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

The effect of volume replacement with crystalloidal and colloidal solutions was analyzed in 40 anesthetized Foxhounds subjected to a standardized traumatic-hemorrhagic shock. Following trauma and hypotension (MAP 40 mmHg; 3.0 +/- 0.5 hr) the animals were randomized to treatment with autologous blood and hydroxyethyl starch 6% (HES 450/0.7), or human serum albumin 5% (ALB), dextran-60 6% (DX), Ringer's lactate (RL), and hyperosmolar saline 1.3% (HS), respectively. While analgesia and sedation were maintained, the hemodynamic measurements were continued for a 24-hr period. Crystalloids and colloids were found equally effective in maintaining the macrohemodynamics following resuscitation from traumatic-hemorrhagic shock. To keep central hemodynamics at pre-shock level required at least four times higher volumes of crystalloids than colloids. No specific advantage for one of the substitutes tested was found with regard to accumulation of water in the lung during the first 24 hr following shock in dogs. Extravascular lung water (thermo-dye) and organ water (gravimetry) were not different between the groups. However, fluid loss into the abdominal cavity as well as albumin extravasation into lung interstitium and abdominal cavity were more pronounced in the crystalloid-treated animals, whereas albumin redelivery by the lymph was decreased. The deterioration of tissue oxygen extractions as well as the changes in acid-base balance in both crystalloid-treated groups reflect the persistent microcirculatory inhomogeneity in spite of normal macrohemodynamics.
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PMID:Long-term observation following traumatic-hemorrhagic shock in the dog: a comparison of crystalloidal vs. colloidal fluids. 321 30

Sickle cell disease patients with relatively high hemoglobin (> or = 12 g x dl) and those who have elevated alloimmunizations antibodies with rare phenotype subgroups, are problems challenging anesthesiologists. Acute Normovolemic Hemodilution (ANH) is rarely used in the perioperative management of homozygous sickle cell disease (SCD) in patients undergoing surgery. We hereby present a case in which ANH was used successfully. A 22 year old male patient with known homozygous sickle cell disease undergoing orthopedic surgery, underwent Acute Normovolemic Hemodilution (ANH) because of the absence of blood and suitable blood donors and high hemoglobin level. Just before establishing spinal anesthesia, a 400 ml blood was extracted from patient and then replaced by 6 % Hydroxyethylstarch HES solution.The surgery was performed uneventfully under spinal analgesia. Patient was discharged 48 hours later. A week later, his follow up visit showed no complications and his lab work returned to basic levels. We recommend the ANH technique as an on hand tool in the perioperative anesthetic management of sickle cell disease patients who have high Hb S with relatively high Hb levels, and in those special patients who have no blood available because of high alloimmunization antibodies or rare phenotype blood groups.
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PMID:Acute normovolemic hemodilution in sickle cell patient--a case report. 1995 Jul 47