Abstract:
UNLABELLED:Intraoperative recording of myogenic motor responses evoked by transcranial electrical stimulation (tcMEPs) is a method of assessing the integrity of the motor pathways during aortic surgery. To identify conditions for optimal spinal cord monitoring, we investigated the effects of manipulating the level of neuromuscular blockade (T1 response of the train-of-four (TOF) stimulation 5%-15% versus T1 response 45%-55% of baseline), as well as the number of transcranial pulses (two versus six stimuli) on the within-patient variability and amplitude of tcMEPs. Ten patients (30-76 yr) scheduled to undergo surgery on the thoracic and thoracoabdominal aorta were studied. After achieving a stable anesthetic state and before surgery, 10 tcMEPs were recorded from the right extensor digitorum communis muscle and the right tibialis anterior muscle in response to two-pulse and six-pulse transcranial electrical stimulation with an interstimulus interval of 2 ms during two levels of neuromuscular blockade. The right thenar eminence was used for recording the level of relaxation. The tcMEP amplitude using the six-pulse paradigm was larger (P < 0.01; leg and arm) compared with the amplitude evoked by two-pulse stimulation during both levels of relaxation. The within-patient variability, expressed as median coefficient of variation, was less when six-pulse stimulation was used. At a T1 response of 45%-55% of baseline, larger, less variable tcMEPs were recorded than at a T1 response of 5%-15%. Our results suggest that the best quality of tcMEP signals (tibialis anterior muscle) is obtained when the six-pulse paradigm is used with a stable level of muscle relaxation (the first twitch of the TOF-thenar eminence-at 45%-55% of baseline). IMPLICATIONS:This study shows that six-pulse (rather than two-pulse) transcranial electrical stimulation during a stable anesthetic state and a stable neuromuscular blockade aimed at 45%-55% (rather than 5%-15%) of baseline provides reliable and recordable muscle responses sufficiently robust for spinal cord monitoring in aortic surgery.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
van Dongen EP,ter Beek HT,Schepens MA,Morshuis WJ,Langemeijer HJ,de Boer A,Boezeman EHdoi
10.1097/00000539-199901000-00005subject
Has Abstractpub_date
1999-01-01 00:00:00pages
22-7issue
1eissn
0003-2999issn
1526-7598journal_volume
88pub_type
临床试验,杂志文章abstract:BACKGROUND:The intrathoracic blood volume index (ITBVI) and central venous pressure (CVP) are routinely used to predict fluid responsiveness in critically ill patients with acute circulatory failure (systolic blood pressure < 90 mm Hg or vasopressor requirement). However, they have never been compared. METHODS:In this...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e31817e6618
更新日期:2008-08-01 00:00:00
abstract:UNLABELLED:We tested baicalin for its antiinflammatory and analgesic effects (and the mechanisms) in a rat model of carrageenan-evoked thermal hyperalgesia. Pre- or posttreatment with baicalin (10, 30, or 100 mg/kg intraperitoneally) caused a significant analgesic effect with a similar effect of dose-matched ibuprofen....
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000087066.71572.3f
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:The incidence and implications of anti-heparin-platelet factor 4 (PF4) antibody seroconversion in the pediatric cardiac surgical population remain largely unexplored. We sought to prospectively characterize the incidence of seroconversion in two populations: neonates undergoing primary cardiac surgery and ch...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181734604
更新日期:2008-08-01 00:00:00
abstract::The acute central nervous and cardiovascular effects of the local anesthetics ropivacaine and bupivacaine were compared in 12 volunteers in a randomized double-blind manner with use of intravenous infusions at a rate of 10 mg/min up to a maximal dose of 150 mg. The volunteers were all healthy men. They were familiariz...
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:1989-11-01 00:00:00
abstract:UNLABELLED:Sameridine is a new compound with local anesthetic and analgesic properties when injected intrathecally. We studied the anesthetic and analgesic efficacy of three doses of isobaric sameridine (15, 20, and 23 mg) compared with 100 mg of hyperbaric lidocaine for spinal anesthesia in 140 healthy male patients u...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/00000539-199904000-00025
更新日期:1999-04-01 00:00:00
abstract:IMPLICATIONS:A dose of 0.1 mg/kg of verapamil, administered immediately before anesthesia, significantly reduces the increase in peak heart rate and mean arterial blood pressure after electroconvulsive therapy. Furthermore, the administration of verapamil does not reduce the duration of the seizure. ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200208000-00030
更新日期:2002-08-01 00:00:00
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
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:As part of the Thai Anesthesia Incidents Study of anesthetic adverse outcomes, we evaluated the incidence and factors related to cardiac arrest during spinal anesthesia. METHODS:During a 12-mo period (March 1, 2003, to February 28, 2004), a prospective, multicenter registry of patients receiv...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究
doi:10.1213/ane.0b013e31817bd143
更新日期:2008-11-01 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::The aim of this prospective, randomized, controlled clinical trial was to define the opioid analgesic requirement after a remifentanil (REMI)-based anesthetic with spinal anesthetic blockade (SAB+REMI) or without (REMI) spinal blockade for open-heart surgery in children. We enrolled 45 patients who were candidates for...
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.0000148698.84881.10
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Many of the complications of mechanical ventilation are related to inappropriate endotracheal tube (ETT) cuff pressure. The aim of the current study was to evaluate the effectiveness of automatic cuff pressure closed-loop control in patients under prolonged intubation, where presence of carbon dioxide (CO2) ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1213/ANE.0000000000002358
更新日期:2017-10-01 00:00:00
abstract::General anesthesia results in increases in respiratory elastance and flow resistance within 10-15 min after induction. Stabilization (compensation) of the respiratory system in the face of this added load is related to the addition of active (contractile) force-length and force-velocity properties to its internal impe...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:UNLABELLED:Supraclavicular nerve blocks are effective but may be complicated by pneumothorax. We hypothesized that, to avoid this complication, the depths of the brachial plexus and the lung could be estimated to guide needle placement. In 17 patients undergoing surgical relief of thoracic outlet syndrome, we designate...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199905000-00028
更新日期:1999-05-01 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::The purpose of the present study was to quantify the inhibitory effect of inhaled halothane and isoflurane on acute hypercapnia-induced responses of capacitance-regulating veins and related cardiovascular variables in response to sequential 40-s periods of 5%, 10%, 15%, and 20% inspired CO2 (FICO2). Measurements were ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199602000-00024
更新日期:1996-02-01 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:BACKGROUND:Increasing costs of material resources challenge hospitals to stay profitable. Particularly in anesthesia departments and intensive care units, bronchoscopes are used for various indications. Inefficient management of single- and multiple-use systems can influence the hospitals' material costs substantially....
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001729
更新日期:2017-06-01 00:00:00
abstract:UNLABELLED:Diabetic patients are at increased risk of wound infection after major surgery, but the effect of perioperative glucose control on postoperative wound infection rates after surgery is uncertain. We tested the effect of an insulin infusion on perioperative neutrophil function in diabetic patients scheduled fo...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199905000-00008
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:The α2-adrenergic agonist dexmedetomidine is a sedative and can be used as an adjunct to anesthetics. Our primary goal was thus to determine the extent to which dexmedetomidine reduces the requirement for propofol and remifentanil. METHODS:This double-blinded, randomized study (NCT00921284) used an automate...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000000185
更新日期:2014-05-01 00:00:00
abstract::The advantages of laparoscopic over open surgery have been documented in nonblinded settings. Our prospective, double-blind setting evaluated pain scores 72 h after surgery by comparing patients who underwent laparoscopic myomectomy or with laparotomy. Forty women referred for conservative myomectomy were included in ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ane.0000204321.85599.0d
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:The extent to which insufflation of oxygen into the posterior pharynx during laryngoscopy prolongs adequate saturation in infants and small children remains unknown. Therefore, we compared oxygen saturation over time in preoxygenated small children with and without posterior pharynx oxygen insufflation. MET...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001189
更新日期:2016-04-01 00:00:00
abstract::Dantrolene effectively treats malignant hyperthermia (MH) hut the current form, Dantrium, must be dissolved to a 0.33 mg/mL, pH 9.5 solution. This study describes lecithin-coated microcrystal formulations of sodium dantrolene (MC-NaD) and neutral dantrolene (MC-D) which reconstitute to 200 mg/mL within 1 min. In rats,...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199604000-00021
更新日期:1996-04-01 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::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::To learn the latest developments in the various forms of postoperative cognitive dysfunction, a group of scientists and physicians met in Stockholm for a full day of presentations and interactive discussions. This article summarizes the discussion; highlighting progress, challenges, and new directions in the area of p...
journal_title:Anesthesia and analgesia
pub_type:
doi:10.1213/ANE.0000000000000624
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Research information for children is often presented in a manner that is difficult to understand. We designed this study, therefore, to examine the effect of improved readability and processability of written study information on children's understanding. METHODS:One-hundred-ninety children aged 7-17 yr who...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ane.0000270326.44507.11
更新日期:2007-08-01 00:00:00
abstract:UNLABELLED:I designed this study to determine the efficacy of heart rate (HR), systolic blood pressure (SBP), and digital skin blood flow (DSBF) in detecting intravascular injection after a simulated epidural test dose containing 15 mug of epinephrine in sevoflurane-anesthetized adults. In addition, the testing thresho...
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.0000157571.00717.08
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:We determined the sensitivity of motor responses evoked by stimulating catheters in determining catheter-nerve contact using ultrasonography as reference. METHODS:Femoral nerves were contacted using stimulating catheters under ultrasonography scanning in 25 patients. The output current was increased from it...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31822c9887
更新日期:2011-11-01 00:00:00
abstract::Several studies have investigated differential block during spinal anesthesia using transcutaneous electrical stimulation (TES) applied to patient's skin. These TES stimuli are claimed to be a surrogate for surgical stimulation, but TES has never been shown to be a realistic surrogate for a surgical stimulus during re...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000156219.47961.74
更新日期:2005-05-01 00:00:00
abstract:UNLABELLED:Endothelial dysfunction and platelet activation with thromboxane release may contribute to spasm or alterations in internal mammary artery (IMA) graft flow during coronary artery surgery. Clevidipine, an ultrashort-acting dihydropyridine calcium channel blocker, is undergoing clinical development, but there ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199711000-00008
更新日期:1997-11-01 00:00:00