Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2011
Forced needle advancement during needle-nerve contact in a porcine model: histological outcome.
In this study, we determined whether needle advancement during needle-nerve contact (forced needle-nerve contact) is associated with a higher risk of nerve injury compared with needle-nerve contact without needle advancement (nonforced needle-nerve contact). ⋯ The severity of structural nerve injury after needle-nerve contact was directly related to force exposure via needle advancement.
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Anesthesia and analgesia · Aug 2011
Historical ArticleThe making of an anesthesia historian: lessons from a worldwide biographical survey.
There are few, if any, training opportunities for individuals wishing to pursue a career as an anesthesia historian. We surveyed anesthesia historians to learn about their training and experience, with an emphasis on mentoring, obstacles faced, and opportunities for improvement. ⋯ A study of history does not necessarily produce changes in clinical practice, which may limit the perceived value of historical study. The suggestions by these historians should help preserve the history and heritage of anesthesiology.
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Anesthesia and analgesia · Aug 2011
The macrophage-mediated effects of the peroxisome proliferator-activated receptor-gamma agonist rosiglitazone attenuate tactile allodynia in the early phase of neuropathic pain development.
Neuroinflammation triggered by macrophage infiltration into sites of peripheral nerve injury may result in neuropathic pain. Peroxisome proliferator-activated receptor (PPAR)γ signaling regulates the properties of macrophages. However, the macrophage-mediated effects of PPARγ signaling on neuropathic pain triggered by peripheral inflammation have not been investigated. ⋯ Rosiglitazone treatment in the early phase of neuropathic pain significantly alleviated the development of tactile allodynia by regulating macrophage infiltration and production of proinflammatory molecules at the inflamed site. Our results indicate that the activation of PPARγ signaling in macrophages during the early phase may suppress neuropathic pain development.
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Anesthesia and analgesia · Aug 2011
Airway collapse with an anterior mediastinal mass despite spontaneous ventilation in an adult.
Patients with anterior mediastinal masses are at increased risk for perioperative complications. Our case demonstrates that airway collapse and inability to ventilate may occur in the asymptomatic adult despite spontaneous ventilation with inhaled anesthesia and an endotracheal tube. ⋯ Though repositioning the pediatric patient lateral or prone has been reported to reestablish airway patency, this maneuver may be of limited benefit in the adult population because of a more ossified and developed chest wall. Lastly, if a high-risk patient requires a general anesthetic, strong consideration should be given to preinduction placement of femoral cardiopulmonary bypass cannulae and the availability to immediately initiate cardiopulmonary bypass.