Abstract:
:Multiple drugs are used to provide anesthesia. Volatile anesthetics are commonly combined with opioids. Several studies have demonstrated that small doses of opioid (i.e., within the analgesic range) result in a marked reduction in minimum alveolar concentration (MAC) of the volatile anesthetic that will prevent purposeful movement in 50% of patients at skin incision). Further increases in opioid dose provide only a further small reduction in MAC. Thus, a ceiling effect of the opioid is observed at a MAC value of the volatile anesthetic equal to its MAC awake. Recovery from anesthesia when an opioid is combined with a volatile anesthetic is dependent on the rate of decrease of both drugs to their respective concentrations that are associated with adequate spontaneous ventilation and awakening. Through an understanding of the pharmacodynamic interaction of volatile anesthetics with opioids and the pharmacokinetic processes responsible for the recovery from drug effect, optimal dosing schemes can thus be developed. A review of these pharmacodynamic and pharmacokinetic principles that will allow clinicians to administer drugs to provide a more optimal anesthetic is provided.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Glass PS,Gan TJ,Howell S,Ginsberg Bdoi
10.1016/s0952-8180(97)00122-0subject
Has Abstractpub_date
1997-09-01 00:00:00pages
18S-22Sissue
6 Suppleissn
0952-8180issn
1873-4529pii
S0952-8180(97)00122-0journal_volume
9pub_type
杂志文章,评审abstract:STUDY OBJECTIVE:To describe our systematic approach to securing the airway in patients with laryngeal tumors, developed over a 10-year period. DESIGN:Retrospective analysis. SETTING:University-affiliated veterans administration medical center. PATIENTS:Eight hundred one patients presenting for laryngeal tumor surger...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2004.12.019
更新日期:2005-12-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the effects of respiratory acidosis and alkalosis by mechanical ventilation on the onset, duration, and recovery times of vecuronium. DESIGN:Randomized, prospective study. SETTING:Operating rooms in the Sapporo Medical University Hospital and Kitami Red Cross Hospital. PATIENTS:90 ASA ph...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(01)00361-0
更新日期:2002-03-01 00:00:00
abstract:STUDY OBJECTIVE:The aim of this study is to compare the effects of intravenous single-dose dexketoprofen trometamol and diclofenac sodium 30 minutes before the end of the surgery on relief of postoperative pain in patients undergoing laparoscopic cholecystectomy. DESIGN:A randomized fashion. SETTING AND PATIENTS:Sixt...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2016.02.020
更新日期:2016-08-01 00:00:00
abstract:STUDY OBJECTIVE:To compare spinal anesthesia and combined sciatic-femoral nerve block for outpatient knee arthroscopy. DESIGN:Prospective, randomized, controlled study. SETTING:Postoperative recovery area at a university-affiliated medical center. PATIENTS:50 ASA physical status I and II adult outpatients undergoing...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2008.04.003
更新日期:2008-09-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the effect of intravenous administration of prostaglandin E1 (PGE1) in inducing controlled hypotension during general anesthesia. DESIGN:Randomized, prospective study. SETTING:Inpatient surgery at a university hospital. PATIENTS:57 ASA physical status I and II patients scheduled for tota...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0952-8180(93)90125-x
更新日期:1993-07-01 00:00:00
abstract:STUDY OBJECTIVE:To estimate the optimal endotracheal tube (ETT) length in orotracheally intubated patients. DESIGN:Prospective study. SETTING:Operating room of a medical center hospital. PATIENTS:293 ASA physical status I and II patients (150 male and 143 female), requiring general anesthesia and orotracheal intubat...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(02)00355-0
更新日期:2002-06-01 00:00:00
abstract:STUDY OBJECTIVE:To ascertain if coughing during emergence from general anesthesia can be suppressed with a modified endotracheal tube. DESIGN:Randomized, double-blind, controlled study. SETTING:Operating rooms at a university hospital. PATIENTS:46 adult ASA physical status I, II, and III patients requiring elective ...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(01)00299-9
更新日期:2001-09-01 00:00:00
abstract:STUDY OBJECTIVE:To compare postoperative nausea, emesis, analgesia, and recovery between propofol-ketamine and propofol-fentanyl in outpatient laparoscopic tubal ligations with general anesthesia. STUDY DESIGN:Prospective, randomized, blinded study. SETTING:Tertiary-care women's hospital. PATIENTS:120 ASA physical s...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(02)00391-4
更新日期:2002-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate whether alkalizing local anesthetic with sodium bicarbonate reduces pain related to infiltration of local anesthetic during dorsal penile nerve block for circumcision. DESIGN:Prospective, randomized, double-blind, controlled study. SETTING:E. Wolfson Medical Center, Holon, Israel. PATIENT...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(99)00097-5
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Strabismus surgery is perhaps a pediatric surgical procedure that has the strongest evidence of postoperative nausea and vomiting (PONV) risk. This randomized controlled blind study was designed to evaluate the efficacy of combined therapy of dexamethasone and intraoperative superhydration vs their monothera...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2016.03.049
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:The American Society of Anesthesiologists physical status (ASA-PS) is associated with increased morbidity and mortality in the perioperative period. When surgeries are scheduled by surgeons and their staff at our large institution a presumed ASA-PS is chosen. This is because our institution (and, anecdotally,...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2017.02.002
更新日期:2017-05-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the quality of cell salvaged (CS) blood in patients undergoing hemihepatectomy (study group) and compare it with CS-blood from aortic surgery (control group). DESIGN:Observational study. SETTING:Operating room in a university hospital. MEASUREMENTS:6 patients undergoing hemihepatectomy...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2009.01.012
更新日期:2009-12-01 00:00:00
abstract:STUDY OBJECTIVE:Outpatient continuous interscalene brachial plexus blocks containing bupivacaine or ropivacaine are commonly used to control pain after shoulder surgery. Interscalene blocks cause hemidiaphragmatic paresis. Because ropivacaine preferentially blocks sensory fibers, it may cause less blockade of the phren...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2015.03.006
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Childhood and adolescent obesity increased in recent decades, and caregivers face an increasing number of obese pediatric surgical patients. Some clinical and pharmacogenetic data suggest that obese patients have altered pain sensitivity and analgesic requirements. OBJECTIVE:To test the primary hypothesis t...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2020.109729
更新日期:2020-06-01 00:00:00
abstract:STUDY OBJECTIVE:To compare a multiport, firm-tipped, close-ended, epidural catheter (Portex catheter) with a uniport, open-ended, soft-tipped, wire-reinforced catheter (Arrow catheter) in obstetric patients. STUDY DESIGN:Prospective data collection for intradepartmental quality assurance. SETTING:Obstetric unit in a ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(00)00116-1
更新日期:2000-03-01 00:00:00
abstract::Myotonic dystrophy (DM), though rare, can significantly complicate anesthesia due to muscular and extra-muscular involvement. When this condition is compounded by a pheochromocytoma, anesthetizing such patients becomes extra challenging. We present a case report of a 61-year-old lady with congenital DM, with the whole...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.03.035
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:Although parental presence during anesthesia induction is suggested to diminish operative stress level in children, there have been conflicting results about this strategy. The aim of this study was to evaluate the effects of maternal presence during induction on operative stress level in children who had ton...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2017.03.001
更新日期:2017-06-01 00:00:00
abstract::We present the case of a patient who first presented with unexpected difficult laryngoscopy and intubation after induction of general anesthesia. After multiple failed attempts using direct laryngoscopy, tracheal intubation was successfully performed with the Intubating Laryngeal Mask Airway. He returned to the operat...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2007.04.009
更新日期:2007-12-01 00:00:00
abstract:STUDY OBJECTIVE:To test the feasibility and efficacy of a new approach to paravertebral catheter placement in patients undergoing major surgery of the breast. DESIGN:Single-group, single-center observational study. SETTING:Operating room, postoperative recovery area, and normal ward of a university hospital. PATIENT...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2010.12.015
更新日期:2011-09-01 00:00:00
abstract:STUDY OBJECTIVE:To survey graduates from our residency program to determine their involvement and their interest in becoming certified in neonatal resuscitation. DESIGN:Survey questionnaire. SETTING:Graduates from the University of Pennsylvania Anesthesia Program between 1989 and 1999. SUBJECTS:212 individuals compl...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/s0952-8180(01)00285-9
更新日期:2001-08-01 00:00:00
abstract::We report the case of a 13 year old patient who received 3.0 mg of remifentanil during a 50-minute surgical procedure as a result of a dosage miscalculation. The patient failed to awaken at the conclusion of the procedure and showed signs of opioid overdose. She recovered spontaneously two hours later. ...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2010.07.005
更新日期:2011-06-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the effects of dexmedetomidine premedication on the minimum alveolar concentration of sevoflurane for tracheal intubation (MACTI) in children. DESIGN:Prospective, randomized, clinical comparison study. SETTING:Operating room of an academic hospital. PATIENTS:90 pediatric, ASA physical st...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2013.12.012
更新日期:2014-06-01 00:00:00
abstract:STUDY OBJECTIVES:The aim of the present study was to assess the quality of recovery from anesthesia in patients undergoing laparoscopic cholecystectomy (LC) under total intravenous anesthesia, who received either methadone or morphine for post-surgical analgesia by means of questionnaire Quality of Recovery-40 (QoR-40)...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2018.09.031
更新日期:2019-03-01 00:00:00
abstract:STUDY OBJECTIVE AND DESIGN:The mechanism of action of commonly used general anesthetics is largely unknown. One hypothesized mechanism is through modulation of microtubule stability. Taxanes, a subset of chemotherapeutic drugs known to alter microtubule stability and commonly used to treat breast cancer, offer a natura...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2015.05.001
更新日期:2015-09-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate whether gender difference has an effect on an anesthesia resident's ability to perform successful mask ventilation. DESIGN:Cohort study. SETTING:Surgical operation theater of a university-affiliated hospital. PATIENTS:839 ASA physical status I, II, and III patients undergoing general a...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2008.06.037
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:To examine the severity of cough and straining at the time of emergence from anesthesia. DESIGN:Double-blind randomized, placebo-controlled study. SETTING:University-affiliated hospital. PATIENTS:Sixty-two American Society of Anesthesiologists 2 patients undergoing craniotomy and excision of supratentorial...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2015.09.001
更新日期:2016-09-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate whether the type of anesthetic agent administered affects the antitussive effect of remifentanil. DESIGN:Prospective randomized study. SETTING:Operating room of a university hospital. PATIENTS:78 ASA physical status 1 and 2 women, aged 20 to 65 years, who were scheduled to undergo a th...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinane.2014.02.002
更新日期:2014-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate and compare cardiovascular responses to a new method of orotracheal intubation incorporating TV monitoring, with conventional orotracheal intubation via rigid blade laryngoscopy. DESIGN:Prospective single-blind study. SETTING:Operating room of a medical college hospital. PATIENTS:90 ASA p...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(00)00196-3
更新日期:2000-11-01 00:00:00
abstract:STUDY OBJECTIVE:Neuraxial blockade may increase external cephalic version (ECV) success rates. This survey aimed to assess the frequency and characteristics of neuraxial blockade used to facilitate ECV. SETTING AND DESIGN:We surveyed Society for Obstetric Anesthesia and Perinatology members regarding ECV practice usin...
journal_title:Journal of clinical anesthesia
pub_type: 杂志文章
doi:10.1016/j.jclinane.2016.05.040
更新日期:2016-11-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the efficacy and safety of four commercial propofol solutions marketed in Israel. DESIGN:Prospective, randomized, double-blind study. SETTING:University-affiliated medical center. PATIENTS:120 ASA physical status I and II nullipara patients undergoing dilatation and curettage for interrupt...
journal_title:Journal of clinical anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0952-8180(01)00271-9
更新日期:2001-08-01 00:00:00