Journal of Anesthesia & Critical Care: Open Access最新文献

{"title":"Optimization of Xylazine-Ketamine anesthetic dose in mice suffering chronic liver injury","authors":"Omar Y Tammam, A. Taha, M. El-Sherif","doi":"10.15406/JACCOA.2019.11.00403","DOIUrl":"https://doi.org/10.15406/JACCOA.2019.11.00403","url":null,"abstract":"Mice and rats are served as the preferable lab animal for biomedical research model due to their small size, ease of handling, short life span and similarity in anatomical, physiological and genetic disceplens to humans. They have been used for in vivo studying of mechanisms of liver fibrosis and its possible treatments. Carbon tetrachloride induced liver fibrosis resembles human liver fibrosis and serves as an attractive model for chronic liver intoxication on the molecular levels.1,2 Completion of certain research may require keeping all participated animals alive, despite of frustrated procedures of examination or samples collection. These procedures are performed in anesthetized mice in order to facilitate the procedure and enable the operator to perform safely and accurately. General anesthesia has been described in lab mice. Ether and isoflurane inhalant agents have been reported for inducing general anesthesia in mice.3 Several injectable protocols have been described. Xylazine 10mg/kg-Ketamine 100mg/ kg, Xylazine 10mg/kg-Ketamine 100mg/kg-Acetyl promazine 3mg/ kg and Diazepam 5mg/kg -Ketamine 200 mg/kg mixtures have been designated for survival procedures in mice.4−7 The combination of ketamine and xylazine is still the most widely used ketamine combination in mice, providing good immobilization with some degree of analgesia. Several different dosage combinations of the ketamine/xylazine mixture have been reported for mice in the medical literature, varying from 65/4 to 100/13 mg/kg. The large variability of the recommended dosages depends on differences related to strain, sex, age, and type of experimental procedure.8−12 Injectable anesthetics may be associated with cardiovascular and respiratory depression, prolonged recoveries, lower margin of safety and hard to control the depth of anesthesia. Both xylazine and ketamine are metabolized by liver enzymes.13 Animals with end stage liver disease are at significant risk of mortality during and after anesthesia and surgery.14 In the text below, we studied four doses of Ketamine-Xylazine mixture, and we report our own experience in selection of a safe and reliable anesthetic protocol.","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83432022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain control, adverse effects and degree of satisfaction of postsurgical patients in the acute pain unit in a Mexican hospital using an electronic platform as a tool for assessment","authors":"Carlos Garza Garibay, G. E. A. Ornelas, Stephanie Victoria Gómez Rodríguez, Diana Romina Bucio Cedeño, A. Cueva, Ana Karen Cornejo Huerta","doi":"10.15406/jaccoa.2019.11.00402","DOIUrl":"https://doi.org/10.15406/jaccoa.2019.11.00402","url":null,"abstract":"The pathophysiology is the result of the harmful stimulation of the skin, the subcutaneous tissues, the viscera and the neuronal structures, so this is a form of exceptional acute pain. The pain occurs because inflammatory and sensitizing mediators are released that include cytokines, bradykinin and prostaglandins from injured and inflammatory cells at the site of tissue damage. Nociceptors demonstrate reversible plasticity in response to inflammatory mediators. The activation threshold of nociceptors decreases, which results in greater sensitivity to pain at the site of tissue injury. The release of ATP by the injured cells plays an important role in allodynia and the spontaneous activity by incision in the primary afferent fibers provides a maintenance of the neurons of wide dynamic range in the posterior horn in a sensitized state, as well as the repetitive stimulation of primary afferents Type C fibers that promote an exaggerated response to painful stimuli.11 The NMDA receptor acts through the large influx of calcium ions (Ca2þ) that occurs when the channel is activated. Once inside the cell, Ca2þ can activate several effectors and promote later changes. That can promote plasticity mechanisms such as long-term potentiation.","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83363256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of pain management methods used at kakamega county teaching & refferal hospital, Kenya","authors":"C. Lusweti, A. Asik","doi":"10.15406/jaccoa.2019.11.00408","DOIUrl":"https://doi.org/10.15406/jaccoa.2019.11.00408","url":null,"abstract":"Effective managing acute postoperative pain is a major challenge for practitioners, given that more than 80% of patients report pain after surgery, and 75% report the pain as moderate, severe, or even extreme .The American pain Society states that ‘In more than half of cases, patients report not receiving adequate pain management following their procedure’, which has raised concerns over the development of chronic pain. The objective of the study was to assess the effectiveness of pain management methods used at Kakamega County Teaching and Referral Hospital, Kenya (KCTRH). The study adopted a descriptive cross-sectional study which was carried out KCTRH. The participants in the study included all adult male and female patients who had undergone major surgical procedure within 24 hours post-operative.at KCTRH. The target population, (N) is 250. Purposive sampling method was used, meaning that only patients available during the data collection period and meets the inclusion criteria were included in the sample. Majority of the patients interviewed were aged between 31-40 years and most of the respondents were females accounting to 67(61%) of the respondents. All the respondents interviewed were Christians and worked in the informal sector. Most of the respondents 80(73%) reported that painkillers were given through intra-venous. 64(59%) of the respondents were given general anesthesia whereas 45(41%) were given regional block type of anesthesia.","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"103 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89337235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcutaneous radiofrequency: clinical experience","authors":"Francisco Vicente Tomas Rios, Eva Romero","doi":"10.15406/jaccoa.2018.10.00399","DOIUrl":"https://doi.org/10.15406/jaccoa.2018.10.00399","url":null,"abstract":"Methods: A retrospective study of 14 patients was performed during the period 2014 -2015 10 diagnosed with knee pathology and 4 chronic shoulder pathology. We included in our study those patients referred for specialist diagnosed osteoarticular pathology (shoulder and knee) for more than three months duration after entering your conventional therapies performed ineffectively after handling conventional, including steroid injections, hyaluronic acid or ozone, discarded for surgery. All were treated as outpatients. Patients receive 3 treatments with a monthly interval between the two, regardless of the evolution of his dolor.En here is an initial study and a month, pending realization of the other treatments. The TCPRFT was performed with a radio frequency generator 1100 using Neurotherm NT modified leads, connected to two channels in a surface mounted TENS adhesive, and managed not termoacoplado mode with manual voltage. Treatment was done always in the same position, with two parameters pps, 20 msec, 90V, for 12 minutes, providing the electrodes as images: Knee: A. Previous Position: Suprapatellar medial, lateral suprapatellar, infrapatellar medial, lateral infrapatellar. B. Rear-Position: popliteal fossa in four quadrants. C. Transverse-transcutaneous Shoulder: a. acromioclavicular joint and deltoid insertion on the humerus. b. glenohumeral joint in the anteroposterior plane, and subsequent behind the spine of the scapula. 3. deltopectoral the supraspinatus muscle-Triangle. D. Same as above, but a little more lateral delto-pectoral Triangle, and supraespoinoso muscle. E. Triangle delto-pectoral and spine of the scapula. F. Articulacion acromioclavicular, and under the root of the armpit. After the patient’s informed and assessment of VAS and SF-36 agreement, the above described technique is performed and 4 weeks evaluates the patient again (VAS and SF-36).","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88339808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capnothorax, capnomediastinum and subcutaneous emphysema as complication of laparoscopic nissen´s fundoplication ","authors":"M. Duque, Maria José Arede, Y. Ribeiro, J. Assunção","doi":"10.15406/JACCOA.2018.10.00400","DOIUrl":"https://doi.org/10.15406/JACCOA.2018.10.00400","url":null,"abstract":"","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"837 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77548120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management strategy for inadvertent arterial cannulation during central venous catheter insertion","authors":"Bhakti Trivedi, Anamika Yadav, S. Patil","doi":"10.15406/JACCOA.2018.10.00397","DOIUrl":"https://doi.org/10.15406/JACCOA.2018.10.00397","url":null,"abstract":"","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74864238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for mechanical ventilation in cancer patients","authors":"F. D. Martos-Benítez","doi":"10.15406/jaccoa.2018.10.00398","DOIUrl":"https://doi.org/10.15406/jaccoa.2018.10.00398","url":null,"abstract":"","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89210982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Survey of pediatric anesthesia practice for magnetic resonance imaging in French hospitals","authors":"K. C","doi":"10.15406/jaccoa.2018.10.00395","DOIUrl":"https://doi.org/10.15406/jaccoa.2018.10.00395","url":null,"abstract":"","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74383489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaesthesia for an infant with anterior mediastinal teratoma with impending cardiorespiratory collapse: a case report","authors":"N. Nishanth, Mahantesh Sm, S. Agnihotri, Harihar VHegde, Venkatesh MAnnigeri, Anil B. Halgeri, B. AkshayKalavant, S. Mukkannavar","doi":"10.15406/jaccoa.2018.10.00394","DOIUrl":"https://doi.org/10.15406/jaccoa.2018.10.00394","url":null,"abstract":"Anterior mediastinal mass in a child has serious life threatening anaesthetic implications and its management is a challenge for the anaesthesiologist. The anterior and superior mediastinal masses lie in close proximity with the airway, major vessels and heart, and can cause compression of these structures leading to reduced cardiac output. Sedative premedication, induction of general anaesthesia (GA) with or without skeletal muscle relaxants, intermittent positive pressure ventilation (IPPV), change of posture, and tumour manipulation or resection can cause catastrophic airway and cardiovascular collapse even in a previously asymptomatic child.1−4 Induction of GA may cause airway and cardiovascular collapse even in a previously asymptomatic child. In the presence of severe symptoms such as positional dyspnoea, orthopnoea, stridor, syncope and superior vena cava syndrome administration of GA may be fatal.5,6 Airway collapse may occur even after endotracheal intubation and an emergency tracheostomy performed to relieve the obstruction may prove futile, as the obstruction may be distal to the tube.7 We present the successful management of an infant with mediastinal tumour in circulatory shock, the difficulties faced in decision making and discuss the anaesthetic challenges encountered.","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78162973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the postoperative analgesic effects of intrathecal Clonidine and Fentanyl as adjuvant: Mata Analysis of randomized control trials","authors":"Fantahun Tarekegn Kumie, A. Hailekiros, Setegn Eshetie","doi":"10.15406/JACCOA.2019.11.00411","DOIUrl":"https://doi.org/10.15406/JACCOA.2019.11.00411","url":null,"abstract":"\u0000 Background: Intrathecal clonidine and fentanyl added to bupivacaine prolongs the postoperative analgesic effects for below umbilicus surgery. However, the overall effect of clonidine and fentanyl mixed with spinal anesthesia is not harmonized. Therefore, the aim of this Meta - analysis was to assess the post operative analgesic effects of intrathecal clonidine and fentanyl for different randomized control trials of study.\u0000Methods: Pubmed, Cochrane Review, EMBASE, and Google Scholar were searched and a total of four studies have been selected for Meta – Analysis. Three authors engaged independently to extract data on the efficacy of intrathecal clonidine and fentanyl for lower abdomen and limb surgeries. The statistical analysis was accomplished by RevMan (version 5.3) software. The overall efficacy of intrathecal clonidine and fentanyl were pooled by Forrest plot, table, and figure with 95% confidence interval.\u0000Results: The pooled effect size mean difference of intrathecal clonidine versus fentanyl was 83.57(95 % CI, 29.33 to 137.82) minutes. Furthermore, the lowest and highest mean difference of effect size was 10.60 and 175.98 minutes respectively.\u0000Conclusion: Intrathecal clonidine as adjuvant to bupivacaine gave the prolonged postoperative analgesia in comparison to intrathecal fentanyl. So it is recommended to use clonidine as intrathecal adjuvant when we consider the extended postoperative analgesia.","PeriodicalId":14916,"journal":{"name":"Journal of Anesthesia & Critical Care: Open Access","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86100366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}