The Open Anesthesiology Journal最新文献_第9页

Effect of Ketamine on Inflammatory and Immune Responses After Short-Duration Surgery in Obese Patients 氯胺酮对肥胖患者短期手术后炎症和免疫反应的影响

The Open Anesthesiology Journal Pub Date : 2008-05-22 DOI: 10.2174/1874321800802010040

Efim Roussabrov, J. Davies, H. Bessler, L. Greemberg, L. Roytblat, I. Yardeni, A. Artru, Y. Shapira

{"title":"Effect of Ketamine on Inflammatory and Immune Responses After Short-Duration Surgery in Obese Patients","authors":"Efim Roussabrov, J. Davies, H. Bessler, L. Greemberg, L. Roytblat, I. Yardeni, A. Artru, Y. Shapira","doi":"10.2174/1874321800802010040","DOIUrl":"https://doi.org/10.2174/1874321800802010040","url":null,"abstract":"In non-obese patients ketamine decreases inflammatory responses and prevents overexpression of immune re- sponses. Its effect in obese patients is unknown. This prospective, blinded, randomized controlled trial was designed to determine the effect of ketamine on cytokines and immune cell responses after short-duration surgery in obese patients. Thirty-six patients received either ketamine 0.15 mg/kg IV prior to induction of general anesthesia, or an equal volume of normal saline. Cytokine concentrations and immune cell responses were determined pre-operatively and at 4, 24, and 48 h after operation. Interleukin (IL)-6 production was significantly greater in the control group (126.0 ± 18.8 ng/ml, mean ± SEM, n = 19) than in the ketamine group (57.9 ± 8.4 ng/ml) at 4 h. At other time periods IL-6 and tumor necrosis factor � increased and IL-2, lymphocyte proliferation, and natural killer cell cytotoxity decreased compared to pre-operative values in the control group but not in the ketamine group. We conclude that effects of ketamine on inflammatory and immune re- sponses after short-duration surgery in obese patients are similar to those previously reported in non-obese patients.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"2015 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133165516","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}

引用次数: 10

Revisited: Haemodynamic Instability and Endocrine Response During Endotracheal Tube-Placement. A Prospective, Randomized Trial Using Topical Lidocaine and a Lightwand 重访:气管内置管期间的血流动力学不稳定性和内分泌反应。一项前瞻性随机试验，使用局部利多卡因和Lightwand

The Open Anesthesiology Journal Pub Date : 2008-05-13 DOI: 10.2174/1874321800802010030

B. Dünges, F. Heid, M. Dauster, U. Strecker, B. Röhrig, A. Brambrink

{"title":"Revisited: Haemodynamic Instability and Endocrine Response During Endotracheal Tube-Placement. A Prospective, Randomized Trial Using Topical Lidocaine and a Lightwand","authors":"B. Dünges, F. Heid, M. Dauster, U. Strecker, B. Röhrig, A. Brambrink","doi":"10.2174/1874321800802010030","DOIUrl":"https://doi.org/10.2174/1874321800802010030","url":null,"abstract":"Endotracheal intubation via direct laryngoscopy frequently provokes cardiovascular side-effects. Although us- ing a lightwand intubation device reduces laryngeal stimulation, previous reports indicated a similar stress response com- pared to classical laryngoscopy. We hypothesized that endotracheal tube (ET) placement itself elicits haemodynamic in- stability and that topical anaesthesia can attenuate this response. Methods: 30 patients were randomized to three groups (n = 10 each). After induction of general anaesthesia (fentanyl, etomidate, vecuronium) 5 ml of test solution was applied to laryngo-tracheal structures via a lightwand guided EDGAR- Tube ® . Control group received 5 ml saline 0.9%, group lido 1% 5 ml lidocaine 1%, and group lido 2% 5 ml lidocaine 2%. After 2 minutes of bag-mask ventilation lightwand guided ET placement was performed. Invasive systolic arterial pres- sure (SAP, mmHg), heart rate (HR, bpm) and arterial plasma concentrations of catecholamines ((adr)(nor), pcg ml-) were determined. Results: After ET placement control group patients showed increased HR and SAP (meanHR = 15.3; meanSAP = 45.6) compared to both lido groups (� HR: lido1%/2% = 5.8/3.7; � SAP: lido1%2% = 8.7/13.0). Catecholamine concen- trations also increased only in the control group (mean � (adr) = 101.43; � (nor) = 89.41) but not in lido groups (� (adr): lido1%/2% = -12.93/7.05; � (nor): lido1%/2% = -6.61/-30.55). Effect size calculation indicated strong clinical effects of topical lidocaine for almost all variables (ES > 0.8). Conclusion: ET placement into the non-anaesthesized trachea causes haemodynamic and endocrine stress even if direct laryngoscopy is omitted. Topical anaesthesia effectively reduces this response.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116954570","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}

引用次数: 4

Inspiratory Carbon Monoxide and Compound A Concentrations During Desflurane and Sevoflurane Anesthesia in Humans: An Observational Study 地氟醚和七氟醚麻醉期间人体吸入一氧化碳和化合物A浓度:一项观察性研究

The Open Anesthesiology Journal Pub Date : 2008-05-08 DOI: 10.2174/1874321800802010026

C. Keijzer, R. Perez, J. Lange

{"title":"Inspiratory Carbon Monoxide and Compound A Concentrations During Desflurane and Sevoflurane Anesthesia in Humans: An Observational Study","authors":"C. Keijzer, R. Perez, J. Lange","doi":"10.2174/1874321800802010026","DOIUrl":"https://doi.org/10.2174/1874321800802010026","url":null,"abstract":"All modern vapor anesthetics are capable of carbon monoxide (CO) production as a result of interaction with desiccated strong base containing carbon dioxide absorbents. In desiccated absorbents, desflurane produces the highest concentrations of CO. Sevoflurane is known to produce the nephrotoxic compound A (CA) independently from water content of the carbon dioxide absorbent. The purpose of this study was to register the average CO concentrations in forty patients receiving anesthesia with desflurane or sevoflurane after implementation of a safety protocol adapted from Woehlck et al.. This protocol was developed to prevent desiccation of the strong base containing absorbent Dragersorb 800 Plus ® . Methods: In 40 patients a low-flow anesthesia was maintained using an oxygen/air mixture with either sevoflu- rane or desflurane in combination with the CO2 absorbent Dragersorb 800 plus ® . CO and CA production was measured in the inspiratory limb of the anesthesia machine using a portable gas chromatograph, with a sampling frequency of 12 sam- ples per hour. Results: No carbon monoxide was measured in any of the desflurane or sevoflurane anesthesia's. The mean concentration of CA for anesthesia with sevoflurane was 17.1 ± 5.5 parts per million. Conclusion: With the introduction of a safety protocol no carbon monoxide was measured in anesthesia performed with desflurane or sevoflurane. Com- pound A is almost continuously detected in anesthetic procedures with the use of sevoflurane in very low concentrations. Implementation of a simple safety protocol possibly prevents desiccation of the absorbent and could subsequently reduce the risk of carbon monoxide intoxication.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116329388","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}

引用次数: 0

Pulse Transit Time (PTT) Measurements During Laparoscopic and Open Abdominal Surgery: A Pilot Study in ASA I-II Female Patients 腹腔镜和开腹手术期间脉搏传递时间(PTT)测量:ASA I-II型女性患者的初步研究

The Open Anesthesiology Journal Pub Date : 2008-05-07 DOI: 10.2174/1874321800802010020

M. Sigtermans, Jasper Looijestijn, E. Olofsen, A. Dahan

{"title":"Pulse Transit Time (PTT) Measurements During Laparoscopic and Open Abdominal Surgery: A Pilot Study in ASA I-II Female Patients","authors":"M. Sigtermans, Jasper Looijestijn, E. Olofsen, A. Dahan","doi":"10.2174/1874321800802010020","DOIUrl":"https://doi.org/10.2174/1874321800802010020","url":null,"abstract":"Background: The pulse transit time (PTT) is the time interval between the R-wave of the ECG and the appear- ance of the pulse wave in the periphery during the same cardiac cycle. PTT is influenced by various factors including sympathetic tone and vascular compliance. The authors assessed the effect of anesthesia, intubation and laparoscopic (LPS) versus laparotomic (LPT) surgery on PTT. Methods: PTT, mean arterial blood pressure (MAP) and heart rate (HR) were measured during induction of anesthesia and during the first 45-min of LPS (n = 17) and LPT (n = 13) surgery in a group of female patients. Results: Anesthesia increased PTT values, while painful stimuli caused an immediate reduction. During surgery, we ob- served group effects on PTT and MAP with 10-25% lower PTT values (P < 0.001) and 15-30% greater MAP values (P < 0.01) in the LPS group. HR did not differ between groups. Conclusions: The pulse transit time was used successfully to track the effect of anesthesia and stressful nociceptive stimuli during induction of anesthesia. The shorter PTT values during laparoscopic abdominal surgery compared to open abdomi- nal surgery suggest a higher sympathetic tone in patients undergoing laparoscopic surgery and/or an effect of the in- creased abdominal pressure on PTT.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115984868","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}

引用次数: 4

The Benefits of a Human Simulator Training Course for Initial First-Year Anesthesia Residency Education § 第一学年麻醉住院医师教育人体模拟器培训课程的好处

The Open Anesthesiology Journal Pub Date : 2008-04-21 DOI: 10.2174/1874321800802010013

Todd M. Oravitz, David G. Metro, William R. McIvor

{"title":"The Benefits of a Human Simulator Training Course for Initial First-Year Anesthesia Residency Education §","authors":"Todd M. Oravitz, David G. Metro, William R. McIvor","doi":"10.2174/1874321800802010013","DOIUrl":"https://doi.org/10.2174/1874321800802010013","url":null,"abstract":"Introduction: Simulator training offers an opportunity to safely educate new residents in a conducive learning environment. Methods: New, first-year anesthesia residents received a 3-day training course prior to beginning clinical training. Instruc- tion focused on developing knowledge and skills for operating room preparation, general anesthesia induction, airway and anesthesia management, and post-operative transfer of care. Before training, residents rated their confidence for perform- ing basic anesthesia skills and completed a knowledge test. At course completion, residents performed operative manage- ment for a simulated healthy patient undergoing uncomplicated general anesthesia and repeated the confidence and knowledge tests. Results: Forty-five new, first-year residents enrolled in and completed the simulator course. Prior to training, residents were neutral about their confidence for performing laryngeal mask airway placement, operating room preparation, general anesthesia induction, or transfer of patient care. They were confident that they could perform bag-mask ventilation and di- rect laryngoscopy prior to training. Mean percentage of correct answers on the knowledge test was 53% before training. After training, confidence for performing each of the six assessed anesthesia skills increased numerically, with residents expressing confidence in performing every skill. Increases achieved statistical significance (P<0.01) for all skills except for bag-mask ventilation. Mean correct responses on the knowledge test after training increased to 69%. Conclusions: A brief, 3-day didactic and simulator training course for new, first-year anesthesia residents can improve resident confidence and competency to begin clinical anesthesia training.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129552858","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}

引用次数: 1

Lethal Injection, Anesthesia, Medicine and Organ Donation - Ethical and Clinical Considerations Regarding the Pending Supreme Court Case: Baze vs Rees 致命注射，麻醉，药物和器官捐赠-关于悬而未决的最高法院案件的伦理和临床考虑:贝斯诉里斯

The Open Anesthesiology Journal Pub Date : 2008-04-21 DOI: 10.2174/1874321800802010007

P. Kempen

引用次数: 1

Prolonged Mechanical Ventilation After Aortic Arch Repair Requiring Deep Hypothermic Circulatory Arrest: Incidence, Effect on Outcome, and Clinical Predictors 主动脉弓修复后需要深度低温循环停止的延长机械通气:发生率、结果的影响和临床预测因素

The Open Anesthesiology Journal Pub Date : 2008-04-07 DOI: 10.2174/1874321800802010001

J. Augoustides, W. Szeto, B. Kohl, D. Cowie, Aaron Hoo, A. Gambone, D. Jobes

{"title":"Prolonged Mechanical Ventilation After Aortic Arch Repair Requiring Deep Hypothermic Circulatory Arrest: Incidence, Effect on Outcome, and Clinical Predictors","authors":"J. Augoustides, W. Szeto, B. Kohl, D. Cowie, Aaron Hoo, A. Gambone, D. Jobes","doi":"10.2174/1874321800802010001","DOIUrl":"https://doi.org/10.2174/1874321800802010001","url":null,"abstract":"Objective: To delineate the incidence, outcome impact, and clinical predictors of prolonged mechanical ventila- tion (PMV) after adult aortic arch repair requiring deep hypothermic circulatory arrest (AAR-DHCA) Aims: (1) To determine the incidence of PMV after AAR-DHCA. (2) To determine whether PMV after AAR-DHCA is a multivariate predictor for mortality or length of stay in the intensive care unit. (3) To determine multivariate predictors for PMV after AAR-DHCA. (4) To determine whether aprotinin influences PMV after AAR-DHCA. Study Design: Retrospective and observational. Prolonged mechanical ventilation was defined as mechanical ventilation via an endotracheal tube for longer than 72 hours. Study Setting: Single large university hospital. Participants: All adults undergoing AAR-DHCA in 2000 and 2001. Main Results: Cohort size was 144. Antifibrinolytic exposure was 100%: aprotinin 66% and aminocaproic acid 34%. The incidence of AF was 21.5 %. PMV did not independently predict for mortality or prolonged stay in the intensive care unit. The multivariate predictors for PMV were chronic obstructive pulmonary disease, stroke, and infection. In multivariate analysis, aprotinin exposure has no significant association with PMV. Conclusions: PMV after AAR-DHCA is common, but does not independently predict mortality or ICU stay. The risk of PMV after AAR-DHCA increases with preexisting chronic obstructive pulmonary disease, stroke and infection. Pe- rioperative intervention should focus on protection against stroke and infection.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127712152","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}

引用次数: 2

Bispectral Index Monitoring in a Severe Comatose Patient During Surgery 重度昏迷患者术中双谱指数监测

The Open Anesthesiology Journal Pub Date : 2007-12-06 DOI: 10.2174/1874321800701010006

S. F. Galinski, E. Barrera, A. Valls, M. Montero, J. Alvarez, F. Escolano

引用次数: 0

Methodological Aspects of Lactate Measurement – Evaluation of the Accuracy of Photometric and Biosensor Methods 乳酸测量的方法学方面。光度法和生物传感器法准确性的评价

The Open Anesthesiology Journal Pub Date : 2007-07-30 DOI: 10.2174/1874321800701010001

A. Biedler, S. Schneider, F. Bach, S. Soltesz, W. Wilhelm, S. Ziegeler, S. Kreuer

{"title":"Methodological Aspects of Lactate Measurement – Evaluation of the Accuracy of Photometric and Biosensor Methods","authors":"A. Biedler, S. Schneider, F. Bach, S. Soltesz, W. Wilhelm, S. Ziegeler, S. Kreuer","doi":"10.2174/1874321800701010001","DOIUrl":"https://doi.org/10.2174/1874321800701010001","url":null,"abstract":"Introduction: The present investigation was designed to investigate the accuracy and precision of lactate meas- urement obtained with contemporary biosensors (Chiron Diagnostics, Nova Biomedical) and standard enzymatic pho- tometric procedures (Sigma Diagnostics, Abbott Laboratories, Analyticon). Materials and Methods: Measurements were performed in vitro before and after the stepwise addition of 1molar sodium lactate solution to samples of fresh frozen plasma to systematically achieve lactate concentrations of up to 20 mmol/l. Results: Precision of the methods investigated varied between 1% and 7%, accuracy ranged between 2% and -33% with the variability being lowest in the Sigma photometric procedure (6%) and more than 13% in both biosensor methods. Conclusion: Biosensors for lactate measurement provide adequate accuracy in mean with the limitation of highly variable results. A true lactate value of 6 mmol/l was found to be presented between 4.4 and 7.6 mmol/l or even with higher differ- ence. Biosensors and standard enzymatic photometric procedures are only limited comparable because the differences be- tween paired determinations presented to be several mmol. The advantage of biosensors is the complete lack of preana- lytical sample preparation which appeared to be the major limitation of standard photometry methods.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131933664","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}

引用次数: 8