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Physiology and anesthesia

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https://www.readbyqxmd.com/read/29049457/association-of-patient-frailty-with-increased-morbidity-after-common-ambulatory-general-surgery-operations
#1
Carolyn D Seib, Holly Rochefort, Kathryn Chomsky-Higgins, Jessica E Gosnell, Insoo Suh, Wen T Shen, Quan-Yang Duh, Emily Finlayson
Importance: Frailty is a measure of decreased physiological reserve that is associated with morbidity and mortality in major elective and emergency general surgery operations, independent of chronological age. To date, the association of frailty with outcomes in ambulatory general surgery has not been established. Objective: To determine the association between frailty and perioperative morbidity in patients undergoing ambulatory general surgery operations. Design, Setting, and Participants: A retrospective cohort study was conducted of 140 828 patients older than 40 years of age from the 2007-2010 American College of Surgeons National Surgical Quality Improvement Program Participant Use File who underwent ambulatory and 23-hour-stay hernia, breast, thyroid, or parathyroid surgery...
October 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29049297/functional-connectivity-structure-of-cortical-calcium-dynamics-in-anesthetized-and-awake-mice
#2
Patrick W Wright, Lindsey M Brier, Adam Q Bauer, Grant A Baxter, Andrew W Kraft, Matthew D Reisman, Annie R Bice, Abraham Z Snyder, Jin-Moo Lee, Joseph P Culver
The interplay between hemodynamic-based markers of cortical activity (e.g. fMRI and optical intrinsic signal imaging), which are an indirect and relatively slow report of neural activity, and underlying synaptic electrical and metabolic activity through neurovascular coupling is a topic of ongoing research and debate. As application of resting state functional connectivity measures is extended further into topics such as brain development, aging and disease, the importance of understanding the fundamental physiological basis for functional connectivity will grow...
2017: PloS One
https://www.readbyqxmd.com/read/29049074/physiology-and-role-of-intraocular-pressure-in-contemporary-anesthesia
#3
Dermot J Kelly, Sinéad M Farrell
More than 26 million Americans suffer with cataracts, and with 3.6 million cataract extractions performed annually in the United States, it is the most common surgical procedure. The integrity of the delicate structures of the eye that mediate vision is dependent on the intraocular pressure (IOP). Yet, IOP acts to compress the vessels within the globe-akin to a Starling resistor-and is a key component that determines the ocular perfusion pressure, defined as the difference between arterial pressure and IOP...
October 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29034255/perioperative-management-of-elderly-patients-with-gastrointestinal-malignancies-the-contribution-of-anesthesia
#4
REVIEW
Rudolf Mörgeli, Kathrin Scholtz, Johannes Kurth, Sascha Treskatsch, Bruno Neuner, Susanne Koch, Lutz Kaufner, Claudia Spies
INTRODUCTION: Elderly patients suffering from gastrointestinal malignancies are particularly prone to perioperative complications. Elderly patients often present with reduced physiological reserves, and comorbidities can limit treatment options and promote complications. Surgeons and anesthesiologists must be aware of strategies required to deal with this vulnerable subgroup. METHODS: We provide a brief review of current and emerging perioperative strategies for the treatment of elderly patients with gastrointestinal malignancies and frequent comorbidities...
August 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29033572/role-of-heart-rate-variability-in-preoperative-assessment-of-physiological-reserves-in-patients-undergoing-major-abdominal-surgery
#5
Petr Reimer, Jan Máca, Pavel Szturz, Ondřej Jor, Roman Kula, Pavel Ševčík, Michal Burda, Milan Adamus
BACKGROUND: Major abdominal surgery (MAS) is associated with increased morbidity and mortality. The main objective of our study was to evaluate the predictive value of heart-rate variability (HRV) concerning development of postoperative complications in patients undergoing MAS. The secondary objectives were to identify the relationship of HRV and use of vasoactive drugs during anesthesia, intensive care unit length of stay (ICU-LOS), and hospital length of stay (H-LOS). PATIENTS AND METHODS: Sixty-five patients scheduled for elective MAS were enrolled in a prospective, single-center, observational study...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29020956/guaiphenesin-ketamine-xylazine-infusion-to-maintain-anesthesia-in-mules-undergoing-field-castration
#6
Cecilia Vullo, Augusto Carluccio, Domenico Robbe, Marina Meligrana, Linda Petrucci, Giuseppe Catone
BACKGROUND: In order to determine whether a combination of guaiphenesin, ketamine and xylazine can induce safe and satisfactory anaesthesia in mules undergoing field castration, eight healthy adult intact male mules were employed. They were premedicated with intravenous (IV) xylazine (1.3 mg/kg); an additional dose of xylazine (0.3 mg/kg IV) was administered in case of inadequate depth of sedation. Anaesthesia was induced with IV thiopental (6 mg/kg). The quality of sedation and induction was recorded...
October 11, 2017: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/29019577/influence-of-the-colon-in-liver-regeneration-of-rats-submitted-to-hepatectomy-and-colectomy
#7
Marília Carvalho Moreira, Ítalo Medeiros Azevedo, Cláudia Nunes Oliveira, Aldo da Cunha Medeiros
OBJECTIVE: to evaluate whether colectomy, associated with 70% hepatectomy, influences liver regeneration in rats. METHODS: we distributed 18 Wistar rats in three groups of six animals each. In group I (sham), we performed laparotomy; In group II, colectomy + 70% hepatectomy; In group III, only 70% hepatectomy. On the 6th postoperative day, we collected blood by cardiac puncture under anesthesia, followed by euthanasia. We performed serum dosages of aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin and alkaline phosphatase (AF), hepatocyte growth factor (HGF) and transforming growth factor-α (TGF-α)...
September 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28989831/intraoperative-awareness-and-recall-a-comparative-study-of-dexmedetomidine-and-propofol-in-cardiac-surgery
#8
Tufail Ahmad, Nadeem A Sheikh, Nihida Akhter, Bashir A Dar, Riyaz Ahmad
Background Awareness during general anesthesia is undesired and unanticipated patient wakefulness during surgery or recall of intraoperative events. Incidence of awareness in patients undergoing cardiac surgery is significantly higher than the overall incidence of 1% during general surgery. Awareness during cardiac surgery can be prevented by a number of methods. One such method is the supplemental, intraoperative use of sedative agents. Propofol, a bisubstituted phenol, is an intravenous general anesthetic that has been shown to reduce the incidence of awareness...
August 5, 2017: Curēus
https://www.readbyqxmd.com/read/28973220/effect-of-individualized-vs-standard-blood-pressure-management-strategies-on-postoperative-organ-dysfunction-among-high-risk-patients-undergoing-major-surgery-a-randomized-clinical-trial
#9
RANDOMIZED CONTROLLED TRIAL
Emmanuel Futier, Jean-Yves Lefrant, Pierre-Gregoire Guinot, Thomas Godet, Emmanuel Lorne, Philippe Cuvillon, Sebastien Bertran, Marc Leone, Bruno Pastene, Vincent Piriou, Serge Molliex, Jacques Albanese, Jean-Michel Julia, Benoit Tavernier, Etienne Imhoff, Jean-Etienne Bazin, Jean-Michel Constantin, Bruno Pereira, Samir Jaber
Importance: Perioperative hypotension is associated with an increase in postoperative morbidity and mortality, but the appropriate management strategy remains uncertain. Objective: To evaluate whether an individualized blood pressure management strategy tailored to individual patient physiology could reduce postoperative organ dysfunction. Design, Setting, and Participants: The Intraoperative Norepinephrine to Control Arterial Pressure (INPRESS) study was a multicenter, randomized, parallel-group clinical trial conducted in 9 French university and nonuniversity hospitals...
October 10, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28968196/report-of-workshop-on-euthanasia-for-zebrafish-a-matter-of-welfare-and-science
#10
Almut Köhler, Chereen Collymore, Karin Finger-Baier, Robert Geisler, Larissa Kaufmann, Kieran C Pounder, Stefan Schulte-Merker, Ana Valentim, Zoltan M Varga, Jürgen Weiss, Uwe Strähle
The increasing importance of zebrafish as a biomedical model organism is reflected by the steadily growing number of publications and laboratories working with this species. Regulatory recommendations for euthanasia as issued in Directive 2010/63/EU are, however, based on experience with fish species used for food production and do not take the small size and specific physiology of zebrafish into account. Consequently, the currently recommended methods of euthanasia in the Directive 2010/63/EU are either not applicable or may interfere with research goals...
October 2, 2017: Zebrafish
https://www.readbyqxmd.com/read/28966677/effects-of-sevoflurane-on-rats-with-ischemic-brain-injury-and-the-role-of-the-trek-1-channel
#11
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/28960161/geriatric-comanagement-reduces-perioperative-complications-and-shortens-duration-of-hospital-stay-after-lumbar-spine-surgery-a-prospective-single-institution-experience
#12
Owoicho Adogwa, Aladine A Elsamadicy, Victoria D Vuong, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE Geriatric patients undergoing lumbar spine surgery have unique needs due to the physiological changes of aging. They are at risk for adverse outcomes such as delirium, infection, and iatrogenic complications, and these complications, in turn, contribute to the risk of functional decline, nursing home admission, and death. Whether preoperative and perioperative comanagement by a geriatrician reduces the incidence of in-hospital complications and length of in-hospital stay after elective lumbar spine surgery remains unknown...
September 29, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28960129/development-of-veterinary-anesthesia-simulations-for-pre-clinical-training-design-implementation-and-evaluation-based-on-student-perspectives
#13
Jana L Jones, Jim Rinehart, Jacqueline Jordan Spiegel, Ryane E Englar, Brian K Sidaway, Joie Rowles
Anesthesia simulations have been used in pre-clinical medical training for decades to help learners gain confidence and expertise in an operating room environment without danger to a live patient. The authors describe a veterinary anesthesia simulation environment (VASE) with anesthesia scenarios developed to provide a re-creation of a veterinarian's task environment while performing anesthesia. The VASE uses advanced computer technology with simulator inputs provided from standard monitoring equipment in common use during veterinary anesthesia and a commercial canine training mannequin that allows intubation, ventilation, and venous access...
September 29, 2017: Journal of Veterinary Medical Education
https://www.readbyqxmd.com/read/28957364/age-related-inverse-dose-relation-of-sedatives-and-analgesics-in-the-intensive-care-unit
#14
Amartya Mukhopadhyay, Bee Choo Tai, Deepa Remani, Jason Phua, Matthew Edward Cove, Yanika Kowitlawakul
Sedative and analgesic practices in intensive care units (ICUs) are frequently based on anesthesia regimes but do not take account of the important patient related factors. Pharmacologic properties of sedatives and analgesics change when used as continuous infusions in ICU compared to bolus or short-term infusions during anesthesia. In a prospective observational cohort study, we investigated the association between patient related factors and sedatives/analgesics doses in patients on mechanical ventilation (MV) and their association with cessation of sedation/analgesia...
2017: PloS One
https://www.readbyqxmd.com/read/28948452/citral-and-linalool-chemotypes-of-lippia-alba-essential-oil-as-anesthetics-for-fish-a-detailed-physiological-analysis-of-side-effects-during-anesthetic-recovery-in-silver-catfish-rhamdia-quelen
#15
Carine de Freitas Souza, Matheus Dellaméa Baldissera, Adriane Erbice Bianchini, Elisia Gomes da Silva, Rosa Helena Veraz Mourão, Lenise Vargas Flores da Silva, Denise Schmidt, Berta Maria Heinzmann, Bernardo Baldisserotto
The viability using Lippia alba essential oil as an anesthetic for fish was studied, particularly with respect to physiological effects during recovery. Anesthesia of silver catfish (Rhamdia quelen) using 100 and 300 μL L(-1) of two different chemotypes of L. alba essential oil (citral EO-C and linalool EO-L) prevented the increase of plasma cortisol levels caused by handling, but did not avoid alterations in energetic metabolism. Silver catfish did not have increased the levels of thiobarbituric acid reactive species in the kidney and liver during recovery after anesthesia with either EO, avoiding lipid damage...
September 26, 2017: Fish Physiology and Biochemistry
https://www.readbyqxmd.com/read/28942060/functional-networks-and-network-perturbations-in-rodents
#16
REVIEW
Kai-Hsiang Chuang, Fatima A Nasrallah
Synchronous low-frequency oscillation in the resting human brain has been found to form networks of functionally associated areas and hence has been widely used to map the functional connectivity of the brain using techniques such as resting-state functional MRI (rsfMRI). Interestingly, similar resting-state networks can also be detected in the anesthetized rodent brain, including the default mode-like network. This opens up opportunities for understanding the neurophysiological basis of the rsfMRI signal, the behavioral relevance of the network characteristics, connectomic deficits in diseases and treatment effects on brain connectivity using rodents, particularly transgenic mouse models...
September 21, 2017: NeuroImage
https://www.readbyqxmd.com/read/28939143/a-physiologically-based-model-to-predict-individual-pharmacokinetics-and-pharmacodynamics-of-remifentanil
#17
Sara Cascone, Gaetano Lamberti, Ornella Piazza, Roberto Andrea Abbiati, Davide Manca
Remifentanil based anesthesia is nowadays spread worldwide. This drug is characterized by a rapid onset of the analgesic effects, but also by a rapid onset of the side effects. For this reason, the knowledge of the remifentanil concentration in the human body is a key topic in anesthesiology. The aims of this work are to propose and validate a physiologically based pharmacokinetic model capable to predict both the pharmacokinetics and pharmacodynamics of remifentanil, and to take into account the inter-individual differences among the patients (such as height and body mass)...
September 20, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28938276/anesthesia-with-dexmedetomidine-and-low-dose-isoflurane-increases-solute-transport-via-the-glymphatic-pathway-in-rat-brain-when-compared-with-high-dose-isoflurane
#18
Helene Benveniste, Hedok Lee, Fengfei Ding, Qian Sun, Ehab Al-Bizri, Rany Makaryus, Stephen Probst, Maiken Nedergaard, Elliot A Stein, Hanbing Lu
BACKGROUND: The glymphatic pathway transports cerebrospinal fluid through the brain, thereby facilitating waste removal. A unique aspect of this pathway is that its function depends on the state of consciousness of the brain and is associated with norepinephrine activity. A current view is that all anesthetics will increase glymphatic transport by inducing unconsciousness. This view implies that the effect of anesthetics on glymphatic transport should be independent of their mechanism of action, as long as they induce unconsciousness...
September 22, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28937235/heart-rate-variability-in-newborns
#19
K Javorka, Z Lehotska, M Kozar, Z Uhrikova, B Kolarovszki, M Javorka, M Zibolen
Heart rate (HR) and heart rate variability (HRV) in newborns is influenced by genetic determinants, gestational and postnatal age, and other variables. Premature infants have a reduced HRV. In neonatal HRV evaluated by spectral analysis, a dominant activity can be found in low frequency (LF) band (combined parasympathetic and sympathetic component). During the first postnatal days the activity in the high frequency (HF) band (parasympathetic component) rises, together with an increase in LF band and total HRV...
September 22, 2017: Physiological Research
https://www.readbyqxmd.com/read/28928594/anesthesia-management-of-a-child-with-osteopetrosis
#20
Hashem Jarineshin, Fereydoon Fekrat, Mehdi Feiz Dowlat Abadi
Osteopetrosis is a rare genetic disorder of osteoclast dysfunction leading to anatomical and physiological disorders. We present the anesthesia management for the femur fracture of a 4-year-old girl with malignant infantile type of osteopetrosis. She had a ventriculoperitoneal shunt, impaired motion, visual disturbance, growth failure, facial deformity, heart murmur of moderate tricuspid regurgitation, and left ventricular heart failure, with splenomegaly and severe anemia.
July 2017: Anesthesia, Essays and Researches
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