Disease relevance of Anesthesia, Conduction

• Cardiac arrest following regional anesthesia with ropivacaine: here we go again [1]!
• Controversy persists about the cardiac toxicity of bupivacaine if accidentally administered intravenously during regional anesthesia [2].
• CONCLUSIONS: Comparable intraoperative hypothermia during general and regional anesthesia presumably resulted because the combination of spinal anesthesia and meperidine administration obliterated effective peripheral and central thermoregulatory control [3].
• In this study we assessed the effect of moderately deep propofol sedation on the ICP of patients undergoing stereotactic brain tumor biopsy under regional anesthesia [4].
• Emesis occurred in 4 (3.4%) patients in the eventrated group and was directly related to fundal traction under regional anesthesia [5].

High impact information on Anesthesia, Conduction

• Because of possible harmful fetal effects, preoperative fluid loading, a necessary part of conduction anesthesia, is changing from the customary 5% glucose to the use of fluids containing no glucose [6].
• BACKGROUND: Bupivacaine is a potent local anesthetic widely used for prolonged local and regional anesthesia [7].
• Use of ephedrine, an alpha-agonist, during regional anesthesia was associated with elevated plasma AVP and ACTH concentrations compared to those in women receiving general anesthesia [8].
• Regional anesthesia of the DG resulted in a reduction of pain scores when administered contralateral to the site of subcutaneous formalin injection [9].
• When using ropivacaine or levobupivacaine for regional anesthesia, for test dose purposes, the authors recommend the addition of epinephrine to the local anesthetic solution or the use of a separate agent with more predictable CNS characteristics [10].

Chemical compound and disease context of Anesthesia, Conduction

• We report a case of cardiac arrest after uncomplicated regional anesthesia in a patient with scleroderma who received labetalol and metoclopramide after surgery [11].
• Although it is well recognized that accidental intravascular injection of bupivacaine during regional anesthesia can cause severe circulatory collapse, the direct cardiac effects at concentrations below the cardiotoxic level have not been described, despite increased use of regional anesthesia and its combination with general anesthesia [12].
• Inhibition of the stress response to breast cancer surgery by regional anesthesia and analgesia does not affect vascular endothelial growth factor and prostaglandin E2 [13].
• The addition of tramadol to lidocaine does not reduce tourniquet and postoperative pain during iv regional anesthesia [14].
• Case 2: A 73-yr-old woman with controlled hypertension had Dupuytren fasciotomy of her right hand under iv regional anesthesia with 200 mg lidocaine and sedation using 75 microg fentanyl and 1.5 mg midazolam [15].

Biological context of Anesthesia, Conduction

• Twelve patients undergoing lower limb orthopedic surgery during regional anesthesia additionally received propofol by target-controlled infusion for sedation [16].
• CONCLUSIONS: In the healthy term fetus there is an advantage in using angiotensin II to maintain maternal blood pressure during regional anesthesia [17].
• Third trimester levels of maternal BE and ACTH were significantly related; however, the relationship was significant only in subjects who did not receive conduction anesthesia (n = 24) at delivery [18].
• OBJECTIVE: To document that regional anesthesia of the infraorbital and inferior alveolar nerves would abolish reflex-evoked muscle action potentials (REMP) in the digastricus muscle during noninvasive stimulation of tooth pulp in halothane-anesthetized dogs [19].
• Local or regional anesthesia is very useful in patients with osteogenesis imperfecta, but when general anesthesia is mandatory ketamine hydrochloride is often a good choice [20].

Anatomical context of Anesthesia, Conduction

• CONCLUSIONS: Because millimolar concentrations of local anesthetics are within the range measured in spinal cord during intrathecal and epidural procedures, these results are consistent with a direct action of local anesthetics on tachykinin-mediated neurotransmission during regional anesthesia [21].
• We studied ketamine intravenous regional anesthesia of the upper extremity in volunteers using concentrations of 0.5%, 0.3%, and 0.2% [22].
• IMPLICATIONS: In this dose-finding, placebo-controlled study, remifentanil infusions were used to provide sedation during spinal and brachial plexus regional anesthesia [23].
• Intraarticular patient-controlled regional anesthesia after arthroscopically assisted anterior cruciate ligament reconstruction: ropivacaine/morphine/ketorolac versus ropivacaine/morphine [24].
• A 68-yr-old hypertensive patient with ischemic heart disease and intractable atrial fibrillation with stable hemodynamics and poor chest compliance underwent pleomorphic adenoma of the parotid gland using regional anesthesia with continuous propofol sedation [25].

Associations of Anesthesia, Conduction with chemical compounds

• Regional anesthesia of the LH resulted in a significant bilateral reduction of pain scores in the formalin test but had no effect in the foot-flick test [26].
• Intravenous regional anesthesia using lidocaine and clonidine [27].
• METHODS: Patients undergoing surgery with local or regional anesthesia and sedation were randomized to sevoflurane (n = 23), midazolam (n = 21), or propofol (n = 22) [28].
• CONCLUSION: Compared with lidocaine, intravenous regional anesthesia with ropivacaine appears to be comparable but has longer-lasting residual anesthesia [29].
• Epidural clonidine produces regional anesthesia as well as sedation and a decrease in anesthetic requirements [30].

Gene context of Anesthesia, Conduction

• Although there is little information about the application of regional anesthesia in MELAS patients, we demonstrate that it may be a satisfactory choice [31].
• Regional anesthesia: vintage Bordeaux (and Napa Valley) [32].
• Interscalene regional anesthesia in the prevention of autonomic hyperreflexia in a quadriplegic patient undergoing shoulder surgery [33].
• Such OT surge was suppressed by effective spinal and pelvic regional anesthesia [34].
• Inhibition of TREK-1 channels and consecutive depolarization of the cell membrane by bupivacaine may contribute to blockade of neuronal signal conduction during regional anesthesia [35].

Analytical, diagnostic and therapeutic context of Anesthesia, Conduction

• Modulation of the norepinephrine response by regional anesthesia/analgesia appears to be related, in part, to superior analgesia [36].
• BACKGROUND: Lower systemic toxicity reported with ropivacaine and levobupivacaine may produce less reliable recognition of inadvertent intravenous injection during regional anesthesia [10].
• These results demonstrate that dose-dependent arteriolar constriction occurs even with blood bupivacaine levels that are at the upper limits of those expected to occur during regional anesthesia [37].
• We tested the hypothesis that the addition of clonidine may improve the quality of IV regional anesthesia, especially tourniquet tolerance [38].
• One hundred patients having total hip replacements were randomly assigned to a regimen that included or excluded N2O (50%-60%) during regional anesthesia supplemented with isoflurane and intravenous adjuvants [39].

References