4e Wetenschapsdag Anesthesiologie 2 november 2007 Academisch Medisch Centrum Amsterdam
Programma
Nederlandse Vereniging voor Anesthesiologie
Algemene Informatie Datum vrijdag 2 november 2007 Locatie Academisch Medisch Centrum Amsterdam Meibergdreef 9 1105 AZ Amsterdam tel 020 566 9111 (alg. nummer) tel 020 566 3402 (ontvangstbalie NVA) Een uitgebreide routebeschrijving vindt u op www.amc.uva.nl Gratis parkeren kunt u op P6. Parkeergarage P2 (betaald parkeren) is dichtbij collegezaal 5. Uitrijdkaarten worden niet uitgereikt. Het AMC is goed bereikbaar met het openbaar vervoer. De voordrachten worden gehouden in collegezaal 5. De posters staan opgesteld rondom deze zaal. De koffie- en lunchbuffetten voor de deelnemers staan bij de ingang van collegezaal 5. Huisregels AMC Het is in het AMC slechts toegestaan mobiel te bellen op de begane grond, openbare pleinen en gangen. In het AMC geldt een algemeen rookverbod. Eten of drinken in de collegezalen is niet toegestaan. Fotograferen of te filmen in het AMC kan alleen met toestemming van de daartoe bevoegde persoon. Voertaal Voordrachten en presentaties zijn Engelstalig. Abstracts Abstracts zijn geselecteerd voor óf een oralpresentation óf voor een posterdiscussion óf voor een poster-view groep. De oralpresentations en de posterdiscussions vinden plaats in congreszaal 5. De posters staan opgesteld rondom collegezaal 5. Alle voordrachten en presentaties vinden plaats onder leiding van moderatoren. Abstractboeken worden op 2 november ter beschikking gesteld. Accreditatie De Wetenschapsdag 2007 is geaccrediteerd voor 7 uur. Inschrijving Extra formulieren zijn verkrijgbaar bij de NVA of te downloaden van www. anesthesiologie.nl. De Wetenschapsdag wordt de leden aangeboden door de NVA. Gezien het aantal deelnemers van vorig jaar en de beperkte ruimte verzoeken wij u nadrukkelijk om vooraf in te schrijven (deadline inschrijving 26 oktober). U kunt zich ook inschrijven op de dag zelf, maar de toegang kan dan niet gegarandeerd worden.
Annulering Bij annulering na 26 oktober of no-show op 2 november wordt een bijdrage in de kosten ad € 25 in rekening gebracht. Er kan eventueel een vervanger worden aangemeld. Coördinatie Nederlandse Vereniging voor Anesthesiologie Mw. S.A.B. Gijtenbeek Postbus 20063 3502 LB Utrecht tel 030 282 32 70 fax 030 282 38 56
[email protected] Organiserend Comité Wetenschapsdag Prof.dr. G.J. Scheffer, voorzitter Prof.dr. L.P.H.J. Aarts Mw.dr. C. Boer Dr. R.A. Bouwman Dr. R.H.J. Breuer Dr. L. van den Broek Prof.dr. A. Dahan Dr. J.C.H. de Graaff Mw.dr. A. de Haes Prof.dr. C.J. Kalkman Prof.dr. M. van Kleef Dr. M.M.J. Snoeck
Geachte collegae, De Wetenschapsdag van de Nederlandse Vereniging voor Anesthesiologie begint inmiddels al een echte traditie te worden en het aantal deelnemers vertoont elk jaar weer een gestaag stijgende lijn. Dit jaar werden zoveel abstracts ingestuurd dat de commissie een zware selectie heeft moeten maken. Tevens blijkt uit de enquêtes dat de Wetenschapsdag ook door de bezoekers zeer gewaardeerd wordt. De Wetenschapsdag geeft een overzicht van het anesthesiologisch onderzoek in Nederland en biedt onderzoekers en andere geïnteresseerden de mogelijkheid elkaar te ontmoeten om kennis en ervaring uit te wisselen. We voorzien hier dus duidelijk in een behoefte onder de Nederlandse Anesthesiologen! Ook dit jaar is het Organiserend Comité er weer in geslaagd een tweetal zeer gerenommeerde sprekers naar Nederland te halen; Mervyn Maze en Nick Franks (Imperial College, Londen). Zij zullen een interessante bijdrage leveren: Franks geeft een update over moleculair mechanisme (met de nadruk op xenon) en Maze verzorgt een presentatie over het gebruik van xenon als neuroprotector. Ik wens u namens de commissie een interessante en uitdagende vierde Wetenschapsdag. Gert Jan Scheffer, voorzitter
Programma 08.30 - 09.00
Ontvangst en koffie
Collegezaal 5: 9.00 - 9.05
Opening Prof.dr. G.J. Scheffer, voorzitter Organiserend Comité Wetenschapsdag
9.05 - 9.25
Glutamine prevents morphine induced preconditioning in the isolated rat heart A. Heinen, R. Huhn, M.W. Hollmann, B. Preckel, C.J. Zuurbier, W. Schlack, N.C. Hauck-Weber Academisch Medisch Centrum Amsterdam
9.25 - 9.45
Mice lacking L1 have reduced nociceptive CGRP fibre in-growth into spinal transection lesions Robby J.P. Jaken, E.A.J. Joosten, M. Lübers, W.M. Honig, M. Schachner, G.A. Brook, M.A.E. Marcus, M. van Kleef, R. Deumens Recovery from inflammatory pain in the rat: influence of the socio-physical environment A.F. Gabriel, M.A.E. Marcus, W.M.M Honig, R. Deumens, M. van Kleef, E.A.J. Joosten Academisch Ziekenhuis Maastricht
9.45 - 10.05
Measuring mitochondrial oxygen tension in vivo: mitochondrial protoporphyrin IX as endogenous PO2 sensor E.G. Mik, T. Johannes, C.J. Zuurbier, H.P.M. Houben-Weerts, J. Stap, J.F. Beek, C. Ince Erasmus Medisch Centrum
10.05 - 10.45
Molecular Mechanisms of Chanisms of General Anaesthesia - Current Thinking N.P. Franks (zie pag 7)
10.45 - 12.00
Pauze / Poster Walk Around groep 1 & 2
Collegezaal 5: 12.00 - 13.00
Fluoroscopically guided cryoanalgesia for SI joint pain - a preliminary report Mw. K.M. Szadek, W.W.A. Zuurmond, S.A. Loer, R.S.G.M. Perez VU Medisch Centrum Amsterdam Perception of safety differs between professionals Mw. M. van Beuzekom, F. Boer, S.P. Akkerboom Leids Universitair Medisch Centrum Failure to demonstrate a disturbed forearm blood flow in patients with chronic stage CRPS-1 J.J. Brunnekreef, J. Oosterhof, O.H.G. Wilder-Smith, A.P. Wolff, B.J.P. Crul, R.A.B. Oostendorp UMC St. Radboud Nijmegen
Plain articaine or prilocaine for spinal anaesthesia in day-care knee arthroscopy M.P. Hendriks, C.J.M. de Weert, M.M.J. Snoeck, J.L. Giele, M.A.L. Pluim, M.J. Gielen UMC St. Radboud Nijmegen Effects of isoflurane and adjunct nitrous oxide on the vascular reactivity during short-term haemorrhagic shock Mw. I.V. Samarska, R.H. Henning, H. Buikema, L.P.H.J. Aarts, A.H. Epema Universitair Medisch Centrum Nijmegen Effects of isoflurane versus propofol on intestinal mucosal damage and gastrointestinal morbidity in patients undergoing on-pump coronary artery bypass grafting. A randomised controlled trial Mw. S. Flier, X. Feng, W. Renooij, W.F.F.A. Buhre, C.J. Kalkman Universitair Medisch Centrum Utrecht 13.00 - 14.30
Lunch / Poster Walk Around groep 3 & 4
Collegezaal 5: 14.30 - 14.50
The efficacy and safety of sugammadex in patients with end-stage renal failure Mw. L.M. Staals, M.M.J. Snoeck, J.J. Driessen UMC St. Radboud Nijmegen
14.50 - 15.10
S(+)-ketamine for treatment of CRPS type 1: A randomized double-blind study in patients and a PK/PD study in healthy volunteers. M. Sigtermans, A.Yassen, E. Olofsen, M. Bauer, E. Sarton, A. Dahan Leids Universitair Medisch Centrum
15.10 - 15.30
Insulin therapy causes hypolipidemia after coronary artery surgery C.J. Zuurbier, F. Hoek, J. van Dijk, N.G. Abeling, J.C.M. Meijers, J.H.M. Levels, E. de Jonge, B.A. de Mol, H.B. van Wezel Academisch Medisch Centrum
15.30 - 15.45
Pauze
Collegezaal 5: 15.45 - 16.30
Xenon for Neuroprotection M. Maze (zie pag. 8)
16.30 - 16.40
Uitreiking award voor beste voordracht
16.40
Afsluiting + aperitief
Posters Groep 1 01
Do Urinary IL-6 Levels Reflect Local Renal Inflammation in Cardiac Surgery with CPB H.E. Mungroop, B.G. Loef, W. van Oeveren, L.P.H.J. Aarts, A.H. Epema Universitair Medisch Centrum Groningen
02
Inhibition of mPTP reverses hyperglycemia blocked cardioprotection by Sevoflurane induced postconditioning in vivo R. Huhn, A. Heinen, N.C. Hauck-Weber, M.W. Hollmann, W. Schlack, B. Preckel Academisch Medisch Centrum Amsterdam (L.E.I.C.A.)
03
Septal thickness as marker for the degree of right ventricular overload in pulmonary hypertensionPain on the PACU Predicts Pain on the Ward Mw. C. Boer, M.C. de Waard, C.T. Gan, A. Vonk-Noordegraaf, D.J. Duncker VU Medisch Centrum Amsterdam
04
Determination of sevoflurane pharmacokinetics during cardiopulmonary bypass A.J.C. Rokx, mw. C. Boer, S.R. Spielenberg, J. Weimann, S.A. Loer, D.P. Veerman, R.A. Lamberts VU Medisch Centrum Amsterdam
05
The beneficial effect of salmeterol in oleic acid injured pig lungs, assessment during 6-h ex-vivo lung perfusion M.H. Fernhout, M.E. Erasmus, L.P.H.J. Aarts Universitair Medisch Centrum Groningen
06
Cardiovascular monitoring by pulse dye densitometry or arterial ICG dilution Mw. M. Reekers, M.J.G. Simon, F. Boer, R.A.G. Mooren, J. Vuyk Leids Universitair Medisch Centrum
07
Postoperative morphine-6-glucuronide versus morphine: equal analgesia but reduced nausea/vomiting E. van Dorp, Mw. E. Sarton, R. Stienstra, J.W. van Kleef, A. Dahan Leids Universitair Medisch Centrum
08
Population pharmacokinetic/pharmacodynamic modeling of epidural Anesthesia A. Dahan E. Olofsen, M. Simon, B.Th. Veering, A.G.L. Burm, J.W. van Kleef Leids Universitair Medisch Centrum
09
Psos compartment block for lower extremity surgery: a systematic review S.T.A. Touray, M.A. de Leeuw, W.W.A. Zuurmond, R.S.G.M. Perez VU Medisch Centrum Amsterdam
10
Prevalence and predictors of post-operative pain in ENT-patients B.K.K. Stessel, M. Sommer, J. Geurts, M. Peters, M. van Kleef, B. Cremer, M. Marcus Academisch Ziekenhuis Maastricht
Groep 2
11
Registration of epiduroscopic findings in patients with chronic low back pain radiating to the leg (CLBP-r) L.M. Dick, F. Wille, A.P. Wolff, G.J. Groen, K.C.P. Vissers UMC St. Radboud Nijmegen
12
Intravenous magnesium sulphate for the treatment of pain in Complex Regional Pain Syndrome type 1 (CRPS1): a pilot study Mw. S. Collins, W.W.A. Zuurmond, S.A. Loer, R.S.G.M. Perez VU Medisch Centrum Amsterdam
13
Pharmacokinetic/pharmacodynamic modeling of the sedative effect of buprenorphine in volunteers A. Dahan, A. Yassen, E. Olofsen Leids Universitair Medisch Centrum
14
Mixed effect modeling of the influence of midazolam on propofol pharmacokinetics B.J. Lichtenbelt, E. Olofsen, J. Vuyk Leids Universitair Medisch Centrum
15
Cardiovascular parameters and liver blood flow after infusion of a colloid solution and epidural administration of ropivacaine 0.75% . The influence of age and level of analgesia. M.J.G. Simon, M. Reekers, B.Th. Veering, F. Boer, A.G.L. Burm, J.W. van Kleef, J. Vuyk Leids Universitair Medisch Centrum
16
Plasticity of central chemoreceptors: effect of bilateral carotid body resection on central CO2 sensitivity A. Dahan, L.J. Teppema, D.J.F. Nieuwenhuijs Leids Universitair Medisch Centrum
17
Intraoperative glucose management in pancreatic surgery G. van Samkar, S.D. Stoker, B. Preckel, M.W. Hollmann Academisch Medisch Centrum Amsterdam
18
Fetal pain can be suppressed with intra amniotic sufentanil J.B. Coonen, W.M.M. Honig, E.A.J. Joosten, M.A.E. Marcus Academisch Ziekenhuis Maastricht
19
Implementation of a postoperative pain protocol at the Academic Hospital Paramaribo (AZP) Mw. A. Schalkwijk, R.T.M. van Dongen UMC St. Radboud Nijmegen
Groep 3
Groep 4
20
Evaluation of the I-gel, a new supra-glottic airway device, in anaesthetized patients: a pilot study M. Erwteman, Mw. N.S. Klaver Westfriesgasthuis Hoorn
21
Inhalation trauma does not affect the fluid balance in ventilated burn E.J. Spoelder, R. Paauw, R.S.G.M. Perez, C. Boer, P. Knape, D.P. Mackie VU Medisch Centrum Amsterdam
22
Patient satisfaction with perioperative care in the eight Dutch university medical centres Mw. M.A.A. Caljouw, M. van Beuzekom, F. Boer Leids Universitair Medisch Centrum
23
Primary caregivers of cancer patients: relationship between caregiver strain in the palliative phase and grief after death Mw. Y.M.P. Engels, S. Nikolaus, Y. Kuin, J.B. Prins, K.C.P. Vissers UMC St. Radboud Nijmegen
24
Reproducing a known animal-model: pitfalls and results Mw. J.L.P. Giele, W.A. van den Brink, F.M. van de Pol, J. van Egmond, K.C.P. Vissers UMC St. Radboud Nijmegen
Wijzigingen voorbehouden
Introductie keynote speakers N.P. Franks Biophysics Section, Blackett Laboratory, Imperial College of Science, Technology and Medicine, South Kensington, London SW7 2AZ, U.K. After my first degree in Physics I worked with Professor Maurice Wilkins (Nobel Laureate in Physiology & Medicine) at King’s College London where I used on X-ray and neutron diffraction to study membrane structure for my PhD, which I completed in 1975. After a short period with Don Caspar at Brandeis University I moved to Imperial College as one of the founding members of the Biophysics Section which was formed in 1977 in the Blackett Laboratory. During my PhD I became interested in how general anaesthetics act and have worked on mechanisms of general anaesthesia ever since. A major accomplishment, made together with my collaborator Bill Lieb, has been to show that the traditional view that general anaesthetics acted by perturbing the structure of neuronal cell membranes, which had dominated this field since the 1890s, was incorrect. By using a combination of enzymology, electrophysiology and X-ray crystallography we have shown that general anaesthetics, despite their chemical diversity, act by directly and selectively binding to a small number of protein targets in the central nervous system, a paradigm that is now widely accepted. We have developed various strategies, including the use of anaesthetic stereoselectivity, to identify which targets are relevant to anaesthesia and which are not and we have helped establish the important role that the GABAA receptor is likely to play. In 1988 we discovered a potassium channel in molluscs which could be selectively activated by inhalational anaesthetics and the mammalian homologues, the two-pore domain superfamily, have recently been shown to be important targets for volatile anaesthetics in mammals. Most recently we have identified the NMDA receptor as a likely target for xenon, and this work has led to investigations into the neuroprotective properties of this “inert” gas. My major current research interest is the relationship between anaesthetic-induced sedation and natural sleep, and have been able to show that anaesthetics act, at least in part, by activating specific neuronal sleep pathways. MOLECULAR MECHANISMS OF GENERAL ANAESTHESIA - CURRENT THINKING Because the potencies of most anaesthetics can be accurately predicted by lipid partitioning (the Meyer-Overton correlation), they have long been considered to be archetypal “non-specific” drugs. However, this view has now changed radically and it is recognised that even the simplest anaesthetics (including the inert gas xenon) can be surprisingly selective in their actions and exert their effects by binding directly to protein targets. Identifying which protein targets are pharmacologically relevant, and
which are not, has been a major challenge, yet great progress has been made in recent years. In this talk I will briefly review the evidence on the nature and identity of anaesthetic binding sites in the central nervous system and show that for some commonly used agents, the relevant targets can be unambiguously identified. If time allows, I will describe experiments that show how certain key nuclei in the brain, which are involved in the regulation of natural sleep, are also involved in the actions of general anaesthetics.
M. Maze After qualifying with a degree in Medicine (conferred with honours) from University of Cape Town, South Africa in 1970, I trained in Internal Medicine initially at the Groote Schuur Hospital in Cape Town, and thereafter at Royal Free Hospital in London under Dame Sheila Sherlock. In 1976 I undertook a three year Postdoctoral Research Fellowship in Biochemical Gastroenterology at Stanford University in California after which I trained there in Anesthesiology, Pain Management and Critical Care Medicine. I joined the faculty at Stanford in 1981 and was funded by both the National Institutes of Health and the Department of Veterans Affairs for the next 20 years to investigate the mechanisms of anesthetic and analgesic action at the molecular and neural substrate levels. I was initially promoted to a tenured position at Stanford in 1987 and became a full Professor at the same institution in 1993. I was recruited back to the UK in 1999 and continue to chair the Department of Anaesthetics, Pain Medicine and Intensive Care at Imperial College, London until the present. In studying the mechanism of the anesthetic action of alpha-2 adrenergic agonists we were the first to prove in a living organism the Franks and Lieb’s prediction that species of proteins were the site of action in a series of studies involving pharmacologic and genetic manipulations. Having established the transmembrane signalling pathway involved in the hypnotic action of alpha-2 agonists, in collaboration with Nick Franks we demonstrated that the neural substrates for its hypnotic action converge on the endogenous sleep pathway providing a clinical state similar to non-REM sleep and is associated with the same physiological benefits of restoration and repair as is present in natural sleep. This has led to the adoption of alpha-2 agonists for providing sedation in the setting of the intensive care unit. Several other insights have been gained from our studies into the action of general anesthetics that have been translated into clinical utility. In the case of Nitrous Oxide we have found that the analgesic mechanism is dependent on activation of a descending noradrenergic pathway that interrupts pain signalling at the level of the dorsal horn. Because the functional connectivity is not mature at the time of birth, we predicted, and then established that nitrous oxide is ineffective as an analgesic in this setting. Following the discovery that xenon is an NMDA antagonist, Nick Franks, Daqing Ma, and I have undertaken a series of investigations to establish that xenon is an effective and non-toxic neuroprotectant; these findings has led to the preparation for an FDA filing of of an IND for xenon’s neuroprotective effects. My current positions are the Sir Ivan Magill Chair of Anaesthesia, the Director of Research and Development for the Chelsea and Westminster, NHS Hospital Trust (C&W), and the Campus Dean for Imperial College at C&W. I have received Fellowships from the Royal College of Physicians, the Royal College of Anaesthetists, and the Academy of Medical Sciences. In 2003 I received the Excellence in Research Award from the American Society of Anesthesiology.
Aantekeningen
Aantekeningen
