Abstract:
:The insertion of implantable cardioverter/defibrillators (ICD) requires induction of repeated episodes of ventricular fibrillation (VF). The neuropsychological repercussions associated with repeated inducement of hypotension and cerebral ischemia are unknown. In this prospective clinical trial, 1 day prior to ICD assessment/implantation and 5 days postprocedure, 14 patients underwent neurological and cognitive screening. Cognitive dysfunction was defined as impaired performance in one of four cognitive domains. Neurological impairment was defined as a decrement of 2 or more points from baseline of a total possible score of 45 points. Intraoperative hemodynamics, including the reperfusion interval (RI; end of preceding fibrillation to beginning of the next), were recorded. Patients underwent an average of 12 +/- 6 episodes of VF with average duration of mean arterial pressure (MAP) <50 mm Hg for 17 +/- 9 s (range 6-39 s) and of MAP <30 mm Hg for 11 +/- 5 s (range 2-22 s). Nine patients, in none of whom the predetermined criteria for neurologic impairment was met, demonstrated a new subtle neurologic finding postoperatively. Ten of 14 patients met the criterion for cognitive dysfunction 5 days postoperatively. The mean RI between episodes of VF was significantly different between those patients demonstrating cognitive dysfunction and the unimpaired patients (3.1 +/- 0.5 min in the group with cognitive dysfunction vs 3.9 +/- 0.8 min in the unimpaired group, P = 0.027). Five patients without cognitive impairment had longer RI between episodes of circulatory arrest than those showing impaired cognition. We conclude that cognitive dysfunction can occur after insertion of ICD and is related to the duration of RI.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Murkin JM,Baird DL,Martzke JS,Yee Rdoi
10.1097/00000539-199706000-00003subject
Has Abstractpub_date
1997-06-01 00:00:00pages
1186-92issue
6eissn
0003-2999issn
1526-7598journal_volume
84pub_type
临床试验,杂志文章abstract:UNLABELLED:We evaluated the timing effect of a 10-mg IV administration of dexamethasone on its efficacy as a prophylactic antiemetic on postoperative nausea and vomiting (PONV). One hundred twenty women (n = 40 in each of three groups) undergoing abdominal total hysterectomy under general anesthesia were enrolled in th...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200007000-00025
更新日期:2000-07-01 00:00:00
abstract::The electroencephalograms of seven elderly (70-85 years) and seven younger patients (23-31 years) anesthetized with a concentration of isoflurane sufficient to produce burst suppression were studied. Anesthesia in these unpremedicated subjects was induced by inhalation of nitrous oxide, isoflurane, and oxygen. Trachea...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:Mitochondrial injury is a major cause of sepsis-induced organ failure. Polydatin (PD), a natural polyphenol, demonstrates protective mitochondrial effects in neurons and arteriolar smooth muscle cells during severe shock. In this study, we investigated the effects of PD on renal tubular epithelial cell (RTEC...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000977
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Propofol-evoked injection site pain is not observed with fospropofol. We hypothesized that unlike propofol, fospropofol does not activate the irritant receptor, transient receptor potential 1 (TRPA1). METHODS:We tested the hypothesis using electrophysiology and behavioral studies. RESULTS:Our data demonstr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e318258b9db
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:The switch from International Classification of Diseases, Ninth Revision, Clinical Modification to International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) for coding of inpatient procedures in the United States increased the number of procedural codes more than 19-fold,...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000003340
更新日期:2019-06-01 00:00:00
abstract::The effects of adenosine-induced hypotension on central as well as myocardial hemodynamics and metabolism were studied in five neurolept-anesthetized patients without known heart or lung diseases, who were undergoing cerebral aneurysm surgery. Adenosine (217 +/- 32 micrograms.kg-1.min-1) decreased mean arterial pressu...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1988-03-01 00:00:00
abstract:BACKGROUND:Sedatives and analgesics, in doses that alter consciousness in the intensive care unit (ICU), contribute to delirium and mortality. Pain, agitation, and delirium can be monitored in ICU patients. These symptoms were noted before (PRE) and after (POST) a protocol to alleviate undesirable symptoms. Analgesia a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181d7e1b8
更新日期:2010-08-01 00:00:00
abstract:UNLABELLED:Epidural catheters (EC) are often used in pediatric patients for intraoperative and postoperative pain relief. The small anatomical structures and catheter insertion under general anesthesia make it more difficult to perform EC and to prevent damage. In this study we investigated the use of ultrasound (US) i...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000156579.11254.D1
更新日期:2005-08-01 00:00:00
abstract::In order to evaluate the possible physiologic significance of intra- and postoperative hypotension, we monitored arterial blood pressure and heart rate continuously for 36 hr starting the night before and ending the morning after operation in 34 gynecologic patients. The lowest pressures that occurred during physiolog...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1984-07-01 00:00:00
abstract::During surgery, patients are exposed to multiple foreign substances including anesthetic drugs, antibiotics, blood products, heparin, polypeptides (aprotinin, latex, and protamine), and intravascular volume expanders, which have the potential to produce life-threatening allergic reactions termed "anaphylaxis." The hal...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ane.0b013e3181602e0d
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Computerized reviews of patient data promise to improve patient care through early and accurate identification of at-risk and well patients. The significance of sampling strategy for patient vital signs data is not known. In the instance of the surgical Apgar score (SAS), we hypothesized that larger sampling...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3182a46d6d
更新日期:2013-12-01 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:UNLABELLED:Linking physiological pharmacokinetic models to models of the cardiovascular system requires knowledge of the sites in the body that mediate a drug's cardiovascular effects. We examined the role of the coronary concentrations of propofol. Nine sheep anesthetized with isoflurane (2%) were instrumented acutely...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000060561.16583.a7
更新日期:2003-06-01 00:00:00
abstract::Patients referred to the Pain Clinic at the University of Virginia Medical Center with genuine phantom pain rather than stump pain have been treated by a variety of technics. Simple revision of drug therapy has proved helpful in some instances, as has repeated injection of trigger areas or neuromata, though surgical e...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197711000-00019
更新日期:1977-11-01 00:00:00
abstract:UNLABELLED:Calcium-sensitizing drugs, such as levosimendan, are a novel class of drug therapy for heart failure. We investigated the hypothesis that levosimendan is a pulmonary vasodepressor mediated through inhibition of phosphodiesterase, adenosine triphosphate (ATP)-dependent potassium channels, or both. We investig...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200206000-00009
更新日期:2002-06-01 00:00:00
abstract:UNLABELLED:We tested the ability of electroconvulsive treatment (ECT) to block thermal hyperalgesia and mechanical allodynia in rats with peripheral neuropathy. Repeated ECT (six times daily) significantly reduced thermal hyperalgesia 48 h after the end of the final treatment but had no significant effects on mechanica...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199803000-00028
更新日期:1998-03-01 00:00:00
abstract::The number of anesthesiology residents pursuing critical care medicine (CCM) fellowship training has been decreasing in recent years. A significant number of training positions remain unfilled each year. Possible causes of this decline were evaluated by surveying residents regarding their attitudes toward practice and...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199309000-00002
更新日期:1993-09-01 00:00:00
abstract:UNLABELLED:We describe the development and evaluation of a simple slide rule that enables the bedside determination of the infusion rate for a particular target plasma concentration of propofol. The infusion rate to reach this target concentration at time (t) is the product of the target concentration, body weight, and...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200301000-00029
更新日期:2003-01-01 00:00:00
abstract:UNLABELLED:Previous reports indicate that cyclosporine increases sleeping time from barbiturate administration, and analgesia from fentanyl administration, suggesting a possible contribution of cyclosporine to anesthesia. Accordingly, we determined whether cyclosporine pretreatment decreases isoflurane MAC (the minimum...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200210000-00025
更新日期:2002-10-01 00:00:00
abstract::Epinephrine-induced dysrhythmias were studied in 19 dogs anesthetized with 1.25 MAC enflurane or isoflurane, or the same preceded by thiopental (20 mg/kg). In 11 (group 1) dogs, thiopental reduced the dose of epinephrine required for production of ventricular ectopy, bigeminy and tachycardia with enflurane, and only v...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1986-05-01 00:00:00
abstract::Controversy exists concerning the choice of anesthetic technic for elective cesarean section. Several maternal and newborn parameters were compared during general anesthesia (GA) and lumbar epidural analgesia (LEA). High inspired maternal O2 levels were achieved with both technics. Vigorous, well-oxygenated infants wi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1977-03-01 00:00:00
abstract::We compared the effect of the lithotomy position on the systolic blood pressure (SBP) with the horizontal position after spinal block. The lithotomy position was performed 5 min after spinal block. The change in SBP was expressed as percent of depression from the baseline value. The SBP increased by the lithotomy posi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199507000-00019
更新日期:1995-07-01 00:00:00
abstract:UNLABELLED:Symptoms of orthostatic intolerance are common after general anesthesia and are associated with an increased risk of postoperative morbidity. The contribution of orthostatic hypotension (OH) has not been well defined. We conducted a head-up tilt test on patients after general anesthesia for minor surgery to ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000093388.17298.90
更新日期:2004-01-01 00:00:00
abstract::A previous demonstration that the ratio of analgesic to anesthetic endpoints is not constant across inhalation anesthetic agents implies that more than one mechanism of action may be operant in general anesthesia. We hypothesized that the endogenous opiate systems might account for this observed disparity in ratios. T...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1986-04-01 00:00:00
abstract::An early transesophageal echocardiography (TEE) study reported that there was high inter- and intraobserver variability in measurements of wall thickening (WT). This study reevaluated TEE for the measurement of WT in the transverse plane and, for the first time, evaluated it in the longitudinal plane. Ten patients wer...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199404000-00002
更新日期:1994-04-01 00:00:00
abstract::Intraoperative hypoxia occurred in two patients during the maintenance of the medical gas system. Engineers were purging oxygen pipelines with nitrogen to remove particulate debris but were unaware of a connection to operating room pipelines. This case illustrates the importance of communication between anesthesia pro...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200007000-00045
更新日期:2000-07-01 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::Although clonidine has been shown to increase the duration of local anesthetic action and prolong postoperative analgesia when included in single-injection nerve blocks, a controlled investigation of the efficacy of this practice to improve analgesia for continuous perineural local anesthetic infusion has not been rep...
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.0000075840.52964.a7
更新日期:2003-09-01 00:00:00
abstract::The swallowing reflex is depressed by anesthetics. During recovery from anesthesia the rapid return of laryngeal and upper airway reflexes is important to protect the lower airway from aspiration. This study measures the recovery of the swallowing reflex after propofol anesthesia. Fifteen patients undergoing a colonos...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199411000-00007
更新日期:1994-11-01 00:00:00
abstract::Studies were conducted on the effects of isoflurane and halothane on intracellular mechanisms of striated muscle contraction: Ca2+ activation of the contractile proteins and Ca2+ uptake and release from the sarcoplasmic reticulum. Functionally skinned muscle fibers (sarcolemma disrupted by homogenization) from isolate...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1986-05-01 00:00:00