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Anaesth Intensive Care 2002 Feb;30(1):99-100
Publication Types:
PMID: 11939453, UI: 21936510
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Anaesth Intensive Care 2002 Feb;30(1):101-2
PMID: 11939430, UI: 21936513
Eur J Pharmacol 2002 Aug 30;450(3):263
Department of Pharmacology and Therapeutics, Faculty of Medicine, The University of British Columbia, 2176 Health Sciences Mall, V6T 1Z3, Vancouver, BC, Canada
[Medline record in process]
This study examined the vasodilator action of nociceptin, an endogenous opioid receptor-like ligand (ORL1), in thiobutabarbital-anesthetized rats, via the triple-isotope microspheres technique. Nociceptin (10, 30 nmol/kg, left ventricular injection) reduced mean arterial pressure (-27, -29 mm Hg), total peripheral resistance (-36, -41% of baseline) and heart rate (-8, -11% of baseline), but did not significantly affect cardiac output. The vehicle (0.9% NaCl) did not alter hemodynamics. Both doses of nociceptin caused similar changes in arterial flow and conductance of all tissues. Nociceptin increased flows to the skeletal muscle, slightly reduced flows to the caecum and colon, but did not alter flows to other organs and tissues. With flow normalized by pressure to reflect intrinsic vascular tone, nociceptin was found to increase arterial conductance of all tissues, except for the intestine, spleen, caecum and colon. Its dilator influence was greater in the skeletal muscle ( approximately 250% of baseline conductance) than the lungs, heart, liver, stomach, kidneys, skin, testes and brain (140-160% of baseline). Thus, nociceptin causes generalized vasodilatation; its greatest influence is on the skeletal muscle bed.
PMID: 12208319, UI: 22197970
J Clin Monit Comput 2002 Feb;17(2):125-34
Department of Anesthesiology, Oulu University Hospital, Finland. mika.sarkela@datex-ohmeda.com
OBJECTIVE: We studied the spectral characteristics of the EEG burst suppression patterns (BSP) of two intravenous anesthetics, propofol and thiopental. Based on the obtained results, we developed a method for automatic segmentation, classification and compact presentation of burst suppression patterns. METHODS: The spectral analysis was performed with the short time Fourier transform and with autoregressive modeling to provide information of frequency contents of bursts. This information was used when designing appropriate filters for segmentation algorithms. The adaptive segmentation was carried out using two different nonparametric methods. The first one was based on the absolute values of amplitudes and is referred to as the ADIF method. The second method used the absolute values of the Nonlinear Energy Operator (NLEO) and is referred to as the NLEO method. Both methods have been described earlier but they were modified for the purposes of BSP detection. The signal was classified to bursts, suppressions and artifacts. Automatic classification was compared with manual classification. Results. The NLEO method was more accurate, especially in the detection of artifacts. NLEO method classified correctly 94.0% of the propofol data and 92.8% of the thiopental data. With the ADIF method, the results were 90.5% and 88.1% respectively. CONCLUSIONS: Our results show that burst suppression caused by the different anesthetics can be reliably detected with our segmentation and classification methods. The analysis of normal and pathological EEG, however, should include information of the anesthetic used. Knowledge of the normal variation of the EEG is necessary in order to detect the abnormal BSP of, for instance, seizure patients.
PMID: 12212991, UI: 22200715
J Oral Maxillofac Surg 2002 Sep;60(9):1004-10
Received from the Department of Clinical Oral Physiology, Institute of Odontology, Karolinska Institutet, Huddinge, Sweden., Assistant Professor., dagger Professor.
PURPOSE: The purpose of this study was to determine the optimal concentration and volumes of ropivacaine for dental anesthesia as regards onset and duration of action. SUBJECTS AND METHODS: Thirty healthy individuals with a mean age of 32 years participated in the study on a voluntary basis. All subjects received a ropivacaine injection in 1 of 3 randomized concentrations (2.0, 5.0, or 7.5 mg/mL) for infiltration anesthesia and mandibular nerve block in a double-blind manner. The onset time and duration of anesthesia were assessed by electric pulp test, pinprick test of the gingiva, and presence of feeling of numbness of the lip. RESULTS: Regardless of dose, only 5 patients received pulpal anesthesia after infiltration, but all 3 concentrations anesthetized the gingiva and upper lip. The onset of pulpal anesthesia occurred less than 5 minutes after injection and lasted for 4 to 58 minutes. Pinprick anesthesia lasted for 8 to 48 minutes, and numbness of the upper lip lasted 1 to 4 hours. The effectiveness of the mandibular nerve block with regard to pulpal anesthesia was dose dependent. Only ropivacaine at 7.5 mg/mL produced sufficient anesthesia. The onset of pulpal anesthesia occurred less than 10 minutes after injection and lasted for 2 to 6 hours. Pinprick anesthesia lasted for 3 to 6 hours and numbness of the lower lip lasted for 5 to 9 hours. CONCLUSION: This study shows that ropivacaine could be useful as a local anesthetic for mandibular nerve block in dentistry and that the very long duration of both pulpal and soft tissue anesthesia may be favorable in reducing postoperative pain. Copyright 2002 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 60:1004-1010, 2002
PMID: 12215984, UI: 22204243
Pediatr Dent 2002 Jul-Aug;24(4):333-6
Department of Pediatric Dentistry, The Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel.
PURPOSE: The purpose of this study was to assess children's reactions and record their sensations while receiving a warmed local anesthetic solution for dental procedures (37 degrees C; W) compared with one at room temperature (21 degrees C; RT). METHODS: Forty-four children between the ages of 6 to 11 (mean age = 7.9 +/- 2.2 years) who were undergoing dental treatment participated in the study. A random crossover design was used. Each patient was randomly assigned to receive either a W or a RT local anesthesia on the first visit and the alternate local anesthesia on the second visit. During the injection, the modified Behavioral Pain Scale (BPS) was used. For subjective evaluation, the Wong-Baker FACES Pain Rating Scale (FPS) and the Visual Analogue Scale (VAS) were used. RESULTS: No significant difference was found between the W or RT local anesthesia when used during the first or second visit. In all parameters, children's reactions to both types of injection were similar, with no statistically significant difference. Using the FPS, 19 boys (91%) ranked the experience of local anesthesia as a positive experience (0 to 2 in the scale) while 4 boys (9%) ranked the same experience as negative. This was true for both types (W and RT). All 21 girls who participated in the study ranked the local anesthesia experience using the FPS as a positive experience (0 to 2 in the scale). No significant difference was found in the mean VAS scores between the room-temperature group and the warm group (23.4 +/- 21.8 and 20.8 +/- 18.9, respectively). CONCLUSIONS: There is no advantage to warming local anesthetic solution prior to injection.
PMID: 12212876, UI: 22200597
Pediatr Dent 2002 Jul-Aug;24(4):315-20
Faculty Pediatric Dentistry, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, USA. kdallen@unmc.edu
PURPOSE: The purpose of this investigation was to evaluate the efficacy of a computerized injection device (Wand) on reducing pain behavior during injections with preschool-aged children. METHODS: Subjects consisted of 40 patients between the ages of 2 and 5 requiring local anesthesia for dental restorations in the maxilla. Patients were randomly assigned to either the Wand or the traditional anesthetic delivery system. A palatal approach to the anterior and middle superior alveolar nerves and the anterior superior alveolar nerve was used with the Wand injections. Buccal infiltration and palatal injections were used for the traditional method. Pain behavior was observed and coded. RESULTS: Results of Fisher Exact tests found that using the Wand to deliver anesthetic lead to significantly fewer (P < .01) disruptive behaviors in preschool-aged children when compared with a traditional injection regimen. In addition, none of the preschool-aged children exposed to the Wand required restraint during the initial interval, while nearly half of the children receiving a traditional injection required some type of immediate restraint. CONCLUSIONS: These results demonstrate that the Wand can significantly reduce disruptive behaviors in a population of young children who are traditionally more difficult to manage and may be one method of creating a more positive experience for the young child and the practitioner.
PMID: 12212873, UI: 22200594
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