Anesthesiology
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D-Amino acid oxidase (DAAO) is a flavin adenine dinucleotide-dependent peroxisomal flavoenzyme which is almost exclusively expressed within astrocytes in the spinal cord. DAAO catalyzes oxidation of D-amino acids to hydrogen peroxide, which is a stable and less active reactive oxygen species, and may represent a final form of reactive oxygen species. This study tested the hypothesis that the spinal astroglial DAAO-hydrogen peroxide pathway plays an important role in the development of morphine antinociceptive tolerance. ⋯ For the first time, the authors' result identify a novel spinal astroglial DAAO-hydrogen peroxide pathway that is critically involved in the initiation and maintenance of morphine antinociceptive tolerance, and suggest that this pathway is of potential utility for the management of morphine tolerance and chronic pain.
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Much is still unknown about the actual incidence of anesthesia-related cardiac arrest in the United States. ⋯ As judged by an independent study commission, anesthesia-related cardiac arrest occurred in 37 of 160 cardiac arrests within the 24-h perioperative period.
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Randomized Controlled Trial Multicenter Study
Patient Blood Management in Elective Total Hip- and Knee-replacement Surgery (Part 2): A Randomized Controlled Trial on Blood Salvage as Transfusion Alternative Using a Restrictive Transfusion Policy in Patients with a Preoperative Hemoglobin above 13 g/dl.
There is no benefit of blood salvage during or after total knee or hip replacement surgery for patients with pre-operative Hb over 13 g/dL.
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Multicenter Study Clinical Trial
Monitoring depth of anesthesia utilizing a combination of electroencephalographic and standard measures.
For decades, monitoring depth of anesthesia was mainly based on unspecific effects of anesthetics, for example, blood pressure, heart rate, or drug concentrations. Today, electroencephalogram-based monitors promise a more specific assessment of the brain function. To date, most approaches were focused on a "head-to-head" comparison of either electroencephalogram- or standard parameter-based monitoring. In the current study, a multimodal indicator based on a combination of both electro encephalographic and standard anesthesia monitoring parameters is defined for quantification of "anesthesia depth." ⋯ A multimodal integration of both standard monitoring and electroencephalographic parameters may more precisely reflect the level of anesthesia compared with monitoring based on one of these aspects alone.