Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2011
Comparative StudyEnhancing the relative safety of intentional or unintentional intrathecal methylprednisolone administration by removing polyethylene glycol.
Previous studies have shown that intrathecal methylprednisolone is a very effective treatment for postherpetic neuralgia. However, widespread use of intrathecal methylprednisolone is limited by the presence of polyethylene glycol (PEG) as a preservative in the commercial formulation. In this study, we are proposing a method to reduce the concentration of PEG in the methylprednisolone acetate (MPA) suspension by inverting a vial before sterilely aspirating the contents into a syringe for subsequent injection. The purpose of this brief study was to precisely quantify the concentration of PEG in the MPA suspension. ⋯ We believe that by decreasing the PEG concentration using our method, MPA-related complications will potentially be reduced, and this should be considered in patients with postherpetic neuralgia refractory to other treatments who might be candidates for repeated intrathecal injections.
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Anesthesia and analgesia · Dec 2011
Comparative StudyAn uncalibrated pulse contour method to measure cardiac output during aortic counterpulsation.
Less-invasive monitoring systems, such as pulse contour methods, are increasingly being used to estimate cardiac output (CO). However, alterations in the arterial waveform caused by intraaortic balloon pump counterpulsation may affect the ability of pulse contour algorithms to determine CO. We investigated the reliability of an uncalibrated pulse contour method, the MostCare system, in patients with cardiac failure receiving intraaortic balloon pump counterpulsation by comparing its measurements of CO with those determined by an intermittent thermodilution method. ⋯ The MostCare system provided measurements of CO that were comparable to ThD-CO in patients assisted with an intraaortic balloon pump. The reliability of the MostCare system is not significantly affected by changes in arterial waveform morphology caused by inflation and deflation of the intraaortic balloon pump.
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Anesthesia and analgesia · Dec 2011
Comparative StudyKnockdown of synaptic scaffolding protein Homer 1b/c attenuates secondary hyperalgesia induced by complete Freund's adjuvant in rats.
Previous studies have demonstrated that Homer 1b/c, a postsynaptic molecular scaffolding protein that binds and clusters metabotropic glutamate receptors at neuronal synapses, has an important role in the metabotropic glutamate receptor signaling process. In the current study, we investigated the possible involvement of Homer 1b/c in secondary hyperalgesia induced by complete Freund's adjuvant (CFA). ⋯ These novel results demonstrate that Homer 1b/c in the spinal cord contributes to the maintenance of secondary hyperalgesia induced by CFA and suggest that Homer 1b/c may be a novel target for pain therapy.
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Anesthesia and analgesia · Dec 2011
Comparative StudyIsoflurane anesthesia preserves liver and lung mitochondrial oxidative capacity after gut ischemia-reperfusion.
Lung and liver dysfunction is involved in gut ischemia-reperfusion (IR)-induced multiple organ failure. We compared the effects of ketamine and isoflurane on liver and lung mitochondrial oxidative capacity after gut IR. ⋯ Isoflurane preserved liver and lung mitochondrial oxidative capacity after gut IR.
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Anesthesia and analgesia · Dec 2011
Case ReportsHigh thoracic/cervical epidural blood patch for spontaneous cerebrospinal fluid leak: a new challenge for anesthesiologists.
Spontaneous cerebral spinal fluid leakage is increasingly recognized as a cause of headache due to low intracranial pressure. The site of leakage can be identified with radionuclide cisternography, and anesthesiologists are increasingly requested to provide epidural blood patch for their management. This series of case reports demonstrates some of the issues relating to the management of this condition.