, such as cesarean sections. It is not known whether adding fentanyl to a morphine-lidocaine spinal solution would provide any benefits to patients undergoing cesarean sections. Sixty-tw...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/00000539-199405000-00014
更新日期:1994-05-01 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::To improve operating room workflow, an internal transfer pricing system (ITPS) for anesthesia services was introduced in our hospital in 2001. The basic principle of the ITPS is that the department of anesthesia receives reimbursement only for the surgically controlled time, not for anesthesia-controlled time (ACT). A...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000154187.47998.60
更新日期:2005-07-01 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::Perioperative thermal manipulations are usually directed at the skin surface because methods of directly warming the core are invasive or ineffective. However, inadequate heat flow between peripheral and core compartments will decrease the rate at which core temperature changes. We therefore determined whether core hy...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199605000-00006
更新日期:1996-05-01 00:00:00
abstract:IMPLICATIONS:Clinical productivity measurements that account for differences in clinical settings and concurrencies provided more precise comparisons between two anesthesiology groups. The data show that different concurrencies confound the current industry standard, "per full-time equivalent" measurements, whereas "pe...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200108000-00014
更新日期:2001-08-01 00:00:00
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
更新日期:1999-06-01 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:UNLABELLED:Intravenous and volatile general anesthetics inhibit norepinephrine (NE) release from sympathetic neurons and other neurosecretory cells. However, the actions of general anesthetics on NE release from central nervous system (CNS) neurons are unclear. We investigated the effects of representative IV and volat...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200211000-00032
更新日期:2002-11-01 00:00:00
abstract::To evaluate the effects of acute sympathetic denervation on the baroreflex control of heart rate, baroreflex sensitivities were compared in lightly anesthetized humans who had either cervical (N = 20) or lumbar epidural anesthesia (N = 18), or neither (N = 18). Levels of anesthesia during cervical block using 10 ml of...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1983-09-01 00:00:00
abstract:BACKGROUND:We studied the effects that the lung recruitment maneuver (RM) and positive end-expiratory pressure (PEEP) have on the elimination of CO(2) per breath (Vtco(2,br)). METHODS:In 7 healthy and 7 lung-lavaged pigs at constant ventilation, PEEP was increased from 0 to 18 cm H(2)O and then decreased to 0 in steps...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181f0c2da
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:The arterial pulse oximeter, which was introduced clinically in the 1970s, is a convenient, useful, and now ubiquitous anesthesia monitor. Unfortunately, although percent saturation of arterial hemoglobin is, along with cardiac output and concentration of hemoglobin, one of 3 components of oxygen delivery, i...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3182166a26
更新日期:2011-06-01 00:00:00
abstract::Stellate ganglion block (SGB) is an established procedure for the diagnosis and treatment of chronic pain. SGB results in an acute sympathetic denervation of a part of the left ventricular (LV) wall innervated by the blocked ganglion, which may impair regional contractility. The resulting imbalance of myocardial contr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199412000-00010
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:The status of neuropathic pain alters the responsiveness to formalin injection in rats. However, the mechanism by which this alteration occurs is unknown. METHODS:We used immunocytochemistry to examine the expression of brain-derived neurotrophic factor (BDNF) and calcitonin gene-related peptide (CGRP) in t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000258762.22607.15
更新日期:2007-04-01 00:00:00
abstract:UNLABELLED:The nonhalogenated anesthetic alkanes, cyclopropane and butane, do not enhance gamma-aminobutyric acid-elicited GABAergic currents, suggesting that these agents produce anesthesia via interactions with other molecular targets. Perhalogenated nonimmobilizing alkanes, such as 1,2-dichlorohexafluorocyclobutane ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200209000-00015
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:The cellular mechanisms underlying the sedative effect of general anesthetics are not completely understood. Accumulating evidence indicates that the ventrolateral preoptic area (VLPO) of the hypothalamus plays a critical role. The VLPO contains 2 major types of neurons, the noradrenalin-inhibited GABAergic ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e318297366e
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:In 2001, the Center for Medicare and Medicaid Services issued a rule permitting states to "opt-out" of federal regulations requiring physician supervision of nurse anesthetists. We examined the extent to which this rule increased access to anesthesia care for urgent cases. METHODS:Using data from a national...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001154
更新日期:2016-06-01 00:00:00
abstract::The application of digital pressure above the injection site during interscalene block has been advocated to prevent cephalad spread of local anesthetic. In prior studies, radiographs taken immediately after interscalene injection of radiographic contrast have supported this concept. However, the clinical efficacy of ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199608000-00028
更新日期:1996-08-01 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::Adrenomedullin is a potent vasodilatory peptide. Plasma adrenomedullin (AM) concentrations increase during and after cardiopulmonary bypass (CPB). However, the cause of this increase and its site of production have not been identified. We investigated the role of the hepatosplanchnic and cerebral circulations in the i...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000072543.78106.aa
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:Impaired cerebral blood flow (CBF) autoregulation during cardiopulmonary bypass (CPB) is associated with stroke and other adverse outcomes. Large and small arterial stenosis is prevalent in patients undergoing cardiac surgery. We hypothesize that large and/or small vessel cerebral arterial disease is associa...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000003384
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Lidocaine is used clinically for tactile allodynia associated with diabetes-induced neuropathy. Although the analgesic effect of lidocaine through suppression of microglial activation has been implicated in the development of injury-induced neuropathic pain, its mechanism of action in diabetes-induced tactil...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31822827a2
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Aspects of intraoperative management (eg, hypotension) are associated with acute kidney injury (AKI) in noncardiac surgery patients. However, it is unclear if and how the addition of intraoperative data affects a baseline risk prediction model for postoperative AKI. METHODS:With institutional review board (...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000005057
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:Both femoral and obturator nerve blocks have been suggested to be useful in relieving pain after total knee arthroplasty (TKA). We sought to compare their efficacy. METHODS:Sixty patients undergoing elective unilateral TKA under spinal anesthesia received in a randomized, double-blind manner a femoral, obtu...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ane.0000278158.36843.f7
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Recombinant activated factor VII (rFVIIa) is increasingly used for treating refractory bleeding after cardiac surgery. However, hemostasis also depends on coagulation factors, including fibrinogen, which stabilizes platelet plugs at sites of vascular injury. We compared the hemostatic effects of rFVIIa, fibr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e318163fc76
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Manikins are widely used in airway management training; however, simulation of realism and interpatient variability remains a challenge. We investigated whether cadavers embalmed with the novel Fix for Life (F4L) embalmment method are a suitable and realistic model for teaching 3 basic airway skills: facemas...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000003678
更新日期:2018-10-01 00:00:00
abstract::Artificial intelligence-driven anesthesiology and perioperative care may just be around the corner. However, its promises of improved safety and patient outcomes can only become a reality if we take the time to examine its technical, ethical, and moral implications. The aim of perioperative medicine is to diagnose, tr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000004728
更新日期:2020-05-01 00:00:00
abstract:IMPLICATIONS:In this study, although 41%-94% of the patients were fast-track eligible after laparoscopic surgery, only 35%-53% of the patients actually bypassed the postanesthesia care unit (PACU) because of anesthetic-related factors and surgical complications. Residual sedation was the most common anesthetic-related ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200107000-00024
更新日期:2001-07-01 00:00:00
abstract::In a randomized study, we evaluated lag time (time from the end of injection of muscle relaxant until the first depression of the train-of-four response [TOF]), onset time (time from the end of injection of muscle relaxant until the maximum depression of the first twitch of the TOF [T1]), neuromuscular block, and endo...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199309000-00026
更新日期:1993-09-01 00:00:00