Anesthesiology
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Neonatal pain and injury can alter long-term sensory thresholds. Descending rostroventral medulla (RVM) pathways can inhibit or facilitate spinal nociceptive processing in adulthood. As these pathways undergo significant postnatal maturation, the authors evaluated long-term effects of neonatal surgical injury on RVM descending modulation. ⋯ Neonatal surgical injury alters the postnatal development of RVM descending control, resulting in a predominance of descending inhibition and generalized reduction in baseline reflex sensitivity. Prevention by local anesthetic blockade highlights the importance of neonatal perioperative analgesia.
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Randomized Controlled Trial Comparative Study
Comparison of Surgical Pleth Index-guided Analgesia with Conventional Analgesia Practices in Children: A Randomized Controlled Trial.
Surgical Pleth Index-guided analgesia used during pediatric tonsillectomy results in worse post-operative analgesia than BP and HR guided analgesia dosing.
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Randomized Controlled Trial
Intraoperative tight glucose control using hyperinsulinemic normoglycemia increases delirium after cardiac surgery.
Tight intraoperative blood glucose control is associated with postop delirium after cardiac surgery.
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Hypoxic pulmonary vasoconstriction (HPV) is critically important in regionally heterogeneous lung diseases by directing blood toward better-oxygenated lung units, yet the molecular mechanism of HPV remains unknown. Transient receptor potential (TRP) channels are a large cation channel family that has been implicated in HPV, specifically in the pulmonary artery smooth muscle cell (PASMC) Ca and contractile response to hypoxia. In this study, the authors probed the role of the TRP family member, TRPV4, in HPV. ⋯ TRPV4 plays a critical role in HPV, potentially via cooperation with TRPC6.