Current Issue : July - September Volume : 2020 Issue Number : 3 Articles : 6 Articles
Background. The purpose of this study was to correlate intraoperative anesthetic complications of trauma patients with their\nrespective urine toxicology results. Methods. This retrospective, single-center cohort study at a Level 1 trauma center included\npatients with the following criteria: (1) trauma admission between January 1, 2010, and December 31, 2016, (2) required surgical\nintervention, (3) are age 18 and older, and (4) urine toxicology screening was completed. Anesthetic records were evaluated for\nintraoperative complications. Results. The final analysis included 847 patients. The mean anesthesia time, American Society of\nAnesthesiologists physical status classification scores, change in body temperature, anesthetic complication rate, and mortality\nwere not significantly different between urine toxicology positive and negative patients. Of note, a significantly lower proportion\nof the urine toxicology positive patients were extubated postoperatively in comparison to urine toxicology negative patients\n(57.32% vs 63.83%). Conclusions. Trauma patients who presented with a positive urine toxicology screening are not at an increased\nrisk for intraoperative anesthetic complications compared to those with a negative urine toxicology screening. However, our\nresults indicated that the need for postoperative mechanical ventilation increased in the acutely intoxicated trauma patients when\ncompared to those without preinjury intoxication....
Background: The comparative efficacy of epidural bupivacaine alone and bupivacaine combined with magnesium\nsulfate in providing postoperative analgesia remains controversial.\nMethods: We searched Mediline (OvidSP), EMBASE (OvidSP) and Cochrane Central Register of Controlled Trials\n(CENTRAL) to identify trials that compared epidural bupivacaine and magnesium sulfate combination (intervention)\nwith bupivacaine alone (control). Grading of Recommendations, Assessment, Development and Evaluations (GRADE)\nframework was used to assess the quality of evidence.\nResults: Eleven studies fulfilled our inclusion criteria after screening. We found that epidural bupivacaine combined\nwith magnesium sulfate could prolong the time for first rescue analgesics (SMD 4.96; 95% CI [2.75, 7.17],............
Background: Substantial clinical and preclinical evidence have indicated the association between amide-linked\nlocal anesthesia and the long-term outcomes of cancer patients. However, the potential effects of local anesthesia\non cancer recurrence are inconclusive and the underlying mechanisms remain poorly understood.\nMethods: We systematically examined the effects of three commonly used local anesthetics in melanoma cells and\nanalyzed the underlying mechanisms focusing on small GTPases.\nResults: Ropivacaine and lidocaine but not bupivacaine inhibited migration and proliferation, and induced\napoptosis in melanoma cells. In addition, ropivacaine and lidocaine but not bupivacaine significantly augmented\nthe in vitro efficacy of vemurafenib (a B-Raf inhibitor for melanoma with BRAF V600E mutation) and dacarbazine (a\nchemotherapeutic drug). Mechanistically, ropivacaine but not bupivacaine decreased the activities of Ras\nsuperfamily members with the dominant inhibitory effects on RhoA and Ras, independent of sodium channel\nblockade. Rescue studies using constitutively active Ras and Rho activator calpeptin demonstrated that ropivacaine\ninhibited migration mainly through RhoA whereas growth and survival were mainly inhibited through Ras in\nmelanoma cells. We further detected a global reduction of downstream signaling of Ras and RhoA in ropivacainetreated\nmelanoma cells.\nConclusion: Our study is the first to demonstrate the anti-melanoma activity of ropivacaine and lidocaine but not\nbupivacaine, via targeting small GTPases. Our findings provide preclinical evidence on how amide-linked local\nanesthetics could affect melanoma patients....
Background: Nonoperating room anesthesia during gastroenterological procedures is a growing field in anesthetic\npractice. While the numbers of patients with severe comorbidities are rising constantly, gastrointestinal endoscopic\ninterventions are moving closer to minimally invasive endoscopic surgery. The LMA Gastroâ?¢ is a new supraglottic\nairway device, developed specifically for upper gastrointestinal endoscopy and interventions. The aim of this study\nwas to evaluate the feasibility of LMA Gastroâ?¢ in patients with ASA physical status.......................
Background: Phase lag entropy (PLE) is a novel anesthetic depth indicator that uses four-channel\nelectroencephalography (EEG) to measure the temporal pattern diversity in the phase relationship of frequency\nsignals in the brain. The purpose of the study was to evaluate the anesthetic depth monitoring using PLE and to\nevaluate the correlation between PLE and bispectral index (BIS) values during propofol anesthesia.\nMethods: In thirty-five adult patients undergoing elective surgery, anesthesia was induced with propofol using\ntarget-controlled infusion (the Schneider model). We recorded the PLE value, raw EEG, BIS value, and hemodynamic\ndata when the target effect-site concentration (Ce) of propofol reached 2, 3, 4, 5, and 6.....................
There are few studies about restlessness and awakening of children\nduring recovering from anesthesia accompanied by parents. Only one related\nstudy was retrieved in China. The purpose of this study is to investigate\nthe effect of awakening, agitation and pain level in children after tonsillectomy\naccompanied by their parents. Methods: Children who met the inclusion\ncriteria were randomly divided into experimental group and control group\naccording to coin tossing method. There were 30 cases in the experimental\ngroup and 32 in the control group. The control group received routine nursing\nwhile the experimental group was given parental presence on the basis of\nroutine nursing. Steward awakening score, Pediatric anesthesia emergence\ndelirium (PAED), Scale and FLACC pain assessment scale were used to evaluate\nthe children when they entered anesthesia recovery room and awaked\nrespectively. Results: There was no significant difference in the scoring of\nthree scales between the two groups when they entered anesthesia recovery\nroom (P > 0.05). There was significant difference in Steward awakening score\nand PAED scale between the two groups when they came to recovery room (P\n< 0.05), but there was no significant difference in FLACC pain score between\nthe two groups (P > 0.05). Conclusion: Parental presence can improve the\nrecovery effect and reduce the restlessness of children after operation. Our\nstudy suggests that anesthetic children should be accompanied by their parents\nin the future....
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