Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2010
Comparative StudyThe performance of compartmental and physiologically based recirculatory pharmacokinetic models for propofol: a comparison using bolus, continuous, and target-controlled infusion data.
With the growing use of pharmacokinetic (PK)-driven drug delivery and/or drug advisory displays, identifying the PK model that best characterizes propofol plasma concentration (Cp) across a variety of dosing conditions would be useful. We tested the accuracy of 3 compartmental models and 1 physiologically based recirculatory PK model for propofol to predict the time course of propofol Cp using concentration-time data originated from studies that used different infusion schemes. ⋯ When combining the performance during various infusion regimens, it seems that the Schnider model, although still not perfect, is the recommended model to be used for TCI and advisory displays.
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Anesthesia and analgesia · Aug 2010
Comparative StudyTranscutaneous carbon dioxide monitoring accurately predicts arterial carbon dioxide partial pressure in patients undergoing prolonged laparoscopic surgery.
There may be large differences between measurements of end-tidal carbon dioxide partial pressure (Petco(2)) and arterial carbon dioxide partial pressure (Paco(2)) during laparoscopic surgeries. Transcutaneous carbon dioxide (Ptcco(2)) monitoring can be used to noninvasively and continuously estimate Paco(2). In the present study we evaluated the accuracy of Ptcco(2) monitoring in predicting the Paco(2) during laparoscopic surgeries with prolonged pneumoperitoneum. ⋯ While undergoing long-term pneumoperitoneum laparoscopic surgery, Ptcco(2) monitoring is more accurate than is PETCO(2) monitoring in predicting the patients' Paco(2).
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Anesthesia and analgesia · Aug 2010
Case ReportsCase report: pudendal nerve injury after a sciatic nerve block by the posterior approach.
We report a pudendal nerve injury that developed after a posterior approach to the sciatic nerve. A classical Labat's posterior sciatic nerve block on the right side was performed using an insulated needle and a nerve stimulator set at an initial current of 2 mA, 2 Hz frequency, and 0.1 ms duration. Painful paresthesia radiating to the right side of the patient's penis and right leg was experienced shortly after needle insertion. ⋯ The trauma resulted in erectile dysfunction and partial loss of penile sensation as well as evidence of injury to the sciatic nerve itself. Symptoms and clinical signs of pudendal nerve injury lasted 7 months. This is the first time that sexual dysfunction as a result of a unilateral pudendal nerve injury that occurred after a posterior sciatic nerve block has been reported.
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Anesthesia and analgesia · Aug 2010
Preoperative statin therapy is not associated with a reduced incidence of postoperative acute kidney injury after cardiac surgery.
Our objective was to examine the association between preoperative statin therapy and the prevalence of postoperative acute kidney injury (AKI) in patients undergoing cardiac surgery with the use of cardiopulmonary bypass. ⋯ These results suggest that previously reported reductions in perioperative mortality for patients taking preoperative statins and undergoing cardiac surgery is likely not mediated through a reduction in postoperative AKI.