2 resultados para Epidural anesthesia


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The present project aims to describe and study the nature and transmission of nerve pulses. First we review a classical model by Hodgkin-Huxley which describes the nerve pulse as a pure electric signal which propagates due to the opening of some time- and voltage-dependent ion channels. Although this model was quite successful when introduced, it fails to provide a satisfactory explanation to other phenomena that occur in the transmission of nerve pulses, therefore a new theory seems to be necessary. The soliton theory is one such theory, which we explain after introducing two topics that are important for its understanding: (i) the lipid melting of membranes, which are found to display nonlinearity and dispersion during the melting transition, and (ii) the discovery and the conditions required for the existence of solitons. In the soliton theory, the pulse is presented as an electromechanical soliton which forces the membrane through the transition while propagating. The action of anesthesia is also explained in the new framework by the melting point depression caused by anesthetics. Finally, we present a comparison between the two models.

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Background: Fentanyl is widely used off-label in NICU. Our aim was to investigate its cerebral, cardiovascular and pulmonary effects as well as pharmacokinetics in an experimental model for neonates. Methods: Fentanyl (5 mu g/kg bolus immediately followed by a 90 minute infusion of 3 mu g/kg/h) was administered to six mechanically ventilated newborn piglets. Cardiovascular, ventilation, pulmonary and oxygenation indexes as well as brain activity were monitored from T = 0 up to the end of experiments (T = 225-300 min). Also plasma samples for quantification of fentanyl were drawn. Results: A "reliable degree of sedation" was observed up to T = 210-240 min, consistent with the selected dosing regimen and the observed fentanyl plasma levels. Unlike cardiovascular parameters, which were unmodified except for an increasing trend in heart rate, some of the ventilation and oxygenation indexes as well as brain activity were significantly altered. The pulmonary and brain effects of fentanyl were mostly recovered from T = 210 min to the end of experiment. Conclusion: The newborn piglet was shown to be a suitable experimental model for studying fentanyl disposition as well as respiratory and cardiovascular effects in human neonates. Therefore, it could be extremely useful for further investigating the drug behaviour under pathophysiological conditions.