Anesthesiology

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BACKGROUND: Surgery causes transient impairment in cognition and function, which may impact driving safety. We hypothesized that the risk of a motor vehicle crash would increase after compared to before surgery. METHODS: We performed a nested case-crossover study within population-based observational data from the New Jersey Safety Health Outcomes Data Warehouse. We included adults aged ≥ 18 years with a valid driver's license who underwent general surgery in an acute care hospital in New Jersey between January 1st, 2016 and November 30th, 2017 and were discharged home...

BACKGROUND: We hypothesized that both perineural and systemic dexamethasone as adjuncts to bupivacaine increase the duration of an ulnar nerve block compared with bupivacaine alone, and that systemic dexamethasone is non-inferior to perineural dexamethasone. METHODS: We performed bilateral ulnar nerve blocks with 3 ml bupivacaine 5 mg/ml in 16 healthy volunteers on two trial days. According to randomization, subjects received adjunct treatment with 1 ml dexamethasone 4 mg/ml + 1 ml of saline (perineural condition) in one arm and 2 ml saline in the other arm (systemic condition, through absorption and redistribution of the contralaterally administered perineural dexamethasone) on one trial day; and 2 ml of saline in one arm (placebo condition) and 2 ml of lidocaine in the other arm (lidocaine condition) on the other trial day...

BACKGROUND: Maintenance of ion homeostasis is essential for normal brain function. Inhalational anesthetics are known to act on various receptors but their effects on ion homeostatic systems, such as the Na+/K+-ATPase, remain largely unexplored. Based on reports demonstrating global network activity and wakefulness modulation by interstitial ions, we hypothesized that deep isoflurane anesthesia affects ion homeostasis and the key mechanism for clearing extracellular K+, the Na+/K+-ATPase...

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BACKGROUND: Nonsense-mediated mRNA decay increases targeted mRNA degradation and has been implicated in the regulation of gene expression in neurons. We hypothesized that nonsense-mediated μ opioid receptor mRNA decay in the spinal cord is involved in the development of neuropathic allodynia-like behavior in rats. METHODS: Adult Sprague-Dawley rats of both sexes received spinal nerve ligation to induce neuropathic allodynia-like behavior. The mRNA and protein expression contents in the dorsal horn of animals were measured by biochemical analyses...

Inherited and acquired coagulopathy are frequently associated with major bleeding in severe trauma, cardiac surgery with cardiopulmonary bypass, and postpartum hemorrhage. Perioperative management is multifactorial and includes preoperative optimization and discontinuation of anticoagulants and antiplatelet therapy in elective procedures. Prophylactic or therapeutic use of antifibrinolytic agents is strongly recommended in guidelines and has been shown to reduce bleeding and need for allogeneic blood administration...

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BACKGROUND–: Heparin anticoagulation has been used successfully for cardiopulmonary bypass (CPB). However, an alternative anticoagulant approach is desirable due to the cases of heparin-induce thrombocytopenia. Dabigatran provides anticoagulation for an in-vitro model of simulated CPB. The current analysis tests the hypothesis that dabigatran provides sufficient anticoagulation for CPB in intact rabbits. METHODS –: Nonlinear mixed effects models were used to estimate dabigatran parameters for a 2-compartment pharmacokinetic model in 10 New Zealand White rabbits...

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BACKGROUND: Radial artery cannulation in young children is challenging. Here, we invented a single-operator laser-assisted ultrasound-guidance system projecting the path of the target artery on the skin surface and hypothesized that this system would improve the first-attempt success rate of radial arterial cannulation in young pediatric patients relative to traditional ultrasound guidance. METHODS: This single-center, prospective, parallel-group, randomized controlled study enrolled pediatric patients (n = 80, age less than two years) requiring radial artery cannulation during general anesthesia...

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