Effects of Epidural Anesthesia on Cardiovascular Response and Survival in Experimental Hemorrhagic Shock in Dogs

Sato, Keizo; Yamamoto, Yasunori; Murakami, S

doi:10.1097/00000542-198912000-00020

Cited by 26 publications

(11 citation statements)

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“…During light general anesthesia, the sympathetic reflex relates to tachycardia. In animal studies, regional anesthesia caused slower heart rates, greater stroke volume, higher arterial pH, higher bicarbonate concentration, and lower catecholamine concentrations than general anesthesia [23]. The present study also showed an association between GA and higher frequency of blood transfusion.…”

Section: Discussionsupporting

confidence: 69%

Brief communication (Original). Anesthesia for cesarean section in parturients diagnosed with placenta previa in a Thai university hospital: a retrospective analysis of 562 consecutive cases

et al. 2014

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Background: Anesthesia for cesarean delivery in parturients diagnosed with placenta previa remains controversial. Objectives: To investigate factors correlated with choice of anesthesia in these parturients and their outcomes. Methods: Retrospective analysis of patients with placenta previa and cesarean delivery at King Chulalongkorn Memorial Hospital. Peri operative anesthetic and complication data were collected using a structured collection form. Univariate analysis and multivariate logistic regression were used. P < 0.05 was considered significant. Results: Among 50,237 deliveries from July 1, 2005 to June 30, 2011, there were 562 cesarean sections in diagnosed cases of placenta previa. Cesarean deliveries (479) were performed under spinal anesthesia (81%), epidural anesthesia (1.8%), and if the effects spinal anesthesia dissipated, general anesthesia (2.3%). Among 46 cases of cesarean hysterectomy, 27 patients (58.7%) received regional anesthesia. However, 6 of 10 patients with planned cesarean hysterectomy underwent general anesthesia, while 1 of 4 of a group with regional anesthesia needed conversion to general anesthesia. There was no serious anesthesia-related complication. Factors related to general anesthesia were: a higher American Society of Anesthesiologists (ASA) physical status OR 2.7 (95% CI 1.7-4.3) P < 0.001; presentation with bleeding OR 1.8(95% CI 1.0-3.1) P = 0.033; anterior site of placenta OR 1.8 (95% CI 1.1-3.2) P = 0.025; heart rate >125 bpm OR 5.6 (95% CI 1.5-214) P = 0.01; and pack red cell transfusion OR 3.4 (95% CI 2.0-5.7) P < 0.001. Conclusions: Most parturients received regional anesthesia. Neuroaxial anesthesia and general anesthesia are safe.

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Section: Discussionsupporting

confidence: 69%

Brief communication (Original). Anesthesia for cesarean section in parturients diagnosed with placenta previa in a Thai university hospital: a retrospective analysis of 562 consecutive cases

et al. 2014

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“…There is compelling evidence to support the upregulation of skeletal muscle Na + -K + -ATPase associated glycolysis as a clinically significant source of lactate in septic and hemorrhagic shock, as well as exercise-related hyperlactatemia. 191,195,196,201,203,204,[208][209][210][211][212][213][214][215][216][217][218][219] Not only does plasma lactate correlate with catecholamine concentrations, 83,88,212,220-222 but both selective Na + -K + -ATPase and adrenergic blockade have been shown to prevent or decrease lactate concentrations in hemorrhagic shock, 195,211,[223][224][225][226][227] septic shock, 99,191,196 and during exercise. 217,228,229 Hyperlactatemia has even been documented in healthy university students following a university exam.…”

Section: Microcirculatory Dysfunctionmentioning

confidence: 99%

Clinical use of plasma lactate concentration. Part 1: Physiology, pathophysiology, and measurement

Rosenstein

Tennent‐Brown

Hughes

2018

J Vet Emergen Crit Care

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“…Reductions of pain can improve tissue oxygenation in the affected portion of the body [181], improve functionality [11,182] and improve the rate of recovery [183][184][185][186]. It is known that epidural analgesia can improve pulmonary function, improve nitrogen balance, reduce bleeding, reduce thromboembolic complications, attenuate the stress response, increase the rate of return of bowel function and may be protective in haemorrhagic shock [187][188][189][190][191][192]. Overall, these effects may reduce the number of perioperative complications [193][194][195][196].…”

Section: Outcomes Other Than Painmentioning

confidence: 99%

Current treatment options for acute pain

Gottschalk

Ochroch

2002

Expert Opinion on Pharmacotherapy

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The pain that accompanies surgical procedures remains prevalent and is an aspect of the perioperative experience that generates the greatest concern for patients about to undergo surgery. There is also a growing recognition of the extent that acute painful experiences can lead to longer-term painful consequences, even when tissue healing appears to be complete. The neurobiologic basis of this has been partially elucidated. The key observations are that multiple sites and multiple receptors collectively contribute, and that noxious stimuli initiate a cascade of events that sensitise the nervous system so that subsequent noxious stimuli are perceived with greater intensity and even previously non-painful stimuli can be painful. Incorporating these observations into effective perioperative regimens designed to limit acute pain and its consequences leads to a multimodal pre-emptive approach to acute pain management. Acute perioperative pain is an ideal setting for the use of pre-emptive analgesic techniques because the timing of noxious stimuli is known in advance and surgical sensitisation of the nervous system is ongoing despite adequate levels of general anaesthesia with volatile anaesthetics. The relevant neurobiology of pain, reviewed in this article, is the basis for advocating an aggressive, multimodal, pre-emptive approach to acute pain therapy throughout the entire perioperative period. A growing body of outcome studies demonstrates the long-term efficacy of this approach.

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Effects of Epidural Anesthesia on Cardiovascular Response and Survival in Experimental Hemorrhagic Shock in Dogs

Cited by 26 publications

References 0 publications

Brief communication (Original). Anesthesia for cesarean section in parturients diagnosed with placenta previa in a Thai university hospital: a retrospective analysis of 562 consecutive cases

Brief communication (Original). Anesthesia for cesarean section in parturients diagnosed with placenta previa in a Thai university hospital: a retrospective analysis of 562 consecutive cases

Clinical use of plasma lactate concentration. Part 1: Physiology, pathophysiology, and measurement

Current treatment options for acute pain

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