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Neuroprotection in anaesthesia

B V Owoyele, A L Oyewole, S A Biliaminu, Y Alashi
BACKGROUND: Caffeine is a component of several beverages such as coffee and tea. It has been shown to possess psychoactive properties because it increases alertness, energy and ability to concentrate at moderate doses. Taurine on the other hand, is an amino acid which has the capacity to promote neural development, osmoregulation and neuroprotection. There is paucity of information on the effect of the combined administration of taurine and caffeine on C-reactive protein (CRP)--a marker of inflammation and plasma calcium level in rats...
September 2015: African Journal of Medicine and Medical Sciences
Hemmen Sabir, Thomas Wood, Hannah Gill, Xun Liu, John Dingley, Marianne Thoresen
BACKGROUND: Changes in electroencephalography (EEG) voltage range are used to monitor the depth of anaesthesia, as well as predict outcome after hypoxia-ischaemia in neonates. Xenon is being investigated as a potential neuroprotectant after hypoxic-ischaemic brain injury, but the effect of Xenon on EEG parameters in children or neonates is not known. This study aimed to examine the effect of 50% inhaled Xenon on background amplitude-integrated EEG (aEEG) activity in sedated healthy newborn pigs...
April 15, 2016: Journal of the Neurological Sciences
Felix Ulbrich, Leonardo Eisert, Hartmut Buerkle, Ulrich Goebel, Nils Schallner
BACKGROUND: Propofol, midazolam and ketamine are widely used in today's anaesthesia practice. Both neuroprotective and neurotoxic effects have been attributed to all three agents. OBJECTIVE: To establish whether propofol, midazolam and ketamine in the same neuronal injury model exert neuroprotective effects on injured neurones in vitro and in vivo by modulation of the Toll-like receptor 4-nuclear factor kappa-light-chain-enhancer of activated B cells (TLR-4-NF-κB) pathway...
September 2016: European Journal of Anaesthesiology
Kevin K Noguchi, Stephen A Johnson, Lauren E Kristich, Lauren D Martin, Gregory A Dissen, Emily A Olsen, John W Olney, Ansgar M Brambrink
Exposure of infant animals, including non-human primates (NHPs), to anaesthetic drugs causes apoptotic death of neurons and oligodendrocytes (oligos) and results in long-term neurodevelopmental impairment (NDI). Moreover, retrospective clinical studies document an association between anaesthesia exposure of human infants and significant increase in NDI. These findings pose a potentially serious dilemma because millions of human infants are exposed to anaesthetic drugs every year as part of routine medical care...
2016: Scientific Reports
T V Klypa, A A Eremenko, A N Shepelyuk, I O Antonov
The following paper is the second part of pubished review which reveals today state of pharmacology in neuroprotection issue. In the first part of the review we discussed neuroprotective possibilities of anesthesia medicine, but there is also another trend in pharmacological neuroprotection which is on high demand today: medicine that are not general anaesthesia drugs. This paper surveys medicines from different pharmacological groups and possible neuroprotective properties of these medicine are widely discussed in medical media...
September 2015: Anesteziologiia i Reanimatologiia
Ann D Liebert, Roberta T Chow, Brian T Bicknell, Euahna Varigos
Postoperative cognitive dysfunction (POCD) is a decline in memory following anaesthesia and surgery in elderly patients. While often reversible, it consumes medical resources, compromises patient well-being, and possibly accelerates progression into Alzheimer's disease. Anesthetics have been implicated in POCD, as has neuroinflammation, as indicated by cytokine inflammatory markers. Photobiomodulation (PBM) is an effective treatment for a number of conditions, including inflammation. PBM also has a direct effect on microtubule disassembly in neurons with the formation of small, reversible varicosities, which cause neural blockade and alleviation of pain symptoms...
2016: Journal of Experimental Neuroscience
Rafael Badenes, Shaun E Gruenbaum, Federico Bilotta
PURPOSE OF REVIEW: This article reviews the recent evidence on perioperative neuroprotection in patients undergoing brain surgery and in patients with acute stroke. RECENT FINDINGS: With varying degrees of success, numerous pharmacological and nonpharmacological therapies have been employed to provide neuroprotection for patients during the perioperative period and after acute ischemic stroke (IAS). Recent studies have failed to demonstrate neuroprotective effects of intraoperative remifentanil or propofol use, although hypertonic saline may provide better brain relaxation than mannitol during elective intracranial surgery for tumor...
October 2015: Current Opinion in Anaesthesiology
Alice Brandli, Jonathan Stone
The ERG is the sum of all retinal activity. The ERG is usually recorded from the cornea, which acts as an antenna that collects and sums signals from the retina. The ERG is a sensitive measure of changes in retinal function that are pan-retinal, but is less effective for detecting damage confined to a small area of retina. In the present work we describe how to record the 'flash' ERG, which is the potential generated when the retina is exposed to a brief light flash. We describe methods of anaesthesia, mydriasis and corneal management during recording; how to keep the retina dark adapted; electrode materials and placement; the range and calibration of stimulus energy; recording parameters and the extraction of data...
2015: Journal of Visualized Experiments: JoVE
Sarah Devroe, Jurgen Lemiere, Marc Van de Velde, Marc Gewillig, Derize Boshoff, Steffen Rex
BACKGROUND: Xenon has minimal haemodynamic side effects when compared to volatile or intravenous anaesthetics. Moreover, in in vitro and in animal experiments, xenon has been demonstrated to convey cardio- and neuroprotective effects. Neuroprotection could be advantageous in paediatric anaesthesia as there is growing concern, based on both laboratory studies and retrospective human clinical studies, that anaesthetics may trigger an injury in the developing brain, resulting in long-lasting neurodevelopmental consequences...
2015: Trials
Sarah Devroe, Jurgen Lemiere, Marc Van de Velde, Marc Gewillig, Derize Boshoff, Steffen Rex
BACKGROUND: Xenon has minimal haemodynamic side effects when compared to volatile or intravenous anaesthetics. Moreover, in in vitro and in animal experiments, xenon has been demonstrated to convey cardio- and neuroprotective effects. Neuroprotection could be advantageous in paediatric anaesthesia as there is growing concern, based on both laboratory studies and retrospective human clinical studies, that anaesthetics may trigger an injury in the developing brain, resulting in long-lasting neurodevelopmental consequences...
December 2015: Trials
Denis Azzopardi
The cerebral function monitor is a device for trend monitoring of changes in the amplitude of the electroencephalogram, typically recorded from one or two pairs of electrodes. Initially developed and introduced to monitor cerebral activity in encephalopathic adult patients or during anaesthesia, it is now most widely used in newborns to assess the severity of encephalopathy and for determining prognosis. The duration and severity of abnormalities of the amplitude-integrated electroencephalogram tracing is highly predictive of subsequent neurologic outcome following neonatal hypoxic-ischemic encephalopathy, including in newborns receiving neuroprotective treatment with prolonged moderate hypothermia...
June 2015: Seminars in Fetal & Neonatal Medicine
Imelda M Galvin, Ron Levy, J Gordon Boyd, Andrew G Day, Micheal C Wallace
BACKGROUND: Patients undergoing neurosurgery are at risk of cerebral ischaemia with resultant cerebral hypoxia and neuronal cell death. This can increase both the risk of mortality and long term neurological disability. Induced hypothermia has been shown to reduce the risk of cerebral ischaemic damage in both animal studies and in humans who have been resuscitated following cardiac arrest. This had lead to an increasing interest in its neuroprotective potential in neurosurgical patients...
2015: Cochrane Database of Systematic Reviews
Z H Anastasian
Anaesthetic management of the acute stroke patient demands consideration of the penumbra as the central focus. Recent studies have shown that patients who receive general anaesthesia for endovascular therapy for acute ischaemic stroke have worse outcomes than those who receive local anaesthesia. Although baseline condition of the patients in these studies differed, we should heed the warnings evident in the results. 'Time is brain': therapy should be quickly provided. Arterial pressure should be monitored carefully upon induction, avoiding a drastic reduction, and allowing for a reduction in arterial pressure upon recanalization...
December 2014: British Journal of Anaesthesia
Konstanze Plaschke, Ann-Katrin Müller, Jürgen Kopitz
Pharmacological enhancement of cholinergic activity following administration of physostigmine is known to induce protective effects generally. However, it is unclear whether the effect of physostigmine on inflammation and acetylcholine (ACh) metabolism is related to different types of surgical intervention or anaesthesia alone. To investigate this, rats were subjected to partial liver resection (PLR) or sham surgery, with a control group receiving anaesthesia alone. Half of each treatment group received a single intra-operative dose of physostigmine (0...
September 2014: Clinical and Experimental Pharmacology & Physiology
A A Viatkin, L G Petrosian, V M Mizikov, S A Vasil'ev
Neuroprotection could be the aim to use Xenon for general anesthesia. However the experience of Xenon anesthesia in neurosurgery is quite limited. The appraisal of Xenon based anesthesia was accomplished in 12 patients during various brain surgery. Xe in concentration 65% was used to maintenance of anesthesia, other medication was avoided. As a resuIt there were 8 cases of arterial hypertension and 2 cases of superficial hypnotic state. Excitation (n = 3), hyperdynamic reaction (n = 8), PONV (n = 8) were detected in early postoperative period...
November 2013: Anesteziologiia i Reanimatologiia
Adam Denes, Jesus M Pradillo, Caroline Drake, Hannah Buggey, Nancy J Rothwell, Stuart M Allan
Acute brain injury results in peripheral inflammatory changes, although the impact of these processes on neuronal death and neuroinflammation is currently unclear. To facilitate the translation of experimental studies to clinical benefit, it is vital to characterize the mechanisms by which acute brain injury induces peripheral inflammatory changes, and how these are affected by surgical manipulation in experimental models. Here we show that in mice, even mild surgical manipulation of extracranial tissues induced marked granulocyte mobilization (300%) and systemic induction of cytokines...
2013: Frontiers in Neuroscience
Robert D Combes
Military research, testing, and surgical and resuscitation training, are aimed at mitigating the consequences of warfare and terrorism to armed forces and civilians. Traumatisation and tissue damage due to explosions, and acute loss of blood due to haemorrhage, remain crucial, potentially preventable, causes of battlefield casualties and mortalities. There is also the additional threat from inhalation of chemical and aerosolised biological weapons. The use of anaesthetised animal models, and their respective replacement alternatives, for military purposes -- particularly for blast injury, haemorrhaging and resuscitation training -- is critically reviewed...
November 2013: Alternatives to Laboratory Animals: ATLA
Yajie Liu, Cheng Ni, Yi Tang, Xiaosheng Tian, Yang Zhou, Min Qian, Zhengqian Li, Dehua Chui, Xiangyang Guo
Melatonin is an endogenous hormone with neuroprotective effects. Melatonin levels in elderly patients are reduced after surgeries that require anaesthesia. Whether reduced melatonin levels are important for postoperative cognitive dysfunction (POCD) remains unclear. Here, we investigated the effects of melatonin on cognitive dysfunctions induced by isoflurane and mechanisms underlying these effects. Seventy-two 20-month-old Sprague-Dawley rats were randomly divided into six groups (n = 12). These groups included M1 and M10 groups that received intraperitoneal melatonin at 1 mg/kg or 10 mg/kg, respectively, and an ISO group that received 4 hr of inhaled 2% isoflurane...
October 2013: Basic & Clinical Pharmacology & Toxicology
A Boscolo, C Ori, J Bennett, B Wiltgen, V Jevtovic-Todorovic
BACKGROUND: Exposure to general anaesthesia during critical stages of brain development results in long-lasting cognitive impairment. Co-administration of protective agents could minimize the detrimental effects of anaesthesia. Co-administration of R(+)pramipexole (PPX), a synthetic aminobenzothiazol derivative that restores mitochondrial integrity, prevents anaesthesia-induced mitochondrial and neuronal damage and prevents early development of cognitive impairment. Here, we determine the protective effects of PPX into late adulthood in male and female rats...
June 2013: British Journal of Anaesthesia
C Stoppe, A V Fahlenkamp, S Rex, N C Veeck, S C Gozdowsky, G Schälte, R Autschbach, R Rossaint, M Coburn
BACKGROUND: To date, only limited data exist about the use of xenon as an anaesthetic agent in patients undergoing cardiac surgery. The favourable cardio- and neuroprotective properties of xenon might attenuate postoperative complications, improve outcome, and reduce the incidence of delirium. Thus, the aims of this study were to investigate the feasibility and safety of balanced xenon anaesthesia in patients undergoing cardiac surgery and to gather pilot data for a future randomized multicentre study...
September 2013: British Journal of Anaesthesia
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