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Where and How Does the Anesthetic Process Help or Hurt Patients Independent of Producing Anesthesia?

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The Wondrous Story of Anesthesia
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Abstract

This chapter provides exemplars of good and bad outcomes that can result from anesthesia and anesthetists. In the 1850s, Snow determined that chloroform could kill by “cardiac syncope.” In the 1930s, Lundy guided the banking and administration of blood, and Lundy and Rovenstine established pain clinics. In the 1970s, Bonica established pain as a subspecialty. Ibsen’s response to the terrible 1952 Copenhagen polio epidemic, manual support of breathing, led to intensive care units, ventilator development, and the creation of modern blood-gas analysis by Astrup and Severinghaus. In 1953, Apgar devised her “score”, a number describing the neonate’s condition. In 1956, Lassen showed the lethality of prolonged nitrous oxide administration. Later investigators suggested health hazards to occupational exposure to nitrous oxide.

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References

  1. Snow J. On Chloroform and other anaesthetics: their action and administration. London: John Churchill; 1858. pp. 1–443.

    Google Scholar 

  2. Snow J. On the inhalation of the vapour of ether in surgical operations: containing a description of the various stages of etherization, and a statement of the result of nearly eighty operations in which ether has been employed in St. George’s and University College Hospitals. London: John Churchill; 1847. pp. 1–88.

    Google Scholar 

  3. Sayres LA. Two cases of traumatic tetanus. New York J Med. 1858;4:250–3.

    Google Scholar 

  4. Lassen HC, Bjorneboe M, Ibsen B, Neukirch F. Treatment of tetanus with curarisation, general anaesthesia, and intratracheal positive-pressure ventilation. Lancet. 1954;267:1040–4.

    Article  CAS  PubMed  Google Scholar 

  5. Honey GE, Dwyer BE, Smith AC, Spalding JM. Tetanus treated with tubocurarine and intermittent positive-pressure respiration. Brit Med J. 1954;2:442–3.

    Article  CAS  PubMed  Google Scholar 

  6. Rabbitts JA, Bacon DR, Nuttall GA, Moore SB. Mayo Clinic and the origins of blood banking. Mayo Clin Proc. 2007;82:1117–8.

    Article  PubMed  Google Scholar 

  7. Boyan CP, Howland WS. Cardiac arrest and temperature of bank blood. JAMA. 1963;183:58–60.

    Article  CAS  PubMed  Google Scholar 

  8. Miller RD, Robbins TO, Tong MJ, Barton SL. Coagulation defects associated with massive blood transfusions. Ann Surg. 1971;174:794–801.

    Article  CAS  PubMed  Google Scholar 

  9. Koch CG, Li L, Duncan AI, Mihaljevic T, Loop FD, Starr NJ, Blackstone EH. Transfusion in coronary artery bypass grafting is associated with reduced long-term survival. Ann Thorac Surg. 2006;81:1650–7.

    Article  PubMed  Google Scholar 

  10. Wang D, Sun J, Solomon SB, Klein HG, Natanson C. Transfusion of older stored blood and risk of death: a meta-analysis. Transfusion. 2012;52:1184–95.

    Article  PubMed  Google Scholar 

  11. Weiskopf RB, Feiner J, Hopf H, Lieberman J, Finlay HE, Quah C, Kramer JH, Bostrom A, Toy P. Fresh blood and aged stored blood are equally efficacious in immediately reversing anemia-induced brain oxygenation deficits in humans. Anesthesiology. 2006;104:911–20.

    Article  PubMed  Google Scholar 

  12. Sen S, Martin DP, Bacon DR. Exploring origins: was John Bonica’s model of modern-day pain management influenced by John Lundy’s earlier work? Reg Anesth Pain Med. 2007;32:258–62.

    PubMed  Google Scholar 

  13. Jacob AK, Kopp SL, Bacon DR, Smith HM. The history of anesthesia. In: Barash PG, Cullen BF, Stoelting RK, Cahalan M, Stock MC, editors. Clinical anesthesia. Philadelphia: Wolters Kluwer, Lippincott Williams & Wilkins. 2009. pp. 3–26.

    Google Scholar 

  14. Liebeskind JC, Meldrum ML, John JB. World champion of pain. In: Jensen TS, Turner JA, Wiesenfeld-Hallin Z, editors. Proceedings of the Eighth World Congress on Pain: Progress in pain research and management. Vol 8. Seattle: International Association for the Study of Pain Press; 1997. pp. 19–32.

    Google Scholar 

  15. Beecher HK. Pain in men wounded in battle. Ann Surg. 1946;123:96–105.

    Article  CAS  PubMed  Google Scholar 

  16. Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150:971–9.

    Article  CAS  PubMed  Google Scholar 

  17. Beecher HK. The powerful placebo. JAMA. 1955;159:1602–6.

    Article  CAS  Google Scholar 

  18. Beecher HK. Experimentation in man. JAMA. 1959;169:461–78.

    Article  CAS  Google Scholar 

  19. Kopp VJ. Henry Knowles Beecher and the development of informed consent in anesthesia research. Anesthesiology. 1999;90:1756–65.

    Article  CAS  PubMed  Google Scholar 

  20. A definition of irreversible coma. Report of the Ad Hoc Committee of the Harvard Medical School to examine the definition of brain death. JAMA. 1968;205:337–40.

    Google Scholar 

  21. Bentolila L. General anesthesia with cyclopropane for the treatment of status asthmaticus. Ann Allergy. 1951;9:519–21.

    CAS  PubMed  Google Scholar 

  22. Kofke WA, Snider MT, Young RS, Ramer JC. Prolonged low flow isoflurane anesthesia for status epilepticus. Anesthesiology. 1985;62:653–6.

    Article  CAS  PubMed  Google Scholar 

  23. Loi du 6 janvier 1986 relative à l’aide médicale urgente et aux transport sanitaires. Journal Officiel de la République Française 7 janvier 1986.

    Google Scholar 

  24. West JB. The physiological challenges of the 1952 Copenhagen poliomyelitis epidemic and a renaissance in clinical respiratory physiology. J Appl Physiol. 2005;99:424–32.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Astrup P. A simple electrometric technique for the determination of carbon dioxide tension in blood and plasma, total content of carbon dioxide in plasma and bicarbonate content in “separated” plasma at a fixed carbon dioxide tension. Scand J Clin Lab Invest. 1956;8:33–44.

    Article  CAS  PubMed  Google Scholar 

  26. Berthelsen PG, Cronqvist M. The first intensive care unit in the world: Copenhagen 1953. Acta Anaesthesiol Scand. 2003;47:1190–5.

    Google Scholar 

  27. Apgar V. Oxygen as a supportive therapy in fetal anoxia. Bull N Y Acad Med. 1950;26:474–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg. 1953;32:260–7.

    CAS  PubMed  Google Scholar 

  29. Stow RW, Randall BF. Electrical measurement of the PCO2 of blood. Am J Physiol. 1954;179:678 (abstract).

    Google Scholar 

  30. Severinghaus JW. Gadgeteering for health care: the John W. Severinghaus lecture on translational science. Anesthesiology. 2009;110:721–8.

    Article  PubMed  Google Scholar 

  31. Clark LC. Monitor and control of blood and tissue O2 tensions. Trans Am Soc Artif Intern Organs. 1956;2:41–8.

    Google Scholar 

  32. Severinghaus JW, Bradley AF. Electrodes for blood pO2 and pCO2 determination. J Appl Physiol. 1958;13:515–20.

    CAS  PubMed  Google Scholar 

  33. Severinghaus JW. Electrodes for blood and gas PCO2, PO2, and blood pH. Acta Anesth Scand Suppl. 1962;11:207–20.

    Article  CAS  Google Scholar 

  34. Lassen HCA, Henriksen E, Neukirch F, Kristensen HS. Treatment of tetanus. Severe bone-marrow depression after prolonged nitrous-oxide anaesthesia. Lancet. 1956;1:527–30.

    Article  Google Scholar 

  35. Banks RGS, Henderson RJ, Pratt JM. Reactions of gases in solution. III. Some reactions of nitrous oxide with transition-metal complexes. J Chem Soc Sec (A). 1968;3:2886–90.

    Article  Google Scholar 

  36. Koblin DD, Watson JE, Deady JE, Stokstad ELR, Eger EII. Inactivation of methionine synthetase by nitrous oxide in mice. Anesthesiology. 1981;54:318–24.

    Article  CAS  PubMed  Google Scholar 

  37. Selzer RR, Rosenblatt DS, Laxova R, Hogan K. Adverse effect of nitrous oxide in a child with 5,10-methylenetetrahydrofolate reductase deficiency. N Engl J Med. 2003;349:45–50.

    Article  PubMed  Google Scholar 

  38. Hunt TK. A new method of determining tissue oxygen tension. Lancet. 1964;2:1370–1.

    Article  CAS  PubMed  Google Scholar 

  39. Hopf HW, Hunt TK, West JM, Blomquist P, Goodson WH 3rd, Jensen JA, Jonsson K, Paty PB, Rabkin JM, Upton RA, Smitten K von, Whitney JD. Wound tissue oxygen tension predicts the risk of wound infection in surgical patients. Arch Surg. 1997;132:997–1004; discussion 1005

    Article  CAS  PubMed  Google Scholar 

  40. Huch R, Huch A, Lubbers DW. Transcutaneous measurement of blood Po2 (tcPo2)’method and application in perinatal medicine. J Perinat Med. 1973;1:183–91.

    Article  CAS  PubMed  Google Scholar 

  41. Huch R, Lubbers DW, Huch A. Quantitative continuous measurement of partial oxygen pressure on the skin of adults and new-born babies. Pflugers Arch. 1972;337:185–98.

    Article  CAS  PubMed  Google Scholar 

  42. Severinghaus JW, Stafford M, Bradley AF. tcPCO2 electrode design, calibration and temperature gradient problems. Acta Anaesthesiol Scand Suppl. 1978;68:118–22.

    Article  CAS  PubMed  Google Scholar 

  43. Beran AV, Huxtable RF. Sperling DR: Electrochemical sensor for continuous transcutaneous PCO2 measurement. J Appl Physiol. 1976;41:442–7.

    CAS  PubMed  Google Scholar 

  44. Severinghaus JW. A combined transcutaneous PO2-PCO2 electrode with electrochemical HCO3- stabilization. J Appl Physiol. 1981;51:1027–32.

    CAS  PubMed  Google Scholar 

  45. Hauser CJ, Shoemaker WC. Use of a transcutaneous PO2 regional perfusion index to quantify tissue perfusion in peripheral vascular disease. Ann Surg. 1983;197:337–43.

    Article  CAS  PubMed  Google Scholar 

  46. Fife CE, Buyukcakir C, Otto GH, Sheffield PJ, Warriner RA, Love TL, Mader J. The predictive value of transcutaneous oxygen tension measurement in diabetic lower extremity ulcers treated with hyperbaric oxygen therapy: a retrospective analysis of 1,144 patients. Wound Repair Regen. 2002;10:198–207.

    Article  PubMed  Google Scholar 

  47. Fife CE, Smart DR, Sheffield PJ, Hopf HW, Hawkins G, Clarke D. Transcutaneous oximetry in clinical practice: consensus statements from an expert panel based on evidence. Undersea Hyperb Med. 2009;36:43–53.

    CAS  PubMed  Google Scholar 

  48. Johnston RR, Eger EI II, Wilson C. A comparative interaction of epinephrine with enflurane, isoflurane, and halothane in man. Anesth Analg. 1976;55:709–12.

    Article  CAS  PubMed  Google Scholar 

  49. Deutsch E, Berger M, Kussmaul WG, Hirshfeld JW Jr, Herrmann HC, Laskey WK. Adaptation to ischemia during percutaneous transluminal coronary angioplasty: clinical, hemodynamic, and metabolic features. Circulation. 1990;82:2044–51.

    Article  CAS  PubMed  Google Scholar 

  50. Freedman BM, Hamm DP, Everson CT, Wechsler AS, Christian CM 2nd. Enflurane enhances postischemic functional recovery in the isolated rat heart. Anesthesiology. 1985;62:29–33.

    Article  CAS  PubMed  Google Scholar 

  51. Zaugg M, Lucchinetti E, Uecker M, Pasch T, Schaub MC. Anaesthetics and cardiac preconditioning. Part I. Signalling and cytoprotective mechanisms. Br J Anaesth. 2003;91:551–65.

    Article  CAS  PubMed  Google Scholar 

  52. Zaugg M, Lucchinetti E, Garcia C, Pasch T, Spahn DR, Schaub MC. Anaesthetics and cardiac preconditioning. Part II. Clinical implications. Br J Anaesth. 2003;91:566–76.

    Article  CAS  PubMed  Google Scholar 

  53. Cahalan MK, Litt L, Botvinick EH, Schiller NB. Advances in noninvasive cardiovascular imaging: implications for the anesthesiologist. Anesthesiology. 1987;66:356–72.

    Article  CAS  PubMed  Google Scholar 

  54. Hartmann M, Jonsson K, Zederfeldt B. Effect of tissue perfusion and oxygenation on accumulation of collagen in healing wounds. Randomized study in patients after major abdominal operations. Eur J Surg. 1992;158:521–6.

    CAS  PubMed  Google Scholar 

  55. Chappell D, Jacob M, Hofmann-Kiefer K, Conzen P, Rehm M. A rational approach to perioperative fluid management. Anesthesiology. 2008;109:723–40.

    Article  PubMed  Google Scholar 

  56. Greif R, Akca O, Horn EP, Kurz A, Sessler DI. Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection. Outcomes Research Group. N Engl J Med. 2000;342:161–7.

    Article  CAS  PubMed  Google Scholar 

  57. Meyhoff CS, Jorgensen LN, Wetterslev J, Christensen KB, Rasmussen LS. Increased long-term mortality after a high perioperative inspiratory oxygen fraction during abdominal surgery: follow-up of a randomized clinical trial. Anesth Analg. 2012;115:849–54.

    Article  PubMed  Google Scholar 

  58. Langer G, Neumark J, Koinig G, Graf M, Schoenbeck G. Rapid psychotherapeutic effects of anesthesia with isoflurane (ED narcotherapy) in treatment-refractory depressed patients. Neuropsychobiology. 1985;14:118–20.

    Article  CAS  PubMed  Google Scholar 

  59. Langer G, Karazman R, Neumark J, Saletu B, Schoenbeck G, Gruenberger J, Dittrich R, Petricek W, hoffmann P, Linzmayer L, Anderer P, Steinberger K. Isoflurane narcotherapy in depressive patients refractory to conventional antidepressant drug treatment. A double-blind comparison with electroconvulsive treatment. Neuropsychobiology. 1995;31:182–94.

    Article  CAS  PubMed  Google Scholar 

  60. Engelhardt W, Carl G, Hartung E. Intra-individual open comparison of burst-suppression-isoflurane-anaesthesia versus electroconvulsive therapy in the treatment of severe depression. Eur J Anaesthesiol. 1993;10:113–8.

    CAS  PubMed  Google Scholar 

  61. Tadler S, Weeks HR, Smith KW, Iacob E, Cahalan MK, Bushnell L, Sakata D, Light KC. Isoflurane treatment of depression. Anesthesiology. 2011;115:A002 (abstract).

    Google Scholar 

  62. Weeks HR III, Tadler SC, Smith KW, Iacob E, Saccoman M, et al. Neurocognitive effects of isoflurane anesthesia versus electroconvulsive therapy in refractory depression. PLos ONE 8:e69809. doi:10.1371/journal.pone.0069809

    Google Scholar 

  63. Ibrahim L, Diazgranados N, Luckenbaugh DA, Machado-Vieira R, Baumann J, Mallinger AG, Zarate CA Jr. Rapid decrease in depressive symptoms with an N-methyl-d-aspartate antagonist in ECT-resistant major depression. Prog Neuro-Psychopharm Biol Psych. 2011;35:1155–9.

    Article  CAS  Google Scholar 

  64. Ishimaru M, Fukamauchi F, Olney JW. Halothane prevents MK-801 neurotoxicity in the rat cingulate cortex. Neurosci Lett. 1995;193:1–4.

    Article  CAS  PubMed  Google Scholar 

  65. Jevtovic-Todorovic V, Kirby CO, Olney JW. Isoflurane and propofol block neurotoxicity caused by MK-801 in the rat posterior cingulate/retrosplenial cortex. J Cerebral Bld Flow Metab. 1997;17:168–74.

    Google Scholar 

  66. Jevtovic-Todorovic V, Hartman RE, Izumi Y, Benshoff ND, Dikranian K, Zorumski CF, Olney JW, Wozniak DF. Early exposure to common anesthetic agents causes widespread neurodegeneration in the developing rat brain and persistent learning deficits. J Neurosci. 2003;23:876–82.

    CAS  PubMed  Google Scholar 

  67. Jevtovic-Todorovic V, Beals J, Benshoff N, Olney JW. Prolonged exposure to inhalational anesthetic nitrous oxide kills neurons in adult rat brain. Neuroscience. 2003;122:609–16.

    Article  CAS  PubMed  Google Scholar 

  68. Moller JT, Cluitmans P, Rasmussen LS, Houx P, Rasmussen H, Canet J, Rabbitt P, Jolles J, Larsen K, Hanning CD, Langeron O, Johnson T, Lauven PM, Kristensen PA, Biedler A, Beem H van, Fraidakis O, Silverstein JH, Beneken JE, Gravenstein JS. Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study of Post-Operative Cognitive Dysfunction. Lancet. 1998;351:857–61.

    Article  CAS  PubMed  Google Scholar 

  69. Rasmussen LS, Johnson T, Kuipers HM, Kristensen D, Siersma VD, Vila P, Jolles J, Papaioannou A, Abildstrom H, Silverstein JH, Bonal JA, Raeder J, Nielsen IK, Korttila K, Munoz L, Dodds C, Hanning CD, Moller JT. Does anaesthesia cause postoperative cognitive dysfunction? A randomised study of regional versus general anaesthesia in 438 elderly patients. Acta Anaesthesiol Scand 2003;47:260–6.

    Google Scholar 

  70. Ramsay JG, Rappaport BA. SmartTots: a multidisciplinary effort to determine anesthetic safety in young children. Anesth Analg. 2011;113:963–4.

    Article  PubMed  Google Scholar 

  71. Weiskopf RB, Viele MK, Feiner J, Kelley S, Lieberman J, Noorani M, Leung JM, Fisher DM, Murray WR, Toy P, Moore MA. Human cardiovascular and metabolic response to acute, severe isovolemic anemia. JAMA. 1998;279:217–21.

    Article  CAS  PubMed  Google Scholar 

  72. Sessler DI, Olofsson CI, Rubinstein EH, Beebe JJ. The thermoregulatory threshold during halothane anesthesia in humans. Anesthesiology. 1988;68:836–42.

    Article  CAS  PubMed  Google Scholar 

  73. Augustine SD. The Bair Hugger patient warming system. J Post Anesth Nurs. 1991;6:2–4.

    CAS  PubMed  Google Scholar 

  74. Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med. 1996;334:1209–15.

    Article  CAS  PubMed  Google Scholar 

  75. Schmied H, Kurz A, Sessler DI, Kozek S, Reiter A. Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet. 1996;347:289–92.

    Article  CAS  PubMed  Google Scholar 

  76. Sessler DI, Moayeri A. Skin-surface warming: heat flux and central temperature. Anesthesiology. 1990;73:218–24.

    Article  CAS  PubMed  Google Scholar 

  77. Lindblad B, Eriksson A, Bergqvist D. Autopsy-verified pulmonary embolism in a surgical department: analysis of the period from 1951 to 1988. Br J Surg. 1991;78:849–52.

    Article  CAS  PubMed  Google Scholar 

  78. Sandler DA, Martin JF. Autopsy proven pulmonary embolism in hospital patients: are we detecting enough deep vein thrombosis? J Roy Soc Med. 1989;82:203–5.

    CAS  PubMed  Google Scholar 

  79. Anderson FA, Audet A-M. Best practices. Preventing deep vein thrombosis and pulmonary embolism. A practical guide to evaluation and improvement. University of Massachussets Medical School Centre for Outcomes Research. 1998.http://www.outcomes-umassmed.org/dvt/best_practice/. Last accessed 23 May 2012.

  80. http://en.wikipedia.org/wiki/Montreal_Protocol. Accessed 23 May 2012.

  81. Langbein T, Sonntag H, Trapp D, Hoffmann A, Malms W, Roth E-P, Mors V, Zellner R. Volatile anaesthetics and the atmosphere: atmospheric lifetimes and atmospheric effects of halothane, enflurane, isoflurane, desflurane and sevoflurane. Br J Anaesth. 1999;82:66–73.

    Article  CAS  PubMed  Google Scholar 

  82. Luft K. Über eine neue Methode der registrierenden Gasanalyse mit Hilfe der Absorption ultraroter Strahlen ohne spektrale Zerlegung. Ztschrf Techn Phys. 1943;24:97–104.

    CAS  Google Scholar 

  83. Dale O, Dale T. Anesthetic gases, the ozone layer and the greenhouse effect. How harmful are the anesthetic emissions for the global environment? Tidsskr Nor Laegeforen. 1991;111:2115–7.

    CAS  PubMed  Google Scholar 

  84. Ryan SM, Nielsen CJ. Global warming potential of inhaled anesthetics: application to clinical use. Anesth Analg. 2010;111:92–8.

    PubMed  Google Scholar 

  85. Ryan S, Sherman J. Sustainable anesthesia. Anesth Analg. 2012;114:921–3.

    Article  PubMed  Google Scholar 

  86. Andersen MP, Nielsen OJ, Wallington TJ, Karpichev B, Sander SP. Medical intelligence article: assessing the impact on global climate from general anesthetic gases. Anesth Analg. 2012;114:1081–5.

    Article  CAS  Google Scholar 

  87. Sherman JD, Ryan S. Ecological responsibility in anesthesia practice. Int Anesthesiol Clin. 2010;48:139–51.

    Article  PubMed  Google Scholar 

  88. Petrucci N, Iacovelli W. Ventilation with lower tidal volumes versus traditional tidal volumes in adults for acute lung injury and acute respiratory distress syndrome. Cochrane database of systematic reviews 2003: CD003844.

    Google Scholar 

  89. Mascia L, Zavala E, Bosma K, Pasero D, Decaroli D, Andrews P, Isnardi D, Davi A, Arguis MJ, Berardino M, Ducati A. High tidal volume is associated with the development of acute lung injury after severe brain injury: an international observational study. Crit Care Med. 2007;35:1815–20.

    Article  PubMed  Google Scholar 

  90. Meade MO, Cook DJ, Guyatt GH, Slutsky AS, Arabi YM, Cooper DJ, Davies AR, Hand LE, Zhou Q, Thabane L, Austin P, Lapinsky S, Baxter A, Russell J, Skrobik Y, Ronco JJ, Stewart TE. Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA. 2008;299:637–45.

    Article  CAS  PubMed  Google Scholar 

  91. Lellouche F, Dionne S, Simard S, Bussieres J, Dagenais F. High tidal volumes in mechanically ventilated patients increase organ dysfunction after cardiac surgery. Anesthesiology. 2012;116:1072–82.

    Article  PubMed  Google Scholar 

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Hopf, H. (2014). Where and How Does the Anesthetic Process Help or Hurt Patients Independent of Producing Anesthesia?. In: Eger II, E., Saidman, L., Westhorpe, R. (eds) The Wondrous Story of Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8441-7_42

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