ABSTRACT
BACKGROUND: The bispectral index (BIS) is a measure of the hypnotic component of anesthesia and can be used to guide the administration of anesthetics. This study compares the emergence and recovery characteristics of total intravenous anesthesia using propofol/remifentanil with sevoflurane/remifentanil anesthesia under bispectral index guidance. METHODS: Fifty-six patients (ASA 1, 2) were randomly assigned to two groups, receiving either propofol/ remifentanil (Group P) or sevoflurane/remifentanil (Group S) anesthesia. Following induction with propofol and remifentanil, anesthesia was maintained with propofol/remifentanil or sevoflurane/ remifentanil. After the induction of anesthesia, the target effect-site concentration of remifentanil was constantly maintained at 3 ng/ml. Propofol and sevoflurane administration was guided using the bispectral index (40-60). Thirty minutes before the end of surgery, ketorolac was administered (0.5 mg/kg intravenously). At the end of surgery, the anesthetic agents were discontinued. Patients in the groups were compared for recovery characteristics (eye opening, response to command, extubation, orientation, time in the Operating room after the end of surgery, Aldrete score >9) using the unpaired t-test (P < 0.05). RESULTS: There were no significant differences in the demographic data between patients in the two groups. Recovery data was not different between the two groups. CONCLUSIONS: BIS-guided anesthesia with propofol or sevoflurane plus remifentanil both provided satisfactory anesthesia for lower abdominal surgery in gynecologic patients.
Subject(s)
Humans , Anesthesia , Anesthesia, General , Anesthesia, Intravenous , Anesthetics , Ketorolac , Operating Rooms , PropofolABSTRACT
BACKGROUND: Orthostatic intolerance is a debilitating problem that can occur after prolonged bed-rest, exposure to microgravity, and in the elderly. This study examined the integrated cardiovascular response to baroreceptor activation in a hind-limb unweighing (HLU) mouse model of microgravity to test the hypothesis that both the pressor and contractility response are attenuated in HLU mice. METHODS: C57BL/6 mice (25-30 g body wt, 8-10 wk old) were exposed to HLU for 2 weeks. A bilateral carotid artery occlusion and open-loop baroreceptor stimulus was performed to measure the myocardial contractile responses using a left ventricular micromanometer-conductance catheter in the mice. In isolated myocytes simultaneous sarcomere shortening and calcium transient were measured in response to increasing concentrations of the beta-agonist isoproterenol. RESULTS: In the controls, bilateral carotid artery occlusion increased the heart rate and mean arterial pressure. These responses were markedly attenuated in the HLU mice. A bilateral carotid artery occlusion also increased the slope of the end-systolic pressure volume relationship (Ees) by 70 +/- 11% and the slope was markedly attenuated to 10 +/- 8% in the HLU mice. Isoproterenol increased the sarcomere shortening in both control and HLU mice in a dose-dependent manner. However the contractile response to isoproterenol was significantly attenuated in the HLU mice than the controls. CONCLUSIONS: Both the pressor and myocardial contractile responses appear to be impaired in a mouse model of microgravity.
Subject(s)
Aged , Animals , Humans , Mice , Arterial Pressure , Baroreflex , Calcium , Carotid Arteries , Catheters , Heart Rate , Isoproterenol , Muscle Cells , Orthostatic Intolerance , Pressoreceptors , Sarcomeres , WeightlessnessABSTRACT
Vinyl acetate has been widely used for the manufacture of polyvinyl alcohol emulsion, which is primary ingredient of adhesive, paints, textile, paperboard coatings, etc. Since these products are plentiful and frequently used around us, workers and consumers are at health risk. International Agency for Research on Cancer (IARC) classified vinyl acetate as group 2B (possibly carcinogenic to humans). Among the organs targeted, the oral cavity is the most vulnerable organ affected by the carcinogenic effects of vinyl acetate. Since the origin of most of oral cancer is derived from the epithelial cells, it is important to understand the carcinogenic potential of vinyl acetate in human epithelial cells. Thus, the present study has attempted to utilize the immortalized human epithelial cell model to assess the carcinogenic potency of this chemical and to understand the underlying mechanisms.
Subject(s)
Humans , Adhesives , Epithelial Cells , International Agencies , Mouth , Mouth Neoplasms , Paint , Polyvinyl Alcohol , TextilesABSTRACT
Percutaneous vertebroplasty consists of the percutaneous injection of polymethylmethacrylate (PMMA) cement into a collapsed vertebral body in order to obtain pain relief and mechanically strengthen the vertebral body. This procedure is now extensively used in treating osteoporotic vertebral compression fracture. It is an efficient treatment, but it is not free of complications. Most complications after vertebroplasty are associated with PMMA leakage. Pulmonary embolism of PMMA is rare, but this can occur when there is a failure to recognize venous migration of cement early during the procedure. We encountered a case of a patient with asymptomatic pulmonary embolism because of PMMA after percutaneous vertebroplasty. Chest X-ray and CT scanning revealed numerous tubular branching opacities that corresponded to the pulmonary vessels at the segmental and subsegmental levels.
Subject(s)
Humans , Fractures, Compression , Polymethyl Methacrylate , Pulmonary Embolism , Thorax , Tomography, X-Ray Computed , VertebroplastyABSTRACT