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Neonates and Anaesthetics

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https://www.readbyqxmd.com/read/29406172/the-impact-of-neuraxial-clonidine-on-postoperative-analgesia-and-perioperative-adverse-effects-in-women-having-elective-caesarean-section-a-systematic-review-and-meta-analysis
#1
REVIEW
T K Allen, B M Mishriky, R Y Klinger, A S Habib
Neuraxial clonidine improves postoperative analgesia in the general surgical population. The efficacy and safety of neuraxial clonidine as a postoperative analgesic adjunct in the Caesarean section population still remains unclear. This systematic review and meta-analysis aims to evaluate the effect of perioperative neuraxial clonidine on postoperative analgesia in women having Caesarean section under neuraxial anaesthesia. We included randomized controlled trials comparing the analgesic efficacy of the perioperative administration of neuraxial clonidine alone or in combination with a local anaesthetic and/or opioids in women having elective Caesarean section under neuraxial anaesthesia when compared with placebo...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29401517/role-of-%C3%AE-7nachr-nmdar-in-sevoflurane-induced-memory-deficits-in-the-developing-rat-hippocampus
#2
XiaoHong Tang, YiZe Li, JiYing Ao, Ling Ding, Yang Liu, Yuan Yuan, ZhiFen Wang, GuoLin Wang
Detrimental effects of volatile anaesthetics, including sevoflurane, on the structure and function of the developing brain have been reported. The internalization of N-methyl-D-aspartate receptors (NMDARs) contributes to anaesthetic neurotoxicity. Both nicotinic acetylcholine receptors (nAChRs) and NMDAR play a critical role in the development of the nervous system. Moreover, nAChR can interact with NMDAR, and previous studies have demonstrated modulation of NMDAR by nAChR. In our study, we used an α7 nicotinic acetylcholine receptor (α7nAChR) agonist and α7nAChR antagonist to explore the role of α7nAChR and NMDAR in sevoflurane-induced long-term effects on memory and dendritic spine both in vivo and in vitro...
2018: PloS One
https://www.readbyqxmd.com/read/29338142/patient-controlled-epidural-analgesia-with-and-without-basal-infusion-using-ropivacaine-0-15-and-fentanyl-2%C3%AE-ml-for-labour-analgesia-a-prospective-comparative-randomised-trial
#3
Paraskevi K Matsota, Kalliopi H Drachtidi, Chrysanthi Z Batistaki, Agathi V Karakosta, Ioanna C Koukopoulou, Eugenia I Koursoumi, Georgia G Kostopanagiotou
BACKGROUND: Patient-Controlled Epidural Analgesia (PCEA) is a common practice for labour pain relief. This study aimed to compare two different settings of a PCEA device using the same solution to obtain labour analgesia. METHODS: Fifty two parturients were randomly allocated to receive ropivacaine 0.15% and fentanyl 2γ/mL via a PCEA device either as a background infusion of 5mL/h plus 5mL demand bolus doses with 10 min lockout (group B/D, n=26) or as only demand bolus doses of 5mL with 10 min lockout (group D, n=26)...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29331007/anaesthetic-management-of-nesidioblastosis-in-two-infants
#4
Muhammad Saad Yousuf, Mohsin Nazir Butt, Fauzia Anis Khan
Nesidioblastosis is the most common cause of non-transient, recurrent and persistent hypoglycaemia in neonates and infants. It is a disorder of diffuse proliferation of beta cells of the pancreas leading to hyperinsulinemia and hypoglycaemia. The main aim is to prevent the severe episodes of hypoglycaemia which can cause damage to the brain and/or mental retardation. In this case report we present two cases of nesidioblastosis and their perioperative anaesthetic course for near-total pancreatectomy. First case was a 7 months old female who had repeated episodes of convulsions since birth...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29213167/pain-assessment-and-management-the-knowledge-attitude-and-practice-of-sudanese-paediatric-residents
#5
Mohammed A A Alhassan, Fathelrahman E Ahmed, Abdolmoneim A Bannaga
This was a prospective, descriptive, cross sectional study that was conducted in 9 major paediatric hospitals accredited for training of residents in Sudan to assess the knowledge, attitude and practice of residents in paediatrics on issues related to pain assessment and pain management in children A semi-structured and validated questionnaire was distributed to 174 residents working in these hospitals. One hundred and twenty residents, out of 174, responded by filling the questionnaire, with a response rate of 68%...
2017: Sudanese Journal of Paediatrics
https://www.readbyqxmd.com/read/29161390/thiopental-to-desflurane-an-anaesthetic-journey-where-are-we-going-next
#6
J R Sneyd
Development targets in anaesthetic pharmacology have evolved from minimizing harm caused by unwanted effects through an era in which rapid onset and offset of drug effect were prioritised. Today's anaesthetists have access to a library of effective drugs whose characteristics offer controllable hypnosis, analgesia and paralysis with manageable off-target effects. The availability of these agents at generic prices inhibits commercial interest and this is reflected in the limited number of current anaesthetic drug development projects...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29140997/topical-anaesthesia-reduces-sensitivity-of-castration-wounds-in-neonatal-piglets
#7
Sabrina Lomax, Charissa Harris, Peter A Windsor, Peter J White
The aim of this study was to do determine the efficacy of the topical anaesthetic Tri-Solfen® in the amelioration of the pain of castration in piglets. The trial was conducted over a three day period, and blocked across six litters with 12 piglets treated on days one and two, and 16 on day three. The piglets were randomly allocated by weight and litter to 1 of 4 treatment groups: (i) sham castration (SHAM; n = 10); (ii) surgical castration with no anaesthetic intervention (CAST; n = 10); (iii) surgical castration with post-operative topical anaesthesia (TRI; n = 10); (iv) surgical castration with a pre-operative intra-testicular lignocaine hydrochloride injection (LIG; n = 10)...
2017: PloS One
https://www.readbyqxmd.com/read/28974111/in-vitro-neurotoxicity-by-ropivacaine-is-reduced-by-silencing-cav3-3-t-type-calcium-subunits-in-neonatal-rat-sensory-neurons
#8
Xianjie Wen, Hua Liang, Heng Li, Weiming Ou, Han-Bing Wang, Hongzhen Liu, Shijie Li
Neurotoxicity of local anaesthetics has been alerted by more and more peoples. Cav3.1 and Cav3.2 T-type calcium channels were closely related with local anaesthetics toxicity. However, the role of Cav3.3, another subtype of the T-type calcium channel, on the neurotoxicity induced by local anaesthetics remains unclear. CaMKIIγ is a kind of multifunctional kinase and associated with a variety of physiological and pathological process. T-type calcium channel is closely related with CaMKIIγ. Up-regulation CaMKIIγ can increase T-type currents at the dorsal root ganglia (DRG)...
October 3, 2017: Artificial Cells, Nanomedicine, and Biotechnology
https://www.readbyqxmd.com/read/28969320/isoflurane-exposure-for-three-hours-triggers-apoptotic-cell-death-in-neonatal-macaque-brain
#9
K K Noguchi, S A Johnson, G A Dissen, L D Martin, F M Manzella, K J Schenning, J W Olney, A M Brambrink
Background: Retrospective clinical studies suggest there is a risk for neurodevelopmental impairment following early childhood exposure to anaesthesia. In the developing animal brain, including those of non-human primates (NHPs), anaesthetics induce apoptotic cell death. We previously reported that a 5 h isoflurane (ISO) exposure in infant NHPs increases apoptosis 13-fold compared with control animals. However, the majority of paediatric surgeries requiring anaesthesia are of shorter durations...
September 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28969317/dexmedetomidine-mediated-neuroprotection-against-sevoflurane-induced-neurotoxicity-extends-to-several-brain-regions-in-neonatal-rats
#10
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
#11
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/28969308/inhibition-of-p75-neurotrophin-receptor-does-not-rescue-cognitive-impairment-in-adulthood-after-isoflurane-exposure-in-neonatal-mice
#12
J M Schilling, A Kassan, C Mandyam, M L Pearn, A Voong, G G Grogman, V B Risbrough, I R Niesman, H H Patel, P M Patel, B P Head
Background: Isoflurane is widely used for anaesthesia in humans. Isoflurane exposure of rodents prior to post-natal day 7 (PND7) leads to widespread neurodegeneration in laboratory animals. Previous data from our laboratory suggest an attenuation of apoptosis with the p75 neurotrophin receptor (p75NTR) inhibitor TAT-Pep5. We hypothesized that isoflurane toxicity leads to behavioural and cognitive abnormalities and can be rescued with pre-anaesthesia administration of TAT-Pep5. Methods: Neonatal mouse pups were pretreated with either TAT-Pep5 (25 μl, 10 μM i...
September 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28962511/granulocyte-colony-stimulating-factor-significantly-decreases-density-of-hippocampal-caspase-3-positive-nuclei-thus-ameliorating-apoptosis-mediated-damage-in-a-model-of-ischaemic-neonatal-brain-injury
#13
Peter Pastuszko, Gregory J Schears, Joanna Kubin, David F Wilson, Anna Pastuszko
OBJECTIVES: Ischaemic brain injury is a major complication in patients undergoing surgery for congenital heart disease, with the hippocampus being a particularly vulnerable region. We hypothesized that neuronal injury resulting from cardiopulmonary bypass and associated circulatory arrest is ameliorated by pretreatment with granulocyte colony-stimulating factor (G-CSF), a cytokine and an anti-apoptotic neurotrophic factor. METHODS: In a model of ischaemic brain injury, 4 male newborn piglets were anaesthetized and subjected to deep hypothermic circulatory arrest (DHCA) (cooled to 18°C, DHCA maintained for 60 min, rewarmed and recovered for 8-9 h), while 4 animals received G-CSF (34 µg/kg, intravenously) 2 h prior to the DHCA procedure...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28950826/long-term-effects-of-early-exposure-to-stress-pain-opioids-and-anaesthetics-on-pain-sensitivity-and-neurocognition
#14
Gerbrich E van den Bosch, Monique van Dijk, Dick Tibboel, Jurgen C de Graaff
Background Experimental studies have shown that neonatal exposure to stress, pain, opioids and anaesthetics may cause histologic and morphologic changes in the central nervous system with associated functional and behavioural changes in the long term. An important question is whether this holds true for humans also - and in particular for sick neonates who often are exposed to pain and receive anaesthetics and sedatives. Methods In this narrative review, we evaluate the effects of neonatal exposure to stress, pain, opioids and anaesthetics in infancy and childhood in animals and in preterm born and term born humans on pain sensitivity, brain morphology, cognition and behaviour later in life...
September 26, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28881034/microrna-27a-3p-suppression-of-peroxisome-proliferator-activated-receptor-%C3%AE-contributes-to-cognitive-impairments-resulting-from-sevoflurane-treatment
#15
Xiang Lv, Jia Yan, Jue Jiang, Xuhui Zhou, Yi Lu, Hong Jiang
Sevoflurane is the most widely used anaesthetic administered by inhalation. Exposure to sevoflurane in neonatal mice can induce learning deficits and abnormal social behaviours. MicroRNA (miR)-27a-3p, a short, non-coding RNA that functions as a tumour suppressor, is up-regulated after inhalation of anaesthetic, and peroxisome proliferator-activated receptor γ (PPAR-γ) is one of its target genes. The objective of this study was to investigate how the miR-27a-3p-PPAR-γ interaction affects sevoflurane-induced neurotoxicity...
November 2017: Journal of Neurochemistry
https://www.readbyqxmd.com/read/28814087/effects-of-sevoflurane-on-apoptosis-bdnf-and-cognitive-functions-in-neonatal-rats
#16
A B Ozer, S Ceribasi, A O Ceribasi, I Demirel, M K Bayar, B Ustundag, A Ileri, O L Erhan
OBJECTIVE: To evaluate the early and late effects of sevoflurane on the neonatal brain. BACKGROUND: Sevoflurane is the most used anaesthetics in neonatal subjects. METHODS: The study included 7-day-old male Wistar-Albino rats (n = 30), which were divided into the two groups according to the anaesthetic received: sevoflurane (S) and control group (C). Half of each group was sacrificed six hours after anaesthesia (early, E) while the remaining subjects were sacrificed six weeks later (late, L)...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/28794527/the-effect-of-addition-of-dexamethasone-to-levobupivacaine-in-parturients-receiving-combined-spinal-epidural-for-analgesia-for-vaginal-delivery
#17
Amr Samir Wahdan, Ahmed Ibrahim El-Sakka, Hassan Mostafa Ismail Gaafar
BACKGROUND AND AIMS: Regional analgesia is commonly used for the relief of labour pain, Prolongation of analgesia can be achieved by adjuvant medications. The aim of this randomised controlled trial was to evaluate the efficacy of intrathecal levobupivacaine with dexamethasone for labour analgesia. METHODS: A total of 80 females were included in this study, all were primigravidas undergoing vaginal delivery with cervical dilatation ≥4 cm and 50% or more effacement...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28743959/continual-conscious-bioluminescent-imaging-in-freely-moving-somatotransgenic-mice
#18
Rajvinder Karda, Dany P Perocheau, Natalie Suff, Joanne Ng, Juliette M K M Delhove, Suzanne M K Buckley, Samantha Richards, John R Counsell, Henrik Hagberg, Mark R Johnson, Tristan R McKay, Simon N Waddington
Luciferase bioimaging in living animals is increasingly being applied in many fields of biomedical research. Rodent imaging usually involves anaesthetising the animal during data capture, however, the biological consequences of anaesthesia have been largely overlooked. We have evaluated luciferase bioimaging in conscious, unrestrained mice after neonatal intracranial or intravascular administration of lentiviral, luciferase reporter cassettes (biosensors); we present real-time analyses from the first day of life to adulthood...
July 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28711179/immediate-birth-an-analysis-of-women-and-their-babies-undergoing-time-critical-birth-in-a-tertiary-referral-obstetric-hospital
#19
M H Warren, J Kamania, A T Dennis
BACKGROUND: At our institution, the emergency obstetric 'code green' activates the system for immediate birth, usually by caesarean section. This study aimed to determine the incidence of immediate birth, indications, modes of anaesthesia, and short-term neonatal and maternal outcomes. METHOD: A review was performed for all women at the Royal Women's Hospital, Parkville, Australia who underwent immediate birth over a two-year period: January 1, 2013 to December 31, 2014...
June 16, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28676256/neurotoxicity-of-propofol-on-rat-hypoglossal-motoneurons-in-vitro
#20
Laura Monni, Filippo Ghezzi, Silvia Corsini, Andrea Nistri
Although propofol is a widely used intravenous general anaesthetic, many studies report its toxic potential, particularly on the developing central nervous system. We investigated its action on hypoglossal motoneurons (HMs) that control two critical functions in neonates, namely tongue muscle activity and airway patency. Thus, clinically relevant concentrations of propofol (1 and 5μM) were applied (4h) to neonatal rat brainstem slices to evaluate the expression of apoptosis-inducing factor (AIF) as biomarker of toxicity...
August 10, 2017: Neuroscience Letters
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