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Volatile anesthetic

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https://www.readbyqxmd.com/read/27903013/isoflurane-associated-mydriasis-mimicking-blown-pupils-in-a-patient-treated-in-a-neurointensive-care-unit
#1
Eva Magdalena Korf, Volker Martin Tronnier, Jan Gliemroth, Jan Nils Küchler
We report a misinterpretation of bilateral mydriasis as blown pupils related to elevated intracranial pressure (ICP) under volatile sedation with isoflurane (Anesthetic Conserving Device [AnaConDa], Hudson RCI, Uppland Vasby, Sweden) in a 59-year-old patient with a severe traumatic brain injury with frontal contusion. The patient showed bilateral mydriasis and a missing light reflex 8 hours after changing sedation from intravenous treatment with midazolam and esketamine to volatile administration of isoflurane...
November 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27901329/comparing-incidence-of-emergence-delirium-between-sevoflurane-and-desflurane-in-children-following-routine-otolaryngology-procedures
#2
Jeremy N Driscoll, Brian M Bender, Carlos A Archilla, Carol M Klim, J Hossain, George Mychaskiw, Julie L Wei
BACKGROUND: Emergence delirium (ED) is a state of aggressive agitation that can occur temporarily in the process of emerging from anesthesia in children exposed to volatile or intravenous anesthetics. Emergence delirium is typically assessed using the published and validated pediatric emergence delirium (PAED) scale. Due to some variation in properties between sevoflurane and desflurane for maintenance of anesthesia after standard sevoflurane induction, we designed a prospective study to examine potential differences in emergence behavior and incidence of ED in children undergoing elective ear-nose-throat (ENT) surgery...
November 30, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27897153/isoflurane-promotes-non-small-cell-lung-cancer-malignancy-by-activating-the-akt-mammalian-target-of-rapamycin-mtor-signaling-pathway
#3
Wenhua Zhang, Xueqian Shao
BACKGROUND Lung cancer is one of the leading causes of cancer mortalities worldwide, and non-small cell lung cancer (NSCLC) accounts for the majority of all lung cancer cases. Surgery remains one of the front-line treatment options for NSCLC, but events within the perioperative period were found to affect cancer prognosis, such as anesthesia procedures. Isoflurane, a commonly used volatile anesthetic, enhances the malignant potential of renal, prostate, and ovarian cancer cells, but its effects on NSCLC development have not been previously reported...
November 29, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27896927/a-retrospective-review-of-anesthesia-and-perioperative-care-in-children-with-medium-chain-acyl-coa-dehydrogenase-deficiency
#4
Claire Allen, Russell Perkins, Bernd Schwahn
BACKGROUND: Medium-chain acyl-CoA dehydrogenase deficiency is the most common genetically determined disorder of mitochondrial fatty acid oxidation. Decompensation can result in hypoglycemia, seizures, coma, and death but may be prevented by ensuring glycogen stores do not become depleted. Perioperative care is of interest as surgery, fasting, and infection may all trigger decompensation and the safety of anesthetic agents has been questioned. Current guidelines from the British Inherited Metabolic Disease Group advise on administering fluid containing 10% glucose during the perioperative period...
November 29, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27895665/sugammadex-enhanced-neuronal-apoptosis-following-neonatal-sevoflurane-exposure-in-mice
#5
Maiko Satomoto, Zhongliang Sun, Yushi U Adachi, Koshi Makita
In rodents, neonatal sevoflurane exposure induces neonatal apoptosis in the brain and results in learning deficits. Sugammadex is a new selective neuromuscular blockade (NMB) binding agent that anesthesiologists can use to achieve immediate reversal of an NMB with few side effects. Given its molecular weight of 2178, sugammadex is thought to be unable to pass through the blood brain barrier (BBB). Volatile anesthetics can influence BBB opening and integrity. Therefore, we investigated whether the intraperitoneal administration of sugammadex could exacerbate neuronal damage following neonatal 2% sevoflurane exposure via changes in BBB integrity...
2016: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/27871537/-1-8-million-and-counting-how-volatile-agent-education-has-decreased-our-spending-1000-per-day
#6
Scott A Miller, Carol A Aschenbrenner, Justin R Traunero, Loren A Bauman, Samuel S Lobell, Jeffrey S Kelly, John E Reynolds
STUDY OBJECTIVE: Volatile anesthetic agents comprise a substantial portion of every hospital's pharmacy budget. Challenged with an initiative to lower anesthetic drug expenditures, we developed an education-based intervention focused on reducing volatile anesthetic costs while preserving access to all available volatile anesthetics. When postintervention evaluation demonstrated a dramatic year-over-year reduction in volatile agent acquisition costs, we undertook a retrospective analysis of volatile anesthetic purchasing data using time series analysis to determine the impact of our educational initiative...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27866303/anesthetic-technique-and-cancer-recurrence-in-oncologic-surgery-unraveling-the-puzzle
#7
Ryungsa Kim
Surgery/anesthetic technique-stimulated immunosuppression in the perioperative period might cause an increase in cancer-related mortality. Whether anesthetic technique can affect the outcomes of cancer patients remains inconclusive. This review discusses data from the available literature on anesthetic techniques applied in oncologic surgery, the long-term outcomes of anesthetic technique, and their relation to survival and cancer recurrence. Searches of the PubMed database up to June 30, 2016, were conducted to identify publications with the terms "anesthetic technique and cancer recurrence," "regional anesthesia and cancer recurrence," "local anesthesia and cancer recurrence," "anesthetic technique and immunosuppression," and "anesthetic technique and oncologic surgery...
November 19, 2016: Cancer Metastasis Reviews
https://www.readbyqxmd.com/read/27856739/fluorine-19-nmr-and-computational-quantification-of-isoflurane-binding-to-the-voltage-gated-sodium-channel-nachbac
#8
Monica N Kinde, Vasyl Bondarenko, Daniele Granata, Weiming Bu, Kimberly C Grasty, Patrick J Loll, Vincenzo Carnevale, Michael L Klein, Roderic G Eckenhoff, Pei Tang, Yan Xu
Voltage-gated sodium channels (NaV) play an important role in general anesthesia. Electrophysiology measurements suggest that volatile anesthetics such as isoflurane inhibit NaV by stabilizing the inactivated state or altering the inactivation kinetics. Recent computational studies suggested the existence of multiple isoflurane binding sites in NaV, but experimental binding data are lacking. Here we use site-directed placement of (19)F probes in NMR experiments to quantify isoflurane binding to the bacterial voltage-gated sodium channel NaChBac...
November 29, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27851525/1890-complications-with-the-administration-of-a-volatile-anesthetic-agent-for-asthma-in-the-picu
#9
Brittany Shutes, W Joshua Frazier, Todd Karsies, Joseph Tobias
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27844299/comparison-of-pneumotachography-and-anemometery-for-flow-measurement-during-mechanical-ventilation-with-volatile-anesthetics
#10
Jarred R Mondoñedo, Jacob Herrmann, John S McNeil, David W Kaczka
Volatile anesthetics alter the physical properties of inhaled gases, such as density and viscosity. We hypothesized that the use of these agents during mechanical ventilation would yield systematic biases in estimates of flow ([Formula: see text]) and tidal volume (V T) for two commonly used flowmeters: the pneumotachograph (PNT), which measures a differential pressure across a calibrated resistive element, and the hot-wire anemometer (HWA), which operates based on convective heat transfer from a current-carrying wire to a flowing gas...
November 14, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27833818/sevoflurane-postconditioning-attenuates-cardiomyocyte-hypoxia-reoxygenation-injury-via-restoring-mitochondrial-morphology
#11
Jin Yu, Jianjiang Wu, Peng Xie, Yiliyaer Maimaitili, Jiang Wang, Zhengyuan Xia, Feng Gao, Xing Zhang, Hong Zheng
BACKGROUND: Anesthetic postconditioning is a cellular protective approach whereby exposure to a volatile anesthetic renders a tissue more resistant to subsequent ischemic/reperfusion event. Sevoflurane postconditioning (SPostC) has been shown to exert cardioprotection against ischemia/reperfusion injury, but the underlying mechanism is unclear. We hypothesized that SPostC protects cardiomyocytes against hypoxia/reoxygenation (H/R) injury by maintaining/restoring mitochondrial morphological integrity, a critical determinant of cell fate...
2016: PeerJ
https://www.readbyqxmd.com/read/27828800/safety-and-efficacy-of-volatile-anesthetic-agents-compared-with-standard-intravenous-midazolam-propofol-sedation-in-ventilated-critical-care-patients-a-meta-analysis-and-systematic-review-of-prospective-trials
#12
Angela Jerath, Jonathan Panckhurst, Matteo Parotto, Nicholas Lightfoot, Marcin Wasowicz, Niall D Ferguson, Andrew Steel, W Scott Beattie
BACKGROUND: Inhalation agents are being used in place of intravenous agents to provide sedation in some intensive care units. We performed a systematic review and meta-analysis of prospective randomized controlled trials, which compared the use of volatile agents versus intravenous midazolam or propofol in critical care units. METHODS: A search was conducted using MEDLINE (1946-2015), EMBASE (1947-2015), Web of Science index (1900-2015), and Cochrane Central Register of Controlled Trials...
November 8, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27828796/perioperative-anesthesia-care-and-tumor-progression
#13
Mir W Sekandarzad, André A J van Zundert, Philipp B Lirk, Chris W Doornebal, Markus W Hollmann
This narrative review discusses the most recent up-to-date findings focused on the currently available "best clinical practice" regarding perioperative anesthesia care bundle factors and their effect on tumor progression. The main objective is to critically appraise the current literature on local anesthetics, regional outcome studies, opioids, and nonsteroidal anti-inflammatory drugs (NSAIDs) and their ability to decrease recurrence in patients undergoing cancer surgery. A brief discussion of additional topical perioperative factors relevant to the anesthesiologist including volatile and intravenous anesthetics, perioperative stress and anxiety, nutrition, and immune stimulation is included...
November 8, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27826417/desflurane-impairs-outcome-of-organotypic-hippocampal-slices-in-an-in-vitro-model-of-traumatic-brain-injury
#14
Matthias Krings, Anke Höllig, Jingjin Liu, Linda Grüsser, Rolf Rossaint, Mark Coburn
Decreased mortality and disability after traumatic brain injury is a significant medical challenge. Desflurane, a widely used volatile anesthetic has proven to be neuroprotective in a variety of in vitro and in vivo models of ischemic brain injury. The aim of this study was to investigate whether desflurane exhibits neuroprotective properties in an in vitro model of traumatic brain injury. Organotypic hippocampal slice cultures were prepared from brains of 5-7-day-old C57/BL6 mouse pups. After 14 days of culture, the slices were subjected to a focal mechanical trauma and thereafter incubated with three different concentrations of desflurane (2, 4 and 6%) for 2, 24 and 72 hours...
March 2016: Medical Gas Research
https://www.readbyqxmd.com/read/27825646/the-risk-of-postoperative-nausea-and-vomiting-between-surgical-patients-received-propofol-and-sevoflurane-anesthesia-a-matched-study
#15
Hideki Matsuura, Satoki Inoue, Masahiko Kawaguchi
OBJECTIVES: The current consensus guidelines for managing postoperative nausea and vomiting (PONV) suggest that one of anesthetic risk factors is the use of volatile anesthetics. However, in clinical settings, it is rare to perceive propofol to be superior to volatile anesthetics for the prevention of PONV. To assess whether PONV is related to the type of anesthetic delivered, we compared the incidence and duration of PONV between propofol anesthesia and sevoflurane anesthesia. METHODS: We performed a retrospective review of an institutional registry containing 21606 general anesthesia cases conducted following ethics board approval...
November 4, 2016: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
https://www.readbyqxmd.com/read/27817157/isoflurane-decreases-proliferation-and-differentiation-but-none-of-the-effects-persist-in-human-embryonic-stem-cell-derived-neural-progenitor-cells
#16
Hye-Min Sohn, Hye Young Kim, Seongjoo Park, Sung-Hee Han, Jin-Hee Kim
PURPOSE: Volatile anesthetics are a potential risk for cognitive impairment in the developing brain. Isoflurane causes cell death, reduces neurogenesis, and changes neuronal differentiation. In this study, the effects of a single isoflurane exposure on the developing human brain were evaluated using human embryonic stem cell (hESC)-derived neural progenitor cells (NPCs). METHODS: Multipotent NPCs were derived from hESCs and randomly exposed to either 5 vol% isoflurane (4 h) or no isoflurane (control group)...
November 5, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27812757/counter-flow-suggests-transport-of-dantrolene-and-5-oh-dantrolene-by-the-organic-anion-transporters-2-oat2-and-3-oat3
#17
Birgitta C Burckhardt, Maja Henjakovic, Yohannes Hagos, Gerhard Burckhardt
Dantrolene is the only available drug for the treatment of malignant hyperthermia, a life-threatening inborn sensitivity of the ryanodine receptor (RyR1) in skeletal muscles to volatile anesthetics. Dantrolene is metabolized in the liver to 5-OH dantrolene. Both compounds are zwitterions or net negatively charged. Here, we investigated interactions of dantrolene and 5-OH dantrolene with solute carrier (SLC) family members occurring in skeletal muscle cells, hepatocytes, and renal proximal tubule cells. SLC22A8 (organic anion transporter 3, OAT3) was very sensitive to both compounds exhibiting IC50 values of 0...
November 2016: Pflügers Archiv: European Journal of Physiology
https://www.readbyqxmd.com/read/27810409/a-novel-anti-pollution-filter-for-volatile-agents-during-cardiopulmonary-bypass-preliminary-tests
#18
Caetano Nigro Neto, Giovanni Landoni, Maria Angela Tardelli
OBJECTIVE: Concerns regarding pollution of the operating room by volatile anesthetics and effects on atmospheric ozone depletion exist. Volatile agents commonly are used during cardiopulmonary bypass to provide anesthesia independent of any supposed myocardial protective effects. The authors' aim was to create and to assess the performance of a prototype filter for volatile agents to be connected to the cardiopulmonary bypass circuit to avoid the emission of volatile agents to the operating room, and also to the environment without causing damage to the membrane oxygenator...
August 10, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27800510/sevoflurane-mitigates-shedding-of-hyaluronan-from-the-coronary-endothelium-also-during-ischemia-reperfusion-an-ex-vivo-animal-study
#19
Congcong Chen, Daniel Chappell, Thorsten Annecke, Peter Conzen, Matthias Jacob, Ulrich Welsch, Bernhard Zwissler, Bernhard F Becker
Glycosaminoglycan hyaluronan (HA), a major constituent of the endothelial glycocalyx, helps to maintain vascular integrity. Preconditioning the heart with volatile anesthetic agents protects against ischemia/reperfusion injury. We investigated a possible protective effect of sevoflurane on the glycocalyx, especially on HA. The effect of pre-ischemic treatment with sevoflurane (15 minutes at 2% vol/vol gas) on shedding of HA was evaluated in 28 isolated, beating guinea pig hearts, subjected to warm ischemia (20 minutes at 37°C) followed by reperfusion (40 minutes), half with and half without preconditioning by sevoflurane...
2016: Hypoxia
https://www.readbyqxmd.com/read/27793236/isoflurane-provides-neuroprotection-in-neonatal-hypoxic-ischemic-brain-injury-by-suppressing-apoptosis
#20
De-An Zhao, Ling-Yun Bi, Qian Huang, Fang-Min Zhang, Zi-Ming Han
BACKGROUND AND OBJECTIVES: Isoflurane is halogenated volatile ether used for inhalational anesthesia. It is widely used in clinics as an inhalational anesthetic. Neonatal hypoxic ischemia injury ensues in the immature brain that results in delayed cell death via excitotoxicity and oxidative stress. Isoflurane has shown neuroprotective properties that make a beneficial basis of using isoflurane in both cell culture and animal models, including various models of brain injury. We aimed to determine the neuroprotective effect of isoflurane on hypoxic brain injury and elucidated the underlying mechanism...
November 2016: Brazilian Journal of Anesthesiology
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