Anesthesia and analgesia
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Anesthesia and analgesia · May 2009
The effect of milrinone on platelet activation as determined by TEG platelet mapping.
Milrinone is a phosphodiesterase III inhibitor that increases intracellular cyclic adenosine monophosphate resulting in improved ventricular function and vasodilation. Increased intracellular levels of cyclic adenosine monophosphate also inhibit adenosine diphosphate (ADP) and arachidonic acid (AA)-induced platelet aggregation. We hypothesized that inhibition of ADP and AA-induced platelet activation by therapeutic blood concentrations of milrinone could be quantified using TEG Platelet Mapping. ⋯ Therapeutic blood concentrations of milrinone exhibit a significant inhibitory effect on ADP and AA-induced platelet activation as determined by TEG Platelet Mapping, without affecting the conventional kaolin-activated TEG. We suggest that TEG Platelet Mapping results be interpreted with caution in patients being treated with milrinone, and other drugs that modify platelet cyclic nucleotide concentrations.
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Anesthesia and analgesia · May 2009
Case ReportsPostoperative intensive care unit drug fever caused by dexmedetomidine.
Dexmedetomidine hydrochloride is a potent, highly selective alpha-2 adrenergic receptor agonist, broadly used as a sedative drug in intensive care units. We describe the case of a 59-yr-old patient who experienced drug fever caused by dexmedetomidine hydrochloride. ⋯ This symptom improved rapidly 7 h after stopping dexmedetomidine hydrochloride. Other possible causes (such as infection) were sequentially eliminated.
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Anesthesia and analgesia · May 2009
The effects of platelet transfusions evaluated using rotational thromboelastometry.
In this study, we assessed the immediate effects of platelet transfusion on whole blood coagulation. ⋯ Statistically significant improvements in rotational thromboelastometry-measured parameters were observed in association with a mean increase of 12 x 109/L in platelet count after platelet transfusion in these patients.
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Anesthesia and analgesia · May 2009
Case ReportsAnesthetic management of seven deliveries in three sisters with the May-Hegglin anomaly.
May-Hegglin anomaly is a rare genetic hematological disorder characterized by thrombocytopenia, but platelet function is usually normal. Three sisters with May-Hegglin anomaly and thrombocytopenia (platelet counts 14,000-100,000/mm(3)) were given neuraxial anesthesia for a total of 7 deliveries, 5 vaginal and 2 cesarean. None of the women had complications and no blood products were transfused.
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Anesthesia and analgesia · May 2009
An anatomical study of the parasacral block using magnetic resonance imaging of healthy volunteers.
The parasacral approach to sciatic blockade is reported to be easy to learn and perform, with a high success rate and few complications. ⋯ These findings question the reliability of the anatomical landmarks of the parasacral block and raise the possibility of frequent visceral puncture using this technique.