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Anesthetic agents

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https://www.readbyqxmd.com/read/29675258/livedo-reticularis-a-cutaneous-clue-to-an-underlying-endocrine-crisis
#1
Natasha Shrikrishnapalasuriyar, Mirena Noyvirt, Philip Evans, Bethan Gibson, Elin Foden, Atul Kalhan
A 54-year-old woman was admitted to hospital with a presumed allergic reaction to a single dose of amoxicillin given for a suspected upper respiratory tract infection. She complained of chest tightness although there was no wheeze or stridor. On examination, she was pyrexial, tachycardic, hypertensive and had a diffuse mottled rash on her lower limbs. Her initial investigations showed raised inflammatory markers. She was treated in the intensive care for a presumed anaphylactic reaction with an underlying sepsis...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29674333/intravenous-and-intratracheal-thyrotropin-releasing-hormone-and-its-analog-taltirelin-reverse-opioid-induced-respiratory-depression-in-isoflurane-anesthetized-rats
#2
James D Boghosian, Anita Luethy, Joseph F Cotten
Thyrotropin releasing hormone (TRH) is a tripeptide hormone and a neurotransmitter widely-expressed in the CNS that regulates thyroid function and that maintains physiologic homeostasis. Following injection in rodents, TRH has multiple effects including increased blood pressure and breathing. We tested the hypothesis that TRH and its long-acting analog, taltirelin, will reverse morphine-induced respiratory depression in anesthetized rats following intravenous(IV) or intratracheal(IT) administration. TRH (1 mg/kg plus 5 mg/kg/hour IV) and talitrelin (1 mg/kg IV), when administered to rats pretreated with morphine (5 mg/kg IV), increased ventilation from 50±6 to 131±7% and 45±6 to 168±13% (percent baseline; n=4±SEM), primarily through increased breathing rates (from 76+/-9 to 260±14% and 66±8 to 318±37%)...
April 19, 2018: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/29673523/anesthetic-drug-discovery-and-development-a-case-study-of-novel-etomidate-analogs
#3
Megan McGrath, Douglas E Raines
All currently available general anesthetic agents possess potentially lethal side effects requiring their administration by highly trained clinicians. Among these agents is etomidate, a highly potent imidazole-based intravenous sedative-hypnotic that deleteriously suppresses the synthesis of adrenocortical steroids in a manner that is both potent and persistent. We developed two distinct strategies to design etomidate analogs that retain etomidate's potent hypnotic activity, but produce less adrenocortical suppression than etomidate...
2018: Methods in Enzymology
https://www.readbyqxmd.com/read/29673289/systematic-review-of-the-pharmacological-agents-that-have-been-tested-against-spreading-depolarizations
#4
Anna Klass, Renan Sánchez-Porras, Edgar Santos
Spreading depolarization (SD) occurs alongside brain injuries and it can lead to neuronal damage. Therefore, pharmacological modulation of SD can constitute a therapeutic approach to reduce its detrimental effects and to improve the clinical outcome of patients. The major objective of this article was to produce a systematic review of all the drugs that have been tested against SD. Of the substances that have been examined, most have been shown to modulate certain SD characteristics. Only a few have succeeded in significantly inhibiting SD...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29672336/cost-benefit-analysis-of-maintaining-a-fully-stocked-malignant-hyperthermia-cart-versus-an-initial-dantrolene-treatment-dose-for-maternity-units
#5
Phi T Ho, Brendan Carvalho, Eric C Sun, Alex Macario, Edward T Riley
BACKGROUND: The Malignant Hyperthermia Association of the United States recommends that dantrolene be available for administration within 10 min. One approach to dantrolene availability is a malignant hyperthermia cart, stocked with dantrolene, other drugs, and supplies. However, this may not be of cost benefit for maternity units, where triggering agents are rarely used. METHODS: The authors performed a cost-benefit analysis of maintaining a malignant hyperthermia cart versus a malignant hyperthermia cart readily available within the hospital versus an initial dantrolene dose of 250 mg, on every maternity unit in the United States...
April 19, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29672287/early-administration-of-magnesium-sulfate-during-open-fetal-myelomeningocele-repair-reduces-the-dose-of-inhalational-anesthesia
#6
Roopali Donepudi, Melissa Huynh, Kenneth J Moise, Ramesha Papanna, Anthony Johnson, Mary Austin, KuoJen Tsao, Ranu Jain
INTRODUCTION: Optimal uterine relaxation is achieved through higher minimum alveolar concentration (MAC) of inhalational anesthetics, increasing risks to mother and fetus. Our objective was to determine if earlier administration of magnesium sulfate would reduce the requirement of inhalational anesthetics in fetal myelomeningocele repair. MATERIALS AND METHODS: Prospective observational study of fetal myelomeningocele repair was performed from September 2011 to August 2017...
April 19, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29664887/%C3%AE-aminobutyric-acid-type-a-receptor-potentiation-inhibits-learning-in-a-computational-network-model
#7
Kingsley P Storer, George N Reeke
BACKGROUND: Propofol produces memory impairment at concentrations well below those abolishing consciousness. Episodic memory, mediated by the hippocampus, is most sensitive. Two potentially overlapping scenarios may explain how γ-aminobutyric acid receptor type A (GABAA) potentiation by propofol disrupts episodic memory-the first mediated by shifting the balance from excitation to inhibition while the second involves disruption of rhythmic oscillations. We use a hippocampal network model to explore these scenarios...
April 17, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29663938/cohousing-male-mice-with-and-without-segmental-bone-defects
#8
Jeffrey D Rytlewski, Paul J Childress, David C Scofield, Faisal Khan, Marta B Alvarez, Aamir T Tucker, Jonathan S Harris, Jessica L Peveler, Debra L Hickman, Tien-Min G Chu, Melissa A Kacena
Spaceflight results in bone loss like that associated with osteoporosis or decreased weight-bearing (for example, high-energy trauma such as explosive injuries and automobile accidents). Thus, the unique spaceflight laboratory on the International Space Station presents the opportunity to test bone healing agents during weightlessness. We are collaborating with NASA and the US Army to study bone healing in spaceflight. Given the unique constraints of spaceflight, study design optimization was required. Male mice were selected primarily because their femur is larger than females', allowing for more reproducible surgical outcomes...
April 2, 2018: Comparative Medicine
https://www.readbyqxmd.com/read/29663492/efficacy-of-epinephrine-free-articaine-compared-to-articaine-with-epinephrine-1-100-000-for-maxillary-infiltration-a-randomized-clinical-trial
#9
Konstantinos Paterakis, Marc Schmitter, Sareh Said Yekta-Michael
OBJECTIVE: The selection of local anesthetic in dental practice is essential to the patient's comfort and the success of the treatment. Many patients prefer anesthesia even for short treatments. Articaine is a local anesthetic commonly used for dental practice. The duration of the effect of articaine on the nerve fibers is not yet precisely reported. This study was aimed to evaluate the clinical efficacy of 4% articaine with and without epinephrine in treatment of occlusal caries. MATERIALS AND METHODS: Thirty healthy patients were included in this randomized double-blind study...
April 16, 2018: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/29661126/gnao1-mutation-induced-pediatric-dystonic-storm-rescue-with-pallidal-deep-brain-stimulation
#10
C Michael Honey, Armaan K Malhotra, Maja Tarailo-Graovac, Clara D M van Karnebeek, Gabriella Horvath, Adi Sulistyanto
Dystonic storm or status dystonicus is a life-threatening hyperkinetic movement disorder with biochemical alterations due to the excessive muscle contractions. The medical management can require pediatric intensive care unit admission and a combination of medications while the underlying trigger is managed. Severe cases may require general anesthesia and paralytic agents with intubation and may relapse when these drugs are weaned. Deep brain stimulation of the globus pallidum has been reported to terminate dystonic storm in several pediatric cases...
May 2018: Journal of Child Neurology
https://www.readbyqxmd.com/read/29660915/hemorheological-and-metabolic-consequences-of-renal-ischemia-reperfusion-and-their-modulation-by-n-n-dimethyl-tryptamine-on-a-rat-model
#11
Katalin Peto, Norbert Nemeth, Anita Mester, Zsuzsanna Magyar, Souleiman Ghanem, Viktoria Somogyi, Bence Tanczos, Adam Deak, Laszlo Bidiga, Ede Frecska, Balazs Nemes
BACKGROUND: Micro-rheological relations of renal ischemia-reperfusion (I/R) have not been completely elucidated yet. Concerning anti-inflammatory agents, it is supposed that sigma-1 receptor agonist N,N-dimethyl-tryptamin (DMT) can be useful to reduce I/R injury. OBJECTIVE: To investigate the micro-rheological and metabolic parameters, and the effects of DMT in renal I/R in rats. METHODS: In anesthetized rats from median laparotomy both kidneys were exposed...
April 13, 2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29655774/twenty-years-experience-with-anaphylaxis-like-reactions-to-local-anesthetics-genuine-allergy-is-rare
#12
Axel Trautmann, Matthias Goebeler, Johanna Stoevesandt
BACKGROUND: Anaphylaxis-like reactions occur within minutes after application of local anesthetics (LA), most commonly during dental interventions. Impressive symptoms including respiratory distress or loss of consciousness frequently give rise to a suspicion of allergy and may prompt patients and treating physicians to refuse future LA injections. OBJECTIVE: Non-allergic mechanisms are responsible for the majority of LA-induced immediate-type reactions. In view of the preponderance of non-allergic reactions, the question arises whether genuine LA allergy may be missed during routine testing procedures...
April 12, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29651421/when-the-nose-doesn-t-know-canine-olfactory-function-associated-with-health-management-and-potential-links-to-microbiota
#13
REVIEW
Eileen K Jenkins, Mallory T DeChant, Erin B Perry
The impact of health, management, and microbiota on olfactory function in canines has not been examined in review. The most important characteristic of the detection canine is its sense of smell. Olfactory receptors are primarily located on the ethmoturbinates of the nasal cavity. The vomeronasal organ is an additional site of odor detection that detects chemical signals that stimulate behavioral and/or physiological changes. Recent advances in the genetics of olfaction suggest that genetic changes, along with the unique anatomy and airflow of the canine nose, are responsible for the macrosmia of the species...
2018: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29645361/perioperative-analgesia-for-patients-undergoing-endoscopic-sinus-surgery-an-evidence-based-review
#14
REVIEW
Peter F Svider, Brandon Nguyen, Brian Yuhan, Giancarlo Zuliani, Jean Anderson Eloy, Adam J Folbe
BACKGROUND: Misuse and diversion of prescription opioids have been critical in facilitating the opioid epidemic. Our objective was to perform a systematic evidence-based review delineating perioperative regimens (including opioid alternatives) evaluated for endoscopic sinus surgery. METHODS: PubMed/MEDLINE, Cochrane Library, and EmBase databases were evaluated for studies detailing analgesics employed after endoscopic sinus surgery. Studies were assessed for level of evidence...
April 12, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29643633/anesthetic-efficacy-of-4-articaine-and-2-lignocaine-in-achieving-palatal-anesthesia-following-a-single-buccal-infiltration-during-periodontal-therapy-a-randomized-double-blind-split-mouth-study
#15
Balachandran Ashwath, Sundaram Subramoniam, Rajaram Vijayalakshmi, Muthukali Shanmugam, Bagavathiperumal Meena Priya, Vijayarangan Anitha
Background: The aim of this randomized split-mouth double-blind study was to evaluate whether 4% articaine hydrochloride with 1:100,000 epinephrine administered as a single buccal infiltration in the maxillary posterior sextant can provide palatal anesthesia when compared with 2% lignocaine with 1:100,000 epinephrine during scaling and root planing and access flap surgery (AFS). Material and Methods: A total of 40 patients with chronic generalized periodontitis requiring periodontal therapy in the maxillary posterior sextants were recruited in this study...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29643621/evaluation-of-dexmedetomidine-and-fentanyl-as-additives-to-ropivacaine-for-epidural-anesthesia-and-postoperative-analgesia
#16
S Kiran, Kavita Jinjil, Urvashi Tandon, Soumita Kar
Background and Aims: The synergism between epidural local anesthetic agent and opioids is well established, but evidence for the combination of local anesthetic agent with dexmedetomidine in epidurals is limited. This study evaluates the clinical efficacy of dexmedetomidine versus fentanyl as an additive to ropivacaine for epidural anesthesia. Material and Methods: Patients undergoing infraumbilical surgeries were divided randomly into three groups - Group R (n = 25): received 18 ml of 0...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29630033/a-randomized-comparison-between-interscalene-and-small-volume-supraclavicular-blocks-for-arthroscopic-shoulder-surgery
#17
Julián Aliste, Daniela Bravo, Diego Fernández, Sebastián Layera, Roderick J Finlayson, De Q Tran
BACKGROUND AND OBJECTIVES: This randomized trial compared ultrasound (US)-guided interscalene block (ISB) and small-volume supraclavicular block (SCB) for arthroscopic shoulder surgery. We hypothesized that SCB would provide equivalent analgesia to ISB 30 minutes after surgery without the risk of hemidiaphragmatic paralysis (HDP). METHODS: All patients received an US-guided intermediate cervical plexus block. In the ISB group, US-guided ISB was performed with 20 mL of levobupivacaine 0...
April 6, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29629959/baseline-cerebral-metabolic-rate-is-a-critical-determinant-of-the-cerebral-vasodilating-potency-of-volatile-anesthetic-agents
#18
John C Drummond
Halothane is commonly viewed as a more potent cerebral vasodilator than isoflurane. It was speculated that the lesser vasodilation caused by isoflurane might be the result of the greater reduction in cerebral metabolic rate (CMR) that it causes, and that the relative vasodilating potencies of halothane and isoflurane would be similar if the two agents were administered in a situation that precluded volatile-agent-induced depression of CMR. To test this hypothesis, cerebral blood flow (CBF) and the cerebral metabolic rate for oxygen (CMRO2) were measured in two groups of rabbits before and after the administration of 0...
April 9, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29628875/profiling-of-long-non-coding-rnas-and-mrnas-by-rna-sequencing-in-the-hippocampi-of-adult-mice-following-propofol-sedation
#19
Jun Fan, Quan Zhou, Yan Li, Xiuling Song, Jijie Hu, Zaisheng Qin, Jing Tang, Tao Tao
Propofol is a frequently used intravenous anesthetic agent. The impairment caused by propofol on the neural system, especially the hippocampus, has been widely reported. However, the molecular mechanism underlying the effects of propofol on learning and memory functions in the hippocampus is still unclear. In the present study we performed lncRNA and mRNA analysis in the hippocampi of adult mice, after propofol sedation, through RNA-Sequencing (RNA-Seq). A total of 146 differentially expressed lncRNAs and 1103 mRNAs were identified...
2018: Frontiers in Molecular Neuroscience
https://www.readbyqxmd.com/read/29628682/perioperative-pain-management-following-total-joint-arthroplasty-a-review-and-update-to-an-institutional-pain-protocol
#20
REVIEW
Kimberly L Stevenson, Alexander L Neuwirth, Neil Sheth
As the rate of total joint arthroplasty increases with the aging population of the United States, new focus on decreasing opioid use through the development of multimodal pain regimens (MPRs) is becoming an important area of research. MPRs use different agents and modes of delivery in order to synergistically address pain at many levels of the pain pathway. MPRs include a combination of acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), gabapentinoids, opioids (short- and long-acting), spinal/epidural analgesia, regional nerve blocks, and local anesthetics...
January 2018: Journal of Clinical Orthopaedics and Trauma
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