Anesthesiology
-
Editorial Comment
Hydrogen sulfide in lung injury: therapeutic hope from a toxic gas?
-
The number of fluctuations of skin conductance per second (NFSC) has been shown to correlate with induced pain and self-report pain scales. This study aimed to evaluate the validity and feasibility of NFSC as an objective measurement of nociception intensity in school-aged children after surgery. ⋯ NFSC measurement is feasible in a perioperative setting but was not specific for postoperative pain intensity and was unable to identify analgesia requirements when compared with self-report measures.
-
During cardiopulmonary bypass, mixed venous oxygen saturation (Svo2) is frequently measured to assess circulatory adequacy. Fluctuations in Svo2 not related to patient movement or inadequate oxygen delivery have been attributed clinically to increased cerebral oxygen consumption due to "light" anesthesia. To evaluate the relationship between anesthetic depth and Svo2, we prospectively measured bispectral index (BIS) and Svo2 values in patients undergoing cardiac surgery with cardiopulmonary bypass. ⋯ In patients undergoing cardiopulmonary bypass, we found no overall association between BIS and Svo2. A weak but statistically significant association between BIS and Svo2 was observed in patients with temperatures less than 34.1 degrees C. These data suggest that low Svo2 values on bypass are unlikely to be due to light or inadequate anesthesia. The relationship among temperature, BIS and Svo2 deserves further study.
-
Preclinical studies demonstrate increased neuroapoptosis after general anesthesia in early life. Neuraxial techniques may minimize potential risks, but there has been no systematic evaluation of spinal analgesic safety in developmental models. We aimed to validate a preclinical model for evaluating dose-dependent efficacy, spinal cord toxicity, and long-term function after intrathecal morphine in the neonatal rat. ⋯ The therapeutic ratio for intrathecal morphine (toxic dose/antinociceptive dose) was at least 300 at P3 and at least 20 at P21 (latter doses limited by side effects). These data provide relative efficacy and safety for comparison with other analgesic preparations and contribute supporting evidence for the validity of this preclinical neonatal safety model.