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https://www.readbyqxmd.com/read/29034967/evaluation-of-a-method-for-isocapnic-hyperventilation-a-clinical-pilot-trial
#1
K Hallén, P Jildenstål, O Stenqvist, S-E Ricksten, S Lindgren
BACKGROUND: Isocapnic hyperventilation (IHV) is a method that shortens time to extubation after inhalation anaesthesia using hyperventilation (HV) without lowering airway CO2 . In a clinical trial on patients undergoing long-duration sevoflurane anaesthesia for major ear-nose-throat (ENT) surgery, we evaluated the utility of a technique for CO2 delivery (DCO2 ) to the inspiratory limb of a closed breathing circuit, during HV, to achieve isocapnia. METHODS: Fifteen adult ASA 1-3 patients were included...
October 16, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29033734/microlaryngeal-endotracheal-tube-for-lung-isolation-in-pediatric-patient-with-significant-tracheal-narrowing
#2
Renu Sinha, Anjan Trikha, Rajkumar Subramanian
A 15-year-old boy, weighing 45 kg, 160 cm height with large anterior mediastinal mass and significant tracheal narrowing was scheduled for thoracotomy and excision of the mass. He had a history of progressive dyspnea, inability to lie supine, and a right upper hemithorax mass 13 cm × 13 cm × 11 cm as evident on a computerized tomography with significant compression of the trachea and right main stem bronchus. Inhalational induction was carried out using sevoflurane with 100% oxygen. After achieving adequate depth of anesthesia with the maintenance of spontaneous respiration with oxygen and sevoflurane (minimum alveolar concentration 1...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033729/use-of-rocuronium-and-sugammadex-under-neuromuscular-transmission-monitoring-in-a-patient-with-multiple-sclerosis
#3
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/29032753/halogenated-agents-and-cardiovascular-surgery-has-mortality-really-decreased
#4
Giovanni Landoni, Juan Carlos Lopez-Delgado, Chiara Sartini, Simona Tamà, Alberto Zangrillo
Halogenated anesthetic agents (desflurane, isoflurane and sevoflurane) may have cardioprotective properties at therapeutic doses against myocardial intraoperative ischemia-reperfusion injury. Cardioprotection mechanisms are related to mitochondrial and anti-apoptotic signaling pathways. Experimental and human studies have proven that their use may reduce morbidity and mortality in the setting of cardiac surgery, including a reduction in myocardial infarct size and mechanical ventilation needs. On the contrary, total intra-venous propofol based anesthesia may be detrimental...
October 10, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29032007/the-effect-of-sevoflurane-compared-to-propofol-maintenance-on-post-surgical-quality-of-recovery-in-patients-undergoing-an-ambulatory-gynecological-surgery-a-prospective-randomized-double-blinded-controlled-clinical-trial
#5
Gildasio S De Oliveira, Jane Bialek, Meghan E Rodes, Mark C Kendall, Robert J McCarthy
OBJECTIVE: The main objective of the current investigation was to evaluate the effect of propofol used as anesthetic maintenance compared to sevoflurane on global post-surgical quality of recovery in female patients undergoing ambulatory gynecological surgery. DESIGN: The study was a prospective randomized double blinded, controlled, clinical trial. INTERVENTIONS: Healthy female subjects were randomized to receive propofol or sevoflurane as anesthetic maintenance...
October 12, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29028933/novel-method-for-intraoperative-assessment-of-cerebral-autoregulation-by-paced-breathing
#6
N H Sperna Weiland, J Hermanides, M W Hollmann, B Preckel, W J Stok, J J van Lieshout, R V Immink
Background: Cerebral autoregulation (CA) is the mechanism that maintains constancy of cerebral blood flow (CBF) despite variations in blood pressure (BP). Patients with attenuated CA have been shown to have an increased incidence of peri-operative stroke. Studies of CA in anaesthetized subjects are rare, because a simple and non-invasive method to quantify the integrity of CA is not available. In this study, we set out to improve non-invasive quantification of CA during surgery. For this purpose, we introduce a novel method to amplify spontaneous BP fluctuations during surgery by imposing mechanical positive pressure ventilation at three different frequencies and quantify CA from the resulting BP oscillations...
October 6, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028932/surgical-pleth-index-prediction-of-postoperative-pain-in-children
#7
T Ledowski, D Sommerfield, L Slevin, J Conrad, B S von Ungern-Sternberg
Background: Surgical Pleth Index (SPI) is a non-invasive, dimensionless score (0-100) aimed to allow an estimate of intraoperative nociception. Thus, it may be a useful tool to guide intraoperative analgesia. However, no optimum SPI target range for the use in children has yet been defined. It was the aim of this study to define a clinically appropriate SPI target to predict moderate-severe postoperative pain in children. Methods: After ethics approval 105 children (2-16 yr) undergoing elective sevoflurane/opioid-based anaesthesia were included...
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29023577/sevoflurane-protects-rat-brain-endothelial-barrier-structure-and-function-after-hypoxia-reoxygenation-injury
#8
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/28993095/comparison-of-the-brainstem-auditory-evoked-responses-during-sevoflurane-or-alfaxalone-anaesthesia-in-adult-cats
#9
Carlos Ros, Carme Soler, Alejandra García de Carellán Mateo
OBJECTIVE: To compare the effects of general anaesthesia using sevoflurane or alfaxalone on the brainstem auditory evoked response (BAER) test in adult healthy cats. STUDY DESIGN: Prospective, clinical, 'blinded', crossover study. ANIMALS: Ten feral adult healthy cats. METHODS: Premedication consisted of dexmedetomidine (0.01 mg kg(-1)) intramuscularly (IM). The first general anaesthesia was induced and maintained with sevoflurane (treatment S) for physical examination, BAER test, complete blood tests, thoracic radiographs and abdominal ultrasound...
March 2, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28984090/bispectral-index-monitored-sevoflurane-requirement-might-be-decreased-in-individuals-with-major-depressive-disorder
#10
Veysel Erden, Cihan Güler, Seda Seven, Sevda Bağ, Ali G Kara, Şenay Kirgezen
BACKGROUND: GABA (γ-aminobutyric acid) is the primary inhibitory neurotransmitter in the CNS and well-known target for general anesthetics. In addition, the dysregulation of GABA could be involved in the etiology of MDD. In this study, we aimed to determine whether MDD has any effect on anesthetic requirement measured by bispectral index (BIS). METHODS: This study was designed as a prospective, observational study, registered ANZCTR (ACTRN12616001295437), with institutional review board approval and written informed consent...
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28982596/subsequent-maternal-separation-exacerbates-neurobehavioral-abnormalities-in-rats-neonatally-exposed-to-sevoflurane-anesthesia
#11
Jiaojiao Yang, Lingsha Ju, Min Jia, Hui Zhang, Xiaoru Sun, Muhuo Ji, Jianjun Yang, Anatoly E Martynyuk
Several recent studies suggest that in the human population, a routine, short anesthetic in otherwise healthy infants is void of neurodevelopmental insult. On the other hand, many human retrospective epidemiological studies report evidence of cognitive abnormalities in children after testing those who had different anesthesia-requiring procedures in early childhood. We tested in a rat model whether post-anesthesia stressful environmental factors can contribute to developmental abnormalities that were initiated by a relatively short exposure to sevoflurane, the most widely used anesthetic in pediatric anesthesia, whose polyvalent actions include enhancement of gamma-aminobutyric acid type A receptor (GABAAR) activity...
October 2, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28981700/sevoflurane-activates-hippocampal-ca3-kainate-receptors-gluk2-to-induce-hyperactivity-during-induction-and-recovery-in-a-mouse-model
#12
P Liang, F Li, J Liu, D Liao, H Huang, C Zhou
Background: In addition to general anaesthetic effects, sevoflurane can also induce hyperactive behaviours during induction and recovery, which may contribute to neurotoxicity; however, the mechanism of such effects is unclear. Volatile anaesthetics including isoflurane have been found to activate the kainate (GluK2) receptor. We developed a novel mouse model and further explored the involvement of kainate (GluK2) receptors in sevoflurane-induced hyperactivity. Methods: Maximal speed, mean speed, total movement distance and resting percentage of C57BL/6 mice were quantitatively measured using behavioural tracking software before and after sevoflurane anaesthesia...
July 19, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28976881/sevoflurane-and-isoflurane-genotoxicity-in-kidney-cells-of-mice
#13
Gordana Brozović, Nada Oršolić, Ružica Rozgaj, Fabijan Knežević, Anica Horvat Knežević, Martina Maričić, Dajana Krsnik, Vesna Benković
The aim of this study was to evaluate the DNA damage and repair in kidney cells of Swiss albino mice after repeated exposure to sevoflurane and isoflurane and compare their detrimental effects. We used the alkaline comet assay to establish the genetic damage and measured three parameters: tail length, tail moment, and tail intensity of comets. These parameters were measured immediately after exposure to the above mentioned inhalation anaesthetics, two hours, six hours, and 24 hours later and were compared with the control group...
September 26, 2017: Arhiv za Higijenu Rada i Toksikologiju
https://www.readbyqxmd.com/read/28970101/modulation-of-hyperpolarization-activated-cation-current-ih-by-volatile-anesthetic-sevoflurane-in-the-mouse-striatum-during-postnatal-development
#14
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
https://www.readbyqxmd.com/read/28969317/dexmedetomidine-mediated-neuroprotection-against-sevoflurane-induced-neurotoxicity-extends-to-several-brain-regions-in-neonatal-rats
#15
J F Perez-Zoghbi, W Zhu, M R Grafe, A M Brambrink
Background: Exposure of infant animals to clinically used anaesthetics is associated with acute structural brain abnormalities and development functional alterations. The α 2 -adrenoceptor agonist dexmedetomidine (DEX) induces sedation, analgesia, and provides neuroprotection in experimental brain injury models. However, it is unknown whether DEX also affords protection in the developing brain against anaesthesia using sevoflurane (SEVO), which is commonly used in paediatric anaesthesia...
September 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28969315/alternative-technique-or-mitigating-strategy-for-sevoflurane-induced-neurodegeneration-a-randomized-controlled-dose-escalation-study-of-dexmedetomidine-in-neonatal-rats
#16
J-R Lee, E P Lin, R D Hofacer, B Upton, S Y Lee, L Ewing, B Joseph, A W Loepke
Background: Brain injury in newborn animals from prolonged anaesthetic exposure has raised concerns for millions of children undergoing anaesthesia every yr. Alternative anaesthetic techniques or mitigating strategies are urgently needed to ameliorate potentially harmful effects. We tested dexmedetomidine, both as a single agent alternative technique and as a mitigating adjuvant for sevoflurane anaesthesia. Methods: Neonatal rats were randomized to three injections of dexmedetomidine (5, 25, 50, or 100 µg kg -1 every 2 h), or 6 h of 2...
September 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28968276/sevoflurane-acts-on-ubiquitination-proteasome-pathway-to-reduce-postsynaptic-density-95-protein-levels-in-young-mice
#17
Han Lu, Ning Liufu, Yuanlin Dong, Guanghong Xu, Yiying Zhang, Liqi Shu, Sulpicio G Soriano, Hui Zheng, Buwei Yu, Zhongcong Xie
BACKGROUND: Children with multiple exposures to anesthesia and surgery may have an increased risk of developing cognitive impairment. Sevoflurane, a commonly used anesthetic in children, has been reported to decrease levels of postsynaptic density 95 protein. However, the upstream mechanisms and downstream consequences of the sevoflurane-induced reduction in postsynaptic density 95 protein levels remains largely unknown. We therefore set out to assess whether sevoflurane acts on ubiquitination-proteasome pathway to facilitate postsynaptic density 95 protein degradation...
October 2, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28966686/sevoflurane-may-be-more-beneficial-than-propofol-in-patients-receiving-endoscopic-variceal-ligation-and-endoscopic-variceal-sclerotherapy-a-randomized-double-blind-study
#18
Linghua Tang, Huimin Liu, Yang Wu, Mei Li, Wei Li, Meng Jiang, Jiabao Hou, Ying Jiang, Zhongyuan Xia, Qingtao Meng
The aim of the present study was to evaluate the safety and efficacy of various general anesthesia regimens during endoscopic variceal ligation (EVL) and endoscopic variceal sclerotherapy (EVS). A total of 123 patients with American Society of Anesthesiologists physical status III and IV, aged 40-70 years, undergoing general anesthesia for EVL and EVS were randomly divided into two groups: Sevoflurane anesthesia (group S; n=60) and propofol anesthesia (group P; n=60). Vital signs, particularly heart rate (HR) and mean arterial pressure (MAP), were monitored...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28966677/effects-of-sevoflurane-on-rats-with-ischemic-brain-injury-and-the-role-of-the-trek-1-channel
#19
Lixiao Pan, Fengyun Yang, Caixia Lu, Changxin Jia, Qing Wang, Kexue Zeng
The purpose of this investigation was to determine the effects of sevoflurane on rats with ischemic brain injury and to determine the potential role of the TREK-1 channel in this process. Normal rats were randomly divided into three groups: Sham operation, sevoflurane anesthesia or chloral hydrate anesthesia group, an additional group of TREK-1 knockout rats were also studied. Semi-quantitative PCR and western blot analysis confirmed the lack of TREK-1 expression in the brain of TREK-1 knockout rats. The thread-tie method was used to establish middle cerebral artery occlusion (MCAO) model to induce cerebral ischemic brain injury...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28964314/optimal-dose-of-rocuronium-bromide-undergoing-adenotonsillectomy-under-5-sevoflurane-with-fentanyl
#20
Hyub Huh, Jeong Jun Park, Ji Yeong Kim, Tae Hoon Kim, Seung Zhoo Yoon, Hye Won Shin, Hye-Won Lee, Hye-Ja Lim, Jang Eun Cho
OBJECTIVE: Adenotonsillectomy is a short surgical procedure under general anaesthesia in children. An ideal muscle relaxant for adenotonsillectomy would create an intense neuromuscular block while having a quick recovery time without postoperative morbidity. We compared the effect of different doses of rocuronium for the tracheal intubation in children under 5% sevoflurane and fentanyl. MATERIALS AND METHODS: 75 children (aged 3-10 years, ASA I) scheduled for adenotonsillectomy were enrolled...
October 2017: International Journal of Pediatric Otorhinolaryngology
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