Acta anaesthesiologica Sinica
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Acta Anaesthesiol. Sin. · Dec 2003
Randomized Controlled Trial Comparative Study Clinical TrialMinimal low-flow isoflurane-based anesthesia benefits patients undergoing coronary revascularization via preventing hyperglycemia and maintaining metabolic homeostasis.
The objectives of this study were to determine whether minimal low-flow isoflurane-based anesthesia could be a feasible technique for patients undergoing coronary artery bypass graft surgery. It is hypothesized that isoflurane-based anesthesia facilitates an agreeable recovery from surgery is mediated through preventing hyperglycemia and metabolic disturbance associated with cardiopulmonary bypass. ⋯ These results demonstrate that isoflurane, not fentanyl, benefits patients undergoing coronary artery bypass grafting surgery. This benefit perhaps is mediated through maintaining hemodynamic stability and metabolic homeostasis and preventing hyperglycemia.
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Acta Anaesthesiol. Sin. · Dec 2003
ReviewImplications of intrathecal pertussis toxin animal model on the cellular mechanisms of neuropathic pain syndrome.
Like opioid tolerance, neuropathic pain syndrome manifested by hyperalgesia and allodynia responds poorly to opioids. Hitherto, its development is still not clear and its treatment and prevention are still disputable. Pertussis toxin (PTX) which ADP-ribosylates the alpha-subunit of inhibitory guanine nucleotide binding regulatory proteins (Gi/Go), is used to induce morphine tolerance through intrathecal (i.t.) injection. ⋯ PTX-induced neuropathic pain syndrome is accompanied by increasing of EAAs, decreasing of IAA release, and a selective increasing of PKC gamma expression in the spinal cord. Inhibition of PKC not only blocked thermal hyperalgesia, but also reversed the reduction of morphine's analgesic effect in PTX-rats. These results suggest that PTX-induced neuropathic pain syndromes are involved in EAAs, IAAs and PKC alternations.
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Acta Anaesthesiol. Sin. · Dec 2003
Case ReportsIntraoperative TEE monitoring on pulmonary thromboembolectomy--a case report.
We present a successful thromboembolectomy under intraoperative transesophageal echocardiography (TEE) monitoring on a woman with massive pulmonary embolism (PE). Sudden onset of dyspnea happened 7 days after lumbar spine surgery and ventilation/perfusion scan and angiography performed right away were suggestive of PE. Operation was performed 17 days later after invalid anticoagulant treatments and unavailing catheter fragmentation. ⋯ The dilation of RA, right ventricle (RV) and PA were resolved soon after thromboembolectomy. The patient was extubated the next day with obvious improvement of clinical symptoms and discharged two weeks later without neurological sequale. We conclude that TEE can be an excellent tool not only for early diagnosing PE in high risk patients but also for intraoperative monitoring on removing emboli and managing cardiac functions.
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Acta Anaesthesiol. Sin. · Dec 2003
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the recovery from isoflurane anesthesia with or without fentanyl infusion in patients undergoing elective supratentorial craniotomy.
Several anesthetic agents have been used successfully to provide optimal anesthetic maintenance in neurosurgery for supratentorial tumors. Due to longer surgical time that these procedures demand and thoughout avoidance of intracranial bleeding from a hastened emergence of anesthesia in the operating room, the neurosurgeons in our hospital favor a placid late emergence from anesthesia in the neurosurgical intensive care unit (NCU). Accordingly, we designed this clinical trial to compare the effects of volatile general anesthesia with or without fentanyl infusion on postoperative hemodynamics, Glasgow coma scale (GCS) score, extubation time, as well as neurological outcome in patients after craniotomy. ⋯ In pursuance of the policy of late emergence, we are of the opinion that isoflurane anesthesia offers an earlier recovery than fentanyl-isoflurane anesthesia in patients undergoing supratentorial craniotomy.
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Acta Anaesthesiol. Sin. · Dec 2003
Multicenter StudyA two-center survey of cardiac events and peri-operative managements of cardiac patients undergoing non-cardiac surgery in Taiwanese population.
The risk of cardiac patients undergoing noncardiac surgery is relatively high. Successful preoperative evaluation and perioperative anesthetic management of a patient require a good communication among the patient, the anesthesiologist and the surgeon as well as excellent cooperation between the surgeon and anesthesiologist with a tacit understanding of the peri-operative risks. Peri-operative risk factors have been readily investigated in Caucasians or Westerners. As different ethnic populations may have different risk factors for a same disease entity, understanding the uniqueness in this respect in Taiwanese is mandatory. The purpose of this study is to examine the risk factors, perioperative cardiac events and the qualities of preoperative preparation and post-operative intensive care in Taiwanese cardiac patients undergoing noncardiac surgery. ⋯ The quality of care for preoperative evaluation and quality assurance need to be improved in Taiwan.