Anesthesiology
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We previously described the use of the nematode Caenorabditis elegans as a genetic model for studying the mechanism of action of volatile anesthetics. All previous strains of C. elegans with altered responses to anesthetics have been identified by screening the response to halothane. The current study was designed to identify classes of mutations by screening for alterations in sensitivity to enflurane, isoflurane, and diethylether. ⋯ The interaction of these mutations indicates that multiple sites of anesthetic action exist and that there are at least three such sites. A pathway for control of sensitivity to volatile anesthetics is proposed.
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Comparative Study
In vitro modeling of spinal anesthesia. A digital video image processing technique and its application to catheter characterization.
Maldistribution of intrathecal local anesthetic has recently been implicated as a contributor to neurotoxic injury. In vitro modeling can be used to understand the distribution of anesthetic agents within the subarachnoid space. We describe an in vitro modeling technique that uses digital video image processing and its application to catheter injection of local anesthetic. ⋯ The digital video image processing technique can be used to quantify anesthetic distribution rapidly within a model of the subarachnoid space without disturbing the distribution. The current results demonstrate a strong dependence of anesthetic distribution on catheter angle, catheter size, and injection rate. Comparisons between 28-G catheters suggest that the difference in reported incidence of cauda equina syndrome associated with different 28-G catheters cannot be explained on the basis of differences in anesthetic distribution.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of ondansetron in the prevention of postoperative nausea and vomiting in children.
Postoperative nausea and vomiting (PONV) is a commonly observed adverse effect of general anesthesia. Recently, ondansetron, a new serotonin3 (5-hydroxytryptamine3) receptor antagonist was shown to be effective in the prophylaxis and prevention of chemotherapy-induced nausea and vomiting in children and adults as well as of PONV in adults. The aim of the current study was to evaluate the capacity of ondansetron to prevent PONV in pediatric patients. ⋯ Ondansetron is effective in the prevention of PONV in pediatric patients for the first 4 h after general anesthesia. Lower sedation scores with ondansetron compared with droperidol may be an advantage, especially in ambulatory surgery. However, the incidence of late-onset PONV (> 4-24 h) was not influenced by prophylactic treatment with one dose of ondansetron preoperatively.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prophylactic antiemetic treatment with ondansetron in children undergoing tonsillectomy.
Children undergoing tonsillectomy are at high risk for postoperative vomiting. This study was undertaken to compare ondansetron with metoclopramide and droperidol for the prevention of postoperative vomiting after tonsillectomy. ⋯ The intravenous administration of ondansetron 0.15 mg.kg-1 is highly effective in reducing postoperative emesis in children undergoing tonsillectomy. Metoclopramide and droperidol at the doses tested are ineffective in this population.