Molecular Mechanisms of Cell Adaptation to Hypoxia and the Role of Ischemic and Anesthetic Preconditioning. Implications for the Anesthetist

Postoperative cognitive impairment and postoperative delirium: risk factors, pathophysiology and management

Διατήρηση της ακεραιότητας του νωτιαίου μυελού κατά τις επεμβάσεις επιδιόρθωσης θωρακοκοιλιακών ανευρυσμάτων: αναισθητικές και χειρουργικές πρακτικές

Assessment of heart rate variability at different depths of anaesthesia during surgery

Caudal administration of levobupivacaine and neostigmine for postoperative analgesia in children

Μεταβολές της πίεσης στα πνευμονικά τριχοειδή μετά από χορήγηση ενδοτοξίνης σε χοίρους

Anaesthetic techniques during pregnancy. A case report and review of the literature

Cell protection against hypoxia can be mediated by brief periods of sublethal ischemia, a phenomenon called ‘preconditioning’. The molecular mechanisms that are responsible for cell protection are extremely complicated; however, extensive research in molecular biology and cellular physiology has uncovered many different signaling pathways, especially in cardiac tissues.

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A significant number of patients exhibit impairment in cognitive function immediately following surgery or later; the impact of this postoperative cognitive dysfunction on the recovery and quality of life of the patient but also on the necessity for supportive and rehabilitation care is important. Risk factors for postoperative cognitive impairment and postoperative delirium have been described and it is these groups of patients that require early identification and careful follow up to avoid complications in postoperative care.

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This article aims at presenting the anesthetic and surgical techniques used to preserve spinal cord integrity during thoracoabdominal aortic aneurysm (ΤΑΑΑ – ThoracoAbdominal Aortic Aneurysm) repair operations.

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General anaesthesia is associated with a reduction in heart rate variability (HRV) compared to awake situation. In this study the hypothesis of reduction in HRV was tested in two different levels of anaesthesia depth. Forty six patients were randomly allocated in two groups, where anaesthesia was maintained with sevoflurane (n=23) or propofol (n=23). Administration of both anaesthetics was regulated in order to achieve a BIS value 25±5, followed by an increase to 55±5, both being stable for 5 min.

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In order to evaluate the postoperative analgesic effect of caudal administration of levobupivacaine, plain or in combination with neostigmine, 50 children who underwent medium gravity operations were studied. The children were randomly divided into two groups: Group L received 1 ml/kg of levobupivacaine 0.25% solution via caudal route, while in Group LN the same solution plus 2 μg/kg neostigmine was given.

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Pulmonary capillary pressure (Pcp) is the primary driving force determining the fluid flux across pulmonary capillary wall. Alterations of Pcp have been described in systemic inflammation, sepsis, ARDS, hypoxaemia and acute heart failure. The purpose of this study was to examine the Pcp alterations after lipopolysaccharide (LPS) intravenous administration in pigs. LPS has been administered (150μg/Kg BW) in the right atrium of 8 anesthetized and mechanical ventilated pigs (Group A) and the Pcp was calculated from pulmonary artery pressure tracings using the Gaar equation before, after LPS infusion and in 20min intervals for two hours.

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As general anaesthesia administered during the first two trimesters of pregnancy for gynaecological procedures was associated with a high incidence of mis-carriage and exposes the fetus to teratogenic effects of drugs, a case of successful breast tumour extraction under thoracic paravertebral block is reported with review of the literature.

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