Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2007
Hypercapnic hyperventilation shortens emergence time from isoflurane anesthesia.
To shorten emergence time after a procedure using volatile anesthesia, 78% of anesthesiologists recently surveyed used hyperventilation to rapidly clear the anesthetic from the lungs. Hyperventilation has not been universally adapted into clinical practice because it also decreases the Paco2, which decreases cerebral bloodflow and depresses respiratory drive. Adding deadspace to the patient's airway may be a simple and safe method of maintaining a normal or slightly increased Paco2 during hyperventilation. ⋯ The emergence time after isoflurane anesthesia can be shortened significantly by using hyperventilation to rapidly clear the anesthetic from the lungs and CO2 rebreathing to induce hypercapnia during hyperventilation. The device should be considered when it is important to provide a rapid emergence, especially after surgical procedures where a high concentration of the volatile anesthetic was maintained right up to the end of the procedure, or where surgery ends abruptly and without warning.
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Anesthesia and analgesia · Mar 2007
Hydroxyethyl starch, but not modified fluid gelatin, affects inflammatory response in a rat model of polymicrobial sepsis with capillary leakage.
Intravascular volume therapy is crucial in septic patients to improve tissue perfusion and maintain stable hemodynamics. Modified fluid gelatins (MFG) and medium weight hydroxyethyl starches (HES) are the most widely used synthetic colloids. Our aim in this study, performed in septic rats challenged by cecal ligation and puncture (CLP), was to investigate the effects of HES and MFG on pulmonary capillary leakage and to determine whether an antiinflammatory mechanism was involved. ⋯ HES may attenuate capillary leakage by modulating an inflammatory response, whereas an antiinflammatory mechanism was not involved in the effects of MFG on capillary leakage.
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Anesthesia and analgesia · Mar 2007
Case ReportsEmergency use of sugammadex after failure of standard reversal drugs.
Administration of sugammadex, 350 mg IV (4 mg/kg), in the postanesthesia care unit immediately (<60 s) relieved acute respiratory distress due to residual neuromuscular blockade in a 42-yr-old patient with chronic renal failure who had received vecuronium, 10 mg IV, for tracheal intubation, after inadequate reversal of neuromuscular blockade in the operating room with neostigmine, 5 mg IV, and glycopyrrolate, 1 mg IV.
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Anesthesia and analgesia · Mar 2007
Lung mechanics and histology during sevoflurane anesthesia in a model of chronic allergic asthma.
There are no studies examining the effects of sevoflurane on a chronically inflamed and remodeled airway, such as that found in asthma. In the present study, we sought to define the respiratory effects of sevoflurane in a model of chronic allergic asthma. For this purpose, pulmonary mechanics were studied and lung morphometry analyzed to determine whether the physiological modifications reflected underlying morphological changes. ⋯ Sevoflurane anesthesia acted both at airway level and lung periphery reducing ([DELTA]P1 and [DELTA]P2 pressures, and Est in chronic allergic asthma.