Anesthesia and analgesia
-
Anesthesia and analgesia · Nov 2011
Editorial CommentImportant new model for studying anesthetic action.
-
Anesthesia and analgesia · Nov 2011
Pleth variability index to predict fluid responsiveness in colorectal surgery.
Goal-directed fluid therapy during major abdominal surgery may reduce postoperative morbidity. The Pleth Variability Index (PVI), derived from the pulse oximeter waveform, has been shown to be able to predict fluid responsiveness in a number of surgical circumstances. In the present study, we sought to determine whether PVI could predict fluid responsiveness in low-risk colorectal surgery patients who had fluid therapy guided by esophageal Doppler stroke volume measurements. ⋯ PVI measured at the finger may be able to predict fluid responsiveness during surgery in ventilated patients.
-
Anesthesia and analgesia · Nov 2011
The toxic effects of s(+)-ketamine on differentiating neurons in vitro as a consequence of suppressed neuronal Ca2+ oscillations.
In the immature brain, neuronal Ca2+ oscillations are present during a time period of high plasticity and regulate neuronal differentiation and synaptogenesis. In this study we examined the long-term blockade of hippocampal Ca2+ oscillations, the role of the N-methyl-D-aspartate (NMDA) receptors and the effects of S(+)-ketamine on neuronal synapsin expression. ⋯ Neuronal Ca2+ oscillations mediate neuronal differentiation and synaptogenesis via activating CaMKII. By acting via the NMDA receptor, S(+)-ketamine exerts its toxic effect through the suppression of neuronal Ca2+ oscillations, down-regulation of the CaMKII, and consecutively reduced synaptic integrity.
-
Anesthesia and analgesia · Nov 2011
Case ReportsCase report: Anti-N-methyl-D-aspartate receptor encephalitis and its anesthetic implications.
We describe the anesthetic management and implications of 2 patients with anti-N-methyl-D-aspartate (NMDA) receptor encephalitis. Anti-NMDA receptor encephalitis is a neurological disorder caused by production of antibodies to the NMDA receptor. ⋯ It is important to understand the pharmacologic interactions these anesthetics have with a disabled NMDA receptor while preparing an anesthetic plan for patients with anti-NMDA receptor encephalitis. Symptoms of the disease such as psychosis, paroxysmal sympathetic hyperactivity, and central hypoventilation pose risks to the induction and maintenance of anesthesia in these patients.