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https://www.readbyqxmd.com/read/29772592/-cardiac-anaesthesia-anaesthesiological-management
#1
Jochen Renner, Berthold Bein, Ole Broch
The anaesthesiological management of patients scheduled for cardiac surgery has been refined distinctively over the last decade due to different reasons. The continuing growth of the elderly patient population and the increasing number of combined cardiac surgery procedures in octogenarians on the one hand are one aspect. The rapid development of minimally invasive cardiac surgery and the enhancements in mechanical, artificial heart assist devices on the other hand can be seen as additional decisive factors...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29739451/reflex-erection-in-the-rat-reciprocal-interplay-between-hemodynamic-and-somatic-events
#2
Alexander Andreev-Andrievskiy, Evgeniia Lagereva, Anfisa Popova
BACKGROUND: Penile erection is a complex reflex under spinal control and modulated by the brain. The hemodynamic events under autonomic control and the perineal muscles somatic activity are interconnected during the reflex erection at the spinal level, however if the afferent feedback on the corpus cavernosum pressure during an erection affects the somatic activity (perineal muscles contractions) and vice versa is not known. This study was aimed to test this hypothesis using a rat model...
May 8, 2018: BMC Urology
https://www.readbyqxmd.com/read/29736913/effects-of-caffeine-on-behavioural-and-cognitive-deficits-in-rats
#3
Melissa S Assis, Aluízio C Soares, Dircilei N de Sousa, João Eudes-Filho, Lilian Rosana F Faro, Fabiana P Carneiro, Mônica V da Silva, Andrea B Motoyama, Greice Maria R de Souza, Stéphanie Marchiori, Nadyelle T de Lima, Raphael Boëchat-Barros, Vania M Ferreira
There are many studies that have sought to find drug therapies to prevent harm arising from sepsis. Such studies have represented a progress in the support to septic patients and also in the development of new pharmacological alternatives. Our interest was to investigate the caffeine effect on sepsis behavioural and memory impairments. Male rats were anaesthetized and the surgery was made to allow exposure of the cecum, which was then squeezed to extrude a small amount of faeces from the perforation site, which was later placed back into the peritoneal cavity...
May 7, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29701421/rapid-pacing-for-thoracic-endovascular-aortic-repair-a-case-report
#4
Hugo Silva, Andreia Fernandes, João Rodrigues, Daniel Brandão, Manuela Vieira, Catarina Celestino
INTRODUCTION: Endovascular aortic interventions are suitable alternatives to open surgery, being less invasive and having lower mortality and complications. Accurate positioning of the stent graft is a critical point because of systolic thrush. Techniques used to prevent it include pharmacological (antihypertensive drugs, nitroglycerin, adenosine) and mechanical methods (temporary caval occlusion by balloon). Rapid Right Ventricular Pacing (RRVP) is an emerging alternative with good patient tolerance and low level of complications...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29652744/clinical-pearls-part-3-anaesthetic-management-of-abnormally-invasive-placentation
#5
Vinod Patil, Gamunu Ratnayake, Galina Fastovets, D S Wijayatilake
PURPOSE OF REVIEW: Abnormal placentation is a clinical condition seen increasingly in the pregnant population. It is associated with significant morbidity and mortality, which may be mitigated through robust multidisciplinary care for these patients. The role of maternal critical care for these patients has largely been ignored in the literature. RECENT FINDINGS: Advances in pharmacological management of bleeding with recent publications of large multicentre trials in addition to new technologies in the management of massive obstetric haemorrhage (MOH) have revolutionized the management of abnormal placentation...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29645283/sympathoexcitation-following-intermittent-hypoxia-in-rat-is-mediated-by-circulating-angiotensin-ii-acting-at-the-carotid-body-and-subfornical-organ
#6
Seung Jae Kim, Angelina Y Fong, Paul M Pilowsky, Stephen B G Abbott
Circulating angiotensin II (AngII) is vital for arterial pressure elevation following intermittent hypoxia in rats, but its importance in the induction of sympathetic changes is unclear. We tested the contribution of the RAS to the effects of acute intermittent hypoxia (AIH) in anaesthetized ventilated adult rats. AIH caused a 33.7 ± 2.9% increase in sympathetic nerve activity (SNA), and a one-fold increase in sympathetic peripheral chemoreflex sensitivity and central sympathetic-respiratory coupling. The sympathetic effects of AIH were prevented by blocking angiotensin type 1 receptors with systemic losartan and intermittent systemic injections of AngII (Int...
April 12, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29644990/distraction-technique-for-pain-reduction-in-peripheral-venous-catheterization-randomized-controlled-trial
#7
Ihor Balanyuk, Giuseppina Ledonne, Marco Provenzano, Roberto Bianco, Cristina Meroni, Paola Ferri, Loris Bonetti
BACKGROUND AND AIM OF THE WORK: Procedural pain during Peripheral Venous Catheterization (PVC) is a significant issue for patients. Reducing procedure-induced pain improves the quality of care and reduces patient discomfort. We aimed to compare a non-pharmacological technique (distraction) to anaesthetic cream (EMLA) for the reduction of procedural pain during PVC, in patients undergoing Computerized Tomography (CT) or Nuclear Magnetic Resonance (NMR) with contrast. METHODS: This is a Prospective, Randomized Controlled Trial...
February 21, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29629881/propofol-a-safe-anaesthetic-drug-in-experimental-cardiac-surgery-in-rabbits
#8
Enrico Giuliani, Antonio Manenti, Alberto Barbieri, Alberto Farinetti, Anna Vittoria Mattioli
ACKGROUND: Experimental surgery needs a pharmacological approach that can interfere with cardiac function. CASE REPORT: In a animal model of regenerative medicine of myocardium we use an anaesthesiological protocol that included Propofol, a benzodiazepine (Midazolam) and an alpha-2 adrenergic agent. RESULTS: In a group of 15 rabbits undergoing cardiac surgery we reported 1 arrhythmic complication during stem cell injection. DISCUSSION: The functional cardio- respiratory depressor activity of Propofol was compensated by alpha-2 adrenergic drugs, avoiding serious complications...
2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29620988/a-simple-guide-to-regional-anaesthesia
#9
E M Valsamis, S Wade, C Thornhill, C Carey, D Ricketts
Regional anaesthesia is widely used in modern anaesthetic practice for perioperative and postoperative analgesia. In the operating theatre, regional anaesthesia is used both on its own and in combination with other techniques (general anaesthesia and sedation). Regional anaesthesia is now a core skill set in anaesthetic training. This article provides a basic outline of regional anaesthesia for surgeons and other non-anaesthetic staff working with anaesthetists, reviewing preparation, consent, basic and specialist equipment, central neuraxial blocks (spinal, epidural and caudal), trunk blocks, upper limb blocks (interscalene, supraclavicular, infraclavicular and axillary) and lower limb blocks (femoral, fascia iliaca, sciatic, popliteal and ankle)...
April 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29496229/intravenous-lidocaine-infusion
#10
G Soto, M Naranjo González, F Calero
Systemic lidocaine used in continuous infusion during the peri-operative period has analgesic, anti-hyperalgesic, as well as anti-inflammatory properties. This makes it capable of reducing the use of opioids and inhalational anaesthetics, and the early return of bowel function, and patient hospital stay. The aim of this narrative review was to highlight the pharmacology and indications for clinical application, along with new and interesting research areas. The clinical applications of peri-operative lidocaine infusion have been reviewed in several recent systematic reviews and meta-analyses in patients undergoing open and laparoscopic abdominal procedures, ambulatory procedures, and other types of surgery...
May 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29328846/a-review-of-nausea-and-vomiting-in-the-anaesthetic-and-post-anaesthetic-environment
#11
Claire Matthews
Postoperative nausea and vomiting (PONV) has long been known as a complication of anaesthesia and surgery. This paper focuses on the assessment of the risk factors related to PONV along with the strategies and interventions which can be put in place to manage the condition. The pharmacological and multi-modal treatment methods of managing the risk factors that contribute to PONV are discussed.
October 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29283170/perioperative-events-influence-cancer-recurrence-risk-after-surgery
#12
REVIEW
Jonathan G Hiller, Nicholas J Perry, George Poulogiannis, Bernhard Riedel, Erica K Sloan
Surgery is a mainstay treatment for patients with solid tumours. However, despite surgical resection with a curative intent and numerous advances in the effectiveness of (neo)adjuvant therapies, metastatic disease remains common and carries a high risk of mortality. The biological perturbations that accompany the surgical stress response and the pharmacological effects of anaesthetic drugs, paradoxically, might also promote disease recurrence or the progression of metastatic disease. When cancer cells persist after surgery, either locally or at undiagnosed distant sites, neuroendocrine, immune, and metabolic pathways activated in response to surgery and/or anaesthesia might promote their survival and proliferation...
April 2018: Nature Reviews. Clinical Oncology
https://www.readbyqxmd.com/read/29196683/preferential-selection-of-arginine-at-the-lipid-water-interface-of-trpv1-during-vertebrate-evolution-correlates-with-its-snorkeling-behaviour-and-cholesterol-interaction
#13
Somdatta Saha, Arijit Ghosh, Nikhil Tiwari, Ashutosh Kumar, Abhishek Kumar, Chandan Goswami
TRPV1 is a thermo-sensitive ion channel involved in neurosensory and other physiological functions. The trans-membrane helices of TRPV1 undergo quick and complex conformational changes governed by thermodynamic parameters and membrane components leading to channel opening. However, the molecular mechanisms underlying such events are poorly understood. Here we analysed the molecular evolution of TRPV1 at the lipid-water-interface region (LWI), typically defined as a layer of 6 Å thickness on each side of the membrane with less availability of free water...
December 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29182798/pharmacological-interventions-for-pain-relief-during-orthodontic-treatment
#14
REVIEW
Aoife B Monk, Jayne E Harrison, Helen V Worthington, Annabel Teague
BACKGROUND: Pain is a common side effect of orthodontic treatment. It increases in proportion to the amount of force applied to the teeth, and the type of orthodontic appliance used can affect the intensity of the pain. Pain during orthodontic treatment has been shown to be the most common reason for people wanting to discontinue treatment, and has been ranked as the worst aspect of treatment. Although pharmacological methods of pain relief have been investigated, there remains some uncertainty among orthodontists about which painkillers are most suitable and whether pre-emptive analgesia is beneficial...
November 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29161398/role-of-gabaa-receptor-subtypes-in-the-behavioural-effects-of-intravenous-general-anaesthetics
#15
C J Weir, S J Mitchell, J J Lambert
Since the introduction of general anaesthetics into clinical practice, researchers have been mystified as to how these chemically disparate drugs act to produce their dramatic effects on central nervous system function and behaviour. Scientific advances, particularly during the last 25 years, have now begun to reveal the molecular mechanisms underpinning their behavioural effects. For certain i.v. general anaesthetics, such as etomidate and propofol, a persuasive case can now be made that the GABAA receptor, a major inhibitory receptor in the mammalian central nervous system, is an important target...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161390/thiopental-to-desflurane-an-anaesthetic-journey-where-are-we-going-next
#16
J R Sneyd
Development targets in anaesthetic pharmacology have evolved from minimizing harm caused by unwanted effects through an era in which rapid onset and offset of drug effect were prioritised. Today's anaesthetists have access to a library of effective drugs whose characteristics offer controllable hypnosis, analgesia and paralysis with manageable off-target effects. The availability of these agents at generic prices inhibits commercial interest and this is reflected in the limited number of current anaesthetic drug development projects...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29122916/task-1-kcnk3-channels-in-the-lung-from-cell-biology-to-clinical-implications
#17
REVIEW
Andrea Olschewski, Emma L Veale, Bence M Nagy, Chandran Nagaraj, Grazyna Kwapiszewska, Fabrice Antigny, Mélanie Lambert, Marc Humbert, Gábor Czirják, Péter Enyedi, Alistair Mathie
TWIK-related acid-sensitive potassium channel 1 (TASK-1 encoded by KCNK3) belongs to the family of two-pore domain potassium channels. This gene subfamily is constitutively active at physiological resting membrane potentials in excitable cells, including smooth muscle cells, and has been particularly linked to the human pulmonary circulation. TASK-1 channels are sensitive to a wide array of physiological and pharmacological mediators that affect their activity such as unsaturated fatty acids, extracellular pH, hypoxia, anaesthetics and intracellular signalling pathways...
November 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29112549/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-patients-with-preexisting-coagulation-disorders-and-after-severe-perioperative-bleeding
#18
Aamer Ahmed, Sibylle Kozek-Langenecker, François Mullier, Sue Pavord, Cedric Hermans
: In patients with inherited bleeding disorders undergoing surgery, we recommend assessment of individual risk for venous thromboembolism, taking into account the nature of the surgery and anaesthetic, type and severity of bleeding disorder, age, BMI, history of thrombosis, the presence of malignancy and other high-risk comorbidities. Venous thromboembolism risk should be balanced against the increased bleeding risk associated with anticoagulant use in patients with known bleeding disorders (Grade 1C). In these patients undergoing major surgery, we recommend against routine postoperative use of pharmacological thromboprophylaxis, especially for patients with haemophilia A and B (Grade 1B)...
February 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29018164/termination-of-vernakalant-resistant-atrial-fibrillation-by-inhibition-of-small-conductance-ca-2-activated-k-channels-in-pigs
#19
Jonas Goldin Diness, Lasse Skibsbye, Rafel Simó-Vicens, Joana Larupa Santos, Pia Lundegaard, Carlotta Citerni, Daniel Rafael Peter Sauter, Sofia Hammami Bomholtz, Jesper Hastrup Svendsen, Søren-Peter Olesen, Ulrik S Sørensen, Thomas Jespersen, Morten Grunnet, Bo Hjorth Bentzen
BACKGROUND: Evidence has emerged that small-conductance Ca2+ -activated K+ (SK) channels constitute a new target for treatment of atrial fibrillation (AF). SK channels are predominantly expressed in the atria as compared with the ventricles. Various marketed antiarrhythmic drugs are limited by ventricular adverse effects and efficacy loss as AF progresses. METHODS AND RESULTS: A total of 43 pigs were used for the studies. AF reversion in conscious long-term tachypaced pigs: Pigs were subjected to atrial tachypacing (7 Hz) until they developed sustained AF that could not be reverted by vernakalant 4 mg/kg (18...
October 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28972127/functional-characterization-of-5-ht-1b-receptor-drugs-in-nonhuman-primates-using-simultaneous-pet-mr
#20
Hanne D Hansen, Joseph B Mandeville, Christin Y Sander, Jacob M Hooker, Ciprian Catana, Bruce R Rosen, Gitte M Knudsen
In the present study, we used a simultaneous PET-MR experimental design to investigate the effects of functionally different compounds (agonist, partial agonist, and antagonist) on 5-HT1B receptor (5-HT1B R) occupancy and the associated hemodynamic responses. In anesthetized male nonhuman primates ( n = 3), we used positron emission tomography (PET) imaging with the radioligand [11 C]AZ10419369 administered as a bolus followed by constant infusion to measure changes in 5-HT1B R occupancy. Simultaneously, we measured changes in cerebral blood volume (CBV) as a proxy of drug effects on neuronal activity...
November 1, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
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