Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2011
Technical communication: An initial evaluation of a novel anesthetic scavenging interface.
Waste anesthetic gas scavenging technology has not changed appreciably in the past 30 years. Open reservoir systems entrain high volumes of room air and dilute waste gases before emission into the atmosphere. This process requires a large vacuum pump, which is both costly to install and, although efficient, operates continuously and at near-full capacity. ⋯ Using the ventilator increased this flow by approximately 6 L/min because of the exhaust of ventilator drive gas into the scavenging circuit. Daytime workload of the central vacuum pump decreased from 92% to 12% (expressed as duty cycle). The new system produces energy savings and may increase vacuum pump lifespan.
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Anesthesia and analgesia · Nov 2011
Case ReportsCase report: Severe vasospasm mimics hypotension after high-dose intrauterine vasopressin.
Intramyometrial vasopressin injection reduces bleeding during myomectomy. Subsequent loss of peripheral pulses and nonmeasurable arterial blood pressure have been attributed to cardiovascular collapse or hypotension. ⋯ We describe a patient who developed loss of peripheral pulses and nonmeasurable blood pressure by noninvasive means after myometrial administration of 60 U vasopressin, with documented severe peripheral arterial vasospasm and elevated proximal blood pressure. We discuss the pathophysiology and emphasize the danger of misinterpreting pulselessness as global hypotension instead of vasospasm in this setting.
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Anesthesia and analgesia · Nov 2011
Ketamine activates the L-arginine/Nitric oxide/cyclic guanosine monophosphate pathway to induce peripheral antinociception in rats.
The involvement of the L-arginine/nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) pathway in antinociception has been implicated as a molecular mechanism of antinociception produced by several antinociceptive agents, including μ-, κ-, or δ-opioid receptor agonists, nonsteroidal analgesics, cholinergic agonist, and α2C adrenoceptor agonist. In this study, we investigated whether ketamine, a dissociative anesthetic N-methyl-D-aspartate receptor antagonist, was also capable of activating the L-arginine/NO/cGMP pathway and eliciting peripheral antinociception. ⋯ Our results suggest that ketamine stimulates the L-arginine/NO/cyclic GMP pathway via neuronal NO synthase to induce peripheral antinociceptive effects.