Anesthesiology
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Comparative Study
Endothelial glycocalyx as an additional barrier determining extravasation of 6% hydroxyethyl starch or 5% albumin solutions in the coronary vascular bed.
The impact on the endothelial glycocalyx for the extravasation of colloidal infusion solutions has not been investigated sufficiently. ⋯ The endothelial glycocalyx acts as a competent barrier for water and colloids. Only after its destruction do changes in endothelial morphology (postischemic reperfusion or histamine application) become effective determinants of coronary extravasation.
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Comparative Study
Smoking behavior and perceived stress in cigarette smokers undergoing elective surgery.
The forced abstinence from cigarettes accompanying surgery in smoke-free facilities may increase psychological stress by removing a coping mechanism and by nicotine withdrawal. The authors tested the hypothesis that abstinence from cigarette smoking contributes to psychological stress in the perioperative period. ⋯ Although smokers report increased baseline stress, smoking status does not affect changes in perceived stress over the perioperative period. Nicotine withdrawal symptoms do not seem to be a clinically significant problem in the perioperative period for most smokers.
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Comparative Study
Can acceleromyography detect low levels of residual paralysis? A probability approach to detect a mechanomyographic train-of-four ratio of 0.9.
The incidence of residual paralysis, i.e., a mechanomyographic train-of-four (TOF) ratio (T4/T1) less than 0.9, remains frequent. Routine acceleromyography has been proposed to detect residual paralysis in clinical practice. Although acceleromyographic data are easy to obtain, they differ from mechanomyographic data, with which they are not interchangeable. The current study aimed to determine (1) the acceleromyographic TOF ratio that detects residual paralysis with a 95% probability, and (2) the impact of calibration and normalization on this predictive acceleromyographic value. ⋯ To exclude residual paralysis reliably when using acceleromyography, TOF recovery to 1.0 is mandatory.
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Randomized Controlled Trial Comparative Study Clinical Trial
Experimental pain models reveal no sex differences in pentazocine analgesia in humans.
Accumulating evidence suggests that there are sex differences in analgesic responses to opioid agonists. Several studies using an oral surgery pain model have reported more robust analgesia to kappa-agonist-antagonists (e.g., pentazocine, nalbuphine, butorphanol) among women than among men. However, evidence of sex differences in kappa-agonist-antagonist effects from studies of experimentally induced pain in humans is lacking. ⋯ These findings indicate significant analgesic responses to pentazocine in both men and women across multiple experimental pain assays, and the absence of sex differences contrasts with previous data from the oral surgery model. The most likely explanation for the discrepancy in results is that of differences in the pain assays. These findings are important because they suggest that sex differences in opioid analgesia may be specific to certain types of pain.