Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2008
The Pentax-AWS video-laryngoscope: the first experience in one hundred patients.
We studied the efficacy of the Pentax-AWS (Tokyo, Japan), a new portable, battery-operated video-laryngoscope, in 100 patients. It was possible to insert the blade of the Pentax-AWS and to see a full view of the glottis on the first attempt in 99 of 100 patients. ⋯ Tracheal intubation was successful in 98 patients. The median time taken for tracheal intubation was 35 s (range, 5-120 s).
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Anesthesia and analgesia · Jan 2008
Clinical TrialThe effects of dexmedetomidine on cardiac electrophysiology in children.
Dexmedetomidine (DEX) is an alpha2-adrenergic agonist that is approved by the Food and Drug Administration for short-term (<24 h) sedation in adults. It is not approved for use in children. Nevertheless, the use of DEX for sedation and anesthesia in infants and children appears to be increasing. There are some concerns regarding the hemodynamic effects of the drug, including bradycardia, hypertension, and hypotension. No data regarding the effects of DEX on the cardiac conduction system are available. We therefore aimed to characterize the effects of DEX on cardiac conduction in pediatric patients. ⋯ DEX significantly depressed sinus and atrioventricular nodal function in pediatric patients. Heart rate decreased and arterial blood pressure increased during administration of DEX. The use of DEX may not be desirable during electrophysiology study and may be associated with adverse effects in patients at risk for bradycardia or atrioventricular nodal block.
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Anesthesia and analgesia · Jan 2008
Sevoflurane enhances ethanol-induced cardiac preconditioning through modulation of protein kinase C, mitochondrial KATP channels, and nitric oxide synthase, in guinea pig hearts.
Volatile anesthetics and regular ethanol consumption induce cardioprotection mimicking ischemic preconditioning. We investigated whether sevoflurane enhances ethanol preconditioning and whether inhibition of protein kinase C (PKC) and mitochondrial K(ATP) channels attenuated this enhanced cardioprotection. The effects of regular ethanol consumption on expression of inducible (iNOS) and endothelial (eNOS) nitric oxide synthase were determined. ⋯ Sevoflurane enhances cardiac preconditioning induced by regular EtOH consumption. This effect is mediated in part by modulation of PKC and mitochondrial K(ATP) channels, and possibly by altered modulation of NOS expression.
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Anesthesia and analgesia · Jan 2008
Case ReportsSubcutaneous cervical and facial emphysema with the use of the Bonfils fiberscope and high-flow oxygen insufflation.
We present a case in which use of the Bonfils retromolar intubation fiberscope resulted in cervical and facial subcutaneous emphysema. The patient was a 75-yr-old woman with Mallampati Grade I airway. The Bonfils retromolar intubation fiberscope was used for teaching purposes. ⋯ The patient was intubated conventionally and the emphysema resolved within 24 h. Subcutaneous emphysema after air insufflation is known from dental procedures with air entering through holes in the teeth. In our case, the oxygen insufflation was sufficient to create emphysema, probably through tiny mucosal lesions.
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Anesthesia and analgesia · Jan 2008
Preconditioning by isoflurane retains its protection against ischemia-reperfusion injury in postinfarct remodeled rat hearts.
Postinfarct remodeling in the heart may affect protective signaling. We tested whether isoflurane preconditioning retains its protection in postinfarct remodeled hearts. ⋯ Myocardial preconditioning with isoflurane retains its protection against ischemia/reperfusion injury in postinfarct remodeled rat hearts via similar signaling pathways, as previously reported in healthy hearts.