Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2012
Randomized Controlled TrialVocalization assessed by electrolaryngography is unaffected by topical lidocaine anesthesia: a prospective, crossover, randomized, double-blind placebo-controlled study.
Topical anesthesia of the upper airway is often recommended when difficulty in airway management is anticipated. There are published reports, however, of administration of topical anesthesia resulting in complete loss of airway control. Adverse effects are mostly attributed to interference with involuntary protective airway reflexes, while gross motor function itself generally is thought to be preserved. We hypothesized that if motor control is affected, measurable quantitative changes in vocalization should follow the use of topical anesthesia. ⋯ Although gargling with local anesthetic affected vocalization, no pharmacological effect attributable to local anesthetic was observed.
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Anesthesia and analgesia · Apr 2012
Case ReportsUltrasound-guided peripheral nerve stimulator placement in two soldiers with acute battlefield neuropathic pain.
Acute peripheral neuropathic pain after combat-related polytrauma is a common occurrence in the United States military that is often refractory to current drugs and regional anesthesia. Both spinal cord and peripheral nerve stimulation are successfully used for chronic neuropathic pain states, but are not reported for acute neuropathic pain. We present 2 cases of percutaneous ultrasound-guided sciatic peripheral nerve stimulation placement in soldiers who had conditions precluding them from spinal cord stimulation placement. Opioid reduction and marked increase in functionality were possible in one case, and cessation of opioid escalation, with eventual reduction after permanent implantation, was possible in the other.
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Anesthesia and analgesia · Apr 2012
Comparative StudyThe comparative effects of lipid, epinephrine, and their combination in the reversal of bupivacaine-induced asystole in the isolated rat heart.
It remains unclear whether lipid combined with epinephrine is superior or inferior to either drug alone in treating bupivacaine cardiotoxicity. We compared the effects of lipid, epinephrine, and the combination of the two in reversing bupivacaine-induced asystole in the isolated rat heart model. We also measured the effects of lipid, epinephrine, and the combination of the two on bupivacaine content in cardiac tissue. ⋯ Lipid combined with epinephrine resulted in better recovery of cardiac function than either drug alone in reversal of bupivacaine-induced asystole in the isolated rat heart model.
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Anesthesia and analgesia · Apr 2012
Delayed treatment with lidocaine reduces mouse microglial cell injury and cytokine production after stimulation with lipopolysaccharide and interferon γ.
Neuroinflammation is an important pathological process for almost all acquired neurological diseases. Microglial cells play a critical role in neuroinflammation. We determined whether lidocaine, a local anesthetic with anti-inflammatory property, protected microglial cells and attenuated cytokine production from activated microglial cells. ⋯ Delayed treatment with lidocaine protects microglial cells and reduces cytokine production from these cells. These effects may involve action site(s) on the cell surface.
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Anesthesia and analgesia · Apr 2012
The volatile anesthetic isoflurane prevents ventilator-induced lung injury via phosphoinositide 3-kinase/Akt signaling in mice.
Mechanical ventilation leads to ventilator-induced lung injury in animals, and can contribute to acute lung injury/acute respiratory distress syndrome in humans. Acute lung injury/acute respiratory distress syndrome currently causes an unacceptably high rate of morbidity and mortality among critically ill patients. Volatile anesthetics have been shown to exert anti-inflammatory and organ-protective effects in vivo. We investigated the effects of the volatile anesthetic isoflurane on lung injury during mechanical ventilation. ⋯ Inhalation of isoflurane during mechanical ventilation protects against lung injury by preventing proinflammatory responses. This protection is mediated via phosphoinositide 3-kinase/Akt signaling.