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https://www.readbyqxmd.com/read/28800884/ionic-mechanisms-of-the-action-of-anaesthetics-on-sinoatrial-node-automaticity
#1
REVIEW
Akiko Kojima, Hiroshi Matsuura
Although various general anaesthetics affect the heart rate in clinical settings, their precise mechanisms remain to be fully elucidated. Because the heart rate is determined by automaticity of the cardiac pacemaker sinoatrial node and its regulation by autonomic nervous system, it is important to clarify the effect of anaesthetics on sinoatrial node automaticity. The spontaneous electrical activity of sinoatrial node is generated by a complex but coordinated interaction of multiple ionic currents, such as the hyperpolarisation-activated cation current (If), T-type and L-type Ca(2+) currents (ICa,T and ICa,L), Na(+)/Ca(2+) exchange current (INCX), and rapidly and slowly activating delayed rectifier K(+) currents (IKr and IKs)...
August 8, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28791477/electroencephalographic-effect-of-age-adjusted-1-mac-desflurane-and-sevoflurane-in-young-middle-aged-and-elderly-patients
#2
Shinya Kanazawa, Yutaka Oda, Chika Maeda, Ryu Okutani
PURPOSE: We examined the hypothesis that 1 minimum alveolar concentration (MAC) of desflurane and sevoflurane provides different depth of anesthesia. METHODS: One hundred and twenty young (20-30 years), middle-aged (31-65 years), and elderly (66-80 years) patients were randomly allocated to receive either desflurane or sevoflurane (n = 20, each group). General anesthesia was induced with propofol 2 mg/kg bolus and remifentanil 0.25 µg/kg/min, which was stopped after tracheal intubation...
August 8, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28757832/sugammadex-versus-two-doses-of-neostigmine-for-reversal-of-rocuronium-in-gastric-sleeve-surgery
#3
Abdulhamid Alsaeed, Fahad Bamehriz, Sharaf Eldin, Tareq Alzahrani, Abdullah Alharbi, Abdelazeem Eldawlatly
BACKGROUND AND AIM: The aim of this prospective randomized trial is to compare the quality of reversal of rocuronium with either sugammadex (SUG) versus 2.5 mg or 5 mg neostigmine (NEO). PATIENTS AND METHODS: A total of 110 patients with body mass index >40 underwent elective gastric sleeve surgery were enrolled in this study. Exclusion criteria included patients with co-existing muscular and cardiovascular diseases. Patients were randomly allocated to one of the following groups: group A (SUG), Group B (NEO 2...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28745667/-prevention-and-correction-of-cognitive-dysfunction-after-general-anesthesia
#4
A Yu Novikov, V A Kovalev, N V Vinichuk, Yu A Chernyh, I E Golub, L V Sorokina
AIM: To evaluate clinical efficacy of intraoperative use of cytoflavin in the prevention and correction of cognitive functions in surgical patients with no history of neurological and psychosomatic disorders. MATERIAL AND METHODS: The study included 60 female patients who underwent surgery on the thyroid gland. Patients were stratified into two equal groups matched for main indices. Patients of the main group received infusions of cytoflavin (20 ml in 200 ml of 5% glucose solution)...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28714298/effect-of-sugammadex-on-coagulation-as-detected-by-rotational-thromboelastometry-in-morbidly-obese-patients
#5
Michele Carron, Diana Bertini, Tancredi Prandini, Francesca Fanton, Mirto Foletto, Carlo Ori, Egle Perissinotto, Paolo Simioni
BACKGROUND: Sugammadex, which is used to reverse rocuronium-induced neuromuscular blockade, has a limited and transient effect on activated partial thromboplastin time and prothrombin time. However, no data are available on the effects of sugammadex on coagulation in morbidly obese patients, as assessed by rotational thromboelastometry (ROTEM®). METHODS: Sixty patients received sugammadex 2 mg/kg or 4 mg/kg to reverse moderate or deep rocuronium-induced neuromuscular blockade (n = 30/group) at the end of surgery under desflurane anesthesia...
July 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28655953/effect-of-nitrous-oxide-on-bispectral-index-values-at-equi-minimum-alveolar-concentrations-of-sevoflurane-and-desflurane
#6
Rajeeb Kumar Mishra, Charu Mahajan, Hemanshu Prabhakar, Indu Kapoor, Parmod Kumar Bithal
BACKGROUND AND AIMS: Bispectral index (BIS) values may be anaesthetic agent-specific, depending on their ability to suppress the electroencephalogram (EEG) signals. We carried out a prospective, randomised clinical trial to study the effect of nitrous oxide (N2O) on the BIS values at an equi-minimum alveolar concentration (MAC) of sevoflurane and desflurane. METHODS: Sixty adult patients undergoing spine surgery were randomised into two groups; Group S (sevoflurane; n = 30) and Group D (desflurane; n = 30) for the maintenance of anaesthesia in oxygen and air or oxygen and N2O mixture (FiO2-0...
June 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28625437/inhalation-versus-intravenous-anaesthesia-for-adults-undergoing-on-pump-or-off-pump-coronary-artery-bypass-grafting-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#7
REVIEW
Regina El Dib, José E Guimarães Pereira, Arnav Agarwal, Huda Gomaa, Ana Patricia Ayala, Andresa Graciutti Botan, Leandro Gobbo Braz, Luciane Dias de Oliveira, Luciane Cruz Lopes, Preethy J Mathew
STUDY OBJECTIVE: To compare the use of inhalation versus intravenous anaesthesia for adults undergoing on-pump or off-pump coronary artery bypass grafting. DESIGN: A systematic review. SETTING: A hospital-affiliated university. MEASUREMENTS: The following databases were searched: the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 10), MEDLINE, EMBASE, and LILACS (from inception to October 2016). We used the GRADE approach to rate overall certainty of the evidence...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28618676/re-the-effect-of-sevoflurane-versus-desflurane-on-postoperative-catheter-related-bladder-discomfort-in-patients-undergoing-transurethral-excision-of-a-bladder-tumour-a-randomized-controlled-trial
#8
https://www.readbyqxmd.com/read/28611600/changes-in-alpha-frequency-and-power-of-the-electroencephalogram-during-volatile-based-general-anesthesia
#9
Darren Hight, Logan J Voss, Paul S Garcia, Jamie Sleigh
Oscillations in the electroencephalogram (EEG) at the alpha frequency (8-12 Hz) are thought to be ubiquitous during surgical anesthesia, but the details of how this oscillation responds to ongoing changes in volatile anesthetic concentration have not been well characterized. It is not known how often alpha oscillations are absent in the clinical context, how sensitively alpha frequency and power respond to changes in anesthetic concentration, and what effect increased age has on alpha frequency. Bipolar EEG was recorded frontally from 305 patients undergoing surgery with sevoflurane or desflurane providing general anesthesia...
2017: Frontiers in Systems Neuroscience
https://www.readbyqxmd.com/read/28607337/safety-aspects-of-desflurane-anesthesia-and-laryngeal-mask-airway
#10
Marco Rossi, Antonio Corcione, Clelia Esposito, Massimo Micaglio, Roberta Monzani, Carlo Ori
Laryngeal mask (LM) and inhaled anesthesia combination is often deemed unsuitable. Actually the evolution of surgical procedures towards minimal invasiveness, the search of improved productivity, and the contemporary need for patient safety and faster recovery, push the anesthetists to get interested in their use in the daily practice. An Expert Panel composed by anesthetists coming from university and tertiary hospitals undertook to write an Expert Opinion on the correct management of LM and desflurane in adult patients, with a view to issuing a simple operative protocol for their combined intraoperative usage...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28600624/desflurane-usage-during-anesthesia-with-and-without-n2o-using-flow-i-automatic-gas-control-with-three-different-wash-in-speeds
#11
Robrecht De Medts, Rik Carette, Andre M De Wolf, Jan F A Hendrickx
AGC(®) (Automatic Gas Control) is the FLOW-i's automated low flow tool (Maquet, Solna, Sweden) that target controls the inspired O2 (FIO2) and end-expired desflurane concentration (FAdes) while (by design) exponentially decreasing fresh gas flow (FGF) during wash-in to a maintenance default FGF of 300 mL min(-1). It also offers a choice of wash-in speeds for the inhaled agents. We examined AGC performance and hypothesized that the use of lower wash-in speeds and N2O both reduce desflurane usage (Vdes). After obtaining IRB approval and patient consent, 78 ASA I-II patients undergoing abdominal surgery were randomly assigned to 1 of 6 groups (n = 13 each), depending on carrier gas (O2/air or O2/N2O) and wash-in speed (AGC speed 2, 4, or 6) of desflurane, resulting in groups air/2, air/4, air/6, N2O/2, N2O/4, and N2O/6...
June 9, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28591053/use-of-sugammadex-in-a-patient-with-progressive-muscular-atrophy-and-in-a-patient-with-amyotrophic-lateral-sclerosis-case-report
#12
Jae Hwa Yoo, Soon Im Kim, Sun Young Park, Mi Roung Jun, Yong Eun Kim, Hyoung June Kim
INTRODUCTION: We herein present 2 cases involving the combination of rocuronium and sugammadex in patients with motor neuron disease. The patients were a 54-year-old man with progressive muscular atrophy who underwent removal of internal fixators in the arm and leg, and a 66-year-old woman with amyotrophic lateral sclerosis who underwent skin grafting in the left lower leg. General anesthesia was induced with propofol, rocuronium, and remifentanil and maintained with desflurane and remifentanil...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28551058/-anesthesia-recovery-comparison-between-remifentanil-propofol-and-remifentanil-desflurane-guided-by-bispectral-index-%C3%A2-monitoring
#13
Raphael Grossi Rocha, Eduardo Giarola Almeida, Lara Moreira Mendes Carneiro, Natália Farias de Almeida, Walkíria Wingester Vilas Boas, Renato Santiago Gomez
BACKGROUND AND OBJECTIVES: There is a strong demand for fast and predictable anesthesia recovery with few side effects. Choice of the hypnotic agent could impact on that. This study investigated the differences between recoveries after remifentanil-propofol and remifentanil-desflurane anesthesias guided by bispectral index (BIS(®)). METHODS: Forty patients were randomly assigned into 2 groups according to the anesthesia technique applied: remifentanil-propofol (REM-PRO) and remifentanil-desflurane (REM-DES)...
May 25, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28515519/desflurane-for-ambulatory-anaesthesia-a-comparison-with-sevoflurane-for-recovery-profile-and-airway-responses
#14
Kajal Sachin Dalal, Meghana Vijay Choudhary, Adit Jagdish Palsania, Pratibha Vinayak Toal
BACKGROUND AND AIMS: Desflurane and sevoflurane have low blood gas solubility co-efficients, allowing a rapid awakening from anaesthesia. However, desfluraneis pungent and may cause airway irritability. We compared desflurane and sevoflurane with respect to recovery and occurrence of adverse airway responses in spontaneously breathing patients while using the ProSeal™ laryngeal mask airway (LMA). METHODS: Ninety-four adult patients undergoing hysteroscopic procedures were divided into sevoflurane (S) group or desflurane (D) group...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28494898/the-effect-of-desflurane-versus-propofol-anesthesia-on-postoperative-delirium-in-elderly-obese-patients-undergoing-total-knee-replacement-a-randomized-controlled-double-blinded-clinical-trial
#15
Pedro Tanaka, Stuart Goodman, Barbara R Sommer, William Maloney, James Huddleston, Hendrikus J Lemmens
STUDY OBJECTIVE: The goal of this study was to investigate the incidence of delirium, wake-up times and early post-operative cognitive decline in one hundred obese elderly patients undergoing total knee arthroplasty. DESIGN: Prospective randomized trial. SETTINGS: Operating room, postoperative recovery area, hospital wards. PATIENTS: 100 obese patients (ASA II and III) undergoing primary total knee replacement under general anesthesia with a femoral nerve block catheter...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28494378/ftir-cryospectroscopic-and-ab-initio-studies-of-desflurane-dimethyl-ether-h-bonded-complexes
#16
S M Melikova, K S Rutkowski, M Rospenk
The IR spectra of mixtures of desflurane and dimethyl ether are studied with the help of FTIR cryospectroscopy in liquefied Kr at T~118-158K. Comparative analysis of the experimental data and results of ab initio calculations show that either of the two C-H groups of desflurane is involved in heterodimer formation of comparable strengths. The blue frequency shift is found for stretching vibrations of those C-H donors which directly participate in H-bond formation. Additionally the complexes are stabilized by weaker contacts between hydrogen atoms of dimethyl ether and fluorine atoms of desflurane...
May 2, 2017: Spectrochimica Acta. Part A, Molecular and Biomolecular Spectroscopy
https://www.readbyqxmd.com/read/28444779/a-randomised-controlled-trial-of-propofol-vs-thiopentone-and-desflurane-for-fatigue-after-laparoscopic-cholecystectomy
#17
T Nostdahl, O M Fredheim, T Bernklev, T S Doksrod, R M Mohus, J Raeder
Fatigue may delay functional recovery after day surgery and may be more common after propofol anaesthesia. We randomly allocated 123 participants scheduled for ambulatory laparoscopic cholecystectomy to induction and maintenance of general anaesthesia with propofol or thiopentone and desflurane. Postoperative fatigue was unaffected by the allocated anaesthetic. The combined mean (SD) Identity-Consequences Fatigue Scale of 34.3 (15.1) before surgery increased in the first postoperative week: to 60.4 (21.1) on day 1, p < 0...
April 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28439441/comparison-of-effects-of-low-flow-sevoflurane-and-low-flow-desflurane-anaesthesia-on-renal-functions-using-cystatin-c
#18
Gökçen Duymaz, Seyhan Yağar, Ayşegül Özgök
OBJECTIVE: Numerous studies have indicated nephrotoxic effects of sevoflurane because of its two bioproducts compound A and fluoride. Cystatin C (CyC) is a more sensitive biomarker than creatinine to show early and mild changes in kidney function. We designed this prospective randomised study to compare the effects of low-flow sevoflurane anaesthesia and low-flow desflurane anaesthesia on renal functions based on CyC levels. No studies have evaluated the effects of low-flow sevoflurane anaesthesia on renal functions based on CyC levels to date...
April 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28422881/comparison-of-effects-of-desflurane-and-sevoflurane-on-postoperative-nausea-vomiting-and-pain-in-patients-receiving-opioid-based-intravenous-patient-controlled-analgesia-after-thyroidectomy-propensity-score-matching-analysis
#19
COMPARATIVE STUDY
Il Jae Yoon, Hyun Kang, Chong Wha Baek, Geun Joo Choi, Yong-Hee Park, Yong Hun Jung, Young Cheol Woo, Sangseok Lee
In this study, we aimed to compare the effect of desflurane and sevoflurane on postoperative nausea and vomiting and pain in patients receiving opioid-based intravenous patient-controlled analgesia (IV-PCA) after thyroidectomy.We reviewed the electronic medical records of 1042 patients administered opioid-based IV-PCA after a thyroidectomy at Chung-Ang University Hospital between January 1, 2010 and June 30, 2016. We classified the patients into 2 groups according to the inhalation anesthetic used for anesthesia: desflurane versus sevoflurane (groups D and S, n = 587 and 455, respectively)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28420728/a-membrane-embedded-pathway-delivers-general-anesthetics-to-two-interacting-binding-sites-in-the-gloeobacter-violaceus-ion-channel
#20
Mark J Arcario, Christopher G Mayne, Emad Tajkhorshid
General anesthetics exert their effects on the central nervous system by acting on ion channels, most notably pentameric ligand-gated ion channels. Although numerous studies have focused on pentameric ligand-gated ion channels, the details of anesthetic binding and channel modulation are still debated. A better understanding of the anesthetic mechanism of action is necessary for the development of safer and more efficacious drugs. Herein, we present a computational study identifying two anesthetic binding sites in the transmembrane domain of the Gloeobacter violaceus ligand-gated ion channel (GLIC) channel, characterize the putative binding pathway, and observe structural changes associated with channel function...
June 9, 2017: Journal of Biological Chemistry
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