Issues

The results of this randomized, blinded trial suggest that adductor canal block results in less motor impairment after surgery, but provides a comparable level of pain relief.

Review of more than 190,000 records from 400 hospitals in an administrative database showed an incidence of inpatient falls of 1.6% in this patient group, associated with morbidity and mortality. Peripheral nerve block did not alter the risk of inpatient fall, whereas use of neuraxial anesthesia reduced the risk by 30% compared with general anesthesia.

Myocardial injury after noncardiac surgery is common among adults undergoing noncardiac surgery and associated with substantial mortality.

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The incidence of severe hypotension and mortality did not differ significantly in patients who did and did not receive etomidate. The duration of postoperative mechanical ventilation and time to hospital discharge were also similar in the two groups.

The incidence of blood product transfusion up to postoperative day 7 did not differ significantly between the tranexamic acid doses (63% for low dose vs. 60% for high dose).

In an exploratory, pilot study, memory and executive dysfunction occurred but only brain markers of vascular disease associated with executive decline.

Exposure of third-trimester fetal macaque monkeys to isoflurane in utero caused widespread apoptosis of neurons and of oligodendroglia that are critical for myelination. Compared with its neurotoxicity in neonatal macaques, isoflurane produced quantitatively less apoptosis with a more diffuse distribution in the fetus, consistent with developmental changes in toxic potential.

Tranexamic acid enhanced neuronal excitation at concentrations relevant to its clinical use by impairing neuronal inhibition in the mouse amygdala. This was due to postsynaptic blockade of receptors for the inhibitory neurotransmitter γ-aminobutyric acid, with no effect on excitatory glutamate receptors.

The use of intravascular catheters in the United States varies significantly across individual intensive care units, with greater variability associated with the use of arterial catheters than with central venous catheters.

Propofol-anesthetized rats were ventilated for 24 h or allowed to spontaneously breathing for 24 h and were compared with pentobarbital-anesthetized rats. Diaphragm contractile deficit and atrophy were present after propofol administration in both ventilated and spontaneously breathing rats.

In anesthetized pigs with moderate acute respiratory distress syndrome induced by saline lavage, higher levels of spontaneous breathing with controlled ventilation decreased the mechanical stress in lungs compared with ventilation without spontaneous breathing.

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In sheep undergoing mild smoke exposure to one lung, [¹⁸F]-fluorodeoxyglucose uptake, as measured by positron emission tomography, increased in the exposed lung 4 h after exposure, before worsening shunt or aeration.

Metabolomic studies document changes in the lungs of experimental animals with ventilator-induced lung injury; these pilot data suggest that it is possible to identify ventilator-induced lung injury with metabolic investigations.

Using ultrasound guidance, quality of recovery was improved in 64 women randomized to multilevel paravertebral blocks and total intravenous anesthesia for breast tumor resection compared with general anesthesia with sevoflurane.

Dezocine is a κ opioid receptor antagonist. Dezocine also interacts with the norepinephrine transporter and the serotonin transporter and inhibits norepinephrine and serotonin reuptake in vitro in a concentration-dependent manner.

The study demonstrates that a lipid emulsion partially reverses the effects of bupivacaine on the action potential and the fast Na+ current of left ventricular cardiomyocytes, and provides evidence for a lipid sink mechanism.

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Pretreatment of rodents with ceftriaxone provided antinociceptive effects in inflammatory pain models. Using inflammatory somatic and visceral pain models, synergistic interactions of ceftriaxone and several commonly used analgesics were demonstrated.

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Aged skin is at increased risk of poor postoperative wound healing. Changes in the cutaneous microcirculation with aging contribute to this risk. This review examines the role of anesthesia management on microcirculatory function.

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