A comparison of the volume and pH of gastric contents of obese and lean surgical patients.

Abstract:

UNLABELLED:Obese surgical patients are typically considered to be more likely than lean patients to possess high-volume and low-pH (HVLP) gastric contents after a standard preoperative fast, based on a study of a population predominately consisting of patients receiving intramuscular preoperative sedation. We revisited this issue in a study population of 256 fasted surgical patients, of which 232 received no preoperative antacid or gastric prokinetic drug. Immediately after endotracheal intubation, an 18-French sump tube was placed, and gastric contents were withdrawn. Subjects' gastric contents were defined as HVLP if they exhibited a combination of a volume > 25 mL and a pH < 2.5. Obesity was defined as a body mass index > 30. Among nonmedicated obese patients, the proportion with HVLP gastric contents was 20 of 75 (26.6%). The proportion of lean patients with HVLP gastric contents was 66 of 157 (42.0%). The difference between the HVLP proportions for these two groups was found to be significant (P < 0.05) using chi 2 analysis. Obesity seems to be associated with a significantly decreased risk of HVLP gastric contents among surgical patients with no history of gastroesophageal pathology after a normal interval of preoperative fasting. IMPLICATIONS:Previous studies have shown that obese surgical patients have a greater volume of acidic stomach contents than lean patients, despite a routine preoperative fast. We have reexamined this issue and found that among otherwise healthy, fasted, obese surgical patients, there is a lower incidence of combined high-volume, low-pH stomach contents compared with lean patients.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Harter RL,Kelly WB,Kramer MG,Perez CE,Dzwonczyk RR

doi

10.1097/00000539-199801000-00030

subject

Has Abstract

pub_date

1998-01-01 00:00:00

pages

147-52

issue

1

eissn

0003-2999

issn

1526-7598

journal_volume

86

pub_type

杂志文章
  • The prevalence and significance of low preoperative hemoglobin in ASA 1 or 2 outpatient surgery candidates.

    abstract::Asymptomatic anemia in healthy patients undergoing low risk surgery is rare. In this retrospective study, we examined the records of 9584 ASA class I-II patients scheduled for elective low risk surgery who had a preoperative hemoglobin (hgb) test for the presence of anemia. Hgb <9 g/dL was detected in 75 patients (0.8...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000180836.02142.E6

    authors: Olson RP,Stone A,Lubarsky D

    更新日期:2005-11-01 00:00:00

  • Plasma concentrations of bupivacaine after lumbar sympathetic block.

    abstract::To determine the pharmacokinetics of local anesthetics after lumbar sympathetic blocks, total and free (unbound) plasma concentrations of bupivacaine in venous blood samples were measured in 12 patients using a high-performance liquid chromatography (HPLC) technique. Administration of 30 mL of plain bupivacaine 0.175%...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199411000-00017

    authors: Wulf H,Gleim M,Schele HA

    更新日期:1994-11-01 00:00:00

  • Cardiovascular responses to clamping of the aorta during epidural and general anesthesia.

    abstract::The cardiovascular responses of aortic cross-clamping and declamping with normal and high ventricular filling pressures were compared during epidural and nitrous oxide-morphine anesthesia in 32 male patients undergoing reconstructive aortic surgery. The patients were divided into four groups. Groups I and II had lumba...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-197909000-00005

    authors: Lunn JK,Dannemiller FJ,Stanley TH

    更新日期:1979-09-01 00:00:00

  • Effects of Obesity and Leptin Deficiency on Morphine Pharmacokinetics in a Mouse Model.

    abstract:BACKGROUND:Obesity causes multiorgan dysfunction, specifically metabolic abnormalities in the liver. Obese patients are opioid-sensitive and have high rates of respiratory complications after surgery. Obesity also has been shown to cause resistance to leptin, an adipose-derived hormone that is key in regulating hunger,...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000001578

    authors: Dalesio NM,Hendrix CW,McMichael DH,Thompson CB,Lee CK,Pho H,Arias RS,Lynn RR,Galinkin J,Yaster M,Brown RH,Schwartz AR

    更新日期:2016-12-01 00:00:00

  • Anesthetic preconditioning: the role of free radicals in sevoflurane-induced attenuation of mitochondrial electron transport in Guinea pig isolated hearts.

    abstract::Cardioprotection by anesthetic preconditioning (APC) can be abolished by nitric oxide (NO*) synthase inhibitors or by reactive oxygen species (ROS) scavengers. We previously reported attenuated mitochondrial electron transport (ET) and increased ROS generation during preconditioning sevoflurane exposure as part of the...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000139346.76784.72

    authors: Riess ML,Kevin LG,McCormick J,Jiang MT,Rhodes SS,Stowe DF

    更新日期:2005-01-01 00:00:00

  • The effect of a perioperative clinical pathway for knee replacement surgery on hospital costs.

    abstract:UNLABELLED:Clinical pathways are being introduced by hospitals to reduce costs and control unnecessary variation in care. We studied 766 inpatients to measure the impact of a perioperative clinical pathway for patients undergoing knee replacement surgery on hospital costs. One hundred twenty patients underwent knee rep...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199805000-00012

    authors: Macario A,Horne M,Goodman S,Vitez T,Dexter F,Heinen R,Brown B

    更新日期:1998-05-01 00:00:00

  • A comparison of remifentanil and sufentanil as adjuvants during sevoflurane anesthesia with epidural analgesia for upper abdominal surgery: effects on postoperative recovery and respiratory function.

    abstract:UNLABELLED:We compared the recovery profile and postoperative SpO(2) after the administration of general anesthesia with either sevoflurane-remifentanil or sevoflurane-sufentanil in 30 healthy patients undergoing upper abdominal surgery. They were randomly allocated to receive general anesthesia with sevoflurane and sm...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200011000-00040

    authors: Casati A,Albertin A,Fanelli G,Deni F,Berti M,Danelli G,Grifoni F,Torri G

    更新日期:2000-11-01 00:00:00

  • Isoflurane and halothane produce similar alterations in aortic distensibility and characteristic aortic impedance.

    abstract::The effects of volatile anesthetics on arterial mechanical properties in vivo are incompletely understood. The present investigation tested the hypothesis that isoflurane and halothane cause differential actions on the mechanical characteristics of the aorta in barbiturate-anesthetized dogs instrumented for measuremen...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199612000-00006

    authors: Hettrick DA,Pagel PS,Warltier DC

    更新日期:1996-12-01 00:00:00

  • Operating room nursing directors' influence on anesthesia group operating room productivity.

    abstract:BACKGROUND:Implementation of initiatives to increase anesthesia group productivity depends not just on anesthesia groups, but on operating room (OR) nursing administration. OR nursing directors may encourage organizational change based on the needs of their hospitals and nurses. These changes may differ from those that...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e31818874a8

    authors: Masursky D,Dexter F,Nussmeier NA

    更新日期:2008-12-01 00:00:00

  • Rapid recovery from sevoflurane and desflurane with hypercapnia and hyperventilation.

    abstract:BACKGROUND:Hypercapnia with hyperventilation shortens the time between turning off the vaporizer (1 MAC) and when patients open their eyes after isoflurane anesthesia by 62%. METHODS:In the present study we tested whether a proportional shortening occurs with sevoflurane and desflurane. RESULTS:Consistent with a prop...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000265849.33203.60

    authors: Sakata DJ,Gopalakrishnan NA,Orr JA,White JL,Westenskow DR

    更新日期:2007-07-01 00:00:00

  • Epinephrine injection in lipid-based resuscitation from bupivacaine-induced cardiac arrest: transient circulatory return in rabbits.

    abstract:BACKGROUND:IV lipid emulsion has demonstrated to be effective therapy for bupivacaine-induced cardiotoxicity. However, the role of epinephrine when coadministered with lipid emulsion in toxin-induced cardiac arrest is unclear. We postulated superior resuscitation outcome in the absence of epinephrine in a rabbit model ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3181e66050

    authors: Harvey M,Cave G,Prince G,Lahner D

    更新日期:2010-09-01 00:00:00

  • The potency of succinylcholine in obese adolescents.

    abstract:UNLABELLED:We constructed a single-dose response curve for succinylcholine in 30 obese adolescents during thiopental-fentanyl anesthesia administration by using 100 microg/kg, 150 microg/kg, or 250 microg/kg IV. The maximal response (percent depression of neuromuscular function) of the adductor pollicis to supramaximal...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200003000-00015

    authors: Rose JB,Theroux MC,Katz MS

    更新日期:2000-03-01 00:00:00

  • Neuraxial Anesthesia Reduces Lymphatic Flow: Proof-of-Concept in First In-Human Study.

    abstract::Dilation of lymphatic vessels may contribute to iatrogenic dissemination of cancer cells during surgery. We sought to determine whether neuraxial anesthesia reduces regional lymphatic flow. Using nuclear lymphoscintigraphy, 5 participants receiving spinal anesthesia for brachytherapy had lower extremity lymph flow at ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/ANE.0000000000001562

    authors: Hiller JG,Ismail HM,Hofman MS,Narayan K,Ramdave S,Riedel BJ

    更新日期:2016-11-01 00:00:00

  • The incidence of intraoperative awareness in children: childhood awareness and recall evaluation.

    abstract:BACKGROUND:There is a considerable discrepancy between the reported incidences of awareness under anesthesia in children (0.2%-2.7%). In this prospective, observational, cohort study we evaluated 1) the incidence of awareness during general anesthesia in children across three settings, 2) factors contributing to awaren...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,多中心研究

    doi:10.1213/ANE.0b013e3181b620b0

    authors: Malviya S,Galinkin JL,Bannister CF,Burke C,Zuk J,Popenhagen M,Brown S,Voepel-Lewis T

    更新日期:2009-11-01 00:00:00

  • Paradoxical embolus after multiple trauma resulting in a cerebrovascular accident.

    abstract:UNLABELLED:We present the case of a 57-yr-old patient who suffered an unexplained cerebrovascular event 3 days after being struck by a motor vehicle. Workup demonstrated a previously unknown patient foramen ovale. The etiologies of paradoxical embolism in trauma are discussed. IMPLICATIONS:Paradoxical embolism after m...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000102069.59203.a4

    authors: Price MD,Kanake P,Talmor D

    更新日期:2004-04-01 00:00:00

  • Comparison of Thrombelastography-Derived Fibrinogen Values at Rewarming and Following Cardiopulmonary Bypass in Cardiac Surgery Patients.

    abstract:BACKGROUND:The inflated costs and documented deleterious effects of excess perioperative transfusion have led to the investigation of targeted coagulation factor replacement strategies. One particular coagulation factor of interest is factor I (fibrinogen). Hypofibrinogenemia is typically tested for using time-consumin...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/ANE.0000000000001465

    authors: Fabbro M 2nd,Gutsche JT,Miano TA,Augoustides JG,Patel PA

    更新日期:2016-09-01 00:00:00

  • The peripheral antinociceptive effects of endomorphin-1 and kynurenic acid in the rat inflamed joint model.

    abstract:BACKGROUND:Several data suggest that both opioid and N-methyl-d-aspartate (NMDA) receptors are localized at the peripheral level, and drugs acting on these receptors may produce antinociception after topical administration; however, the antinociceptive effect of endogenous ligands at these receptors is poorly clarified...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e3181b21c5e

    authors: Mecs L,Tuboly G,Nagy E,Benedek G,Horvath G

    更新日期:2009-10-01 00:00:00

  • Effects of fentanyl, naloxone, and clonidine on hemodynamics and plasma catecholamine levels in dogs.

    abstract::A 50-micrograms/kg dose of fentanyl, given intravenously in divided doses to dogs under enflurane-nitrous oxide anesthesia caused sharp decreases in heart rate (HR), arterial blood pressure (AP), left ventricular dP/dt, and plasma levels of catecholamines. Naloxone, 20 micrograms/kg given 65-70 min later, completely a...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Flacke JW,Flacke WE,Bloor BC,Olewine S

    更新日期:1983-03-01 00:00:00

  • Avoiding transfusions in children undergoing cardiac surgery: a meta-analysis of randomized trials of aprotinin.

    abstract::Aprotinin, a potent antifibrinolytic drug, reduces the proportion of adults who receive blood transfusions during cardiac surgery, although the effect in children remains unclear. We performed a systematic review of the literature to identify all English language, randomized controlled trials of aprotinin involving ch...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,meta分析

    doi:10.1213/01.ane.0000194954.64293.61

    authors: Arnold DM,Fergusson DA,Chan AK,Cook RJ,Fraser GA,Lim W,Blajchman MA,Cook DJ

    更新日期:2006-03-01 00:00:00

  • The effect of celiac plexus block in critically ill patients intolerant of enteral nutrition: a randomized, placebo-controlled study.

    abstract:BACKGROUND:In this study, we evaluated the efficacy of celiac plexus block for the treatment of feeding intolerance in critically ill patients. METHODS:Nineteen mechanically ventilated medical patients intolerant of enteral nutrition and receiving metoclopramide underwent bilateral celiac plexus block. The anterior pr...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验,收录出版

    doi:10.1213/ANE.0b013e3181cde870

    authors: Memis D,Inal MT,Temizoz O,Genchallac H,Ozdemir H,Sut N

    更新日期:2010-04-01 00:00:00

  • One-lung anesthesia: percent shunt and arterial oxygen tension during continuous insufflation of oxygen to the nonventilated lung.

    abstract::Twenty-four male patients scheduled for elective pulmonary resection were studied to determine whether continuous insufflation of oxygen to the nonventilated lung would reduce intrapulmonary shunting (Qs/Qt) and arterial oxygen desaturation. Measurements of physiologic variables were made using pulmonary arterial and ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Rees DI,Wansbrough SR

    更新日期:1982-06-01 00:00:00

  • Autotriggering during pressure support ventilation due to cardiogenic oscillations.

    abstract::Newer generation anesthesia machines are equipped with a pressure support mode of ventilation, which can be used to support spontaneous ventilation in anesthetized patients. The Drager Apollo anesthesia machine uses an inspiratory limb hot-wire flow sensor to measure inspiratory flow rates. Detected flow rates that ex...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e3181a9d75a

    authors: Sheikh E,Maguire DP,Gratch D

    更新日期:2009-08-01 00:00:00

  • Hemodynamic effects of esmolol in chronically beta-blocked patients undergoing aortocoronary bypass surgery.

    abstract::The hemodynamic effects of esmolol were studied in 40 patients scheduled for elective coronary artery surgery to determine whether the administration of esmolol in chronically beta-blocked patients would result in additional attenuation of sympathetically mediated hemodynamic stress responses to noxious stimuli. Patie...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: de Bruijn NP,Croughwell N,Reves JG

    更新日期:1987-02-01 00:00:00

  • Hemodynamic and analgesic effects of clonidine added repetitively to continuous epidural and spinal blocks.

    abstract::Clonidine in spinal and epidural blocks prolongs anesthesia, but can cause hypotension and bradycardia. The aim of our study was to compare hemodynamic and analgesic effects of spinal versus epidural clonidine alone and after repetitive dosing. In a prospective, randomized, double-blind study, we evaluated 40 patients...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199502000-00020

    authors: Klimscha W,Chiari A,Krafft P,Plattner O,Taslimi R,Mayer N,Weinstabl C,Schneider B,Zimpfer M

    更新日期:1995-02-01 00:00:00

  • Pharmacokinetics of fentanyl in neonates.

    abstract::The pharmacokinetics of fentanyl were studied in fourteen neonates undergoing major surgical procedures. Five patients were less than 1 day of age, seven were 1-4 days old, and two were 7-14 days old. Fentanyl was given intravenously, 10 micrograms/kg (n = 1), 25 micrograms/kg (n = 4), or 50 micrograms/kg (n = 9), and...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Koehntop DE,Rodman JH,Brundage DM,Hegland MG,Buckley JJ

    更新日期:1986-03-01 00:00:00

  • Emergency tracheal intubation: complications associated with repeated laryngoscopic attempts.

    abstract::Repeated conventional tracheal intubation attempts may contribute to patient morbidity. Critically-ill patients (n = 2833) suffering from cardiovascular, pulmonary, metabolic, neurologic, or trauma-related deterioration were entered into an emergency intubation quality improvement database. This practice analysis was ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000122825.04923.15

    authors: Mort TC

    更新日期:2004-08-01 00:00:00

  • Sequencing cases in the operating room: predicting whether one surgical case will last longer than another.

    abstract:UNLABELLED:A microscope will be used for the first case of the day in operating room (OR) 1 and then may be used in the second case of the day by a different surgeon in a different OR, OR 2. Provided that the probability is reasonably high that the first case of the day in OR 2 will last longer than the first case in O...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200004000-00037

    authors: Dexter F,Traub RD

    更新日期:2000-04-01 00:00:00

  • Operating room managerial decision-making on the day of surgery with and without computer recommendations and status displays.

    abstract:BACKGROUND:There are three basic types of decision aids to facilitate operating room (OR) management decision-making on the day of surgery. Decision makers can rely on passive status displays (e.g., big screens or whiteboards), active status displays (e.g., text pager notification), and/or command displays (e.g., text ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000268539.85847.c9

    authors: Dexter F,Willemsen-Dunlap A,Lee JD

    更新日期:2007-08-01 00:00:00

  • Effect of injection rate on level and duration of hypobaric spinal anesthesia.

    abstract::The purpose of this study was to determine whether injection rate affects the spread of hypobaric spinal anesthesia. Hypobaric spinal anesthesia was performed on 20 patients for total hip arthroplasty. Dural puncture was performed with a 22-gauge Whitacre needle. All patients received 10 mg of hypobaric tetracaine wit...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:

    authors: Atchison SR,Wedel DJ,Wilson PR

    更新日期:1989-10-01 00:00:00

  • Comparative life cycle assessment of disposable and reusable laryngeal mask airways.

    abstract:BACKGROUND:Growing awareness of the negative impacts from the practice of health care on the environment and public health calls for the routine inclusion of life cycle criteria into the decision-making process of device selection. Here we present a life cycle assessment of 2 laryngeal mask airways (LMAs), a one-time-u...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e31824f6959

    authors: Eckelman M,Mosher M,Gonzalez A,Sherman J

    更新日期:2012-05-01 00:00:00