Anesthesia and analgesia
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Anesthesia and analgesia · May 2012
Cyanide toxicity in juvenile pigs and its reversal by a new prodrug, sulfanegen sodium.
Cyanide (CN) toxicity is a serious clinical problem and can occur with sodium nitroprusside (SNP) administration, accidental smoke inhalation, industrial mishaps, and bio-terrorism. In this study, we induced severe CN toxicity independently with SNP or sodium cyanide (NaCN) in a juvenile pig model to demonstrate reversal of severe CN toxicity with a new antidote, sulfanegen sodium, a prodrug of 3-mercaptopyruvate. ⋯ CN toxicity can be successfully induced in a juvenile pig model with SNP or NaCN. The prodrug, sulfanegen sodium, is effective in reversing CN toxicity induced by SNP or NaCN.
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Drug waste has been implicated as a significant contributor to environmental contamination and unnecessary health care costs. ⋯ Propofol does not degrade in nature, accumulates in body fat, and is toxic to aquatic life. We reduced wastage by removing 50 and 100 mL vials of propofol from the pharmacy, retaining only the smallest size (20 mL).
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Anesthesia and analgesia · May 2012
A survey of anesthesiologists' views of operating room recycling.
Operating rooms contribute significantly to the increasing volumes and costs of hospital waste. Little is known, however, about doctors' views of hospital waste recycling despite their potential influence in improving recycling programs. We surveyed the waste recycling views held by anesthesiologists in Australia, New Zealand, and England in regional or metropolitan and public or private practice. We asked the following: (1) What proportion of anesthesiologists consider recycling operating room waste to be important? (2) What do respondents consider to be identifiable barriers preventing operating room recycling? ⋯ Most responding anesthesiologists supported greater operating room waste recycling but thought that there were identifiable barriers. Anesthesiologists could take a leadership role and work with other hospital employees to improve operating room recycling. We suggest studies of the effect of improving operating room recycling facilities, education, and staff attitudes.
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Anesthesia and analgesia · May 2012
The emergence level of the musculocutaneous nerve from the brachial plexus: implications for infraclavicular nerve blocks.
In this cadaveric study we assessed the level of the emergence of the musculocutanous nerve (MCN) relative to needle insertion site during infraclavicular block. ⋯ This anatomical study suggests that MCN may be one of the factors explaining MCN block failure for the single-injection technique of infraclavicular block using lateral needle trajectory.
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Anesthesia and analgesia · May 2012
Prevention of paclitaxel-induced neuropathy through activation of the central cannabinoid type 2 receptor system.
Peripheral neuropathy is a major dose-limiting toxicity of chemotherapy, especially after multiple courses of paclitaxel. The development of paclitaxel-induced neuropathy is associated with the activation of microglia followed by the activation and proliferation of astrocytes, and the expression and release of proinflammatory cytokines in the spinal dorsal horn. Cannabinoid type 2 (CB(2)) receptors are expressed in the microglia in neurodegenerative disease models. ⋯ Our findings suggest an innovative therapeutic approach to prevent chemotherapy-induced neuropathy and may permit more aggressive use of active chemotherapeutic regimens with reduced long-term sequelae.