Journal of anesthesia
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Journal of anesthesia · Feb 2012
Case ReportsSevere post-burn neck contracture release and skin graft harvest using tumescent local anaesthesia as the sole anesthetic technique.
Severe post-burn contractures in the neck often cause anatomical distortion and restriction of neck movements, resulting in varying degrees of difficulty in airway management. Any mode of anesthesia that may obviate the need for imperative airway control may be desirable in such situations in which a difficult airway may be anticipated. ⋯ The other benefits of this method were minimal blood loss and excellent postoperative analgesia. In conclusion, it can be emphasized that the application of tumescent anesthesia is an important anesthetic tool in patients with predicted difficult airway management.
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Journal of anesthesia · Feb 2012
Case ReportsLarge mediastinal tumor in a neonate: an anesthetic challenge.
Mediastinal tumors pose a grave risk of cardiopulmonary complications during the perioperative course, particularly in neonates and small children. These tumors can cause displacement and compression of vital thoracic structures such as the tracheobronchial tree, the heart, and the great vessels. Catastrophic complications often occur during induction of anesthesia, use of muscle relaxants, positioning, and at the time of extubation. We present our experience of anesthetic management of a neonate with a mediastinal mass who had features of both airway and vascular obstruction.
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Journal of anesthesia · Feb 2012
Clinical dose of lidocaine destroys the cell membrane and induces both necrosis and apoptosis in an identified Lymnaea neuron.
Although lidocaine-induced cell toxicity has been reported, its mechanism is unclear. Cell size, morphological change, and membrane resistance are related to homeostasis and damage to the cell membrane; however, the effects of lidocaine on these factors are unclear. Using an identified LPeD1 neuron from Lymnaea stagnalis, we sought to determine how lidocaine affects these factors and how lidocaine is related to damage of the cell membrane. ⋯ A clinical dose of lidocaine greater than 5 mM destroys the cell membrane and induces both necrosis and apoptosis in an identified Lymnaea neuron.
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Journal of anesthesia · Feb 2012
Effects of neostigmine on bronchoconstriction with continuous electrical stimulation in rats.
When neostigmine is used to reverse muscle relaxants in patients with asthma without signs of airway inflammation, asthma attack is occasionally encountered. It is likely that abnormally increased electrical impulses traveling from the brain through cholinergic nerves to airway smooth muscles may be one of the pathogeneses of asthma attack. We applied continuous electrical field stimulation (c-EFS) or continuous electrical stimulation (c-ES) of low frequency to the vagal nerve of the rat in vitro and in vivo to determine the role of cholinergic nerve activation in inducing airway constriction. ⋯ The contractile response of the tracheal ring to c-EFS is potentiated by neostigmine. P (max) is increased by c-ES of the vagal nerve, and is potentiated by neostigmine. These data suggest that increased activity of the cholinergic nerve could be involved in asthma attack.
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Journal of anesthesia · Feb 2012
Vascular reactivity in human arteries: from experimental study to clinical application.
The principal function of VSM cells in mature animals is contraction. The endothelium is now recognized to elaborate various vasoactive factors and to play a critical part in regulation of vascular tone. ⋯ In humans,systemic, pulmonary, and various organ circulation(s) are maintained by an intricate and complex cardiovascular system. We expect future studies to clarify the sophisticated but complex mechanisms of VSM in humans.