Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2009
Comparative StudyThe effects of cardiopulmonary bypass on the number of cerebral microemboli and the incidence of cognitive dysfunction after coronary artery bypass graft surgery.
Postoperative cognitive dysfunction (POCD) can be a debilitating complication after coronary artery bypass graft (CABG) surgery. Cerebral microemboli during cardiopulmonary bypass (CPB) are believed to be an important etiologic factor of POCD. In this study, we examined whether avoidance of CPB with "off-pump" surgery reduces the number of cerebral microemboli and the incidence of POCD after CABG surgery in Chinese population. ⋯ In Chinese population, avoidance of CPB during CABG surgery significantly decreased the number of cerebral microemboli, but it did not decrease the incidence of POCD at either 1 wk or 3 mo after CABG. Neither CPB nor cerebral microemboli was independently associated with the risk of POCD.
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Anesthesia and analgesia · Oct 2009
Monitoring with head-mounted displays: performance and safety in a full-scale simulator and part-task trainer.
Head-mounted displays (HMDs) can help anesthesiologists with intraoperative monitoring by keeping patients' vital signs within view at all times, even while the anesthesiologist is busy performing procedures or unable to see the monitor. The anesthesia literature suggests that there are advantages of HMD use, but research into head-up displays in the cockpit suggests that HMDs may exacerbate inattentional blindness (a tendency for users to miss unexpected but salient events in the field of view) and may introduce perceptual issues relating to focal depth. We investigated these issues in two simulator-based experiments. ⋯ The HMD helped anesthesiologists detect events when physically constrained, but not when physically unconstrained. Although there was no conclusive evidence of worsened inattentional blindness, found in aviation, the perceptual properties of the HMD display appear to influence whether events are detected. Anesthesiologists wearing HMDs should self-adjust the focus to minimize eyestrain and should be aware that some changes may not attract their attention. Future areas of research include developing principles for the design of HMDs, evaluating other types of HMDs, and evaluating the HMD in clinical contexts.
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Anesthesia and analgesia · Oct 2009
Epidemiology of anesthesia-related complications in labor and delivery, New York State, 2002-2005.
Epidemiologic data on anesthesia-related complications occurring during labor and delivery are essential for measuring and evaluating the safety and quality of obstetric anesthesia care but are lacking. We aimed to fill this research gap by exploring the epidemiologic patterns and risk factors of anesthesia-related complications in a large sample of women giving birth in New York hospitals. ⋯ The incidence of anesthesia-related complications during labor and delivery seems to be low but remains a cause of concern, particularly in women undergoing cesarean delivery, living in rural areas, or having preexisting medical conditions.
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Anesthesia and analgesia · Oct 2009
Complete Freund's adjuvant-induced intervertebral discitis as an animal model for discogenic low back pain.
Although numerous animal models for low back pain associated with intervertebral disk (IVD) degeneration have been proposed, insufficient data have been provided to make any conclusions regarding pain. Our aim in this study was to determine the reliability of complete Freund's adjuvant (CFA) injection into the rat spine as an animal model representing human discogenic pain. ⋯ Intradiscal CFA injection led to chronic disk degeneration with allodynia, which was suggested by pain behavior and expression of pain-related mediators. The increment of CGRP, PGE, and iNOS also suggest pain-related signal processing between the IVD and the neural pathway in this animal model. This animal model may be useful for future research related to the pathophysiology and development of novel treatment for spine-related pain.
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Anesthesia and analgesia · Oct 2009
Activation of extracellular signal-regulated kinase in sciatic nerve contributes to neuropathic pain after partial sciatic nerve ligation in mice.
The mitogen-activated protein kinase family plays an important role in several types of pain. However, the detailed role of phosphorylated extracellular signal-regulated kinase (pERK) in the region of injured peripheral nerve is poorly understood. In this study, we investigated whether pERK in injured sciatic nerve contributes to neuropathic pain induced by partial sciatic nerve ligation (PSL) in mice. ⋯ Activation of ERK in Schwann cells of the injured peripheral nervous system may play an important role in the development of neuropathic pain. Our results suggest that pERK itself and ERK-related mediators are potential therapeutic targets for the treatment of neuropathic pain.