Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 69-year-old patient with severe impairment of left ventricular function secondary to dilated cardiomyopathy underwent a successful total hip replacement under epidural analgesia. Perioperative heart rate and mean arterial pressure were stable at an analgesic level up to the seventh thoracic dermatome, achieved with mepivacaine two per cent with epinephrine. Asymptomatic pulmonary hypertension, occurring during the insertion of the femoral prosthesis, subsided spontaneously over the next twelve hours. The circulatory effects of epidural analgesia and their significance in a patient with dilated cardiomyopathy are discussed.
 ...
PMID:Epidural analgesia for total hip replacement in a patient with dilated cardiomyopathy. 394 54

We report our experience with total intravenous anesthesia (TIVA) with propofol and ketamine combined with continuous epidural analgesia in a 72-year-old-male patient with dilated cardiomyopathy scheduled for a total prostatectomy. After premedication with atropine 0.5 mg and pethidine 35 mg, anesthesia was induced with ketamine 50 mg, fentanyl 0.1 mg and using a step down method of propofol (6-->4-->2 mg.kg-1.hr-1). After hemodynamic parameters had been stabilized, the trachea was intubated. Then, 1.5% lidocaine 6 ml was injected through an epidural catheter, placed at the L 1-2 intervertebral space. Anesthesia was maintained with continuous infusion of propofol 1 mg.kg-1.hr-1 and ketamine 1 mg.kg-1.hr-1, and continuous epidural analgesia with 1.5% lidocaine 2 ml.hr-1. Hemodynamics remained stable throughout the operative procedure. No postoperative complications occurred. TIVA with propofol and ketamine in combination with epidural analgesia is useful for patients with dilated cardiomyopathy in order to maintain stable hemodynamics during anesthesia.
 ...
PMID:[Anesthetic management of a patient with dilated cardiomyopathy under total intravenous anesthesia with propofol and ketamine combined with continuous epidural analgesia]. 1058 58

Bardet-Biedl syndrome is a rare autosomal recessive disease characterized by renal abnormalities, obesity, dysmorphic extremities, retinal dystrophy, and hypogenitalism, as well as cardiac abnormalities, diabetes mellitus, hypertension and mental retardation. Renal failure is the leading cause of death and survival is substantially reduced. We describe the anesthetic management of a patient with Bardet-Biedl syndrome, dilated cardiomyopathy and fractured right femur and tibia requiring open reduction and internal fixation. A combined spinal-epidural (CSE) block was performed; 7.5 mg of bupivacaine and 20 microg of fentanyl were administered into the subarachnoid space. Postoperative analgesia was obtained with an epidural infusion mixture of bupivacaine (0.125%) and fentanyl (1 microg/mL). Hemodynamic status was monitored by direct measurement of intra-arterial blood pressure and central venous pressure. The perioperative course was uneventful.
 ...
PMID:Anesthetic management of a patient with Bardet-Biedl syndrome and dilated cardiomyopathy. 1724 58

We report successful anesthetic management of elective cesarean section in a 31-year-old patient with dilated cardiomyopathy (DCM) using combined spinal-epidural anesthesia (CSEA). After inserting an arterial catheter and central venous catheter, isobaric bupivacaine (0.5% ; 5 mg) with fentanyl 10 microg was injected intrathecally at the L4-5 interspace under administration of dopamine 3 microg kg(-1) min(-1). 10 min and later, a total of ropivacaine (0.5%; 70 mg) with fentanyl 50 microg was titrated at 2-3 min intervals through the epidural catheter inserted at the L1-2 interspace resulting in analgesic level of T4 25 min after induction of spinal anesthesia. A baby was delivered uneventfully with good Apgar score, and the patient's perioperative hemodynamic change was minimal. CSEA is a reliable, titratable technique, which provides excellent analgesia with minimal hemodynamic changes for patients with DCM undergoing cesarean section.
 ...
PMID:[Combined spinal-epidural anesthesia for cesarean section in a patient with dilated cardiomyopathy]. 1827 68

Takayasu aortoarteritis in a pregnant patient is often associated with severe life-threatening complications. The coexistence of associated dilated cardiomyopathy can further complicate the pregnancy, particularly during parturition and at the time of delivery. We describe the management of labor analgesia in a symptomatic parturient suffering from advanced Takayasu aortoarteritis with dilated cardiomyopathy and a recent episode of congestive cardiac failure. The patient was man-aged with graded epidural analgesia instituted early in labor. Intermittent boluses of 0.0625% bupivacaine with 2 microg/mL fentanyl were administered epidurally, which provided adequate analgesia without impaired hemodynamic status.
 ...
PMID:Takayasu aortoarteritis with dilated cardiomyopathy: anesthetic management of labor analgesia. 2064 70

A 37-year-old man with advanced Friedreich's ataxia was referred to our emergency department with acute exacerbated abdominal pain of unclear aetiology. Laboratory tests showed slightly increased inflammatory parameters, elevated troponin and B-type natriuretic peptide, as well as minimal proteinuria. Transthoracic echocardiography revealed a pre-existing dilated cardiomyopathy. Abdominal sonography showed no pathological alterations. Owing to persistent pain under analgesia, a contrast-enhanced CT-abdomen was performed, which revealed a non-homogeneous perfusion deficit of the right kidney, although neither abdominal vascular alteration, cardiac thrombus, deep vein thrombosis nor a patent foramen ovale could be detected. Taking all clinical and radiological results into consideration, the current incident was diagnosed as a thromboembolic kidney infarction. As a consequence, lifelong oral anticoagulation was initiated.
 ...
PMID:Kidney infarction in Friedreich's ataxia with dilated cardiomyopathy. 2303 61