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Anesthesia and consciousness

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https://www.readbyqxmd.com/read/28422877/suxamethonium-induces-a-prompt-increase-in-the-bispectral-index
#1
Jong Bum Choi, Se Hee Na, Sook Young Lee, Jong Yeop Kim, Sung Yong Park, Ji Eun Kim, Seungbae Hong, Jiwon An, Chung Hoon Park, Yong Chan Kim, Woo Young Park
Upon inducting general anesthesia in the operating room, we have observed a prompt increase in the bispectral index (BIS) after the intravenous injection of suxamethonium. We hypothesized that the cause of this BIS increase is muscle hyperactivity owing to fasciculation. However, no reports have been published regarding this abrupt increase in the BIS upon the induction of general anesthesia by suxamethonium. To investigate the degree of change in the BIS in patients receiving anesthesia with suxamethonium, we performed a prospective observational study of 63 participants who underwent closed reduction for nasal bone fracture...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28422113/increased-spontaneous-meg-signal-diversity-for-psychoactive-doses-of-ketamine-lsd-and-psilocybin
#2
Michael M Schartner, Robin L Carhart-Harris, Adam B Barrett, Anil K Seth, Suresh D Muthukumaraswamy
What is the level of consciousness of the psychedelic state? Empirically, measures of neural signal diversity such as entropy and Lempel-Ziv (LZ) complexity score higher for wakeful rest than for states with lower conscious level like propofol-induced anesthesia. Here we compute these measures for spontaneous magnetoencephalographic (MEG) signals from humans during altered states of consciousness induced by three psychedelic substances: psilocybin, ketamine and LSD. For all three, we find reliably higher spontaneous signal diversity, even when controlling for spectral changes...
April 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28418641/classics-in-chemical-neuroscience-ketamine
#3
Marshall W Tyler, Harmony B Yourish, Dawn F Ionescu, Stephen J Haggarty
Ketamine, a molecule of many faces, has contributed immeasurably to numerous realms of clinical practice and scientific inquiry. From anesthesia and analgesia to depression and schizophrenia, it continues to shed light on the molecular underpinnings of pain, consciousness, and the pathophysiology of neuropsychiatric disorders. In particular, research on ketamine's mechanism of action is providing new hope in the search for therapies for treatment-resistant depression and affords insights into disorders of glutamatergic dysfunction...
April 21, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28416960/medical-thoracoscopy-in-pleural-disease-experience-from-a-one-center-study
#4
Soo Jung Kim, Sun Mi Choi, Jinwoo Lee, Chang-Hoon Lee, Sang-Min Lee, Jae-Joon Yim, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, Young Sik Park
BACKGROUND: Medical thoracoscopy (MT) is a minimally invasive, endoscopic procedure for exploration of the pleural cavity under conscious sedation and local anesthesia. MT has been performed at the Seoul National University Hospital since February 2014. This paper summarizes the findings and outcomes of MT cases at this hospital. METHODS: Patients who had undergone MT were enrolled in the study. MT was performed by pulmonologists, using both rigid and semi-rigid thoracoscopes...
April 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28416429/-life-threatening-sleepwalking-elpenor-s-syndrome-in-a-10-year-old-child
#5
M-A Madigand-Tordjman, P-J Egler, F Bertran, M Jokic, F Guénolé
Though benign in the majority of cases, sleepwalking sometimes causes injuries due, among other causes, to falls. Such accidents can be life-threatening - a situation that has been termed Elpenor syndrome (in reference to an accident experienced by a character in Homer's epic The Odyssey) - in particular when entailing defenestration. This syndrome has been described in adults and adolescents; we report here a case in a child. OBSERVATION: This 10-year-old girl was admitted at night to our hospital after a 3-m fall at home...
April 14, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28414657/death-by-propofol
#6
James H Diaz, Alan David Kaye
Since its introduction in 1986, propofol ( two, 6-diisopropylphenol) , an intravenous sedative-hypnotic agent, has been utilized for the induction and maintenance of general anesthesia and conscious sedation in over 80 percent of cases; largely replacing thiopental ( sodium pentothal) over a decade ago. Unrestricted as a controlled substance, propofol's abuse potential emerged quickly and was highlighted by the death of pop singer, Michael Jackson, in 2009. In order to assess the epidemiological features of fatal propofol abuse, a descriptive analysis of the scientific literature was conducted using Internet search engines...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413268/novel-propofol-derivatives-and-implications-for-anesthesia-practice
#7
REVIEW
Aiden Y Feng, Alan D Kaye, Rachel J Kaye, Kumar Belani, Richard D Urman
Propofol (2,6-diisopropylphenol) is the most commonly used intravenous agent for induction of anesthesia. It is also used for maintenance of anesthesia and sedation in both Intensive Care Units and outpatient procedural settings. Its success in the clinical setting has been a result of its rapid onset, short duration of action, and minimal side effects despite disadvantages associated with its oil emulsion formulation. Early attempts to alter the standard emulsion or to develop new formulations with cyclodextrins and micelles to resolve issues with pain upon injection, the need for antimicrobial agents, and possible hyperlipidemia have mostly failed...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28402867/functional-connectivity-and-network-analysis-during-hypoactive-delirium-and-recovery-from-anesthesia
#8
Tianne Numan, Arjen J C Slooter, Arendina W van der Kooi, Annemieke M L Hoekman, Willem J L Suyker, Cornelis J Stam, Edwin van Dellen
OBJECTIVE: To gain insight in the underlying mechanism of reduced levels of consciousness due to hypoactive delirium versus recovery from anesthesia, we studied functional connectivity and network topology using electroencephalography (EEG). METHODS: EEG recordings were performed in age and sex-matched patients with hypoactive delirium (n=18), patients recovering from anesthesia (n=20), and non-delirious control patients (n=20), all after cardiac surgery. Functional and directed connectivity were studied with phase lag index and directed phase transfer entropy...
March 6, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28398813/neural-correlates-of-consciousness-at-near-electrocerebral-silence-in-an-asphyxial-cardiac-arrest-model
#9
Donald E Lee, Lauren G Lee, Danny Siu, Afsheen K Bazrafkan, Maryam H Farahabadi, Tin J Dinh, Josue Orellana, Wei Xiong, Beth A Lopour, Yama Akbari
Recent electrophysiological studies have suggested surges in electrical correlates of consciousness (i.e., elevated gamma power and connectivity) after cardiac arrest (CA). This study examines electrocorticogram (ECoG) activity and coherence of the dying brain during asphyxial CA. Male Wistar rats (n = 16) were induced with isoflurane anesthesia, which was washed out before asphyxial CA. Mean phase coherence and ECoG power were compared during different stages of the asphyxial period to assess potential neural correlates of consciousness...
April 2017: Brain Connectivity
https://www.readbyqxmd.com/read/28392760/accelerated-recovery-of-consciousness-after-general-anesthesia-is-associated-with-increased-functional-brain-connectivity-in-the-high-gamma-bandwidth
#10
Duan Li, Viviane S Hambrecht-Wiedbusch, George A Mashour
Recent data from our laboratory demonstrate that high-frequency gamma connectivity across the cortex is present during consciousness and depressed during unconsciousness. However, these data were derived from static and well-defined states of arousal rather than during transitions that would suggest functional relevance. We also recently found that subanesthetic ketamine administered during isoflurane anesthesia accelerates recovery upon discontinuation of the primary anesthetic and increases gamma power during emergence...
2017: Frontiers in Systems Neuroscience
https://www.readbyqxmd.com/read/28392004/-paradox-of-slow-frequencies-are-slow-frequencies-in-upper-cortical-layers-a-neural-predisposition-of-the-level-state-of-consciousness-npc
#11
Georg Northoff
Consciousness research has much focused on faster frequencies like alpha or gamma while neglecting the slower ones in the infraslow (0.001-0.1Hz) and slow (0.1-1Hz) frequency range. These slower frequency ranges have a "bad reputation" though; their increase in power can observed during the loss of consciousness as in sleep, anesthesia, and vegetative state. However, at the same time, slower frequencies have been conceived instrumental for consciousness. The present paper aims to resolve this paradox which I describe as "paradox of slow frequencies"...
April 5, 2017: Consciousness and Cognition
https://www.readbyqxmd.com/read/28391200/quasi-periodicities-detection-using-phase-rectified-signal-averaging-in-eeg-signals-as-a-depth-of-anesthesia-monitor
#12
Quan Liu, Yi-Feng Chen, Shou-Zen Fan, Maysam Abbod, Jiann-Shing Shieh
Phase-rectified signal averaging (PRSA) has been known to be a useful method to detect periodicities in non-stationary biological signals. Determination of quasi-periodicities in electroencephalogram (EEG) is a candidate for quantifying the changes of depth of anesthesia (DOA). In this paper, DOA monitoring capacity of periodicities detected using PRSA was quantified by assessing EEG signals collected from 56 patients during surgery. The method is compared to sample entropy (SampEn), detrended fluctuation analysis (DFA) and permutation entropy (PE)...
April 3, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28379981/improved-costs-and-outcomes-with-conscious-sedation-vs-general-anesthesia-in-tavr-patients-time-to-wake-up
#13
William Toppen, Daniel Johansen, Sohail Sareh, Josue Fernandez, Nancy Satou, Komal D Patel, Murray Kwon, William Suh, Olcay Aksoy, Richard J Shemin, Peyman Benharash
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has become a commonplace procedure for the treatment of aortic stenosis in higher risk surgical patients. With the high cost and steadily increasing number of patients receiving TAVR, emphasis has been placed on optimizing outcomes as well as resource utilization. Recently, studies have demonstrated the feasibility of conscious sedation in lieu of general anesthesia for TAVR. This study aimed to investigate the clinical as well as cost outcomes associated with conscious sedation in comparison to general anesthesia in TAVR...
2017: PloS One
https://www.readbyqxmd.com/read/28365683/unintended-return-of-consciousness-in-a-patient-during-surgery-and-general-anesthesia
#14
Wioletta Mędrzycka-Dąbrowska, Sebastian Dąbrowski, Aleksandra Gutysz-Wojnicka, Dorota Ozga, Marek Wojtaszek
No abstract text is available yet for this article.
April 1, 2017: European Neurology
https://www.readbyqxmd.com/read/28363984/blood-pressure-regulation-by-the-rostral-ventrolateral-medulla-in-conscious-rats-effects-of-hypoxia-hypercapnia-baroreceptor-denervation-and-anesthesia
#15
Ian C Wenker, Chikara Abe, Kenneth E Viar, Daniel S Stornetta, Ruth L Stornetta, Patrice G Guyenet
Current understanding of the contribution of C1 neurons to blood pressure (BP) regulation derives predominantly from experiments carried out in anesthetized animals or reduced ex vivo preparations. Here we use ArchaerhodopsinT3.0 (ArchT) loss-of-function optogenetics to explore BP regulation by C1 neurons in intact unanesthetized rats. Using a lentivirus that expresses ArchT under the Phox2b-activated promoter PRSx8 (PRSx8-ArchT), ∼65% of transduced neurons were C1 (balance retrotrapezoid nucleus, RTN). Other rats received CaMKII-ArchT3...
March 31, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28360352/intracranial-venous-pressures-under-conscious-sedation-and-general-anesthesia
#16
Daniel M S Raper, Thomas J Buell, Ching-Jen Chen, Dale Ding, Robert M Starke, Kenneth C Liu
INTRODUCTION: Venous outflow obstruction has been implicated in the pathophysiology of a subset of patients with idiopathic intracranial hypertension (IIH), and venous sinus stenting (VSS) has emerged as an effective treatment. However, the effect of anesthesia on venous sinus pressure measurements is unpredictable. A more thorough understanding of the effect of the level of anesthesia on intracranial venous pressures might help to better define patients who might benefit most from stent placement...
March 30, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28340389/minilaparotomy-without-general-anesthesia-for-the-treatment-of-sigmoid-volvulus-in-high-risk-patients-a-case-series-of-4-patients
#17
Ernesto L Enrique, Kareem A Hamdy
BACKGROUND: Sigmoid volvulus (SV) is a common cause of large bowel obstruction worldwide. Presenting symptoms can be nonspecific and varied amongst the elderly population, making medical and surgical management challenging. This population is at markedly increase risk of complications and mortality with surgery under general anesthesia. In this case series, we describe 4 cases of sigmoid volvulus in octogenarians. GOALS: To demonstrate that sigmoid colectomy under local anesthesia, with or without intravenous conscious sedation, is feasible and can be done safely and with a low rate of converting to a general anesthetic...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28306578/selective-low-volume-nerve-block-for-the-open-surgical-fixation-of-a-midshaft-clavicle-fracture-in-a-conscious-high-risk-patient-a-case-report
#18
Carlos I Salvadores de Arzuaga, José M Naya Sieiro, Oscar Salmeron Zafra, Miguel A González Posada, Esther Marquez Martínez
We report a case of successful intraoperative management using only low-volume regional anesthesia for the open surgical fixation of a traumatic clavicle fracture in a conscious 69-year-old man with severe chronic obstructive pulmonary disease. To avoid general anesthesia, we provided low-volume C5 and C6 nerve root blocks along with a superficial cervical plexus block using only 9 mL of anesthetic solution to avoid the often encountered complications of higher volume injections. Throughout the procedure, the patient remained comfortable and cooperative with stable hemodynamics and respiration...
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28300332/computer-vision-based-diameter-maps-to-study-fluoroscopic-recordings-of-small-intestinal-motility-from-conscious-experimental-animals
#19
I Ramírez, J J Pantrigo, A S Montemayor, A E López-Pérez, M I Martín-Fontelles, S J H Brookes, R Abalo
BACKGROUND: When available, fluoroscopic recordings are a relatively cheap, non-invasive and technically straightforward way to study gastrointestinal motility. Spatiotemporal maps have been used to characterize motility of intestinal preparations in vitro, or in anesthetized animals in vivo. Here, a new automated computer-based method was used to construct spatiotemporal motility maps from fluoroscopic recordings obtained in conscious rats. METHODS: Conscious, non-fasted, adult, male Wistar rats (n=8) received intragastric administration of barium contrast, and 1-2 hours later, when several loops of the small intestine were well-defined, a 2 minutes-fluoroscopic recording was obtained...
March 16, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28298764/postoperative-sore-throat-prevention-in-ambulatory-surgery-a-comparison-between-preoperative-aspirin-and-magnesium-sulfate-gargle-a-prospective-randomized-double-blind-study
#20
Surajit Chattopadhyay, Anjan Das, Sabyasachi Nandy, Sandip RoyBasunia, Tapobrata Mitra, Partha Sarathi Halder, Subinay Chhaule, Subrata Kumar Mandal
BACKGROUND: Postoperative sore throat (POST) frequently hampers the positive feedback of ambulatory surgery in spite of so many measures. This study was carried out to compare the efficacy of preoperative magnesium sulfate and aspirin gargle in preventing POST after ambulatory surgery. MATERIALS AND METHODS: It was a prospective, randomized, and double-blinded study. Fifty-six adult patients of either sex, aged 25-50, of American Society of Anesthesiologists physical status I-II, scheduled for day care surgery, were randomly allocated to Group A ([n = 28] receiving aspirin gargle [325 mg tablet]) and Group M ([n = 28] receiving magnesium sulfate [20 mg/kg] gargle)...
January 2017: Anesthesia, Essays and Researches
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