Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2007
Comparative StudyThe influence of race and socioeconomic factors on patient acceptance of perioperative epidural analgesia.
Ethnic minorities and patients of lower socioeconomic status may be more averse to the acceptance of epidural analgesia than nonminority counterparts and those of higher socioeconomic status, despite evidence for substantial benefit to the patient. ⋯ Acceptance of perioperative epidural analgesia is strongly affected by race and socioeconomic status. Anesthesiologists need to recognize this potential barrier when trying to maximize patient comfort and outcome.
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Anesthesia and analgesia · Dec 2007
Comparative StudyReference values for kaolin-activated thromboelastography in healthy children.
The hemostatic system of children changes with age and differs significantly from the hemostatic system of adults. Age-specific reference values are therefore required for most hemostatic variables. Thromboelastography (TEG) is a point-of-care coagulation test that may provide superior evaluation and management of coagulopathies after cardiac surgery, when large-dose unfractionated heparin is administered for cardiopulmonary bypass. In this study, we established reference values for kaolin-activated TEG in healthy children, to facilitate accurate interpretation of pediatric TEG results. ⋯ TEG results, from a particular clinical setting, must be compared to age-specific, as well as analyzer- and activator-specific, reference values to allow for correct interpretation of the results. Reference values provided here will be of use in acute clinical situations where a practical monitor of hemostasis is required.
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Anesthesia and analgesia · Dec 2007
Comparative StudyProgramming pressure support ventilation in pediatric patients in ambulatory surgery with a laryngeal mask airway.
Anesthesia workstations with pressure support ventilation (PSV) are available, but there are few studies published on how to program flow-triggered PSV using a laryngeal mask airway (LMA) under general anesthesia in pediatric patients. ⋯ PSV with a Proseal LMA in outpatient pediatric anesthesia can be programmed simply using the common clinical noninvasive variables studied. However, more studies are needed to estimate the level of pressure support that may be required in other clinical situations (respiratory pathology, endotracheal tubes, or other types of surgeries) or with other anesthesia workstations.
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Anesthesia and analgesia · Dec 2007
Historical ArticleMultiwavelength pulse oximetry: theory for the future.
As the use of pulse oximeters increases, the needs for higher performance and wider applicability of pulse oximetry have increased. To realize the full potential of pulse oximetry, it is indispensable to increase the number of optical wavelengths. To develop a multiwavelength oximetry system, a physical theory of pulse oximetry must be constructed. In addition, a theory for quantitative measurement of optical absorption in an optical scatterer, such as in living tissue, remains a difficult theoretical and practical aspect of this problem. ⋯ Our theory of multiwavelength pulse oximetry can be expected to be useful for solving almost all problems in pulse oximetry such as accuracy, motion artifact, low-pulse amplitude, response delay, and errors using reflection oximetry which will expand the application of pulse oximetry. Our theory is probably a rare case of success in solving the difficult problem of quantifying optical density of a substance embedded in an optically scattering medium.
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Anesthesia and analgesia · Dec 2007
Comparative StudyThe influence of p38 mitogen-activated protein kinase inhibitor on synthesis of inflammatory cytokine tumor necrosis factor alpha in spinal cord of rats with chronic constriction injury.
Tumor necrosis factor alpha (TNF-alpha) could trigger p38 mitogen-activated protein kinase (MAPK) activation. Conversely phosphorylated p38 (p-p38) could induce the upregulation of TNF-alpha. In this study, we examined the hypothesis that chronic constrictive injury (CCI) of the sciatic nerve could promote spinal cord release of TNF-alpha and produce allodynia via the p38 MAPK pathway. ⋯ p38 MAPK activation is one aspect of the signaling cascade that culminates in TNF-alpha synthesis and contributes to mechanical allodynia after peripheral nerve injury.