Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2012
Randomized Controlled TrialIntravenous sodium bicarbonate verifies intravenous position of catheters in ventilated children.
Vascular access in children carries a significant risk of accidental extravasation of IV fluids and medications with the potential for tissue injury. In this prospective controlled study we assessed the diagnostic utility of using IV diluted sodium bicarbonate to confirm placement of IV catheters in ventilated children. Diluted sodium bicarbonate was created using undiluted standard 8.4% (1 mEq/mL) sodium bicarbonate mixed in a 1:3 and 1:5 ratio with sterile water to achieve a final diluted concentration of 2.1% (0. 25 mEq/mL) and 1.05% (0.125 mEq/mL) sodium bicarbonate, respectively. ⋯ The injection of 2.1% sodium bicarbonate in mechanically ventilated ASA I-II children identified intravascular placement and patency of an IV catheter by an increase in the exhaled CO(2) concentration. The injections did not have any clinically significant effects on blood pH, bicarbonate, or sodium concentration.
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Anesthesia and analgesia · Oct 2012
Review Case ReportsEchocardiographic assessment of atrial septal defects.
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Anesthesia and analgesia · Oct 2012
Bedside assessment of total systemic vascular compliance, stressed volume, and cardiac function curves in intensive care unit patients.
Mean systemic filling pressure (Pmsf) can be measured at the bedside with minimally invasive monitoring in ventilator-dependent patients using inspiratory hold maneuvers (Pmsf(hold)) as the zero flow intercept of cardiac output (CO) to central venous pressure (CVP) relation. We compared Pmsf(hold) with arm vascular equilibrium pressure during vascular occlusion (Pmsf(arm)) and their ability to assess systemic vascular compliance (Csys) and stressed volume by intravascular fluid administration. ⋯ Csys, stressed volume, and cardiac function curves can be determined at the bedside and can be used to characterize patients' hemodynamic status.
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Anesthesia and analgesia · Oct 2012
Day or night administration of ketamine and pentobarbital differentially affect circadian rhythms of pineal melatonin secretion and locomotor activity in rats.
Surgery with general anesthesia disturbs circadian rhythms, which may lead to postoperative sleep disorders and delirium in patients. However, it is unclear how circadian rhythms are affected by different anesthetics administered at different times during the rest-activity cycle. We hypothesized that pentobarbital (an agonist at the γ-aminobutyric acid A receptors) and ketamine (an antagonist at the N-methyl-d-aspartate receptors) would have differential effects on circadian rhythms, and these effects would also be influenced by the time of their administration (the active versus resting phase). ⋯ Ketamine has opposite phase-shifting effects on circadian rhythms according to the time of administration, whereas pentobarbital has no effect. Furthermore, both anesthetics decrease the postoperative amplitude of pineal melatonin secretion if administered during the active, but not the resting, phase of the 24-hour rest-activity cycle.
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Anesthesia and analgesia · Oct 2012
Resveratrol regulates N-methyl-D-aspartate receptor expression and suppresses neuroinflammation in morphine-tolerant rats.
In the present study, we examined the effects and mechanisms of the Chinese herb resveratrol on attenuation of morphine tolerance in rats. ⋯ Resveratrol attenuates morphine tolerance by inhibiting neuroinflammation and down-regulating NMDAR NR1 and NR2B subunit expression. Resveratrol regulates the NMDAR expression, which might be involved in a loss of scaffolding postsynaptic density-95 protein.