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Anesthesia and consciousness

Chao-Liang Tang, Juan Li, Zhe-Tao Zhang, Bo Zhao, Shu-Dong Wang, Hua-Ming Zhang, Si Shi, Yang Zhang, Zhong-Yuan Xia
Dexmedetomidine has sedative, anxiolytic, analgesic, anti-sympathetic, and anti-shivering effects. Dexmedetomidine might be effective in combination with sevoflurane for anesthesia, but prospective randomized controlled clinical trials with which to verify this hypothesis are lacking. In total, 120 patients who underwent embolization of an intracranial aneurysm were recruited from Anhui Provincial Hospital and Renmin Hospital of Wuhan University of China and randomly allocated to two groups. After intraoperative administration of 2% to 3% sevoflurane inhalation, one group of patients received pump-controlled intravenous injection of 1...
February 2018: Neural Regeneration Research
Brittany A Baker, Debra L Hickman
Selection of an appropriate method of euthanasia involves balancing the wellbeing of the animal during the procedure with the intended use of the animal after death and the physical and psychologic safety of the observer or operator. The recommended practices for anesthesia as compared with euthanasia are very disparate, despite the fact that all chemical methods of euthanasia are anesthetic overdoses. To explain this disparity, this study sought to determine whether perception bias is inherent in the discussion of euthanasia compared with anesthesia...
March 1, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
Shereen M Hamza, John E Hall
Renal sympathetic nerves contribute significantly to both physiological and pathophysiological phenomena. Evaluating renal sympathetic nerve activity (RSNA) is of great interest in many areas of research such as chronic kidney disease, hypertension, heart failure, diabetes and obesity. Unequivocal assessment of the role of the sympathetic nervous system is thus imperative for proper interpretation of experimental results and understanding of disease processes. RSNA has been traditionally measured in anesthetized rodents, including mice...
February 14, 2018: Journal of Visualized Experiments: JoVE
Amrita Aranake-Chrisinger, Jenny Zhao Cheng, Maxwell R Muench, Rose Tang, Angela Mickle, Hannah Maybrier, Nan Lin, Troy Wildes, Eric Lenze, Michael Simon Avidan
INTRODUCTION: Postoperative delirium (POD) is a common complication in elderly patients, characterised by a fluctuating course of altered consciousness, disordered thinking and inattention. Preliminary research has linked POD with persistent cognitive impairment and decreased quality of life. However, these findings maybe confounded by patient comorbidities, postoperative complications and frailty. Our objective is to determine whether POD is an independent risk factor for persistent impairments in attention and executive function after elective surgery...
March 17, 2018: BMJ Open
Emanuele Rondonotti, Cristiano Spada, Samuel Adler, Andrea May, Edward J Despott, Anastasios Koulaouzidis, Simon Panter, Dirk Domagk, Ignacio Fernandez-Urien, Gabriel Rahmi, Maria Elena Riccioni, Jeanin E van Hooft, Cesare Hassan, Marco Pennazio
SMALL-BOWEL CAPSULE ENDOSCOPY (SBCE): 1: ESGE recommends that prior to SBCE patients ingest a purgative (2 L of polyethylene glycol [PEG]) for better visualization.Strong recommendation, high quality evidence.However, the optimal timing for taking purgatives is yet to be established. 2: ESGE recommends that SBCE should be performed as an outpatient procedure if possible, since completion rates are higher in outpatients than in inpatients.Strong recommendation, moderate quality evidence...
March 14, 2018: Endoscopy
Chang-Hua Li, Wen-Liang Chen, Guang-Mao Lin
OBJECTIVE: To study the risk factors of perioperative heart failure in the elderly patients with femoral shaft fracture by the regression analysis, so as to provide relevant clinical reference. METHODS: From July 2012 to April 2017, 143 elderly patients with femoral shaft fracture who underwent surgical treatment in our hospital were retrospectively studied. Among them, 25 patients with perioperative heart failure included 10 males and 15 females with a mean age of (77...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Aravind K Bommiasamy, Dayton Opel, Raluca McCallum, John D Yonge, Vicente Undurraga Perl, Christopher R Connelly, Darin Friess, Martin A Schreiber, Richard J Mullins
BACKGROUND: Traumatic hip dislocations (THD) are a medical emergency. There is debate whether the painful reduction of a dislocated hip should be first attempted using primary conscious sedation (PCS) or primary general anesthesia (PGA) METHODS: All cases of native THD from 2006 to 2015 in the trauma registry of a level 1 trauma center were reviewed. The primary outcome was successful reduction of the THD. RESULTS: 67 patients had a native, meaning not a hip prosthesis, THD...
February 27, 2018: American Journal of Surgery
H T Sun, M Xu, G L Chen, J He
Objective: This study aimed to compare dexmedetomidine with remifentanil for conscious sedation in patients undergoing radiofrequency ablation of hepatocellular carcinoma. Methods: Sixty patients, who were aged 41 to 73 years with American Society of Anesthesiologists (ASA) physical status Ⅰ-Ⅱ, and scheduled for elective radiofrequency ablation of hepatocellular carcinoma under conscious sedation in National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, from January 2014 to June 2016, were allocated randomly to receive dexmedetomidine maintenance regimen(group D, n =30)or remifentanil maintenance regimen(group R, n =30)by random digital table...
February 27, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Guangming Wang, Jinlu Yu
INTRODUCTION: Chronic subdural hematoma(CSDH) can be treated by a relatively simple burr hole surgery. Acute subarachnoid hemorrhage (SAH) occurring after surgery for CSDH has been reported as a rare but severe complication. CASE REPORT: An 88-year-old female complained of progressive headache and dizziness for one month. A right fronto-temporo-parietal CSDH with a shift in the midline structures and lateral ventricle compression was shown by computed tomography (CT) scans...
March 3, 2018: International Journal of Surgery Case Reports
Hanna M Butler-Struben, Samantha M Brophy, Nasira A Johnson, Robyn J Crook
Cephalopod molluscs are among the most behaviorally and neurologically complex invertebrates. As they are now included in research animal welfare regulations in many countries, humane and effective anesthesia is required during invasive procedures. However, currently there is no evidence that agents believed to act as anesthetics produce effects beyond immobility. In this study we demonstrate, for the first time, that two of the most commonly used agents in cephalopod general anesthesia, magnesium chloride and ethanol, are capable of producing strong and reversible blockade of afferent and efferent neural signal; thus they are genuine anesthetics, rather than simply sedating agents that render animals immobile but not insensible...
2018: Frontiers in Physiology
Zhenhu Liang, Cheng Huang, Yongwang Li, Darren F Hight, Logan J Voss, Jamie W Sleigh, Xiaoli Li, Yang Bai

 Objective. Significant spectral characteristics of electroencephalogram (EEG) patterns exist in individual patients during re-establishing consciousness after general anesthesia. However, these EEG patterns cannot be quantitatively identified using commercially available depth of anesthesia (DoA) monitors. This study proposed an effective classification method and indices to classify these patterns among patients.
 Approach. Four types of emergence EEG patterns were identified based on EEG data set from 52patients undergoing sevoflurane general anesthesia from two hospitals...
March 7, 2018: Physiological Measurement
C-H Wang, J Luo, J Li, J-Z Zhang, S-Y Huang, W Shao, H-S Ma
OBJECTIVE: To investigate the efficacy of inhalational sevoflurane anesthesia induction on inhibiting the stress response to endotracheal intubation in pediatric patients with congenital heart disease (CHD). PATIENTS AND METHODS: Forty ASA physical status I/II pediatric patients scheduled for interventricular septal defect repair or interatrial septal defect repair, were randomly divided into two groups (20 each): intravenous induction group (Group C) and inhalational sevoflurane anesthesia induction group (Group D)...
February 2018: European Review for Medical and Pharmacological Sciences
Ayako Kukida, Yasushi Takasaki, Mio Nakata, Tasuku Nishihara, Sakiko Kitamura, Sonoko Fujii, Yuji Watanabe, Toshihiro Yorozuya
RATIONALE: Although an inferior vena cave (IVC) filter is placed to prevent fatal pulmonary embolism (PE), several complications associated with an IVC filter have been reported. We describe a case with symptomatic PE, of which the origin was an occlusive IVC thrombus that developed from the placement of an IVC filer after a laparoscopy-assisted total gastrectomy (LATG). PATIENT CONCERNS: A 71-year-old man underwent LATG under general anesthesia alone. He had an IVC filter implanted 13 years ago...
January 2018: Medicine (Baltimore)
Yushan Ma, Hao Li, Jin Liu, Xuemei Lin, Hui Liu
RATIONALE: Thyroid storm is a rare complication during caesarean section of patients with hyperthyroidism. It occurs abruptly, with a high mortality rate if not recognized immediately and aggressively treated. Herein, we reported a case of impending thyroid storm during a caesarean section. PATIENT CONCERNS: A healthy 23-year-old woman with undiagnosed hyperthyroidism underwent an emergency caesarean section under general anesthesia. After tracheal extubation, the patient exhibited abnormal tachycardia, agitation, sweating, and hyperpyrexia...
January 2018: Medicine (Baltimore)
Hyoungkyu Kim, Anthony G Hudetz, Joseph Lee, George A Mashour, UnCheol Lee
The integrated information theory (IIT) proposes a quantitative measure, denoted as Φ, of the amount of integrated information in a physical system, which is postulated to have an identity relationship with consciousness. IIT predicts that the value of Φ estimated from brain activities represents the level of consciousness across phylogeny and functional states. Practical limitations, such as the explosive computational demands required to estimate Φ for real systems, have hindered its application to the brain and raised questions about the utility of IIT in general...
2018: Frontiers in Human Neuroscience
Hesameddin Modir, Esmail Moshiri, Bijan Yazdi, Abolfazl Mohammadbeigi, Amirreza Modir
Adverse events following surgical operations are common complications due to removal of tracheal tube in contrast to the tracheal intubation. Awareness about the new methods and strategies for tracheal tube extubation is necessary for a safe and successful extubation. Therefore, we aimed to assess the safety and efficacy of laryngeal mask airway (LMA), streamlined liner of the pharyngeal airway (SLIPA) and I-gel in extubation time of tracheal tube. A one-single randomized clinical trial was conducted in 105 eligible patients in three groups including LMA, SLIPA and I-gel...
October 2017: Medical Gas Research
Yuchen Wang, Lanlan Ma, Xuejiao Wang, Ling Qin
Auditory steady state response (ASSR) and inhibitory gating (IG) are electrophysiological examinations commonly used to evaluate the sensory and cognitive functions of the brain. In some clinic examinations and animal experiments, general anesthesia is necessary to conduct electrophysiological recordings. However, the effects of anesthesia on ASSR and IG remain unclear. For this reason, we recorded local field potentials though electrodes implanted in different brain areas of rats: the auditory cortex (AC), hippocampus (HC), amygdala (AMY), and prefrontal cortex (PFC), and compared the characteristics of ASSR and IG under anesthetized and conscious conditions...
February 27, 2018: Scientific Reports
Yun Li, Shengpei Wang, Chuxiong Pan, Fushan Xue, Junfang Xian, Yaqi Huang, Xiaoyi Wang, Tianzuo Li, Huiguang He
BACKGROUND: The mechanism of general anesthesia (GA) has been explored for hundreds of years, but unclear. Previous studies indicated a possible correlation between NREM sleep and GA. The purpose of this study is to compare them by in vivo human brain function to probe the neuromechanism of consciousness, so as to find out a clue to GA mechanism. METHODS: 24 healthy participants were equally assigned to sleep or propofol sedation group by sleeping ability. EEG and Ramsay Sedation Scale were applied to determine sleep stage and sedation depth respectively...
2018: PloS One
Valthierre Nunes de Lima, Gustavo Antonio Correa Momesso, Luara Teixeira Colombo, Gabriel Mulinari-Santos, Cecília Alves de Sousa, Tárik Ocon Braga Polo, Idelmo Rangel Garcia-Júnior, Leonardo Perez Faverani
The frequency of accidents due to dog bite in children is high, and in the most cases, the child already knows the aggressor dog. Patient, 3 years, female, melanoderm, victim of pet dog attack on the right side of the face region. After the physical examination, conscious sedation was performed with the supplementation of oxygen by pediatrics and the suture by oral and maxillofacial surgeon, under local anesthesia with adrenergic vasoconstrictor, with internal points in the muscles using vicryl 4-0 and in the skin with 5-0 nylon; the lesser number of stitches were performed in the lower region of the wound, allowing spontaneous drainage spaces...
February 23, 2018: Journal of Craniofacial Surgery
Jesús Escrivá Muñoz, Pedro Gambús, Erik W Jensen, Montserrat Vallverdú
OBJECTIVE: This works investigates the time-frequency content of impedance cardiography signals during a propofol-remifentanil anesthesia. MATERIALS AND METHODS: In the last years, impedance cardiography (ICG) is a technique which has gained much attention. However, ICG signals need further investigation. Time-Frequency Distributions (TFDs) with 5 different kernels are used in order to analyze impedance cardiography signals (ICG) before the start of the anesthesia and after the loss of consciousness...
January 2018: Methods of Information in Medicine
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