Anesthesia and analgesia
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Anesthesia and analgesia · Jun 2010
Presynaptic actions of general anesthetics are responsible for frequency-dependent modification of synaptic transmission in the rat hippocampal CA1.
In clinical anesthesia, robust surgical stress occasionally causes unintended light anesthesia during operation. To test the hypothesis that neural input condition could modify actions of general anesthetics as a result of presynaptic alteration in the central nervous system, we investigated the mechanisms by which the stimulus frequency modifies synaptic transmission of the rat hippocampus in the presence of general anesthetics. ⋯ IV anesthetics, but not volatile drugs, enhance the discharge of a readily releasable pool of GABA vesicles from presynaptic terminals. Depletion of an active pool of GABA after high-frequency stimuli would produce frequency- and use-dependent recurrent inhibition in the presence of IV anesthetics. The stimulus frequency-dependent modification of synaptic transmission might be responsible for the unsuccessful immobilization or hypnosis during general anesthesia after IV anesthetic administration.
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Anesthesia and analgesia · Jun 2010
ReviewCore review: three-dimensional transesophageal echocardiography is a major advance for intraoperative clinical management of patients undergoing cardiac surgery: a core review.
Echocardiography is a key assessment tool for the evaluation of cardiac structure and function. The ability to image cardiac structures using 3-dimensional (3D) echocardiography is evolving. In this article, we present some of the key features of the emerging 3D technology and review its applications with an emphasis on real-time 3D transesophageal echocardiography.
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Anesthesia and analgesia · Jun 2010
Do intraoperative analgesics influence breast cancer recurrence after mastectomy? A retrospective analysis.
Whether intraoperative analgesics have an impact on postoperative cancer recurrence is unknown. Some investigations suggest that the opioids could favor relapse and that regional analgesia and nonsteroidal antiinflammatory drugs could improve cancer prognosis. We retrospectively reviewed our series of breast cancer surgery patients. ⋯ This retrospective analysis suggests that intraoperative administration of ketorolac decreases the risk of breast cancer relapse compared with other analgesícs.