Anesthesia and analgesia
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Anesthesia and analgesia · May 2010
The effects of isoflurane pretreatment on cerebral blood flow, capillary permeability, and oxygen consumption in focal cerebral ischemia in rats.
We performed experiments to test whether isoflurane pretreatment produces vascular effects, especially at the levels of arterioles and capillaries affecting regional cerebral blood flow (rCBF), O(2) supply and consumption, or capillary permeability in focal cerebral ischemia. Because inducible nitric oxide synthase (iNOS) was implicated as one of the mechanisms of isoflurane preconditioning, the effect of iNOS inhibition on rCBF was also studied. ⋯ Our data demonstrate that isoflurane pretreatment improved rCBF and increased the regional O(2) supply and consumption in the focal ischemic area but did not affect capillary permeability during the early stage of focal cerebral ischemia. The isoflurane-induced increase in rCBF in the ischemic area became insignificant with inhibition of iNOS.
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Anesthesia and analgesia · May 2010
Meta AnalysisMeta-analysis of average and variability of time to extubation comparing isoflurane with desflurane or isoflurane with sevoflurane.
We recently determined how to use anesthesia information management system data to model the time from end of surgery to extubation. We applied that knowledge for meta-analyses of trials comparing extubation times after maintenance with desflurane and sevoflurane. In this study, we repeated the meta-analyses to compare isoflurane with desflurane and sevoflurane. ⋯ The pharmacoeconomics of volatile anesthetics are highly sensitive to measurement of relatively small time differences. Therefore, surgical facilities should use these values combined with their local data (e.g., mean baseline extubation times) when making evidence-based management decisions regarding pharmaceutical purchases and usage guidelines.
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Anesthesia and analgesia · May 2010
Randomized Controlled TrialLidocaine eye drops attenuate pain associated with ophthalmic postherpetic neuralgia.
Topical lidocaine (LDC) treatment using a gel or patch preparation is effective in the treatment of postherpetic neuralgia (PHN), but neither is suited for the eye in patients with ophthalmic PHN. Herein, we examined the effect of LDC 4% eye drops on ophthalmic PHN pain. ⋯ This study suggests that LDC provides a significant improvement of ophthalmic PHN because of its prompt analgesia, lack of systemic side effects, and convenience of use.