Anesthesia and analgesia
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Anesthesia and analgesia · Jun 2014
Randomized Controlled TrialIs video laryngoscope-assisted flexible tracheoscope intubation feasible for patients with predicted difficult airway? A prospective, randomized clinical trial.
Failed intubation may result in both increased morbidity and mortality. The combination of a video laryngoscope and a flexible tracheoscope used as a flexible video stylet may improve the success rate of securing a difficult airway. We tested the hypothesis that this combination is a feasible way to facilitate intubation in patients with a predicted difficult airway in that it will shorten intubation times and reduce the number of intubation attempts. ⋯ Flexible tracheoscope-assisted video laryngoscopic intubation is a feasible alternative to video laryngoscope only intubation in patients with predicted difficult airways. A flexible tracheoscope used in combination with video laryngoscope may also further increase the success rate of intubation in select patients with a proven difficult airway, particularly when in-line stabilization is required.
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Anesthesia and analgesia · Jun 2014
Subclinical Carbon Monoxide Limits Apoptosis in the Developing Brain After Isoflurane Exposure.
Volatile anesthetics cause widespread apoptosis in the developing brain. Carbon monoxide (CO) has antiapoptotic properties, and exhaled endogenous CO is commonly rebreathed during low-flow anesthesia in infants and children, resulting in subclinical CO exposure. Thus, we aimed to determine whether CO could limit isoflurane-induced apoptosis in the developing brain. ⋯ Taken together, the data indicate that CO can limit apoptosis after isoflurane exposure via inhibition of cytochrome c peroxidase depending on concentration. Although it is unknown whether CO directly inhibited isoflurane-induced apoptosis, it is possible that low-flow anesthesia designed to target rebreathing of specific concentrations of CO may be a desired strategy to develop in the future in an effort to prevent anesthesia-induced neurotoxicity in infants and children.
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Anesthesia and analgesia · Jun 2014
Randomized Controlled Trial Comparative StudyA randomized comparison between double-injection and targeted intracluster-injection ultrasound-guided supraclavicular brachial plexus block.
Ultrasound-guided supraclavicular block has faster onset when a targeted intracluster-injection technique is used compared with double injection.
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Anesthesia and analgesia · Jun 2014
Nanoanesthesia: A Novel, Intravenous Approach to Ankle Block in the Rat by Magnet-Directed Concentration of Ropivacaine-Associated Nanoparticles.
As an alternative to current methods of local nerve block, we studied the feasibility of producing ankle block in the rat with IV injection of magnetic nanoparticles (MNPs) associated with ropivacaine and application of a magnet at the ankle. ⋯ The current study establishes proof of principle that it is possible to produce ankle block in the rat by IV injection of MNP/Ropiv complexes and magnet application at the ankle. The results indicate that further study of this approach is warranted.
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Anesthesia and analgesia · Jun 2014
Randomized Controlled Trial Comparative StudyDehydration Enhances Pain-Evoked Activation in the Human Brain Compared with Rehydration.
Negative effects of dehydration on the human brain and cognitive function have been reported. In this study, we examined the effects of dehydration on pain thresholds and cortical activations in response to pain, compared with rehydration with an oral rehydration solution (ORS) by functional magnetic resonance imaging. ⋯ Our findings suggest that dehydration brings about increased brain activity related to painful stimuli together with enhanced thirst, whereas rehydration with ORS alleviates thirst and decreases brain activity related to painful stimuli.