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BACKGROUND Remifentanil hydrochloride is an ultra-short-acting, esterase-metabolized mu-opioid receptor agonist. This study compared the use of remifentanil or fentanyl during elective supratentorial craniotomy for space-occupying lesions. METHODS Sixty-three adults gave written informed consent for this prospective, randomized, double-blind,(More)
BACKGROUND Different anesthetic agents have different effects on cerebrovascular physiology. However, the importance of these differences in neuroanesthetic practice are unclear. In an effort to determine whether important clinical differences are present, the authors compared three anesthetic techniques in 121 adults undergoing elective surgical removal of(More)
The choroid plexus contains receptors for angiotensin II and a very high concentration of angiotensin-converting enzyme. The goal of this study was to test the hypothesis that angiotensin II decreases blood flow to the choroid plexus. In rabbits anesthetized with chloralose, blood flow (microspheres) to the choroid plexus was 438 +/- 46 (mean +/- SE)(More)
BACKGROUND Advancing the endotracheal tube (ETT) over a flexible bronchoscope (FB) during awake fiberoptic orotracheal intubation is often impeded. The goal of this study was to identify the sites and mechanisms that inhibit the passing of the ETT into the trachea. METHODS Forty-five consenting patients underwent a clinically indicated awake fiberoptic(More)
BACKGROUND Manual in-line stabilization (MILS) is recommended during direct laryngoscopy and intubation in patients with known or suspected cervical spine instability. Because MILS impairs glottic visualization, the authors hypothesized that anesthesiologists would apply greater pressure during intubations with MILS than without. METHODS Nine anesthetized(More)
To determine the role of arterial O2 content (CaO2) in the cerebral blood flow (CBF) responses to hypoxemia and hemodilution, CaO2 was progressively reduced from approximately 18 to approximately 6 ml O2/dl in normocapnic, normothermic, pentobarbital-anesthetized rabbits. This was done either by reducing PaO2 (hypoxemia, minimum PaO2 approximately 26 mmHg)(More)
BACKGROUND Recent work in animals suggests that nitric oxide may play a role in the cerebral blood flow (CBF) changes produced by anesthetics, particularly the vasodilation seen with volatile anesthetics. It is not clear, however, whether nitric oxide causes the flow increase or simply plays some constitutive role. To distinguish between these(More)
BACKGROUND Circulating vasoactive hormones (e.g., vasopressin) play an important role in the regulation of blood flow to the choroid plexus and the rate of cerebrospinal fluid (CSF) production. We tested the hypothesis that halothane decreases CSF production through a vasopressin-related mechanism and examined the related changes in blood flow to the(More)
The choroid plexus contains receptors for angiotensin II (ANG II) and a very high concentration of angiotensin-converting enzyme. The goal of this study was to test the hypothesis that central, as well as circulating, ANG I and II decrease blood flow to the choroid plexus. Under control conditions in anesthetized rabbits, blood flow (microspheres) to the(More)
If children use the same tongue skills in swallowing and clearing remnants of sticky foods from the mouth as they do in articulating during speech, it could then be hypothesized that those with impaired articulation might have poorer tongue skills and, consequently, slower rates of food clearance. Does age alter these skills and rates of clearance?(More)