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https://www.readbyqxmd.com/read/27932959/exposure-to-ketamine-anesthesia-affects-rat-impulsive-behavior
#1
António Melo, Hugo Leite-Almeida, Clara Ferreira, Nuno Sousa, José M Pêgo
Introduction: Ketamine is a general anesthetic (GA) that activates several neurotransmitter pathways in various part of the brain. The acute effects as GA are the most well-known and sought-after: to induce loss of responsiveness and to produce immobility during invasive procedures. However, there is a concern that repeated exposure might induce behavioral changes that could outlast their acute effect. Most research in this field describes how GA affects cognition and memory. Our work is to access if general anesthesia with ketamine can disrupt the motivational behavior trait, more specifically measuring impulsive behavior...
2016: Frontiers in Behavioral Neuroscience
https://www.readbyqxmd.com/read/27928715/the-impaired-anesthesiologist-what-you-should-know-about-substance-abuse
#2
Stefan T Samuelson, Ethan O Bryson
PURPOSE: Despite our considerable experience with the problem of addiction in our specialty, most anesthesia care providers don't know how to identify or help an impaired colleague. The purpose of this article to provide sufficient information on substance use disorder (SUD) to aid in its identification amongst colleagues and to assist in its management. PRINCIPAL FINDINGS: Depending on the region, 10-15% of the general population is prone to developing a SUD and will abuse drugs or alcohol at some point in their life...
December 7, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27919700/exposure-to-sevoflurane-anesthesia-during-development-does-not-impair-aspects-of-attention-during-adulthood-in-rats
#3
Kathy L Murphy, Jill McGaughy, Paula L Croxson, Mark G Baxter
Exposure to general anesthetic agents during development has been associated with neurotoxicity and long-term behavioral impairments in rodents and non-human primates. The phenotype of anesthetic-induced cognitive impairment has a robust learning and memory component, however less is known about other psychological domains. Data from retrospective human patient studies suggest that children undergoing multiple procedures requiring general anesthesia are at increased risk of attention deficit hyperactivity disorder...
December 2, 2016: Neurotoxicology and Teratology
https://www.readbyqxmd.com/read/27918332/isoflurane-impairs-motor-function-recovery-by-increasing-neuroapoptosis-and-degeneration-during-spinal-ischemia-reperfusion-injury-in-rats
#4
Shih-Yuan Fang, Jung-Shun Lee, Jun-Neng Roan, Yu-Chuan Tsai, Chen-Fuh Lam
BACKGROUND: Spinal cord ischemia (SCI) leads to variable degrees of neurologic deficit in patients undergoing major cardiovascular surgery. The effect of intraoperative neuroprotection against SCI and the subsequent ischemia-reperfusion injury is still limited. Because isoflurane is a commonly used anesthetic agent during major operation, and its neuroprotective and neurotoxicity effects have both been discussed, this study aimed to investigate the effect of isoflurane on the spinal cord's functional recovery in a rat model of cord ischemia...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27918326/anesthetic-considerations-for-patients-with-congenital-central-hypoventilation-syndrome-a-systematic-review-of-the-literature
#5
Saptashree M Basu, Frances F Chung, Shireen F AbdelHakim, Jean Wong
Congenital central hypoventilation syndrome (CCHS) is a form of sleep-disordered breathing characterized by a diminished drive to breathe during sleep, despite progressive hypercapnia and hypoxia. The condition results from mutations in the paired-like homeobox 2B (PHOX2B) gene. The aim of this review was to conduct a systematic search of the current data on CCHS as it relates to perioperative considerations and to discuss the classification, prevalence, pathophysiology, presentation, genetics, and management of the condition...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27912253/sex-and-age-differences-in-epinephrine-mechanisms-and-outcomes-after-brain-injury
#6
William M Armstead, John Riley, Monica S Vavilala
Traumatic brain injury (TBI) is the leading cause of injury related death in children, with boys and children under 4 years having particularly poor outcomes. Cerebral autoregulation is often impaired after TBI, contributing to poor outcome. Cerebral perfusion pressure can be normalized by use of vasoactive agents. The c-Jun-terminal kinase (JNK) isoform of mitogen activated protein kinase (MAPK) produces hemodynamic impairment after TBI, but less is known about its role in histopathology. We investigated whether epinephrine (EPI) age and sex dependently protected cerebral autoregulation and limited histopathology after TBI and the role of JNK in that outcome...
December 2, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27909508/arguments-to-apply-epinephrine-for-pocket-hematoma-reduction-the-maitre-study
#7
REVIEW
Nikolay Ilov Md, Nikolay Ilov Md, Anatoly Nechepurenko Md, Albert Abdulkadyrov, Damir Paskeev, Elena Damrina, Elena Kulikova, Marina Terent'eva, Dinara Stompel, Dmitry Tarasov Md
Pocket hematoma (PH) is a common complication of implantations of cardiac electrophysiological devices with occurring at a particularly high rate in patients on oral anticoagulation or antiplatelet treatment. Different pharmacological agents with hemostatic effect are used to avoid PH. We supposed that the vasoconstrictor effects of epinephrine may reduce bleeding extent and be effective in prevention of PH. Maitre is the first clinical trial conducted with an aim to show the safety and efficacy of epinephrine in PH prophylaxis...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27896927/a-retrospective-review-of-anesthesia-and-perioperative-care-in-children-with-medium-chain-acyl-coa-dehydrogenase-deficiency
#8
Claire Allen, Russell Perkins, Bernd Schwahn
BACKGROUND: Medium-chain acyl-CoA dehydrogenase deficiency is the most common genetically determined disorder of mitochondrial fatty acid oxidation. Decompensation can result in hypoglycemia, seizures, coma, and death but may be prevented by ensuring glycogen stores do not become depleted. Perioperative care is of interest as surgery, fasting, and infection may all trigger decompensation and the safety of anesthetic agents has been questioned. Current guidelines from the British Inherited Metabolic Disease Group advise on administering fluid containing 10% glucose during the perioperative period...
November 29, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27895665/sugammadex-enhanced-neuronal-apoptosis-following-neonatal-sevoflurane-exposure-in-mice
#9
Maiko Satomoto, Zhongliang Sun, Yushi U Adachi, Koshi Makita
In rodents, neonatal sevoflurane exposure induces neonatal apoptosis in the brain and results in learning deficits. Sugammadex is a new selective neuromuscular blockade (NMB) binding agent that anesthesiologists can use to achieve immediate reversal of an NMB with few side effects. Given its molecular weight of 2178, sugammadex is thought to be unable to pass through the blood brain barrier (BBB). Volatile anesthetics can influence BBB opening and integrity. Therefore, we investigated whether the intraperitoneal administration of sugammadex could exacerbate neuronal damage following neonatal 2% sevoflurane exposure via changes in BBB integrity...
2016: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/27893511/continuous-infusion-antiepileptic-medications-for-refractory-status-epilepticus-a-review-for-nurses
#10
Adam L Wiss, Michael Samarin, Jacob Marler, G Morgan Jones
Status epilepticus requires treatment with emergent initial therapy with a benzodiazepine and urgent control therapy with an additional antiepileptic drug (AED) to terminate clinical and/or electrographic seizure activity. However, nearly one-third of patients will prove refractory to the aforementioned therapies and are prone to a higher degree of neuronal injury, resistance to pharmacotherapy, and death. Current guidelines for refractory status epilepticus (RSE) recommend initiating a continuous intravenous (CIV) anesthetic over bolus dosing with a different AED...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27891040/inadvertent-injection-of-potassium-chloride-instead-of-sodium-chloride-during-treatment-of-chronic-low-back-ache-with-epidural-injection-leading-to-paraplegia
#11
Rahul Ranjan, Naiyer Asif, Sohail Ahmad, Syed Ifthekar
Epidural injection of steroid is given for back pain resistant to other conservative management. Normal saline (NS) is used as diluent in 80 mg methylprednisolone and a local anesthetic. Due to a similar looking ampoule of NS and potassium chloride (KCl), there is a probability of accidental use of KCl instead of NS. We present a case of a 50-year-old male patient having low back ache refractory to other conservative treatments. Epidural injection of steroid was given, but accidently KCl was mixed with methylprednisolone instead of NS...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27888525/breaking-sad-unleashing-the-breakthrough-potential-of-ketamine-s-rapid-antidepressant-effects
#12
David Feifel
Preclinical Research The surprising results of a small clinical trial on the effects of low dose ketamine, a 65-year old anesthetic drug that is also used off-label for chronic pain and recreationally as a club drug, in eight depressed subjects unleashed the most significant advance in antidepressant drug development in decades. That study and subsequent ones have demonstrated that low dose, infused ketamine is able to induce a remission of depression in patients who have failed conventional medications, within 24 h...
November 26, 2016: Drug Development Research
https://www.readbyqxmd.com/read/27884218/the-current-state-of-perioperative-pain-management-challenges-and-potential-opportunities-for-nurses
#13
Melanie H Simpson, Patricia Bruckenthal
Achievement of adequate postoperative pain management is a critical challenge in health care, with an estimated three out of four adult surgical patients reporting moderate to extreme pain after surgery. Overreliance on opioids in acute care settings has persisted, despite well-known adverse side effects frequently associated with this class of drugs. Furthermore, patients with a history of chronic opioid use present additional challenges in terms of postsurgical pain management. Advances in the development of newer analgesic agents and anesthetic techniques may be useful in surgical patients with a history of chronic opioid use and in the overall surgical patient population...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27882039/pediatric-tooth-extractions-under-sedoanalgesia
#14
Ayse Hande Arpaci, Berrin Isik
OBJECTIVE: The present study aims to evaluate intravenous ketamine and inhalation sedation in children, their unwanted side-effects and surgeon satisfaction. METHODS: In this study, data of 922 children aged between 1-18 who underwent tooth extraction under sedoanalgesia in our department between September 2015-January 2016 were gathered and anesthesia approaches, unwanted side effects and surgical satisfaction was investigated. Postoperative recovery emergence agitation or delirium was evaluated with Watcha Behavior Scale (WBS)...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27876959/a-rare-cause-of-dysphagia-pharyngeal-ascariasis
#15
Maryam Hajizadeh, Mohammad Taghi Rahimi, Adel Spotin, Ehsan Ahmadpour
Ascaris lumbricoides infection distributed widely in tropical and subtropical areas, especially in the developing countries and affects more than one billion of people. Ascariasis commonly has higher infection rates compared to other parasite species and because of poor sanitation the parasite can be seen in 100 % of the population. A. lumbricoides depending on the provocation by anesthetic agents or intestines becomes hostile, such as with inflammation and obstruction, may cause migration and varies complications such as coming up to the mouth or blocking some ducts...
December 2016: Journal of Parasitic Diseases: Official Organ of the Indian Society for Parasitology
https://www.readbyqxmd.com/read/27876719/-local-anesthesia-selection-algorithm-in-patients-with-concomitant-disease-part-2
#16
E N Anisimova, S T Sokhov, N Yu Letunova, I V Orekhova, M V Gromovik, E A Erilin, N A Ryazantsev
A group of authors presents the rationale for local anesthesia selection in patients with concomitant disease based on case history; interaction analysis of drugs with local anesthetic and sedation agents; estimation of patient functional status; patient anxiety correction; dental care with hemodynamics monitoring. It was found that adhering to this algorithm promotes the prevention of urgent conditions in outpatient settings.
2016: Stomatologii︠a︡
https://www.readbyqxmd.com/read/27876104/a-cohort-study-of-unstable-overdose-patients-treated-with-intravenous-lipid-emulsion-therapy
#17
Shazma Mithani, Kathryn Dong, Ashlea Wilmott, Heather Podmoroff, Nadim Lalani, Rhonda J Rosychuk, Ryan Chuang, Mark C Yarema
OBJECTIVES: Intravenous lipid emulsion (ILE) has been used increasingly over the last decade for a range of drug overdoses. Although the use of ILE in local anesthetic toxicity (LAST) is well established, the hemodynamic effectiveness of ILE in non-LAST poisonings is still unclear. Thus, the primary objective of this study was to examine a cohort of poisoned patients in whom ILE was administered. METHODS: Consecutive patients were identified by calls to a regional poison center from May 1, 2012 to May 30, 2014...
November 23, 2016: CJEM
https://www.readbyqxmd.com/read/27873010/regional-block-via-continuous-caudal-infusion-as-sole-anesthetic-for-inguinal-hernia-repair-in-conscious-neonates
#18
Claudia M Mueller, Tiffany J Sinclair, Megan Stevens, Micaela Esquivel, Noah Gordon
PURPOSE: The use of general anesthesia in young children has come under increasing scrutiny due to its potential long-term neurotoxic effects. Meanwhile, regional anesthesia for surgical procedures in neonates has many advantages, including preservation of respiratory status and faster return to feeding. We describe the successful use of 3% 2-chloroprocaine administered via continuous caudal infusion as the sole anesthetic agent during elective surgical procedures in infants. METHODS: A retrospective chart review of all patients who underwent elective surgical procedures under continuous caudal regional anesthetic at a single institution was performed...
November 21, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27873001/1-2-dimethylimidazole-4-sulfonyl-chloride-dmisc-a-novel-derivatization-strategy-for-the-analysis-of-propofol-by-lc-esi-ms-ms
#19
Alexandra Maas, Christoph Maier, Beate Michel-Lauter, Burkhard Madea, Cornelius Hess
Analysis of the anesthetic agent propofol in biological samples by LC-MS/MS is a great challenge due to weak fragmentation and poor ionization efficacy of propofol resulting in weak signal intensities. Improvements of the ionization and fragmentation efficacy can be achieved by conversion of propofol to its dimethylimidazolesulfonyl (DMIS) derivative by a derivatization reaction using 1,2-dimethylimidazole-4-sulfonyl chloride (DMISC). This DMIS derivative produced intense [M + H](+) ions in positive-ion LC-ESI-MS/MS with the dimethylimidazole moieties representing the most abundant product ions...
November 21, 2016: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/27871903/review-of-preclinical-studies-on-pediatric-general-anesthesia-induced-developmental-neurotoxicity
#20
Jennifer L Walters, Merle G Paule
Thousands of infants and children undergo complicated surgical procedures that require prolonged periods of anesthesia and/or sedation each year. A growing body of preclinical research suggests pediatric anesthetics are harmful to the developing brain; yet, the extent to which these effects generalize to the clinical setting remains unclear. As there will be a continuing need for surgical and other interventions requiring sedation and/or anesthesia during the neonatal period, it seems clear that research efforts should focus on determining the extent to which general anesthetics can affect the developing brain as well as determining strategies for preventing or ameliorating the adverse effects associated with exposure to such agents...
November 18, 2016: Neurotoxicology and Teratology
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