Journal of anesthesia
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Journal of anesthesia · Feb 2016
Predictors and outcomes following naloxone administration during Phase I anesthesia recovery.
To identify characteristics associated with postoperative respiratory depression that required naloxone intervention during Phase I recovery following general anesthesia. A secondary aim is to compare postoperative outcomes between patients who received naloxone and those who did not. ⋯ Obstructive sleep apnea, higher ASA-PS scores and greater doses of intraoperative opioids were associated with naloxone administration during Phase I recovery. Patients administered naloxone had increased adverse events after discharge from the recovery room and may benefit from a higher level of postoperative care.
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Journal of anesthesia · Feb 2016
Review Meta Analysis Comparative StudyCuffed versus uncuffed endotracheal tubes in children: a meta-analysis.
Cuffed endotracheal tubes (ETTs) have increasingly been used in small children. However, the use of cuffed ETTs in small children is still controversial. The goal of this meta-analysis is to assess the current evidence regarding the postextubation morbidity and tracheal tube (TT) exchange rate of cuffed ETTs compared to uncuffed ETTs in children. ⋯ Our study demonstrates that cuffed ETTs reduce the need for TT exchanges and do not increase the risk for postextubation stridor compared with uncuffed ETTs.
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Journal of anesthesia · Feb 2016
Effect of curcumin (Curcuma longa extract) on LPS-induced acute lung injury is mediated by the activation of AMPK.
Curcumin, a biphenolic compound extracted from turmeric (Curcuma longa), possesses potent anti-inflammatory activity. The present study investigated whether curcumin could increase 5' adenosine monophosphate-activated protein kinase (AMPK) activity in macrophages and modulate the severity of lipopolysaccharide (LPS)-induced acute lung injury. ⋯ These results suggest that the protective effect of curcumin on LPS-induced acute lung injury is associated with AMPK activation.
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Emerging evidence from case reports suggests that fentanyl may precipitate potentially life-threatening serotonin syndrome in patients taking serotonergic drugs. However, the underlying mechanism of the association between serotonin syndrome and fentanyl remains under investigation. We therefore investigated the pharmacological effects of an analgesic dose of fentanyl (0.2 mg/kg) injected subcutaneously (s.c.) on serotonergic toxicity-like responses in rats. ⋯ Pretreatment with naloxone [2.0 mg/kg, intraperitoneal (i.p.) injection], an opioid receptor antagonist, failed to antagonize the fentanyl-induced exaggerated serotonin syndrome-like behaviors. In contrast, pretreatment with WAY-100653, a serotonin 5-HT1A receptor antagonist (0.5 mg/kg, i.p. injection) completely inhibited all responses. Our findings provide preclinical proof-of-concept that an analgesic dose of fentanyl enhances serotonin toxicity, likely via its serotonin-reuptake inhibitory activity, independently of interaction with the opioid receptors.
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Journal of anesthesia · Feb 2016
ReviewDevelopment of technologies for placement of perineural catheters.
Continuous peripheral nerve block (CPNB) success is largely dependent on placement of the catheter close enough to the nerve to allow effective and sustained analgesia following painful surgeries with a minimum volume of local anesthetic. One of the most common problems associated with CPNB involves accurate placement of the catheter tip, migration, and dislodgement of the catheter. ⋯ In response to the challenges of providing safe, effective, and consistently reliable analgesia, research and development in this field is expanding rapidly. This review article presents results from recent publications addressing the subject of peripheral nerve catheter localization.