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Anesthesia and consciousness

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https://www.readbyqxmd.com/read/29780956/bilateral-corneal-denting-after-surgery-under-general-anesthesia-a-case-report
#1
Satsuki Obata, Akiko Miki, Hisanori Imai, Makoto Nakamura
Purpose: To report a case of temporary bilateral corneal denting in a patient who underwent cardiovascular surgery under general anesthesia. Observations: A 71-year-old male with no history of ophthalmological disease experienced bilateral corneal denting immediately after undergoing surgery for aneurysm of the thoracic aorta under general anesthesia. Anesthesia was induced with propofol and maintained with rocuronium bromide and remifentanil hydrochloride. The initial examination revealed significant denting on the surface of both the corneas and ocular hypotension...
June 2018: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29772562/using-neuroimaging-to-uncover-awareness-in-brain-injured-and-anesthetized-patients
#2
Mackenzie Graham, Adrian M Owen, Charles Weijer, Lorina Naci
We cast a novel perspective on two distinct populations: patients who become accidentally intraoperatively aware after receiving general anesthesia and severely brain-injured patients who are diagnosed as being in a vegetative state. In both cases, patients are behaviorally non-responsive -and on this basis presumed to lack consciousness- yet, retain covert awareness. In both contexts, detecting consciousness is highly challenging, yet highly important for ensuring adequate patient care. Although great strides have been made in the development of depth-of-anesthesia monitors, these monitors have significant limitations...
June 1, 2018: Frontiers in Bioscience (Scholar Edition)
https://www.readbyqxmd.com/read/29772269/a-new-method-for-determining-levels-of-sedation-in-dogs-a-pilot-study-with-propofol-and-a-novel-neuroactive-steroid-anesthetic
#3
B L Youngblood, Y Ueyama, W W Muir, G M Belfort, R H Hammond, J Dai, F G Salituro, A J Robichaud, J J Doherty
BACKGROUND: Different levels of consciousness are required in order to perform different medical procedures. Sedation scales established to objectively define various levels of sedation in humans have not been thoroughly characterized in non-human species. Postural changes in rats or dogs are useful as gross measures of sedation but are inadequate for quantitative assessment since graded levels of sedation are difficult to delineate and obscured by movement abnormalities. NEW METHOD: A new canine sedation scoring (CSS) method was developed based on the modified observer's assessment of alertness and sedation score (MOAA/S) used in humans...
May 14, 2018: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/29771718/evaluation-of-drug-effects-on-cerebral-blood-flow-and-glucose-uptake-in-un-anesthetized-and-un-stimulated-rats-application-of-free-moving-apparatus-enabling-to-keep-rats-free-during-pet-spect-tracer-injection-and-uptake
#4
Taku Sugita, Yusuke Kondo, Seigo Ishino, Ikuo Mori, Takashi Horiguchi, Mikako Ogawa, Yasuhiro Magata
OBJECTIVES: The purpose of this study is the development of novel fluorine-18-fluorodeoxyglucose (F-FDG)-PET and Tc-hexamethylpropylene amine oxime (HMPAO) SPECT methods with free-moving apparatus on conscious rats to investigate brain activity without the effects of anesthesia and tactual stimulation. We also assessed the sensitivity of the experimental system by an intervention study using fluoxetine as a reference drug. MATERIALS AND METHODS: A catheter was inserted into the femoral vein and connected to a free-moving cannula system...
May 15, 2018: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/29764750/patient-oriented-optimal-depth-of-conscious-sedation-using-midazolam-during-flexible-bronchoscopy-a-prospective-open-labeled-single-arm-trial
#5
Yuichiro Takeda, Hibiki Udagawa, Shinji Nakamichi, Yasuto Yoneshima, Motoyasu Iikura, Satoshi Hirano, Go Naka, Haruhito Sugiyama
BACKGROUND: The British Thoracic Society guidelines for diagnostic flexible bronchoscopy (FB) in adults recommend that intravenous sedation should be offered to patients undergoing bronchoscopy. However, it is difficult to determine the adequate depth of sedation for each patient because of inter-individual variability. METHODS: This prospective, open-label, single-arm study was conducted in patients undergoing routine bronchus examination with FB. All patients underwent FB under local anesthesia and conscious sedation, with initial administration of 0...
May 6, 2018: Respiratory Investigation
https://www.readbyqxmd.com/read/29756058/pupillary-dilation-reflex-and-pupillary-pain-index-evaluation-during-general-anaesthesia-a-pilot-study
#6
Davina Wildemeersch, Michiel Baeten, Natasja Peeters, Vera Saldien, Marcel Vercauteren, Guy Hans
Background: Pupillary response by pupillary dilatation reflex (PDR) is a robust reflex, even measurable during general anaesthesia. However, the ability of infrared pupillometry to detect PDR differences obtained by intraoperative opioid administration in anaesthesized patients remains largely unknown. We analyzed the performance of automated infrared pupillometry in detecting differences in pupillary dilatation reflex response by a inbuilt standardized nociceptive stimulation program in patients under general anesthesia with a standardized propofol/fentanyl scheme...
April 2018: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29755652/correlation-of-mdr1-gene-polymorphism-with-propofol-combined-with-remifentanil-anesthesia-in-pediatric-tonsillectomy
#7
YunLong Zhang, Yongpei Li, Hongfa Wang, Fang Cai, Sheliang Shen, Xiaopan Luo
The motive of this study was to investigate the interaction between polymorphisms in the MDR1 gene and anesthetic effects following pediatric tonsillectomy. In total, 240 children undergoing tonsillectomy with preoperative propofol-remifentanil anesthesia were selected. Genomic DNA was extracted from the peripheral blood of children after operation, and the MDR1 gene polymorphisms of 2677 G>T/A, 1236 C>T and 3435 C>T were detected by direct sequencing. We tested mean arterial pressure, diastolic blood pressure, systolic blood pressure, and heart rate at several time-points: T0 (5 mins after the repose), T1 (0 min after tracheal intubation), T2 (5 mins after the tracheal intubation), T3 (0 min after the tonsillectomy), T4 (0 min after removal of the mouth-gag) and T5 (5 min after the extubation)...
April 17, 2018: Oncotarget
https://www.readbyqxmd.com/read/29750692/trainability-of-cricoid-pressure-force-application-a-simulation-based-study
#8
Eric Noll, Shivam Shodhan, Arnavi Varshney, Christopher Gallagher, Pierre Diemunsch, F Barry Florence, Jamie Romeiser, Elliott Bennett-Guerrero
BACKGROUND: Aspiration of gastric contents is a leading cause of airway management-related mortality during anesthesia practice. Cricoid pressure (CP) is widely used during rapid sequence induction to prevent aspiration. National guidelines for CP suggest a target force of 10 N before and 30 N after loss of consciousness. However, few studies have rigorously assessed whether clinicians can be trained to consistently achieve these levels of force. We hypothesized that clinicians can be trained effectively to deliver 10-30 N during application of CP...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29739917/magnetic-resonance-imaging-selection-for-endovascular-stroke-therapy-workflow-in-the-goliath-trial
#9
Claus Z Simonsen, Albert J Yoo, Mads Rasmussen, Kristina E Sørensen, Thabele Leslie-Mazwi, Grethe Andersen, Leif H Sørensen
BACKGROUND AND PURPOSE: The GOLIATH trial (General or Local Anesthesia in Intra-Arterial Therapy) compared infarct growth and outcome in patients undergoing endovascular therapy under either general anesthesia or conscious sedation. Magnetic resonance imaging was performed before and after the procedure to study infarct growth. In this post hoc analysis of GOLIATH, we aimed to characterize the workflow of patients undergoing magnetic resonance imaging selection before endovascular therapy...
May 8, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29737490/regional-entropy-of-functional-imaging-signals-varies-differently-in-sensory-and-cognitive-systems-during-propofol-modulated-loss-and-return-of-behavioral-responsiveness
#10
Xiaolin Liu, Kathryn K Lauer, B Douglas Ward, Christopher J Roberts, Suyan Liu, Suneeta Gollapudy, Robert Rohloff, William Gross, Zhan Xu, Shanshan Chen, Lubin Wang, Zheng Yang, Shi-Jiang Li, Jeffrey R Binder, Anthony G Hudetz
The level and richness of consciousness depend on information integration in the brain. Altered interregional functional interactions may indicate disrupted information integration during anesthetic-induced unconsciousness. How anesthetics modulate the amount of information in various brain regions has received less attention. Here, we propose a novel approach to quantify regional information content in the brain by the entropy of the principal components of regional blood oxygen-dependent imaging signals during graded propofol sedation...
May 8, 2018: Brain Imaging and Behavior
https://www.readbyqxmd.com/read/29720440/association-of-blood-pressure-with-short-and-long-term-functional-outcome-after-stroke-thrombectomy-post-hoc-analysis-of-the-siesta-trial
#11
Silvia Schönenberger, Lorenz Uhlmann, Matthias Ungerer, Johannes Pfaff, Simon Nagel, Christina Klose, Martin Bendszus, Wolfgang Wick, Peter A Ringleb, Meinhard Kieser, Markus A Möhlenbruch, Julian Bösel
BACKGROUND AND PURPOSE: Outcome after mechanical thrombectomy for ischemic stroke may be influenced by blood pressure (BP). This study aims to assess the association of BP changes during general anesthesia versus conscious sedation with functional outcome after mechanical thrombectomy. METHODS: SIESTA (Sedation vs Intubation for Endovascular Stroke Treatment) was a monocentric randomized trial of general anesthesia versus conscious sedation during mechanical thrombectomy involving BP target protocols...
May 2, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29694305/the-use-of-local-anesthesia-to-perform-lower-limb-revascularization-in-the-fragile-patient-with-critical-limb-ischemia
#12
N Kontopodis, A Papaioannou, E Tavlas, G Papadopoulos, S Lioudaki, K Tzirakis, C V Ioannou
Patients with critical limb ischemia are usually compromised, frequently making administration of general or regional anesthesia problematic. We treated 3 fragile patients presenting contraindications to undertake traditional anesthetic techniques for lower limb revascularization, in whom local anesthesia with conscious sedation was used to complete the operation. An axillo-bifemoral, a unilateral axillo-femoral and a femoro-femoral bypass were performed. Procedure was uneventful in all three cases despite the coexistence of specific surgical challenges (distal anastomosis at the profunda in two cases, redo surgery and scarred groin in the third)...
March 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29683964/outcomes-of-anesthesia-selection-in-endovascular-treatment-of-acute-ischemic-stroke
#13
Yuming Peng, Youxuan Wu, Xiaochuan Huo, Peng Wu, Yang Zhou, Jiaxin Li, Fa Liang, Xiaoyuan Liu, Yuesong Pan, Zhongrong Miao, Ruquan Han
BACKGROUND: The association between anesthesia type and outcomes in patients with acute ischemic stroke undergoing endovascular treatment (EVT) remains a subject of ongoing debate. METHODS: This prospective nonrandomized controlled trial included 149 consecutive patients with acute anterior circulation stroke who underwent EVT. The primary outcome was functional independence assessed by the modified Rankin Scale (mRS) after 3 months. RESULTS: A total of 105 (70...
April 20, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29683806/role-of-network-science-in-the-study-of-anesthetic-state-transitions
#14
UnCheol Lee, George A Mashour
The heterogeneity of molecular mechanisms, target neural circuits, and neurophysiologic effects of general anesthetics makes it difficult to develop a reliable and drug-invariant index of general anesthesia. No single brain region or mechanism has been identified as the neural correlate of consciousness, suggesting that consciousness might emerge through complex interactions of spatially and temporally distributed brain functions. The goal of this review article is to introduce the basic concepts of networks and explain why the application of network science to general anesthesia could be a pathway to discover a fundamental mechanism of anesthetic-induced unconsciousness...
April 23, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29682503/imaging-behavior-and-endocrine-analysis-of-jealousy-in-a-monogamous-primate
#15
Nicole Maninger, Sally P Mendoza, Donald R Williams, William A Mason, Simon R Cherry, Douglas J Rowland, Thomas Schaefer, Karen L Bales
Understanding the neurobiology of social bonding in non-human primates is a critical step in understanding the evolution of monogamy, as well as understanding the neural substrates for emotion and behavior. Coppery titi monkeys ( Callicebus cupreus ) form strong pair bonds, characterized by selective preference for their pair mate, mate-guarding, physiological and behavioral agitation upon separation, and social buffering. Mate-guarding, or the "maintenance" phase of pair bonding, is relatively under-studied in primates...
October 2017: Frontiers in Ecology and Evolution
https://www.readbyqxmd.com/read/29677106/effect-of-propofol-continuous-rate-infusion-on-intravenous-glucose-tolerance-test-in-dogs
#16
Kenichi Maeda, Munehiro Iwasaki, Yuki Itou, Satomi Iwai, Shozo Okano
Hyperglycemia causes perioperative complications and many anesthetics impair glucose metabolism and cause hyperglycemia. We evaluated the effects of propofol on blood glucose metabolism and insulin secretion during an intravenous glucose tolerance test (IVGTT) in dogs. Blood glucose, insulin, triglyceride, cholesterol, and free fatty acid (FFA) levels were measured in dogs during IVGTT in a conscious state and under the effect of 2.0% isoflurane, low-concentration propofol (0.2 mg/kg/min), and high-concentration propofol (0...
April 20, 2018: Veterinary Sciences
https://www.readbyqxmd.com/read/29673531/using-positron-emission-tomography-in-revealing-the-mystery-of-general-anesthesia-study-design-challenges-and-opportunities
#17
Harry Scheinin, Emilee C Alkire, Annalotta Scheinin, Michael T Alkire, Oskari Kantonen, Jaakko Långsjö
Functional neuroimaging with positron emission tomography (PET) is one of the cornerstones for studying the central nervous system effects of general anesthetics and anesthesia mechanisms. General anesthesia offers a unique and safe way to directly manipulate consciousness, and can thus be used as a powerful research tool to study the neurobiology of human consciousness. In this chapter, we will address the possibilities of PET imaging in revealing the mysteries of general anesthesia and anesthetic induced unconsciousness and summarize some of the recent advancements in the field...
2018: Methods in Enzymology
https://www.readbyqxmd.com/read/29673529/neurochemistry-of-anesthetic-states
#18
Ralph Lydic, Helen A Baghdoyan, Amanda L May
Anesthetic mechanisms that eliminate consciousness and perception of pain are products of the nervous system. Chemical approaches to the study of anesthetic mechanisms have the potential to serve as an ideal interface between basic and clinical neuroscience. There are disproportionately more basic neurochemical studies than clinical studies of anesthetic mechanisms. Even within neuroscience, the study of anesthetic mechanisms is sparse. The Society for Neuroscience hosts one of the world's largest and most vibrant scientific meetings, yet the content themes of that meeting do not include anesthesia...
2018: Methods in Enzymology
https://www.readbyqxmd.com/read/29669562/comfort-in-palliative-sedation-compas-a-transdisciplinary-mixed-method-study-protocol-for-linking-objective-assessments-to-subjective-experiences
#19
Stefaan Six, Steven Laureys, Jan Poelaert, Johan Bilsen, Peter Theuns, Reginald Deschepper
BACKGROUND: In case of untreatable suffering at the end of life, palliative sedation may be chosen to assure comfort by reducing the patient's level of consciousness. An important question here is whether such sedated patients are completely free of pain. Because these patients cannot communicate anymore, caregivers have to rely on observation to assess the patient's comfort. Recently however, more sophisticated techniques from the neurosciences have shown that sometimes consciousness and pain are undetectable with these traditional behavioral methods...
April 18, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29665587/interstitial-transpedal-mr-lymphangiography-of-central-lymphatics-using-a-standard-mr-contrast-agent-feasibility-and-initial-results-in-patients-with-chylous-effusions
#20
Claus Christian Pieper, Hans Heinz Schild
PURPOSE:  To describe a novel technique for transpedal magnetic resonance lymphangiography (tMRL) with interstitial injection of a standard gadolinium-based contrast agent, and to assess its ability to visualize the central lymphatic system (CLS) in patients with chylous effusions. MATERIALS AND METHODS:  Experiences with tMRL were retrospectively reviewed in seven patients with chylous effusions. High-resolution three-dimensional multi-echo (mDIXON) images of the entire torso were obtained before and after interstitial injection of an extracellular gadolinium-based contrast agent...
April 17, 2018: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
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