Abstract:
:Near-infrared spectroscopy (NIRS) is a noninvasive optical technique to monitor cerebral oxygen saturation at the bedside. Despite its applicability, NIRS has had limited clinical use because of concerns about accuracy, noted by intersubject variability in slope and intercept of the line between NIRS- and weighted-average arterial-cerebrovenous saturation (SMO2). This study evaluated transcranial optical pathlength and cerebral hemoglobin concentration as sources for this intersubject variability. Experiments were performed in an in vitro brain model and in piglets. Optical pathlength and cerebral hemoglobin concentration were measured by time-resolved spectroscopy (TRS). NIRS and TRS were recorded in the model, as perfusate blood saturation was varied (0%-100%) at several hemoglobin concentrations, and in piglets, as SMO2 was varied (15%-90%) before and after hemodilution. In the model, hemoglobin concentration significantly altered the NIRS versus blood saturation line slope and intercept, as well as optical pathlength. In piglets (before hemodilution), there was significant intersubject variability in NIRS versus SMO2 line slope (0.73-1.4) and intercept (-24 to 36) and in transcranial optical pathlength (13.4-16 cm) and cerebral hemoglobin concentration (0.58-1.1 g/dL). By adjusting the NIRS algorithm with optical pathlength or cerebral hemoglobin measurements, intersubject variability in slope (0.9-1.2) and intercept (-9 to 18) decreased significantly. Hemodilution significantly changed NIRS versus SMO2 line slope and intercept, as well as transcranial optical pathlength and cerebral hemoglobin concentration (before versus after hemodilution: slope 0.9 vs 0.78, intercept 13 vs 19, pathlength 13.9 vs 15.6 cm, cerebral hemoglobin 0.98 vs 0.73 g/dL). By adjusting the NIRS algorithm with the cerebral hemoglobin measurements, slope and intercept remained unchanged by hemodilution. These data indicate that intersubject variability in NIRS originates, in part, from biologic variations in transcranial optical pathlength and cerebral hemoglobin concentration. Instruments to account for these factors may improve NIRS cerebral oxygen saturation measurements.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Kurth CD,Uher Bdoi
10.1097/00000539-199706000-00023subject
Has Abstractpub_date
1997-06-01 00:00:00pages
1297-305issue
6eissn
0003-2999issn
1526-7598journal_volume
84pub_type
杂志文章abstract::Perioperative interventions aimed at decreasing costs and improving outcomes have become increasingly popular in recent years. Anesthesiologists are often faced with a choice among different treatment strategies with little data available on the comparative cost-effectiveness. We performed a systematic review of the E...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000003334
更新日期:2018-11-01 00:00:00
abstract::The intracranial and systemic hemodynamic effects of sufentanil (20 micrograms/kg) were studied in 10 mongrel dogs. Baseline anesthesia was maintained with 0.7% end-tidal isoflurane and 50% nitrous oxide in oxygen. Catheters were inserted for blood pressure measurement, arterial and sagittal sinus blood sampling, radi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199102000-00006
更新日期:1991-02-01 00:00:00
abstract:UNLABELLED:Decreased hepatic blood flow, and impaired hepatic oxygen delivery caused by endotoxin, result in hepatic metabolic deterioration followed by liver dysfunction and multiple organ failure. Among phosphodiesterase III inhibitors, only olprinone increases hepatosplanchnic blood flow. We evaluated the effects of...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200103000-00024
更新日期:2001-03-01 00:00:00
abstract::The protective effect of a nonionic surface-active polyol agent (Pluronic F-68) against bolus injection and constant-rate IV infusion of air was studied in 21 dogs anesthetized with pentobarbital. Aortic, pulmonary artery and right ventricular pressures, cardiac output, end-tidal CO2 concentration, wasted ventilation,...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197511000-00030
更新日期:1975-11-01 00:00:00
abstract:UNLABELLED:Controversy surrounds the use of the antiemetic droperidol, because of the Food and Drug Administration-imposed "black box" warning alleging that even small doses of the drug can lead to serious (even fatal) arrhythmias when it is used for antiemetic prophylaxis during the perioperative period. We used mathe...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000111103.86567.f6
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:The possibility that μ opioid agonists can influence cancer recurrence is a subject of recent interest. Epidemiologic studies suggested that there were differences in cancer recurrence in breast and prostate cancer contingent on anesthetic regimens. In this study, we identify a possible mechanism for these e...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31820568af
更新日期:2011-03-01 00:00:00
abstract::Cardiac output characteristically decreases during trimethaphan infusion but is well maintained or increased during sodium nitroprusside infusion. We postulated that at similar levels of mean arterial pressure, sodium nitroprusside might be associated with greater blood loss than trimethaphan due to the increase in ca...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1980-03-01 00:00:00
abstract::Intravenous lidocaine has been reported previously to inhibit postoperative pain when given either as single injections or as short infusions in amounts usually causing adverse reactions. To determine the efficacy of a continuous low-dose (2 mg/kg) intravenous infusion of lidocaine, postoperative pain (visual analogue...
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:1985-10-01 00:00:00
abstract:UNLABELLED:Concern about the side effects of allogeneic red blood cell transfusion has increased interest in methods of minimizing perioperative transfusion. We performed meta-analyses of randomized trials evaluating the efficacy and safety of aprotinin, desmopressin, tranexamic acid, and epsilon-aminocaproic acid in c...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,meta分析
doi:10.1097/00000539-199712000-00014
更新日期:1997-12-01 00:00:00
abstract:UNLABELLED:The Valsalva maneuver in the awake patient and the ventilation maneuver in the tracheally intubated anesthetized patient are two provocation methods to detect a patent foramen ovale (PFO) by means of contrast transesophageal echocardiography. In 60 patients undergoing posterior fossa surgery, a contrast agen...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200105000-00006
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Preoperative flushing of an anesthesia workstation is an alternative for preparation of the anesthesia workstation before use in malignant hyperthermia-susceptible patients (MHS). We studied in vitro, using a test lung, the washout profile of sevoflurane in 7 recent workstations during adult and, for the fir...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000208
更新日期:2014-07-01 00:00:00
abstract::Prior studies have suggested that the antifibrinolytic drug aprotinin increases the infarct size after ischemia and reperfusion (I/R) and attenuates the effect of ischemic preconditioning (IPC). Aprotinin was replaced by tranexamic acid (TXA) in clinical practice. Here, we investigated whether TXA influences I/R injur...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000002230
更新日期:2018-02-01 00:00:00
abstract::With the recent rapid adoption of electronic medical records (EMRs), studies reporting results based on EMR data have become increasingly common. While analyzing data extracted from our EMR for a retrospective study, we identified various types of erroneous data entries. This report investigates the root causes of the...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000002134
更新日期:2017-09-01 00:00:00
abstract::Critically ill patients often have cardiopulmonary perturbations that require rapid and frequent assessment for optimal care, including cardiac output determinations, measurement of cardiac filling pressures, and arterial and mixed venous blood gas determinations. We evaluated the performance of a rapid, on-demand bed...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199609000-00010
更新日期:1996-09-01 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:Adenosine and adenosine analogs induce analgesia in humans and presumed antinociception in animal models when administered both systemically and intrathecally. In the present investigation in rats, we studied the effects of intrathecally administered adenosine analogs, with or without systemic coadministrati...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199709000-00025
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:Midazolam is the most commonly used premedication in children. It has been shown to be more effective than parental presence or placebo in reducing anxiety and improving compliance at induction of anesthesia. Clonidine, an alpha(2) agonist, has been suggested as an alternative. Dexmedetomidine is a more alph...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ane.0b013e31816c8929
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:In this prospective, randomized, observer-blinded trial, we compared ultrasound-guided subparaneural popliteal sciatic nerve blocks performed either at or proximal to the neural bifurcation (B). We hypothesized that the total anesthesia-related time (sum of performance and onset times) would be decreased wit...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e31828a73be
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:In this pilot study, we hypothesized that velocity parameters obtained from changes in clot amplitude (A) and clot elasticity (E) measured with thromboelastometry (ROTEM, Tem International GmbH, Munich, Germany) could improve detection of fibrinolysis in whole blood obtained from children undergoing surgery ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000795
更新日期:2015-08-01 00:00:00
abstract::Epidural catheter placement offers flexibility in block management. However, during epidural catheter insertion, complications such as paresthesia and venous and subarachnoid cannulation may occur, and suboptimal catheter placement can affect the quality of anesthesia. We performed this prospective, randomized, double...
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.0000181005.50958.1E
更新日期:2005-11-01 00:00:00
abstract::These experiments investigated the effect of halothane or fentanyl anesthesia on plasma atrial natriuretic polypeptide (ANP) and angiotensin II (AII) concentrations and the response to a 30% blood volume load in rats. Halothane (1.1% and 2.2% inspired) or fentanyl (50 and 200 micrograms/kg) anesthesia alone produced l...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract::Jet ventilation is often used during laryngoscopy to permit improved visualization of the larynx and to eliminate a potentially flammable endotracheal tube when laser surgery of the airway is performed. Observation of chest wall movement and blood gas analysis are the usual standards for assessing the adequacy of vent...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199707000-00028
更新日期:1997-07-01 00:00:00
abstract::In susceptible patients, halothane, enflurane, isoflurane, and desflurane can produce severe hepatic injury by an immune response directed against reactive anesthetic metabolites covalently bound to hepatic proteins. The incidence of hepatotoxicity appears to directly correlate with anesthetic metabolism catalyzed by ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199701000-00031
更新日期:1997-01-01 00:00:00
abstract::This double-blind, randomized, multicenter study was designed to determine the short-term and long-term efficacy of intravenous regional block with guanethidine in patients with reflex sympathetic dystrophy (RSD)/causalgia. Sixty patients were enrolled to receive four intravenous regional blocks at 4-day intervals wit...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000539-199510000-00011
更新日期:1995-10-01 00:00:00
abstract:UNLABELLED:Repetitive transient ischemic depolarizations (IDs) during focal cerebral ischemia are thought to contribute to ischemic damage. Isoflurane and pentobarbital reduce injury (versus the nonanesthetized state) after focal cerebral ischemia. The mechanism by which these drugs reduce injury is not known. This pro...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199804000-00018
更新日期:1998-04-01 00:00:00
abstract:UNLABELLED:Despite their contribution to overall perioperative treatment of patients, anesthesiologists often remain in anonymity. We evaluated the impact of business cards on physician recognition after general anesthesia. Using a questionnaire, 441 patients were interviewed for recall of the anesthesiologist's name, ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200111000-00045
更新日期:2001-11-01 00:00:00
abstract::Availability of physiologic monitoring equipment to ensure the safe administration of anesthesia is an expected standard in many parts of the world. Many hospitals in China may not have an adequate quantity and variety of anesthesia delivery and patient monitoring equipment to assure safe administration of anesthesia ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31825018cf
更新日期:2012-06-01 00:00:00
abstract:UNLABELLED:Many drugs are tested intrathecally to investigate alternatives to opioids. We aimed to explore the analgesic and possible neurotoxic effects of chronic intrathecally-administered ketorolac tromethamine in rats. Catheters were placed via atlantoaxial interval in 28 Wistar rats under anesthesia of intraperito...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000093226.75543.90
更新日期:2004-01-01 00:00:00
abstract::Mitral valve replacement is frequently complicated by a low cardiac output syndrome and elevated pulmonary arterial pressures. In the present study, we used dobutamine to increase cardiac index and measured the pulmonary hemodynamic effects in 10 patients with increased pulmonary vascular tone following mitral valve r...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1989-04-01 00:00:00
abstract::Heart transplant recipients are susceptible to a number of complications in the immediate postoperative period. Despite advances in surgical techniques, mechanical circulatory support (MCS), and immunosuppression, evidence supporting optimal management strategies of the critically ill transplant patient is lacking on ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000004220
更新日期:2019-10-01 00:00:00