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anaesthetic pharmacology

Hannah A Blair, James E Frampton
Methoxyflurane (Penthrox(®)) is a halogenated ether first used clinically as a volatile inhalational anaesthetic. It has been used as an analgesic in Australia and New Zealand for the past 30 years. In the UK and Europe, methoxyflurane has been approved for the emergency relief of moderate to severe trauma pain in conscious adult patients. Methoxyflurane is self-administered using a hand-held inhaler. This article reviews the pharmacological properties of methoxyflurane and its clinical efficacy and tolerability in these patients...
October 13, 2016: Clinical Drug Investigation
Maria Jenelyn M Alviar, Tom Hale, Monalisa Dungca
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 12, 2011. Phantom limb pain (PLP) is pain that arises in the missing limb after amputation and can be severe, intractable, and disabling. Various medications have been studied in the treatment of phantom pain. There is currently uncertainty in the optimal pharmacologic management of PLP. OBJECTIVES: This review aimed to summarise the evidence of effectiveness of pharmacologic interventions in treating PLP...
October 14, 2016: Cochrane Database of Systematic Reviews
Polpun Boonmak, Suhattaya Boonmak, Malinee Laopaiboon
BACKGROUND: Functional endoscopic sinus surgery (FESS) is a minimally invasive technique that is used to treat chronic sinusitis. Small bleeding areas can reduce operative visibility and result in destruction of surrounding structures. Deliberate hypotension (lowering the mean arterial blood pressure to between 50 and 65 mm Hg in normotensive patients) using a range of pharmacological agents during general anaesthesia reduces blood loss in many operations. This review was originally published in 2013 and updated in February 2016...
October 12, 2016: Cochrane Database of Systematic Reviews
B G Challis, R T Casey, H L Simpson, M Gurnell
Phaeochromocytomas and paragangliomas (PPGLs) are catecholamine secreting neuroendocrine tumours that predispose to haemodynamic instability. Currently, surgery is the only available curative treatment, but carries potential risks including hypertensive and hypotensive crises, cardiac arrhythmias, myocardial infarction and stroke, due to tumoral release of catecholamines during anaesthetic induction and tumour manipulation. The mortality associated with surgical resection of PPGL has significantly improved from 20-45% in the early 20(th) century(1) to 0-2...
October 3, 2016: Clinical Endocrinology
Yao Wang, Yu-Zhang Liu, Shi-Yi Wang, Zhiru Wang
As a critical technique for dissection of synaptic and cellular mechanisms, whole-cell patch-clamp recording has become feasible for in vivo preparations including both anaesthetized and awake mammalian brains. However, compared with in vitro whole-cell recording, in vivo whole-cell recording often suffers from low success rates and high access resistance, preventing its wide application in physiological analysis of neural circuits. Here, we describe experimental procedures for achieving in vivo amphotericin B-perforated whole-cell recording as well as conventional (breakthrough) whole-cell recording from rats and mice...
September 29, 2016: Molecular Brain
B Yang, A Fung, C Pac-Soo, D Ma
Whilst there has been a reduction in the prevalence of peripheral vascular disease worldwide, a significant proportion of the world's growing population is still affected by disease of the aorta, carotid, iliac and lower limb arteries. These if left untreated can result in severe morbidity and mortality. However vascular surgery, the main definitive treatment for such conditions, is associated with subsequent injury to vital organs including the kidneys, heart, brain, intestines and lungs, with a consequent increase in both morbidity and mortality...
September 2016: British Journal of Anaesthesia
Joseph J Smolich, Jonathan P Mynard
Recent fetal lamb data have suggested that the pulmonary trunk (PT) region displays a reservoir function and that a pharmacologically induced fall in pulmonary vascular resistance (PVR) increases and redistributes diastolic discharge from this central pulmonary reservoir toward the lungs, thereby producing a positive diastolic offset in the pulmonary arterial (PA) blood flow profile. As a similar offset in PA flow characteristically occurs after birth, this study tested the hypotheses that 1) central pulmonary reservoir discharge is both redistributed toward the lungs and increased in magnitude during the birth transition and 2) discharge from this reservoir constitutes a major component of increased PA diastolic blood flow after birth...
October 1, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Maximilian S Schaefer, Peter Kranke, Stephanie Weibel, Robert Kreysing, Peter Kienbaum
BACKGROUND: Postoperative nausea and vomiting (PONV) are among the most unfavourable anaesthetic outcomes attributed to the administration of inhaled anaesthetics. Accordingly, inhaled anaesthetics are frequently substituted by propofol when patients are at risk of PONV. As, on some occasions, inhalational anaesthesia may be favourable, the relative impact of propofol anaesthesia needs to be established based on robust data. OBJECTIVE: To compare the effectiveness of a single-drug pharmacological prophylaxis with total intravenous anaesthesia (TIVA) for prevention of PONV...
October 2016: European Journal of Anaesthesiology
Elpidio Santillo, Monica Migale, Demetrio Postacchini, Fabrizio Balestrini, Raffaele Antonelli Incalzi
BACKGROUND: At present, ischemic heart disease (IHD) is one of the main causes of morbidity and mortality world-wide. An important insight into both IHD pathophysiology and cardioprotection was achieved in 1986 when Murry et al. described for the first time the ischemic preconditioning (IP). IP can be defined as an innate phenomenon by which brief episodes of ischemia confer protection to a tissue from a subsequent more protracted ischemic insult. Suggested mechanisms explaining IP comprise the action of circulating substances (e...
July 19, 2016: Anti-inflammatory & Anti-allergy Agents in Medicinal Chemistry
Bonnie Stevens, Janet Yamada, Arne Ohlsson, Sarah Haliburton, Allyson Shorkey
BACKGROUND: Administration of oral sucrose with and without non-nutritive sucking is the most frequently studied non-pharmacological intervention for procedural pain relief in neonates. OBJECTIVES: To determine the efficacy, effect of dose, method of administration and safety of sucrose for relieving procedural pain in neonates as assessed by validated composite pain scores, physiological pain indicators (heart rate, respiratory rate, saturation of peripheral oxygen in the blood, transcutaneous oxygen and carbon dioxide (gas exchange measured across the skin - TcpO2, TcpCO2), near infrared spectroscopy (NIRS), electroencephalogram (EEG), or behavioural pain indicators (cry duration, proportion of time crying, proportion of time facial actions (e...
2016: Cochrane Database of Systematic Reviews
Fang Fang, Wendong Lin, Xiaomin Ling, Ruixue Song, Qiuaxue Liu, Bin Lai, Jing Cang
AIMS: Increasing evidence has suggested cognitive impairment and neuronal apoptosis induced by anaesthetics are due to abnormal hyperphosphorylation of tau protein, but the detailed mechanism remains unknown. MAIN METHODS: Aged mice and neurons were both exposed to 2.5% sevoflurane for 2h. Spatial learning ability of the aged mice was tested with Morris water maze. The changes of neuroapoptosis, tau protein and cell-cycle-related factors (cyclin D1, p27) were determined using Western blot analysis...
September 1, 2016: Life Sciences
Alessandro Arena, Jacopo Lamanna, Marco Gemma, Maddalena Ripamonti, Giuliano Ravasio, Vincenzo Zimarino, Assunta De Vitis, Luigi Beretta, Antonio Malgaroli
General anaesthetics, which are expected to silence brain activity, often spare sensory responses. To evaluate differential effects of anaesthetics on spontaneous and sensory-evoked cortical activity, we characterized their modulation by sevoflurane and propofol. Power spectra and bust-suppression ratio from EEG data were used to evaluate anaesthesia depth. ON and OFF cortical responses were elicited by light-pulses of variable intensity, duration and frequency, during light and deep states of anaesthesia. Both anaesthetics reduced spontaneous cortical activity but sevoflurane greatly enhanced while propofol diminished the ON visual response...
July 15, 2016: Journal of Physiology
Amy Hsin-Chieh Hsieh, Ganessan Kichenadasse, Sina Vatandoust, Amitesh Roy, Shawgi Sukumaran, Christos S Karapetis, Helen Martin, Li Chia Chong, Bogda Koczwara
BACKGROUND: Goserelin, a form of medical ovarian suppression (MOS), is an effective treatment for premenopausal women with breast cancer (PMBC). Meta-analysis data showed that similar efficacy is achieved with MOS and non-pharmacological ovarian suppression (NPOS) - oophorectomy or ovarian irradiation. Acceptance rate of NPOS remains low. AIMS: This study explored the reported toxicities of PMBC women and their preferred ovarian suppression method whilst on goserelin...
July 8, 2016: Internal Medicine Journal
June Bryan de la Peña, Jae Hoon Cheong
The tiletamine-zolazepam (TZ) combination is an anaesthetic drug commonly used in veterinary medicine. It is an equal amount combination of tiletamine, a dissociative anaesthetic pharmacologically classified as an N-methyl-D-aspartate (NMDA) receptor antagonist, and zolazepam, a benzodiazepine tranquilizer. There are concerns regarding the safety profile of this drug combination due to incidents of human misuse/abuse. In this paper, we discuss the abuse liability of this drug combination based on currently available scientific evidence...
August 2016: Drug Testing and Analysis
Han Chow Chua, Emilie T H Christensen, Kirsten Hoestgaard-Jensen, Leonny Y Hartiadi, Iqbal Ramzan, Anders A Jensen, Nathan L Absalom, Mary Chebib
Extracts of the pepper plant kava (Piper methysticum) are effective in alleviating anxiety in clinical trials. Despite the long-standing therapeutic interest in kava, the molecular target(s) of the pharmacologically active constituents, kavalactones have not been established. γ-Aminobutyric acid type A receptors (GABAARs) are assumed to be the in vivo molecular target of kavalactones based on data from binding assays, but evidence in support of a direct interaction between kavalactones and GABAARs is scarce and equivocal...
2016: PloS One
Luka R Srejic, Kevin M Wood, Anisa Zeqja, Parastoo Hashemi, William D Hutchison
The subcallosal cingulate (SCC) region, or its rodent homologue the medial prefrontal cortex (mPFC), and midbrain dorsal raphe (DR) are crucial nodes of the widespread network implicated in emotional regulation. Stimulation of the SCC is being explored as a potential treatment for depression. Because modulation of the 5-HT system is the most common pharmacological means of treating depression, we sought to establish 5-HT's role in the mPFC-DR projection. Using anaesthetized mice, we recorded neuronal activity in 49 neurons of the DR before, during, and after high frequency stimulation (HFS) of the mPFC...
October 2016: Neurobiology of Disease
Carol McCrum
The use of an intra-articular methylprednisolone acetate (MPA) injection has been shown to have benefits for symptoms of knee osteoarthritis (OA). However, considerations beyond drug efficacy can influence the appropriateness, clinical effectiveness and potential harm of an injection. A review of research evidence and published literature on clinical and procedural factors influencing the effectiveness and safety of a knee injection has been undertaken. Factors include dose, frequency, contraindications, precautions, drug interactions, side-effects, and procedural and patient-related considerations...
June 13, 2016: Musculoskeletal Care
G Becker, R Bolbos, N Costes, J Redouté, A Newman-Tancredi, L Zimmer
Serotonin 1A (5-HT1A) receptors are involved in several physiological and pathological processes and constitute therefore an important therapeutic target. The recent pharmacological concept of biased agonism asserts that highly selective agonists can preferentially direct receptor signaling to specific intracellular responses, opening the possibility of drugs targeting a receptor subtype in specific brain regions. The present study brings additional support to this concept thanks to functional magnetic resonance imaging (7 Tesla-fMRI) in anaesthetized rats...
2016: Scientific Reports
Guido van Amerongen, Matthijs W de Boer, Geert Jan Groeneveld, Justin L Hay
AIMS: Human evoked pain models can be used to determine the efficacy of new and existing analgesics and to aid in the identification of new targets. Aspects of neuropathic pain can be simulated by inducing hyperalgesia resulting from provoked sensitization. The present literature review aimed to provide insight into the sensitivity of different hyperalgesia and allodynia models of pharmacological treatment. METHODS: A literature search was performed to identify randomized, double-blind, placebo-controlled studies that included human hyperalgesia pain models and investigated the pharmacodynamic effects of different classes of drugs...
October 2016: British Journal of Clinical Pharmacology
Abbas Ahmadi, Mohsen Khalili, Mohammad Kazem Mohammadinoude, Babak Nahri-Niknafs
Local anesthetics are the most widely consumed drugs in the practice of medicine which provide a loss of sensation in a certain body part without loss of consciousness or impairment of central control of essential functions. Lidocaine (I) is the most commonly local anaesthetic drug which is widely used in all species due to its fabulous diffusing and penetrating properties as well as prompt onset of surgical analgesia. In this study, new aminobenzothiazole (with many useful biological and pharmacological properties) analogues were synthesized by changing of amine moiety of I...
2016: Combinatorial Chemistry & High Throughput Screening
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