Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2014
Editorial Biography Historical ArticleThank you, larry saidman!
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Anesthesia and analgesia · Dec 2014
Excessive variations in the plethysmographic waveform during spontaneous ventilation: an important sign of upper airway obstruction.
The respiratory variations in the plethysmographic (PLET) waveform of the pulse oximeter during mechanical ventilation can be automatically quantified as the PLET variation index (PVI(®)). Like other dynamic variables, the PVI may provide useful information about fluid responsiveness but only when the patient is receiving fully controlled mechanical ventilation with no spontaneous breathing activity. However, a growing number of monitors that automatically measure and display the values of the PVI and other dynamic variables are being introduced into clinical practice. ⋯ In 2 of these cases, simultaneously measured values of the pulse pressure variation were high as well (19% and 34%), while the calculated pulsus paradoxus was 28 and 40 mm Hg. In 2 cases, the analog signals of impedance plethysmography and capnography persisted, despite the presence of clinically significant UAO. It is, therefore, suggested that monitoring the sPVI may be of great clinical importance in spontaneously breathing patients who are susceptible to develop UAO.
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Anesthesia and analgesia · Dec 2014
The Analgesic Effect of a Vapocoolant Stream Spray in Reducing Heat Nociception on the Glabrous Skin of Rat Pups.
Blood sampling is a common screening and diagnostic test in newborn infants in the neonatal intensive care unit, and heel lancing accounts for two-thirds of these tests. Heel lancing causes acute pain and distress, and most infants rarely receive analgesics because of fear of respiratory depression from opioids and lack of effectiveness of topical local anesthetics on the glabrous skin. To circumvent this latter problem, we investigated the analgesic efficacy and safety of a topical vapocoolant spray. ⋯ Vapocoolant spray treatment of the glabrous skin is effective and safe after a single treatment.