Anesthesia and analgesia
-
Anesthesia and analgesia · Nov 2004
Electron microscopic evaluations of clot morphology during thrombelastography.
In this study, we characterized clot morphology with a scanning electron microscope (SEM) at time points corresponding to the commonly used thrombelastography (TEG) variables, illustrating the correlation of the physical clot formation with TEG(R) tracings. The first channel of the TEG analyzer was used to obtain the tracings of clot formation, while the sub-samples for the SEM were obtained from the second TEG channel. Different types of samples were examined, including whole blood, abciximab-treated whole blood, platelet-rich plasma (PRP), and abciximab-treated PRP. ⋯ The process of fibrin formation and platelet activation was also examined in PRP. Abciximab did not block platelet shape change, although the blockage of fibrin binding to platelets was shown on the TEG analyzer. In summary, we have shown structural changes of the forming clot in relation to TEG variables.
-
Anesthesia and analgesia · Nov 2004
Data envelopment analysis to determine by how much hospitals can increase elective inpatient surgical workload for each specialty.
We apply data envelopment analysis to discharge data from the 115 hospitals in the rural state of a study hospital to answer three questions. We use a case study to investigate the usefulness and limitations of data envelopment analysis for assessing three common questions regarding hospital market capture for elective inpatient surgery. (i) The hospital studied in this paper performs 40% of the neurosurgery and 25% of the inpatient urology surgery in its state. Workloads are twice that of the hospitals with the next largest workloads. ⋯ Controlling for the distance patients would need to travel for care, would increasing capacity likely increase cardiac surgery workload? (ii) The study hospital has fewer hospitalizations for thoracic surgery than for any other specialty. Is thoracic surgery inpatient workload of 121 lung resections large or small compared with those of orthopedics' 213 hip replacements, urology's 132 nephrectomies, and cardiac surgery's 304 coronary artery bypass grafts? (iii) The hospital's busiest specialty by discharges is orthopedics. How sensitive is the hospital's orthopedic workload to changes in decision making at nearby competing hospitals?
-
Anesthesia and analgesia · Nov 2004
Small-dose capsaicin reduces systemic inflammatory responses in septic rats.
We investigated the influence of small- and large-dose capsaicin in modulating systemic inflammatory responses during different stages of sepsis in rats. Rats were divided into six groups: group C, control; group S, sepsis; group CLC, small dose of capsaicin (1 mg/kg subcutaneously); group SLC, small dose of capsaicin plus sepsis; group CHC, large dose of capsaicin (150 mg/kg subcutaneously); group SHC, large dose of capsaicin plus sepsis. Rats were made septic by cecal ligation and puncture (CLP). ⋯ CGRP was increased in groups S, CLC, and SLC when compared with the other groups. In the SLC group, plasma concentrations of TNF-alpha, IL-6, NOx, and tissue MDA levels were reduced and IL-10 level was increased when compared with groups S and SHC 18 h after CLP (P < 0.05). Small-dose capsaicin treatment increased antiinflammatory IL-10 levels and attenuated the increases in proinflammatory cytokines, NOx, and tissue MDA in septic rats.
-
Anesthesia and analgesia · Nov 2004
Impaired acquisition of spatial memory 2 weeks after isoflurane and isoflurane-nitrous oxide anesthesia in aged rats.
Aged rats are impaired on a spatial memory task for at least 24-48 h after isoflurane-nitrous oxide anesthesia. In this study, we tested how long the impairment lasts and investigated the role of nitrous oxide. Eighteen-month-old rats were randomized to anesthesia for 2 h with 1.2% isoflurane with or without 70% nitrous oxide or a control group (30% oxygen). ⋯ Post hoc analysis comparing all anesthetized rats to controls demonstrated that anesthetized rats made fewer correct choices to first error (P < or = 0.05) and took longer to complete the maze (P
-
Anesthesia and analgesia · Nov 2004
Preconditioning by isoflurane is mediated by reactive oxygen species generated from mitochondrial electron transport chain complex III.
Reactive oxygen species (ROS) mediate volatile anesthetic preconditioning. We tested the hypothesis that isoflurane (ISO) generates ROS from electron transport chain complexes I and III. Rabbits (n = 55) underwent 30 min coronary artery occlusion followed by 3 h reperfusion and received 0.9% saline, the complex I inhibitor diphenyleneiodonium (DPI; 1.5 mg/kg bolus followed by 1.5 mg/kg over 1 h), or the complex III inhibitor myxothiazol (MYX; 0.1 mg/kg bolus followed by 0.3 mg/kg over 1 h) in the absence and presence of 1.0 minimum alveolar concentration ISO. ⋯ MYX (35 +/- 3 U), but not DPI (78 +/- 9 U), abolished ROS generation. DPI and MYX selectively reduced complex I- and complex III-mediated ATP synthesis, respectively. ROS generated from electron transport chain complex III mediate ISO-induced cardioprotection.