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Anesthesia and consciousness

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https://www.readbyqxmd.com/read/28916485/moderate-intravenous-sedation-for-first-trimester-surgical-abortion-a-comparison-of-adverse-outcomes-between-obese-and-normal-weight-women
#1
Gillian Horwitz, Danielle Roncari, Kari Braaten, Rie Maurer, Jennifer Fortin, Alisa B Goldberg
OBJECTIVE: To determine if obese women experience increased rates of adverse outcomes with moderate intravenous sedation during first trimester surgical abortion compared to normal weight women. STUDY DESIGN: We performed a retrospective cohort study of all first trimester surgical abortions with moderate intravenous sedation at an outpatient facility between September 2010 and June 2015. The primary outcome was supplemental oxygen administration. Secondary outcomes included reversal agent administration, anesthesia-related adverse events, and intraoperative lowest level of consciousness (LLOC)...
September 13, 2017: Contraception
https://www.readbyqxmd.com/read/28904717/aseptic-meningitis-following-a-bupivacaine-spinal-anesthesia
#2
Nawfal Doghmi, Amine Meskine, Aziz Benakroute, Mustapha Bensghir, Abdelouahed Baite, Charki Haimeur
Spinal anesthesia complicated by meningitis is rare. The diagnosis is difficult and the clinical signs are unspecific. There is a subgroup called aseptic meningitis of a different mechanism (hypersensitive reaction and irritation of the meninges), which must be identified for appropriate care. We report the case of aseptic meningitis resulting from bupivacaine use complicating spinal anesthesia. She is 31 years old and was admitted to the intensive care unit for meningitis following a Caesarean delivery. 10 hours after the procedure, she was found to have severe headache, neck stiffness and was found restless...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28904676/-gestational-diabetes-revealed-by-inaugural-diabetic-ketoacidosis-about-a-case
#3
Serge Irie Bi Gohi, Pete Yaich, Koffi N'guessan, Bernard Ogondon, Yapo Brouh
Ketoacidosis complicating gestational diabetes is rare and responsible for severe maternal-fetal mortality. It is an acute metabolic emergency whose management is multidisciplinary. Early diagnosis and treatment affect the vital prognosis of both the mother and the fetus. We report the case of a 27-year old pregnant woman at term, with a family history of diabetes, admitted to the emergency obstetric care with alertness problems associated with dyspnoea. The diagnosis of inaugural ketoacidosis decompensated due to severe malaria associated with gestational diabetes was retained on the basis of patient's medical history, of clinical examination and paraclinical assessment...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28904228/anesthesia-related-outcomes-for-endovascular-stroke-revascularization-a-systematic-review-and-meta-analysis
#4
Waleed Brinjikji, Jeffrey Pasternak, Mohammad H Murad, Harry J Cloft, Tasha L Welch, David F Kallmes, Alejandro A Rabinstein
BACKGROUND AND PURPOSE: There is currently controversy on the ideal anesthesia strategy during mechanical thrombectomy for acute ischemic stroke. We performed a systematic review and meta-analysis of studies comparing clinical and angiographic outcomes of patients undergoing general anesthesia (GA group) and those receiving either local anesthesia or conscious sedation (non-GA group). METHODS: A literature search on anesthesia and endovascular treatment of acute ischemic stroke was performed...
September 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28889004/quantitative-vascular-neuroimaging-of-the-rat-brain-using-superparamagnetic-nanoparticles-new-insights-on-vascular-organization-and-brain-function
#5
Codi A Gharagouzloo, Liam Timms, Ju Qiao, Zihang Fang, Joseph Nneji, Aniket Pandya, Praveen Kulkarni, Anne L van de Ven, Craig Ferris, Srinivas Sridhar
A method called Quantitative Ultra-Short Time-to-Echo Contrast Enhanced (QUTE-CE) Magnetic Resonance Imaging (MRI) which utilizes superparamagnetic iron oxide nanoparticles (SPIONs) as a contrast agent to yield positive contrast angiograms with high clarity and definition is applied to the whole live rat brain. QUTE-CE MRI intensity data are particularly well suited for measuring quantitative cerebral blood volume (qCBV). A global map of qCBV in the awake resting-state with unprecedented detail was created via application of a 3D MRI rat brain atlas with 173 segmented and annotated brain areas...
September 6, 2017: NeuroImage
https://www.readbyqxmd.com/read/28866718/hypersomnia-and-cognitive-impairment-in-a-patient-with-bipolar-disorder-a-case-report
#6
Katarzyna Szaulińska, Anna Antosik-Wójcińska, Ewa Paszkowska, Łukasz Święcicki, Marek Jarema, Adam Wichniak
OBJECTIVES: Obstructive sleep apnea (OSA) is a common clinical problem that can have serious health consequences and complicate the course of mental disorders. It is estimated that the prevalence of sleep apnea in patients with bipolar disorder can be 21-47.5%. Some symptoms of OSA are the same as the symptoms of depression: daytime drowsiness, cognitive dysfunction, decreased drive, apathy, depressed mood, anhedonia. METHODS: We present a case of a patient whose depressive symptoms persisted despite repeated changes of pharmacological treatment and were exacerbated by severe sleep disorder...
June 18, 2017: Psychiatria Polska
https://www.readbyqxmd.com/read/28864443/conscious-sedation-versus-general-anesthesia-for-transcatheter-aortic-valve-replacement-insights-from-the-ncdr%C3%A2-sts-acc-tvt-registry
#7
Matthew C Hyman, Sreekanth Vemulapalli, Wilson Y Szeto, Amanda Stebbins, Prakash A Patel, Roland A Matsouaka, Howard C Herrmann, Saif Anwaruddin, Taisei Kobayashi, Nimesh D Desai, Prashanth Vallabhajosyula, Fenton H McCarthy, Robert Li, Joseph E Bavaria, Jay Giri
Background -Conscious sedation is used during transcatheter aortic valve replacement (TAVR) with limited evidence as to the safety and efficacy of this practice. Methods -The NCDR STS/ACC TVT Registry was used to characterize the anesthesia choice and clinical outcomes of all U.S. patients undergoing elective percutaneous transfemoral TAVR between April 1, 2014 and June 30, 2015. Raw and inverse probability of treatment weighted (IPTW) analyses were performed to compare general anesthesia patients with conscious sedation patients on an intention-to-treat basis for the primary outcome of in-hospital mortality, and secondary outcomes including 30-day mortality, in-hospital and 30-day death/stroke, procedural success, ICU and hospital length-of-stay, and rates of discharge to home...
September 1, 2017: Circulation
https://www.readbyqxmd.com/read/28863720/harmonic-brain-modes-a-unifying-framework-for-linking-space-and-time-in-brain-dynamics
#8
Selen Atasoy, Gustavo Deco, Morten L Kringelbach, Joel Pearson
A fundamental characteristic of spontaneous brain activity is coherent oscillations covering a wide range of frequencies. Interestingly, these temporal oscillations are highly correlated among spatially distributed cortical areas forming structured correlation patterns known as the resting state networks, although the brain is never truly at "rest." Here, we introduce the concept of harmonic brain modes-fundamental building blocks of complex spatiotemporal patterns of neural activity. We define these elementary harmonic brain modes as harmonic modes of structural connectivity; that is, connectome harmonics, yielding fully synchronous neural activity patterns with different frequency oscillations emerging on and constrained by the particular structure of the brain...
September 1, 2017: Neuroscientist: a Review Journal Bringing Neurobiology, Neurology and Psychiatry
https://www.readbyqxmd.com/read/28856114/total-intravenous-anesthesia-for-neurosurgical-procedures-in-narcoleptic-patients-two-case-reports
#9
Sara Pedrosa, Nuno Lareiro, Pedro Amorim
INTRODUCTION: Narcoleptic patients may be at increased risk of prolonged emergence, postoperative hypersomnia, apneic episodes, and sleep paralysis after general anesthesia. Modafinil is the first-line treatment, however, the implication it has on general anesthesia is not clear. This report present 2 cases of narcoleptic patients medicated with modafinil that were submitted to total intravenous anesthesia for neurosurgical procedures. CASE PRESENTATION: Informed consent was obtained from both patients...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28852014/anesthetic-alterations-of-collective-terahertz-oscillations-in-tubulin-correlate-with-clinical-potency-implications-for-anesthetic-action-and-post-operative-cognitive-dysfunction
#10
Travis J A Craddock, Philip Kurian, Jordane Preto, Kamlesh Sahu, Stuart R Hameroff, Mariusz Klobukowski, Jack A Tuszynski
Anesthesia blocks consciousness and memory while sparing non-conscious brain activities. While the exact mechanisms of anesthetic action are unknown, the Meyer-Overton correlation provides a link between anesthetic potency and solubility in a lipid-like, non-polar medium. Anesthetic action is also related to an anesthetic's hydrophobicity, permanent dipole, and polarizability, and is accepted to occur in lipid-like, non-polar regions within brain proteins. Generally the protein target for anesthetics is assumed to be neuronal membrane receptors and ion channels, however new evidence points to critical effects on intra-neuronal microtubules, a target of interest due to their potential role in post-operative cognitive dysfunction (POCD)...
August 29, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28851965/comparison-of-continuous-glucose-monitoring-between-dexcom-g4-platinum-and-hd-xg-systems-in-nonhuman-primates-macaca-fascicularis
#11
Bingdi Wang, Wei Qiao, Weiwei Ye, Xiaoli Wang, Yongqiang Liu, Yixin Jim Wang, Yong-Fu Xiao
Timely knowing glucose level helps diabetic patients to manage the disease, including decisions about food, physical activity and medication. This study compared two continuous glucose monitoring systems in conscious and moving-free nonhuman primates (NHPs, Macaca fascicularis). Each normoglycemic or diabetic monkey was implanted with one Dexcom G4 Platinum subcutaneously or one HD-XG glucose sensor arterially for glucose monitoring. The glucose levels measured by both telemetry devices significantly correlated with the glucometer readings...
August 29, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28821646/location-of-the-mesopontine-neurons-responsible-for-maintanance-of-anesthetic-loss-of-consciousness
#12
Anne Minert, Shai-Lee Yatziv, Marshall Devor
The transition from wakefulness to general anesthesia is widely attributed to suppressive actions of anesthetic molecules distributed by the systemic circulation to the cerebral cortex (for amnesia and loss-of-consciousness) and to the spinal cord (for atonia and antinociception). An alternative hypothesis proposes that anesthetics act on one or more brainstem or diencephalic nuclei, with suppression of cortex and spinal cord mediated by dedicated axonal pathways. We previously documented induction of an anesthesia-like state in rats by microinjection of small amounts of GABAA-R agonists into an upper brainstem region named the mesopontine tegmental anesthesia area(MPTA)...
August 16, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28800575/disruption-of-frontal-parietal-connectivity-during-conscious-sedation-by-propofol-administration
#13
Pil-Jong Kim, Hong-Gee Kim, Gyu-Jeong Noh, Yong-Seo Koo, Teo Jeon Shin
The sedative state is a transitional state from wakefulness to general anesthesia. However, little is understood regarding the mechanism of conscious sedation, different from general anesthesia while maintaining wakefulness. In this study, we aimed to investigate changes in functional connectivity of the parietal-frontal network, implicated in wakefulness during conscious sedation induced by propofol infusion. The electroencephalography was obtained at the frontal and parietal areas of adult volunteers who maintain wakefulness during low-dose propofol infusion (1...
September 27, 2017: Neuroreport
https://www.readbyqxmd.com/read/28767479/resistance-to-propofol-induction-in-a-patient-taking-modafinil-a-case-report
#14
Timothy N Harwood
After sedation with midazolam, induction of anesthesia with propofol was attempted in a patient taking modafinil. However, even after administration of a total of 6 mg/kg propofol IV, the patient continued to respond to tactile stimulation. Concurrently, the bispectral index was 72. Subsequent administration of low concentration sevoflurane by facemask induced an anesthetic depth that allowed unproblematic insertion of a laryngeal mask airway. Anesthesia for ophthalmologic surgery was maintained with sevoflurane...
August 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28756422/transradial-coronary-angiogram-in-a-sitting-position
#15
Konstantinos Marmagkiolis, Mehmet Cilingiroglu, Cindy L Grines
Transradial coronary angiography has significantly increased in the United States over the last decade. When the patient is unable to lie down despite analgesia and conscious sedation, general anesthesia may be recommended. We report the feasibility of transradial coronary angiogram in a sitting position.
August 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28750775/breakdown-of-long-range-temporal-correlations-in-brain-oscillations-during-general-anesthesia
#16
Dominik Krzemiński, Maciej Kamiński, Artur Marchewka, Michał Bola
Consciousness has been hypothesized to emerge from complex neuronal dynamics, which prevails when brain operates in a critical state. Evidence supporting this hypothesis comes mainly from studies investigating neuronal activity on a short time-scale of seconds. However, a key aspect of criticality is presence of scale-free temporal dependencies occurring across a wide range of time-scales. Indeed, robust long-range temporal correlations (LRTCs) are found in neuronal oscillations during conscious states, but it is not known how LRTCs are affected by loss of consciousness...
July 24, 2017: NeuroImage
https://www.readbyqxmd.com/read/28749263/measuring-intraocular-pressure-in-white-s-tree-frogs-litoria-caerulea-by-rebound-tonometry-comparing-device-time-of-day-and-manual-versus-chemical-restraint-methods
#17
Jennifer C Hausmann, Ashley Krisp, Kurt Sladky, Paul E Miller, Christoph Mans
Ocular diseases reported in frogs include uveitis and glaucoma, which are associated with changes in intraocular pressure (IOP). The objectives of this study were to characterize the normal IOP for White's tree frogs ( Litoria caerulea ) using two types of rebound tonometers, and to assess whether time of day or method of restraint affected IOP. Eighteen conscious, unrestrained, ophthalmologically normal frogs were used to measure IOP using TonoVet® and TonoLab® tonometers, at three time points during the day...
June 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28744243/the-odyssey-of-dental-anxiety-from-prehistory-to-the-present-a-narrative-review
#18
REVIEW
Enrico Facco, Gastone Zanette
Dental anxiety (DA) can be considered as a universal phenomenon with a high prevalence worldwide; DA and pain are also the main causes for medical emergencies in the dental office, so their prevention is an essential part of patient safety and overall quality of care. Being DA and its consequences closely related to the fight-or-flight reaction, it seems reasonable to argue that the odyssey of DA began way back in the distant past, and has since probably evolved in parallel with the development of fight-or-flight reactions, implicit memory and knowledge, and ultimately consciousness...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28743752/thalamocortical-synchronization-during-induction-and-emergence-from-propofol-induced-unconsciousness
#19
Francisco J Flores, Katharine E Hartnack, Amanda B Fath, Seong-Eun Kim, Matthew A Wilson, Emery N Brown, Patrick L Purdon
General anesthesia (GA) is a reversible drug-induced state of altered arousal required for more than 60,000 surgical procedures each day in the United States alone. Sedation and unconsciousness under GA are associated with stereotyped electrophysiological oscillations that are thought to reflect profound disruptions of activity in neuronal circuits that mediate awareness and cognition. Computational models make specific predictions about the role of the cortex and thalamus in these oscillations. In this paper, we provide in vivo evidence in rats that alpha oscillations (10-15 Hz) induced by the commonly used anesthetic drug propofol are synchronized between the thalamus and the medial prefrontal cortex...
August 8, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28738447/comparison-of-local-versus-general-anesthesia-in-patients-undergoing-transcatheter-aortic-valve-replacement-a-meta-analysis
#20
Pedro A Villablanca, Divyanshu Mohananey, Katarina Nikolic, Sripal Bangalore, David P Slovut, Verghese Mathew, Vinod H Thourani, Josep Rode's-Cabau, Iván J Núñez-Gil, Tina Shah, Tanush Gupta, David F Briceno, Mario J Garcia, Jacob T Gutsche, John G Augoustides, Harish Ramakrishna
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is typically performed under general anesthesia (GA). However, there is increasing data supporting the safety of performing TAVR under local anesthesia/conscious sedation (LA). We performed a meta-analysis to gain better understanding of the safety and efficacy of LA versus GA in patients with severe aortic stenosis undergoing TAVR. METHODS AND RESULTS: We comprehensively searched EMBASE, PubMed, and Web of Science...
July 24, 2017: Catheterization and Cardiovascular Interventions
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