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Volatile anesthetics desflurane

Kátina M Souza, Leandro G Braz, Flávia R Nogueira, Marajane B Souza, Lahis F Bincoleto, Aline G Aun, José E Corrente, Lídia R Carvalho, José Reinaldo C Braz, Mariana G Braz
Data on the genotoxic and mutagenic effects of occupational exposure to the most frequently used volatile anesthetics are limited and controversial. The current study is the first to evaluate genomic instability, cell death and proliferative index in exfoliated buccal cells (EBC) from anesthesiologists. We also evaluated DNA damage and determined the concentrations of the anesthetic gases most commonly used in operating rooms. This study was conducted on physicians who were allocated into two groups: the exposed group, which consisted of anesthesiologists who had been exposed to waste anesthetic gases (isoflurane, sevoflurane, desflurane and nitrous oxide - N2O) for at least two years; and the control group, which consisted of non-exposed physicians matched for age, sex and lifestyle with the exposed group...
September 2016: Mutation Research
Julie K Drobish, Zoe S Gan, Amanda D Cornfeld, Maryellen F Eckenhoff
Volatile anesthetics can cause neuronal and glial toxicity in the developing mammalian brain, as well as long-term defects in learning and memory. The goals of this study were to compare anesthetics using a clinically relevant exposure paradigm, and to assess the anesthetic effects on hippocampal development and behavior. Our hypothesis was that volatile anesthetics disrupt hippocampal development, causing neurobehavioral defects later in life. Bromodeoxyuridine (BrdU) was administered to rats on postnatal day (P)1, and the rats were exposed to volatile anesthetics (isoflurane, sevoflurane, or desflurane) for 2 hours on P2...
August 25, 2016: Toxicological Sciences: An Official Journal of the Society of Toxicology
Hyun-Joung No, Bon-Wook Koo, Ah-Young Oh, Kwang-Suk Seo, Hyo-Seok Na, Jung-Hee Ryu, Soo-Won Lee
Desflurane is the most pungent of the currently used volatile anesthetics. We assessed whether the incidence of perioperative upper respiratory events in children undergoing general anesthesia via a supraglottic airway is higher with desflurane than with sevoflurane as maintenance anesthetic.We retrospectively reviewed and analyzed the electronic medical records of consecutive children 1 to 15 years of age who underwent general anesthesia via a supraglottic airway at Seoul National University Bundang Hospital between June 2013 and June 2015...
July 2016: Medicine (Baltimore)
Hagen Bomberg, Marcel Wessendorf, Martin Bellgardt, Max Veddeler, Stefan Wagenpfeil, Thomas Volk, Heinrich V Groesdonk, Andreas Meiser
With the AnaConDa™ and the MIRUS™ system, volatile anesthetics can be administered for inhalation sedation in intensive care units. Instead of a circle system, both devices use anesthetic reflectors to save on the anesthetic agent. We studied the efficiency of desflurane reflection with both devices using different tidal volumes (VT), respiratory rates (RR), and 'patient' concentrations (CPat) in a bench study. A test lung was ventilated with four settings (volume control, RR × VT: 10 × 300 mL, 10 × 500 mL, 20 × 500 mL, 10 × 1000 mL)...
July 8, 2016: Journal of Clinical Monitoring and Computing
Thomas Kiss, Thomas Bluth, Marcelo Gama de Abreu
PURPOSE OF REVIEW: The perioperative care of obese patients can often be challenging, as the presence of comorbidities is common in this patient population. In this article, we present recent data on perioperative complications of obese patients and discuss relevant details for daily practice, including drug dosing, airway management, and mechanical ventilation. RECENT FINDINGS: The volatile agent desflurane reduces extubation time, without major effects on postoperative anesthesia care unit discharge time, incidence of postoperative nausea and vomiting, or postoperative pain scores compared with other volatile anesthetics...
August 2016: Current Opinion in Critical Care
Sara K Cheung, Timur Özelsel, Saifee Rashiq, Ban C Tsui
PURPOSE: This study was designed to compare waste anesthetic gas (WAG) concentrations within patients' breathing zones after removal of the patient's airway device in the postanesthesia care unit (PACU) vs in the operating room (OR). METHODS: Following Research Ethics Board approval and patient consent, we recruited patients undergoing surgery who received volatile anesthesia via an endotracheal tube or supraglottic airway. Patients had their airway device removed in the OR or in the PACU depending on the attending anesthesiologist's preference...
September 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Mina Mehrata, Carol Moralejo, William A Anderson
For the development of emission control strategies, activated carbon, zeolite, molecular sieves, and a silica gel were tested for adsorption of the newer anesthetic gases isoflurane, sevoflurane, and desflurane from air. The activated carbon Norit GCA 48 was selected for the best performance, and adsorption isotherms at room temperature were developed for the three anesthetics. Equilibrium capacities for this carbon were in the range of 500 to 1,000 mg g(-1) for these anesthetics at partial pressures ranging from 5 to 45 Torr, with the most volatile compound (desflurane) showing the least favorable adsorption...
August 23, 2016: Journal of Environmental Science and Health. Part A, Toxic/hazardous Substances & Environmental Engineering
Beatrice Beck-Schimmer, John M Bonvini, Julia Braun, Manfred Seeberger, Thomas A Neff, Tobias J Risch, Frank Stüber, Andreas Vogt, Walter Weder, Didier Schneiter, Miodrag Filipovic, Milo Puhan
BACKGROUND: One-lung ventilation during thoracic surgery is associated with hypoxia-reoxygenation injury in the deflated and subsequently reventilated lung. Numerous studies have reported volatile anesthesia-induced attenuation of inflammatory responses in such scenarios. If the effect also extends to clinical outcome is yet undetermined. We hypothesized that volatile anesthesia is superior to intravenous anesthesia regarding postoperative complications. METHODS: Five centers in Switzerland participated in the randomized controlled trial...
August 2016: Anesthesiology
Laura K Diaz, J William Gaynor, Shannon J Koh, Richard F Ittenbach, Marsha Gerdes, Judy C Bernbaum, Elaine H Zackai, Robert R Clancy, Mohamed A Rehman, Jeffrey W Pennington, Nancy Burnham, Thomas L Spray, Susan C Nicolson
OBJECTIVES: Despite improved survival in children with hypoplastic left heart syndrome (HLHS), significant concern persists regarding their neurodevelopmental (ND) outcomes. Previous studies have identified patient factors, such as prematurity and genetic syndromes, to be associated with worse ND outcomes. However, no consistent relationships have been identified among modifiable management factors, including cardiopulmonary bypass strategies, and ND outcomes after cardiac surgery in infancy...
August 2016: Journal of Thoracic and Cardiovascular Surgery
Christopher Uhlig, Thomas Bluth, Kristin Schwarz, Stefanie Deckert, Luise Heinrich, Stefan De Hert, Giovanni Landoni, Ary Serpa Neto, Marcus J Schultz, Paolo Pelosi, Jochen Schmitt, Marcelo Gama de Abreu
BACKGROUND: It is not known whether modern volatile anesthetics are associated with less mortality and postoperative pulmonary or other complications in patients undergoing general anesthesia for surgery. METHODS: A systematic literature review was conducted for randomized controlled trials fulfilling following criteria: (1) population: adult patients undergoing general anesthesia for surgery; (2) intervention: patients receiving sevoflurane, desflurane, or isoflurane; (3) comparison: volatile anesthetics versus total IV anesthesia or volatile anesthetics; (4) reporting on: (a) mortality (primary outcome) and (b) postoperative pulmonary or other complications; (5) study design: randomized controlled trials...
June 2016: Anesthesiology
Flávia R Nogueira, Leandro G Braz, Leonardo R de Andrade, Ana Lygia R de Carvalho, Luiz A Vane, Norma Sueli P Módolo, Aline G Aun, Kátina M Souza, José Reinaldo C Braz, Mariana G Braz
There is controversy over the genotoxic effects of volatile anesthetics. The available literature on the genotoxicity of desflurane, one of the newest volatile halogenated agents used for general anesthesia maintenance, is scarce. This study aimed to evaluate the genotoxic potential of desflurane in 15 patients without comorbidities, of both sexes, who underwent minor surgeries lasting at least 90 min. Patients enrolled in the study received desflurane anesthesia (6%); blood samples were collected before anesthesia induction (T0), 90 min after the beginning of anesthesia (T1), and on the day following surgery (T2)...
May 2016: Environmental and Molecular Mutagenesis
Masae Iwasaki, Hailin Zhao, Tanweer Jaffer, Sandeep Unwith, Laura Benzonana, Qingquan Lian, Atsuhiro Sakamoto, Daqing Ma
The majority of ovarian cancer patients relapse after surgical resection. Evidence is accumulating regarding the role of surgery in disseminating cancer cells; in particular anaesthesia may have an impact on cancer re-occurrence. Here, we have investigated the metastatic potential of volatile anaesthetics isoflurane, sevoflurane and desflurane on ovarian cancer cells. Human ovarian carcinoma cells (SKOV3) were exposed to isoflurane (2%), sevoflurane (3.6%) or desflurane (10.3%) for 2 hours. Metastatic related gene expression profiles were measured using the Tumour Metastasis PCR Array and qRT-PCR...
May 3, 2016: Oncotarget
Wenguo Fan, Qin Liu, Xiao Zhu, Zhi Wu, Dongpei Li, Fang Huang, Hongwen He
Nitric oxide (NO) is a free radical gas in the biological system, which is produced by nitric oxide synthase (NOS) family. NO acts as a biological mediator and plays important roles in different systems in humans. The NO/NOS system exerts a broad spectrum of signaling functions involved in vasodilation, inflammation, oxidative stress, cardioprotection and neuroprotection. It has been demonstrated that intravenous and volatile anesthetics (such as propofol, ketamine, midazolam, isoflurane, sevoflurane, and desflurane, etc...
April 15, 2016: Life Sciences
Richard H Epstein, Franklin Dexter, David P Maguire, Niraj K Agarwalla, David M Gratch
BACKGROUND: Reducing fresh gas flow (FGF) during general anesthesia reduces costs by decreasing the consumption of volatile anesthetics and attenuates their contribution to greenhouse gas pollution of the environment. The sevoflurane FGF recommendations in the Food and Drug Administration package insert relate to concern over potential toxicity from accumulation in the breathing circuit of compound A, a by-product of the reaction of the volatile agent with legacy carbon dioxide absorbents containing strong alkali such as sodium or potassium hydroxide...
April 2016: Anesthesia and Analgesia
Ikuomi Mikuni, Shuto Harada, Ryuta Yakushiji, Hiroshi Iwasaki
PURPOSE: Desflurane has the lowest solubility of currently available volatile anesthetics and may allow for more rapid emergence and recovery compared with sevoflurane. Nevertheless, after volatile induction with sevoflurane, it has not been determined whether the use of desflurane provides faster emergence and recovery. The present study aimed to elucidate the effects of changing from sevoflurane to desflurane during the early part of anesthesia. METHODS: Fifty-two patients who were scheduled for vitreous surgery with general anesthesia were enrolled in this randomized controlled study...
March 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Moritz Kretzschmar, Alf Kozian, James E Baumgardner, Jens Schreiber, Göran Hedenstierna, Anders Larsson, Thomas Hachenberg, Thomas Schilling
Bronchoconstriction is a hallmark of asthma and impairs gas exchange. We hypothesized that pharmacokinetics of volatile anesthetics would be affected by bronchoconstriction. Ventilation/perfusion (VA/Q) ratios and pharmacokinetics of desflurane in both healthy state and during inhalational administration of methacholine (MCh) to double peak airway pressure were studied in a piglet model. In piglets, MCh administration by inhalation (100 μg/ml, n=6) increased respiratory resistance, impaired VA/Q distribution, increased shunt, and decreased paO2 in all animals...
January 2016: Respiratory Physiology & Neurobiology
Vyacheslav Yu Cherebillo, Andrei Yu Elizarov, Andrei V Polegaev
A possibility to use the Membrane-Introduction Mass Spectrometry (MIMS) with membrane separator interface has evolved into a powerful method for measurement of anaesthetic agents absolute concentration in blood plasma and cerebrospinal fluid for the study of blood-brain barrier (BBB) properties. Recent advanced a new membrane material was used for drug concentration measurement in biologic fluids. A hydrophobic membrane was used in the interface to separate anaesthetic agents from biological fluids: inhalational anaesthetic desflurane,hypnotic propofol, analgesic fentanyl...
September 2015: Experimental Neurobiology
Jiwon Lee, Yong-Jae Yoo, Jung-Man Lee, Young Jae Park, Ho Geol Ryu
BACKGROUND: Various interventions to reduce postreperfusion syndrome during liver transplantation have been explored, but the effect of volatile anesthetics used during liver transplantation on the incidence of postreperfusion syndrome has not been evaluated. A randomized controlled trial was performed to compare the incidence of postreperfusion syndrome between 2 commonly used volatile anesthetics, sevoflurane and desflurane. METHODS: Sixty-two adult liver recipients scheduled for living-donor liver transplantation were randomized to receive either sevoflurane or desflurane for general anesthesia...
March 2016: Transplantation
Zhirong Sun, Jianing Lv, Yun Zhu, Dongli Song, Biao Zhu, Changhong Miao
Volatile anesthetics modulate endothelial cell apoptosis and inhibit nuclear factor-κB (NF-κB) signaling. In this study, we aimed to assess whether desflurane preconditioning protects human umbilical vein endothelial cells (HUVECs) agaist anoxia/reoxygenation (A/R) injury. HUVECs were pre-conditioned with desflurane (1.0 MAC) for 30 min, followed by a 15-min washout, then exposed to 60 min anoxia and 60 min reoxygenation (A/R), and incubated with 10 ng/ml tumor necrosis factor (TNF)-α for 60 min. HUVEC viability and apoptosis were measured by MTT assay and annexin V staining, and immunoblot analysis was used to measure the levels of Smac and cellular inhibitor of apoptosis 1 (cIAP1)...
November 2015: International Journal of Molecular Medicine
Henry Rosenberg, Neil Pollock, Anja Schiemann, Terasa Bulger, Kathryn Stowell
Malignant hyperthermia (MH) is a pharmacogenetic disorder of skeletal muscle that presents as a hypermetabolic response to potent volatile anesthetic gases such as halothane, sevoflurane, desflurane, isoflurane and the depolarizing muscle relaxant succinylcholine, and rarely, in humans, to stressors such as vigorous exercise and heat. The incidence of MH reactions ranges from 1:10,000 to 1: 250,000 anesthetics. However, the prevalence of the genetic abnormalities may be as great as one in 400 individuals. MH affects humans, certain pig breeds, dogs and horses...
2015: Orphanet Journal of Rare Diseases
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