Journal of anesthesia
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Journal of anesthesia · Feb 2020
ReviewMedical cannabis for chronic pain: can it make a difference in pain management?
Globally, chronic pain is a major therapeutic challenge and affects more than 15% of the population. As patients with painful terminal diseases may face unbearable pain, there is a need for more potent analgesics. Although opioid-based therapeutic agents received attention to manage severe pain, their adverse drug effects and mortality rate associated with opioids overdose are the major concerns. ⋯ Healthcare professionals should keep themselves updated with the changing state of medical cannabis and its applications. The pharmacokinetics and safety of medical cannabis need to be studied by conducting clinical research. The complex and variable chemically active contents of herbal cannabis and methodological limitations in the administration of cannabis to study participants, make the clinical research difficult.
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Journal of anesthesia · Feb 2020
Inadvertent hyperoxia during intraoperative care in neonates: a case-series study.
While oxygen administration has been in clinical practice, the focus has generally been on avoidance of hypoxemia. More recently, renewed emphasis has been placed on the potential deleterious effects of hyperoxia. The aim of this study is to investigate the incidence of intraoperative inadvertent hyperoxia among neonate, which was defined at three different thresholds: normoxia (PaO2 60-100 mmHg), hyperoxia (PaO2 101-199 mmHg), and severe hyperoxia (PaO2 ≥ 200 mmHg). ⋯ Among the 174 ABG readings, only 28 (16%) had PaO2 levels within our defined normoxia range. The incidence of hyperoxia in neonate under general anesthesia is high. Although it is unknown if brief exposure during anesthesia is associated with similar outcomes, educational initiatives seem warranted to increase awareness of these clinical concerns, as there seems to be limited clinical benefit from such care.
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Journal of anesthesia · Feb 2020
The protective effect of hydroxyethyl starch solution on the glycocalyx layer in an acute hemorrhage mouse model.
Fluid therapy focused on glycocalyx (GCX) protection in hemorrhagic shock is a current focus of research. Hydroxyethyl starch (HES) solution is commonly used for fluid resuscitation; however, its effects on the GCX remain unclear. The primary aim of this study was to explore the protective effect of HES130 in maintaining GCX thickness and reducing plasma syndecan-1 expression. ⋯ Resuscitation with HES130 protected the GCX and suppressed vascular permeability of HES70 during early stages of acute massive hemorrhage.
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Journal of anesthesia · Feb 2020
Differential effects of sevoflurane on the growth and apoptosis of human cancer cell lines.
There have been contradictory findings regarding the effects of sevoflurane on the oncogenic properties of cancer cells. This study was conducted to gain insights into the fundamental rules governing the differential effects of sevoflurane exposure on various cancer cells derived from multiple origins. ⋯ Sevoflurane augmented or hampered cell proliferation and Matrigel invasion depending on the cancer cell line examined. Loss of sevoflurane-induced apoptosis occurring in cancer cell lines is likely to be correlated with their enhanced proliferation after sevoflurane exposure.