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Volatile anesthetic

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https://www.readbyqxmd.com/read/29141380/-the-analysis-of-anesthetic-management-for-renal-cell-carcinoma-with-associated-inferior-vena-cava-tumor-thrombus
#1
H Zeng, X Y Rong, Y Wang, X Y Guo
Objective: To explore the key points of anesthetic management for renal cell carcinoma combined with inferior vena cava (IVC) tumor thrombus. Methods: Twenty-seven cases of renal cell carcinoma with inferior vena cava (IVC) tumor thrombus underwent radical nephrectomy and inferior caval venous thrombectomy were reviewed retrospectively during January 2014 to January 2017 in our hospital.Analyzed data includs demographics, classification of tumor, perioperative anesthetic management and monitoring approaches, IVC clamping time , vital signs during cardiopulmonary bypass(CPB), estimated blood loss (EBL), usage of blood products, hospitalization time and ICU time , as well as postoperative outcomes...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29136012/regional-knockdown-of-ndufs4-implicates-a-thalamocortical-circuit-mediating-anesthetic-sensitivity
#2
Renjini Ramadasan-Nair, Jessica Hui, Pavel I Zimin, Leslie S Itsara, Philip G Morgan, Margaret M Sedensky
Knockout of the mitochondrial complex I protein, NDUFS4, profoundly increases sensitivity of mice to volatile anesthetics. In mice carrying an Ndufs4lox/lox gene, adeno-associated virus expressing Cre recombinase was injected into regions of the brain postulated to affect sensitivity to volatile anesthetics. These injections generated otherwise phenotypically wild type mice with region-specific, postnatal inactivation of Ndufs4, minimizing developmental effects of gene loss. Sensitivities to the volatile anesthetics isoflurane and halothane were measured using loss of righting reflex (LORR) and movement in response to tail clamp (TC) as endpoints...
2017: PloS One
https://www.readbyqxmd.com/read/29125194/amyotrophic-lateral-sclerosis-a-case-report-and-mechanistic-review-of-the-association-with-toluene-and-other-volatile-organic-compounds
#3
Marcia H Ratner, Joe F Jabre, William M Ewing, Mohamed Abou-Donia, L Christine Oliver
Unmasking of latent neurodegenerative disease has been reported following exposure to chemicals that share one or more mechanisms of action in common with those implicated in the specific disease. For example, unmasking of latent Parkinson's disease (PD) has been associated with exposure to anti-dopaminergic agents, while the progression of pre-existing mild cognitive impairment and unmasking of latent Alzheimer's disease has been associated with exposure to general anesthetic agents which promote Aβ protein aggregation...
November 10, 2017: American Journal of Industrial Medicine
https://www.readbyqxmd.com/read/29120931/perioperative-neurocognition-in-elderly-patients
#4
Huiqun Fu, Long Fan, Tianlong Wang
PURPOSE OF REVIEW: The extrinsic risk factors for postoperative cognitive disturbance have been a source of concern during the perioperative period, and these risk factors remain the subject of controversy. This review of recent studies focuses on the effect of these factors on postoperative cognitive disturbance during the perioperative period. RECENT FINDINGS: Impairment of cerebral autoregulation may predispose patients to intraoperative cerebral malperfusion, which may subsequently induce postoperative cognitive disturbance...
November 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29098494/toxicity-of-inhaled-agents-after-prolonged-administration
#5
Panumart Manatpon, W Andrew Kofke
Inhaled anesthetics have been utilized mostly for general anesthesia in the operating room and oftentimes for sedation and for treatment of refractory status epilepticus and status asthmaticus in the intensive care unit. These contexts in the ICU setting are related to potential for prolonged administration wherein potential organ toxicity is a concern. Over the last decade, several clinical and animal studies of neurotoxicity attributable to inhaled anesthetics have been emerging, particularly in extremes of age...
November 2, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29073151/inhalation-of-volatile-anesthetics-via-a-laryngeal-mask-is-associated-with-lower-incidence-of-intraoperative-awareness-in-non-critically-ill-patients
#6
Pei-Jen Kuo, Chia-Ling Lee, Jen-Huang Wang, Shiu-Ying Hsieh, Shian-Che Huang, Chen-Fuh Lam
BACKGROUND: Increased incidence of intraoperative awareness was reported in critically ill patients during major operations, particularly under total intravenous (TIVA) or endotracheal general anesthesia (ETGA). However, the incidence and effect of anesthesia techniques on awareness in generally healthy, non-critically ill patients during operations have yet to receive significant attention. METHODS AND RESULTS: This retrospective matched case-control study was conducted between January 2009 to December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/29070852/impact-of-anesthetic-agents-on-overall-and-recurrence-free-survival-in-patients-undergoing-esophageal-cancer-surgery-a-retrospective-observational-study
#7
In-Jung Jun, Jun-Young Jo, Jong-Il Kim, Ji-Hyun Chin, Wook-Jong Kim, Hyeong Ryul Kim, Eun-Ho Lee, In-Cheol Choi
Given that surgical stress response and surgical excision may increase the likelihood of post-surgery cancer dissemination and metastasis, the appropriate choice of surgical anesthetics may be important for oncologic outcomes. We evaluated the association of anesthetics used for general anesthesia with overall survival and recurrence-free survival in patients who underwent esophageal cancer surgery. Adult patients (922) underwent elective esophageal cancer surgery were included. The patients were divided into two groups according to the anesthetics administered during surgery: volatile anesthesia (VA) or intravenous anesthesia with propofol (TIVA)...
October 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29058547/volatile-anesthetics-and-immunity
#8
Siavash Sedghi, Hilliard L Kutscher, Bruce A Davidson, Paul R Knight
Historically, volatile anesthetics have demonstrated interesting interactions with both the innate and adaptive immune systems. This review organizes these interactions into four phases: recognition, recruitment, response, and resolution. These phases represent a range of proinflammatory, inflammatory, and innate and adaptive immune regulatory responses. The interaction between volatile anesthetics and the immune system is discussed in the context of pathogenesis of infectious disease.
November 2017: Immunological Investigations
https://www.readbyqxmd.com/read/29055725/evaluation-of-prolonged-administration-of-isoflurane-on-cerebral-blood-flow-and-default-mode-network-in-macaque-monkeys-anesthetized-with-different-maintenance-doses
#9
Chun-Xia Li, Xiaodong Zhang
OBJECT: Isoflurane is a commonly used volatile anesthetic agent in clinical anesthesia and biomedical research. Prior study suggested the cerebral blood flow (CBF) and default mode network (DMN) could be changed after prolonged administration of isoflurane. The normal maintenance doses of isoflurane may vary from light (∼0.75%) to deep (∼1.5 or 2%) anesthesia. However, it is not clear how the duration effects are affected by the altered doses. The present study is aimed to examine if the duration effects are affected when isoflurane concentration is altered within normal maintenance doses...
October 18, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/29043601/pupillary-reflex-dilation-in-response-to-incremental-nociceptive-stimuli-in-patients-receiving-intravenous-ketamine
#10
Nada Sabourdin, Thomas Giral, Risa Wolk, Nicolas Louvet, Isabelle Constant
Pupillometry is a non-invasive monitoring technique, which allows dynamic pupillary diameter measurement by an infrared camera. Pupillary diameter increases in response to nociceptive stimuli. In patients anesthetized with propofol or volatile agents, the magnitude of this pupillary dilation is related to the intensity of the stimulus. Pupillary response to nociceptive stimuli has never been studied under ketamine anesthesia. Our objective was to describe pupillary reflex dilation after calibrated tetanic stimulations in patients receiving intravenous ketamine...
October 17, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29042718/are-local-anesthesia-vials-similar-to-champagne-do-they-lose-their-potency-once-opened-an-in-vitro-study
#11
P S Gopinath Thilak, Sameep S Shetty, Jagadeesh Chandra, Kavana Gowda
BACKGROUND AND OBJECTIVES: Epinephrine is volatile and unstable on exposure to air. Addition of sodium metabisulfite as an antioxidant has been effective, but there are no clear-cut consensus on its efficiency in retarding the oxidation that sets in once the anesthetic vials are kept open with a needle in situ. There is a paucity of scientific data regarding the risks of reuse of anesthetic vials following the use of cartridges, a common practice in western countries. It is our endeavor to shed light on the constant change in pH, drug deterioration, and instability that sets in an anesthetic vial with a needle in situ...
July 2017: Contemporary Clinical Dentistry
https://www.readbyqxmd.com/read/29042297/trek-1-pathway-mediates-isoflurane-induced-memory-impairment-in-middle-aged-mice
#12
Yanhui Cai, Zhengwu Peng, Haiyun Guo, Feng Wang, Yi Zeng
Post-operative cognitive dysfunction (POCD) has been widely reported, especially in elderly patients. An association between POCD and inhalational anesthetics, such as isoflurane, has been suggested. The TWIK-related K(+) channel-1 (TREK-1) controls several major cellular responses involved in memory formation and is believed to participate in the development of depression, cerebral ischemia and blood-brain barrier dysfunction. However, the specific role of TREK-1 in mediating anesthesia-induced POCD remains unknown...
October 16, 2017: Neurobiology of Learning and Memory
https://www.readbyqxmd.com/read/29040168/failure-of-isoflurane-cardiac-preconditioning-in-obese-type-2-diabetic-mice-involves-aberrant-regulation-of-microrna-21-endothelial-nitric-oxide-synthase-and-mitochondrial-complex-i
#13
Zhi-Dong Ge, Yingchuan Li, Shigang Qiao, Xiaowen Bai, David C Warltier, Judy R Kersten, Zeljko J Bosnjak, Mingyu Liang
BACKGROUND: Diabetes impairs the cardioprotective effect of volatile anesthetics, yet the mechanisms are still murky. We examined the regulatory effect of isoflurane on microRNA-21, endothelial nitric-oxide synthase, and mitochondrial respiratory complex I in type II diabetic mice. METHODS: Myocardial ischemia/reperfusion injury was produced in obese type 2 diabetic (db/db) and C57BL/6 control mice ex vivo in the presence or absence of isoflurane administered before ischemia...
October 17, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29033729/use-of-rocuronium-and-sugammadex-under-neuromuscular-transmission-monitoring-in-a-patient-with-multiple-sclerosis
#14
Chryssoula Staikou, Martina Rekatsina
Multiple sclerosis (MS) is a potentially disabling disease characterized by demyelinating lesions in the central nervous system. One of the anesthetic challenges encountered in surgical patients with MS is the management of neuromuscular blockade (NMB) and its reversal. We report a case of a 31-year-old female patient suffering from MS, who underwent gynecological surgery under general anesthesia with sevoflurane, fentanyl, and rocuronium which was successfully reversed with sugammadex. Neuromuscular transmission (NMT) monitoring was used to guide the intraoperative doses of rocuronium and also the reversal of NMB by the use of sugammadex to ensure a safe tracheal extubation...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29023577/sevoflurane-protects-rat-brain-endothelial-barrier-structure-and-function-after-hypoxia-reoxygenation-injury
#15
Tanja Restin, Marie-Elisabeth Kajdi, Martin Schläpfer, Birgit Roth Z'graggen, Christa Booy, Claudia Dumrese, Beatrice Beck-Schimmer
BACKGROUND: After cerebral injury blood-brain barrier disruption significantly impairs brain homeostasis. Volatile anesthetics have been shown to be protective in ischemia-reperfusion injury scenarios. Their impact on brain endothelial cells after hypoxia-reoxygenation (H/R) has not yet been studied in detail. METHODS: Rat brain endothelial cells (RBE4) were exposed to severe hypoxia and reoxygenated in air in the presence or absence of sevoflurane. Changes in dextran permeability and architecture of the cellular junctional proteins ZO-1 and β-catenin were measured...
2017: PloS One
https://www.readbyqxmd.com/read/28994673/an-innovative-technique-to-improve-safety-of-volatile-anesthetics-suction-from-the-cardiopulmonary-bypass-circuit
#16
Francesco De Simone, Luigi Cassarà, Salvatore Sardo, Elena Scarparo, Omar Saleh, Caetano Nigro Neto, Alberto Zangrillo, Giovanni Landoni
CONTEXT: Myocardial injury during cardiac surgery on cardiopulmonary bypass (CPB) is a major determinant of morbidity and mortality. Preclinical and clinical evidence of dose- and time-related cardioprotective effects of volatile anesthetic drugs exist and their use during the whole surgery duration could improve perioperative cardiac protection. Even if administering volatile agents during CPB are relatively easy, technical problems, such as waste gas scavenging, may prevent safe and manageable administration of halogenated vapors during CPB...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28991117/thermal-a-%C3%AE-nociceptors-identified-by-transcriptomics-express-higher-levels-of-anesthesia-sensitive-receptors-than-thermal-c-fibers-and-are-more-suppressible-by-low-dose-isoflurane
#17
Stephen J Raithel, Matthew R Sapio, Michael J Iadarola, Andrew J Mannes
We investigated the effect of isoflurane on 2 main types of thermal nociceptors: A-δ and C-fibers. Surprisingly, 1% inhaled isoflurane led to a hyperalgesic response to C-fiber thermal stimulation, whereas responses to A-δ thermal stimulation were blunted. We explored the hypothesis that differences in withdrawal behavior are mediated by differential expression of isoflurane-sensitive proteins between these types of thermal nociceptors. Multiple transcriptomic databases of peripheral neurons were integrated to reveal that isoflurane-susceptible proteins Htr3a, Kcna2, and Scn8a were enriched in thermosensitive A-δ neurons...
October 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28990517/anesthetic-agents-and-neuronal-autophagy-what-we-know-and-what-we-don-t
#18
Lili Xu, Jianjun Shen, Patrick M McQuillan, Zhiyong Hu
Numerous experimental data have demonstrated that neonatal animal exposure to commonly used anesthetic agents may cause neuronal death resulting in cognitive impairment. The underlying mechanism(s) remain elusive. Depending on the circumstances, autophagy may produce an effect that can be either protective or deleterious. Recent evidence demonstrates that this process can reduce the development of ethanol induced neurotoxicity and, as we know, ethanol has γ-Aminobutyric acid (GABA) agonist and N-methyl-D-aspartate (NMDA) antagonist characteristics similar to commonly used volatile anesthetic agents...
October 9, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28979044/use-of-volatile-anesthetic-agent-in-extracorporeal-circuit-as-a-cause-of-break-in-polycarbonate-connector-lessons-learnt
#19
Deepak Gowda, K Rashmi, Naveen Pandarinathan, Neelam Desai
Mishaps, near misses, and lethal incidents are known to occur during cardiopulmonary bypass. We share one such rare case of break in polycarbonate connector because of the use of isoflurane in extracorporeal circuit and its successful management.
September 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28970101/modulation-of-hyperpolarization-activated-cation-current-ih-by-volatile-anesthetic-sevoflurane-in-the-mouse-striatum-during-postnatal-development
#20
Yusuke Sugasawa, Masataka Fukuda, Nozomi Ando, Ritsuko Inoue, Sakura Nakauchi, Masami Miura, Kinya Nishimura
Volatile anesthetics have been reported to inhibit hyperpolarization-activated cyclic-nucleotide gated channels underlying the hyperpolarization-activated cation current (Ih) that contributes to generation of synchronized oscillatory neural rhythms. Meanwhile, the developmental change of Ih has been speculated to play a pivotal role during maturation. In this study, we examined the effect of the volatile anesthetic sevoflurane, which is widely used in pediatric surgery, on Ih and on functional Ih activation kinetics of cholinergic interneurons in developing striatum...
September 29, 2017: Neuroscience Research
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