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Anesthesia sleep

Julia N Bailey, Laurence de Nijs, Dongsheng Bai, Toshimitsu Suzuki, Hiroyuki Miyamoto, Miyabi Tanaka, Christopher Patterson, Yu-Chen Lin, Marco T Medina, María E Alonso, José M Serratosa, Reyna M Durón, Viet H Nguyen, Jenny E Wight, Iris E Martínez-Juárez, Adriana Ochoa, Aurelio Jara-Prado, Laura Guilhoto, Yolly Molina, Elsa M Yacubian, Minerva López-Ruiz, Yushi Inoue, Sunao Kaneko, Shinichi Hirose, Makiko Osawa, Hirokazu Oguni, Shinji Fujimoto, Thierry M Grisar, John M Stern, Kazuhiro Yamakawa, Bernard Lakaye, Antonio V Delgado-Escueta
BACKGROUND: In juvenile myoclonic epilepsy, data are limited on the genetic basis of networks promoting convulsions with diffuse polyspikes on electroencephalography (EEG) and the subtle microscopic brain dysplasia called microdysgenesis. METHODS: Using Sanger sequencing, we sequenced the exomes of six members of a large family affected with juvenile myoclonic epilepsy and confirmed cosegregation in all 37 family members. We screened an additional 310 patients with this disorder for variants on DNA melting-curve analysis and targeted real-time DNA sequencing of the gene encoding intestinal-cell kinase ( ICK)...
March 15, 2018: New England Journal of Medicine
M Chavez, F Grosselin, A Bussalb, F De Vico Fallani, X Navarro-Sune
OBJECTIVE: the recent emergence and success of electroencephalography (EEG) in low-cost portable devices, has opened the door to a new generation of applications processing a small number of EEG channels for health monitoring and brain-computer interfacing. These recordings are, however, contaminated by many sources of noise degrading the signals of interest, thus compromising the interpretation of the underlying brain state. In this paper, we propose a new data-driven algorithm to effectively remove ocular and muscular artifacts from single-channel EEG: the surrogate-based artifact removal (SuBAR)...
March 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
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
Alexandra M Arambula, Deborah X Xie, Amy S Whigham
OBJECTIVES: To characterize postoperative respiratory complications following adenotonsillectomy (AT) in children with obstructive sleep apnea (OSA) and to identify variables associated with pediatric intensive care unit (PICU) admission. METHODS: Retrospective analysis of 133 pediatric OSA patients with prior AT. Assessment of the postoperative hospital course informed patient stratification based on respiratory event severity, PICU admission status, and unscheduled escalation of care...
April 2018: International Journal of Pediatric Otorhinolaryngology
Lin-Hui Wang, Zi-Lan Wang, Wen-Yue Chen, Ming-Jia Chen, Guang-Yin Xu
The glymphatic system is a cerebrospinal fluid-interstitial fluid exchange system dependent on the water channel aquaporin-4 polarized on astrocyte endfeet, which is proposed to account for the clearance of abnormal proteins (e.g. β-amyloid) and metabolites (e.g. lactate) from the brain. Accumulating studies have revealed that glymphatic activity during sleep and general anesthesia is dramatically enhanced, while its function is significantly damaged during aging, traumatic brain injury, Alzheimer's disease, stroke, and diabetes...
February 25, 2018: Sheng Li Xue Bao: [Acta Physiologica Sinica]
Karina Woodling, Juan Fiorda-Diaz, Bradley A Otto, Christie A Barnes, Alberto A Uribe, Sergio D Bergese, Vedat Yildiz, Nicoleta Stoicea, Michael G Guertin
Background: Obstructive sleep apnea (OSA) may be related to episodes of oxygen de-saturation, hypercapnia, cardiovascular dysfunction, cor-pulmonale, and pulmonary hypertension. STOP-BANG is an acronym for eight specific questions used to assess the likelihood of OSA. If the individual exhibits three or more of these indicators, he/she should be considered to be at high risk for OSA complications. Therefore, the decision of proceeding with inpatient versus outpatient ENT surgery still remains controversial...
February 2018: Laryngoscope Investigative Otolaryngology
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
Kimmo T Murto, Wesley Chen, Sherri L Katz, Deborah A Schwengel, Lisa M Elden, Kumar G Belani, David Gozal
Recent concerns have been raised about the quality and safety of adenotonsillectomy, a common surgery performed to treat obstructive sleep apnea (OSA) in children. OSA is a risk factor for opioid-related perioperative respiratory complications including those associated with anoxic brain injury or death. Our objective was to identify controversial issues related to the care of children with OSA. A standardized Delphi consensus technique involving an interdisciplinary group of 24 pediatric OSA experts identified 3 key issues: "postoperative disposition, preoperative screening, and pain management...
February 23, 2018: Anesthesia and Analgesia
Maëva Ferraris, Antoine Ghestem, Ana F Vicente, Lauriane Nallet-Khosrofian, Christophe Bernard, Pascale P Quilichini
Gamma oscillations are involved in long-range coupling of distant regions which support various cognitive operations. Here we show in adult male rats that synchronized bursts of gamma oscillations bind the hippocampus (HPC) and prefrontal cortex (mPFC) during slow oscillations and slow wave sleep, a brain state that is central for consolidation of memory traces. These gamma bursts entrained the firing of the local HPC and mPFC neuronal populations. Neurons of the nucleus reuniens (NR), which is a structural and functional hub between HPC and mPFC, demonstrated a specific increase in their firing prior to gamma burst onset, suggesting their involvement in HPC-mPFC binding...
February 19, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Joerg Schnoor, Thilo Busch, Nazar Turemuratov, Andreas Merkenschlager
BACKGROUND: Children with obstructive sleep apnea are at high risk for perioperative airway obstruction. Many "at risk" children may remain unrecognized. The aim of this study is to find a clinically practicable test to identify obstructive sleep apnea in childhood. METHODS: In this pilot study, we prospectively compared four parental questionnaires with the respective findings of subsequent sleep laboratory testing in children. Right before sleep laboratory testing, children's parents answered both the Pediatric Sleep Questionnaire, a subscale of the Sleep Related Breathing Disorder questionnaire (PSQ-SRBD-Subscale), and an eight-item questionnaire derived from it...
February 20, 2018: BMC Anesthesiology
P Palumbo, S Usai, C Amatucci, B Perotti, L Ruggeri, G Illuminati, G Tellan
BACKGROUND: The extension of indications for procedures in a Day Surgery (DS) setting has led to changes in the anesthetic and surgical treatment of Inguinal Hernias (IH). According to the recommendations of the European Hernia Society, the treatment of IH in DS units should be performed under Monitored Anesthesia Care (MAC). PATIENTS AND METHODS: 960 patients underwent IH repairs over a period of 24 months. The patients were randomly divided into two groups: R (remifentanil) and F (fentanyl); the group F was considered as a control group...
November 2017: Il Giornale di Chirurgia
Rodney A Gabriel, Alison M A'Court, Ulrich H Schmidt, Richard P Dutton, Richard D Urman
STUDY OBJECTIVE: There is a lack of large, multi-institutional studies analyzing the association of timing of emergency surgery with death occurring either intraoperatively or in the recovery room setting. The primary objective of this study was to determine if time of day for emergency surgeries was associated with mortality. DESIGN: Retrospective analysis. SETTING: U.S. healthcare facilities. PATIENTS: Adult patients undergoing emergency surgery and general anesthesia...
February 7, 2018: Journal of Clinical Anesthesia
Feng Jin, Zhe Li, Wen-Fei Tan, Hong Ma, Xiao-Qian Li, Huang-Wei Lu
BACKGROUND: Nerve block is usually performed before surgery because it inhibits reflection of the skin incision and reduces the amount of intraoperative anesthetic used. We hypothesized that performing rectus sheath block (RSB) after surgery would result in a longer duration of the analgesic effects and have a subtle influence on sleep time after surgery but that it would not decrease the perioperative cytokine levels of patients undergoing gynecological surgery. METHODS: A randomized, double-blinded, controlled trial was conducted from October 2015 to June 2016...
February 9, 2018: BMC Anesthesiology
Philipp Fassbender, Silja Bürgener, Ali Haddad, Marie-Therese Silvanus, Jürgen Peters
BACKGROUND: Obstructive sleep apnea (OSA) is a risk factor for perioperative complications but data on anesthesia regimen are scarce. METHODS: In patients with established or strongly suspected OSA, we assessed in a prospective, randomized design the effects on nocturnal apnea-hypopnea-index (AHI) and oxygen saturation (SpO2 ) of propofol/remifentanil or sevoflurane/remifentanil based anesthesia. Patients were selected by a history for OSA and / or a positive STOP - questionnaire and received general anesthesia using remifentanil (12 μg/kg/h) combined either with propofol (4-6 mg/kg/h, n = 27) or sevoflurane (approx...
January 27, 2018: BMC Anesthesiology
Valeria Mossetti, Karen Boretsky, Marinella Astuto, Bruno G Locatelli, David Zurakowski, Rodolfo Lio, Roberta Nicoletti, Valter Sonzogni, Micol Maffioletti, Noemi Vicchio, Giorgio Ivani
INTRODUCTION: The prevalence of persistent postsurgical pain in children is over 20% after major surgeries; however, data are scarce on the prevalence, character, and risk factors among children undergoing common ambulatory surgeries. The primary aim of this study was to evaluate the prevalence of persistent pain following pediatric ambulatory surgery at 1, 3, and 6 months. Secondary aims were to identify risk factors and characterize the pain and consequences of persistent postsurgical pain...
January 20, 2018: Paediatric Anaesthesia
Ahmet Kemalettin Koltka, Mehmet İlhan, Achmet Ali, Ali Fuat Kaan Gök, Nükhet Sivrikoz, Teoman Hakan Yanar, Mustafa Kayıhan Günay, Cemalettin Ertekin
BACKGROUND: Fatigue and sleep deprivation can affect rational decision-making and motor skills, which can decrease medical performance and quality of patient care. The aim of the present study was to investigate the association between times of the day when laparoscopic general surgery under general anesthesia was performed and their adverse outcomes. METHODS: All laparoscopic cholecystectomies and appendectomies performed at the emergency surgery department of a tertiary university hospital from 01...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Clement Gakuba, Thomas Gaberel, Suzanne Goursaud, Jennifer Bourges, Camille Di Palma, Aurélien Quenault, Sara Martinez de Lizarrondo, Denis Vivien, Maxime Gauberti
INTRODUCTION: According to the "glymphatic system" hypothesis, brain waste clearance is mediated by a continuous replacement of the interstitial milieu by a bulk flow of cerebrospinal fluid (CSF). Previous reports suggested that this cerebral CSF circulation is only active during general anesthesia or sleep, an effect mediated by the dilatation of the extracellular space. Given the controversies regarding the plausibility of this phenomenon and the limitations of currently available methods to image the glymphatic system, we developed original whole-brain in vivo imaging methods to investigate the effects of general anesthesia on the brain CSF circulation...
2018: Theranostics
Sa'ar Lanir-Azaria, Guy Meiri, Tamir Avigdor, Anne Minert, Marshall Devor
The induction of general anesthesia shares many features with the transition from wakefulness to non-rapid eye movement (NREM) sleep, suggesting that the two types of brain-state transition are orchestrated by a common neuronal mechanism. Previous studies revealed a brainstem locus, the mesopontine tegmental anesthesia area (MPTA), that is of singular importance for anesthetic induction. Microinjection there of GABAergic anesthetics induces rapid loss-of-consciousness and lesions render the animal relatively insensitive to anesthetics administered systemically...
December 27, 2017: Behavioural Brain Research
Vidya Chidambaran, Anurag Tewari, Mohamed Mahmoud
PURPOSE: Anesthetic management of obese pediatric patients is challenging. With increasing prevalence of childhood obesity, more severely obese children with comorbidities present for surgery every day. The purpose of this review is to provide an up-to-date comprehensive narrative review on the impact of pathophysiological changes imposed by pediatric obesity on the perioperative management of obese children, especially drug dosing. This knowledge is necessary to provide safe delivery of anesthesia for severely obese children...
December 21, 2017: Journal of Clinical Anesthesia
Kemal Findikcioglu, Serhat Sibar, Ayse Gulsen
INTRODUCTION: As well as the chin is an important esthetic unit of the facial structure, it is also the region having a key role in the appearance of the face. Correction of cosmetic and functional deformities that may occur in this region because of serious hypoplasia (microgenia) is performed by chin augmentation. Chin augmentation is most frequently performed via implant or osseous genioplasty in the literature. Both 2 techniques have their own advantages and disadvantages. In the literature, various studies comparing these 2 techniques and their long-term results are present, but in some severe microgenia cases, these techniques can be insufficient only for augmentation...
December 19, 2017: Journal of Craniofacial Surgery
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