Abstract:
UNLABELLED:We evaluated the effect of the fresh gas flow (FGF) rate and the anesthetic technique on the ability to control the acute hyperdynamic response to a specific surgical stimulus during surgery in 90 consenting ASA physical status I-III patients undergoing lower abdominal procedures. After the administration of midazolam 2 mg IV, anesthesia was induced in all patients with propofol 1.5 mg/kg IV and fentanyl 1 microg/kg IV and was initially maintained with desflurane or isoflurane, 0.7 minimum alveolar anesthetic concentration, at total FGF rates of either 1 or 3 L/min. In response to the surgical stimulation of skin incision and retropubic dissection, an increase in mean arterial pressure (MAP) >20% above the preincision baseline MAP value provoked a stepwise increase in the inspired concentration of the volatile anesthetic or the IV administration of a variable-rate infusion of esmolol. At both FGF rates, the acute hemodynamic response to surgical stimulation was more efficiently treated by increasing the inspired concentration of desflurane than isoflurane. At 1 L/min, the average time to control the increase in MAP was significantly shorter with desflurane (17+/-12 min) compared with isoflurane (29+/-16 min), with 60% of the patients in the isoflurane group requiring rescue therapy. When an esmolol infusion was used to control the increase in MAP, supplementation with fentanyl was required in 40% and 53% of patients anesthetized with desflurane and isoflurane, respectively. In conclusion, desflurane provided more rapid and reliable control of acute hemodynamic responses to surgical stimulation than isoflurane or esmolol when the volatile anesthetics were administered at low FGF rates. IMPLICATIONS:At low fresh gas flow rates (1 L/min), desflurane more successfully and rapidly controlled the acute hemodynamic responses to painful surgical stimuli than isoflurane.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Avramov MN,Griffin JD,White PFdoi
10.1097/00000539-199809000-00033subject
Has Abstractpub_date
1998-09-01 00:00:00pages
666-70issue
3eissn
0003-2999issn
1526-7598journal_volume
87pub_type
临床试验,杂志文章,随机对照试验abstract::The effect of release of intraoperative thigh tourniquets on velocity of blood flow in the middle cerebral artery was examined in five patients given general anesthesia with controlled ventilation for lower extremity orthopedic procedures using transcranial Doppler sonography. Middle cerebral artery blood flow velocit...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199011000-00009
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:The clinical utility of focused transthoracic echocardiography (TTE) is increasingly recognized in perioperative medicine. However its use is limited among anesthesiologists because of a lack of training. The most efficient training methods have not been determined. We hypothesized that simulation-based TTE ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e318265408f
更新日期:2012-11-01 00:00:00
abstract::In recent years the off-label use of recombinant activated factor VII (rFVIIa) has markedly increased, particularly in pediatric cardiac surgery patients, and practitioners differ widely in their usage of the drug. In 2009, the Congenital Cardiac Anesthesia Society (CCAS) assembled a task force to review the literatur...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0b013e31825aff10
更新日期:2012-08-01 00:00:00
abstract::Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the contin...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000002280
更新日期:2017-11-01 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:UNLABELLED:Whether tracheal intubation is more difficult in obese patients is debatable. We compared the incidence of difficult tracheal intubation in obese and lean patients by using a recently validated objective scale, the intubation difficulty scale (IDS). We studied 134 lean (body mass index, <30 kg/m2) and 129 ob...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000072547.75928.b0
更新日期:2003-08-01 00:00:00
abstract::We studied the performance of a target-controlled drug infusion device, computer-assisted continuous infusion (CACI). Forty-one volunteers received one of midazolam (n = 11), propofol (n = 10), thiopental (n = 10), or fentanyl (n = 10) in sedative concentrations. Concentrations were kept constant for 45-70 min at five...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199705000-00018
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:Sepsis is currently the leading cause of direct maternal death in the United Kingdom. In this study, we aimed to determine frequency, temporal trends, and independent associations for severe sepsis during hospitalization for delivery in the United States. METHODS:Data were obtained from the Nationwide Inpat...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3182a009c3
更新日期:2013-10-01 00:00:00
abstract::Delirium is an acute change in cognition and attention, which may include alterations in consciousness and disorganized thinking. Although delirium may affect any age group, it is most common in older patients, especially those with preexisting cognitive impairment. Patients with delirium after surgery recover more sl...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0b013e3182147f6d
更新日期:2011-05-01 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::Selective segmental nerve blocks with local anesthetics are applied for diagnostic purposes in patients with chronic back pain to determine the segmental level of the pain. We performed this study to establish myotomal motor effects after L4 spinal nerve blocks by lidocaine and ropivacaine and to evaluate the relation...
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.0000122268.70154.A9
更新日期:2004-08-01 00:00:00
abstract::This study defines some characteristics of a standard anesthetic circuit that may impede anesthetic induction and recovery with I-653, sevoflurane, isoflurane, and halothane. Partition coefficients for anesthetic circuit components (masks, bellows, bags, airways, and circuit tubes) consistently ranked halothane greate...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1989-08-01 00:00:00
abstract:UNLABELLED:The purpose of this study was to investigate whether propofol protects rat hepatocyte suspensions against an oxidant attack by a free radical generator 2,2'-azobis (2-amidinopropane) dihydrochloride (AAPH). Rat hepatocyte suspensions (2 x 10(6) cells/mL) were prepared using Seglen's collagenase perfusion tec...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199811000-00033
更新日期:1998-11-01 00:00:00
abstract::Bradykinin, an endogenous nonapeptide and an important mediator of inflammation, is also implicated in the initiation and maintenance of pain. Both des-Arg(8), Leu(8)-bradykinin (dALBK) and HOE-140, the prototypic bradykinin B1 and B2 receptor antagonists, respectively, have been shown to reduce pain behaviors and inf...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000130348.85587.BE
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Previous animal and human studies suggested that nicotine might have an antinociceptive effect. We hypothesized that the preoperative application of a 7 mg nicotine patch would result in reduced postoperative analgesic requirements in patients undergoing radical retropubic prostatectomy (RRP) under general a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ane.0b013e31816f2616
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Among the various factors influencing the success rate, onset time, and duration of peripheral nerve blocks, the role of local anesthetics concentration remains uncertain. In this prospective, randomized, single-blinded study, we evaluated whether varying the dilution of a fixed dose of mepivacaine solution ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000000293
更新日期:2014-08-01 00:00:00
abstract::We assessed the efficacy of patient-controlled analgesia (PCA) techniques for extended femoral nerve sheath block after total hip arthroplasty. Forty-five patients were divided into three groups of 15. Over 48 h, all patients received 0.125% bupivacaine with clonidine 1 microg/mL and sufentanil 0.1 microg/mL via a fem...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200102000-00033
更新日期:2001-02-01 00:00:00
abstract:UNLABELLED:In this prospective investigation, we evaluated the efficacy and accuracy of transcutaneous monitoring of CO2 (TC-CO2) in infants and children after cardiothoracic surgery. Cardiothoracic surgery patients whose ETCO2 and arterial CO2 values did not correlate (gradient > or = 5 mm Hg) during the first postope...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-199903000-00012
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Because children's anxiety influences pain perception, perioperative anxiety should be evaluated in clinical practice with a unique, useful, and valid tool to optimize pain management. In this study, we evaluated psychometric properties of the visual analog scale (VAS)-anxiety for children and to study its p...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181af00e4
更新日期:2009-09-01 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::The effects of narcotic agents and two inhalation anesthetics on intrabiliary pressure (IBP) were measured before and after morphine (0.2 mg/kg), meperidine (2 mg/kg), fentanyl (0.002 mg/kg), or pentazocine (1 mg/kg) given intramuscularly to guinea pigs, and after halothane (0.5, 1.0, 1.5, or 2.0 MAC) or enflurane (sa...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1979-03-01 00:00:00
abstract::A guinea pig model of halothane hepatitis was used to explore the humoral immune response induced by multiple halothane exposures and the potential role this response might play in contributing to liver damage. Three different strains of guinea pigs (Strain 2, Amana, and Hartley) were exposed to 1% halothane under eit...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1987-12-01 00:00:00
abstract::A pharmacokinetic evaluation of bupivacaine was carried out after intercostal nerve blocks performed on 28 occasions in 27 children varying in age from 3 months to 16 yr. Bupivacaine HCl, 0.5%, with epinephrine 1:200,000 was employed. Doses of 2 mg/kg, 3 mg/kg, and 4 mg/kg resulted in peak whole blood arterial bupivac...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract:BACKGROUND:Intraoperative hypotension is common and associated with organ injury and death, although randomized data showing a causal relationship remain sparse. A risk-adjusted measure of intraoperative hypotension may therefore contribute to quality improvement efforts. METHODS:The measure we developed defines hypot...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000005287
更新日期:2020-11-23 00:00:00
abstract::In in vitro pharmacological experiments, determination of effective concentration values for various anesthetics depends on understanding the exact concentration of the drugs dissolved in physiological solutions. Actual anesthetic concentration may differ from expectations because of drug adsorption, absorption or oth...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000142112.30807.5C
更新日期:2005-02-01 00:00:00
abstract::To quantify the effects of succinylcholine at the laryngeal adductor muscles and the adductor pollicis, 17 adult patients were studied during propofol-fentanyl anesthesia. Train-of-four stimulation was applied to the ulnar nerve at the wrist and the recurrent laryngeal nerve at the notch of the thyroid cartilage. Lary...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199109000-00009
更新日期:1991-09-01 00:00:00
abstract::To evaluate the effects of high-frequency jet ventilation (HFJV) (f = 60, 120 breaths/min) and conventional mechanical ventilation (CMV) (f = 10, 20) during equivalent conditions of cardiac tamponade, stroke index (SI), intrapericardial pressure (IPP), airway pressure (P(aw)), and cardiac pressures were measured in an...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199004000-00006
更新日期:1990-04-01 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: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: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