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At least 559 records · Page 31Linked to original sources

Functional imaging of the brain in sedated newborn infants using near infrared topography during passive knee movement.

Near infrared topography was used for functional imaging of the sensorimotor cortex of newborn infants during passive knee movement under sedated sleep. Contralateral knee movement caused a marked increase in oxyhemoglobin and total hemoglobin from the baseline values at almost all locations in the primary sensorimotor area of all neonates and a decrease in local deoxyhemoglobin in six of seven neonates. During ipsilateral knee movement, oxyhemoglobin and total hemoglobin showed slighter changes at a few locations, equal to 30% (mean) and 29% (mean) of the changes that occurred with contralateral stimulation, respectively. The mean times corresponding to maximal changes were 11.9 s for oxyhemoglobin and 19.1 s for deoxyhemoglobin, demonstrating that oxyhemoglobin has a much faster response than does deoxyhemoglobin.

Brain Mapping↗

Comparison of the lightwand technique with direct laryngoscopy for awake endotracheal intubation in emergency cases.

STUDY OBJECTIVE: To clarify the efficacy of the lightwand technique compared with that of the conventional laryngoscopic technique for awake endotracheal intubation in patients requiring emergency surgery. DESIGN: Prospective clinical study. SETTING: Anesthesia department of a teaching hospital. PATIENTS: 60 ASA physical status IE patients undergoing emergency surgery. INTERVENTIONS: Awake intubations using the lightwand technique (LW group) and a laryngoscope (LS group) were performed with conscious sedation with midazolam and fentanyl. MEASUREMENTS AND MAIN RESULTS: Time to intubation and number of intubation attempts in the LW group were significantly shorter and smaller, respectively, than those in the LS group (p < 0.01). Fewer LW group patients complained of a sore throat than in the LS group. DeltaP [changes from "before intubation" to "immediately after intubation" in mean arterial pressure (MAP)] in the LS group was significantly larger than that in the LW group (p < 0.05), although doses of sedatives in the two groups were not different. No hypoxemia or apnea associated with sedation was found in either of the groups. CONCLUSIONS: The lightwand technique produces less magnitude of stress following tracheal intubation than does the conventional laryngoscopic technique for awake intubation. Lightwand-assisted awake intubation is thought to be a useful means for induction of anesthesia in cases of emergency surgery.

Analgesics, Opioid↗

Synthesis and pharmacological activity of thiohexital enantiomers.

(S)-(+)- and (R)-(-)-5-Allyl-5-(1-methyl-2-pentynyl)-2-thiobarbituric acid (1, thiohexital) were prepared. The anesthetic activity (loss of righting reflex) and acute toxicity of the optically pure enantiomers of 1 were compared to the racemic isomer in mice. The S(+) isomer was found to be more potent as an anesthetic agent than the R(-) or RS(+/-) isomers. The therapeutic index was 2.5, 2.4, and 3.2 for the RS(+/-), R(-), and S(+) isomers, respectively. There were no significant differences in onset and duration of anesthesia when administered at the respective AD50 values. The prominent side effect is tremor, which is less for the S(+) isomer than for the R(-) or RS(+/-) isomers.

Anesthetics↗

Anaesthetic management for caesarean section combined with removal of phaeochromocytoma.

In this case report, the anaesthetic management for a removal of phaeochromocytoma undertaken immediately following Caesarean section is described. A 32-year-old female patients was given epidural anaesthesia for Caesarean section, and thereafter, general anaesthesia for a resection of phaeochromocytoma. During surgery, phentolamine, nitroglycerine and prostaglandin E1 were electively administered to decrease blood pressure and heart rate. A live infant was delivered and the supra-adrenal tumour was excised successfully. The patient's post-operative recovery was uneventful.

Adrenal Gland Neoplasms↗

A huge frontal meningioma associated with intraoperative massive bleeding and severe brain swelling--case report.

A 58 year old female presented with progressive memory disturbance and personality change. Magnetic resonance (MR) imaging disclosed a huge mass lesion accompanied by prominent oedema in the right frontal lobe. Cerebral angiogram demonstrated a vascular-rich tumour and a major drainer through diploic vein. A right frontotemporal craniotomy was performed. We encountered massive bleeding from diploic vein and dura mater immediately at the craniotomy. We were also faced with severe brain swelling at the dural incision. The tumour was solid, highly vascularised, and fairly well demarcated. We performed total removal of the tumour as quickly as possible in order to reduce the intracranial hypertension and avoid the impending brain herniation. The patient had an uneventful recovery and was asymptomatic at 10 months follow-up.

Blood Loss, Surgical↗