DP - 2003 Feb
TI - [High resolution fluorescence microscopy in combination with mathematical
modelling. First evidence of sub-cellular anesthetic effects on Ca(2+)
sparks in situ]
PG - 162-8
AB - Volatile anesthetics used in daily clinical routine, are associated with
a
rare but life-threatening disease, malignant hyperthermia.To date it is
well known that, with the exception of xenon and nitrous oxide, all
volatile anesthetics have the potential to trigger calcium (Ca(2+))
release from the sarcoplasmic reticulum, thereby influencing the Ca(2+)
homeostasis in muscle fibers.The effects of volatile anesthetics have been
previously studied by recording Ca(2+)-activated force transients in
muscle fibers and by quantifying the effects on isolated intracellular
Ca(2+)-release channels (ryanodin receptors).The use of high resolution
fluorescence microscopy methods in combination with spatio-temporal
mathematical models allows the effects of volatile anesthetics on
functional clusters of ryanodin receptors in mammalian skeletal muscle
fibers to be studied in situ for the first time.Thus, the analysis of
cellular Ca(2+)-activated force production and single channel properties
in conjunction with mathematical models allows the quantification of the
effects of volatile anesthetics on Ca(2+)-release in the natural
physiological environment on the basis of the underlying molecular
architecture. In addition to the basic understanding of alterations in the
Ca(2+) homeostasis induced by volatile anesthetics in muscle and nerve
cells, the results are also of direct clinical importance for the
understanding of the pathogenesis of malignant hyperthermia,where ryanodin
receptor mutations are currently thought to result in an increased Ca(2+)
release under the influence of volatile anesthetics.
AD - AK Medizinische Biophysik, Institut fur Physiologie und Pathophysiologie,
Ruprecht-Karls-Universitat Heidelberg.
PT - Journal Article
TT - Hoch auflosende Fluoreszenzmikroskopie in Kombination mit mathematischer
Modellierung Erstmaliger Nachweis von subzellularen Anasthetikawirkungen
auf Ca(2+)-Sparks in situ.
SO - Anaesthesist 2003 Feb;52(2):162-8.
DP - 2003 Feb
TI - [Accessible price lists at the anaesthesiologist's workplace enhance
cost
consciousness as a part of process and cost optimization]
PG - 154-61
AB - The imminent introduction of the DRG (diagnosis-related-group) system
is
putting hospitals in Germany under considerable pressure. This requires
that personnel are efficiently allocated by optimizing organizational
procedures and that the limited resources be distributed in a
cost-effective manner. One prerequisite for this is a marked
costconsciousness on the part of those who "incur costs" in providing
a
service.To increase the awareness of costs in clinical physicians, the
cost structures must be transparent. In order to achieve this goal, a
project was initiated at the Department of Anaesthesiology at the
University Hospital of Heidelberg, which aimed to enhance the
cost-consciousness of the staff by making price lists available to
anaesthesiologists at the workplace. In addition to the price lists, the
25 most expensive medications and medical products were added as an ABC
analysis.The departmental staff was interviewed by questionnaire as to
whether this project was reasonable. After 1 year the interview was
repeated. The results of the questionnaire showed that in the opinion of
the staff, price lists are an effective tool, as cost-consciousness on the
part of clinical physicians can be enhanced by making price structures
transparent. This is a major prerequisite for individual motivation in the
cost-effective management. Although the ABC analyses demonstrate no
long-term effect of the price-transparency on the cost structures, the
staff showed increased cost-consciousness and individual motivation for
economic tasks.
PT - Journal Article
TT - Preislisten am anasthesiologischen Arbeitsplatz Starkung des
Kostenbewusstseins durch Einbeziehung in Prozess- und
Kostenoptimierungsmassnahmen.
SO - Anaesthesist 2003 Feb;52(2):154-61.
DP - 2003 Feb
TI - [Peripartum cardiomyopathy. Perioperative anaesthesiological management
of
a rare complication of pregnancy]
PG - 137-41
AB - Peripartum cardiomyopathy is a rare disorder with an incidence from
1:3,000 to 1:15,000 live births and thus not often described in the
anaesthesiology literature.The ethiology of this disease is still not
known but the symptoms are similar to idiopathic dilated
cardiomyopathy.Echocardiographic findings show a dilatation of the left
ventricle in addition to abnormal wall motion with a severe reduction of
the cardiac function. Despite the rarity of this disorder, the
anaesthesiologist or ICU physician should consider peripartal
cardiomyopathy as a differential diagnosis to ensure an adequate
perioperative management.There seems to be an increased incidence in
pregnant women who are elderly (age >30 years),who have a history of
gestosis/hypertension,have a gemini pregnancy or are of black origin.The
prognosis depends on the recovery of the left ventricular contractility
within the first 6 months after onset of the disease.The mortality rate is
reported to vary between 25% and 50%.Heart transplantation is regarded as
the last resort which has successfully been performed with several
patients.This case describes the perioperative management of a 32-year-old
women with peripartum cardiomyopathy.
AD - Klinik fur Anasthesiologie, operative Intensivmedizin und Schmerztherapie,
Klinik am Eichert,Goppingen.
PT - Journal Article
TT - Peripartale Kardiomyopathie Perioperatives anasthesiologisches Management
bei einer seltenen Schwangerschaftskomplikation.
SO - Anaesthesist 2003 Feb;52(2):137-41.
DP - 2003 Feb
TI - [Emergency from anesthesia in small children. From laryngospasm to
prolonged apnea]
PG - 127-31
AB - Postoperative laryngospasm during emergence from anaesthesia represents
a
potentially life-threatening complication.Even if this is successfully
overcome using drug therapy, new, serious problems may develop.We report
the case of a 31/2 -year-old boy of African descent weighing 15 kg who
developed a laryngospasm during emergence from anaesthesia.Because the
airway obstruction could not be controlled by deepening the anaesthesia
again and administering anti-obstructive drugs, the boy was given 15 mg
succinylcholine.Thereafter prolonged apnea developed such that the patient
had to be admitted to the pediatric intensive care unit.The child was
extubated 6 h later and the further course was normal so that he could be
released from the hospital the following day.Further diagnostic study
revealed a dibucaine-sensitive, fluoride-resistant pseudocholinesterase in
the plasma, which is a rare form of atypical pseudocholinesterase,
explaining the prolonged arousal phase after the administration of
succinylcholine.Three significant aspects of this case are discussed: 1.
risk factors and treatment of perioperative airway obstruction 2. factors
and treatment of prolonged apnea, and 3. delayed arousal reactions and
their management in an outpatient setting.
SO - Anaesthesist 2003 Feb;52(2):127-31.
DP - 2002 Dec
TI - [Transient neurologic symptoms following spinal anesthesia. Reply]
PG - 1022; author reply 1023
SO - Anaesthesist 2002 Dec;51(12):1022; author reply 1023.
DP - 2002 Dec
TI - [Spinal anesthesia: articaine, prilocaine, lidocaine?]
SO - Anaesthesist 2002 Dec;51(12):1022.
DP - 2002 Dec
TI - [50th anniversary of the Swiss Society for Anesthesiology and
Resuscitation]
PG - 1015-9
AD - Institut fur Anasthesiologie, Universitatsspital Zurich.
thomas.pasch@ifa.usz.ch
SO - Anaesthesist 2002 Dec;51(12):1015-9.
DP - 2002 Dec
TI - [Nociceptin and the ORL1 receptor: pharmacology of a new opioid receptor]
PG - 996-1005
AB - Molecular biological investigations led to the discovery of the ORL1
receptor ( opioid receptor like-1 receptor) and its endogenous ligand
nociceptin. Although its sequence and structure are closely related to
traditional opioid receptors, the ORL1 receptor shows low binding
affinities for selective opioid agonists and antagonists. On the other
hand, the ORL1 ligand nociceptin does not bind to the three traditional
opioid receptors.The activation of the G protein-coupled ORL1 receptor
inhibits adenlylate cyclase activity, reduces the intracellular
concentration of the second messenger cAMP and regulates ion channels. The
supraspinal administration of nociceptin produces hyperalgesia. unlike
opioids. Spinal intrathecal and peripheral administration of nociceptin
causes hyperalgesia in low doses and analgesia in high doses.The
physiological role and detailed mechanisms of these dose-dependent
nociceptin effects in opposite directions are not yet known.In addition,
nociceptin modulates other biological phenomena such as feeding,
locomotion, gastrointestinal function,memory, cardiovascular
function,immunity, renal function, anxiety,dependence and tolerance.Future
research on the physiological and pathophysiological importance of the
nociceptin/ORL1 receptor systems may provide a target for novel
therapeutics.
AD - Klinik fur Anasthesiologie und Operative Intensivmedizin,
Martin-Luther-Universitat Halle-Wittenberg.
stefan.grond@medizin.uni-halle.de
SO - Anaesthesist 2002 Dec;51(12):996-1005.
DP - 2002 Dec
TI - [Analgesia during labour: from taboo to evidence-based medicine]
PG - 959-72
AB - Peripartum care of parturients has contributed a great deal to the
development of modern anaesthesia during the past 150 years. The
introduction of general and regional anaesthesia provided new options of
relieving pain during delivery and preventing suffering. However,provision
of effective labor analgesia gave and still gives rise to controversy as
to whether interfering with natural events such as delivery was
justifiable on a religious,moral or ideological level. A new era of
obstetric pain relief was initiated when a study design was devised to
define the Minimum Local Analgesic Concentration (MLAC) needed for
epidural analgesia. Using the MLAC model as a scientifically based
pharmacodynamic measure of analgesia, empirically developed "recipes"
can
be compared and validated. The importance of this clinical model will be
put into a pharmacological context including issues such as the up-down
sequential allocation technique, dose-response curves and differential
nerve blockade.
AD - Anasthesie, Universitatsfrauenklinik Basel, Switzerland.
Schneiderma@ubaclu.unibas.ch
SO - Anaesthesist 2002 Dec;51(12):959-72.
DP - 2003 Mar
TI - Streptococcal meningitis after spinal anesthesia: report of a case.
SO - Can J Anaesth 2003 Mar;50(3):314-5.
DP - 2003 Mar
TI - Epidural analgesia for a laparotomy in a morbidly obese patient with
a
history of difficult intubation.
SO - Can J Anaesth 2003 Mar;50(3):312-3.
DP - 2003 Mar
TI - Anesthesia for a child with a congenital antithrombin deficiency.
SO - Can J Anaesth 2003 Mar;50(3):311.
DP - 2003 Mar
TI - Volatile anesthetics regulate pulmonary vascular tension through different
potassium channel subtypes in isolated rabbit lungs: [Les anesthesiques
volatils maintiennent la tension vasculaire pulmonaire par differents
sous-types de canaux potassiques dans des poumons de lapins isoles].
PG - 301-4
AB - BACKGROUND: The effects of volatile anesthetics on subtypes of K(+)
channels located on pulmonary vessels remain largely unexplored. METHODS:
To investigate whether or not potassium channels play a role in the effect
of volatile anesthetic on pulmonary vessels, isolated and perfused rabbit
lungs were divided into four groups (n = 7 each): a control group without
treatment, a glibenclamide (Glib) group treated with adenosine
triphosphate-sensitive K(+) (K(ATP)) channel inhibitor, a 4-aminopyridine
(4-AP) group treated with voltage-sensitive K(+) (K(V)) channel inhibitor,
and an iberiotoxin (IbTX) group treated with high conductance
calcium-activated K(+) (K(Ca)) channel inhibitor. After inhibitor
administration and stabilization, two minimum alveolar concentration (MAC)
of halothane, enflurane, isoflurane, or 1.8 MAC of sevoflurane were
randomly administered for 15 min followed by eight minutes of fresh gas
mixture after each agent inhalation. RESULTS: Isoflurane did not change
pulmonary vascular tension in the control group but instead constricted
the pulmonary vessels when K(V) channels were inhibited with 4-AP;
constrictive effects of enflurane and halothane were observed on pulmonary
vessels, and were enhanced by K(V) channel inhibition with 4-AP, but they
were inhibited by K(Ca) channel inhibition with IbTX; the dilation effect
of sevoflurane was observed on pulmonary vessels but was not significantly
affected by any of the K(+) channel inhibitors. CONCLUSION: Halothane,
enflurane and isoflurane, but not sevoflurane, regulate pulmonary vascular
tension through K(V) and/or K(Ca) channels in isolated rabbit lungs.
AD - Department of Anaesthesiology and Reanimatology, Tottori University
Faculty of Medicine, Tottori, Yonago, and the Department of Anaesthesia,
Toyooka Hospital, Toyooka, Hyogo, Japan.
SO - Can J Anaesth 2003 Mar;50(3):301-4.
DP - 2003 Mar
TI - Bronchodilator premedication does not decrease respiratory adverse events
in pediatric general anesthesia.
PG - 277-84
AB - PURPOSE: Upper respiratory infections (URI) presage perioperative
respiratory complications, but thresholds to cancel surgery vary widely.
We hypothesized that autonomically-mediated complications seen during
emergence from anesthesia would be predicted by capnometry and reduced
with preoperative bronchodilator administration. METHODS: Afebrile
outpatient tertiary-care children (age two months to 18 yr, n = 109)
without lung disease or findings, having non-cavitary, non-airway surgery
for under three hours, were randomized to bronchodilator premedication vs
placebo and had preoperative capnometry. After halothane via mask,
laryngeal mask airway, or endotracheal tube, and regional anesthesia as
appropriate, patients recovered breathing room air while cough, wheeze,
stridor, laryngospasm, and cumulative desaturations were recorded for 15
min. RESULTS: In this specific population, there was no association
between adverse events and either URI within six weeks (n = 76) or URI
within seven days (n = 21). Neither albuterol nor ipratropium
premedication decreased adverse events. Endotracheal intubation was
associated with increased emergence desaturations and placebo nebulized
saline increased emergence coughing. Neither anesthesiologists nor
preoperative capnometry predicted adverse events. CONCLUSIONS: Adverse
events were neither predicted nor prevented. In afebrile outpatient ASA I
and II children with no lung disease or findings, having non-cavitary,
non-airway surgery for under three hours, there was no association between
either recent URI or active URI and desaturation, wheeze, cough, stridor,
or laryngospasm causing desaturation (all P > 0.05). In this highly
selected population of afebrile patients, the results suggest that
anesthesiologists may proceed with surgery using specific criteria in the
presence of a URI.
SO - Can J Anaesth 2003 Mar;50(3):277-84.
DP - 2003 Mar
TI - Patient-controlled epidural analgesia reduces analgesic requirements
compared to continuous epidural infusion after major abdominal surgery:
[L'analgesie peridurale auto-controlee, comparee a une perfusion
peridurale continue, reduit les besoins analgesiques apres une
intervention chirurgicale majeure].
PG - 258-64
AB - PURPOSE: To compare the quality of pain relief and incidence of side
effects between 24-hr postoperative continuous epidural infusion (CEI) and
subsequent patient-controlled epidural analgesia (PCEA) with different
analgesics after major abdominal surgery. METHODS: Twenty-eight women
undergoing extended gynecological tumour surgery received postoperative
CEI with 0.15 mL*kg(-1)*hr(-1) 0.2% ropivacaine (R: n = 14) or 0.125%
bupivacaine plus 0.5 micro g*mL(-1) sufentanil (BS: n = 14) during 24
postoperative hours. Twenty-four hours later, postoperative pain
management was switched to PCEA without background infusion and 5 mL
single bolus application of R or BS every 20 min at most. Visual analogue
scales (VAS; 1-100 mm) were assessed by patients at rest and on coughing
after 24 hr of CEI and PCEA. Side effects, doses of local anesthetics and
opioids were recorded and plasma concentrations of total and unbound
ropivacaine and bupivacaine were measured. RESULTS: Patients required
lower doses of each respective analgesic medication with PCEA (R: 108 +/-
30 mL; BS: 110 +/- 28 mL) than with CEI (R: 234 +/- 40; BS: 260 +/- 45; P
< 0.01). Ropivacaine plasma concentrations were lower 24 hr after PCEA
when compared with CEI (P < 0.01). No patient after PCEA but two after
CEI
(n = 4; NS) presented motor block. PCEA with R provided better
postoperative pain relief than CEI (37 +/- 32 vs 59+/-27, P < 0.05). No
difference in parenteral opioid rescue medication between CEI and PCEA was
seen. CONCLUSION: PCEA in comparison to preceding CEI provides equivalent
analgesia with lower local anesthetic doses and plasma levels, and without
motor blocking side effects, irrespective of the applied drug regimen.
SO - Can J Anaesth 2003 Mar;50(3):258-64.
DP - 2003 Mar
TI - General anesthesia does not impair simulator driving skills in volunteers
in the immediate recovery period - a pilot study: [L'anesthesie generale
n'altere pas les habiletes de conduite sur simulateur chez des volontaires
en recuperation immediate - une etude pilote].
PG - 238-45
AB - PURPOSE: The current recommendations to refrain from driving for 24 hr
after general anesthesia (GA) lack evidence. Our objective was to measure
impairment of driving performance at various time intervals after
anesthesia using driving impairment at different blood alcohol
concentrations (BAC) as a gold standard for comparison. METHODS:
Institutional Review Board approval was obtained. A cross-over design,
within subject comparison was used. Twelve volunteers were randomized to
three treatments: GA, alcohol, and no drug. Psychomotor recovery was
assessed by Digit Symbol Substitution Test (DSST) and Trieger Dot Test
(TDT). On the anesthetic day, GA was induced with propofol 2.5 mg*kg(-1)
and fentanyl l micro g*kg(-1) and maintained with N(2)O-O(2) 50:50 and
approximately one minimum alveolar concentration of desflurane by
spontaneous ventilation for 30 min. Driving simulator test runs occurred
at two, three, four, and 24 hr postanesthesia. On the alcohol treatment
day, a vodka and orange juice beverage was administered to reach the legal
limit for BAC in the province of Ontario, Canada (BAC 0.08%). On the
control day, no drug was given. Driving simulator test runs corresponded
to the same time of day as the postanesthetic test runs. Two-way analysis
of variance for dependent samples (ANOVA) was performed using the SAS
program. P values of less than 0.05 were considered significant. RESULTS:
There was no significant difference in postanesthetic driving skills at
two, three, and four hours postanesthesia, and the corresponding control
sessions. There was no significant difference among the three sessions
with respect to pen and paper tests of psychomotor performance.
Performance during the alcohol session differed significantly from that
during the control and postanesthetic sessions. CONCLUSION: Certain
driving skills return by two hours after one half hour of GA of propofol,
desflurane, and fentanyl in a group of young volunteers.
AD - Department of Anesthesiology, University of Florida, Jacksonville,
Florida, USA, the Department of Anesthesia, Toronto Western Hospital, and
the Human Factors North Inc., Toronto, Ontario, Canada.
SO - Can J Anaesth 2003 Mar;50(3):238-45.
DP - 2002 Oct
TI - Hemodynamic effects of stellate ganglion block: analysis using a model
of
aortic input impedance.
SO - Can J Anaesth 2002 Oct;49(8):887-8.
DP - 2002 Oct
TI - Relieving anxiety by entering the operating room on foot.
SO - Can J Anaesth 2002 Oct;49(8):885-6.
DP - 2003 Feb
TI - Efficacy of epidural analgesia during labour and delivery: a comparison
between singleton vertex presentation, singleton breech presentation and
twin pregnancies.
SO - Eur J Anaesthesiol 2003 Feb;20(2):164-5.
DP - 2003 Feb
TI - Dopamine stabilizes milrinone-induced changes in heart rate and arterial
pressure during anaesthesia with isoflurane.
PG - 120-3
AB - BACKGROUND AND OBJECTIVE: Phosphodiesterase-III inhibitors and dobutamine
effectively improve cardiac function in patients with cardiac failure, but
they are limited by possible hypotensive effects. We tested the hypothesis
that dopamine contributes to stabilizing milrinone-induced haemodynamic
changes. METHODS: Nine patients undergoing major surgery were
anaesthetized using nitrous oxide and oxygen supplemented with isoflurane
1-2%. After baseline haemodynamics were recorded, milrinone (25 or 50
microg kg(-1)) was administered over 10min, followed by a continuous
infusion (0.5 microg kg(-1) min(-1). The second set of haemodynamic values
was measured 50 min after beginning the continuous infusion of milrinone.
Dopamine (4 microg kg(-1) min(-1)) was then administered with milrinone.
RESULTS: Milrinone significantly increased the heart rate from 81 +/- 8 to
102 +/- 16beats min(-1), but it decreased the mean arterial pressure from
83 +/- 10 to 66 +/- 10 mmHg and systemic vascular resistance (P < 0.05
for
each). The pulmonary capillary wedge pressure, cardiac index and pulmonary
vascular resistance did not change significantly. The addition of dopamine
to the milrinone infusion significantly decreased the heart rate (94 +/-
12 beats min(-1)) and increased the mean arterial pressure (82 +/- 11
mmHg). Dopamine and milrinone, but not milrinone alone, significantly
increased the cardiac index and the rate-pressure product. CONCLUSIONS:
The combination regimen of milrinone and dopamine improved cardiac
function, and changes in heart rate and mean arterial pressure induced by
milrinone were attenuated by dopamine. The results suggest that a
combination regimen of milrinone and dopamine rather than milrinone alone
should be used to maintain arterial pressure.
AD - National Defense Medical College, Department of Anaesthesiology, Saitama,
Tokorozawa, Japan. karasawa@me.ndmc.ac.jp
SO - Eur J Anaesthesiol 2003 Feb;20(2):120-3.
DP - 2003 Feb
TI - Effects of repeated anaesthesia on central cholinergic function in the
rat
cerebral cortex.
PG - 93-7
AB - BACKGROUND AND OBJECTIVE: General anaesthesia may contribute to
postoperative cognitive decline in the elderly. The aim was to determine
the effects of repeated pentobarbital anaesthesia throughout life on
central cholinergic function in the rat. METHODS: Young Lewis rats were
randomly allocated to two groups. The anaesthesia group (n = 15) was
anaesthetized with pentobarbital 20 mg kg(-1) intraperitoneally at 6, 8.5,
11, 13.5, 16, 18.5, 21 and 23.5 months of age. The control group (n = 12)
was treated identically, apart from the anaesthesia. At 26 months of age,
the animals were killed and the brain dissected and stored for analysis.
Central cholinergic function in the cortex and hippocampus was assessed by
measuring [3H]-epibatidine and [125I]alpha-bungarotoxin binding to
nicotinic receptors and choline acetyltransferase (ChAT) activity.
RESULTS: Tissue from nine rats in the anaesthesia group and eight in the
control group was available for analysis. There was a significant
reduction in alpha-bungarotoxin binding in the anaesthetized compared with
the control group in the superior cortex (P < 0.0002) and molecular cortex
(P < 0.04). There were no significant differences between the groups for
epibatidine binding or ChAT. CONCLUSIONS: Repeated anaesthesia in rat
reduces central nicotinic cholinergic binding in the cortex. The findings
may have implications for postoperative cognitive function studies.
AD - Leicester General Hospital, Department of Anaesthesia, Leicester, UK.
cdh4@le.ac.uk
SO - Eur J Anaesthesiol 2003 Feb;20(2):93-7.
DP - 2002 Sep
TI - Transient respiratory compromise after infraclavicular vertical brachial
plexus blockade.
SO - Eur J Anaesthesiol 2002 Sep;19(9):693-4.
DP - 2002 Sep
TI - Dilated cardiomyopathy in dystrophic epidermolysis bullosa: a lethal
complication of epidermolysis bullosa.
SO - Eur J Anaesthesiol 2002 Sep;19(9):689-90.
DP - 2002 Sep
TI - Posterior subgluteal approach to block the sciatic nerve: description
of
the technique and initial clinical experiences.
PG - 682-6
AB - BACKGROUND AND OBJECTIVE: A new posterior approach to the sciatic nerve
in
the subgluteal region was developed. We describe our clinical experiences
on 135 consecutive patients. METHODS: All blocks were performed with a
nerve stimulator (stimulation frequency 2 Hz; intensity from 1 reduced to
< or = 0.5 mA before application). A line was drawn from the greater
trochanter to the ischial tuberosity of the femur; then, from the
mid-point of this line, a second line was drawn perpendicularly and
extended caudally for 4 cm: the end of this line represented the entry
point of the needle. Sciatic stimulation was elicited at < or = 0.5 mA;
then ropivacaine 0.75% 20 mL was injected. An independent observer
recorded the time from needle insertion to successful sciatic nerve
stimulation (performance time), the depth of appropriate sciatic
stimulation and the number of needle redirections, as well as the quality
of nerve block, the discomfort during the procedure and patient
acceptance. RESULTS: The performance time was 41 +/- 25 s (mean +/- SD)
and the mean (SD) depth at which the sciatic nerve stimulation was found
was 45 +/- 10 mm. The median (range) number of needle redirections
required to find the proper sciatic stimulation was 2 (1-5). The tibial
response was observed in 77 patients (57%), while the common peroneal
response was observed in 58 patients (43%). The degree of discomfort
reported was very low and only 16 patients (12%) reported severe pain
during placement of the block. The onset time (mean +/- SD) of sensory and
motor block was 7 +/- 4 and 17 +/- 13 min respectively, and the surgical
procedure was completed with only the peripheral nerve block in 127
patients (94%). The same anaesthesia procedure was acceptable by 127
patients (94%) and only eight patients (6%) would prefer a different
anaesthesia technique in the future. CONCLUSIONS: The study demonstrated
that the sciatic nerve can be easily blocked using this new posterior
subgluteal approach, suggesting that it represents a safe and effective
alternative to block the sciatic nerve at a proximal level, with the
potential for reducing the discomfort experienced by the patient during
block placement.
SO - Eur J Anaesthesiol 2002 Sep;19(9):682-6.
DP - 2003 Mar 19
TI - The CRF(1) receptor antagonist, DMP695, abolishes activation of locus
coeruleus noradrenergic neurones by CRF in anesthetized rats.
PG - 127-133
AB - Corticotropin-releasing factor (CRF)(1) receptors have been implicated
in
the excitatory influence of CRF upon noradrenergic perikarya of the locus
coeruleus. This study thus characterized the influence of the novel CRF(1)
receptor antagonist, DMP695
(N-(2-chloro-4,6-dimethylphenyl)-1-[1-methoxymethyl-(2-methoxyethyl]-6-met
hyl-1H-1,2,3-triazolo[4,5-c]pyridin-4-amine mesylate), upon the electrical
activity of noradrenergic perikarya in the locus coeruleus of anesthetized
rats. Intracerebroventricular injection of CRF dose-dependently (0.05-4.0
&mgr;g) enhanced the firing rate of noradrenergic cell bodies and
transformed their firing pattern into a burst mode. This action was
dose-dependently abolished by i.v. administration of DMP695 (0.125-2.0
mg/kg i.v.), which did not itself modify the electrical activity of
noradrenergic neurones. These data demonstrate antagonist properties of
DMP695 at central CRF(1) receptors excitatory to ascending noradrenergic
neurones, an action which may contribute to its distinctive profile of
anxiolytic properties.
AD - Psychopharmacology Department, Institut de Recherches Servier, Centre
de
Recherches de Croissy, 125 Chemin de Ronde, 78290 Croissy/Seine, Paris,
France
SO - Eur J Pharmacol 2003 Mar 19;464(2-3):127-133.