Anesthesia and analgesia
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Anesthesia and analgesia · May 2016
High Glucose Attenuates Anesthetic Cardioprotection in Stem-Cell-Derived Cardiomyocytes: The Role of Reactive Oxygen Species and Mitochondrial Fission.
Hyperglycemia can blunt the cardioprotective effects of isoflurane in the setting of ischemia-reperfusion injury. Previous studies suggest that reactive oxygen species (ROS) and increased mitochondrial fission play a role in cardiomyocyte death during ischemia-reperfusion injury. To investigate the role of glucose concentration in ROS production and mitochondrial fission during ischemia-reperfusion (with and without anesthetic protection), we used the novel platform of human-induced pluripotent stem-cell (iPSC)-derived cardiomyocytes (CMs). ⋯ Human iPSC-CM is a useful, relevant model for studying isoflurane cardioprotection and can be manipulated to recapitulate complex clinical perturbations. We demonstrate that the cardioprotective effects of isoflurane in elevated glucose conditions can be restored by scavenging ROS or inhibiting mitochondrial fission. These findings may contribute to further understanding and guidance for restoring pharmacological cardioprotection in hyperglycemic patients.
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Anesthesia and analgesia · May 2016
Work Habits Are Valid Components of Evaluations of Anesthesia Residents Based on Faculty Anesthesiologists' Daily Written Comments About Residents.
In our department, faculty anesthesiologists routinely evaluate the resident physicians with whom they worked in an operative setting the day before, providing numerical scores to questions. The faculty can also enter a written comment if so desired. Because residents' work habits are important to anesthesiology program directors, and work habits can improve with feedback, we hypothesized that faculty comments would include the theme of the anesthesia resident's work habits. ⋯ Although faculty anesthesiologists completed (numerical) questions based on the American College of Graduate Medical Education competencies to evaluate residents, an important percentage of written comments included the theme of work habits. The implication is that the theme has validity as one component of the routine evaluation of anesthesia residents.
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Anesthesia and analgesia · May 2016
A Novel Proliposomal Ropivacaine Oil: Pharmacokinetic-Pharmacodynamic Studies After Subcutaneous Administration in Pigs.
Liposomal local anesthetics are limited by a short liposomal shelf-life, even when under refrigeration. We describe a novel proliposomal ropivacaine that produces liposomes in situ, only after exposure to aqueous media. ⋯ Proliposomal ropivacaine exerted prolonged anesthesia with delayed elimination, typical for liposomal drugs. The advantage of this novel proliposomal ropivacaine is its ease of preparation and its extended shelf-stability (>2 years) at room temperature.