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Sample records for anesthetics local

  1. Strabismus complications from local anesthetics.

    Science.gov (United States)

    Guyton, David L

    2008-01-01

    Strabismus developing after retrobulbar or peribulbar anesthesia for both anterior and posterior segment eye surgery may be due to myotoxicity to an extraocular muscle from the local anesthetic agent. Initial paresis often causes diplopia immediately after surgery, but later progressive segmental fibrosis occurs, and/or hypertrophy of the muscle, producing diplopia in the opposite direction from the direction of the initial diplopia. The inferior rectus muscle is most commonly affected. Usually a large recession on an adjustable suture of the involved muscle(s) yields good alignment. Using topical anesthesia or sub-Tenon's anesthesia can avoid this complication.

  2. Local anesthetics: dentistry's most important drugs.

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    Malamed, S F

    1994-12-01

    One hundred and fifty years ago, Horace Wells opened the door to local anesthetics. Since then, many advances have been made in pain control. The development of dentistry's most important drugs is highlighted here.

  3. LOCAL ANESTHETICS IN PATIENTS WITH CARDIOVASCULAR DISEASES.

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    risto Daskalov

    2015-03-01

    Full Text Available A significant problem in the dental medicine is pain alleviation. Many studies in the dental anesthesiology result in the production of new agents for locoregional anesthesia. Objective: This article aim to present the results of the last studies on the effect of the local anesthetics used in the oral surgery on patients with cardiovascular diseases. Material: A general review of the existing literature on the effect of the adrenaline, included as vasoconstrictor in the local anesthetics, used in patients with cardiovascular diseases is made. The benefits of vasoconstrictors for the quality of the anesthetic effect are proven. Conclusion: A small amount of adrenaline in the anesthetic solution does not result in complications development in patients with controlled cardiovascular diseases. Articaine is recommended agent of first choice for local anesthesia in the oral surgery.

  4. SYSTEMIC TOXIC REACTIONS TO LOCAL ANESTHETICS

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    Moore, Daniel C.; Green, John

    1956-01-01

    The topical use of anesthetic agents involves an element of risk. Systemic toxic reactions are rare, but they do occur and may result in death. When a reaction occurs from a topical application, it usually progresses rapidly to respiratory and cardiovascular collapse, and thus therapy must be instituted with more haste to avoid deaths. Fatal systemic toxic reactions from topically administered anesthetic drugs are, in effect, usually not due to well informed use of the drug but to misuse owing to less than complete understanding of absorption. Emphasis is placed on the causes, prophylaxis and treatment of severe systemic toxic reactions which follow the topical application of local anesthetic drugs. If systemic toxic reactions resulting from a safe dose of a local anesthetic agent are correctly treated, there will usually follow an uneventful recovery rather than a catastrophe. PMID:13343009

  5. Knowledge about local anesthetics in odontology students.

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    Guzmán Alvarez, Rodrigo; Campos Sepúlveda, Alfonso Efraín; Martínez González, Adrian Alejandro

    2009-01-01

    The purpose of the study was to identify the level of knowledge of local anesthetics frequently used in the surgical clinic by third and fourth year dental students in daily practice. The importance of pharmacology in dental practice in underscored by potential drug toxicity. The study was performed with 244 third and fourth grade career dental students (CDS). Eleven items regarding the knowledge over local anesthetics at the clinic; i.e., the appropriate doses, possible toxic effects and side effects were examined. The reference questionnaire which is in a validation process, is a way to evaluate student knowledge about most drugs used in odontology practice such as: NSAIDs, antibiotics and local anesthetics. The results were found to be unsatisfactory with a high percentage of students failing (less than six of eleven items correct). We conclude that determination of practice knowledge is an essential step in informing the institution about cognitive deficiencies identified in order to plan learning solutions.

  6. Local anesthetics: dentistry's most important drugs, clinical update 2006.

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    Malamed, Stanley F

    2006-12-01

    Local anesthetics are the safest most effective drugs in medicine for the control and management of pain. They also represent the most important drugs in dentistry. Today, dentistry has a spectrum of local anesthetics that permit pain control to be tailored to the specific needs of the patient: short-, intermediate-, and long-acting drugs. Bupivacaine has become a standard part of the armamentarium for postsurgical pain control while articaine has become the second-most used local anesthetic in the United States since its introduction in 2000. Despite an increase in anecdotal reports of paresthesia since articaine's introduction there is yet, no supporting scientific evidence.

  7. Trigeminal nerve injury associated with injection of local anesthetics

    DEFF Research Database (Denmark)

    Hillerup, Søren; Jensen, Rigmor H.; Ersbøll, Bjarne Kjær

    2011-01-01

    , prilocaine 3 percent, and articaine 4 percent sold in cartridges. Results. The study results showed a highly significant overrepresentation of NSDs associated with articaine 4 percent, in particular with mandibular blocks. Conclusions. The distribution of NSDs was disproportionate to the market share......Background. The authors used comprehensive national registry and clinical data to conduct a study of adverse drug reactions (ADRs), in particular neurosensory disturbance (NSD), associated with local anesthetics used in dentistry. Methods. The study included data sets of annual sales of local...... anesthetics (from 1995 through 2007), 292 reports to the Danish Medicines Agency, Copenhagen, Denmark, of adverse reactions to local anesthetic drugs, and a clinical sample of 115 patients with NSD associated with local anesthetics. The authors assessed lidocaine 2 percent, mepivacaine 2 percent and 3 percent...

  8. Water solvent and local anesthetics: A computational study

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    Bernardi, R. C.; Gomes, D. E. B.; Pascutti, P. G.; Ito, A. S.; Taft, C. A.; Ota, A. T.

    There are various experimental studies regarding the toxicity and the time of action of local anesthetics, which contain general insights about their pharmacological and physicochemical properties. Although a detailed microscopic analysis of the local anesthetics would contribute to understanding these properties, there are relatively few theoretical studies about these molecules. In this article, we present the results from calculations performed for three local anesthetics: tetracaine, procaine, and lidocaine, both in their charged and uncharged forms, in aqueous environment. We have used the density functional theory and molecular dynamics simulations to study the structural characteristics of these compounds. The radial distribution function g(r) was used to examine the structure of water molecules surrounding different regions of the local anesthetics. We demonstrated the nonhomogeneous character of the anesthetics with respect to their affinity to water solvent molecules as well as the modifications in their affinity to water caused by changes in their charge state. We also observed that the biological potency of the anesthetics is more related to the behavior of specific groups within the molecule, which are responsible for the interaction with the lipid phase of membranes, rather than the general properties of the molecule as a whole.

  9. Recognition of local anesthetics by alphabeta+ T cells.

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    Zanni, M P; von Greyerz, S; Hari, Y; Schnyder, B; Pichler, W J

    1999-02-01

    Patients with drug allergy show a specific immune response to drugs. Chemically nonreactive drugs like, for example, local anesthetics are directly recognized by alphabeta+ T cells in an HLA-DR restricted way, as neither drug metabolism nor protein processing is required for T cell stimulation. In this study we identified some of the structural requirements that determine cross-reactivity of T cells to local anesthetics, with the aim to improve the molecular basis for the selection of alternatives in individuals sensitized to a certain local anesthetic and to better understand presentation and T cell recognition of these drugs. Fifty-five clones (52 lidocaine specific, three mepivacaine specific from two allergic donors) were analyzed. Stimulatory compounds induced a down-regulation of the T cell receptor, demonstrating that these non-peptide antigens are recognized by the T cell receptor itself. A consistent cross-reactivity between lidocaine and mepivacaine was found, as all except one lidocaine specific clone proliferated to both drugs tested. Sixteen chemically related local anesthetics (including ester local anesthetics, OH- and desalkylated metabolites) were used to identify structural requirements for T cell recognition. Each of the four clones examined in detail was uniquely sensitive to changes in the structures of the local anesthetic: clone SFT24, i.e., did not recognize any of the tested OH- or desalkylated metabolites, while the clone OFB2 proliferated to all OH-metabolites and other differently modified molecules. The broadly reactive clone OFB2 allowed us to propose a model, suggesting that the structure of the amine side chain of local anesthetics is essential for recognition by the T cell receptor.

  10. Effect of local anesthetics on serotonin1A receptor function.

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    Rao, Bhagyashree D; Shrivastava, Sandeep; Chattopadhyay, Amitabha

    2016-12-01

    The fundamental mechanism behind the action of local anesthetics is still not clearly understood. Phenylethanol (PEtOH) is a constituent of essential oils with a pleasant odor and can act as a local anesthetic. In this work, we have explored the effect of PEtOH on the function of the hippocampal serotonin1A receptor, a representative neurotransmitter receptor belonging to the G protein-coupled receptor (GPCR) family. Our results show that PEtOH induces reduction in ligand binding to the serotonin1A receptor due to lowering of binding affinity, along with a concomitant decrease in the degree of G-protein coupling. Analysis of membrane order using the environment-sensitive fluorescent probe DPH revealed decrease in membrane order with increasing PEtOH concentration, as evident from reduction in rotational correlation time of the probe. Analysis of results obtained shows that the action of local anesthetics could be attributed to the combined effects of specific interaction of the receptor with anesthetics and alteration of membrane properties (such as membrane order). These results assume relevance in the perspective of anesthetic action and could be helpful to achieve a better understanding of the possible role of anesthetics in the function of membrane receptors.

  11. Local anesthetics as pain therapy in horses.

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    Doherty, Thomas J; Seddighi, M Reza

    2010-12-01

    This article describes the rationale behind the use of systemically administered lidocaine as an analgesic. The analgesic efficacy of intravenously administered lidocaine is well documented by studies in human patients and laboratory animals. The mechanism by which systemically administered lidocaine produces analgesia is uncertain but is thought to include action at sodium, calcium, and potassium channels and the N-methyl-D-aspartate acid receptor. In addition, the anti-inflammatory actions of lidocaine are important in producing analgesia because inflammatory mediators augment neuronal excitability. The available studies of systemically administered lidocaine in horses provide evidence for the analgesic and anesthetic effects of intravenous lidocaine in this species.

  12. Local anesthetics: New insights into risks and benefits

    NARCIS (Netherlands)

    Lirk, P.

    2014-01-01

    Conventional local anesthetics in contemporary use block the voltage-gated sodium channel by binding to a specific site on the inner facet of the channel pore. Only little fractions of local anaesthetic are thought to participate in nerve blockade, the rest is absorbed into surrounding tissues or th

  13. Fentanyl, dexmedetomidine, dexamethasone as adjuvant to local anesthetics in caudal analgesia in pediatrics: A comparative study

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    Elham M. El-Feky

    2015-04-01

    Conclusion: Both caudal dexmedetomidine and caudal dexamethasone added to local anesthetics are good alternatives in prolongation of postoperative analgesia compared to caudal local anesthetic alone or added to caudal fentanyl. Also they showed less side effects compared to caudal fentanyl.

  14. Electronic dental anesthesia in a patient with suspected allergy to local anesthetics: report of case.

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    Malamed, S F; Quinn, C L

    1988-01-01

    A 56-year-old patient with alleged allergy to local anesthetics required restorative dental treatment. Electronic dental anesthesia was used successfully, in lieu of injectable local anesthetics, to manage intraoperative pain associated with the restoration of vital mandibular teeth.

  15. Antidepressants and local anesthetics: drug interactions of interest to dentistry

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    Lea Rosa Chioca

    2010-10-01

    Full Text Available Introduction: Since there is a vast variety of pharmacological treatments for mental conditions, it has been increasingly more common that patients seeking dentistry treatment are continually using psychoactive drugs as antidepressants. The number of people taking antidepressants is increasing; consequently, dentists should update their knowledge on the interaction between this drug class and those used in dental daily practice, such as local anesthetics and vasoconstrictors. Objective: To conduct a literature review on this subject. Literature review and conclusion: Literature data suggest that sympathomimetic vasoconstrictors (epinephrine, norepinephrine, and phenylephrine associated with local anesthetics may potentiate the side effects of antidepressants, particularly tricyclics and MAO inhibitors, on the cardiovascular system. There are few clinical trials and preclinical studies on this subject, and most of them were carried out between the 60s and 80s. Current studies are needed, since many new antidepressant drugs with different mechanisms of action are currently marketed and being used.

  16. Intraperitoneal Local Anesthetic in Pediatric Surgery: A Systematic Review.

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    Hamill, James K; Rahiri, Jamie-Lee; Liley, Andrew; Hill, Andrew G

    2016-12-01

    Introduction Systematic reviews report intraperitoneal local anesthetic (IPLA) effective in adults but until now no review has addressed IPLA in children. The objective of this review was to answer the question, does IPLA compared with control reduce pain after pediatric abdominal surgery. Materials and Methods Data sources: MEDLINE, EMBASE, Cochrane databases, trials registries, ProQuest, Web of Science, Google Scholar, and Open Gray.

  17. Interactions of some local anesthetics and alcohols with membranes.

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    Frangopol, P T.; Mihăilescu, D

    2001-09-01

    A review of the results obtained by our group in the last decade regarding the interactions of procaine, lidocaine, dibucaine and tetracaine with membranes is presented in the context of the literature data. The action upon membranes, in first approximation monomolecular film of stearic acid spread at the air/water interface used as a membrane model, the modification of biomembrane structure and function using diffraction methods, lipid phase transition, fluidity of lipids and proteins, membrane expansion and platelet aggregation were studied. The thermodynamic knowledge of membrane-alcohol interactions improved by using highly sensitive calorimetric techniques are briefly reported. One of the main conclusions is that the physical state of a monolayer model membrane was the result of competitive interactions between film-film and film-substrate interactions. It was taken into account that local anesthetics, such as lidocaine, carbisocaine, mesocaine, showed changes in the bilayer structure, reflected in macroscopic mechanical properties. This restructuring of the lipid bilayer has a significant influence on the operation of functional subunits, e.g. ionic channels formed by gramicidin. The results support the concept of non-specific interactions of local anesthetics with lipid bilayers. The theoretical modeling of the interactions of local anesthetics is closely compared with experimental data. Our new theory of relaxation for these interactions is using a non-archimedean formalism based on a process resulting from superpositions of different component processes which take place at different scales of time.

  18. Conformation and kinetic characteristics of interactions between local anesthetics and aqueous solutions of hydroxypropylmethylcellulose.

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    Galenko-Yaroshevskii, A P; Varlashkina, I A; Takhchidi, Kh P; Malyugin, B E; Dukhanin, A S

    2007-05-01

    Conformation and kinetic characteristics of the interactions of local anesthetics lidocaine (xycaine), tetracaine (dicaine), bupivacaine, and new RU-1117 compound with proven anesthetic activity with Visiton (1% hydroxypropylmethylcellulose in phosphate buffer) were studied. It was found that complex formation between the local anesthetics and hydroxypropylmethylcellulose is a time-dependent reversible process. The equilibrium is attained within 2.5-8.0 h and depends on the chemical nature of local anesthetic.

  19. Articaine - the best choice of local anesthetic in contemporary dentistry.

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    Nizharadze, N; Mamaladze, M; Chipashvili, N; Vadachkoria, D

    2011-01-01

    Local anesthesia forms the foundation of pain control techniques in clinical dentistry. Within the rich local anesthetic drugs available in dentistry for the prevention and management of pain 4% articaine solutions achieve highest level of anesthetic potency and lowest systemic toxicity in all clinical situations, prior to its superlative physicochemical characteristics and the pharmacological profile. These are - low lipid solubility, high plasma protein binding rate, fast metabolization, fast elimination half time; low blood level. Articaine inactivates in both ways: in the liver and the blood serum. It has good spreading through tissues. Thus, articaine seems to be the local anesthetic of first choice in tissues with suppurative inflammation, for adults, children (over 4), elderly, pregnant women, breastfeeding women, patients suffering from hepatic disorders and renal function impairment. In Articaine solutions (1: 200,000) epinephrine is in low concentration, thus in patients at high risk adverse responses are maximally decreased. In these patients articaine should be used with careful consideration of risk/benefit ratio. Articaine solutions must not be used in persons who are allergic or hypersensitive to sulphite, due to content of Sodium metabisulfite as vasoconstrictor's antioxidant in it. Incidence of serious adverse effects related to dental anesthesia with articaine is very low. Toxic reactions are usually due to an inadvertent intravascular injection or use of excessive dose. To avoid overdoses maximum recommendation dose (MRD) must not be exceeded and aspiration test always performed prior all LA injections. In these article we introduce new graphs providing a quick and effect way to determine maximum LA dose. If the overdose reactions develop, adherence to the basic step of emergency management with end to a successful outcome in virtually all cases.

  20. Under Utilization of Local Anesthetics in Infant Lumbar Punctures

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    Gorchynski, Julie

    2008-01-01

    Full Text Available Background: Lumbar Puncture (LP is an invasive procedure frequently used to diagnose meningitis among the pediatric population. Neonates and infants have not routinely received local anesthesia prior to LP. Study Objective: To determine whether emergency medicine physicians and pediatricians use local analgesics on neonates and infants prior to performing an LP and to identify which local anesthetics, if any, were used. Methods: Prospective, cohort study of all infants, six months of age or less, that received an LP in the emergency department (ED or inpatient pediatric units for suspected meningitis during a period of year at a university tertiary care hospital. Results: A total sample population of 111 infants that received an LP within the study period. A control population of 42 adults received an LP. Only 40.4% (45/111 of the infants received local analgesia prior to LP: either 1% lidocaine, EMLA or a combination of the two. Infants were less likely to receive lidocaine or EMLA prior to LP compared to adult subjects (OR= 0.27; 95% CI0.12 to 0.62. No neonates that were less than one month of age received local procedural anesthesia by emergency medicine or pediatric physicians. ED physicians’ use of local anesthesia prior to LP increased with increasing age of the infant. The pediatricians in this study used local anesthesia prior to LP when the infant was at least five months of age. Discussion: The data objectively support recent literature regarding the under use or lack of use of analgesia prior to LP among neonates and infants. Local anesthetics should be used routinely without exception prior to performing an LP in the pediatric population.

  1. Vasoconstriction Potency Induced by Aminoamide Local Anesthetics Correlates with Lipid Solubility

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    Hui-Jin Sung

    2012-01-01

    Full Text Available Aminoamide local anesthetics induce vasoconstriction in vivo and in vitro. The goals of this in vitro study were to investigate the potency of local anesthetic-induced vasoconstriction and to identify the physicochemical property (octanol/buffer partition coefficient, pKa, molecular weight, or potency of local anesthetics that determines their potency in inducing isolated rat aortic ring contraction. Cumulative concentration-response curves to local anesthetics (levobupivacaine, ropivacaine, lidocaine, and mepivacaine were obtained from isolated rat aorta. Regression analyses were performed to determine the relationship between the reported physicochemical properties of local anesthetics and the local anesthetic concentration that produced 50% (ED50 of the local anesthetic-induced maximum vasoconstriction. We determined the order of potency (ED50 of vasoconstriction among local anesthetics to be levobupivacaine > ropivacaine > lidocaine > mepivacaine. The relative importance of the independent variables that affect the vasoconstriction potency is octanol/buffer partition coefficient > potency > pKa > molecular weight. The ED50 in endothelium-denuded aorta negatively correlated with the octanol/buffer partition coefficient of local anesthetics (r2=0.9563; P<0.001. The potency of the vasoconstriction in the endothelium-denuded aorta induced by local anesthetics is determined primarily by lipid solubility and, in part, by other physicochemical properties including potency and pKa.

  2. Use of eutectic mixture of local anesthetics in children.

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    Dutta, S

    1999-01-01

    The Eutectic Mixture of Local Anesthetics (EMLA) is a topical application, which has proved to be a useful medication for providing pain relief among children. It is an emulsion containing a 1:1 mixture of lidocaine and prilocaine. The high concentration of the uncharged anesthetic base in the microdroplets of the emulsion ensure effective skin penetration. In the pediatric population EMLA has been shown to be efficacious when it is used prior to venipuncture, cannulation, lumbar puncture, laser treatment of port wine stains, curettage of molluscum contagiosum or vaccination. For several of these indications, the efficacy has been documented by double blind controlled trials, that have used objective and quasi-objective scales for assessing pain relief. The dose of EMLA is between 0.5 to 1 gram, and the cream should be applied half to one hour prior to the procedure. Local side effects are very mild, and the only systemic side effect of importance is the risk of methemoglobinemia in young infants. The literature has conflicting reports about the safety of EMLA in neonates.

  3. COMPARISON OF COMMON CLINICALLY USED LOCAL ANESTHETICS ON ANIMAL MODELS

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    Anthireddy Srinivas

    2012-08-01

    Full Text Available The animal models used in this study were Plexus anesthesia in frogs, Infiltration anesthesia in guinea pigs, Surface anesthesia in rabbits. The drugs were diluted with normal saline. Lignocaine2%: xylocaine hydrochloride injection IP, Bupivacaine 0.5%: Bupivacaine hydrochloride injections IP were prepared. Plexus anesthesia: Frog was pithed and spinal cord was destroyed up to the 3 vertebra. The abdominal pouch was filled with local anesthetic solution. Reflex activity was tested by immersing both feet of the frog every two minutes for not longer than 10 seconds into N/10 Hydrochloric acid. The time was noted. Surface anesthesia: Albino rabbits of either sex weighing 2.5 – 3.0kg ware selected. The conjunctival sac of one eye was held open, thus formed a pouch. 0.5ml of solution of the anesthetic was applied into the conjunctival sac for 30 sec. Infiltration anesthesia: Preparation of guinea pig: Guinea pigs (either sex weighing 250-300grams were used. Lignocaine produced rapid onset of plexus anesthesia in Frogs in comparison to the bupivacaine at concentration of 0.1% & 0.2% which is statistically significant. Bupivacaine is more potent than the lignocaine as a surface anesthetic agent in the Rabbit, where as lignocaine could produce surface anesthesia at concentration of 0.5% or 0.1% or both. Both bupivacaine and lignocaine produced infiltration anesthesia on intradermal injection in guinea pigs but the duration of infiltration anesthesia produced by bupivacaine is more prolonged which is statistically significant in comparison to the lignocaine at all the three concentrations tested i.e. 0.05%, 0.1% & 0.2%.

  4. Loss of anatomical landmarks with eutectic mixture of local anesthetic cream for neonatal male circumcision.

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    Plank, Rebeca M; Kubiak, David W; Abdullahi, Rasak Bamidele; Ndubuka, Nnamdi; Nkgau, Maggie M; Dapaah-Siakwan, Fredrick; Powis, Kathleen M; Lockman, Shahin

    2013-02-01

    We report two cases of newborns who developed marked local edema after application of a eutectic mixture of local anesthetic (EMLA) topical anesthetic cream for neonatal male circumcision (NMC). Although local edema and erythema are known potential side effects of EMLA cream, a common anesthetic used for NMC, the loss of landmarks precluding safe NMC has not previously been reported, and is described here. Although we cannot recommend an alternate local anesthetic for neonates with this reaction to EMLA, based on a review of the published data we think that serious systemic adverse events related to EMLA are extremely rare.

  5. From micro- to nanostructured implantable device for local anesthetic delivery.

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    Zorzetto, Laura; Brambilla, Paola; Marcello, Elena; Bloise, Nora; De Gregori, Manuela; Cobianchi, Lorenzo; Peloso, Andrea; Allegri, Massimo; Visai, Livia; Petrini, Paola

    2016-01-01

    Local anesthetics block the transmission of painful stimuli to the brain by acting on ion channels of nociceptor fibers, and find application in the management of acute and chronic pain. Despite the key role they play in modern medicine, their cardio and neurotoxicity (together with their short half-life) stress the need for developing implantable devices for tailored local drug release, with the aim of counterbalancing their side effects and prolonging their pharmacological activity. This review discusses the evolution of the physical forms of local anesthetic delivery systems during the past decades. Depending on the use of different biocompatible materials (degradable polyesters, thermosensitive hydrogels, and liposomes and hydrogels from natural polymers) and manufacturing processes, these systems can be classified as films or micro- or nanostructured devices. We analyze and summarize the production techniques according to this classification, focusing on their relative advantages and disadvantages. The most relevant trend reported in this work highlights the effort of moving from microstructured to nanostructured systems, with the aim of reaching a scale comparable to the biological environment. Improved intracellular penetration compared to microstructured systems, indeed, provides specific drug absorption into the targeted tissue and can lead to an enhancement of its bioavailability and retention time. Nanostructured systems are realized by the modification of existing manufacturing processes (interfacial deposition and nanoprecipitation for degradable polyester particles and high- or low-temperature homogenization for liposomes) or development of novel strategies (electrospun matrices and nanogels). The high surface-to-volume ratio that characterizes nanostructured devices often leads to a burst drug release. This drawback needs to be addressed to fully exploit the advantage of the interaction between the target tissues and the drug: possible strategies

  6. Dual effect of local anesthetics on the function of excitable rod outer segment disk membrane

    Energy Technology Data Exchange (ETDEWEB)

    Mashimo, T.; Abe, K.; Yoshiya, I.

    1986-04-01

    The effects of local anesthetics and a divalent cation, Ca2+, on the function of rhodopsin were estimated from the measurements of light-induced proton uptake. The light-induced proton uptake by rhodopsin in the rod outer segment disk membrane was enhanced at lower pH (4) but depressed at higher pHs (6 to 8) by the tertiary amine local anesthetics lidocaine, bupivacaine, tetracaine, and dibucaine. The order of local anesthetic-induced depression of the proton uptake followed that of their clinical anesthetic potencies. The depression of the proton uptake versus the concentration of the uncharged form of local anesthetic nearly describes the same curve for small and large dose of added anesthetic. Furthermore, a neutral local anesthetic, benzocaine, depressed the proton uptake at all pHs between 4 and 7. These results indicate that the depression of the proton uptake is due to the effect of only the uncharged form. It is hypothesized that the uncharged form of local anesthetics interacts hydrophobically with the rhodopsin in the disk membrane. The dual effect of local anesthetics on the proton uptake, on the other hand, suggests that the activation of the function of rhodopsin may be caused by the charged form. There was no significant change in the light-induced proton uptake by rhodopsin when 1 mM of Ca2+ was introduced into the disk membrane at varying pHs in the absence or presence of local anesthetics. This fact indicates that Ca2+ ion does not influence the diprotonating process of metarhodopsin; neither does it interfere with the local anesthetic-induced changes in the rhodopsin molecule.

  7. The sodium channel as a target for local anesthetic drugs

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    Harry A Fozzard

    2011-11-01

    Full Text Available Na channels are the source of excitatory currents for the nervous system and muscle. They are the target for a class of drugs called local anesthetics (LA, which have been used for local and regional anesthesia and for excitatory dysfunction problems such as epilepsy and cardiac arrhythmia. LA drugs are prototypes for new analgesic drugs. The LA drug binding site has been localized to the inner pore of the channel, where drugs interact mainly with a phenylalanine in domain IV S6. Drug affinity is both voltage- and use-dependent. Voltage-dependency is the result of changes in the conformation of the inner pore during channel activation and opening, allowing high energy interaction of drugs with the phenylalanine. LA drugs also reduce the gating current of Na channels, which represents the movement of charged residues in the voltage sensors. Specifically, drug binding to phenylalanine locks the domain III S4 in its outward (activated position, and slows recovery of the domain IV S4. Although strongly affecting gating, LA drugs almost certainly also block by steric occlusion of the pore. Molecular definition of the binding and blocking interactions may help in new drug development.

  8. Extended duration local anesthetic agent in a rat paw model.

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    Ickowicz, D E; Golovanevski, L; Domb, A J; Weiniger, C F

    2014-07-01

    Encapsulated local anesthetics extend postoperative analgesic effect following site-directed nerve injection; potentially reducing postoperative complications. Our study aim was to investigate efficacy of our improved extended duration formulation - 15% bupivacaine in poly(DL-lactic acid co castor oil) 3:7 synthesized by ring opening polymerization. In vitro, around 70% of bupivacaine was released from the p(DLLA-CO) 3:7 after 10 days. A single injection of the optimal formulation of 15% bupivacaine-polymer or plain (0.5%) bupivacaine (control), was injected via a 22G needle beside the sciatic nerve of Sprague-Dawley rats under anesthesia; followed (in some animals) by a 1cm longitudinal incision through the skin and fascia of the paw area. Behavioral tests for sensory and motor block assessment were done using Hargreave's hot plate score, von Frey filaments and rearing count. The 15% bupivacaine formulation significantly prolonged sensory block duration up to at least 48 h. Following surgery, motor block was observed for 48 h following administration of bupivacaine-polymer formulation and rearing was reduced (returning to baseline after 48 h). No significant differences in mechanical nociceptive response were observed. The optimized bupivacaine-polymer formulation prolonged duration of local anesthesia effect in our animal model up to at least 48 h.

  9. Pain and efficacy of local anesthetics for central venous access

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    William C Culp Jr

    2008-11-01

    Full Text Available William C Culp Jr1, Mohammed Yousaf2, Benjamin Lowry1, Timothy C McCowan3, William C Culp21Division of Cardiothoracic Anesthesiology, Scott and White Hospital, The Texas A&M University College of Medicine, Temple, TX, USA; 2Division of Interventional Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA; 3Department of Radiology, University of Mississippi Medical Center, Jackson, MS, USAPurpose: To compare pain during injection and efficacy of analgesia of local anesthetics during central venous line placement.Methods: Sixty-two patients were studied in a randomized, double-blinded prospective fashion. Patients received 1% lidocaine (L, buffered 1% lidocaine (LB, or 2% chloroprocaine (CP injected around the internal jugular vein for procedural analgesia for central venous access. Patients reported pain via a standard linear visual analog scale, with 0 representing no pain and 10 being the worst pain imaginable.Results: Overall patient perception of pain was better with CP and L than LB with mean scores of CP 2.4, L 2.6, LB 4.2. Pain with injection mean scores were CP 2.1, L 2.5, LB 3.2. Pain with catheter placement scores were CP 2.5, L 1.7, LB 3.4. Operator assessment of overall pain values were CP 1.9, L 2.2, LB 3.4. LB consistently scored the worst, though compared with CP, this only reached statistical significance in overall patient pain and pain at catheter insertion compared with L.Conclusion: Though chloroprocaine scored better than lidocaine in 3 of 4 parameters, this trend did not achieve statistical significance. Adding sodium bicarbonate to lidocaine isn’t justified in routine practice, nor is routine replacement of lidocaine with chloroprocaine.Keywords: local anesthesia, analgesia, central venous access, lidocaine, chloroprocaine

  10. From micro- to nanostructured implantable device for local anesthetic delivery

    Directory of Open Access Journals (Sweden)

    Zorzetto L

    2016-06-01

    Full Text Available Laura Zorzetto,1 Paola Brambilla,1 Elena Marcello,1 Nora Bloise,2 Manuela De Gregori,3 Lorenzo Cobianchi,4,5 Andrea Peloso,4,5 Massimo Allegri,6 Livia Visai,2,7 Paola Petrini1 1Department of Chemistry, Materials and Chemical Engineering ‘G. Natta’, Politecnico di Milano, Milan, 2Department of Molecular Medicine, Centre for Health Technologies (CHT, INSTM UdR of Pavia, University of Pavia, 3Pain Therapy Service, IRCCS Foundation Policlinico San Matteo Pavia, Pavia, 4General Surgery Department, IRCCS Foundation Policlinico San Matteo, Pavia, 5Departments of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, 6Department of Surgical Sciences, University of Parma, Parma, 7Department of Occupational Medicine, Toxicology and Environmental Risks, S. Maugeri Foundation, IRCCS, Lab of Nanotechnology, Pavia, Italy Abstract: Local anesthetics block the transmission of painful stimuli to the brain by acting on ion channels of nociceptor fibers, and find application in the management of acute and chronic pain. Despite the key role they play in modern medicine, their cardio and neurotoxicity (together with their short half-life stress the need for developing implantable devices for tailored local drug release, with the aim of counterbalancing their side effects and prolonging their pharmacological activity. This review discusses the evolution of the physical forms of local anesthetic delivery systems during the past decades. Depending on the use of different biocompatible materials (degradable polyesters, thermosensitive hydrogels, and liposomes and hydrogels from natural polymers and manufacturing processes, these systems can be classified as films or micro- or nanostructured devices. We analyze and summarize the production techniques according to this classification, focusing on their relative advantages and disadvantages. The most relevant trend reported in this work highlights the effort of moving from microstructured

  11. Activation of TRPA1 by membrane permeable local anesthetics

    Directory of Open Access Journals (Sweden)

    Kronewald Sergej

    2011-08-01

    Full Text Available Abstract Background Low concentrations of local anesthetics (LAs suppress cellular excitability by inhibiting voltage-gated Na+ channels. In contrast, LAs at high concentrations can be excitatory and neurotoxic. We recently demonstrated that LA-evoked activation of sensory neurons is mediated by the capsaicin receptor TRPV1, and, to a lesser extent by the irritant receptor TRPA1. LA-induced activation and sensitization of TRPV1 involves a domain that is similar, but not identical to the vanilloid-binding domain. Additionally, activation of TRPV1 by LAs involves PLC and PI(4,5P2-signalling. In the present study we aimed to characterize essential structural determinants for LA-evoked activation of TRPA1. Results Recombinant rodent and human TRPA1 were expressed in HEK293t cells and investigated by means of whole-cell patch clamp recordings. The LA lidocaine activates TRPA1 in a concentration-dependent manner. The membrane impermeable lidocaine-derivative QX-314 is inactive when applied extracellularly. Lidocaine-activated TRPA1-currents are blocked by the TRPA1-antagonist HC-030031. Lidocaine is also an inhibitor of TRPA1, an effect that is more obvious in rodent than in human TRPA1. This species-specific difference is linked to the pore region (transmembrane domain 5 and 6 as described for activation of TRPA1 by menthol. Unlike menthol-sensitivity however, lidocaine-sensitivity is not similarly determined by serine- and threonine-residues within TM5. Instead, intracellular cysteine residues known to be covalently bound by reactive TRPA1-agonists seem to mediate activation of TRPA1 by LAs. Conclusions The structural determinants involved in activation of TRPA1 by LAs are disparate from those involved in activation by menthol or those involved in activation of TRPV1 by LAs.

  12. Trigeminal nerve injury associated with injection of local anesthetics: needle lesion or neurotoxicity?

    DEFF Research Database (Denmark)

    Hillerup, Søren; Jensen, Rigmor H; Ersbøll, Bjarne Kjær

    2011-01-01

    The authors used comprehensive national registry and clinical data to conduct a study of adverse drug reactions (ADRs), in particular neurosensory disturbance (NSD), associated with local anesthetics used in dentistry...

  13. Wound infiltration with local anesthetics for post-operative pain relief in lumbar spine surgery

    DEFF Research Database (Denmark)

    Kjærgaard, M; Møiniche, S; Olsen, K S

    2012-01-01

    In this systematic review, we evaluated double-blind, randomized and controlled trials on the effect of wound infiltration with local anesthetics compared with the effect of placebo on post-operative pain after lumbar spine surgery.......In this systematic review, we evaluated double-blind, randomized and controlled trials on the effect of wound infiltration with local anesthetics compared with the effect of placebo on post-operative pain after lumbar spine surgery....

  14. Synthesis and antispasmodic activity of lidocaine derivatives endowed with reduced local anesthetic action.

    Science.gov (United States)

    Costa, Jorge C S; Neves, Josiane S; de Souza, Marcus V N; Siqueira, Rodrigo A; Romeiro, Nelilma C; Boechat, Nubia; e Silva, Patrícia M R; Martins, Marco A

    2008-02-01

    The present structure-activity relationship (SAR) study focused on chemical modifications of the structure of the local anesthetic lidocaine, and indicated analogues having reduced anesthetic potency, but with superior potency relative to the prototype in preventing anaphylactic or histamine-evoked ileum contraction. From the SAR analysis, 2-(diethylamino)-N-(trifluoromethyl-phenyl) and 2-(diethylamino)-N-(dimethyl-phenyl) acetamides were selected as the most promising compounds. New insights into the applicability of non-anesthetic lidocaine derivatives as templates in drug discovery for allergic syndromes are provided.

  15. History of T-cain: a local anesthetic developed and manufactured in Japan.

    Science.gov (United States)

    Tobe, Masaru; Saito, Shigeru

    2015-10-01

    In many anesthesia textbooks written in English, lidocaine, tetracaine, bupivacaine, ropivacaine, and chloroprocaine are listed as useful local anesthetics for spinal anesthesia. In contrast, T-cain is not included in these lists, even though it has been reported to be suitable for spinal anesthesia in Japan. T-cain was developed as a local anesthetic in the early 1940s by Teikoku Kagaku Sangyo Inc. in Itami, Japan, by replacing a methyl group on tetracaine (Pantocaine(®)) with an ethyl group. T-cain was clinically approved for topical use in Japan in November 1949, and a mixture of dibucaine and T-cain (Neo-Percamin S(®)) was approved for spinal use in May 1950. Simply because of a lack of foreign marketing strategy, T-cain has never attracted global attention as a local anesthetic. However, in Japan, T-cain has been used topically or intrathecally (as Neo-Percamin S(®)) for more than 60 years. Other than the side effects generally known for all local anesthetics, serious side effects have not been reported for T-cain. In fact, several articles have reported that T-cain decreases the neurotoxicity of dibucaine. In this historical review, the characteristics of T-cain and its rise to become a major spinal anesthetic in Japan are discussed.

  16. Trigeminal nerve injury associated with injection of local anesthetics: needle lesion or neurotoxicity?

    DEFF Research Database (Denmark)

    Hillerup, Søren; Jensen, Rigmor H; Ersbøll, Bjarne Kjær

    2011-01-01

    BACKGROUND: The authors used comprehensive national registry and clinical data to conduct a study of adverse drug reactions (ADRs), in particular neurosensory disturbance (NSD), associated with local anesthetics used in dentistry METHODS: The study included data sets of annual sales of local anes...

  17. Local anesthetics after total knee arthroplasty: intraarticular or extraarticular administration? A randomized, double-blind, placebo-controlled study

    DEFF Research Database (Denmark)

    Andersen, L.O.; Kristensen, B.B.; Husted, H.;

    2008-01-01

    BACKGROUND: High-volume local infiltration analgesia with additional intraarticular and wound administration of local anesthetic has been shown to be effective after knee replacement, but the optimum site of administration of the local anesthetic (i.e. intraarticular or extraarticular) has not been...... or to receive 20 mL ropivacaine (0.2%) intraarticularly plus 30 mL ropivacaine (0.2%) in the extraarticular wound space 24 hours postoperatively. Pain intensity at rest and with mobilization was recorded for 4 hours after administration of additional local anesthetics. RESULTS: Intensity of pain at rest, during...... flexion, or straight leg lift was not statistically significantly different between the two groups, but there was a tendency of improved analgesia with administration of additional local anesthetic in the extraarticular wound space. INTERPRETATION: The optimal site of administration of local anesthetic...

  18. Dexmedetomidine as an adjuvant to local anesthetics in brachial plexus blocks

    Science.gov (United States)

    Ping, Yongmei; Ye, Qigang; Wang, Wenwei; Ye, Pingke; You, Zhibin

    2017-01-01

    Abstract Background: Brachial plexus block (BPB) for upper extremity surgery provides superior analgesia, but this advantage is limited by the pharmacological duration of local anesthetics. Dexmedetomidine (DEX) as a local anesthetics adjuvant for BPB has been utilized to prolong the duration of the nerve block in some randomized controlled trials (RCTs) but is far from unanimous in the efficacy and safety of the perineural route. Hence, an updated meta-analysis was conducted to assess the efficacy and safety of DEX as local anesthetic adjuvants on BPB. Methods: A search in electronic databases was conducted to collect the RCTs that investigated the impact of adding DEX to local anesthetics for BPB. Sensory block duration, motor block duration, onset time of sensory and motor block, time to first analgesic request, the common adverse effects were analyzed. Results: Eighteen trails (1014 patients) were included with 515 patients receiving perineural DEX. The addition of DEX prolonged the duration of sensory block (WMD 257 minutes, 95%CI 191.79–322.24, P administration of DEX. PMID:28121930

  19. Memory-impairing effects of local anesthetics in an elevated plus-maze test in mice

    Directory of Open Access Journals (Sweden)

    S.L. Blatt

    1998-04-01

    Full Text Available Post-training intracerebroventricular administration of procaine (20 µg/µl and dimethocaine (10 or 20 µg/µl, local anesthetics of the ester class, prolonged the latency (s in the retention test of male and female 3-month-old Swiss albino mice (25-35 g body weight; N = 140 in the elevated plus-maze (mean ± SEM for 10 male mice: control = 41.2 ± 8.1; procaine = 78.5 ± 10.3; 10 µg/µl dimethocaine = 58.7 ± 12.3; 20 µg/µl dimethocaine = 109.6 ± 5.73; for 10 female mice: control = 34.8 ± 5.8; procaine = 55.3 ± 13.4; 10 µg/µl dimethocaine = 59.9 ± 12.3 and 20 µg/µl dimethocaine = 61.3 ± 11.1. However, lidocaine (10 or 20 µg/µl, an amide class type of local anesthetic, failed to influence this parameter. Local anesthetics at the dose range used did not affect the motor coordination of mice exposed to the rota-rod test. These results suggest that procaine and dimethocaine impair some memory process(es in the plus-maze test. These findings are interpreted in terms of non-anesthetic mechanisms of action of these drugs on memory impairment and also confirm the validity of the elevated plus-maze for the evaluation of drugs affecting learning and memory in mice

  20. [Pregnancy and lactation period: Which local anesthetics and analgesics?].

    Science.gov (United States)

    Fatori Popovic, Sandra; Lübbers, Heinz-Theo; von Mandach, Ursula

    2016-01-01

    The aim of this paper is to show relevant aspects of dental treatment in pregnancy. Common medication used in dental offices should be highlighted in special regard to the pregnant patient during dental treatment. The reader should gain more security in the election of the proper drugs for local anesthesia and oral analgesics. Local anaesthetics such as articain with adrenalin in a dilution of 1 : 200 000 can be used for dental treatment at any time. Paracetamol should be used as first line oral analgesic. Elective dental procedures should be postponed after delivery and after lactation period.

  1. [Pregnancy and lactation period: Which local anesthetics and analgesics].

    Science.gov (United States)

    Fatori Popovic, Sandra; Lübbers, Heinz-Theo; von Mandach, Ursula

    2016-01-01

    The aim of this paper is to show relevant aspects of dental treatment in pregnancy. Common medication used in dental offices should be highlighted in special regard to the pregnant patient during dental treatment. The reader should gain more security in the election of the proper drugs for local anesthesia and oral analgesics. Local anaesthetics such as articain with adrenalin in a dilution of 1 : 200 000 can be used for dental treatment at any time. Paracetamol should be used as first line oral analgesic. Elective dental procedures should be postponed after delivery and after lactation period.

  2. Evaluation and Management of Hypersensitivity to Local Anesthetics in Pediatric Dentistry

    OpenAIRE

    1987-01-01

    The clinical histories of four children with a history of adverse reactions to local anesthesia and who required dental treatment are reviewed retrospectively. The children described had been referred to the allergy unit for evaluation between 1984 and 1985 and are representative of the dilemma of cases of suspected hypersensitivity to local anesthetics. The first two cases had been previously treated without the use of regional anesthesia because of a family history of atopic reactions as we...

  3. Transient peripheral facial nerve paralysis after local anesthetic procedure

    OpenAIRE

    A. Rosmaninho; Lobo, I.; Caetano, M.; Taipa, R; Magalhães, M.; Costa, V; Selores, M.

    2012-01-01

    Complications may arise after laser therapy of the face. The most common ones are bleeding and infections; facial nerve paresis or paralysis is rarely reported. We describe a case of a transient peripheral facial nerve paralysis after laser therapy of an epidermal verrucous nevus localized at the left preauricular area.

  4. Local anesthesia for extracorporeal shock wave lithotripsy: a study comparing eutetic mixture of local anesthetics cream and lidocaine infiltration

    DEFF Research Database (Denmark)

    Honnens de Lichtenberg, M; Miskowiak, J; Mogensen, P

    1992-01-01

    A study of the anesthetic efficacy of a eutetic mixture of local anesthetics (EMLA cream) versus lidocaine infiltration in extracorporeal shock wave lithotripsy (ESWL) was done. A total of 46 patients had 30 gm. of EMLA cream applied to the skin over the kidney and 45 had subcutaneous infiltration...... analgesics were not significantly different between the 2 groups. There were no significant differences between the groups with regard to post-ESWL skin changes. Therefore, EMLA cream can be recommended for ESWL provided it is applied correctly....

  5. New procedure to synthesize silver nanoparticles and their interaction with local anesthetics

    Directory of Open Access Journals (Sweden)

    Mocanu A

    2013-10-01

    Full Text Available Aurora Mocanu,1 Roxana Diana Pasca,1 Gheorghe Tomoaia,2 Corina Garbo,1 Petre T Frangopol,1 Ossi Horovitz,1 Maria Tomoaia-Cotisel11Chemical Engineering Department, Babes-Bolyai University, 2Orthopedic Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, RomaniaAbstract: Silver nanoparticles (AgNPs were prepared in aqueous colloid dispersions by the reduction of Ag+ with glucose in alkaline medium. Tetraethyl orthosilicate and l-asparagine were added as stabilizers of NPs. The AgNPs were characterized, and their interaction with three local anesthetics (procaine, dibucaine, or tetracaine was investigated. Optical spectra show the characteristic absorption band of AgNPs, due to surface plasmon resonance. Modifications in the position and shape of this band reflect the self-assembly of metal NPs mediated by anesthetic molecules and the progress in time of the aggregation process. Zeta-potential measuring was applied in order to characterize the electrostatic stability of the NPs. The size and shape of the AgNPs, as well as the features of the assemblies formed by their association in the presence of anesthetics, were evidenced by transmission electron microscopy images. Atomic force microscopy images showed the characteristics of the films of AgNPs deposited on glass support. The effect of the anesthetics could be described in terms of electrostatic forces between the negatively charged AgNPs and the anesthetic molecules, existing also in their cationic form at the working pH. But also hydrophobic and hydrogen bonding interactions between the coated nanoparticles and anesthetics molecular species should be considered.Keywords: self-assembled nanostructures, UV-vis spectra, TEM, AFM, zeta potential

  6. Tumescent local anesthetic technique for inguinal hernia repairs

    OpenAIRE

    2014-01-01

    Purpose We evaluated the adequacy and feasibility of a tumescent solution containing lidocaine and bupivacaine for inguinal hernia repairs. Methods The medical records of 146 consecutive inguinal hernia patients with 157 hernia repairs using the tumescent local anesthesia technique performed by a single surgeon between September 2009 and December 2013 were retrospectively reviewed. Results The mean operation time (±standard deviation) and hospital stay were 64.5 ± 17.6 minutes and 2.7 ± 1.5 d...

  7. Do Local Anesthetics Containing Epinephrine Affect Blood Pressure in the Elderly?

    Directory of Open Access Journals (Sweden)

    Ayse Arpaci

    2014-11-01

    Full Text Available Aim: Dental procedures are often performed under local anesthesia. Vasoconstrictors added to local anesthetics might have unwanted effects in the elderly and in patients with comorbid diseases. The aim of this study was to evaluate the effects of local anesthetics containing epinephrine on blood pressure in elderly patients undergoing dental procedures. Material and Method: The study included 479 patients (age, 67.37±6.62 who underwent tooth extraction. Patient demographics, current health conditions, and blood pressure values were recorded before local anesthesia and at 5 minutes after anesthesia administration. Patients were divided into 4 groups: Group I (n=272 received 40 mg articaine/0.012 mg epinephrine (Ultracain® D-S Forte; Group II (n=196 received 40 mg articaine/0.01 mg epinephrine (Maxicaine FORT; Group III (n=6 received 40 mg articaine/0.006 mg epinephrine (Ultracain® D-S; and Group IV (n=5 received 40 mg articaine/0.005 mg epinephrine (Maxicaine. Statistical analyses were performed using SPSS version 20.0. Results: A total of 479 patients were included in the analysis. Hypertension and diabetes were the most frequently reported comorbidities among these patients. Blood pressure values after administration of anesthesia were higher than those recorded before the procedure in all groups. Discussion: Local anesthetics containing epinephrine are not associated with a significant increase in blood pressure in elderly patients undergoing dental procedures. Obtaining a detailed clinical history may reduce the risk of procedure-related morbidity.

  8. Behavioral response and pain perception to computer controlled local anesthetic delivery system and cartridge syringe

    Directory of Open Access Journals (Sweden)

    T D Yogesh Kumar

    2015-01-01

    Full Text Available Aim: The present study evaluated and compared the pain perception, behavioral response, physiological parameters, and the role of topical anesthetic administration during local anesthetic administration with cartridge syringe and computer controlled local anesthetic delivery system (CCLAD. Design: A randomized controlled crossover study was carried out with 120 children aged 7-11 years. They were randomly divided into Group A: Receiving injection with CCLAD during first visit; Group B: Receiving injection with cartridge syringe during first visit. They were further subdivided into three subgroups based on the topical application used: (a 20% benzocaine; (b pressure with cotton applicator; (c no topical application. Pulse rate and blood pressure were recorded before and during injection procedure. Objective evaluation of disruptive behavior and subjective evaluation of pain were done using face legs activity cry consolability scale and modified facial image scale, respectively. The washout period between the two visits was 1-week. Results: Injections with CCLAD produced significantly lesser pain response, disruptive behavior (P < 0.001, and pulse rate (P < 0.05 when compared to cartridge syringe injections. Application of benzocaine produced lesser pain response and disruptive behavior when compared to the other two subgroups, although the result was not significant. Conclusion: Usage of techniques which enhance behavioral response in children like injections with CCLAD can be considered as a possible step toward achieving a pain-free pediatric dental practice.

  9. Topical anesthesia with eutetic mixture of local anesthetics cream in vasectomy: 2 randomized trials

    DEFF Research Database (Denmark)

    Honnens de Lichtenberg, M; Krogh, J; Rye, B

    1992-01-01

    Two paired randomized trials testing topical anesthesia with a eutetic mixture of local anesthetics (EMLA cream*) in vasectomy were performed. In 1 trial EMLA cream was applied on 1 side of the scrotum, while infiltration anesthesia into the skin and subcutaneous tissue with mepivacaine was used...... on the contralateral side. All but 1 of the 13 patients (p less than 0.05) preferred infiltration anesthesia because of pain as the incision reached the subcutaneous tissue. In the other trial 29 patients received EMLA cream on 1 side of the scrotum before bilateral mepivacaine infiltration. There was significantly...... less pain on the sides with the anesthetic cream (p less than 0.001). Many patients would pay the price of the cream. In conclusion, EMLA cream cannot replace but it can supplement infiltration anesthesia during vasectomy....

  10. Improvement of Lidocaine Local Anesthetic Action Using Lallemantia royleana Seed Mucilage as an Excipient.

    Science.gov (United States)

    Atabaki, Rabi; Hassanpour-Ezatti, Majid

    2014-01-01

    Lallemantia royleana (Balangu) is a well known Iranian medicinal plant that its seed mucilage has many applications in modern pharmacology. Plant mucilage traditionally was used as a gel supplement, and natural matrix for sustained release of drugs. But it seems that these compounds are not a simple additive and also have many undiscovered pharmacological properties. In this research, the anesthetic action of gel prepared from Balangu mucilage alone and its mixture with lidocaine hydrochloride are compared with the effect of commercial 2% lidocaine gel by rat tail flick test. Mucilage of Balangu seed alone showed analgesic effect. Duration and potency of anesthesia induced by gel containing mucilage alone (0.01 g/mL) were identical to commercial 2% lidocaine gel. But, local anesthetic potency and duration of gel made from 2% lidocaine-mucilage gel mixture was significantly higher than commercial 2% lidocaine gel. The gel prepared from mucilage causes a good analgesia with unknown mechanism. Besides, mixture of Balangu mucilage prepared gel with lidocaine improves lidocaine anesthesia. The increase in potency of lidocaine action results from mucilage dermal penetration enhancing effects; and longer anesthetic duration of this mixture are related to the capability of mucilage based gel for sustained drug release.

  11. Preparation and characterization of poly(ε-caprolactone) nanospheres containing the local anesthetic lidocaine.

    Science.gov (United States)

    Ramos Campos, Estefânia Vangelie; Silva de Melo, Nathalie Ferreira; Guilherme, Viviane Aparecida; de Paula, Eneida; Rosa, André Henrique; de Araújo, Daniele Ribeiro; Fraceto, Leonardo Fernandes

    2013-01-01

    The objective of this work was to develop a modified release system for the local anesthetic lidocaine (LDC), using poly(ε-caprolactone) (PCL) nanospheres (NSs), to improve the pharmacological properties of the drug when administered by the infiltration route. In vitro experiments were used to characterize the system and investigate the release mechanism. The NSs presented a polydispersion index of 0.072, an average diameter of 449.6 nm, a zeta potential of -20.1 mV, and an association efficiency of 93.3%. The release profiles showed that the release of associated LDC was slower than that of the free drug. Atomic force microscopy analyses showed that the spherical structure of the particles was preserved as a function of time, as well as after the release experiments. Cytotoxicity and pharmacological tests confirmed that association with the NSs reduced the toxicity of LDC, and prolonged its anesthetic action. This new formulation could potentially be used in applications requiring gradual anesthetic release, especially dental procedures.

  12. Effect of needle design on pain from dental local anesthetic injections.

    Science.gov (United States)

    McPherson, Joanna Saenz; Dixon, Sara A; Townsend, Richard; Vandewalle, Kraig S

    2015-01-01

    The purpose of this randomized, double-blind clinical study was to evaluate the effectiveness of a larger-bore compared with a standard-bore dental local anesthetic needle of the same gauge in reducing pain during inferior alveolar (IA) and long buccal (LB) nerve block injections. Twenty active duty military or Department of Defense beneficiaries undergoing dental treatment were anesthetized using a split-mouth design with 4 anesthetic dental injections. Both sides of the mouth received IA nerve block and LB nerve injections, one using the 27-gauge large-bore Septoject XL needle and other using a 27-gauge standard-bore Septoject needle. Patients rated the pain experienced with each method using a visual analogue scale (VAS). The IA injection mean VAS score and standard deviation were 38.9 ± 22.7 mm and 37.1 ± 22.4 mm, respectively, for the larger and standard-bore needles. The LB injection mean VAS score and standard deviation were 33.5 ± 22.8 mm and 35.1 ± 19.6 mm, respectively, for the larger and standard-bore needles. The data were analyzed with a paired t test (α = .05). No significant difference was found between the IA (P = .70) or LB injections (P = .73). The use of a larger-bore 27-gauge needle did not reduce pain on injection compared with the standard-bore 27-gauge needle.

  13. New Updates Pertaining to Drug Delivery of Local Anesthetics in Particular Bupivacaine Using Lipid Nanoparticles.

    Science.gov (United States)

    Beiranvand, Siavash; Eatemadi, Ali; Karimi, Arash

    2016-12-01

    Lipid nanoparticles (liposomes) were first described in 1965, and several work have led to development of important technical advances like triggered release liposomes and drug-loaded liposomes. These advances have led to numerous clinical trials in such diverse areas such as the delivery of anti-cancer, antifungal, and antibiotic drugs; the delivery of gene medicines; and most importantly the delivery of anesthesia drugs. Quite a number of liposomes are on the market, and many more are still in developmental stage. Lipid nanoparticles are the first nano-medicine delivery system to be advanced from laboratory concept to clinical application with high considerable clinical acceptance. Drug delivery systems for local anesthetics (LAs) have caught the interest of many researchers because there are many biomedical advantages connected to their application. There have been several formulation techniques to systemically deliver LA that include encapsulation in liposomes and complexation in cyclodextrins, nanoparticles, and to a little extent gold nanoparticles. The proposed formulations help to decrease the LA concentration utilized, increase its permeability, and most importantly increase the localization of the LA for a long period of time thereby leading to increase in the duration of the LA effect and finally to reduce any local and systemic toxicity. In this review, we will highlight on new updates pertaining to drug delivery of local anesthetics in particular bupivacaine using lipid nanoparticles.

  14. New Updates Pertaining to Drug Delivery of Local Anesthetics in Particular Bupivacaine Using Lipid Nanoparticles

    Science.gov (United States)

    Beiranvand, Siavash; Eatemadi, Ali; Karimi, Arash

    2016-06-01

    Lipid nanoparticles (liposomes) were first described in 1965, and several work have led to development of important technical advances like triggered release liposomes and drug-loaded liposomes. These advances have led to numerous clinical trials in such diverse areas such as the delivery of anti-cancer, antifungal, and antibiotic drugs; the delivery of gene medicines; and most importantly the delivery of anesthesia drugs. Quite a number of liposomes are on the market, and many more are still in developmental stage. Lipid nanoparticles are the first nano-medicine delivery system to be advanced from laboratory concept to clinical application with high considerable clinical acceptance. Drug delivery systems for local anesthetics (LAs) have caught the interest of many researchers because there are many biomedical advantages connected to their application. There have been several formulation techniques to systemically deliver LA that include encapsulation in liposomes and complexation in cyclodextrins, nanoparticles, and to a little extent gold nanoparticles. The proposed formulations help to decrease the LA concentration utilized, increase its permeability, and most importantly increase the localization of the LA for a long period of time thereby leading to increase in the duration of the LA effect and finally to reduce any local and systemic toxicity. In this review, we will highlight on new updates pertaining to drug delivery of local anesthetics in particular bupivacaine using lipid nanoparticles.

  15. Local anesthetic failure associated with inflammation: verification of the acidosis mechanism and the hypothetic participation of inflammatory peroxynitrite

    Directory of Open Access Journals (Sweden)

    Takahiro Ueno

    2008-11-01

    Full Text Available Takahiro Ueno1, Hironori Tsuchiya2, Maki Mizogami1, Ko Takakura11Department of Anesthesiology, Asahi University School of Dentistry, Mizuho, Gifu, Japan; 2Department of Dental Basic Education, Asahi University School of Dentistry, Mizuho, Gifu, JapanAbstract: The presence of inflammation decreases local anesthetic efficacy, especially in dental anesthesia. Although inflammatory acidosis is most frequently cited as the cause of such clinical phenomena, this has not been experimentally proved. We verified the acidosis mechanism by studying the drug and membrane lipid interaction under acidic conditions together with proposing an alternative hypothesis. Liposomes and nerve cell model membranes consisting of phospholipids and cholesterol were treated at different pH with lidocaine, prilocaine and bupivacaine (0.05%–0.2%, w/v. Their membrane-interactive potencies were compared by the induced-changes in membrane fluidity. Local anesthetics fluidized phosphatidylcholine membranes with the potency being significantly lower at pH 6.4 than at pH 7.4 (p < 0.01, supporting the acidosis theory. However, they greatly fluidized nerve cell model membranes even at pH 6.4 corresponding to inflamed tissues, challenging the conventional mechanism. Local anesthetics acted on phosphatidylserine liposomes, as well as nerve cell model membranes, at pH 6.4 with almost the same potency as that at pH 7.4, but not on phosphatidylcholine, phosphatidylethanolamine and sphingomyelin liposomes. Since the positively charged anesthetic molecules are able to interact with nerve cell membranes by ion-paring with anionic components like phosphatidylserine, tissue acidosis is not essentially responsible for the local anesthetic failure associated with inflammation. The effects of local anesthetics on nerve cell model membranes were inhibited by treating with peroxynitrite (50 μM, suggesting that inflammatory cells producing peroxynitrite may affect local anesthesia

  16. Local anesthetic effects of cocaethylene and isopropylcocaine on rat peripheral nerves.

    Science.gov (United States)

    Tokuno, Hajime A; Bradberry, Charles W; Everill, Brian; Agulian, Samuel K; Wilkes, Steven; Baldwin, Ronald M; Tamagnan, Gilles D; Kocsis, Jeffery D

    2004-01-23

    Cocaethylene is a naturally occurring cocaine derivative that has been used as a tool in both clinical studies of cocaine reward and as a potential model compound for agonist substitution therapy in cocaine dependence. It is equipotent to cocaine at inhibiting dopamine uptake in-vitro and in-vivo. Because it has been reported that local anesthetic properties may influence the reinforcing effects of dopamine uptake inhibitors, we investigated the local anesthetic properties of cocaethylene as well as isopropylcocaine, another potential pharmacological tool in studies of cocaine reward and agonist substitution therapy. We compared the efficacy of nerve impulse blockade by lidocaine, cocaine, cocaethylene and isopropylcocaine using rat sciatic nerves and dorsal roots (DRs). Nerves were placed in a modified sucrose gap chamber and repetitively stimulated at high frequency. The amplitude of compound action potentials (CAPs) at the beginning and end of each stimulus train was measured before and after exposure to each compound. All compounds produced concentration-dependent and use-dependent decrements in CAP amplitude, but cocaethylene and isopropylcocaine at medium to high concentration (0.375-1.875 mM) showed a more prolonged block after washout relative to cocaine or lidocaine. Patch clamp studies on dorsal root ganglion (DRG) neurons indicated a use-dependent blockade of sodium channels. These studies provide a more complete understanding of the pharmaocology of potential agonist treatment candidates, and suggest a mechanism whereby cocaethylene produces a decreased euphoria in humans compared to cocaine.

  17. [New anesthetics].

    Science.gov (United States)

    Malamed, S F

    2000-01-01

    Since the introduction of cocaine local analgesia in 1886, and the subsequent development of procaine (1904) and other closely related ester-type compounds, dentistry has prided itself on being as close to 'painless' as possible. In the late 1940s the newest group of the local anesthetic compounds, the amides, was introduced. The initial amide local analgesic, lignocaine (Xylocaine), revolutionised pain control in dentistry worldwide. In succeeding years other amide-type local anesthetics, mepivacaine, prilocaine, bupivacaine and etidocaine, were introduced. They gave the dental practitioner a local anesthetic armamentarium which provided pulpal analgesia for periods of from 20 minutes (mepivacaine) to as long as three hours (bupivacaine and etidocaine with adrenaline). In addition these popular drugs proved to be more rapid-acting than the older ester-type drug and, at least from the perspective of allergenicity, more safe. In 1976, in Germany, the newest amide local analgesic, carticaine HCl was introduced into dentistry. Articaine (the generic name was changed) possesses properties similar to lignocaine but has additional properties which made the drug quite attractive to the general dental practitioner. In 1986 articaine was introduced in North America (Canada) where it has become the most used local anesthetic, supplanting lignocaine. Articaine has been approved for use in the United Kingdom. In this introductory discussion we review the development of articaine and discuss its place in the dental local analgesic armamentarium.

  18. Effects of local anesthetics and hemicholinium-3 on 45-Ca efflux in barnacle muscle fibers.

    Science.gov (United States)

    Chen, S S

    1975-04-01

    Benzocaine, which occurs in the uncharged form in the physiological range of pH, caused inhibition of 45-Ca efflux in branacle muscle fibers. By contrast, in the presence of a low external Ca-2+ concentration it produced stimulation of the efflux. Both the inhibitory and stimulatory actions of benzocaine appeared to be less potent than those of procaine. Hemicholinium-3 (HC-3), on the other hand, which exists only in the charged form, caused a large stimulation of the 45-Ca efflux following microinjection, and the potency of this action was found to be at least 10 times greater than that of procaine. External application of HC-3 produced inhibition occasionally. Effects of tetracaine were similar to those produced by procaine; however, its inhibitory action was greater in more alkaline solution, which is the opposite of that observed with procaine. Lidocaine produced a less consistent effect than procaine; the inhibitory action of the former was less potent but the stimulatory action of the two anesthetics were comparable, p-Aminobenzoic acid was without effect on 45-Ca efflux. These results indicate that both the charged and uncharged forms of local anesthetics are capable of causing stimulatory and inhibitory effects on 45-Ca efflux in barnacle muscle fibers, and that the inhibition produced is the result of action on the CA-Ca exchange system whereas the stimulation is the result of release of Ca from internal storage sites.

  19. Topical amethocaine (Ametop) is superior to EMLA for intravenous cannulation. Eutectic mixture of local anesthetics.

    LENUS (Irish Health Repository)

    Browne, J

    2012-02-03

    PURPOSE: A eutectic mixture of local anesthetics (EMLA) is commonly used to provide topical anesthesia for intravenous (i.v.) cannulation. One of its side effects is vasoconstriction, which may render cannulation more difficult. A gel formulation of amethocaine (Ametop) is now commercially available. The aim of this study was to compare EMLA and Ametop with regard to the degree of topical anesthesia afforded, the incidence of vasoconstriction and the ease of i.v. cannulation. METHODS: Thirty two ASA I adult volunteers had a #16 gauge i.v. cannula inserted on two separate occasions using EMLA and Ametop applied in a double blind fashion for topical anesthesia. Parameters that were recorded after each cannulation included visual analogue pain scores (VAPS), the presence of vasoconstriction and the ease of cannulation, graded as: 1 = easy, 2 = moderately difficult, 3 = difficult and 4 = failed. RESULTS: The mean VAPS +\\/- SD after cannulation with Ametop M was 12+\\/-9.9 and with EMLA was 25.3+\\/-16.6 (P = 0.002). Vasoconstriction occurred after EMLA application on 17 occasions and twice after Ametop (P = 0.001). The grade of difficulty of cannulation was 1.44+\\/-0.88 following EMLA and 1.06+\\/-0.25 with Ametop (P = 0.023). CONCLUSIONS: Intravenous cannulation was less painful following application of Ametop than EMLA. In addition, Ametop caused less vasoconstriction and facilitated easier cannulation. Its use as a topical anesthetic agent is recommended, especially when i.v. access may be problematic.

  20. A survey to access knowledge and practice among dentists regarding local anesthetic dosage in three cities of Uttarakhand

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    Laxman Singh Kaira

    2014-01-01

    Full Text Available Objective: Local anesthetics are the most commonly used drugs in routine dentistry. Although they are considered effective and safe in controlling pain during dental procedures, complications related to their use appear inevitable. Many dentists use these drugs routinely but are unaware of the dose calculations required and the maximum safe and effective dose of the drug. Materials and Methods: This study was aimed to determine the knowledge that general dental practitioners and dental specialists, in three different cities in India, have regarding dose calculations and the maximum-dose required of the most commonly used local anesthetics. A one page survey questionnaire was used in this study and data were analyzed using standard SPSS statistical program version 11, software (SPSS Inc. Chicago, Illinois, USA. Results: The respondents comprised 71.4% general dental practitioners and 28.5% dental specialists, with ages ranging from 26 to 50 years; Nearly 75% of the total respondent was males and 25% females. Nearly 69% of the respondents were unaware of the maximum recommended dose for use on adult, healthy patients and 81% were still confused about the maximum numbers of syringes containing 2% lignocaine with adrenaline that can be given to a patient. A total of 49% of general dental practitioners and specialists do not perform aspiration when injecting local anesthetics, whereas only 38% performed the aspiration in inferior nerve block technique, while only 12% performed aspiration in all types of injection techniques. A high percentage of the dentists (84% who responded are unaware of how to calculate the local anesthetic dose and 31% of them encountered complications during, or after, local anesthetic administration. Conclusion: General practitioners and dental specialists appear to have an inadequate knowledge about local anesthetics maximum-dose and dose calculations; further educational courses are recommended to update them regarding such

  1. Local anesthetic failure associated with inflammation: verification of the acidosis mechanism and the hypothetic participation of inflammatory peroxynitrite.

    Science.gov (United States)

    Ueno, Takahiro; Tsuchiya, Hironori; Mizogami, Maki; Takakura, Ko

    2008-01-01

    The presence of inflammation decreases local anesthetic efficacy, especially in dental anesthesia. Although inflammatory acidosis is most frequently cited as the cause of such clinical phenomena, this has not been experimentally proved. We verified the acidosis mechanism by studying the drug and membrane lipid interaction under acidic conditions together with proposing an alternative hypothesis. Liposomes and nerve cell model membranes consisting of phospholipids and cholesterol were treated at different pH with lidocaine, prilocaine and bupivacaine (0.05%-0.2%, w/v). Their membrane-interactive potencies were compared by the induced-changes in membrane fluidity. Local anesthetics fluidized phosphatidylcholine membranes with the potency being significantly lower at pH 6.4 than at pH 7.4 (p acidosis theory. However, they greatly fluidized nerve cell model membranes even at pH 6.4 corresponding to inflamed tissues, challenging the conventional mechanism. Local anesthetics acted on phosphatidylserine liposomes, as well as nerve cell model membranes, at pH 6.4 with almost the same potency as that at pH 7.4, but not on phosphatidylcholine, phosphatidylethanolamine and sphingomyelin liposomes. Since the positively charged anesthetic molecules are able to interact with nerve cell membranes by ion-paring with anionic components like phosphatidylserine, tissue acidosis is not essentially responsible for the local anesthetic failure associated with inflammation. The effects of local anesthetics on nerve cell model membranes were inhibited by treating with peroxynitrite (50 μM), suggesting that inflammatory cells producing peroxynitrite may affect local anesthesia.

  2. Application of a three-microneedle device for the delivery of local anesthetics

    Directory of Open Access Journals (Sweden)

    Ishikawa K

    2015-04-01

    Full Text Available Kayoko Ishikawa,1 Hidekazu Fukamizu,1 Tetsuya Takiguchi,1 Yusuke Ohta,1 Yoshiki Tokura2 1Department of Plastic and Reconstructive Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan; 2Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan Purpose: We investigated the effectiveness of a newly developed device for the delivery of local anesthetics in the treatment of axillary osmidrosis and hyperhidrosis. We developed a device with three fine, stainless steel needles fabricated with a bevel angle facing outside (“three-microneedle device” [TMD] to release a drug broadly and homogeneously into tissue in the horizontal plane. Use of this device could reduce the risk of complications when transcutaneous injections are undertaken.Patients and methods: Sixteen Japanese patients were enrolled. The mean volume of lidocaine hydrochloride per unit area needed to elicit anesthesia when using a TMD was compared with that the volume required when using a conventional 27-gauge needle. The visual analog scale (VAS score of needlestick pain and injection-associated pain was also compared.Results: The mean volume of lidocaine hydrochloride per unit area to elicit anesthesia using the TMD was significantly lower than that the volume required when using the conventional 27-gauge needle. The VAS score of needlestick pain for the TMD was significantly lower than that the VAS score for the 27-gauge needle.Conclusion: These data suggest that the TMD could be useful for the delivery of local anesthetics in terms of clinical efficacy and avoidance of adverse effects. Keywords: three-microneedle device, transcutaneous drug delivery, local anesthesia, lidocaine, pain

  3. Lipid emulsion-mediated reversal of toxic-dose aminoamide local anesthetic-induced vasodilation in isolated rat aorta

    OpenAIRE

    Ok, Seong-Ho; Han, Jeong Yeol; Lee, Soo Hee; Shin, Il-Woo; Lee, Heon Keun; Chung, Young-Kyun; Choi, Mun-Jeoung; Sohn, Ju-Tae

    2013-01-01

    Background Intravenous lipid emulsion has been used to treat systemic toxicity of local anesthetics. The goals of this in vitro study were to determine the ability of two lipid emulsions (Intralipid® and Lipofundin® MCT/LCT) to reverse toxic dose local anesthetic-induced vasodilation in isolated rat aortas. Methods Isolated endothelium-denuded aortas were suspended for isometric tension recording. Vasodilation was induced by bupivacaine (3 × 10-4 M), ropivacaine (10-3 M), lidocaine (3 × 10-3 ...

  4. Effects of the local anesthetic benzocaine on the human erythrocyte membrane and molecular models.

    Science.gov (United States)

    Suwalsky, Mario; Schneider, Carlos; Villena, Fernando; Norris, Beryl; Cárdenas, Hernán; Cuevas, Francisco; Sotomayor, Carlos P

    2004-04-01

    The interaction of the local anesthetic benzocaine with the human erythrocyte membrane and molecular models is described. The latter consisted of isolated unsealed human erythrocyte membranes (IUM), large unilamellar vesicles (LUV) of dimyristoylphospatidylcholine (DMPC), and phospholipid multilayers of DMPC and dimyristoylphospatidyletanolamine (DMPE), representatives of phospholipid classes located in the outer and inner monolayers of the human erythrocyte membrane, respectively. Optical and scanning electron microscopy of human erythrocytes revealed that benzocaine induced the formation of echinocytes. Experiments performed on IUM and DMPC LUV by fluorescence spectroscopy showed that benzocaine interacted with the phospholipid bilayer polar groups and hydrophobic acyl chains. X-ray diffraction analysis of DMPC confirmed these results and showed that benzocaine had no effects on DMPE. The effect on sodium transport was also studied using the isolated toad skin. Electrophysiological measurements indicated a significant decrease in the potential difference (PD) and in the short-circuit current (Isc) after the application of benzocaine, reflecting inhibition of active ion transport.

  5. Atomic determinants of state-dependent block of sodium channels by charged local anesthetics and benzocaine.

    Science.gov (United States)

    Tikhonov, Denis B; Bruhova, Iva; Zhorov, Boris S

    2006-11-13

    Molecular modeling predicts that a local anesthetic (LA) lidocaine binds to the resting and open Na(v)1.5 in different modes, interacting with LA-sensing residues known from experiments. Besides the major pathway via the open activation gate, LAs can reach the inner pore via a "sidewalk" between D3S6, D4S6, and D3P. The ammonium group of a cationic LA binds in the focus of the pore-helices macrodipoles, which also stabilize a Na(+) ion chelated by two benzocaine molecules. The LA's cationic group and a Na(+) ion in the selectivity filter repel each other suggesting that the Na(+) depletion upon slow inactivation would stabilize a LA, while a LA would stabilize slow-inactivated states.

  6. Bisphenol A binds to the local anesthetic receptor site to block the human cardiac sodium channel.

    Directory of Open Access Journals (Sweden)

    Andrias O O'Reilly

    Full Text Available Bisphenol A (BPA has attracted considerable public attention as it leaches from plastic used in food containers, is detectable in human fluids and recent epidemiologic studies link BPA exposure with diseases including cardiovascular disorders. As heart-toxicity may derive from modified cardiac electrophysiology, we investigated the interaction between BPA and hNav1.5, the predominant voltage-gated sodium channel subtype expressed in the human heart. Electrophysiology studies of heterologously-expressed hNav1.5 determined that BPA blocks the channel with a K(d of 25.4±1.3 µM. By comparing the effects of BPA and the local anesthetic mexiletine on wild type hNav1.5 and the F1760A mutant, we demonstrate that both compounds share an overlapping binding site. With a key binding determinant thus identified, an homology model of hNav1.5 was generated based on the recently-reported crystal structure of the bacterial voltage-gated sodium channel NavAb. Docking predictions position both ligands in a cavity delimited by F1760 and contiguous with the DIII-IV pore fenestration. Steered molecular dynamics simulations used to assess routes of ligand ingress indicate that the DIII-IV pore fenestration is a viable access pathway. Therefore BPA block of the human heart sodium channel involves the local anesthetic receptor and both BPA and mexiletine may enter the closed-state pore via membrane-located side fenestrations.

  7. Evaluation of the effect of locally administered amitriptyline gel as adjunct to local anesthetics in irreversible pulpitis pain

    Directory of Open Access Journals (Sweden)

    Moghadamnia A

    2009-01-01

    Full Text Available Background: Amitriptyline is one of the most common tricyclic antidepressants, which binds to pain sensory nerve fibers close to the sodium channel; hence, it could interact to some degree with receptors of local anesthetics. This study was designed to assess the additional analgesic effects of 2% Amitriptyline local gel administration in irreversible pulpitis pain of the molars. Materials and Methods: This study was a randomized, double-blind clinical trial that was performed on 56 consented adult patients who did not receive enough analgesia after a lidocaine nerve block for their tooth pulpitis pain. Patients were treated with 0.2 ml of either 2% amitriptyline or placebo, which was directly injected into their mandibular molar pulp chamber after they had received two routine lidocaine injections. Patients were asked to score their pain as a mark on a 10-cm Visual Analogue Scale (VAS at different timepoints: 0 (just before gel administration, 1, 3, 5, 7, and 9 minutes after the treatments. Results: There was a 92.5% decrease in VAS scores of patients 9 minutes after amitriptyline administration compared to Time 0, while in the placebo group this difference was only 13.5%. Further, in the amitriptyline group, the VAS score at all timepoints was statistically different from Time 0 ( P < 0.01. The overall pain reduction and its trend was significantly higher in the amitriptyline group compared with the placebo group ( P < 0.001. Conclusion: Inter-pulp space administration of amitriptyline 2% gel for completing analgesia in irreversible pulpitis pain could be effective and useful as a conjunctive therapy to injections of local anesthetics.

  8. Synthesis of Two Local Anesthetics from Toluene: An Organic Multistep Synthesis in a Project-Oriented Laboratory Course

    Science.gov (United States)

    Demare, Patricia; Regla, Ignacio

    2012-01-01

    This article describes one of the projects in the advanced undergraduate organic chemistry laboratory course concerning the synthesis of two local anesthetic drugs, prilocaine and benzocaine, with a common three-step sequence starting from toluene. Students undertake, in a several-week independent project, the multistep synthesis of a…

  9. Adductor Canal Block With 10 mL Versus 30 mL Local Anesthetics and Quadriceps Strength

    DEFF Research Database (Denmark)

    Jæger, Pia; Koscielniak-Nielsen, Zbigniew J; Hilsted, Karen Lisa;

    2015-01-01

    BACKGROUND AND OBJECTIVES: Adductor canal block (ACB) is predominantly a sensory nerve block, but excess volume may spread to the femoral triangle and reduce quadriceps strength. We hypothesized that reducing the local anesthetic volume from 30 to 10 mL may lead to fewer subjects with quadriceps...

  10. Comparison of Local Anesthetic Effect of Bupivacaine versus Bupivacaine plus Dexamethasone in Nasal Surgery

    Directory of Open Access Journals (Sweden)

    Abdolhosein Ma’somi

    2012-12-01

    Full Text Available   Introduction: Adequate pain control is an important consideration in the post-surgical management of patients. Local nerve blockade added to general anesthesia can provide excellent pain control during and after most nasal surgical procedures. The aim of this study was to determine the combined effect of local anesthetic drugs with corticosteroids in nasal surgery. Materials and Methods: In this double-blind clinical study, 60 patients who underwent different nasal surgical procedures were matched and divided into two equal groups. Bilateral local nerve blockade was used in both groups. Bupivacaine or bupivacaine plus dexamethasone was administered by injection (groups B and B+D, respectively. Postoperative visual analog scale (VAS pain values and the need for oral/intramuscular analgesic treatment in the first 24 h were recorded in all patients. Results: Thirty-eight male (63.3% and 22 female (36.7% patients were included in this study, with a mean age of 28.3 ± 8.2 years. At 1, 2, 4, 6, and 12 h post surgery, VAS pain values were significantly lower in the B+D group than in the B group. The analgesic requirement was significantly lower in the B+D group compared with the B group. No relevant complications were seen during surgery or postoperative hospitalization. Conclusion: This study demonstrates the positive effect of a combination of a dexamethasone with a bupivacaine in reducing pain and the need for analgesic drugs after different nasal surgeries. No acute or short-term post-surgical complications were observed in this study.   

  11. The challenge of evaluating pain and a pre-incisional local anesthetic block

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    Carolyn M. McKune

    2014-04-01

    Full Text Available Background. Our objective was to test the effectiveness of a local anesthetic line block administered before surgery in reducing postoperative pain scores in dogs undergoing ovariohysterectomy (OVHX.Methods. This study is a prospective, randomized, blinded, clinical trial involving 59 healthy female dogs. An algometric pressure-measuring device was used to determine nociceptive threshold, and compared to three subjective pain scales. Group L/B received a line block of lidocaine (4 mg/kg and bupivacaine (1 mg/kg subcutaneously in the area of the incision site and saline subcutaneously as premedication; group L/BM (positive control received a similar block and morphine (0.5 mg/kg subcutaneously for premedication; and group SS (negative control received a saline line block and saline premedication. Criteria for rescue analgesia were defined before the study. Dogs were assessed prior to surgery, at extubation (time 0 and at 2, 4, 6, 8 and 24 h post-recovery. The data were analyzed with one-way ANOVA, and a Split Plot Repeated Measures ANOVA with one grouping factor and one repeat factor (time. P < 0.05 was considered statistically significant.Results. Approximately 33% of dogs required rescue analgesia at some point during the study, with no significant difference between groups. There was no significant difference between treatment groups with any assessment method.Conclusions. As there were no statistically significant differences between positive and negative controls, the outcome of this technique cannot be proven.

  12. Faster onset time of supraclavicular brachial plexus block using local anesthetic diluted with dextrose

    Directory of Open Access Journals (Sweden)

    Hong Jin Lim

    Full Text Available Abstract Background and objectives: A high sodium concentration is known to antagonize local anesthetics when infiltrated around neural tissue. Thus, we hypothesized that the onset time for sensory and motor blockade, in supraclavicular brachial plexus block using ropivacaine diluted with dextrose would be shorter than with saline. Methods: Patients scheduled for upper limb surgery were randomized to receive ultrasound guided supraclavicular brachial plexus block with 0.5% ropivacaine. Evaluation of sensory and motor blockade was performed every 5 min for 60 min. Patients were followed-up on postoperative day 1, and between days 7 and 10 for the presence of any complications. Twenty-five patients in each group were analyzed. Results: Mean time for onset of analgesia for the dextrose group was 37.6 ± 12.9 min while the mean time for the saline group was 45.2 ± 13.9 min with a p-value of 0.05. The effect size was 0.567, which was moderate to large. No major complications were observed. Conclusion: We conclude that there was a decrease in onset time of analgesia when dextrose was used as a diluent instead of saline for ultrasound guided supraclavicular block.

  13. Intraarticilar and periarticular injections of triamcinolone acetonide and a local anesthetic in knee osteoarthritis (controlled study

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    A V Glazunov

    2009-01-01

    Full Text Available Efficacy of intraarticular glucocorticoid injections in knee osteoarthritis (OA is considered to be proved. But authors do not know randomized studies comparing efficacy of intraarticular and periarticular injections of triamcinolone acetonide.Objective. To assess efficacy of intraarticular and periarticular injections of mixture of triamcinolone acetonide (TA and a local anesthetic (LA solution in comparison with injections of LA only in pts with knee OA. Material and methods. 86 pts participating in a two-center randomized double blind study ELITA (Efficacy of Local Injection Therapy of osteoArthritis were included. Each knee joint with pain value higher then 40 mm (on VAS was randomized for either intraarticular or periarticular injections of novocaine 0,5% 10 ml or its mixture with TA 20 mg. Periarticular injections were performed in regions of ligaments, muscles or tendons insertions. “Pain”, “Activity” and “Functional status” WOMAC scales were assessed at baseline, in 4, 8, and12 weeks after treatment. Results. LA injections were performed in 21 pts (group 1 – control. TA and LA mixture was injected in both knee joints of 8 pts (group 4. Periarticular injections of TA and LA mixture were performed bilaterally in 5 pts (group 6. Group 4 pts had significantly better effect than group 1 pts after 4 (“Pain” and “Functional status” scales and 8 weeks (“Functional status” scale. Group 6 pts had better results than group 1 pts after 4 (all scales, 8 (“Pain” and “Activity” scales and 12 weeks (“Activity” scale. In group 6 pts treatment was more effective than in group 4 pts after 4 (all scales, 8 and 12 weeks (“Activity” scale. Conclusion. Efficacy of TA and LA mixture intraarticular and periarticular injections in comparison with isolated LA injections was demonstrated. Effect persisted for at least 8 weeks. Periarticular injections were more effective than intraarticular.

  14. The Effect of Local Anesthetic Volume Within the Adductor Canal on Quadriceps Femoris Function Evaluated by Electromyography

    DEFF Research Database (Denmark)

    Grevstad, Ulrik; Jæger, Pia; Sørensen, Johan Kløvgaard;

    2016-01-01

    BACKGROUND: Single-injection adductor canal block (ACB) provides analgesia after knee surgery. Which nerves that are blocked by an ACB and what influence-if any-local anesthetic volume has on the effects remain undetermined. We hypothesized that effects on the nerve to the vastus medialis muscle...... (which besides being a motor nerve innervates portions of the knee) are volume-dependent. METHODS: In this assessor- and subject-blinded randomized trial, 20 volunteers were included. On 3 separate days, subjects received an ACB with different volumes (10, 20, and 30 mL) of lidocaine 1%. In addition......L was used (P = 0.0001). No statistically significant differences were found between volume and effect on the vastus lateralis (P = 0.81) or in muscle strength (P = 0.15). CONCLUSIONS: For ACB, there is a positive correlation between local anesthetic volume and effect on the vastus medialis muscle. Despite...

  15. Hemodynamic response after injection of local anesthetics with or without adrenaline in adult Nigerian subjects undergoing simple tooth extraction

    Directory of Open Access Journals (Sweden)

    Olutayo James

    2015-01-01

    Full Text Available Objective: This study was conducted to determine the changes in the blood pressure (BP and the pulse rate (PR of normotensive patients having dental extraction under the administration of 2% lignocaine local anesthetic with or without adrenaline. Materials and Methods: This prospective study was carried out on 325 consecutive normotensive patients who presented at the exodontia clinic of the Lagos University Teaching Hospital (LUTH, Lagos, Yoruba State, Nigeria from December 2004 to August 2005 for simple tooth extraction. The patients were randomly allocated into two groups according to the type of anesthetic solution employed. Group A had tooth extraction done under the administration of 2% lignocaine with adrenaline (1:80,000 while group B had tooth extraction done under the administration of 2% lignocaine local anesthetic without vasoconstrictor (plain lignocaine. Each patient had single tooth extracted. The following parameters were monitored in each of the surgical interventions: systolic blood pressure (SBP, diastolic blood pressure (DBP, and PR. Measurements were taken in the waiting room before surgery, during the surgery after local anesthesia, during tooth extraction, and 15 min after tooth extraction. Results: The sample consisted of 176 females and 149 males. Age range of the patients was 18-89 years with the mean age of 35.08 ± 15.60 years. The hemodynamic responses to lignocaine with adrenaline (1:80,000 and plain lignocaine essentially follow the same pattern in the study. There was no statistically significant difference between the measured parameters in the two groups after the administration of local anesthetics. Conclusion: This study, therefore, shows that there was no difference in the hemodynamic changes observed with the use of lignocaine with adrenaline or plain lignocaine during a simple tooth extraction in healthy adults.

  16. Local anesthetic failure associated with inflammation: verification of the acidosis mechanism and the hypothetic participation of inflammatory peroxynitrite

    OpenAIRE

    Tsuchiya, Hironori

    2008-01-01

    Takahiro Ueno1, Hironori Tsuchiya2, Maki Mizogami1, Ko Takakura11Department of Anesthesiology, Asahi University School of Dentistry, Mizuho, Gifu, Japan; 2Department of Dental Basic Education, Asahi University School of Dentistry, Mizuho, Gifu, JapanAbstract: The presence of inflammation decreases local anesthetic efficacy, especially in dental anesthesia. Although inflammatory acidosis is most frequently cited as the cause of such clinical phenomena, this has not been experimentally proved. ...

  17. A Novel Technique for Split-Thickness Skin Donor Site Pain Control: Subcutaneous Catheters for Continuous Local Anesthetic Infusion

    Science.gov (United States)

    2012-01-01

    has been described after laparotomy, tho- racotomy, inguinal hernia repair, and rib fractures.2–4 We describe our experience at the U.S. Army Insti... complications (one catheter insertion site infection and one early catheter discontinuation due to poor skin fixation). This report is limited by its...Sanchez B, Waxman K, Tatevossian R, Gamberdella M, Read B. Local anesthetic infusion pumps improve postoperative pain after inguinal hernia repair: a

  18. Prevalence of hypersensitivity to dental local anesthetic drugs in patients referred to Tehran Allergy clinic (2005-2007

    Directory of Open Access Journals (Sweden)

    Akhlaghi F.

    2009-03-01

    Full Text Available "nBackground and Aim: According to controversies in the prevalence of hypersensitivity to dental local anesthetic drugs and patients who claim hypersensitivity to these drugs, the aim of this study was to determine the prevalence of hypersensitivity to dental amide local anesthetic drugs in patients referred to Tehran Allergy Clinic in 2005-2007. "nMaterials and Methods: In this Study (Review of existing data, records of 130 patients who were referred to "Tehran allergy Clinic" (2005-2007 were studied. "nResults: The average age of patients was 29.5±18.8 years. 34% of cases showed positive skin reactions to at least one of the tested Lidocain concentrations and 10% of cases showed positive skin reactions to at least one of the tested Prilocain concentrations. There was a statistically significant difference in hypersensitivity to Lidocain 0.01 and 0.001 (p=0.017 and also between Lidocain 0.001 and 0.0001 (p<0.01. There was no statistically significant difference between other tested drug concentrations (p>0.05. "nConclusion: Many patients with history of hypersensitivity, show positive reaction to local dental anesthetic drugs. Prilocain hypersensitivity reactions are less than Lidocain. So application of Prilocain accompanies with less risk but its application should not be considered completely safe.

  19. Local Anesthetics in the Gas-Phase the Rotational Spectrum of Butamben and Isobutamben

    Science.gov (United States)

    Vallejo-López, Montserrat; Ecija, Patricia; Caminati, Walther; Grabow, Jens-Uwe; Lesarri, Alberto; Cocinero, Emilio J.

    2016-06-01

    Benzocaine (BZ), butamben (BTN) and isobutamben (BTI) are local anesthetics characterized by a hydrophilic head and a lipophilic aliphatic tail linked by an aminobenzoate group. Previous rotational work on BZ (H2N-C6H4-COO-Et) showed that its ethyl aliphatic tail may adopt either in-plane (trans) or out of plane (gauche) conformations, with a low interconversion barrier below 50 cm-1. Here we extend the rotational study to BTN and BTI, isolated in a supersonic jet expansion and vaporized either by heating or UV ps-laser ablation methods. Both molecules share a 14 heavy-atoms skeleton, differing in their butyl (-(CH2)3-CH3) or isobutyl (-CH2-CH(CH3)2) four-carbon tail. We detected a single conformer for BTN and two conformers for BTI. The two molecules do not adopt an all-trans carbon skeleton. Conversely, the β-ethyl carbon in BTN is gauche. For BTI the β-carbon may be either trans or gauche. The microwave spectrum covered the cm- (BTN, BTI, 6-18 GHz) and mm-wave (BTW, 50-75 GHz) frequency ranges.In all the cases, rotational and centrifugal distortion constants as well as the diagonal elements of the 14N nuclear quadrupole coupling tensor were accurate determined and compared to the theoretical results (ab initio and DFT). No transitions belonging to configurations predicted as higher minima of the PES were found, pointing out that conformational interconversions may take place in the jet. A. Lesarri, S. T. Shipman, G. G. Brown, L. Alvarez-Valtierra, R. D. Suenram, B. H. Pate, Int. Symp. Mol. Spectrosc., 2008, Comm. RH07. E. Aguado, A. Longarte, E. Alejandro, J. A. Fernández, F. Castaño, J. Phys. Chem. A, 2006, 110, 6010.

  20. Minimum effective local anesthetic dose of intrathecal hyperbaric ropivacaine and bupivacaine for cesarean section

    Institute of Scientific and Technical Information of China (English)

    GENG Zhi-yu; WANG Dong-xin; WU Xin-min

    2011-01-01

    Background Intrathecal anesthesia is commonly used for cesarean section. Bupivacaine and ropivacaine have all been used as intrathecal drugs. The minimum effective local anesthetic dose (MLAD) of intrathecal ropivacaine for nonobstetric patients has been reported. However, few data are available on the MLAD of hyperbaric ropivacine for obstetric patients and the relative potency to bupivacaine has not been fully determined. In this study, we sought to determine the MLAD of intrathecal ropivacaine and bupivacaine for elective cesarean section and to define their relative potency ratio.Methods We enrolled forty parturients undergoing elective cesarean section under combined spinal-epidural anesthesia and randomized them to one of two groups to receive intrathecal 0.5% hyperbaric ropivacaine or bupivacaine.The initial dose was 10 mg, and was increased in increments of 1 mg, using the technique of up-down sequential allocation. Efficacy was accepted if adequate sensory dermatomal anesthesia to pin prick to T7 or higher was attained within 20 minutes after intrathecal injection, and required no supplementary epidural injection for procedure until at least 50 minutes after the intrathecal injection.Results The intrathecal MLAD was 9.45 mg (95%confidence interval (CI), 8.45-10.56 mg) for ropivacaine and 7.53 mg (95%CI, 7.00-8.10 mg) for bupivacaine. The relative potency ratio was 0.80 (95% Cl, 0.74-0.85) for ropivacaine/bupivacaine when given intrathecally in cesarean section.Conclusion Ropivacaine is 20% less potent than bupivacaine during intrathecal anesthesia for cesarean delivery.

  1. Survey of responsible handling of local anesthetic in Indian dental operatory

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    Thavarajah Rooban

    2013-01-01

    Full Text Available Background: Dental operatory requires handling of numerous toxic fluids such as denture acrylic monomer, alcohol and formalin for effective oral care delivery. The efficacy and responsible handling of such fluids has not been analyzed among Indian dentists and this study aims to address this lacunae. Materials and Methods: Closed ended questionnaire was distributed through email to Indian dentists in July 2012. After inclusion/exclusion criteria, 1484 practitioners constituted the study group with a response rate of 52%. Statistics: SPSS ® Version 17.0 (SPSS-IBM Inc., IL, USA was used to carry out statistical analysis. Descriptive statistics were presented. Chi square test was used to identify the association between the parameters; P ≤ 0.05 was considered as statistically significant. Results: Males (80.8%, undergraduates (78%, exclusive practitioners (81.2%, urban practitioners (68.5% were the predominant respondents. Predominant of the respondents (97% used local anesthetic (LA from bottles. Eight percent have encountered instances of injecting formalin instead of LA in their settings. Safe disposal rules and regulations ( P ≤ 0.05, opinion on injecting the other fluids instead of LA as a severe negligent act ( P ≤ 0.05 were statistically significant between age groups. Educational status did not appear to influence the outcome. Only a third of the respondents were aware of the rules and regulations for safe disposal of empty LA bottles while 49.1% were not aware of them and willing to learn. Discussion: The lacunae in responsible handling of toxic fluids need to be addressed to prevent inadvertent and negligence suits against dentists, highlighting the need through continuing dental education programmes.

  2. Reduction of Environmental Temperature Mitigates Local Anesthetic Cytotoxicity in Bovine Articular Chondrocytes

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    Tarik Onur, Alexis Dang

    2014-09-01

    Full Text Available The purpose of this study was to assess whether reducing environmental temperature will lead to increased chondrocyte viability following injury from a single-dose of local anesthetic treatment. Bovine articular chondrocytes from weight bearing portions of femoral condyles were harvested and cultured. 96-well plates were seeded with 15,000 chondrocytes per well. Chondrocytes were treated with one of the following conditions: ITS Media, 1x PBS, 2% lidocaine, 0.5% bupivacaine, or 0.5% ropivacaine. Each plate was then incubated at 37°C, 23°C, or 4°C for one hour and then returned to media at 37°C. Chondrocyte viability was assessed 24 hours after treatment. Chondrocyte viability is presented as a ratio of the fluorescence of the treatment group over the average of the media group at that temperature (ratio ± SEM. At 37°C, lidocaine (0.35 ± 0.04 and bupivacaine (0.30 ± 0.05 treated chondrocytes show low cell viability when compared to the media (1.00 ± 0.03 control group (p < 0.001. Lidocaine treated chondrocytes were significantly more viable at 23°C (0.84 ± 0.08 and 4°C (0.86±0.085 than at 37°C (p < 0.001. Bupivacaine treated chondrocytes were significantly more viable at 4°C (0.660 ± 0.073 than at 37°C or 23°C (0.330 ± 0.069 (p < 0.001 and p = 0.002 respectively. Reducing the temperature from 37°C to 23°C during treatment with lidocaine increases chondrocyte viability following injury. Chondrocytes treated with bupivacaine can be rescued by reducing the temperature to 4°C.

  3. Cytotoxicity of solid lipid nanoparticles and nanostructured lipid carriers containing the local anesthetic dibucaine designed for topical application

    Science.gov (United States)

    Barbosa, R. M.; da Silva, C. M. G.; Bella, T. S.; de Araújo, D. R.; Marcato, P. D.; Durán, N.; de Paula, E.

    2013-04-01

    Dibucaine (DBC) is powerful long-lasting local anesthetic, but it is also considered fairly toxic to the CNS. Solid lipid nanoparticles (SLN) and nanostructured lipid carriers (NLC) have attracted attention as carriers for drug delivery. The aim of this study was to develop and to evaluate the cytotoxic activity of DBC-loaded SLN and NLC against 3T3 fibroblast and HaCat keratinocyte cells. The SLN and NLC had myristyl myristate and Liponate®GC as their lipid matrices, respectively, plus a surfactant. SLN and NLC were characterized in terms in their diameter, size distribution, surface charge and DBC encapsulation efficiency. The particle size of SLN and NLC were around 234.33 and 166.62 nm, respectively. The polydispersity index was kept below 0.2 for both nanomaterials. Negative surface charges were observed for both nanoparticles, which decreased in the presence of the anesthetic. Encapsulation efficiency reached 76% and 90%, respectively, in SLN and NLC. DBC alone was found to be toxic to 3T3 and HaCat cells in culture. However, NLC and SLN loaded DBC decreased its intrinsic cytotoxic effect against 3T3 and HaCat cells. In conclusion, encapsulation of DBC in SLN and NLC decreased the in vitro toxicity of the local anesthetic, indicating the potential of these nanocarriers for clinical applications.

  4. Local Anesthetic Activity from Extracts, Fractions and Pure Compounds from the Roots of Ottonia anisum Spreng. (Piperaceae).

    Science.gov (United States)

    López, Kelvin S E; Marques, André M; Moreira, Davyson DE L; Velozo, Leosvaldo S; Sudo, Roberto T; Zapata-Sudo, Gisele; Guimarães, Elsie F; Kaplan, Maria Auxiliadora C

    2016-01-01

    Piperaceae species can be found worldwide in tropical and subtropical areas and many of them have been used for centuries in traditional folk medicine and in culinary. In Brazil, species of Piperaceae are commonly used in some communities as local anesthetic and analgesic. Countrified communities have known some species of the genus Ottonia as "anestesia" and it is a common habit of chewing leaves and roots of Ottonia species to relief toothache. The purpose of this study is to report our findings on new molecules entities obtained from the roots of Ottonia anisum Spreng, in which local anesthetic activity (sensory blockage) is demonstrated for the first time in vivo guinea pig model. Phytochemical investigation led to the isolation of three amides (pipercallosidine, piperine and valeramide) and in an enriched mixture of seven amides (valeramide, 4,5-dihydropiperlonguminine, N-isobutil-6-piperonil-2-hexenamide, piperovatine, dihydropipercallosidine, pipercallosidine and pipercallpsine). Our findings demonstrated the anesthetic potential for the methanolic extract from roots, its n-hexane partition and amides from O. anisum and it is in agreement with ethnobotanical survey.

  5. Local Anesthetic Activity from Extracts, Fractions and Pure Compounds from the Roots of Ottonia anisum Spreng. (Piperaceae

    Directory of Open Access Journals (Sweden)

    KELVIN S.E. LÓPEZ

    Full Text Available ABSTRACT Piperaceae species can be found worldwide in tropical and subtropical areas and many of them have been used for centuries in traditional folk medicine and in culinary. In Brazil, species of Piperaceae are commonly used in some communities as local anesthetic and analgesic. Countrified communities have known some species of the genus Ottonia as "anestesia" and it is a common habit of chewing leaves and roots of Ottonia species to relief toothache. The purpose of this study is to report our findings on new molecules entities obtained from the roots of Ottonia anisum Spreng, in which local anesthetic activity (sensory blockage is demonstrated for the first time in vivo guinea pig model. Phytochemical investigation led to the isolation of three amides (pipercallosidine, piperine and valeramide and in an enriched mixture of seven amides (valeramide, 4,5-dihydropiperlonguminine, N-isobutil-6-piperonil-2-hexenamide, piperovatine, dihydropipercallosidine, pipercallosidine and pipercallpsine. Our findings demonstrated the anesthetic potential for the methanolic extract from roots, its n-hexane partition and amides from O. anisum and it is in agreement with ethnobotanical survey.

  6. Effects of single injection of local anesthetic agents on intervertebral disc degeneration: ex vivo and long-term in vivo experimental study.

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    Koji Iwasaki

    Full Text Available Analgesic discography (discoblock can be used to diagnose or treat discogenic low back pain by injecting a small amount of local anesthetics. However, recent in vitro studies have revealed cytotoxic effects of local anesthetics on intervertebral disc (IVD cells. Here we aimed to investigate the deteriorative effects of lidocaine and bupivacaine on rabbit IVDs using an organotypic culture model and an in vivo long-term follow-up model.For the organotypic culture model, rabbit IVDs were harvested and cultured for 3 or 7 days after intradiscal injection of local anesthetics (1% lidocaine or 0.5% bupivacaine. Nucleus pulposus (NP cell death was measured using confocal microscopy. Histological and TUNEL assays were performed. For in vivo study, each local anesthetic was injected into rabbit lumbar IVDs under a fluoroscope. Six or 12 months after the injection, each IVD was prepared for magnetic resonance imaging (MRI and histological analysis.In the organotypic culture model, both anesthetic agents induced time-dependent NP cell death; when compared with injected saline solution, significant effects were detected within 7 days. Compared with the saline group, TUNEL-positive NP cells were significantly increased in the bupivacaine group. In the in vivo study, MRI analysis did not show any significant difference. Histological analysis revealed that IVD degeneration occurred to a significantly level in the saline- and local anesthetics-injected groups compared with the untreated control or puncture-only groups. However, there was no significant difference between the saline and anesthetic agents groups.In the in vivo model using healthy IVDs, there was no strong evidence to suggest that discoblock with local anesthetics has the potential of inducing IVD degeneration other than the initial mechanical damage of the pressurized injection. Further studies should be performed to investigate the deteriorative effects of the local injection of analgesic agents

  7. Clinical parameters of the local anesthetic effects of bupivacaine applied with and without a vasoconstrictor in oral implantology

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    Duka Miloš

    2007-01-01

    Full Text Available Background/Aim. Bupivacaine (Marcaine®, homologue of mepivacaine, chemically related to lidocaine, is used as a local anesthetic for local infiltration, peripheral nerve block, retrobulbar block, symphathetic block, and caudal and epidural anesthesia. The aim of this investigation was to determine and to compare clinical parameters of the local anesthetic effects of bupivacaine applied with and without a vasoconstrictor. Methods. This investigation included a total of 30 randomly selected patients, who ranged in age from 30−60 years, with partial or total anodontia in the molar region of the mandible. These patients with total or partial edentulous molar part of the mandible, scheduled for dental implantation placement, were asked to participate in the study. In the first phase of the investigation, the patients were subjected to local anesthesia with 3.5 cm3 of 0.5% bupivacaine with a vasoconstrictor (adrenalin, 1: 200 000 in the right side of the mandible. After administering local anesthesia, the placement of blade, cylindrical, transdental (B.C.T. implants was performed. In the second stage of the investigation, in 7−10 days period after the first oral surgery, the patients were subjected to local anesthesia with 3.5 cm3 of 0.5% bupivacaine, but without a vasoconstrictor, in the left side of the mandible. After administering local anesthesia, the placement of B.C.T. implants was performed. During the performance of both oral surgery procedures, the following clinical parameters of the local anesthetic effects were monitored: latent period, duration and the potency of anesthesia, and the evaluation of the postoperative pain level. Results. The latent period under local anesthesia with 3.5 cm3 of 0.5% bupivacaine and vasoconstrictor was statistically significantly shorter than without vasoconstrictor. The duration of local anesthesia was longer without vasoconstrictor. There was no difference in the potency of anesthesia with or without a

  8. Improvement of Lidocaine Local Anesthetic Action Using Lallemantia royleana Seed Mucilage as an Excipient

    OpenAIRE

    Atabaki, Rabi; Hassanpour-Ezatti, Majid

    2014-01-01

    Lallemantia royleana (Balangu) is a well known Iranian medicinal plant that its seed mucilage has many applications in modern pharmacology. Plant mucilage traditionally was used as a gel supplement, and natural matrix for sustained release of drugs. But it seems that these compounds are not a simple additive and also have many undiscovered pharmacological properties. In this research, the anesthetic action of gel prepared from Balangu mucilage alone and its mixture with lidocaine hydrochlorid...

  9. Effect of local anesthetics on perioperative oxidative stress injury and nerve conduction function in diabetic or non-diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Dong-Yang Zhu; Ping Li

    2016-01-01

    Objective:To study the effect of local anesthetics on perioperative oxidative stress injury and nerve conduction function in diabetic or non-diabetic patients.Methods:A total of 100 c diabetic patients and 100 non-diabetic patients who received selective surgery under intraspinal block anesthesia were selected as the research subjects, diabetic patients were selected as observation group, non-diabetic patients were selected as control group, serum and urine were collected respectively before and after operation, and reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), 8-hydroxy-2 deoxyguanosine (8-OHdG) levels were determined; electromyography was carried out, and the motor nerve conduction velocity of median nerve and common peroneal nerve as well as sensory nerve conduction velocity of median nerve and superficial peroneal nerve were determined.Results:One day before operation and 1 day after operation, serum ROS and MDA levels and urine 8-OHdG levels of observation group were significantly higher than those of control group, and serum SOD levels were significantly lower than those of control group; ROS, MDA, SOD and 8-OHdG levels of observation group before and after operation changed more significantly than those of control group. 1 week after operation, MNCV of median nerve and common peroneal nerve as well as SNCV of median nerve and superficial peroneal nerve of observation group were significantly lower than those before operation, and MNCV of median nerve and common peroneal nerve as well as SNCV of median nerve and superficial peroneal nerve of control group were not significantly different from those before operation.Conclusions: Local anesthetics can cause peripheral nerve conduction function impairment in diabetic patients, and the possible molecular mechanism is that local anesthetics activate perioperative oxidative stress more significantly in diabetic patients than in non-diabetic patients.

  10. Efficacy of Benzocaine 20% Topical Anesthetic Compared to Placebo Prior to Administration of Local Anesthesia in the Oral Cavity: A Randomized Controlled Trial.

    Science.gov (United States)

    de Freiras, Guilherme Camponogara; Pozzobon, Roselaine Terezinha; Blaya, Diego Segatto; Moreira, Carlos Heitor

    2015-01-01

    The aim of the present study was to compare the effects of a topical anesthetic to a placebo on pain perception during administration of local anesthesia in 2 regions of the oral cavity. A split-mouth, double-blind, randomized clinical trial design was used. Thirty-eight subjects, ages 18-50 years, American Society of Anesthesiologists I and II, received 4 anesthetic injections each in regions corresponding to the posterior superior alveolar nerve (PSA) and greater palatine nerve (GPN), totaling 152 sites analyzed. The side of the mouth where the topical anesthetic (benzocaine 20%) or the placebo was to be applied was chosen by a flip of a coin. The needle used was 27G, and the anesthetic used for administration of local anesthesia was 2% lidocaine with 1:100,000 epinephrine. After receiving the administration of local anesthesia, each patient reported pain perception on a visual analog scale (VAS) of 100-mm length. The results showed that the topical anesthetic and the placebo had similar effects: there was no statistically significant VAS difference between the PSA and the GPN pain ratings. A higher value on the VAS for the anesthesia of the GPN, relative to the PSA, was observed for both groups. Regarding gender, male patients had higher values on the VAS compared with female patients, but these differences were not meaningful. The topical anesthetic and the placebo had similar effects on pain perception for injection of local anesthesia for the PSA and GPN.

  11. Analgesic and Sensory Effects of the Pecs Local Anesthetic Block in Patients with Persistent Pain after Breast Cancer Surgery

    DEFF Research Database (Denmark)

    Wijayasinghe, Nelun; Andersen, Kenneth Geving; Kehlet, Henrik

    2016-01-01

    BACKGROUND: Persistent pain after breast cancer surgery (PPBCS) develops in 15% to 25% of patients, sometimes years after surgery. Approximately 50% of PPBCS patients have neuropathic pain in the breast, which may be due to dysfunction of the pectoral nerves. The Pecs local anesthetic block...... proposes to block these nerves and has provided pain relief for patients undergoing breast cancer surgery, but has yet to be evaluated in patients with PPBCS. METHODS: The aim of this pilot study was to examine the effects of the Pecs block on summed pain intensity (SPI) and sensory function (through...

  12. Local anesthetic wound infiltration for pain management after periacetabular osteotomy. A randomized, placebo-controlled, double-blind clinical trial with 53 patients

    DEFF Research Database (Denmark)

    Bech, Rune D; Ovesen, Ole; Lindholm, Peter;

    2014-01-01

    BACKGROUND AND PURPOSE: To our knowledge, there is no evidence to support the use of local infiltration analgesia (LIA) for postoperative pain relief after periacetabular osteotomy (PAO). We investigated the effect of wound infiltration with a long-acting local anesthetic (ropivacaine) for postop......BACKGROUND AND PURPOSE: To our knowledge, there is no evidence to support the use of local infiltration analgesia (LIA) for postoperative pain relief after periacetabular osteotomy (PAO). We investigated the effect of wound infiltration with a long-acting local anesthetic (ropivacaine...

  13. Onset and duration of anesthesia for local anesthetic combinations commonly used in forefoot surgery; surprise results with sequential blocks.

    Science.gov (United States)

    Blazer, Marie Mantini; Petrozzi, Rocco; Harris, Samantha Y; Greer, Hillary; Goldfarb, Jacqueline; Biernacki, Tomasz; Kawalec, Jill S

    2015-06-01

    Local anesthetic nerve blocks are frequently used for postoperative analgesia and to the best of our knowledge no studies have evaluated the effects of injecting bupivacaine into an area previously injected with lidocaine. Sensation was tested in three groups of subjects receiving local anesthetic digital blocks. Group A received bupivacaine 0.25% plain. Group B received a 1:1 mixture of lidocaine 1% plain and bupivacaine 0.25%. Group C received an initial block of lidocaine 1% plain sequentially followed by bupivacaine 0.25% 1h later. Bupivacaine exhibited a delayed onset and the longest duration when compared to the other two groups. The group receiving the 1:1 mixture showed a rapid onset that resembled that of lidocaine and a shortened duration that did not resemble bupivacaine. The group receiving the sequential injections showed that even after a 1h interval following the lidocaine infiltration, there was a deleterious effect on duration of action of the bupivacaine. Using bupivacaine as a post-surgical block in the presence of residual lidocaine from a preoperative block is not warranted as once again, the extended duration of bupivacaine is mitigated. Bupivacaine alone as an initial operative block affords clinically acceptable onset of anesthesia while also providing extended duration of action.

  14. Image intensifier-guided injection of corticosteroid and local anesthetic agent for the treatment of recalcitrant plantar fasciitis.

    Science.gov (United States)

    Atkins, Kate L; Chin, Kuen Foo; Noorani, Ali M; Nairn, David S

    2010-08-01

    Plantar fasciitis is the most common cause of plantar heel pain. The condition is potentially self-limiting and can respond to conservative treatment, but patients may opt for surgery if the treatments fail. Surgical intervention is associated with potential complications. This study set out to explore the efficacy of the specific nonsurgical intervention offered to treatment-resistant cases in a local clinical setting. The technique involves image intensifier-guided injection of corticosteroid and local anesthetic agents under general anesthesia. Nineteen patients with recalcitrant plantar fasciitis of over 12 months' duration received injections. A simple follow-up questionnaire was given to patients after the procedure that focused on their subjective opinion of any change in their pain. They were also asked if the injection had solved their problems with heel pain. The improvements that the patients reported were found to be statistically significant (P = .012).

  15. 局麻药骨骼肌毒性作用的研究与临床意义%The study and clinical significance of local anesthetic myotoxicity

    Institute of Scientific and Technical Information of China (English)

    马冬梅; 郑宏

    2009-01-01

    最新研究证实,局麻药(locae anesthetic,LA)可导致骨骼肌损伤,甚至引起肌肉坏死,临床上使用的LA均存在骨骼肌毒性,因此将其对骨骼肌的损害视为局麻药的潜在并发症,但在临床上相关病例却很少见.现将近来国外对LA骨骼肌毒性的研究进展综述如下.%A lot of studies revealed that the local anesthetic may cause the degeneration of striated muscle sarcoplasmic reticulum and myocyte edema, even necrosis. All clinically used local anesthetics are myotoxic, with a drug-specific and dose-dependent rate of myotoxicity. We have to see local anesthetic myotoxicity as a potential complication. The molecular mechanism of local anesthetic myotoxicity are still not completely revealed. This articale reviews the recent related myotoxicity studies as follows.

  16. Effects of tertiary amine local anesthetics on the assembly and disassembly of brain microtubules in vitro.

    Science.gov (United States)

    Genna, J M; Coffe, G; Pudles, J

    1980-09-01

    From kinetic and electron microscopy studies on the effects of procaine, tetracaine and dibucaine on the polymerization and depolymerization of the microtubules isolated from pig and rat brains the following results were obtained. 1. Procaine or tetracaine, at the concentration range of 0.5--20 mM and of 0.5--5 mM respectively, increases the rate of tubulin polymerization (24 degrees C or 37 degrees C) and of microtubule depolymerization (4 degrees C) as a linear function of the concentration of the anesthetics, while identical amounts of microtubules are formed. In the absence of microtubule-associated proteins the polymerization of tubulin is not induced by 10 mM procaine, furthermore, the critical concentration of microtubule proteins necessary for assembly into microtubules is not affected at this concentration level of the anesthetic. This suggests that procaine affects not the nucleation, but rather the elongation process. 2. Dibucaine, from 0.5 mM to 3 mM increases the lag time of the polymerization reaction, while from 0.5 mM to 2 mM it linearly decreases both tubulin polymerization (24 degrees C) and microtubule depolymerization (4 degrees C) rates. Dibucaine, up to mM concentration, does not affect the extent of tubulin polymerization; however, above this concentration it induces the formation of amorphous aggregates. 3. Procaine or tetracaine enhances the depolymerizing effect of calcium on microtubules. The half-maximal values for the depolymerizing effect of calcium were 0.96, 0.71 and 0.51 mM for the control, in the presence of 10 mM procaine and 5 mM tetracaine respectively.

  17. Screening of formulation variables for the preparation of poly(epsilon-caprolactone) nanocapsules containing the local anesthetic benzocaine.

    Science.gov (United States)

    Moraes, Carolina Morales; de Matos, Angélica Prado; Grillo, Renato; de Melo, Nathalie F S; de Paula, Eneida; Dias Filho, Newton Luiz; Rosa, André Henrique; Fraceto, Leonardo Fernandes

    2011-03-01

    In this work we describe the screening of four parameters in the preparation, by nanoprecipitation, of poly(epsilon-caprolactone) nanocapsules, used as a drug carrier system for the local anesthetic, benzocaine. A 2(4-1) factorial experimental design was used to study the influence of four different independent variables (polymer, oily phase, Span 60 and Tween 80) on nanocapsule characteristics (size, polydispersion index, zeta potential) and drug loading capability. Best results were obtained using an aqueous formulation comprising 100 mg of polymer, 200 mg of oily phase, 40 mg of Span 60 and 60 mg of Tween 80 in a final volume of 10 mL which produced a colloidal system with particle size of 188 nm, zeta potential -32 mV, polydispersion index 0.07, and benzocaine association efficiency > 87%. These findings open the way for future clinical studies using such formulations.

  18. Local anesthetic interaction with human ether-a-go-go-related gene (HERG) channels: role of aromatic amino acids Y652 and F656

    DEFF Research Database (Denmark)

    Siebrands, Cornelia C; Schmitt, Nicole; Friederich, Patrick

    2005-01-01

    : wild-type IC50 = 22 +/- 2 microm, n = 38; Y652A IC50 = 95 +/- 5 microm, n = 31). The mutations resulted in a change of the stereoselectivity of HERG channel block by ropivacaine. The potency of the local anesthetics to inhibit wild-type and mutant channels correlated with the lipophilicity of the drug...

  19. Effects of Various Antiepileptics Used to Alleviate Neuropathic Pain on Compound Action Potential in Frog Sciatic Nerves: Comparison with Those of Local Anesthetics

    Directory of Open Access Journals (Sweden)

    Yuhei Uemura

    2014-01-01

    Full Text Available Antiepileptics used for treating neuropathic pain have various actions including voltage-gated Na+ and Ca2+ channels, glutamate-receptor inhibition, and GABAA-receptor activation, while local anesthetics are also used to alleviate the pain. It has not been fully examined yet how nerve conduction inhibitions by local anesthetics differ in extent from those by antiepileptics. Fast-conducting compound action potentials (CAPs were recorded from frog sciatic nerve fibers by using the air-gap method. Antiepileptics (lamotrigine and carbamazepine concentration dependently reduced the peak amplitude of the CAP (IC50=0.44 and 0.50 mM, resp.. Carbamazepine analog oxcarbazepine exhibited an inhibition smaller than that of carbamazepine. Antiepileptic phenytoin (0.1 mM reduced CAP amplitude by 15%. On the other hand, other antiepileptics (gabapentin, sodium valproate, and topiramate at 10 mM had no effect on CAPs. The CAPs were inhibited by local anesthetic levobupivacaine (IC50=0.23 mM. These results indicate that there is a difference in the extent of nerve conduction inhibition among antiepileptics and that some antiepileptics inhibit nerve conduction with an efficacy similar to that of levobupivacaine or to those of other local anesthetics (lidocaine, ropivacaine, and cocaine as reported previously. This may serve to know a contribution of nerve conduction inhibition in the antinociception by antiepileptics.

  20. Hyperalgesia by low doses of the local anesthetic lidocaine involves cannabinoid signaling: an fMRI study in mice.

    Science.gov (United States)

    Bosshard, Simone C; Grandjean, Joanes; Schroeter, Aileen; Baltes, Christof; Zeilhofer, Hanns U; Rudin, Markus

    2012-07-01

    Lidocaine is clinically widely used as a local anesthetic inhibiting propagation of action potentials in peripheral nerve fibers. Correspondingly, the functional magnetic resonance imaging (fMRI) response in mouse brain to peripheral noxious input is largely suppressed by local lidocaine administered at doses used in a clinical setting. We observed, however, that local administration of lidocaine at doses 100 × lower than that used clinically led to a significantly increased sensitivity of mice to noxious forepaw stimulation as revealed by fMRI. This hyperalgesic response could be confirmed by behavioral readouts using the von Frey filament test. The increased sensitivity was found to involve a type 1 cannabinoid (CB(1)) receptor-dependent pathway as global CB(1) knockout mice, as well as wild-type mice pretreated systemically with the CB(1) receptor blocker rimonabant, did not display any hyperalgesic effects after low-dose lidocaine. Additional experiments with nociceptor-specific CB(1) receptor knockout mice indicated an involvement of the CB(1) receptors located on the nociceptors. We conclude that low concentrations of lidocaine leads to a sensitization of the nociceptors through a CB(1) receptor-dependent process. This lidocaine-induced sensitization might contribute to postoperative hyperalgesia.

  1. Benzocaine loaded solid lipid nanoparticles: Formulation design, in vitro and in vivo evaluation of local anesthetic effect.

    Science.gov (United States)

    Basha, Mona; Abd El-Alim, Sameh Hosam; Kassem, Ahmed Alaa; El Awdan, Sally; Awad, Gamal

    2015-01-01

    The aim of the present work is the development and evaluation of solid lipid nanoparticles (SLNs) as carrier system for topical delivery of benzocaine (BZC) improving its local anesthesia aiming to produce a fast acting and long lasting topical formulation. BZC loaded SLNs were prepared using a full factorial design to study the influence of the type of polyoxyethylene sorbitan ester surfactants as well as their concentration as independent variables on the particle size, entrapment efficacy and zeta potential selected as dependent variables. Design of experiment (DOE) and the analysis of variance (ANOVA) were conducted to assess the optimization of the developed formulations. The results indicated that the fatty acid chain length of tested surfactants and their concentration had a significant effect on the studied responses. The optimized formulations were spherical in shape of mean particle diameters<350 nm with negatively charged surface <-20mV. Particles were characterized using differential scanning calorimetry and X-ray powder diffraction confirming the amorphous nature and the uniformity of drug inclusion in the lipid matrix. Optimized BZC-SLNs were incorporated into hydrogels characterized by a pseudoplastic non-Newtonian behavior. In vitro release study revealed an apparently biphasic release process with sustained release profile following Higuchi kinetics. BZC loaded SLNs hydrogels showed more potent anesthetic effect compared to BZC hydrogel evaluated using tail-flick analgesimeter, confirming significant improvement in both the intensity and duration of anesthetic effect. The above results proved that SLNs represent good candidates to encapsulate BZC improving its therapeutic efficacy for the topical treatment of pain.

  2. Acute physiological responses to castration-related pain in piglets: the effect of two local anesthetics with or without meloxicam.

    Science.gov (United States)

    Bonastre, C; Mitjana, O; Tejedor, M T; Calavia, M; Yuste, A G; Úbeda, J L; Falceto, M V

    2016-09-01

    Methods to reduce castration-related pain in piglets are still issues of concern and interest for authorities and producers. Our objectives were to estimate the effectiveness of two protocols of local anesthesia (lidocaine and the combination of lidocaine+bupivacaine) as well as the use of meloxicam as a postoperative analgesic in alleviating castration-related pain, measured by acute physiological responses. Eight groups (15 piglets/group) were included in the study: (1) castration without anesthesia or analgesia, without meloxicam (TRAD WITHOUT), (2) castration without anesthesia or analgesia, but with meloxicam (TRAD WITH), (3) handling without meloxicam (SHAM WITHOUT), (4) handling with meloxicam (SHAM WITH), (5) castration after local anesthesia with lidocaine but without meloxicam (LIDO WITHOUT), (6) castration after local anesthesia with lidocaine and meloxicam (LIDO WITH), (7) castration after local anesthesia with lidocaine+bupivacaine without meloxicam (LIDO+BUPI WITHOUT), (8) castration after local anesthesia with lidocaine+bupivacaine and meloxicam (LIDO+BUPI WITH). Acute physiological responses measured included skin surface temperature and serum glucose and cortisol concentrations. On days 4 and 11 post-castration BW was recorded and average daily gain was calculated over this period. Furthermore, piglet mortality was recorded over the 11-day post-castration period. Administration of local anesthetic or meloxicam did not prevent the decrease in skin surface temperature associated with castration. Lidocaine reduced the increase in glucose concentration associated with castration. For castrated pigs, the joint use of lidocaine and meloxicam caused a significant decrease in cortisol concentration; the combination of intratesticular lidocaine and bupivacaine did not seem to be more effective than lidocaine alone. No effect of treatments on mortality and growth were detected.

  3. COMPARISON OF GLYCEMIC EFFECT OF ADRENALIN CONTAINING LOCAL ANESTHETIC IN DIABETIC AND NON-DIABETIC PATIENTS UNDERGOING MINOR ORAL SURGICAL PROCEDURE

    Directory of Open Access Journals (Sweden)

    Pradeep

    2015-12-01

    Full Text Available AIM To compare the changes in blood glucose level associated with administration of adrenaline containing local anesthetic in diabetic and non-diabetic patients undergoing minor oral surgical procedures. METHODS AND MATERIAL The study included 150 well controlled diabetic patients and 150 non-diabetic healthy patients in age group of 40-60 years who underwent minor oral surgical procedures (trans alveolar extractions, alveoplasty and flap surgeries. Patients in both the group were administered 1.8ml of local anesthetic agent containing 1:100,000 adrenaline for inferior alveolar nerve block and 0.2 ml of anesthetic agent for long buccal nerve block. Blood glucose levels were assessed and compared during pre-operative and one hour post-operative period. STATISTICAL ANALYSIS The comparison of the random blood sugar levels preop and postop in both the groups were compared using paired t test and RBS levels between two groups were analysed using unpaired t test. P value less than 0.05 was considered statistically significant. RESULTS No statistically significant change in post-operative blood glucose level was noted between the diabetic and non-diabetic patients. CONCLUSION The study concluded that it is safe to administer local anesthetic containing 1:100,000 adrenaline in smaller volumes to well controlled diabetic patients.

  4. Intravenous regional anesthesia: a review of common local anesthetic options and the use of opioids and muscle relaxants as adjuncts

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    Flamer D

    2011-11-01

    Full Text Available David Flamer, Philip WH PengDepartment of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, CanadaPurpose: To provide a review of local anesthetic (LA agents and adjuncts, opioids and muscle relaxants, and their intraoperative effects and postoperative outcomes in intravenous regional anesthesia (IVRA.Source: A search for prospective, double-blind, randomized controlled trials evaluating LA agents, opioids and muscle relaxants as adjuvants for IVRA, was conducted (MEDLINE®, Embase. Intraoperative benefits (onset/recovery of sensory and motor block, intraoperative analgesia, tourniquet pain, postoperative benefits (pain score, analgesic consumption, time to first analgesia, and side effects were recorded. A conclusion for overall benefit was made based on statistical significance and clinical relevance.Findings: Thirty-one studies were evaluated, with data collected on 1523 subjects. LA agents evaluated were lidocaine, ropivacaine, and prilocaine. Adjuncts evaluated were opioids (morphine, fentanyl, meperidine, sufentanil, tramadol and muscle relaxants (pancuronium, atracurium, mivacurium, cisatacurium. There was good evidence that ropivacaine provided effective IVRA and improved postoperative analgesia. Lidocaine and prilocaine were effective LA agents, however they lacked postoperative benefits. Morphine, fentanyl, and meperidine as sole adjuncts did not demonstrate clinically significant benefits or result in an increased risk of side effects. Sufentanil data was limited, but appeared to provide faster onset of sensory block. Tramadol provided faster onset of sensory block and tourniquet tolerance, however postoperative benefits were not consistent and the risk of minor side effects increased. Muscle relaxants improved the quality of motor block, but at the expense of delayed motor recovery. The combination of fentanyl and muscle relaxants can achieve an equivalent quality of IVRA with 50

  5. β–Cyclodextrin–Propyl Sulfonic Acid Catalysed One-Pot Synthesis of 1,2,4,5-Tetrasubstituted Imidazoles as Local Anesthetic Agents

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    Yan Ran

    2015-11-01

    Full Text Available Some functionalized 1,2,4,5-tetrasubstituted imidazole derivatives were synthesized using a one-pot, four component reaction involving 1,2-diketones, aryl aldehydes, ammonium acetate and substituted aromatic amines. The synthesis has been efficiently carried out in a solvent free medium using β-cyclodextrin-propyl sulfonic acid as a catalyst to afford the target compounds in excellent yields. The local anesthetic effect of these derivatives was assessed in comparison to lidocaine as a standard using a rabbit corneal and mouse tail anesthesia model. The three most potent promising compounds were subjected to a rat sciatic nerve block assay where they showed considerable local anesthetic activity, along with minimal toxicity. Among the tested analogues, 4-(1-benzyl-4,5-diphenyl-1H-imidazol-2-yl-N,N-dimethylaniline (5g was identified as most potent analogue with minimal toxicity. It was further characterized by a more favourable therapeutic index than the standard.

  6. Ion-transfer voltammetry of local anesthetics at an organic solvent/water interface and pharmacological activity vs. ion partition coefficient relationship.

    Science.gov (United States)

    Kubota, Y; Katano, H; Senda, M

    2001-01-01

    The ion-transfer reaction of local anesthetics at an organic solvent/water interface has been studied using cyclic voltammetry (CV) with a stationary nitrobenzene (NB)/water (W) interface. Procaine and seven other local anesthetics gave reversible or quasi-reversible voltammograms at the NB/W interface in the pH range between 0.9 and 9.6. These drugs are present in aqueous solution in either neutral or ionic form, or both forms. The half-wave potential, as determined by the midpoint potential in CV, vs. pH curves, were determined and analyzed to determine the partition coefficients of both neutral and ionic forms of the drugs between NB and W. The partition coefficients of the ionic forms were derived from their formal potential of transfer at an NB/W interface. The dissociation constants of ionic forms of the drugs in NB were also deduced. A high correlation between the pharmacological activity and the partition coefficient of the ionic form of amide-linked local anesthetics has been shown.

  7. Application of carbon nanosorbent for PRiME pass-through cleanup of 10 selected local anesthetic drugs in human plasma samples.

    Science.gov (United States)

    Ma, Jian-Bo; Zhao, Li-Ming; Rui, Qiu-Hong; Liao, Yu-Feng; Chen, Yan-Min; Xu, Jin; Zhu, Yan; Zhao, Yong-Gang

    2017-04-01

    A novel PRiME (process, robustness, improvements, matrix effects, ease of use) pass-through cleanup procedure has been developed to improve the existing commercially available designs. Carbon nanosorbents, i.e., magnetic modified carboxyl-graphene (Mag-CG) and magnetic modified carboxyl-carbon nanotubes (Mag-CCNTs), have been synthesised and evaluated in PRiME pass-through cleanup procedure for human plasma prior to analysis of 10 selected local anesthetic drugs by liquid chromatography-tandem quadrupole mass spectrometry (LC-MS/MS). The matrix effect, an interesting phenomenon of ion suppression for local anesthetic drugs containing ester group and ion enhancement for other drugs containing acylamino group, has been minimized using carbon nanosorbents PRiME pass-through cleanup procedure. Under the optimal conditions, the obtained results show higher cleanup efficiency of the carbon nanosorbents with recoveries between 70.2% and 126%. Furthermore, the carbon nanosorbents are also evaluated for reuse up to 80-100 times. The limits of quantification (LOQs) for local anesthetic drugs are in the range of 0.024-0.15 μg/L. Validation results on linearity, specificity, accuracy, and precision, as well as the application to the analysis of lidocaine in five patients recruited from the lung cancer demonstrate the applicability to clinical studies.

  8. Interaction of local anesthetics with a peptide encompassing the IV/S4-S5 linker of the Na+ channel.

    Science.gov (United States)

    Fraceto, Leonardo F; Oyama, Sérgio; Nakaie, Clóvis R; Spisni, Alberto; de Paula, Eneida; Pertinhez, Thelma A

    2006-08-20

    The peptide pIV/S4-S5 encompasses the cytoplasmic linker between helices S4-S5 in domain IV of the voltage-gated Na+ channel, residues 1644-1664. The interaction of two local anesthetics (LA), lidocaine and benzocaine, with pIV/S4-S5 has been studied by DOSY, heteronuclear NMR 1H-15N-HSQC spectroscopy and computational methods. DOSY indicates that benzocaine, a neutral ester, exhibits stronger interaction with pIV/S4-S5 than lidocaine, a charged amine-amide. Weighted average chemical shifts, Deltadelta(1H-15N), show that benzocaine affects residues L1653, M1655 and S1656 while lidocaine slightly perturbs residues I1646, L1649 and A1659, L1660, near the N- and C-terminus, respectively. Computational methods confirmed the stability of the benzocaine binding and the existence of two binding sites for lidocaine. Even considering that the approach of studying the peptide in the presence of a co-solvent (TFE/H2O, 30%/70% v/v) has an inherently limited implication, our data strongly support the existence of multiple LA binding sites in the IV/S4-S5 linker, as suggested in the literature. In addition, we consider that LA can bind to the S4-S5 linker with diverse binding modes and strength since this linker is part of the receptor for the "inactivation gate particle". Conditions for devising new functional studies, aiming to better understand Na+ channel functionality as well as the various facets of LA pharmacological activity are proposed in this work.

  9. Molecular insights into the local anesthetic receptor within voltage-gated sodium channels using hydroxylated analogues of mexiletine

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    Jean-François eDesaphy

    2012-02-01

    Full Text Available We previously showed that the β-adrenoceptor modulators, clenbuterol and propranolol, directly blocked voltage-gated sodium channels, whereas salbutamol and nadolol did not (Desaphy et al., 2003, suggesting the presence of two hydroxyl groups on the aromatic moiety of the drugs as a molecular requisite for impeding sodium channel block. To verify such an hypothesis, we synthesized five new mexiletine analogues by adding one or two hydroxyl groups to the aryl moiety of the sodium channel blocker and tested these compounds on hNav1.4 channels expressed in HEK293 cells. Concentration-response relationships were constructed using an holding potential of -120 mV at 0.1 Hz (tonic block and 10 Hz (use-dependent block stimulation frequencies. The half-maximum inhibitory concentrations (IC50 were linearly correlated to drug lipophilicity: the less lipophilic the drug, minor was the block. The same compounds were also tested on F1586C and Y1593C hNav1.4 channel mutants, to gain further information on the molecular interactions of mexiletine with its receptor within the sodium channel pore. Alteration of tonic block suggests that the aryl moiety of mexiletine may interact either directly or indirectly with Phe1586 in the closed sodium channel to produce low-affinity binding block, and that this interaction depends on the electrostatic potential of the drug aromatic tail. Alteration of use-dependent block suggests that addition of hydroxyl groups to the aryl moiety may modify high-affinity binding of the drug ammine terminal to Phe1586 through cooperativity between the two pharmacophores, this effect being mainly related to drug lipophilicity. Mutation of Tyr1593 further impaired such cooperativity. In conclusion, these results confirm our former hypothesis showing that the presence of hydroxyl groups to the aryl moiety of mexiletine greatly reduced sodium channel block, and provide molecular insights into the intimate interaction of local anesthetics with

  10. Inhibition of brain cell excitability by lidocaine, QX314, and tetrodotoxin: a mechanism for analgesia from infused local anesthetics?

    Science.gov (United States)

    Butterworth, J; Cole, L; Marlow, G

    1993-07-01

    Local anesthetic infusions have been used to provide analgesia in a variety of painful conditions. The mechanism for this drug effect remains unknown. To better define the electrical effects of lidocaine concentrations comparable to those obtained during analgesic infusions, lidocaine (0.05-3 mmol.l-1), QX314 (an obligatorily charged, quaternary lidocaine derivative applied within the cells), and tetrodotoxin (10 mmol.l-1) were applied to rat hippocampal pyramidal cells. The three drugs, which inhibit Na+ currents by varying mechanisms, produced tonic increases in (firing) current threshold, and decreases in the amplitude of action potentials measured using an intracellular microelectrode technique. Lidocaine inhibited action potential spikes and increased current threshold in a concentration-dependent fashion. Lidocaine 50 and 100 mumol.l-1 did not inhibit action potentials, but increased firing threshold by nearly 100%. Lidocaine 1-3 mmol.l-1 significantly inhibited action potential amplitude and increased threshold by as much as 800%. Similarly, QX314 and tetrodotoxin produced greater increases in current threshold than in action potential amplitude. QX314 produced phasic (or frequency-dependent) block during trains of stimuli at 1 Hz, even when almost no tonic block was present. Lidocaine produced less phasic block than QX314, and required both greater tonic block and more frequent stimulation to produce the phenomenon. Tetrodotoxin demonstrated no phasic block. Increases in current threshold occurred in lidocaine concentrations associated with analgesia and toxicity; inhibition of action potentials occurred scarcely at all at these concentrations. Thus, tonic increases in current threshold may underlie analgesia and supplementation of general anesthesia by intravenous lidocaine.

  11. Anti-metastatic Potential of Amide-linked Local Anesthetics: Inhibition of Lung Adenocarcinoma Cell Migration and Inflammatory Src Signaling Independent of Sodium Channel Blockade

    Science.gov (United States)

    Piegeler, Tobias; Votta-Velis, E. Gina; Liu, Guoquan; Place, Aaron T.; Schwartz, David E.; Beck-Schimmer, Beatrice; Minshall, Richard D.; Borgeat, Alain

    2012-01-01

    Background Retrospective analysis of patients undergoing cancer surgery suggests the use of regional anesthesia may reduce cancer recurrence and improve survival. Amide-linked local anesthetics have anti-inflammatory properties, although the mechanism of action in this regard is unclear. As inflammatory processes involving Src tyrosine protein kinase and intercellular adhesion molecule-1 are important in tumor growth and metastasis, we hypothesized that amide-linked local anesthetics may inhibit inflammatory Src-signaling involved in migration of adenocarcinoma cells. Methods NCI-H838 lung cancer cells were incubated with Tumor Necrosis Factor-α in absence/presence of ropivacaine, lidocaine, or chloroprocaine (1nM-100μM). Cell migration and total cell lysate Src-activation and Intercellular Adhesion Molecule-1 phosphorylation were assessed. The role of voltage-gated sodium-channels in the mechanism of local anesthetic effects was also evaluated. Results Ropivacaine treatment (100μM) of H838 cells for 20 minutes decreased basal Src activity by 62% (p=0.003), and both ropivacaine and lidocaine co-administered with Tumor Necrosis Factor-α statistically significantly decreased Src-activation and Intercellular Adhesion Molecule-1 phosphorylation, whereas chloroprocaine had no such effect. Migration of these cells at 4 hours was inhibited by 26% (p=0.005) in presence of 1μM ropivacaine and 21% by 1μM lidocaine (p=0.004). These effects of ropivacaine and lidocaine were independent of voltage-gated sodium-channel inhibition. Conclusions This study indicates that amide-, but not ester-linked local anesthetics may provide beneficial anti-metastatic effects. The observed inhibition of NCI-H838 cell migration by lidocaine and ropivacaine was associated with the inhibition of Tumor Necrosis Factor-α-induced Src-activation and Intercellular Adhesion Molecule-1 phosphorylation, providing the first evidence of a molecular mechanism which appears to be independent of their

  12. Lumbar segmental nerve blocks with local anesthetics, pain relief, and motor function: a prospective double-blind study between lidocaine and ropivacaine.

    Science.gov (United States)

    Wolff, André P; Wilder Smith, Oliver H G; Crul, Ben J P; van de Heijden, Marc P; Groen, Gerbrand J

    2004-08-01

    Selective segmental nerve blocks with local anesthetics are applied for diagnostic purposes in patients with chronic back pain to determine the segmental level of the pain. We performed this study to establish myotomal motor effects after L4 spinal nerve blocks by lidocaine and ropivacaine and to evaluate the relationship with pain. Therefore, 20 patients, of which 19 finished the complete protocol, with chronic lumbosacral radicular pain without neurological deficits underwent segmental nerve blocks at L4 with both lidocaine and ropivacaine. Pain intensity scores (verbal numeric rating scale; VNRS) and the maximum voluntary muscle force (MVMF; using a dynamometer expressed in newtons) of the tibialis anterior and quadriceps femoris muscles were measured on the painful side and on the control side. The median VNRS decrease was 4.0 (P control side (P = 0.016; Tukey test). Multiple regression revealed a significant negative correlation for change in VNRS score versus change in median MVMF (Spearman R = -0.48: P = 0.00001). This study demonstrates that in patients with unilateral chronic low back pain radiating to the leg, pain reduction induced by local anesthetic segmental nerve (L4) block is associated with increased quadriceps femoris and tibialis anterior MVMF, without differences for lidocaine and ropivacaine.

  13. Enhancement of the 1-Octanol/Water Partition Coefficient of the Anti-Inflammatory Indomethacin in the Presence of Lidocaine and Other Local Anesthetics.

    Science.gov (United States)

    Tateuchi, Ryo; Sagawa, Naoki; Shimada, Yohsuke; Goto, Satoru

    2015-07-30

    Side effects and excessive potentiation of drug efficacy caused by polypharmacy are becoming important social issues. The apparent partition coefficient of indomethacin (log P'IND) increases in the presence of lidocaine, and this is used as a physicochemical model for investigating polypharmacy. We examined the changes in log P'IND caused by clinically used local anesthetics-lidocaine, tetracaine, mepivacaine, bupivacaine, and dibucaine-and by structurally similar basic drugs-procainamide, imipramine, and diltiazem. The quantitative structure-activity relationship study of log P'IND showed that the partition coefficient values (log PLA) and the structural entropic terms (ΔSobs, log f) of the additives affect log P'IND. These results indicate that the local anesthetics and structurally similar drugs function as phase-transfer catalysts, increasing the membrane permeability of indomethacin via heterogeneous intermolecular association. Therefore, we expect that the potency of indomethacin, an acidic nonsteroidal anti-inflammatory drug, will be increased by concurrent administration of the other drugs.

  14. Multi-regional local anesthetic infiltration during laparoscopic cholecystectomy in patients receiving prophylactic multi-modal analgesia: a randomized, double-blinded, placebo-controlled study

    DEFF Research Database (Denmark)

    Bisgaard, T; Klarskov, B; Kristiansen, V B;

    1999-01-01

    Pain is the dominant complaint after laparoscopic cholecystectomy. No study has examined the combined effects of a somato-visceral blockade during laparoscopic cholecystectomy. Therefore, we investigated the effects of a somato-visceral local anesthetic blockade on pain and nausea in patients...... undergoing elective laparoscopic cholecystectomy. In addition, all patients received multi-modal prophylactic analgesic treatment. Fifty-eight patients were randomized to receive a total of 286 mg (66 mL) ropivacaine or 66 mL saline via periportal and intraperitoneal infiltration. During the first 3...... postoperative h, the use of morphine and antiemetics was registered, and pain and nausea were rated hourly. Daily pain intensity, pain localization, and supplemental analgesic consumption were registered the first postoperative week. Ropivacaine reduced overall pain the first two hours and incisional pain...

  15. Studies concerning the interaction between local anesthetics and lipid membrane by phosphorus-31, deuterium and proton NMR; Estudo da interacao entre anestesicos locais e membranas lipidicas por ressonancia magnetica de fosforo ({sup 31} P), deuterio ({sup 2} H) e proton ({sup 1} H)

    Energy Technology Data Exchange (ETDEWEB)

    Paula, Eneida de [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Dept. de Bioquimica; Jarrell, Harold C. [National Research Council of Canada, Ottawa, ON (Canada). Inst. for Biological Sciences; Schreier, Shirley [Sao Paulo Univ., SP (Brazil). Inst. de Quimica

    1993-12-31

    Local anesthetics block the conduction of nervous stimulus by impeding the entrance of sodium ion and the consequently depolarization of the nervous membrane. The action mechanism of local anesthetics, however, is not fully understood yet. In the present work the interaction between local anesthetics and membranes are studied by the perspective of lipid phase perturbation using NMR to elucidate the mechanism. Results are presented and discussed 5 refs., 1 fig., 1 tab.

  16. Inhibition of human two-pore domain K+ channel TREK1 by local anesthetic lidocaine: negative cooperativity and half-of-sites saturation kinetics.

    Science.gov (United States)

    Nayak, Tapan K; Harinath, S; Nama, S; Somasundaram, K; Sikdar, S K

    2009-10-01

    TWIK-related K+ channel TREK1, a background leak K+ channel, has been strongly implicated as the target of several general and local anesthetics. Here, using the whole-cell and single-channel patch-clamp technique, we investigated the effect of lidocaine, a local anesthetic, on the human (h)TREK1 channel heterologously expressed in human embryonic kidney 293 cells by an adenoviral-mediated expression system. Lidocaine, at clinical concentrations, produced reversible, concentration-dependent inhibition of hTREK1 current, with IC(50) value of 180 muM, by reducing the single-channel open probability and stabilizing the closed state. We have identified a strategically placed unique aromatic couplet (Tyr352 and Phe355) in the vicinity of the protein kinase A phosphorylation site, Ser348, in the C-terminal domain (CTD) of hTREK1, that is critical for the action of lidocaine. Furthermore, the phosphorylation state of Ser348 was found to have a regulatory role in lidocaine-mediated inhibition of hTREK1. It is interesting that we observed strong intersubunit negative cooperativity (Hill coefficient = 0.49) and half-of-sites saturation binding stoichiometry (half-reaction order) for the binding of lidocaine to hTREK1. Studies with the heterodimer of wild-type (wt)-hTREK1 and Delta119 C-terminal deletion mutant (hTREK1(wt)-Delta119) revealed that single CTD of hTREK1 was capable of mediating partial inhibition by lidocaine, but complete inhibition necessitates the cooperative interaction between both the CTDs upon binding of lidocaine. Based on our observations, we propose a model that explains the unique kinetics and provides a plausible paradigm for the inhibitory action of lidocaine on hTREK1.

  17. DOES THE ADDITION OF DEXAMETHASON TO LOCAL ANESTHETIC PROLONG THE ANALGESIA OF INTERSCALEN PLEXUS BRACHIALIS BLOCK IN PATIENTS WITH SHOULDER SURGERY?

    Directory of Open Access Journals (Sweden)

    Nancheva Jasminka

    2016-07-01

    Full Text Available Abstract: Introduction: Peripherial nerve blocks is a suitable alternative to general anesthesia especially for one-day case surgery. Interscalene approach of plexus brachialis block as much as supraclavicular and infraclavicular provide reliable, safe, effective, low cost and most complete anesthesia with satisfactory postoperative analgesia for upper limb surgery. Postoperative analgesia of plexus brachialis blocks can be prolonged by using different drugs as adjuvants with local anesthetics. Dexamethasone has been shown to prolong the duration of postoperative analgesia when given as an adjunct for peripheral nerve blocks. The investigation was randomized, prospective, double blinded and controlled study. Objective: The study was designed to compare the effects of dexamethasone administered as an adjunct to bupivacaine in interscalene brachial plexus block on the onset, duration and postoperative analgesia in patients under the shoulder surgery. Methods: A prospective, double-blind study was undertaken in patients scheduled for shoulder surgeries under the interscalene brachial plexus block. We enrolled 60 patients, ASA I-II both sexes, aged 19-65 years, weighing 54-89 kg, divided to two groups G1 and G2. The brachial plexus block was performed by interscalene approach and mixture of 2% lidocaine (12ml and 0.5% bupivacaine (22 ml either alone or combined with dexamethasone (4 mg. The block was performed by using double technique neurostimulator/ultrasound technique. Results: In our investigation we found a significant increase in onset and duration of motor and sensory block in Group G2 (with dexamethasone as compared to Group G1 patients (p < 0.01. Conclusion: Addition of dexamethasone to local anesthetic drugs in interscalene plexus brachialis block, significantly prolongs the duration of analgesia and motor block in patients undergoing shoulder arthroscopy. Moreover, it is a remarkably safe and costeffective method of providing

  18. Hypnotic Actions of Local Anesthetics in Mice%局部麻醉药对小鼠催眠作用的研究

    Institute of Scientific and Technical Information of China (English)

    阿里·塞德; 孟庆涛; 夏中元; 陈向东

    2012-01-01

    目的:研究局部麻醉药的全身麻醉作用及其基本机制.方法:C57BL/6小鼠通过尾静脉分别注射利多卡因、布比卡因和罗哌卡因,同时使用或不使用氯胺酮、钠通道阻滞剂TTX和NMDA受体阻滞剂MK-801.通过翻正反射的消失(LORR)来评估这些药物对小鼠的催眠作用.结果:局部麻醉药利多卡因(15 mg/kg),布比卡因(5mg/kg),罗哌卡因(5 mg/kg)的全身应用均可产生直接的催眠作用,并达到其半数有效浓度(EC50).利多卡因可以增强氯胺酮的催眠作用(达到EC50的氯胺酮+利多卡因),表明了利多卡因和氯胺酮的联合使用可以增强其对小鼠的催眠作用.而钠通道阻滞剂不能改变利多卡因的催眠作用.NMDA受体阻滞剂(11-15 mg/kg)可增强并达到EC50利多卡因的LORR.结论:局部麻醉药可以产生直接的催眠作用,全身麻醉药氯胺酮可增强其麻醉效应,而钠通道阻滞剂则不能,NMDA受体阻滞剂可增强利多卡因的催眠作用.%Objective:. To investigate the systemic action of local anesthetics and their underlying mechanisms. Methods: Lidocaine, bupivacaine, and ropivacaine respectively were injected into C57BL/ 6 mice through tail vein intravenously, and loss of righting reflex (LORR) was used to evaluate the hypnotic action of these drugs with or without ketamine, sodium channel blocker TTX and NMDA receptor blocker MK-801. Results: Systemic application of all three local anesthetics directly produced hypnotic action with half effective concentration (EC50) of 15 mg/kg for lidocaine and 5 mg/kg for bupivacaine and ropivacaine. Lidocaine also enhanced the hypnotic action of ketamine, yielding an EC50 fraction of ketamine plus lidocaine of 1. 09, which suggested that lidocaine and ketamine have additive hypnotic action in mice. Blocking of sodium channel by TTX failed to alter hypnotic action of lidocaine. Blocking of NMDA receptor enhanced the LORR of lidocaine with EC50 from 11 mg/kg to 15 mg/kg. Conclusion

  19. Effect of local anesthetic volume (15 vs 40 mL) on the duration of ultrasound-guided single shot axillary brachial plexus block: a prospective randomized, observer-blinded trial

    NARCIS (Netherlands)

    Schoenmakers, K.P.; Wegener, J.T.; Stienstra, R.

    2012-01-01

    BACKGROUND AND OBJECTIVES: One of the advantages of ultrasound-guided peripheral nerve block is that visualization of local anesthetic spread allows for a reduction in dose. However, little is known about the effect of dose reduction on sensory and motor block duration. The purpose of the present st

  20. A Randomized Controlled Trail Comparing the Efficacy of 0.5% Centbucridine to 2% Lignocaine as Local Anesthetics in Dental Extractions

    Directory of Open Access Journals (Sweden)

    Samir Mansuri

    2011-01-01

    Full Text Available The development of local anesthesia in dentistry has marked the beginning of a new era in terms of pain control. Lignocaine is the most commonly used local anesthetic (LA agent even though it has a vasodilative effect and needs to be combined with adrenaline. Centbucridine is a non-ester, non amide group LA and has not been comprehensively studied in the dental setting and the objective was to compare it to Lignocaine. This was a randomized study comparing the onset time, duration, depth and cardiovascular parameters between Centbucridine (0.5% and Lignocaine (2%. The study was conducted in the dental outpatient department at the Government Dental College in India on patients attending for the extraction of lower molars. A total of 198 patients were included and there were no significant differences between the LAs except those who received Centbucridine reported a significantly longer duration of anesthesia compared to those who received Lignocaine. None of the patients reported any side effects. Centbucridine was well tolerated and its substantial duration of anesthesia could be attributed to its chemical compound. Centbucridine can be used for dental procedures and can confidently be used in patients who cannot tolerate Lignocaine or where adrenaline is contraindicated.

  1. Anesthetics interacting with lipid rafts.

    Science.gov (United States)

    Bandeiras, Cátia; Serro, Ana Paula; Luzyanin, Konstantin; Fernandes, Anabela; Saramago, Benilde

    2013-01-23

    The exact mechanism by which anesthetics induce cell membrane-mediated modifications is still an open question. Although the fluidization effect of the anesthetic molecules on the cellular membrane is widely recognized, it is not known if anesthetics show any preference for specific membrane domains, namely the lipid rafts. The importance of these membrane micro-domains derives from the fact that they have been associated with cell signaling pathways, as well as with specific drug interactions. The objective of this work is to contribute for the elucidation of this question through the comparison of the anesthetic interactions with membranes of various lipid compositions. Liposomes prepared with an equimolar mixture of POPC, sphingomyelin and cholesterol, were chosen as models for lipid rafts. The interactions of these liposomes with two local anesthetics, tetracaine and lidocaine, and one general anesthetic, propofol, were studied. The effect of cholesterol was investigated by comparing anesthetic interactions with POPC/SM liposomes and POPC/SM/CHOL liposomes. The following experimental techniques were used: quartz crystal microbalance with dissipation, differential scanning calorimetry and phosphorus nuclear magnetic resonance. Although the liposomes investigated by the different techniques are not in the same conditions, it is possible to assemble the information obtained from all experimental techniques employed to reach a general conclusion. Tetracaine interacts more with raftlike domains, lidocaine induces stronger modifications on POPC/SM liposomes and the results for propofol are not fully conclusive but it seems to be the least prone to lipid interactions. The results were compared with those obtained with DMPC-containing liposomes, reported in a previous work.

  2. Side effects of subarachnoid and epidural sufentanil associated with a local anesthetic in patients undergoing labor analgesia

    OpenAIRE

    Salem, Isabel C.F. [UNESP; Fernanda B. Fukushima; Giane Nakamura; Fábio Ferrari; Navarro,Laís C.; Yara Marcondes Machado Castiglia; Eliana Marisa Ganem

    2007-01-01

    JUSTIFICATIVA E OBJETIVOS: A associação do opióide ao anestésico local melhora a qualidade da analgesia de parto e reduz o risco de toxicidade sistêmica pelo anestésico local. Os opióides, entretanto, podem determinar efeitos colaterais. O objetivo desta pesquisa foi comparar os efeitos adversos determinados pelo sufentanil, administrado por via subaracnóidea, associado à bupivacaína, com aquele determinado pelo sufentanil por via peridural, associado à ropivacaína, nas doses utilizadas no Se...

  3. Novel serine-based gemini surfactants as chemical permeation enhancers of local anesthetics: A comprehensive study on structure-activity relationships, molecular dynamics and dermal delivery.

    Science.gov (United States)

    Teixeira, Raquel S; Cova, Tânia F G G; Silva, Sérgio M C; Oliveira, Rita; do Vale, M Luísa C; Marques, Eduardo F; Pais, Alberto A C C; Veiga, Francisco J B

    2015-06-01

    This work aims at studying the efficacy of a series of novel biocompatible, serine-based surfactants as chemical permeation enhancers for two different local anesthetics, tetracaine and ropivacaine, combining an experimental and computational approach. The surfactants consist of gemini molecules structurally related, but with variations in headgroup charge (nonionic vs. cationic) and in the hydrocarbon chain lengths (main and spacer chains). In vitro permeation and molecular dynamics studies combined with cytotoxicity profiles were performed to investigate the permeation of both drugs, probe skin integrity, and rationalize the interactions at molecular level. Results show that these enhancers do not have significant deleterious effects on the skin structure and do not cause relevant changes on cell viability. Permeation across the skin is clearly improved using some of the selected serine-based gemini surfactants, namely the cationic ones with long alkyl chains and shorter spacer. This is noteworthy in the case of ropivacaine hydrochloride, which is not easily administered through the stratum corneum. Molecular dynamics results provide a mechanistic view of the surfactant action on lipid membranes that essentially corroborate the experimental observations. Overall, this study suggests the viability of these serine-based surfactants as suitable and promising delivery agents in pharmaceutical formulations.

  4. 脂肪乳用于长效局麻药中毒的救治%Employment of lipid emulsion in the resuscitation for long-acting local anesthetic toxirity

    Institute of Scientific and Technical Information of China (English)

    张鸿飞; 徐世元

    2009-01-01

    There are no effective and convenient therapeutic management on refractory cardiac arrest induced by long-acting local anesthetic toxicity. Although there are no any randomly controlled trials showing the effectiveness of lipid emulsion for anesthetic toxicity resuscitation in human beings mostly because of ethic issues, lipid emulsion has been proved to be effective in animal models undergoing local anesthetic toxicity. This novel approach to treating potentially fatal cardiac toxicity is still at an early stage but holds promise for clinical application. Literatures suggest that lipid emulsion resuscitation should be as a reserve step because of lacking clinical investigative evidence. However, more and more case reports indicate that lipid emulsion should be used earlier in order to avoid local anesthetic toxicity deteriorated. Further work is required to explore mechanism of lipid emulsion on resuscitation of local anesthetic toxicity and optimize the treatment regimens with respect to efficacy and safety of lipid rescue.%长效局麻药(local anesthetic,LA)中毒所致顽固性心跳骤停,目前临床尚无有效便捷的治疗方法.动物研究发现静脉注射脂肪乳(lipid emulsion,LE)可治疗布比卡因所致心跳骤停.因尚缺乏有力的临床研究证据支持,文献建议LE作为LA心脏毒性标准心肺复苏的备用措施.但多例个案报道提示,一旦出现LA毒性症状,应尽早使用LE救治,以避免LA毒性综合征的发展.未来的研究方向应致力于探索LE救治有效性的确切机制,寻求临床适用的最佳使用方法,确立治疗标准.

  5. 脂肪酸逆转局麻药心肌毒性的药理机制研究进展%Progress in Pharmacological Mechanism for the Role of Fatty Acid in Reversal of Myocardial Toxicity of Local Anesthetics

    Institute of Scientific and Technical Information of China (English)

    高晶; 刘超

    2014-01-01

    目前尚没有特异的局麻药解毒剂,严重阻碍了临床治疗效果,寻找有效的局麻药解毒剂日益紧迫。本文从脂肪池、能量代谢、NO、离子通道和增溶作用来诠释脂肪酸逆转局麻药心肌毒性的分子药理学机制,并比较了纳米脂质体与普通脂肪乳剂结构和功能上的不同的特点。%At present, there is no specific antidote for local anesthetic toxicity, which seriously hindered therapeutic efficts of clinical treatment. It is increasingly urgent for finding find the effective antidote to local anesthetic. This article at-tempts to interpret the molecular pharmacological mechanism from fat pool, energy metabolism, NO, ion channel and solubili-zation for the role of fatty acids in reversal of myocardial toxicity of local anesthetics. And the different characteristics of the structure and function of nano liposome and fat emulsion were compared.

  6. 计算机控制局部麻醉系统的应用研究%Application of computer-controlled local anesthetic delivery

    Institute of Scientific and Technical Information of China (English)

    刘艳梅; 刘楠; 李馨

    2013-01-01

      Objective Evaluation on the effect of single tooth anesthesia(STA) computer-controlled local anes-thetic delivery in tooth extraction to the patients with dental anxiety and cardiovascular disease. Methods Two groups were included. In the experimental group, STA was used, and in the control group, hand injection was performed. Anxiety level before and after injection was evaluated with modified dental anxiety scale. The level of pain during injection was assessed with visual analogue scale by patients after injection. Blood pressure and heart rate were observed before, during and after injection. Results The visual analogue scale value showed a statistical difference between the experimental group and the control group. After injection, 86.11% patients in experimental group were decreased about the incidence rate of scores, which was significiantly superior to control group. No changes in blood pressure and heart rate were found before, during and after injection in the experimental group. The blood pressure increased significantly during injection in the control group. Conclusion STA computer-con-trolled local anesthetic delivery can abate the inject pain and anxiety level, reduce the risk in the operation.%  目的评价单颗牙麻醉(STA)计算机辅助口腔局部麻醉技术应用于伴有牙科焦虑的心血管病患者拔牙时的效果。方法试验分为2组,试验组使用STA进行局部麻醉注射,对照组采用手动注射方式。采用改良牙科焦虑量表评定患者局部麻醉前后的牙科焦虑状况。注射后由患者本人用视觉模拟标尺表评价注射时的疼痛程度。监测麻醉前、中、后患者的血压和心率。结果2组注射时的疼痛评分存在统计学差异。试验组麻醉后有86.11%的患者焦虑评分下降,与对照组相比,两者麻醉前后焦虑变化差异显著。试验组麻醉前、中、后血压和心率变化差异无统计学意义。但是,对照组麻醉中

  7. Tetrodotoxin-sensitive α-subunits of voltage-gated sodium channels are relevant for inhibition of cardiac sodium currents by local anesthetics.

    Science.gov (United States)

    Stoetzer, C; Doll, T; Stueber, T; Herzog, C; Echtermeyer, F; Greulich, F; Rudat, C; Kispert, A; Wegner, F; Leffler, A

    2016-06-01

    The sodium channel α-subunit (Nav) Nav1.5 is regarded as the most prevalent cardiac sodium channel required for generation of action potentials in cardiomyocytes. Accordingly, Nav1.5 seems to be the main target molecule for local anesthetic (LA)-induced cardiotoxicity. However, recent reports demonstrated functional expression of several "neuronal" Nav's in cardiomyocytes being involved in cardiac contractility and rhythmogenesis. In this study, we examined the relevance of neuronal tetrodotoxin (TTX)-sensitive Nav's for inhibition of cardiac sodium channels by the cardiotoxic LAs ropivacaine and bupivacaine. Effects of LAs on recombinant Nav1.2, 1.3, 1.4, and 1.5 expressed in human embryonic kidney cell line 293 (HEK-293) cells, and on sodium currents in murine, cardiomyocytes were investigated by whole-cell patch clamp recordings. Expression analyses were performed by reverse transcription PCR (RT-PCR). Cultured cardiomyocytes from neonatal mice express messenger RNA (mRNA) for Nav1.2, 1.3, 1.5, 1.8, and 1.9 and generate TTX-sensitive sodium currents. Tonic and use-dependent block of sodium currents in cardiomyocytes by ropivacaine and bupivacaine were enhanced by 200 nM TTX. Inhibition of recombinant Nav1.5 channels was similar to that of TTX-resistant currents in cardiomyocytes but stronger as compared to inhibition of total sodium current in cardiomyocytes. Recombinant Nav1.2, 1.3, 1.4, and 1.5 channels displayed significant differences in regard to use-dependent block by ropivacaine. Finally, bupivacaine blocked sodium currents in cardiomyocytes as well as recombinant Nav1.5 currents significantly stronger in comparison to ropivacaine. Our data demonstrate for the first time that cardiac TTX-sensitive sodium channels are relevant for inhibition of cardiac sodium currents by LAs.

  8. Exploring the structure of the voltage-gated Na+ channel by an engineered drug access pathway to the receptor site for local anesthetics.

    Science.gov (United States)

    Lukacs, Peter; Gawali, Vaibhavkumar S; Cervenka, Rene; Ke, Song; Koenig, Xaver; Rubi, Lena; Zarrabi, Touran; Hilber, Karlheinz; Stary-Weinzinger, Anna; Todt, Hannes

    2014-08-01

    Despite the availability of several crystal structures of bacterial voltage-gated Na(+) channels, the structure of eukaryotic Na(+) channels is still undefined. We used predictions from available homology models and crystal structures to modulate an external access pathway for the membrane-impermeant local anesthetic derivative QX-222 into the internal vestibule of the mammalian rNaV1.4 channel. Potassium channel-based homology models predict amino acid Ile-1575 in domain IV segment 6 to be in close proximity to Lys-1237 of the domain III pore-loop selectivity filter. The mutation K1237E has been shown previously to increase the diameter of the selectivity filter. We found that an access pathway for external QX-222 created by mutations of Ile-1575 was abolished by the additional mutation K1237E, supporting the notion of a close spatial relationship between sites 1237 and 1575. Crystal structures of bacterial voltage-gated Na(+) channels predict that the side chain of rNaV1.4 Trp-1531 of the domain IV pore-loop projects into the space between domain IV segment 6 and domain III pore-loop and, therefore, should obstruct the putative external access pathway. Indeed, mutations W1531A and W1531G allowed for exceptionally rapid access of QX-222. In addition, W1531G created a second non-selective ion-conducting pore, bypassing the outer vestibule but probably merging into the internal vestibule, allowing for control by the activation gate. These data suggest a strong structural similarity between bacterial and eukaryotic voltage-gated Na(+) channels.

  9. Point mutations at the local anesthetic receptor site modulate the state-dependent block of rat Na v1.4 sodium channels by pyrazoline-type insecticides.

    Science.gov (United States)

    Silver, Kristopher S; Soderlund, David M

    2007-05-01

    Pyrazoline-type insecticides (PTIs) selectively block sodium channels at membrane potentials that promote slow sodium channel inactivation and are proposed to interact with a site that overlaps the local anesthetic (LA) receptor site. Mutagenesis studies identified two amino acid residues in the S6 segment of homology domain IV (Phe-1579 and Tyr-1586 in the rat Na(v)1.4 sodium channel) as principal elements of the LA receptor. To test the hypothesis that PTIs bind to the LA receptor, we constructed mutated Na(v)1.4/F1579A and Na(v)1.4/Y1586A cDNAs, expressed native and mutated channels in Xenopus oocytes, and examined the effects of these mutations on channel block by three PTIs (indoxacarb, its bioactivation product DCJW, and RH3421) by two-electrode voltage clamp. DCJW and RH3421 had no effect on Na(v)1.4 channels held at -120mV but caused a slowly developing block upon depolarization to -30mV. Estimated IC(50) values following 15min of exposure were 1 and 4muM for DCJW and RH3421, respectively. Indoxacarb failed to block Na(v)1.4 channels under all experimental conditions. Sensitivity to block by DCJW and RH3421 at -30mV was significantly reduced in Na(v)1.4/F1579A channels, a finding that is consistent with the impact of this mutation on drug binding. In contrast to its effect on drug binding, the Y1586A mutation increased the sensitivity of Na(v)1.4 channels held at -30mV to all three compounds, conferring modest sensitivity to indoxacarb and increasing sensitivity to DCJW and RH3421 by 58- and 16-fold, respectively. These results provide direct evidence for the action of PTIs at the LA receptor.

  10. Comparison of interscalene brachial plexus block and intra-articular local anesthetic administration on postoperative pain management in arthroscopic shoulder surgery

    Directory of Open Access Journals (Sweden)

    Recep Aksu

    2015-06-01

    Full Text Available BACKGROUND AND OBJECTIVES: In this study, the aim was to compare postoperative analgesia effects of the administration of ultrasound-guided interscalene brachial plexus block and intra-articular bupivacaine carried out with bupivacaine. METHODS: In the first group of patients 20 mL 0.25% bupivacaine and ultrasound-guided interscalene brachial plexus block (ISPB were applied, while 20 mL 0.25% bupivacaine was given via intra-articular (IA administration to the second group patients after surgery. Patients in the third group were considered the control group and no block was performed. Patient-controlled analgesia (PCA with morphine was used in all three groups for postoperative analgesia. RESULTS: In the ISPB group, morphine consumption in the periods between 0-4, 6-12 and 12-24 postoperative hours and total consumption within 24 h was lower than in the other two groups. Morphine consumption in the IA group was lower than in the control group in the period from 0 to 6 h and the same was true for total morphine consumption in 24 h. Postoperative VASr scores in the ISPB group were lower than both of the other groups in the first 2 h and lower than the control group in the 4th and 6th hours (p < 0.05. In the IA group, VASr and VASm scores in the 2nd, 4th and 6th hours were lower than in the control group (p < 0.05. CONCLUSION: Interscalene brachial plexus block was found to be more effective than intra-articular local anesthetic injection for postoperative analgesia.

  11. Influence of topical application of capsaicin, menthol and local anesthetics on intraoral somatosensory sensitivity in healthy subjects: temporal and spatial aspects.

    Science.gov (United States)

    Naganawa, Takuya; Baad-Hansen, Lene; Ando, Tomohiro; Svensson, Peter

    2015-04-01

    The aim of this study was to investigate temporal and spatial aspects of somatosensory changes after topical application of capsaicin, menthol and local anesthetics (LA) on the gingiva with the use of intraoral palpometers and thermal devices. Sixteen healthy volunteers (eight male, eight female) participated. Four topical preparations (capsaicin, menthol, LA and Vaseline as a control) were randomly applied to the gingiva around the first premolar in the upper jaw via individual oral templates, which allowed spatial mapping of somatosensory changes at and adjacent to the site of application. The topical drugs were applied for 15 min in a randomized and balanced sequence. The perceived preparation-evoked pain intensity was recorded with the use of 0-10 visual analog scales (VAS). Standardized mechanical and thermal stimuli were applied before, during and up to 30 min after the topical applications, and numerical rating scales (NRS) were used to score the perceived intensity of the stimuli. Peak VAS, area under the curve and mean VAS preparation-evoked pain scores for capsaicin, menthol, LA and control were compared with paired t tests. NRS scores for mechanical and thermal test stimuli were analyzed with four-way repeated measurements analyses of variance. Capsaicin evoked significantly higher VAS pain parameters as well as higher NRS scores to heat stimuli than control (P capsaicin caused sensitization to heat stimuli at and adjacent to the application area. In conclusion, this study for the first time demonstrates the time course of capsaicin-evoked heat hyperalgesia in and outside the site of application at the oral mucosa (primary and secondary hyperalgesia).

  12. [Facial locoregional anesthetics: principles and precautions].

    Science.gov (United States)

    Lefort, H; Lacroix, G; Cordier, A; Bey, E; Duhamel, P

    2009-12-01

    Facial locoregional anesthetics (ALR) with nervous blocks are simple and reliable to perform, need little technical resources with a very low iatrogenic risk. These blocks allow anesthesia without deforming wound banks using the same materials as usual local anesthetic procedures. Three principal nervous blocks, in a straight line along the vertical pupil axis, allow managing - even extensive - facial wounds. Few side effects may occur which can be easily prevented. It is a good alternative to local anesthetic for the treatment of extensive and deep areas which is performed with a lower number of injections and a high rate of success. These techniques are easy to learn and practise. These anesthetic techniques allow a nice treatment of different kinds of facial wounds from simple suture to flaps.

  13. Effect of buprenorphine as an adjunct with plain local anesthetic solution in supraclavicular brachial plexus block on quality and duration of postoperative analgesia

    Directory of Open Access Journals (Sweden)

    Surekha Patil

    2015-01-01

    Full Text Available Background and Aims: Supraclavicular brachial plexus block is ideal for upper limb surgical procedures. Buprenorphine, an agonist antagonist opioid has been used as an adjunct to prolong analgesia. We aimed to evaluate the quality and duration of postoperative analgesia by addition of buprenorphine to local anesthetic solution. Material and Methods: A prospective, randomized, double-blind control study was conducted on 50 healthy patients of ASA Grade I/II of age group 20-70 years scheduled for orthopedic and reconstructive surgery of upper limb under supraclavicular brachial plexus block. Patients were allocated into two groups, 25 in each group viz.: Group B (buprenorphine group received 20 ml 0.5% bupivacaine + 15 ml 2% lignocaine with adrenaline (1:200,000 + 4 ml normal saline + 1500 units hyaluronidase + 3 μg/kg buprenorphine diluted to 1 ml normal saline. Group C (control group received 20 ml 0.5% bupivacaine + 15 ml 2% lignocaine with adrenaline (1:200,000 + 4 ml normal saline + 1500 units hyaluronidase + 1 ml normal saline. The parameters observed were onset and duration of sensory and motor block, quality and duration of analgesia and side-effects. Results: The mean duration of postoperative analgesia was significantly longer in Group B (16.04 ± 3.19 h than in Group C (6.20 ± 0.74 h. There was no difference between two groups on mean onset of sensory block. The mean duration motor block was significantly longer in Group B (4.93 ± 0.94 h than in Group C (2.25 ± 0.62 h [P < 0.05]. The mean duration of sensory block was also significantly longer in Group B (5.71 ± 0.94 h than in Group C (4.94 ± 0.70 h with P < 0.05. Conclusion: Addition of 3 μg/kg buprenorphine to 0.5% bupivacaine for supraclavicular brachial plexus block prolonged duration of postoperative analgesia and sensory blockade without an increase in side effects.

  14. Endothelial Barrier Protection by Local Anesthetics: Ropivacaine and Lidocaine Block Tumor Necrosis Factor-α–induced Endothelial Cell Src Activation

    Science.gov (United States)

    Piegeler, Tobias; Votta-Velis, E. Gina; Bakhshi, Farnaz R.; Mao, Mao; Carnegie, Graeme; Bonini, Marcelo G.; Schwartz, David E.; Borgeat, Alain; Beck-Schimmer, Beatrice; Minshall, Richard D.

    2014-01-01

    Background Pulmonary endothelial barrier dysfunction mediated in part by Src-kinase activation plays a crucial role in acute inflammatory disease. Proinflammatory cytokines, such as tumor necrosis factor-α (TNFα), activate Src via phosphatidylinositide 3-kinase/Akt-dependent nitric oxide generation, a process initiated by recruitment of phosphatidylinositide 3-kinase regulatory subunit p85 to TNF-receptor-1. Because amide-linked local anesthetics have well-established anti-inflammatory effects, the authors hypothesized that ropivacaine and lidocaine attenuate inflammatory Src signaling by disrupting the phosphatidylinositide 3-kinase–Akt–nitric oxide pathway, thus blocking Src-dependent neutrophil adhesion and endothelial hyperpermeability. Methods Human lung microvascular endothelial cells, incubated with TNFα in the absence or presence of clinically relevant concentrations of ropivacaine and lidocaine, were analyzed by Western blot, probing for phosphorylated/activated Src, endothelial nitric oxide synthase, Akt, intercellular adhesion molecule-1, and caveolin-1. The effect of ropivacaine on TNFα-induced nitric oxide generation, co-immunoprecipitation of TNF-receptor-1 with p85, neutrophil adhesion, and endothelial barrier disruption were assessed. Results Ropivacaine and lidocaine attenuated TNFα-induced Src activation (half-maximal inhibitory concentration [IC50] = 8.611 × 10−10 M for ropivacaine; IC50 = 5.864 × 10−10 M for lidocaine) and endothelial nitric oxide synthase phosphorylation (IC50 = 7.572 × 10−10 M for ropivacaine; IC50 = 6.377 × 10−10 M for lidocaine). Akt activation (n = 7; P = 0.006) and stimulus-dependent binding of TNF-receptor-1 and p85 (n = 6; P = 0.043) were blocked by 1 nM of ropivacaine. TNFα-induced neutrophil adhesion and disruption of endothelial monolayers via Src-dependent intercellular adhesion molecule-1- and caveolin-1-phosphorylation, respectively, were also attenuated. Conclusions Ropivacaine and lidocaine

  15. Anesthetizing the obese child

    DEFF Research Database (Denmark)

    Mortensen, Anette; Lenz, Katja; Abildstrøm, Hanne

    2011-01-01

    The prevalence of childhood obesity is increasing. The focus of this review is the special anesthetic considerations regarding the perioperative management of obese children. With obesity the risk of comorbidity such as asthma, obstructive sleep apnea, hypertension, and diabetes increases....... The obese child has an increased risk of perioperative complications especially related to airway management and ventilation. There is a significantly increased risk of difficult mask ventilation and perioperative desaturation. Furthermore, obesity has an impact on the pharmacokinetics of most anesthetic...

  16. Raquianestesia contínua com altas doses de anestésicos locais Raquianestesia continua con altas dosis de anestésicos locales Continuous spinal anesthesia with high dose of local anesthetics

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2010-10-01

    been gaining credibility. The objective of this paper is to report the possible safety of the new catheter with a large dose of hyperbaric 0.5% bupivacaine with 1.6% glucose associated with hyperbaric 2% lidocaine with 1.6% glucose. CASE REPORT: Male patient, 78 years old, 85 kg, 168 cm, physical status ASA III, with hypertension, coronary artery disease, and chronic renal failure. The patient was candidate for surgery for huge bilateral inguinal and umbilical hernias, being submitted to preoperative pneumoperitoneum for one week to stretch abdominal cavity. After venoclysis with an 18G catheter, he was monitored with cardioscope, non-invasive blood pressure, and pulse oximetry; he was sedated with 1 mg of midazolam and 100 µg of fentanyl intravenously, and placed in left lateral decubitus. He underwent continuous spinal anesthesia by a median puncture in L3-L4 with a set with a 27G cut-bevel needle and 22G catheter. The total dose of anesthetic used was 25 mg of 0.5% bupivacaine (hyperbaric, with 1.6% glucose, 160 mg of 2% lidocaine (hyperbaric, with 1.6% glucose, and morphine (100 µg. The patient was followed-up until the 30th postoperative day without neurological complaints. CONCLUSIONS: Recently, the poor distribution of the local anesthetic through the microcatheter was attributed as the cause of cauda equina syndrome. This case report showed that, with the administration of high doses of hyperbaric anesthetics through the new catheter, poor distribution or risk of cauda equina syndrome were not observed

  17. Preparation and physico-chemical characterization of inclusion complexes between local anesthetics and hydroxypropyl-{beta}-cyclodextrin; Preparacao e caracterizacao fisico-quimica de complexos de inclusao entre anestesicos locais e hidroxipropil-{beta}-ciclodextrina

    Energy Technology Data Exchange (ETDEWEB)

    Moraes, Carolina Morales; Abrami, Priscila; Goncalves, Marcos Moises; Andreo Filho, Newton [Universidade de Sorocaba, SP (Brazil); Fernandes, Sergio Antonio; Paula, Eneida de [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Inst. de Biologia. Dept. de Bioquimica; Fraceto, Leonardo Fernandes [UNESP, Sorocaba, SP (Brazil). Dept. de Engenharia Ambiental]. E-mail: leonardo@sorocaba.unesp.br

    2007-07-15

    S(-) Bupivacaine (S(-)BVC) and Lidocaine (LDC) are widely used local anesthetics (LA). Hydroxypropyl {beta}-cyclodextrin (HP-{beta}-CD) is used as a drug-carrier system. The aim of this work was to characterize inclusion complexes between LA and HP-{beta}-CD. The affinity constants determined at different pHs show favourable complexation. The release kinetics experiments showed that S(-)BVC and LDC changed the released profiles in the presence of HP-{beta}-CD. Nuclear magnetic resonance experiments gave information about the interaction between LA and the cyclodextrin cavity. This study focused on the physicochemical characterization of drug-delivery formulations that come out as potentially new therapeutic options for pain treatment. (author)

  18. Effects of mitogen-activated protein kinases on neurotoxicity of local anesthetics%丝裂原活化蛋白激酶家族在局麻药神经毒性中的作用

    Institute of Scientific and Technical Information of China (English)

    李乐; 徐世元; 卢爱珠

    2013-01-01

    背景 局麻药(local anesthetic,LA)广泛用于神经阻滞、镇痛,其可能引起的神经毒性引起了麻醉医生的关注,其中关于此种毒性作用机制的研究取得了较大的进展. 目的 分析总结各种丝裂原活化蛋白激酶家族(mitogen-activated protein kinases,MAPKs)成员在LA神经毒性中的作用. 内容 越来越多的证据证明LA的神经毒性作用可能与细胞凋亡有关.MAPKs是一种广泛存在细胞内的丝氨酸/苏氨酸蛋白激酶,在细胞凋亡过程中发挥重要作用.故MAPK信号通路逐渐成为LA毒性作用研究中的重点,其中关于细胞外信号调节激酶(extracellular signal-regulated kinase,ERK),c-Jun N-末端激酶(c-jun nterminal kinase,JNK)以及p38MAPK信号转导通路的研究较为成熟. 趋向 MAPKs在LA神经毒性的具体机制中发挥重要作用,这为LA的临床应用及毒性作用防治提供依据和理论指导.%Background The potential toxicity is a well-known side effect of local anesthetics (LA) which is widely used in nerve block and analgesia.The mechanisms of local anesthetic toxicity were further investigated.Objective This review summarized the recent studies examining the mitogen-activated protein kinases (MAPKs) signaling pathway and their regulation,and discussed the effects of MAPKs on neurotoxicity of LA.Content Accumulating evidences indicate that neurotoxicity of LA is related to apoptosis.MAPKs,a serine-threonine protein kinase family,play a crucial role in apoptosis of cells.So that the effects of MAPKs signaling pathway on neurotoxicity of LA is becoming a hot issue to be researched.And the impact of extracellular signalregulated kinase (ERK),c-Jun N-terminal kinase (JNK),p38MAPK are more concerned.Trend The MAPKs signaling pathway and their regulation play an important part in the underlying mechanisms of local anesthetic neurotoxicity which could provide evidences and theory for clinical use of LA.

  19. Comparation of Anesthetic Effect of Articaine in the Extraction of Mandibular Posterior Teeth under Local Anesthesia and Periodontal Membrane Anesthesia%阿替卡因两种麻醉方式在下颌后牙拔除术中麻醉效果的对比

    Institute of Scientific and Technical Information of China (English)

    曹静; 张建强; 李岩峰; 高飞

    2013-01-01

    Objective To compare the anesthetic effect of articaine under local anesthesia and periodontal membrane anesthesia on the extraction of mandibular posterior teeth. Methods 204 patients were randomly divided into two groups;local anesthetic group and periodontal membrane anesthetic group. Patients in each group were anesthetized by local anesthesia or periodontal membrane anesthesia. The anesthetic effect was analyzed. Results The excellence rate of periodontal membrane anesthetic group was 84. 3% . Conclusion Periodontal membrane anesthesia for the extraction of mandibular posterior teeth using articaine is more effective than local anesthesia.%目的 比较复方阿替卡因局部浸润麻醉与牙周膜腔麻醉2种方式在下颌后牙拔除术中的麻醉效果.方法 随机选择204名患者,分为局部浸润麻醉组及牙周膜腔麻醉组,采用标尺法由患者对疼痛程度进行打分;口腔医生评价麻醉效果,统计麻醉完全、良好、有效和失败的比例.结果 达到麻醉完全效果的牙周膜腔麻醉与局部浸润麻醉组有显著性差异(P<0.05),两种麻醉方式成功率无显著性差异(P>0.05).结论 用牙周膜腔麻醉效果优于局部浸润麻醉方式.

  20. Efeito de anestésicos locais com e sem vasoconstritor em pacientes com arritmias ventriculares Effect of local anesthetics with and without vasoconstrictor agent in patients with ventricular arrhythmias

    Directory of Open Access Journals (Sweden)

    Maria Teresa Fernández Cáceres

    2008-09-01

    Full Text Available FUNDAMENTO: A utilização de anestésicos locais associados a vasoconstritores para tratamento odontológico de rotina de pacientes cardiopatas ainda gera controvérsia, em razão do risco de efeitos cardiovasculares adversos. OBJETIVO: Avaliar e comparar os efeitos hemodinâmicos do uso de anestésico local com vasoconstritor não-adrenérgico em pacientes portadores de arritmias ventriculares, em relação ao uso de anestésico sem vasoconstritor. MÉTODOS: Um estudo prospectivo randomizado avaliou 33 pacientes com sorologia positiva para doença de Chagas' e 32 pacientes com doença arterial coronariana, portadores de arritmia ventricular complexa ao Holter (>10 EV/h e TVNS, 21 do sexo feminino, idade de 54,73 + 7,94 anos, submetidos a tratamento odontológico de rotina com anestesia pterigomandibular. Esses pacientes foram divididos em dois grupos: no grupo I, utilizou-se prilocaína a 3% associada a felipressina 0,03 UI/ml, e no grupo II, lidocaína a 2% sem vasoconstritor. Avaliaram-se o número e a complexidade de extra-sístoles, a freqüência cardíaca e a pressão arterial sistêmica dos pacientes no dia anterior, uma hora antes, durante o procedimento odontológico e uma hora após. RESULTADOS: Não foram observadas alterações hemodinâmicas, nem aumento do número e da complexidade da arritmia ventricular, relacionados ao anestésico utilizado, em ambos os grupos. CONCLUSÃO: Os resultados sugerem que prilocaína a 3% associada a felipressina 0,03 UI/ml pode ser utilizada com segurança em pacientes chagásicos e coronarianos, com arritmia ventricular complexa.BACKGROUND: The routine use of local anesthetics associated to vasoconstrictors for the dental treatment of patients with cardiopathies is still controversial, due to the risk of adverse cardiovascular effects. OBJECTIVE: To evaluate and compare the hemodynamic effects of the use of local anesthetics with a non-adrenergic vasoconstrictor in patients with ventricular

  1. Anesthetic management of ostriches.

    Science.gov (United States)

    Cornick, J L; Jensen, J

    1992-06-01

    We evaluated and characterized several anesthetic induction protocols used to facilitate intubation and anesthetic maintenance with isoflurane in 7 adult ostriches and 1 juvenile ostrich. Induction protocols included IV administration of zolazepam/tiletamine, IV administration of diazepam/ketamine with and without xylazine, IV administration of xylazine/ketamine, IM administration of carfentanil or xylazine/carfentanil, and mask induction with isoflurane. General anesthesia was maintained with isoflurane in 100% oxygen for various procedures, including proventriculotomy (6 birds), tibial (1 bird) or mandibular (1 bird) fracture repair, and drainage of an iatrogenic hematoma (1 bird). Heart rate and respiratory rate varied greatly among birds. The arterial blood pressure values recorded from 6 of the birds during maintenance of general anesthesia were higher than values recorded for most mammalian species, but were comparable to values reported for awake chickens and turkeys.

  2. Influência de vasoconstritores associados a anestésicos locais sobre a pressão arterial de ratos hipertensos e normotensos Influence of vasoconstrictors associated with local anesthetics on the arterial pressure of hypertensive and normotensive rats

    Directory of Open Access Journals (Sweden)

    Apparecido Neri Daniel

    1999-07-01

    Full Text Available A utilização de anestésicos locais associados a vasoconstritores em pacientes hipertensos é controversa. Neste estudo, verificamos a influência desta associação sobre a pressão arterial caudal (PA em ratos hipertensos DOCA-sal. Após ligeira anestesia com éter, os anestésicos GRUPO I - lidocaína 2% sem vasoconstritor, GRUPO II - lidocaína com fenilefrina, GRUPO III - lidocaína a 2% com noradrenalina, GRUPO IV - prilocaína 3% com felipressina, GRUPO V - mepivacaína 2% com adrenalina e GRUPO VI - mepivacaína com noradrenalina foram injetados na submucosa da boca (anestesia infiltrativa, em ratos DOCA-sal e controles. A PA foi determinada 5 e 15 minutos após a primeira dose do anestésico e também 5 e 15 minutos após a segunda dose. Os dados obtidos indicaram que: a a PA dos ratos DOCA-sal (193,05 ± 4,25 mmHg; n = 43 foi significativamente superior àquela observada nos animais controles (115,64 ± 2,47 mmHg; n = 43 e, b não houve variação significativa nas PA observadas em animais DOCA-sal e controles pela administração dos anestésicos locais testados. Assim, nossos dados experimentais sugerem que a presença de agentes vasoconstritores associados à lidocaína 2%, à prilocaína 3% e à mepivacaína 2% não interferem na PA desses animais, neste modelo experimental de hipertensão.The utilization of local anesthetics associated with vasoconstrictors in hypertensive patients is controversial. The purpose of this investigation was to verify the influence of this association on the arterial pressure (AP in DOCA-salt hypertensive rats. After light ether anesthesia, the anesthetics (Group I - lidocaine 2% without vasoconstrictor; Group II - lidocaine 2% with phenylephrine, Group III - lidocaine 2% with noradrenaline- Group IV - prylocaine 3% with felypressin; Group V - mepivacaine 2% with epinephrine, and Group VI - mepivacaine 2% with norepinephrine were injected into mucobuccal fold (infiltration anesthesia, in DOCA

  3. Pain fiber anesthetic reduces brainstem Fos after tooth extraction.

    Science.gov (United States)

    Badral, B; Davies, A J; Kim, Y H; Ahn, J S; Hong, S D; Chung, G; Kim, J S; Oh, S B

    2013-11-01

    We recently demonstrated that pain-sensing neurons in the trigeminal system can be selectively anesthetized by co-application of QX-314 with the TRPV1 receptor agonist, capsaicin (QX cocktail). Here we examined whether this new anesthetic strategy can block the neuronal changes in the brainstem following molar tooth extraction in the rat. Adult male Sprague-Dawley rats received infiltration injection of anesthetic 10 min prior to lower molar tooth extraction. Neuronal activation was determined by immunohistochemistry for the proto-oncogene protein c-Fos in transverse sections of the trigeminal subnucleus caudalis (Sp5C). After tooth extraction, c-Fos-like immunoreactivity (Fos-LI) detected in the dorsomedial region of bilateral Sp5C was highest at 2 hrs (p tooth extraction; reduced Fos-LI was also observed with the conventional local anesthetic lidocaine. Pulpal anesthesia by infiltration injection was confirmed by inhibition of the jaw-opening reflex in response to electrical tooth pulp stimulation. Our results suggest that the QX cocktail anesthetic is effective in reducing neuronal activation following tooth extraction. Thus, a selective pain fiber 'nociceptive anesthetic' strategy may provide an effective local anesthetic option for dental patients in the clinic.

  4. Anesthetics drug pharmacodynamics.

    Science.gov (United States)

    Bischoff, P; Schneider, G; Kochs, E

    2008-01-01

    Anesthesia cannot be defined in an unambiguous manner. The essential components of general anesthesia are absence of consciousness and pain. This translates into two particular qualities: (1) sedation and hypnosis, i.e., mental blockade and (2) analgesia/antinociception, i.e., sensory blockade. Anesthetic actions on these two subcomponents are difficult to separate. On the one hand, very few anesthetics act exclusively on one of these components. On the other hand, these components are closely related to each other. Unconsciousness prevents (conscious) perception of pain, and nociception may serve as an arousal stimulus and change the level of sedation and hypnosis. The art of anesthesia lies in adequate dosing of drugs to reach both mental and sensory blockade. Drug administration can be based on pharmacokinetic considerations. Pharmacokinetic models allow an estimation of what happens to the administered drug in the body. Models with an effect site compartment may facilitate a tailored administration of anesthetic drugs. Finally, the quantification of pharmacodynamic effects allows a precise titration of drugs. Clinical assessment of mental blockade is often dichotomous, and therefore not very helpful to guide drug administration. Several scoring systems exist, but once consciousness is lost they become less reliable, in particular because reaction to stimuli is assessed, which mixes assessment of mental blockade with assessment of sensory blockade. Clinical assessment of analgesia requires a conscious patient, so antinociception is difficult to measure. Several methods of objective quantification on the basis of electrical brain activity are discussed including EEG and evoked potentials. Despite numerous indexes of the hypnotic component of anesthesia, there is no parameter that unambiguously quantifies the level of mental or sensory blockade.

  5. Anesthetic-Induced Developmental Neurotoxicity

    Institute of Scientific and Technical Information of China (English)

    Jia-RenLiu; Qian Liu; Jing Li; Sulpicio G. Soriano

    2011-01-01

    1 IntroductionMillions of newborn and infants receive anesthetic,sedative and analgesic drugs for surgery and painful procedures on a daily basis.Recent laboratory reports clearly demonstrate that anesthetic and sedative drugs induced both neuroapoptosis and neurocognitive deficits in laboratory models.This issue is of paramount interest to pediatric anesthesiologists and intensivists because it questions the safety of anesthetics used for fetal and neonatal anesthesia[1-2].In an attempt to summarize the rapidly expanding laboratorybased literature on anesthetic-induced developmental neurotoxicity (AIDN),this review will examine published reports on the characterization,mechanisms and alleviation of this phenomenon.

  6. Llama anesthetic programs.

    Science.gov (United States)

    Heath, R B

    1989-03-01

    Llamas are anesthetized conveniently with guaifenesin thiamylal mixes, or, for short periods of time, with xylazine/ketamine. Small individuals must be accurately weighed. Estimating weight without experience is dangerous in this species. The greatest levels of safety and control, especially for critical patients, is afforded by inhalation anesthesia techniques using small animal equipment. All neonates and juveniles can be masked readily but in adults intravenous induction is most satisfactory. Intubation is aided by a long blade laryngoscope. Blood pressure monitoring is best accomplished with an arterial line in the ear artery. However, doppler equipment on the tail or distal leg usually works well.

  7. Benzocaine-loaded polymeric nanocapsules: study of the anesthetic activities.

    Science.gov (United States)

    De Melo, Nathalie Ferreira Silva; De Araújo, Daniele Ribeiro; Grillo, Renato; Moraes, Carolina Morales; De Matos, Angélica Prado; de Paula, Eneida; Rosa, André Henrique; Fraceto, Leonardo Fernandes

    2012-03-01

    This paper describes a comparison of different polymeric nanocapsules (NCs) prepared with the polymers poly(D,L-lactide-co-glycolide), poly(L-lactide) (PLA), and poly(ε-caprolactone) and used as carrier systems for the local anesthetic (LA) benzocaine (BZC). The systems were characterized and their anesthetic activities investigated. The results showed particle size distributions with polydispersity indices below 0.135, average diameters up to 120 nm, zeta potentials up to -30 mV, and entrapment efficiencies around 70%. Formulations of BZC using the polymeric NCs presented slower release profiles, compared with that of free BZC. Slowest release (release constant, k = 0.0016 min(-1)) was obtained using the PLA NC system. Pharmacological evaluation showed that encapsulation of BZC in PLA NCs prolonged its anesthetic action. This new formulation could potentially be used in future applications involving the gradual release of local anesthetics (LAs).

  8. Anesthetic strategy during endovascular therapy: General anesthesia or conscious sedation? (GOLIATH - General or Local Anesthesia in Intra Arterial Therapy) A single-center randomized trial

    DEFF Research Database (Denmark)

    Simonsen, Claus Z; Sørensen, Leif H; Juul, Niels

    2016-01-01

    RATIONALE: Endovascular therapy after acute ischemic stroke due to large vessel occlusion is now standard of care. There is equipoise as to what kind of anesthesia patients should receive during the procedure. Observational studies suggest that general anesthesia is associated with worse outcomes...... compared to conscious sedation. However, the findings may have been biased. Randomized clinical trials are needed to determine whether the choice of anesthesia may influence outcome. AIM AND HYPOTHESIS: The objective of GOLIATH (General or Local Anestesia in Intra Arterial Therapy) is to examine whether....... Patients with acute ischemic stroke, scheduled for endovascular therapy, are randomized to receive either general anesthesia or conscious sedation. STUDY OUTCOMES: The primary outcome measure is infarct growth after 48-72 h (determined by serial diffusion-weighted magnetic resonance imaging). Secondary...

  9. Dynamic characteristics of the cutaneous vasodilator response to a local external pressure application detected by the laser Doppler flowmetry technique on anesthetized rats

    Science.gov (United States)

    Humeau, Anne; Koitka, Audrey; Saumet, Jean-Louis; L'Huillier, Jean-Pierre

    2003-10-01

    The laser Doppler flowmetry technique has recently been used to report a significant transient increase of the cutaneous blood flow signal when a local non-noxious pressure is applied progressively on the skin (11.1 Pa/s). The present work analyses the dynamic characteristics of this vasodilatory reflex response on anaesthetised rats. A de-noising algorithm using wavelets is proposed to obtain accurate values of these dynamic characteristics. The blood flow peak and the time to reach this peak are computed on the de-noised recordings. The results show that the mean time to reach the peak of perfusion is 85.3 s (time t = 0 at the beginning of the pressure application). The mean peak value is 188.3 arbitrary units (a.u.), whereas the mean value of the perfusion before the pressure application is 113.4 a.u. The mean minimum value obtained at the end of the experiment is 60.7 a.u. This latter value is, on the average, reached 841.3 s after the beginning of the pressure application. The comparison of the dynamic characteristics, computed with the de-noising algorithm on signals obtained in other situations, will give a better understanding on some cutaneous lesions such as those present on diabetic people.

  10. Effects of anesthetic compounds on responses of earthworms to electrostimulation.

    Science.gov (United States)

    Podolak-Machowska, Agnieszka; Kostecka, Joanna; Librowski, Tadeusz; Santocki, Michal; Bigaj, Janusz; Plytycz, Barbara

    2014-01-01

    Earthworms play an important role in biomedical research, and some surgical procedures require anesthesia. Anesthetic treatments used so far usually induce convulsive body movements connected with extrusion of coelomocyte-containing coelomic fluid that may affect experimental results. Extensive movements connected with the expulsion of coelomic fluid are exploited by immunologists as a method of harvesting immunocompetent coelomocytes from worms subjected to mild electrostimulation (4.5V). The aim of the investigations was to find anesthetic drugs without unintentional coelomocyte depletion. Experiments were performed on adult specimens of Dendrobaena veneta, the coelomocytes of which consist of amoebocytes and riboflavin-storing eleocytes. Earthworm mobility was filmed and extrusion of coelomocytes was quantified by detection of eleocyte-derived riboflavin in immersion fluid. Treatments included earthworms (1) immersed either in physiological saline (controls) or in a solution of one of the tested anesthetic drugs; (2) electrostimulated immediately after anesthesia, and (3) electrostimulated a second time after a 1-hour recovery period. The well-established fish and amphibian anesthetic agent MS-222 induced coelomocyte expulsion. In contrast, solutions of the mammalian local anesthetic drug, prilocaine hydrochloride (0.25-0.5%, 5-10 min) caused temporal earthworm immobilization followed by recovery, thus showing utility as an efficient earthworm anesthetic.

  11. Local anesthetics: interaction with human erythrocyte membranes as studied by {sup 1}H and {sup 31}P nuclear magnetic resonance; Anestesicos locais: interacao com membranas de eritrocitos de sangue humano, estudada por ressonancia magnetica nuclear de {sup 1}H e {sup 31}P

    Energy Technology Data Exchange (ETDEWEB)

    Fraceto, Leonardo Fernandes; Paula, Eneida de [Universidade Estadual de Campinas, SP (Brazil). Inst. de Biologia. Dept. de Bioquimica]. E-mail: depaula@unicamp.br

    2004-02-01

    The literature carries many theories about the mechanism of action of local anesthetics (LA). We can highlight those focusing the direct effect of LA on the sodium channel protein and the ones that consider the interaction of anesthetic molecules with the lipid membrane phase. The interaction between local anesthetics and human erythrocyte membranes has been studied by {sup 1}H and {sup 31}P nuclear magnetic resonance spectroscopy. It was found that lidocaine (LDC) and benzocaine (BZC) bind to the membranes, increase the mobility of the protons of the phospholipids acyl chains, and decrease the mobility and/or change the structure of the polar head groups. The results indicate that lidocaine molecules are inserted across the polar and liquid interface of the membrane, establishing both electrostatic (charged form) and hydrophobic (neutral form) interactions. Benzocaine locates itself a little deeper in the bilayer, between the interfacial glycerol region and the hydrophobic core. These changes in mobility or conformation of membrane lipids could affect the Na{sup +}-channel protein insertion in the bilayer, stabilizing it in the inactivated state, thus causing anesthesia. (author)

  12. Anestésicos locais: interação com membranas biológicas e com o canal de sódio voltagem-dependente Local anesthetics: interaction with biological membranes and with the voltage-gated sodium channel

    Directory of Open Access Journals (Sweden)

    Daniele Ribeiro de Araujo

    2008-01-01

    Full Text Available Many theories about the mechanism of action of local anesthetics (LA are described in the literature. Two types of theories can be distinguished: those that focus on the direct effects of LA on their target protein in the axon membranes, i.e. the voltage-gated sodium channel and the ones that take into account the interaction of anesthetic molecules with the lipid membrane phase for the reversible nerve blockage. Since there is a direct correlation between LA hydrophobicity and potency, it is crucial to take this physico-chemical property into account to understand the mechanism of action of LA, be it on the sodium channel protein, lipid(s, or on the whole membrane phase.

  13. Day-surgery patients anesthetized with propofol have less postoperative pain than those anesthetized with sevoflurane.

    LENUS (Irish Health Repository)

    Tan, Terry

    2012-02-01

    BACKGROUND: There have been recent studies suggesting that patients anesthetized with propofol have less postoperative pain compared with patients anesthetized with volatile anesthetics. METHODS: In this randomized, double-blind study, 80 patients undergoing day-case diagnostic laparoscopic gynecological surgery were either anesthetized with IV propofol or sevoflurane. The primary outcome measured was pain on a visual analog scale. RESULTS: Patients anesthetized with propofol had less pain compared with patients anesthetized with sevoflurane (P = 0.01). There was no difference in any of the other measured clinical outcomes. CONCLUSIONS: The patients anesthetized with propofol appeared to have less pain than patients anesthetized with sevoflurane.

  14. An estimation of the minimum effective anesthetic volume of 2% lidocaine in ultrasound-guided axillary brachial plexus block.

    LENUS (Irish Health Repository)

    O'Donnell, Brian D

    2009-07-01

    Ultrasound guidance facilitates precise needle and injectate placement, increasing axillary block success rates, reducing onset times, and permitting local anesthetic dose reduction. The minimum effective volume of local anesthetic in ultrasound-guided axillary brachial plexus block is unknown. The authors performed a study to estimate the minimum effective anesthetic volume of 2% lidocaine with 1:200,000 epinephrine (2% LidoEpi) in ultrasound-guided axillary brachial plexus block.

  15. The thermodynamics of general and local anesthesia

    CERN Document Server

    Graesboll, Kaare; Heimburg, Thomas

    2014-01-01

    General anesthetics are known to cause depression of the freezing point of transitions in biomembranes. This is a consequence of ideal mixing of the anesthetic drugs in the membrane fluid phase and exclusion from the solid phase. Such a generic law provides physical justification of the famous Meyer-Overton rule. We show here that general anesthetics, barbiturates and local anesthetics all display the same effect on melting transitions. Their effect is reversed by hydrostatic pressure. Thus, the thermodynamic behavior of local anesthetics is very similar to that of general anesthetics. We present a detailed thermodynamic analysis of heat capacity profiles of membranes in the presence of anesthetics. This analysis is able to describe experimentally observed calorimetric profiles and permits prediction of the anesthetic features of arbitrary molecules. In addition, we discuss the thermodynamic origin of the cutoff-effect of long-chain alcohols and the additivity of the effect of general and local anesthetics.

  16. Bloqueio combinado para analgesia de parto: a adição de sufentanil ao anestésico local influencia o apgar dos recém-nascidos? Bloqueo combinado para analgesia de parto: ¿la adición de sufentanil al anestésico local influye en el apgar de los reciÿn nacidos? Combined spinal-epidural for labor analgesia: does the addition of sufentanil to the local anesthetic influence apgar scores of the newborns?

    Directory of Open Access Journals (Sweden)

    Domingos Dias Cicarelli

    2007-06-01

    Universidade de São Paulo (USP y evaluar si la utilización de sufentanil asociado al anestésico local en el BC altera el Apgar de los recién nacidos. MÉTODO: Se analizaron las fichas de anestesia en que se realizaron BC para la analgesia de parto durante 12 meses en el Hospital Universitario de la USP. Se registraron el uso y la dosis de sufentanil, la vía de parto utilizada y las puntuaciones de Apgar del 1°, 5° y 10° minutos de los recién nacidos. RESULTADOS: De los 635 BC evaluados, 307 utilizaron sufentanil y anestésico local (Grupo SUF y 328, solo anestésico local (Grupo AL. Ciento veinte y siete (20% fueron realizados a través de la técnica de aguja por dentro de aguja y los otros 508 (80% realizados por la técnica dos punciones. No se verificó diferencia entre el Apgar de los grupos estudiados en el 1°, 5° y 10° minutos. CONCLUSIONES: El sufentanil utilizado en el bloqueo combinado no alteró el Apgar de los recién nacidos.BACKGROUND AND OBJECTIVES: Combined spinal-epidural (CSE is a very common obstetric technique. However, the literature does not present a standardization regarding the technique, doses, and anesthetics used, besides there is also the controversy about the possibility that the addition of opioids to the local anesthetic causes fetal bradycardia and affects its vitality. The aim of this study was to identify the techniques and anesthetics used in the Anesthesiology Service of the Hospital Universitário of Universidade de São Paulo (USP and determine whether the use of sufentanil associated with the local anesthetic affects Apgar scores of newborns. METHODS: The anesthesiology charts of patients submitted to CSE for labor analgesia over a 12-month period at the Hospital Universitário of USP were analyzed. The use and dose of sufentanil, the type of delivery, and Apgar scores in the 1st, 5th, and 10th minutes were recorded. RESULTS: Of the 635 CSE analyzed, 307 used sufentanil and local anesthetic (SUF Group and 328 only local

  17. Costs of anesthetics and other drugs in anesthesia

    Directory of Open Access Journals (Sweden)

    Majstorović Branislava M.

    2012-01-01

    Full Text Available Introduction. Drugs are real and transparent costs of treatment, which are subject to constant monitoring and changes. The study was aimed at measuring and analyzing consumption of anesthetics and other drugs in anesthesia in the Clinical Centre of Serbia. Material and Methods. This paper is part of a five-year (2005-2009, academic, pharmacoeconomic retrospective-prospective study (the 4th phase. We calculated the costs of anesthetics and other drugs in all anesthetized patients at the Institute of Anesthesia and Reanimation, Clinical Center of Serbia in 2006. The data, obtained from the Clinical Centre of Serbia Database, were analyzed by descriptive statistical methods using computer program Microsoft Office Excel 2003 and the Statistical Package for the Social Sciences (SPSS for Windows. Results. The amount of money spent for the application of 33,187 general and 16,394 local anesthesia and 20,614 anesthesiology procedures was 83,322,046.36 RSD (Euros 1,054,705.4, which was 5.93% of the funds allocated for all drugs used at the Clinical Center of Serbia. Of the total fund for drugs, 57.8% was spent for anesthetics (local anesthetics 1.2% and muscle relaxants, whereas 42.2% was spent for other drugs in anesthesia. The highest amount was spent at the Emergency Center (35.8%, then at the Cardio-surgery (11.9% and the Neurosurgery (10.9% because of the large number and length of surgical interventions. Conclusion. There is no space for rationalizing the costs of anesthetics and other drugs in anesthesia.

  18. Formulações de anestésicos locais de liberação controlada: aplicações terapêuticas Formulaciones de anestésicos locales de liberación controlada: aplicaciones terapéuticas Drug-delivery systems for local anesthetics: therapeutic applications

    Directory of Open Access Journals (Sweden)

    Daniele Ribeiro de Araújo

    2003-09-01

    ésicos locales indican una nueva dirección en el desarrollo de formulaciones anestésicas más eficaces y seguras.BACKGROUND AND OBJECTIVES: Many researchers in the last four decades have been devoted to the development of drug-delivery systems. Since its first application in the pharmaceutical industry, many results have been obtained especially in the molecular manipulation of carriers and their interaction with encapsulated drugs. These new carriers have the advantage of bypassing encapsulated drugs restraining physicochemical properties (such as water or membrane solubility, thus improving pharmacodynamics (therapeutic effect potentiation, pharmacokinetics (control of tissue absorption and distribution and toxic effects (lower local and systemic toxicity. Liposomes and cyclodextrins are among the most important carriers which have shown to be quite advantageous in the development of drug-delivery systems for local anesthetics. This study aimed at reviewing the interaction of local anesthetics with liposomes and cyclodextrins, the development of basic and applied research on the field, in addition to therapeutic applicability of these formulations. CONTENTS: Liposomes have the ability to control drug delivery to target tissues, fractionating drug release in its site of action. Cyclodextrins, on the other hand, change intensity and duration of effects due to low systemic drug absorption. Basic and clinical studies have pointed out that the administration of local anesthetics in liposome or cyclodextrin formulations induces slow release of the drugs, prolonging the anesthetic action and decreasing cardiac and nervous systems toxicity. CONCLUSIONS: Although studies are still in progress, drug-delivery systems are flagging a new direction for the development of safer and more effective local anesthetic formulations.

  19. Genotoxicity of Anesthetics Evaluated In Vivo (Animals)

    Science.gov (United States)

    Braz, Mariana G.; Karahalil, Bensu

    2015-01-01

    The anesthesia has been improved all over the years. However, it can have impact on health, in both patients and animals anesthetized, as well as professionals exposed to inhaled anesthetics. There is continuing effort to understand the possible effects of anesthetics at molecular levels. Knowing the effects of anesthetic agents on genetic material could be a valuable basic support to better understand the possible mechanisms of these agents. Thus, the purpose of this review is to provide an overview on the genotoxic potential, evaluated in animal models, of many anesthetics that have already been used and those currently used in anesthesia. PMID:26199936

  20. Scientometrics of anesthetic drugs and their techniques of administration, 1984–2013

    Directory of Open Access Journals (Sweden)

    Vlassakov KV

    2014-12-01

    Full Text Available Kamen V Vlassakov, Igor Kissin Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA Abstract: The aim of this study was to assess progress in the field of anesthetic drugs over the past 30 years using scientometric indices: popularity indices (general and specific, representing the proportion of articles on a drug relative to all articles in the field of anesthetics (general index or the subfield of a specific class of anesthetics (specific index; index of change, representing the degree of growth in publications on a topic from one period to the next; index of expectations, representing the ratio of the number of articles on a topic in the top 20 journals relative to the number of articles in all (>5,000 biomedical journals covered by PubMed; and index of ultimate success, representing a publication outcome when a new drug takes the place of a common drug previously used for the same purpose. Publications on 58 topics were assessed during six 5-year periods from 1984 to 2013. Our analysis showed that during 2009–2013, out of seven anesthetics with a high general popularity index (≥2.0, only two were introduced after 1980, ie, the inhaled anesthetic sevoflurane and the local anesthetic ropivacaine; however, only sevoflurane had a high index of expectations (12.1. Among anesthetic adjuncts, in 2009–2013, only one agent, sugammadex, had both an extremely high index of change (>100 and a high index of expectations (25.0, reflecting the novelty of its mechanism of action. The index of ultimate success was positive with three anesthetics, ie, lidocaine, isoflurane, and propofol, all of which were introduced much longer than 30 years ago. For the past 30 years, there were no new anesthetics that have produced changes in scientometric indices indicating real progress. Keywords: anesthetics, anesthetic adjuvants, mortality, safety margins, therapeutic indices

  1. Potent Inhalational Anesthetics for Dentistry.

    Science.gov (United States)

    Satuito, Mary; Tom, James

    2016-01-01

    Nitrous oxide and the volatile inhalational anesthetics have defined anxiety and pain control in both dentistry and medicine for over a century. From curious experimentation to spectacular public demonstrations, the initial work of 2 dentists, Horace Wells and William T. G. Morton, persists to this day in modern surgery and anesthesia. This article reviews the history, similarities, differences, and clinical applications of the most popular inhalational agents used in contemporary dental surgical settings.

  2. Anesthetic Related Advances with Cyclodextrins

    OpenAIRE

    Mark Welliver; John P. McDonough

    2007-01-01

    Cyclodextrins encapsulate and electrostatically bind to lipophilic molecules. The exterior of cyclodextrins are water-soluble and maintain aqueous solubility despite encapsulation of non-aqueous soluble molecules. This unique ability to encapsulate lipophilic molecules and maintain water solubility confers numerous pharmacologic advantages for both drug delivery and removal. Cyclodextrins, a component part of supramolecular chemistry, may be in its infancy of anesthetic application but recent...

  3. Anesthetic management of transcatheter aortic valve implantation

    Directory of Open Access Journals (Sweden)

    Annalisa Franco

    2012-01-01

    Full Text Available Transcatheter aortic valve implantation (TAVI is an emergent technique for high-risk patients with aortic stenosis. TAVI poses significant challenges about its management because of the procedure itself and the population who undergo the implantation. Two devices are currently available and marketed in Europe and several other technologies are being developed. The retrograde transfemoral approach is the most popular procedure; nevertheless, it may not be feasible in patients with significant aortic or ileo-femoral arterial disease. Alternatives include a transaxillary approach, transapical approach, open surgical access to the retroperitoneal iliac artery and the ascending aorta. A complementary approach using both devices and alternative routes tailored to the anatomy and the comorbidities of the single patient is a main component for the successful implementation of a TAVI program. Anesthetic strategies vary in different centers. Local anesthesia or general anesthesia are both valid alternatives and can be applied according to the patient′s characteristics and procedural instances. General anesthesia offers many advantages, mainly regarding the possibility of an early diagnosis and treatment of possible complications through the use of transesophageal echocardiography. However, after the initial experiences, many groups began to employ, routinely, sedation plus local anesthesia for TAVI, and their procedural and periprocedural success demonstrates that it is feasible. TAVI is burdened with potential important complications: vascular injuries, arrhythmias, renal impairment, neurological complications, cardiac tamponade, prosthesis malpositioning and embolization and left main coronary artery occlusion. The aim of this work is to review the anesthetic management of TAVI based on the available literature.

  4. Anesthetic related advances with cyclodextrins.

    Science.gov (United States)

    Welliver, Mark; McDonough, John

    2007-03-02

    Cyclodextrins encapsulate and electrostatically bind to lipophilic molecules. The exterior of cyclodextrins are water-soluble and maintain aqueous solubility despite encapsulation of non-aqueous soluble molecules. This unique ability to encapsulate lipophilic molecules and maintain water solubility confers numerous pharmacologic advantages for both drug delivery and removal. Cyclodextrins, a component part of supramolecular chemistry, may be in its infancy of anesthetic application but recent advances have been described as novel and revolutionary. A review of current research coupled with an understanding of cyclodextrin properties is necessary to fully appreciate the current uses and future potentials of these unique molecules.

  5. Anesthetic Related Advances with Cyclodextrins

    Directory of Open Access Journals (Sweden)

    Mark Welliver

    2007-01-01

    Full Text Available Cyclodextrins encapsulate and electrostatically bind to lipophilic molecules. The exterior of cyclodextrins are water-soluble and maintain aqueous solubility despite encapsulation of non-aqueous soluble molecules. This unique ability to encapsulate lipophilic molecules and maintain water solubility confers numerous pharmacologic advantages for both drug delivery and removal. Cyclodextrins, a component part of supramolecular chemistry, may be in its infancy of anesthetic application but recent advances have been described as novel and revolutionary. A review of current research coupled with an understanding of cyclodextrin properties is necessary to fully appreciate the current uses and future potentials of these unique molecules.

  6. Nitrogen narcosis and pressure reversal of anesthetic effects in node of Ranvier.

    Science.gov (United States)

    Kendig, J J

    1984-01-01

    To compare sodium channel block by hyperbaric nitrogen with that induced by other anesthetics and to examine the basis for pressure antagonism to anesthetic condition block, voltage clamped nodes of Ranvier were exposed to nitrogen at pressures at 1-14 atm alone and in combination with helium to a total pressure of up to 100 atm. At 7 and 14 atm nitrogen, sodium currents were reversibly depressed without accompanying changes in the current-voltage relation. The curve relating steady-state inactivation (h infinity) to voltage was shifted in the hyperpolarizing direction, as is the case with other general anesthetic agents. The time constant of inactivation (tau h) was slightly decreased at depolarized potentials. The preceding companion paper demonstrated an opposite effect of hyperbaric helium on the properties of sodium inactivation. Addition of helium pressure in the presence of nitrogen at 14 atm did not increase peak sodium current with inactivation maximally removed, but it did shift the h infinity curve back toward control levels, thus increasing sodium current at points on the slope of the curve. It is proposed that these opposing shifts in steady-state inactivation levels are the basis for pressure antagonism to anesthetic conduction block. In the case of inert gases and volatile anesthetic agents, the antagonism may be direct but has not been shown to be so. In the case of the local anesthetic benzocaine, differences in the voltage dependence of anesthetic and pressure-induced changes in tau h indicate the antagonism is indirect.

  7. Anesthetizing animals: Similar to humans yet, peculiar?

    Science.gov (United States)

    Kurdi, Madhuri S; Ramaswamy, Ashwini H

    2015-01-01

    From time immemorial, animals have served as models for humans. Like humans, animals too have to undergo several types of elective and emergency surgeries. Several anesthetic techniques and drugs used in humans are also used in animals. However, unlike humans, the animal kingdom includes a wide variety of species, breeds, and sizes. Different species have variable pharmacological responses, anatomy, temperament, behavior, and lifestyles. The anesthetic techniques and drugs have to suit different species and breeds. Nevertheless, there are several drugs and many peculiar anesthetic techniques used in animals but not in human beings. Keeping this in mind, literature was hand searched and electronically searched using the words "veterinary anesthesia," "anesthetic drugs and techniques in animals" using Google search engine. The interesting information so collected is presented in this article which highlights some challenging and amazing aspects of anesthetizing animals including the preanesthetic assessment, preparation, premedication, monitoring, induction of general anesthesia, intubation, equipment, regional blocks, neuraxial block, and perioperative complications.

  8. Estudo radiológico da dispersão de diferentes volumes de anestésico local no bloqueio de plexo braquial pela via posterior Estudio radiológico de la dispersión de diferentes volúmenes de anestésico local en el bloqueo de plexo braquial por vía posterior Radiological evaluation of the spread of different local anesthetic volumes during posterior brachial plexus block

    Directory of Open Access Journals (Sweden)

    Marcos Guilherme Cunha Cruvinel

    2005-10-01

    aleatoriamente en tres grupos de cinco: Grupo 1: volumen de 20 mL; Grupo 2: volumen de 30 mL; Grupo 3: volumen de 40 mL. En un paciente, sometido al bloqueo continuado del plexo braquial por la vía posterior, la administración de un volumen de 10 mL fue estudiada. En todos, el anestésico usado fue la ropivacaína a 0,375% asociada a solución radiopaca. Fueron hechas radiografías de la región cervical inmediatamente después el bloqueo que fue evaluado a través de la pesquisa de la sensibilidad térmica utilizándose algodón embebido en alcohol, treinta minutos después de su realización y en la sala de recuperación anestésica. RESULTADOS: El comportamiento radiológico y clínico del bloqueo de plexo braquial por vía posterior es muy semejante de aquél descrito con la técnica de Winnie (interescalénico. Invariablemente hay envolvimiento del plexo cervical y de las raíces más altas (C5-C7 del plexo braquial. CONCLUSIONES: Este estudio muestra que la dispersión del anestésico local en el bloqueo del plexo braquial por la vía posterior se da primariamente en las raíces responsables por la inervación del hombroBACKGROUND AND OBJECTIVES: Local anesthetic spread during interscalenic block has been thoroughly studied, however there are few studies on posterior block. This study aimed at evaluating the spread of different local anesthetic volumes during posterior brachial plexus block using contrasted X-rays. METHODS: Participated in this study 16 patients submitted to posterior brachial plexus block, 15 of whom were randomly divided in three groups of five patients: Group 1: 20 mL; Group 2: 30 mL.; Group 3 40 mL. The volume of 10 mL was studied in one patient submitted to continuous posterior brachial plexus block. All patients received 0.375% ropivacaine associated to radio-opaque solution. X-rays of the cervical region were obtained immediately after blockade that were evaluated by thermal sensitivity using cotton soaked in alcohol 30 minutes after being

  9. Child with aplastic anemia: Anesthetic management

    Directory of Open Access Journals (Sweden)

    Manpreet Kaur

    2012-01-01

    Full Text Available Aplastic anemia is a rare heterogeneous disorder of hematopoietic stem cells causing pancytopenia and marrow hypoplasia with the depletion of all types of blood cells. This results in anemia, neutropenia and thrombocytopenia, which pose a challenge to both surgical and anesthetic management of such cases. We report a child with aplastic anemia who sustained traumatic ulcer on the arm and underwent split-thickness skin grafting under general anesthesia. There are only two case reports on anesthetic considerations in aplastic anemia patients in the literature. The anesthetic management is challenging because of the rarity of the disease, associated pancytopenia and immunosuppression.

  10. The bonding of anesthetics and antibiotics on the carboxymethylcellulose

    Directory of Open Access Journals (Sweden)

    Rodić-Grabovac Branka B.

    2007-01-01

    Full Text Available The preparation of biologically active material is one of the most interesting trends in the chemical modification of cellulose. The possibility of obtaining biologically active cellulosic material by sorption of procaine hydrochloride and gentamicin sulphate on CMC was investigated in this paper. The sorption of therapeutics on CMC samples with different degree of substitution was carried out in water solutions of anesthetic and antibiotic, while the desorption was done in 0.95% NaCl solution. The amount of bonded and released therapeutics was determined by UV spe-ctrophotometry. It was found that degree of substitution of car-boxymethylcellulose and concentration of chemotherapeutic water solution have significant influence on the amount of bonded anesthetic and antibiotic. The maximum amount of bonded chemotherapeutic was 72.15 mg of procaine hydrochloride and 165.49 mg of gentamicin sulphate per gram CMC. In both cases the amounts of bonded chemotherape-utics correspond to the concentration of local anesthetic and antibiotic preparation that are used in therapeutic purposes.

  11. Anesthetic Efficacy in Irreversible Pulpitis: A Randomized Clinical Trial.

    Science.gov (United States)

    Allegretti, Carlos E; Sampaio, Roberta M; Horliana, Anna C R T; Armonia, Paschoal L; Rocha, Rodney G; Tortamano, Isabel Peixoto

    2016-01-01

    Inferior alveolar nerve block has a high failure rate in the treatment of mandibular posterior teeth with irreversible pulpitis. The aim of this study was to compare the anesthetic efficacy of 4% articaine, 2% lidocaine and 2% mepivacaine, all in combination with 1:100,000 epinephrine, in patients with irreversible pulpitis of permanent mandibular molars during a pulpectomy procedure. Sixty-six volunteers from the Emergency Center of the School of Dentistry, University of São Paulo, randomly received 3.6 mL of local anesthetic as a conventional inferior alveolar nerve block (IANB). The subjective signal of lip numbness, pulpal anesthesia and absence of pain during the pulpectomy procedure were evaluated respectively, by questioning the patient, stimulation using an electric pulp tester and a verbal analogue scale. All patients reported the subjective signal of lip numbness. Regarding pulpal anesthesia success as measured with the pulp tester, the success rate was respectively 68.2% for mepivacaine, 63.6% for articaine and 63.6% for lidocaine. Regarding patients who reported no pain or mild pain during the pulpectomy, the success rate was, respectively 72.7% for mepivacaine, 63.6% for articaine and 54.5% for lidocaine. These differences were not statistically significant. Neither of the solutions resulted in 100% anesthetic success in patients with irreversible pulpitis of mandibular molars.

  12. Anesthetizing animals: Similar to humans yet, peculiar?

    OpenAIRE

    Madhuri S Kurdi; Ramaswamy, Ashwini H

    2015-01-01

    From time immemorial, animals have served as models for humans. Like humans, animals too have to undergo several types of elective and emergency surgeries. Several anesthetic techniques and drugs used in humans are also used in animals. However, unlike humans, the animal kingdom includes a wide variety of species, breeds, and sizes. Different species have variable pharmacological responses, anatomy, temperament, behavior, and lifestyles. The anesthetic techniques and drugs have to suit differ...

  13. Comparison Effcacy of Local Anesthetic Tetracaineand Lidocaine in Nasal Endoscopy%局麻药物丁卡因与利多卡因在鼻内镜中的疗效比较

    Institute of Scientific and Technical Information of China (English)

    张良

    2016-01-01

    Objective To determine whether there is a difference in the efficacy between atomized 1% tetracaine and 2% lidocaine as a topical anesthetic prior to transnasal endoscopy.Methods A total of 100 patients received oxymetazoline and were randomized to receive either 1%tetracaine or 2% lidocaine prior to transnasal endoscopy. Immediately following the procedure, participants completed a survey assessing level of discomfort and other adverse symptoms pertaining to the procedure using a 10-point visual analog scale. Results There were no significant differences in scores between the lidocaine and tetracaine groups. There were also no signiifcant differences between genders in overall scores and in the lidocaine and tetracaine subgroups. Older patients demonstrated significantly less discomfort or a sensation of bad taste overall. In contrast to patients receiving lidocaine, older patients receiving tetracaine experienced signiifcantly less overall pain and discomfort, unpleasant taste, and dyspnea. Conclusion In patients undergoing transnasal endoscopy, use of either 1%tetracaine or 2%lidocaine has similar effect. Tetracaine may be a better choice in older patients.%目的鼻内镜常用于耳鼻咽喉科的诊断与治疗。患者通常在该手术之前进行局部麻醉,以减轻不适,提高可视化。在优化术中患者体验方面,哪种局部麻醉是最有效的,目前还没有共识。因此,本研究的目的是为了明确雾化1%丁卡因和作为鼻内镜前局部麻醉药的2%利多卡因之间的疗效是否存在差异。方法共有100例患者在鼻内镜前接受羟甲唑啉,并随机分组,分别接受1%丁卡因或2%利多卡因。手术后,患者立即进行调查量表的评分以及与手术有关不良症状级别的评估。结果利多卡因和丁卡因组之间的各条目评分没有明显统计学差异。在全部人群中不同性别之间的各条目评分之间没有统计学差异,在利多卡因组和丁卡因组

  14. The modifying effect of anesthetic technique on the metabolic and endocrine responses to anesthesia and surgery

    DEFF Research Database (Denmark)

    Kehlet, H

    1988-01-01

    and the widespread use of the term "stress free anesthesia" in surgery is therefore not valid. However, continuous administration of local anesthetic agents in the epidural space is the most effective technique in so far as reduction of the stress response is concerned. The clinical implication of a variable...... reduction in the stress response to surgery by different anesthetic techniques remains largely unsettled, since only few controlled studies have been published on the clinical effects of pain relief and general anesthesia. However, a vast amount of data exist from controlled studies comparing regional...... anesthesia with local anesthetics and general anesthesia. The cumulative experience from these studies have demonstrated an advantageous effect on postoperative morbidity parameters such as blood loss, postoperative thromboembolic complications, pulmonary infective complications, gastrointestinal motility...

  15. Sevoflurane: a new inhalational anesthetic agent.

    Science.gov (United States)

    Wallin, R F; Regan, B M; Napoli, M D; Stern, I J

    1975-01-01

    Laboratory screening of a series of halogenated methyl isopropyl ethers revealed sevoflurane (fluoromethyl-1,1,1,3,3,3,-hexafluroro-2-propyl ether) as a potent nonexplosive inhalational anesthetic agent. Sevoflurance, a pleasant-smelling liquid, boils at 58.5 degrees C at 760 torr and has a vapor pressure of 200 torr at 25 degrees C. It is nonflammable in air and has lower flammability limits of 11 vols percent in O2 and 10 vols percent in N2O. Sevoflurane exhibits limited chemical reactivity in vitro; it is subject to slight but measurable hydrolysis, and reacts with soda lime to form traces of related ethers. It provides rapid anesthetic induction and recovery consistent with its low distribution coefficients (blood:gas, 0.6; corn oil:gas, 41.6; olive oil:gas, 53.4). In dogs, anesthetic concentrations of sevoflurane did not produce spontaneous cardiac arrhythmias and did not sensitize the heart to epinephrine. Electroencephalographic patterns were similar to those observed during anesthesia with halothane. In rats, small increases in the urinary excretion of inorganic fluoride ion occurred during the first 24 hours after anesthesia. Subacute studies in dogs and rats, using closed-circle absorption with soda lime, revealed no toxicologically significant changes in animals anesthetized frequently for 2 weeks. Sevoflurane appears to be a unique volatile anesthetic agent worthy of further study.

  16. Evaluation of Surface anesthetic action of Aqueous Extract of Piper Betel leaf On Rabbit Cornea

    Directory of Open Access Journals (Sweden)

    Dr.T.Jayasree

    2014-07-01

    Full Text Available Aim: Piper betel Linn. (Piperaceae commonly known as betel leaf and the habit of betel chewing is widely prevalent in most parts of India. It is claimed to have aphrodisiac, laxative, antimicrobial, mucolytic, antiinflammatory and euphoric properties and proven antimutagenic and anti-carcinogenic effect. It is commonly observed that chewing of betel leaf produces numbness in the mouth, suggesting a possible local anesthetic effect. This observation prompted us to take this study . The aim of the study was to evaluate the local anesthetic activity of betel leaf extract after autoclaving the extract of betel leaf. Materials and methods: Extract of plain betel leaf, was tested for surface anesthetic activity using rabbits. Aqueous extraction of Piper betel leaf (AEPBL done by Soxhelts apparatus .Twenty male Rabbit’s were taken and divided in to four groups each group contain 5 animals, Group I - Standard (2% xylocaine, Group II - Test 0.3% (AEPBL, Group III - Test 0.6 % (AEPBL,Group IV - Test 12 % (AEPBL was instilled in conjunctival sac of right eyes. Standard protocol was followed to elicit light reflex, corneal reflex and to measure pupillary size after instilling the test drugs in the eye. There was dose dependent increase in onset and duration of local anesthetic activity with 6% and 12% doses of alcoholic extract of Piper betel leaf. Results: Betel leaf showed significant surface anesthetic activity comparable to that of Xylocaine. Conclusion: As a surface anesthetic, the onset was as quick as xylocaine and the duration was shorter than xylocaine

  17. Effect of anesthetics on the radiosensitivity of a murine tumor

    Energy Technology Data Exchange (ETDEWEB)

    Sheldon, P.W.; Chu, A.M.

    1979-09-01

    The effect of four anesthetics on the single dose of x rays required to locally control 50% of implanted MT tumors was investigated. Compared with unanesthetized animals, no change in radiosensitivity was observed if mice were irradiated under either tribromoethanol or fentanyl-fluanisone-diazepam anesthesia. However, a small but significant degree of radioprotection was observed under chloral hydrate or pentobarbital anesthesia. Hypothermia or increased hypoxia are considered unlikely mechanisms for the protection, a direct chemical action being most probable. The preferred method for immobilizing the mice in order to locally irradiate the tumors was by simple physical restraint (with care taken to minimize physiological stress). However, if anesthesia was a necessity, the present work suggests that for the MT tumor at least the nonprotecting tribromoethanol and fentanyl-fluanisone-diazepam are preferable to the protecting chloral hydrate and pentobarbital. Tribromoethanol is preferable to fetanyl-fluanisone-diazepam in that it produces a smaller drop in temperature. However, it is only a short-acting anesthetic, and prolongation of the state of anesthesia by repeated doses simply prolongs the temperature decline so that there may be no real benefit over fentanyl-fluanisone-diazepam.

  18. Evaluation of prilocaine for the reduction of pain associated with transmucosal anesthetic administration.

    Science.gov (United States)

    Kramp, L. F.; Eleazer, P. D.; Scheetz, J. P.

    1999-01-01

    This investigation evaluated the use and efficacy of prilocaine HCl (4% plain Citanest) for minimizing pain associated with the intraoral administration of local anesthesia. Clinical anecdotes support the hypothesis that prilocaine without a vasoconstrictor reduces pain during injection. To determine relative injection discomfort, use of 4% plain prilocaine was compared with use of 2% lidocaine with 1:100,000 epinephrine and 2% mepivacaine with 1:20,000 levonordefrin. Prior to routine endodontic procedures, 150 adult patients received 0.3 to 1.8 mL of local anesthetic via the same gauge needle without the use of a topical local anesthetic. Injection methods included buccal infiltration, labial infiltration, palatal infiltration, and inferior alveolar nerve block. Following each injection, patients were asked to describe the level of discomfort by scoring on a visual analog scale of 1 to 10, where 1 = painless and 10 = severe pain. Analyses via 2-way analysis of variance revealed no interaction between anesthetic and site of injection. However, there were statistically significant differences among the injection sites. Post hoc analysis revealed that prilocaine was associated with significantly less pain perception when compared to mepivacaine and lidocaine. These results suggest that differences in initial pain perception during transmucosal injection may be a function of the local anesthetic use, and prilocaine can produce less discomfort than the others tested. Images Figure 1 PMID:10853565

  19. Ensaio mecânico da resistência ao impacto do cimento ósseo puro e associado a duas drogas anestésicas locais Mechanical essay of impact resistance of acrylic bone cement used singly or the cement in combination with two local anesthetic drugs

    Directory of Open Access Journals (Sweden)

    Vincenzo Giordano

    2007-07-01

    resistência entre os cimentos Simplex® e Biomecânica® para as medicações lidocaína (p = 0,13 e bupivacaína (p = 0,63. No cimento Simplex®, a associação com a bupivacaína apresentou resistência significativamente maior do que com a lidocaína e o polímero puro (p = 0,001 e p = 0,012, respectivamente. Não existe diferença significativa na resistência entre a lidocaína e o polímero puro para o cimento Simplex® (p = 0,39. No cimento Biomecânica®, a associação com a bupivacaína apresentou resistência significativamente maior do que com a lidocaína e o polímero puro (p = 0,0001 e p = 0,0001, respectivamente. Não existe diferença significativa na resistência entre a lidocaína e o polímero puro para o cimento Biomecânica® (p = 0,37. CONCLUSÃO: Nas condições estudadas, não há redução significativa da resistência ao impacto na combinação de cimento ortopédico com anestésicos locais.OBJECTIVE: To investigate the mechanical behavior of cement-local anesthetic combinations in vitro. METHODS: Two bone cements were tested (Simplex® and Biomecânica® with two anesthetic drugs (lidocaine and bupivacaine. Anesthetic drugs were added in powder form. The authors compared six groups based on the association between the cement and the drugs. Two grams of anesthetic were mixed with 40 g of acrylic cement powder. 60 prismatic molds were made, measuring 5 x 120 x 30 mm (n = 30 and 5 x 60 x 30 mm (n = 30. The molds were tested on a pendulum impact resistance apparatus. Statistical analysis was performed to verify the effect of bone cement (Simplex® and Biomecânica® and the medication (lidocaine, bupivacaine, and no combination on the strength of the molds, with a level of significance alpha = 5%. RESULTS: Statistical comparison showed a significant influence of the medication on bone strength (p = 0.0001. Tukey multiple comparison test demonstrated better strength with bupivacaine. CONCLUSION: Cement-bone combination does not harm the strength

  20. Efeitos adversos do sufentanil associado ao anestésico local pelas vias subaracnóidea e peridural em pacientes submetidas à analgesia de parto Efectos adversos del sufentanil asociado al anestésico local por las vías subaracnoidea y peridural en pacientes sometidas a la analgesia de parto Side effects of subarachnoid and epidural sufentanil associated with a local anesthetic in patients undergoing labor analgesia

    Directory of Open Access Journals (Sweden)

    Isabel C.F. Salem

    2007-04-01

    la duración del período de trabajo de parto después de la analgesia, al Apgar de los recién nacidos, a la existencia de hipotensión arterial, bradicardia, náusea, vómito, prurito y retención urinaria. La sedación fue más frecuente en las pacientes de G2, en M1 (50% con diferencia estadística significativa. CONCLUSIONES: El sufentanil en las dosis utilizadas, administrado por vía subaracnoidea o peridural, asociado a los anestésicos locales, determinó similitud en la duración del trabajo de parto después de la analgesia y en el Apgar de los recién nacidos. La sedación fue el efecto adverso más frecuente en las pacientes que recibieron el opioide por vía peridural.BACKGROUND AND OBJECTIVES: The association of an opioid with a local anesthetic improves the quality of labor analgesia and reduces the risk of systemic toxicity of the local anesthetic. However, opioids are not devoid of side effects. The aim of this study was to compare the side effects of subarachnoid sufentanil associated with bupivacaine to those caused by epidural sufentanil associated with ropivacaine in the doses used in the Anesthesiology Department in pregnant women undergoing labor analgesia. METHODS: Sixty pregnant women, ASA physical status I and II, ages between 15 and 42 years, at term and with healthy fetuses, undergoing labor analgesia were enrolled in this study. They were randomly divided in two groups: G1 - combined spinal epidural anesthesia - 0.5% bupivacaine (2.5 mg and subarachnoid sufentanil (5 µg; G2 - Epidural Block - 0.2% ropivacaine (20 mg, and epidural sufentanil (10 µg. Complementary doses of 0.2% ropivacaine (12 mg were administered whenever necessary, and 1% ropivacaine (50 mg was administered for labor resolution. Patients were evaluated after analgesia (M1 regarding the presence of hypotension, maternal bradycardia, pruritus, nausea, vomiting, respiratory depression, and sedation. They were also evaluated postoperatively (M2 regarding the presence of

  1. CARDIOPROTECTION BY VOLATILE ANESTHETICS: FROM BENCH TO BEDSIDE AND BACK

    OpenAIRE

    Sedlić, Filip; Šepac, A; Muravyeva, M; Bošnjak, Željko

    2011-01-01

    Ischemia and reperfusion (I/R) injury of the heart can be ameliorated by volatile anesthetics (VAs). Application of VAs prior to the ischemic event triggers endogenous cardioprotective program that persists even after anesthetic removal, and it is called anesthetic-induced preconditioning (APC) (1). VAs can also reduce infarct size if applied during the reperfusion period (anesthetic postconditioning), where they can also exert protection by the direct effects on cardiac cel...

  2. Advances in local anesthesia in dentistry.

    Science.gov (United States)

    Ogle, Orrett E; Mahjoubi, Ghazal

    2011-07-01

    Local pain management is the most critical aspect of patient care in dentistry. The improvements in agents and techniques for local anesthesia are probably the most significant advances that have occurred in dental science. This article provides an update on the most recently introduced local anesthetic agents along with new technologies used to deliver local anesthetics. Safety devices are also discussed, along with an innovative method for reducing the annoying numbness of the lip and tongue following local anesthesia.

  3. Impact of hyaluronidase on anesthetic distribution in retrobulbar region following sub-Tenon anesthesia

    Directory of Open Access Journals (Sweden)

    Šurbatović Maja

    2008-01-01

    Full Text Available Background/Aim. Sub-Tenon's block is nowadays commonly used in ophthalmic surgery because of its safety and efficacy. The aim of this study was to investigate the distribution of the anesthetic solution with different amounts of hyaluronidase in the retrobulbar space, following an injection into the Sub-Tenon's space. Methods. In this experimental study, 40 pig cadaver heads were used (80 eyeballs. The material was divided into four groups (of 20 eyeballs each. Each group was administered 4.5 ml of a mixture of 2% lignocaine, 0.5% bupivacaine, and 0.5 ml of Indian ink, with different amounts of hyaluronidase - 15 IU/ml, 75 IU/ml, 150 IU/ml, except the control one. Samples of retrobulbar tissue were analyzed using the standard histopathological procedure. After that, they were also analyzed using the Adobe Photoshop program® (Windows, USA. The retrobulbar space was divided into eight zones by four perpendicular lines, which crossed in the centre of the optic nerve. The presence of ink in fat and muscle tissues and in the sheath of the optic nerve was observed. Results. The presence of the local anesthetic solution was significantly higher in inferonasal and superonasal quadrants of the fat and muscle tissues (p < 0.01. The distribution in optic nerve sheath is similar in each quadrant. Distribution of local anesthetic in each zone of the muscle tissue (I-VIII was strongly influenced by the amount of hyaluronidase added. In the fat tissue, the distribution of local anesthetic under the influence of hyaluronidase was significantly higher (p < 0.05 in the areas which were distant from the place of injection (I-IV. The distribution in the optic nerve sheath is significantly higher (p < 0.01 in the group with 150 IU/ml of hyaluronidase. Conclusions. Following a sub-Tenon block local anesthetic was present in the retrobulbar space in a high percentage of the cases. The presence of local anesthetic solution in retrobulbar space depends on the amount of

  4. Analysis of efficacy of two types of local anesthetic in tension-free inguinal hernia repair%腹股沟疝无张力修补术中局麻药物选择的效果分析

    Institute of Scientific and Technical Information of China (English)

    周涛; 麻涛; 田文; 李晨; 菅雁兵; 肖西平; 周彬; 彭喆

    2014-01-01

    Objective To investigate the advantages of combined application of lidocaine and ropivacaine in local anesthesia of tension-free inguinal hernia repair.Methods From January 2012 to December 2013, 172 patients with inguinal hernia were randomly divided into 2 groups:88 patients in lidocaine+ropivacaine group (test group) and 84 patients in lidocaine group (control group) , all of whom received tension-free repair . Clinical data were analyzed retrospectively by using SPSS 17.0 software.The operation time, analgesic duration, time to ambulation, hospital stay were compared by using the t test , while postoperative use of analgesic and anesthesia satisfaction of patients were compared by using χ2 test.P <0.05 was considered statistically significant.Results Operation time of the test group was (41 ±8) minutes, which was not significantly shorter than that of the control group [(43 ±7) minutes (t=1.742, P=0.083)].The analgesic duration of the test group was (7.4 ±1.6) hours, which was longer than that of [(4.8 ±1.8) hours] the control group, (t=10.023, P<0.001).There were 18 patients using painkillers in the test group 24 hours after operation, significantly less than 31 patients in the control group (χ2 =5.709, P=0.017).The mean time to ambulation of the test group was (4.6 ±0.8) hours, which was significantly shorter than that of the control group[(6.7 ±1.4) hours (t=12.147, P<0.001)].The mean discharge time of the test group was (2.7 ±0.4) days, which was significantly shorter than that of the control group [(3.6 ±0.5) days (t=13.065, P<0.001)].74 patients were satisfied with the aesthetic effect in the test group, in contrast to 57 patients in the control group of (χ2 =6.238, P=0.013). Conclusion Local anesthesia of ropivacaine combined with lidocaine in tension-free inguinal hernia repair is an effective and safe method with simple operation and minimal invasion , by which patients could gain less pain, faster recovery, and less complications and costs

  5. Clinical application of thoracic paravertebral anesthetic block in breast surgeries

    Directory of Open Access Journals (Sweden)

    Sara Socorro Faria

    2015-04-01

    Full Text Available INTRODUCTION: Optimum treatment for postoperative pain has been of fundamental importance in surgical patient care. Among the analgesic techniques aimed at this group of patients, thoracic paravertebral block combined with general anesthesia stands out for the good results and favorable risk-benefit ratio. Many local anesthetics and other adjuvant drugs are being investigated for use in this technique, in order to improve the quality of analgesia and reduce adverse effects. OBJECTIVE: Evaluate the effectiveness and safety of paravertebral block compared to other analgesic and anesthetic regimens in women undergoing breast cancer surgeries. METHODS: Integrative literature review from 1966 to 2012, using specific terms in computerized databases of articles investigating the clinical characteristics, adverse effects, and beneficial effects of thoracic paravertebral block. RESULTS: On the selected date, 16 randomized studies that met the selection criteria established for this literature review were identified. Thoracic paravertebral block showed a significant reduction of postoperative pain, as well as decreased pain during arm movement after surgery. CONCLUSION: Thoracic paravertebral block reduced postoperative analgesic requirement compared to placebo group, markedly within the first 24 h. The use of this technique could ensure postoperative analgesia of clinical relevance. Further studies with larger populations are necessary, as paravertebral block seems to be promising for preemptive analgesia in breast cancer surgery.

  6. Heart rate effects of intraosseous injections using slow and fast rates of anesthetic solution deposition.

    Science.gov (United States)

    Susi, Louis; Reader, Al; Nusstein, John; Beck, Mike; Weaver, Joel; Drum, Melissa

    2008-01-01

    The authors, using a crossover design, randomly administered, in a single-blind manner, 3 primary intraosseous injections to 61 subjects using: the Wand local anesthetic system at a deposition rate of 45 seconds (fast injection); the Wand local anesthetic system at a deposition rate of 4 minutes and 45 seconds (slow injection); a conventional syringe injection at a deposition rate of 4 minutes and 45 seconds (slow injection), in 3 separate appointments spaced at least 3 weeks apart. A pulse oximeter measured heart rate (pulse). The results demonstrated the mean maximum heart rate was statistically higher with the fast intraosseous injection (average 21 to 28 beats/min increase) than either of the 2 slow intraosseous injections (average 10 to 12 beats/min increase). There was no statistically significant difference between the 2 slow injections. We concluded that an intraosseous injection of 1.4 mL of 2% lidocaine with 1 : 100,000 epinephrine with the Wand at a 45-second rate of anesthetic deposition resulted in a significantly higher heart rate when compared with a 4-minute and 45-second anesthetic solution deposition using either the Wand or traditional syringe.

  7. Hypoxic pulmonary vasoconstriction: physiology and anesthetic implications.

    Science.gov (United States)

    Lumb, Andrew B; Slinger, Peter

    2015-04-01

    Hypoxic pulmonary vasoconstriction (HPV) represents a fundamental difference between the pulmonary and systemic circulations. HPV is active in utero, reducing pulmonary blood flow, and in adults helps to match regional ventilation and perfusion although it has little effect in healthy lungs. Many factors affect HPV including pH or PCO2, cardiac output, and several drugs, including antihypertensives. In patients with lung pathology and any patient having one-lung ventilation, HPV contributes to maintaining oxygenation, so anesthesiologists should be aware of the effects of anesthesia on this protective reflex. Intravenous anesthetic drugs have little effect on HPV, but it is attenuated by inhaled anesthetics, although less so with newer agents. The reflex is biphasic, and once the second phase becomes active after about an hour of hypoxia, this pulmonary vasoconstriction takes hours to reverse when normoxia returns. This has significant clinical implications for repeated periods of one-lung ventilation.

  8. Opioid induced hyperalgesia in anesthetic settings.

    Science.gov (United States)

    Lee, Hyeon Jeong; Yeomans, David C

    2014-11-01

    Pain is difficult to investigate and difficult to treat, in part, because of problems in quantification and assessment. The use of opioids, combined with classic anesthetics to maintain hemodynamic stability by controlling responses to intraoperative painful events has gained significant popularity in the anesthetic field. However, several side effects profiles concerning perioperative use of opioid have been published. Over the past two decades, many concerns have arisen with respect to opioid-induced hyperalgesia (OIH), which is the paradoxical effect wherein opioid usage may decrease pain thresholds and increase atypical pain unrelated to the original, preexisting pain. This brief review focuses on the evidence, mechanisms, and modulatory and pharmacologic management of OIH in order to elaborate on the clinical implication of OIH.

  9. Child with aplastic anemia: Anesthetic management

    OpenAIRE

    Manpreet Kaur; Babita Gupta; Aanchal Sharma; Sanjeev Sharma

    2012-01-01

    Aplastic anemia is a rare heterogeneous disorder of hematopoietic stem cells causing pancytopenia and marrow hypoplasia with the depletion of all types of blood cells. This results in anemia, neutropenia and thrombocytopenia, which pose a challenge to both surgical and anesthetic management of such cases. We report a child with aplastic anemia who sustained traumatic ulcer on the arm and underwent split-thickness skin grafting under general anesthesia. There are only two case reports on anest...

  10. Local anesthesia: a review.

    Science.gov (United States)

    Malamed, S F; Sykes, P; Kubota, Y; Matsuura, H; Lipp, M

    1992-01-01

    Local anesthetics are the most widely administered drugs in dentistry. Significant advances have been made in past decades that have greatly increased both the safety and the efficacy of these important drugs. This paper reviews the history of local anesthesia, pharmacokinetics and clinical implications, techniques, complications, and future directions in the quest for more effective pain control in dentistry.

  11. Use of pethidine as an intravenous regional anesthetic.

    Science.gov (United States)

    el-Bakry, M S; el-Shafei, S B; Seyam, E M; el-Kobbia, N M; Ebrahim, U H

    1989-06-01

    Pethidine 100 mg in 30-40 ml saline was given in a group of patients by the conventional technique of intravenous regional anesthesia. Fourty percent of the patients did not feel any form of pain or discomfort, 26.7% experienced only vague sensations which did not call for additional drugs but 13.3% felt some form of pain or discomfort for which diazepam was given and was enough for surgery to be completed. In the rest of the patients (20%) there was intolerable pain for which patients were given general anesthesia. This last category was operated upon for recent fractures or digital conditions and it is known that intravenous regional anesthesia using conventional local anesthetics for such patients usually fails. In a control group in which 30-40 ml saline without pethidine were injected, there was complete failure of the technique.

  12. Anesthetic management of laparoscopic pheochromocytoma surgery: A case report

    Directory of Open Access Journals (Sweden)

    Hakan Akelma

    2014-06-01

    Full Text Available Pheochromocytoma is a neuroendocrine tumor of the adrenal medulla chromaffin cells. It has a variable clinic indicating symptoms such as hypertension, headache, sweating, palpitations, and anxiety. Determination of vanillylmandelic acid in urine and metanephrines are accepted as the most sensitive tests for diagnosis. Computerized tomography and magnetic resonance imaging cad be used for tumor localization. Anesthetic induction and surgical manipulations usually lead to the catastrophic release of catecholamines. Thus, accurate preoperative pharmacological preparation is vital in these patients. Treatment is a complete surgical resection of the primary tumor and, if possible, metastases after banning dangerous fluctuations in hemodynamic through α-blockers. Today, laparoscopic adrenalectomy has begun to replace open surgery as a standard treatment method in many adrenal diseases. J Clin Exp Invest 2014; 5 (2: 443-446

  13. What is the optimal anesthetic protocol for measurements of cerebral autoregulation in spontaneously breathing mice?

    Science.gov (United States)

    Wang, Zhenghui; Schuler, Beat; Vogel, Olga; Arras, Margarete; Vogel, Johannes

    2010-12-01

    Autoregulation, an important feature of the cerebral circulation, is affected in many diseases. Since genetically modified mice are a fundamental tool in biomedical research, including neuro(bio)logy also in this specie measurements of cerebral autoregulation (CA) are mandatory. However, this requires anesthesia that unfortunately significantly impacts cerebral perfusion and consequently might distort CA measurements directly or by altering arterial pCO(2). The latter can be avoided by artificial ventilation but requires several control measurements of blood gases, each consuming at least 100 μl of blood or 5% of a mouse's blood volume. To avoid such diagnostic hemorrhage, we systematically analyzed the effect of different common anesthetic protocols used for rodents in spontaneously breathing mice on CA measured with Laser speckle perfusion imaging. Halothane, Isoflurane and Pentobarbital abrogated CA and Ketamin/Xylazine as well as Chloralose had a moderate reproducibility. In contrast, the rather rarely used anesthetic Ethomidate applied in low doses combined with local anesthetics had the best reproducibility. Although with this anesthesia the lower CA limit was lower than with Ketamin/Xylazine and Chloralose as reported in the handful of papers so far dealing with CA in mice, we suggest Ethomidate as the anesthetic of choice for CA measurements in spontaneously breathing mice.

  14. Are one or two dangerous? Lidocaine and topical anesthetic exposures in children.

    Science.gov (United States)

    Curtis, Liesl A; Dolan, Teresa Sullivan; Seibert, H Edward

    2009-07-01

    Topical anesthetics are found in a variety of prescription and non-prescription preparations, from teething gels to hemorrhoid creams. In 2003, there were 8576 exposures to local/topical anesthetics reported to the American Association of Poison Control Centers, with 67% of cases in the age group younger than 6 years old. This report reviews the available literature involving topical anesthetic exposures in children younger than 6 years old, including the National Library of Medicine's Pub Med database (limited to English language) and data from POISINDEX. Additionally, we reviewed the American Association of Poison Control Centers' annual reports from 1983 to 2003. There were 7 deaths in this age range from topical anesthetics. Although the number of deaths is low, the fact that there have been deaths reveals the serious nature of the toxicity that can result from these readily available non-prescription analgesics. Toxicity may result from topical absorption, ingestion, or aspiration. Additionally, toxicity can result from unintentional as well as therapeutic mishaps. Although the number of cases is limited, these medications can be toxic at low doses-which, in children younger than 6 years of age, may amount to as little as a teaspoon.

  15. Upper airway collapsibility in anesthetized children.

    Science.gov (United States)

    Litman, Ronald S; McDonough, Joseph M; Marcus, Carole L; Schwartz, Alan R; Ward, Denham S

    2006-03-01

    We sought to establish the feasibility of measuring upper airway narrowing in spontaneously breathing, anesthetized children using dynamic application of negative airway pressure. A secondary aim was to compare differences in upper airway collapsibility after the administration of sevoflurane or halothane. Subjects were randomized to either drug for inhaled anesthetic induction. Each was adjusted to their 1 MAC value (0.9% for halothane and 2.5% for sevoflurane) and a blinded anesthesia provider held the facemask without performing manual airway opening maneuvers but with inclusion of an oral airway device. Inspiratory flows were measured during partial upper airway obstruction created by an adjustable negative pressure-generating vacuum motor inserted into the anesthesia circuit. Critical closing pressure of the pharynx (Pcrit) was obtained by plotting the peak inspiratory flow of the obstructed breaths against the corresponding negative pressure in the facemask and extrapolating to zero airflow using linear correlation. Fourteen children were enrolled, seven in each anesthetic group. Two children in the halothane group did not develop flow-limited airway obstruction despite negative pressures as low as -9 cm H2O. Pcrit for sevoflurane ranged from -6.7 to -11.6 (mean +/- sd, -9.8 +/- 1.9) cm H2O. Pcrit for halothane ranged from -8.1 to -33 (mean +/- sd, -19.4 +/- 9.3) cm H2O (sevoflurane versus halothane, P = 0.048). We conclude that when using dynamic application of negative airway pressure, halothane appears to cause less upper airway obstruction than sevoflurane at equipotent concentrations.

  16. Anesthetic Management of a Child with Mitochondrial Neurogastrointestinal Encephalopathy

    Science.gov (United States)

    Casarez, Vianey Q.; Zavala, Acsa M.; Owusu-Agyemang, Pascal; Hagan, Katherine

    2015-01-01

    Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is an autosomal recessive disorder associated with deficiency of thymidine phosphorylase (TP). Associated manifestations include visual and hearing impairments, peripheral neuropathies, leukoencephalopathy, and malnutrition from concomitant gastrointestinal dysmotility and pseudoobstruction. Given the altered metabolic state in these patients, specific consideration of medication selection is advised. This case report will describe the anesthetic management used in a 10-year-old girl with MNGIE. She had multiple anesthetics while undergoing allogeneic hematopoietic stem cell transplantation. This case report will discuss the successful repeated use of the same anesthetic in this pediatric patient, with the avoidance of volatile anesthetic agents, propofol, and muscle relaxant. PMID:26124966

  17. Anesthetic Management of a Child with Mitochondrial Neurogastrointestinal Encephalopathy

    Directory of Open Access Journals (Sweden)

    Vianey Q. Casarez

    2015-01-01

    Full Text Available Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE is an autosomal recessive disorder associated with deficiency of thymidine phosphorylase (TP. Associated manifestations include visual and hearing impairments, peripheral neuropathies, leukoencephalopathy, and malnutrition from concomitant gastrointestinal dysmotility and pseudoobstruction. Given the altered metabolic state in these patients, specific consideration of medication selection is advised. This case report will describe the anesthetic management used in a 10-year-old girl with MNGIE. She had multiple anesthetics while undergoing allogeneic hematopoietic stem cell transplantation. This case report will discuss the successful repeated use of the same anesthetic in this pediatric patient, with the avoidance of volatile anesthetic agents, propofol, and muscle relaxant.

  18. A Unitary Anesthetic Binding Site at High Resolution

    Energy Technology Data Exchange (ETDEWEB)

    Vedula, L. Sangeetha; Brannigan, Grace; Economou, Nicoleta J.; Xi, Jin; Hall, Michael A.; Liu, Renyu; Rossi, Matthew J.; Dailey, William P.; Grasty, Kimberly C.; Klein, Michael L.; Eckenhoff, Roderic G.; Loll, Patrick J.; (Drexel-MED); (UPENN)

    2009-10-21

    Propofol is the most widely used injectable general anesthetic. Its targets include ligand-gated ion channels such as the GABA{sub A} receptor, but such receptor-channel complexes remain challenging to study at atomic resolution. Until structural biology methods advance to the point of being able to deal with systems such as the GABA{sub A} receptor, it will be necessary to use more tractable surrogates to probe the molecular details of anesthetic recognition. We have previously shown that recognition of inhalational general anesthetics by the model protein apoferritin closely mirrors recognition by more complex and clinically relevant protein targets; here we show that apoferritin also binds propofol and related GABAergic anesthetics, and that the same binding site mediates recognition of both inhalational and injectable anesthetics. Apoferritin binding affinities for a series of propofol analogs were found to be strongly correlated with the ability to potentiate GABA responses at GABA{sub A} receptors, validating this model system for injectable anesthetics. High resolution x-ray crystal structures reveal that, despite the presence of hydrogen bond donors and acceptors, anesthetic recognition is mediated largely by van der Waals forces and the hydrophobic effect. Molecular dynamics simulations indicate that the ligands undergo considerable fluctuations about their equilibrium positions. Finally, apoferritin displays both structural and dynamic responses to anesthetic binding, which may mimic changes elicited by anesthetics in physiologic targets like ion channels.

  19. A Unitary Anesthetic-Binding Site at High Resolution

    Energy Technology Data Exchange (ETDEWEB)

    Vedula, L.; Brannigan, G; Economou, N; Xi, J; Hall, M; Liu, R; Rossi, M; Dailey, W; Grasty, K; et. al.

    2009-01-01

    Propofol is the most widely used injectable general anesthetic. Its targets include ligand-gated ion channels such as the GABAA receptor, but such receptor-channel complexes remain challenging to study at atomic resolution. Until structural biology methods advance to the point of being able to deal with systems such as the GABA{sub A} receptor, it will be necessary to use more tractable surrogates to probe the molecular details of anesthetic recognition. We have previously shown that recognition of inhalational general anesthetics by the model protein apoferritin closely mirrors recognition by more complex and clinically relevant protein targets; here we show that apoferritin also binds propofol and related GABAergic anesthetics, and that the same binding site mediates recognition of both inhalational and injectable anesthetics. Apoferritin binding affinities for a series of propofol analogs were found to be strongly correlated with the ability to potentiate GABA responses at GABA{sub A} receptors, validating this model system for injectable anesthetics. High resolution x-ray crystal structures reveal that, despite the presence of hydrogen bond donors and acceptors, anesthetic recognition is mediated largely by van der Waals forces and the hydrophobic effect. Molecular dynamics simulations indicate that the ligands undergo considerable fluctuations about their equilibrium positions. Finally, apoferritin displays both structural and dynamic responses to anesthetic binding, which may mimic changes elicited by anesthetics in physiologic targets like ion channels.

  20. A Unitary Anesthetic Binding Site at High Resolution

    Energy Technology Data Exchange (ETDEWEB)

    L Vedula; G Brannigan; N Economou; J Xi; M Hall; R Liu; M Rossi; W Dailey; K Grasty; et. al.

    2011-12-31

    Propofol is the most widely used injectable general anesthetic. Its targets include ligand-gated ion channels such as the GABA{sub A} receptor, but such receptor-channel complexes remain challenging to study at atomic resolution. Until structural biology methods advance to the point of being able to deal with systems such as the GABA{sub A} receptor, it will be necessary to use more tractable surrogates to probe the molecular details of anesthetic recognition. We have previously shown that recognition of inhalational general anesthetics by the model protein apoferritin closely mirrors recognition by more complex and clinically relevant protein targets; here we show that apoferritin also binds propofol and related GABAergic anesthetics, and that the same binding site mediates recognition of both inhalational and injectable anesthetics. Apoferritin binding affinities for a series of propofol analogs were found to be strongly correlated with the ability to potentiate GABA responses at GABA{sub A} receptors, validating this model system for injectable anesthetics. High resolution x-ray crystal structures reveal that, despite the presence of hydrogen bond donors and acceptors, anesthetic recognition is mediated largely by van der Waals forces and the hydrophobic effect. Molecular dynamics simulations indicate that the ligands undergo considerable fluctuations about their equilibrium positions. Finally, apoferritin displays both structural and dynamic responses to anesthetic binding, which may mimic changes elicited by anesthetics in physiologic targets like ion channels.

  1. Interaction of anesthetics with neurotransmitter release machinery proteins.

    Science.gov (United States)

    Xie, Zheng; McMillan, Kyle; Pike, Carolyn M; Cahill, Anne L; Herring, Bruce E; Wang, Qiang; Fox, Aaron P

    2013-02-01

    General anesthetics produce anesthesia by depressing central nervous system activity. Activation of inhibitory GABA(A) receptors plays a central role in the action of many clinically relevant general anesthetics. Even so, there is growing evidence that anesthetics can act at a presynaptic locus to inhibit neurotransmitter release. Our own data identified the neurotransmitter release machinery as a target for anesthetic action. In the present study, we sought to examine the site of anesthetic action more closely. Exocytosis was stimulated by directly elevating the intracellular Ca(2+) concentration at neurotransmitter release sites, thereby bypassing anesthetic effects on channels and receptors, allowing anesthetic effects on the neurotransmitter release machinery to be examined in isolation. Three different PC12 cell lines, which had the expression of different release machinery proteins stably suppressed by RNA interference, were used in these studies. Interestingly, there was still significant neurotransmitter release when these knockdown PC12 cells were stimulated. We have previously shown that etomidate, isoflurane, and propofol all inhibited the neurotransmitter release machinery in wild-type PC12 cells. In the present study, we show that knocking down synaptotagmin I completely prevented etomidate from inhibiting neurotransmitter release. Synaptotagmin I knockdown also diminished the inhibition produced by propofol and isoflurane, but the magnitude of the effect was not as large. Knockdown of SNAP-25 and SNAP-23 expression also changed the ability of these three anesthetics to inhibit neurotransmitter release. Our results suggest that general anesthetics inhibit the neurotransmitter release machinery by interacting with multiple SNARE and SNARE-associated proteins.

  2. Anesthetic considerations in Sheldon-Hall syndrome.

    Science.gov (United States)

    Anderson, Thomas Anthony; Kasser, James R; Holzman, Robert S

    2014-05-01

    Arthrogryposis is characterized by multiple, nonprogressive joint contractures which may be caused by maternal disorders such as oligohydramnios as well as fetal akinesia resulting from primary disorders of muscle, connective tissue, or neurologic tissue. Its prevalence is about 1 : 3000. Distal arthrogryposis (DA) is a heterogenous group of genetic disorders with a characteristic flexion of the joints of the hands and feet divided into different types with additional features. Sheldon-Hall Syndrome (SHS), also known as distal arthrogryposis type 2A (DA2A), has some nonorthopedic features of specific importance to anesthetic care.

  3. Gestational trophoblastic disease with hyperthyroidism: Anesthetic management

    Directory of Open Access Journals (Sweden)

    Puneet Khanna

    2012-01-01

    Full Text Available The coexistence of hyperthyroidism with gestational trophoblastic disease is a known albeit rare clinical condition. We herein report the successful anesthetic management of such a case in our institute. There are only few case reports in literature of this association. Often, the diagnosis of hyperthyroid state is retrospective one, as it can be missed in the emergency scenario of patient requiring molar evacuation. This case report highlights the perioperative management and optimization of hyperthyroid state prior to surgical evacuation of the invasive hydatidiform mole.

  4. Methemoglobin levels in generally anesthetized pediatric dental patients receiving prilocaine versus lidocaine.

    Science.gov (United States)

    Gutenberg, Lauren L; Chen, Jung-Wei; Trapp, Larry

    2013-01-01

    The purpose of this study was to measure and compare peak methemoglobin levels and times to peak methemoglobin levels following the use of prilocaine and lidocaine in precooperative children undergoing comprehensive dental rehabilitation under general anesthesia. Ninety children, 3-6 years of age, undergoing dental rehabilitation under general anesthesia were enrolled and randomly assigned into 3 equal groups: group 1, 4% prilocaine plain, 5 mg/kg; group 2, 2% lidocaine with 1:100,000 epinephrine, 2.5 mg/kg; and group 3, no local anesthetic. Subjects in groups 1 and 2 were administered local anesthetic prior to restorative dental treatment. Methemoglobin levels (SpMET) were measured and recorded throughout the procedure using a Masimo Radical-7 Pulse Co-Oximeter (Masimo Corporation, Irvine, Calif, RDS-1 with SET software with methemoglobin interface). Data were analyzed using chi-square, one-way analysis of variance (ANOVA), and Pearson correlation (significance of P < .05). Group 1 had a significantly higher mean peak SpMET level at 3.55% than groups 2 and 3 at 1.63 and 1.60%, respectively. The mean time to peak SpMET was significantly shorter for group 3 at 29.50 minutes than that of group 1 at 62.73 and group 2 at 57.50 minutes. Prilocaine, at 5 mg/kg in pediatric dental patients, resulted in significantly higher peak SpMET levels than lidocaine and no local anesthetic. In comparison to no local anesthetic, the administration of prilocaine and lidocaine caused peak SpMET levels to occur significantly later in the procedure.

  5. Mechanism of Anesthetic Toxicity: Metabolism, Reactive Oxygen Species, Oxidative Stress, and Electron Transfer

    OpenAIRE

    2011-01-01

    There is much literature on the toxic effects of anesthetics. This paper deals with both the volatiles and locals. Adverse effects appear to be multifaceted, with the focus on radicals, oxidative stress (OS), and electron transfer (ET). ET functionalities involved are quinone, iminoquinone, conjugated iminium, and nitrone. The non-ET routes involving radicals and OS apparently pertain to haloalkanes and ethers. Beneficial effects of antioxidants, evidently countering OS, are reported. Knowled...

  6. Relationship between pre-anesthetic and intra-anesthetic airway resistance in patients undergoing general anesthesia: A prospective observational study

    Science.gov (United States)

    Ikeda, Takamitsu; Uchida, Kanji; Yamauchi, Yasuhiro; Nagase, Takahide; Oba, Koji; Yamada, Yoshitsugu

    2017-01-01

    Surgery patients in Japan undergo routine spirometry testing prior to general anesthesia. The use of a flow sensor during general anesthesia has recently become common. However, it is not certain whether the information derived from flow-volume curves is being adequately used for mechanical ventilation management during general anesthesia. So far, there have been no attempts to calculate airway resistance using flow-volume curves. Therefore, we performed a prospective, observational study to investigate the relationship between pre-anesthetic and intra-anesthetic airway resistance in patients scheduled for surgery under general anesthesia. We calculated pre-anesthetic and intra-anesthetic airway resistance in each patient, based on the slopes of flow-volume curves obtained prior to and during general anesthesia. We also calculated endotracheal tube resistance to correct the intra-anesthetic airway resistance values calculated. A total of 526 patients were included in the study, and 98 patients had a forced expiratory volume in the first second/forced vital capacity ratio of mechanical ventilation (p = 0.48). Pre-anesthetic and intra-anesthetic airway resistance values were closer to each other in patients without airflow obstruction, with a mean difference < 1.0 cmH2O L-1s-1, than in those with airflow obstruction, although these respiratory parameters were significantly different (p < 0.001). Intra-anesthetic airway resistance was not related to the FEV1/FVC ratio, regardless of the degree to which the FEV1/FVC ratio reflected pre-anesthetic airway resistance. As compared with patients with airflow obstruction, the mean difference between pre-anesthetic and intra-anesthetic airway resistance was small in patients without airflow obstruction. PMID:28212451

  7. Evaluation of common anesthetic and analgesic techniques for tail biopsy in mice.

    Science.gov (United States)

    Jones, Carissa P; Carver, Scott; Kendall, Lon V

    2012-11-01

    Tail biopsy in mice is a common procedure in genetically modified mouse colonies. We evaluated the anesthetic and analgesic effects of various agents commonly used to mitigate pain after tail biopsy. We used a hot-water immersion assay to evaluate the analgesic effects of isoflurane, ice-cold ethanol, ethyl chloride, buprenorphine, and 2-point local nerve blocks before studying their effects on mice receiving tail biopsies. Mice treated with ethyl chloride spray, isoflurane and buprenorphine, and 2-point local nerve blocks demonstrated increased tail-flick latency compared with that of untreated mice. When we evaluated the behavior of adult and preweanling mice after tail biopsy, untreated mice demonstrated behavioral changes immediately after tail biopsy that lasted 30 to 60 min before returning to normal. The use of isoflurane, isoflurane and buprenorphine, buprenorphine, 2-point nerve block, or ethyl chloride spray in adult mice did not significantly improve their behavioral response to tail biopsy. Similarly, the use of buprenorphine and ethyl chloride spray in preweanling mice did not improve their behavioral response to tail biopsy compared with that of the untreated group. However, immersion in bupivacaine for 30 s after tail biopsy decreased tail grooming behavior during the first 30 min after tail biopsy. The anesthetic and analgesic regimens tested provide little benefit in adult and preweanling mice. Given that tail biopsy results in pain that lasts 30 to 60 min, investigators should carefully consider the appropriate anesthetic or analgesic regimen to incorporate into tail-biopsy procedures for mice.

  8. Cleft lip and palate: recommendations for dental anesthetic procedure based on anatomic evidences.

    Science.gov (United States)

    Trindade-Suedam, Ivy Kiemle; Gaia, Bruno Felipe; Cheng, Cheong Kuo; Trindade, Paulo Alceu Kiemle; Bastos, José Carlos da Cunha; Mattos, Beatriz Silva Câmara

    2012-02-01

    Patients with cleft lip and palate usually present dental anomalies of number, shape, structure and position in the cleft area and the general dentist is frequently asked to restore or extract those teeth. Considering that several anatomic variations are expected in teeth adjacent to cleft areas and that knowledge of these variations by general dentists is required for optimal treatment, the objectives of this paper are: 1) to describe changes in the innervation pattern of anterior teeth and soft tissue caused by the presence of a cleft, 2) to describe a local anesthetic procedure in unilateral and bilateral clefts, and 3) to provide recommendations to improve anesthetic procedures in patients with cleft lip and palate. The cases of 2 patients are presented: one with complete unilateral cleft lip and palate, and the other with complete bilateral cleft lip and palate. The patients underwent local anesthesia in the cleft area in order to extract teeth with poor bone support. The modified anesthetic procedure, respecting the altered course of nerves in the cleft maxilla and soft tissue alterations at the cleft site, was accomplished successfully and the tooth extraction was performed with no pain to the patients. General dentists should be aware of the anatomic variations in nerve courses in the cleft area to offer high quality treatment to patients with cleft lip and palate.

  9. Cleft lip and palate: recommendations for dental anesthetic procedure based on anatomic evidences

    Directory of Open Access Journals (Sweden)

    Ivy Kiemle Trindade-Suedam

    2012-02-01

    Full Text Available Patients with cleft lip and palate usually present dental anomalies of number, shape, structure and position in the cleft area and the general dentist is frequently asked to restore or extract those teeth. Considering that several anatomic variations are expected in teeth adjacent to cleft areas and that knowledge of these variations by general dentists is required for optimal treatment, the objectives of this paper are: 1 to describe changes in the innervation pattern of anterior teeth and soft tissue caused by the presence of a cleft, 2 to describe a local anesthetic procedure in unilateral and bilateral clefts, and 3 to provide recommendations to improve anesthetic procedures in patients with cleft lip and palate. The cases of 2 patients are presented: one with complete unilateral cleft lip and palate, and the other with complete bilateral cleft lip and palate. The patients underwent local anesthesia in the cleft area in order to extract teeth with poor bone support. The modified anesthetic procedure, respecting the altered course of nerves in the cleft maxilla and soft tissue alterations at the cleft site, was accomplished successfully and the tooth extraction was performed with no pain to the patients. General dentists should be aware of the anatomic variations in nerve courses in the cleft area to offer high quality treatment to patients with cleft lip and palate.

  10. Huntington's disease: review and anesthetic case management.

    Science.gov (United States)

    Cangemi, C F; Miller, R J

    1998-01-01

    Huntington's disease is a dominantly inherited progressive autosomal disease that affects the basal ganglia. Symptoms appear later in life and manifest as progressive mental deterioration and involuntary choreiform movements. Patients with Huntington's disease develop a progressive but variable dementia. Dysphagia, the most significant related motor symptom, hinders nutrition intake and places the patient at risk for aspiration. The combination of involuntary choreoathetoid movements, depression, and apathy leads to cachexia. Factors of considerable concern to the anesthesiologist who treats patients with Huntington's disease may include how to treat frail elderly people incapable of cooperation, how to treat patients suffering from malnourishment, and how to treat patients with an increased risk for aspiration or exaggerated responses to sodium thiopental and succinylcholine. The successful anesthetic management of a 65-yr-old woman with Huntington's disease who presented for full-mouth extractions is described.

  11. Renal effects of methoxyverapamil in anesthetized rats.

    Science.gov (United States)

    Brown, B; Churchill, P

    1983-05-01

    The purpose of these experiments was to determine the renal effects of methoxyverapamil (D-600). Three groups of rats were anesthetized with sodium pentobarbital and given 0, 0.85 or 1.69 nmol/min of methoxyverapamil i.v. Increases in urine flow and Na, K and Ca excretory rates occurred, in an apparently dose-dependent manner. Plasma Na and arterial renin concentration decreased at both doses and, at the higher dose, mean arterial blood pressure and effective renal plasma flow decreased while plasma K increased. Plasma Ca, glomerular filtration rate, filtration fraction and total renal plasma flow were not affected. The findings that methoxyverapamil increased urine flow and electrolyte excretion without changing glomerular filtration rate are consistent with the hypothesis that methoxyverapamil acts directly on tubular reabsorptive mechanisms. These effects, and the effect on plasma renin concentration, could contribute to the beneficial effects of this and other Ca entry antagonists in the treatment of hypertension.

  12. Obstetric use of nitroglycerin: Anesthetic implications

    Science.gov (United States)

    Saroa, Richa; Sachan, Shikha; Palta, Sanjeev; Gombar, Satinder; Sahai, Nitika

    2013-01-01

    Nitroglycerin has been used in anesthetic practice for induced hypotension and managing perioperative hypertension and myocardial ischemia. Contrary to the continuous low dose infusions (5-20 mcg/min) used for the same, intravenous bolus dosages are sometimes administered at the behest of obstetricians for removal of retained placenta. Use of nitroglycerine in managing retained placenta is undertaken as a last resort when other measures fail to relax the uterine smooth muscles. Intravenous nitroglycerine relaxes smooth muscle cells by releasing nitric oxide thus causing prompt cervico-uterine relaxation. However, administration of nitroglycerine in this manner is not without risks which should be kept in mind while using it for obstetric purposes. We hereby report a case of 22-year-old female scheduled for manual removal of placenta where unpredictable and unexpected hypoxemia was observed following nitroglycerine administration. PMID:24015145

  13. Obstetric use of nitroglycerin: Anesthetic implications

    Directory of Open Access Journals (Sweden)

    Richa Saroa

    2013-01-01

    Full Text Available Nitroglycerin has been used in anesthetic practice for induced hypotension and managing perioperative hypertension and myocardial ischemia. Contrary to the continuous low dose infusions (5-20 mcg/min used for the same, intravenous bolus dosages are sometimes administered at the behest of obstetricians for removal of retained placenta. Use of nitroglycerine in managing retained placenta is undertaken as a last resort when other measures fail to relax the uterine smooth muscles. Intravenous nitroglycerine relaxes smooth muscle cells by releasing nitric oxide thus causing prompt cervico-uterine relaxation. However, administration of nitroglycerine in this manner is not without risks which should be kept in mind while using it for obstetric purposes. We hereby report a case of 22-year-old female scheduled for manual removal of placenta where unpredictable and unexpected hypoxemia was observed following nitroglycerine administration.

  14. Systemic toxisity of local anesthethics during regional anesthesia in orthopedics and traumatology

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    V. A. Koryachkin

    2015-01-01

    Full Text Available There are cases of accidental intravascular injection of local anesthetic when performing regional anesthesia. The frequency of this complication was 0.28 per 1,000. We describe the clinical manifestations and the basic principles of the treatment of local anesthetics systemic toxicity. Discussed in detail the mechanism of action of fat emulsion and the protocol of lipid resuscitation Accidental intravascular injection of local anesthetics. The mechanism of action of fat emulsion and the protocol of lipidrescue accidental intravascular injection of local anesthetics was discussed.

  15. Effectiveness of topical anesthetics on reducing tactile sensitivity in the paws of newborn rats.

    Science.gov (United States)

    Strain, Misty M; Vineyard, Mary Ann; Roberto, Megan E; Brumley, Michele R

    2014-01-01

    The aim of this study was to evaluate the effectiveness of three local, topical anesthetics on touch response thresholds of the paws of 1-day-old rats. Touch response thresholds were measured using Semmes Weinstein monofilaments after treatment of the paws with EMLA (2.5% lidocaine and 2.5% prilocaine), alcaine (.5% proparacaine), triocaine (20% benzocaine, 6% lidocaine, and 4% tetracaine), or petroleum jelly (treatment control). Touch thresholds significantly increased after treatment with EMLA 18% of the time, and there was no evidence of a systemic effect. Touch thresholds were not significantly altered after treatment with alcaine, triocaine, or petroleum jelly. Therefore, EMLA appears to be a slightly effective topical anesthetic for reducing tactile sensitivity in newborn rats.

  16. Efficacy of tramadol as a preincisional infiltration anesthetic in children undergoing inguinal hernia repair: a prospective randomized study

    Science.gov (United States)

    Numanoğlu, Kemal Varım; Ayoğlu, Hilal; Er, Duygu TatlıEbubekir

    2014-01-01

    Background Preincisional local anesthetic infiltration at the surgical site is a therapeutic option for postoperative pain relief for pediatric inguinal hernia. Additionally, tramadol has been used as an analgesic for postoperative pain in children. Recently, the local anesthetic effects of tramadol have been reported. The aim of this study was to determine both the systemic analgesic and the local anesthetic effects of tramadol and to determine how it differs from bupivacaine when administered preincisionally. Methods Fifty-two healthy children, aged 2–7 years, who were scheduled for elective herniorrhaphy were randomly allocated to receive either preincisional infiltration at the surgical site with 2 mg/kg tramadol (Group T, n=26) or 0.25 mL/kg 0.5% bupivacaine (Group B, n=26). At the time of anesthetic administration, perioperative hemodynamic parameters were recorded. The pain assessments were performed 10 minutes after the end of anesthesia and during the first 6-hour period, using pain scores. The time of first dose of analgesia and need for additional analgesia were recorded. Results Between T and B groups, the anesthesia time, perioperative hemodynamic changes, and pain scores were not statistically different. However, in group B, the postoperative analgesic requirement was higher than in group T. Conclusion Tramadol shows equal analgesic effect to bupivacaine and decreases additional analgesic requirement, when used for preincisional infiltration anesthesia in children undergoing inguinal herniorrhaphy. PMID:25285011

  17. INTRAOCULAR PRESSURE, MEAN ARTERIAL BLOOD PRESSURE AND PUPILLARY DIAMETER IN RABBITS ( (Oryctolagus cuniculus SUBJECTED TO RETROBULBAR BLOCK WITH DIFFERENT ANESTHETIC PROTOCOLS

    Directory of Open Access Journals (Sweden)

    Renata Maria Monção da Silva

    2015-10-01

    Full Text Available The aim of this study was to evaluate four protocols of loco regional anesthesia for ophthalmic procedures that could provide safety and life support, in addition to maintain intraocular pressure stable, with eye centralization and eyelid akinesia. 20 New Zealand rabbits were used to perform local anesthesia by retrobulbar block with four protocols: 2% lidocaine with epinephrine, 2% lidocaine without epinephrine associated with tramadol, 1% ropivacaine and bupivacaine 0.5 %. Each animal received an anesthetic volume of 1 mL. All anesthetic protocols used promoted eyelid akinesia and centralization of the eye during the assessment period. The retrobulbar block with the proposed anesthetic protocols proved to be feasible and safe for the maintenance of intraocular pressure, invasive blood pressure and pupillary diameter and can be used in intraocular surgeries, respecting the time of action of each anesthetic. All protocols showed an excellent blockage action but bupivacaine promoted the highest pupil diameter compared to the other drugs tested.

  18. Comparison of dexmedetomidine and epinephrine as the adjuvant to local anesthetic agents for brachial plexus block%右美托咪定与肾上腺素作为局部麻醉药佐剂对臂丛神经阻滞效果的对比

    Institute of Scientific and Technical Information of China (English)

    李凯; 赵国庆; 李旭洋; 朱志华

    2016-01-01

    Objective To compare the effect of dexmedetomidine (Dex) with epinephrine as adjuvant to ropivacaine in supraclavicular brachial plexus block.Methods Sixty patients,ASA Ⅰ or Ⅱ,44-68 years old,weight 50-75 kg,scheduled for fixation of Colle's fracture under ultrasound-guided supraclavicular brachial plexus block were divided randomly into three groups (n=20) with random number table,double-blinded fashion.In group C,1 ml normal saline was used.In group D,0.75 μg/kg Dex was diluted into 1 ml.In group E,epinephrine(100 μg) was diluted into 1 ml.The adjuvant was added to local anesthetic drug composed by 10 ml 1% hydrochloride ropivacaine and 10 ml normal saline.Onset time of sensory and motor block,duration of analgesia,onset time of postoperative analgesia was recorded in three groups.MAP,HR,SpO2,BIS and anesthetic complications were recorded in time points of before (T0) and 10 min (T1),20 min (T2),30 min (T3),40 min (T4),50 min (T5),60 min (T6) after administration.Results The onset of sensory and motor block in group D are earlier than group C and E (P<0.05).Duration of sensory block and motor block in group D and E were significantly longer than group C (P<0.05).The needs for postoperative analgesia in D and E were postponed.The MAP in group D is lower than group C at T4-T5 and E at T3-T5 (P<0.05).The MAP in group E is higher than group C at T3 (P< 0.05).Group D had lower HR than group C and E from T3 to T6 (P<0.05).The HR in group E is higher than group C from T3 to T5.Group D had significantly lower BIS score than group C and E since T2 (P<0.05).Conclusions Perineural 0.75 μg/kg of Dex has similarly ability of 100 μg epinephrine to enhance the quality and duration of analgesia in supraclavicular brachial plexus block.Dex has the ability to decrease cardiovascular stress and sedation,and should be a better adjuvant to local anesthesia in patients who are cautioned against epinephrine.%目的 对比常用剂量的右美托咪

  19. Blood profiles in unanesthetized and anesthetized guinea pigs (Cavia porcellus).

    Science.gov (United States)

    Williams, Wendy R; Johnston, Matthew S; Higgins, Sarah; Izzo, Angelo A; Kendall, Lon V

    2016-01-01

    The guinea pig is a common animal model that is used in biomedical research to study a variety of systems, including hormonal and immunological responses, pulmonary physiology, corticosteroid response and others. However, because guinea pigs are evolutionarily a prey species, they do not readily show behavioral signs of disease, which can make it difficult to detect illness in a laboratory setting. Minimally invasive blood tests, such as complete blood counts and plasma biochemistry assays, are useful in both human and veterinary medicine as an initial diagnostic technique to rule in or rule out systemic illness. In guinea pigs, phlebotomy for such tests often requires that the animals be anesthetized first. The authors evaluated hematological and plasma biochemical effects of two anesthetic agents that are commonly used with guinea pigs in a research setting: isoflurane and a combination of ketamine and xylazine. Hematological and plasma biochemical parameters were significantly different when guinea pigs were under either anesthetic, compared to when they were unanesthetized. Plasma proteins, liver enzymes, white blood cells and red blood cells appeared to be significantly altered by both anesthetics, and hematological and plasma biochemical differences were greater when guinea pigs were anesthetized with the combination of ketamine and xylazine than when they were anesthetized with isoflurane. Overall these results indicate that both anesthetics can significantly influence hematological and plasma biochemical parameters in guinea pigs.

  20. Can anesthetic treatment worsen outcome in status epilepticus?

    Science.gov (United States)

    Sutter, Raoul; Kaplan, Peter W

    2015-08-01

    Status epilepticus refractory to first-line and second-line antiepileptic treatments challenges neurologists and intensivists as mortality increases with treatment refractoriness and seizure duration. International guidelines advocate anesthetic drugs, such as continuously administered high-dose midazolam, propofol, and barbiturates, for the induction of therapeutic coma in patients with treatment-refractory status epilepticus. The seizure-suppressing effect of anesthetic drugs is believed to be so strong that some experts recommend using them after benzodiazepines have failed. Although the rationale for the use of anesthetic drugs in patients with treatment-refractory status epilepticus seems clear, the recommendation of their use in treating status epilepticus is based on expert opinions rather than on strong evidence. Randomized trials in this context are lacking, and recent studies provide disturbing results, as the administration of anesthetics was associated with poor outcome independent of possible confounders. This calls for caution in the straightforward use of anesthetics in treating status epilepticus. However, there are still more questions than answers, and current evidence for the adverse effects of anesthetic drugs in patients with status epilepticus remains too limited to advocate a change of treatment algorithms. In this overview, the rationale and the conflicting clinical implications of anesthetic drugs in patients with treatment-refractory status epilepticus are discussed, and remaining questions are elaborated. This article is part of a Special Issue entitled "Status Epilepticus".

  1. Comparison of anesthetic agents in the sea otter

    Energy Technology Data Exchange (ETDEWEB)

    Williams, T.D.; Kocher, F.H.

    1978-01-01

    Five anesthetic agents (CI744, etorphine, fentanyl, ketamine hydrochloride, and halothane) were tested to establish the dosage of a safe, effective, short-acting anesthetic for use in the sea otter. Etorphine, at a dosage of 0.75 mg per adult otter and used in conjunction with diazepam, at a dosage of 1.25 mg per adult otter, met most of the requirements for use under field conditions. Halothane, administered through an anesthetic machine, proved to be effective for use in a veterinary hospital.

  2. Challenges Encountered Using Ophthalmic Anesthetics in Space Medicine

    Science.gov (United States)

    Bayuse, T.; Law, J.; Alexander, D.; Moynihan, S.; LeBlanc, C.; Langford, K.; Magalhaes, L.

    2015-01-01

    On orbit, ophthalmic anesthetics are used for tonometry and off-nominal corneal examinations. Proparacaine has been flown traditionally. However, the manufacturers recently changed its storage requirements from room temperature storage to refrigerated storage to preserve stability and prolong the shelf-life. Since refrigeration on orbit is not readily available and there were stability concerns about flying proparacaine unrefrigerated, tetracaine was selected as an alternative ophthalmic anesthetic in 2013. We will discuss the challenges encountered flying and using these anesthetics on the International Space Station.

  3. LOCAL ANAESTHETIC SYSTEMIC TOXICITY: CURRENT CONCEPTS AND MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Lakshmi

    2014-03-01

    Full Text Available Local anesthetics are one of the most commonly used drugs in the field of medicine. Local anesthetics are widely used to induce anesthesia and analgesia for surgical procedures and pain management. Local an aesthetic systemic toxicity (LAST is a rare but potentially fatal complication of regional anesthesia and has been recognized and reported since the late1800s. This narrative review summarizes the pharmacology of local anesthetics, clinical manifestations of systemic toxicity associated with these agents, necessary preventive measures and recent treatment strategies

  4. Anesthesia methods used by anesthetic specialists for circumcision cases

    Science.gov (United States)

    Altaş, Cafer; Küçükosman, Gamze; Yurtlu, Bülent S.; Okyay, Rahşan D.; Aydın, Bengü G.; Pişkin, Özcan; Çimencan, Murat; Ayoğlu, Hilal; Hancı, Volkan; Özkoçak-Turan, Işıl

    2017-01-01

    Objectives: To examine the anesthesiologist’s choice for anesthesia techniques and drugs in circumcision and determine the preoperative examination, intraoperative monitoring techniques, postoperative analgesia methods, and common complications among anesthesiologists working in Turkey. Methods: This cross-sectional study was conducted at Bulent Ecevit University Hospital, Zonguldak, Turkey, between May and July 2012. Survey data were obtained via survey forms through electronic data over the web. The questionnaire consists of 20 questions. These questions included demographic data, methods of anesthesia for circumcision, postoperative analgesia methods, and monitoring methods. Results: The data were obtained from 206 anesthesiologists who agreed to participate in the survey. Circumcision was performed most frequently in the age group of 3-6 years old. It was found that 47% of routine preoperative laboratory tests were coagulation parameters and complete blood count tests. The most common method of anesthesia was laryngeal mask. The frequency of administration of regional anesthesia was 37.4%, and caudal block was more preferable. Bupivacaine as a local anesthetic in regional anesthesia and midazolam and ketamine were the most preferred agents in sedoanalgesia. During regional anesthesia, ultrasound was most often used by anesthesiologists (31.6%). Conclusion: Ambulatory anesthesia protocols, which are also needed in circumcision, can be improved with international recommendation, and these protocols could be conformed as sociocultural structure in societies. This study should be regarded as a preliminary study to attract attention on anesthesia techniques in circumcision. PMID:28042634

  5. Pharmacokinetics of Lidocaine With Epinephrine Following Local Anesthesia Reversal With Phentolamine Mesylate

    OpenAIRE

    Moore, Paul A.; Hersh, Elliot V.; Papas, Athena S; Goodson, J. Max; Yagiela, John A; Rutherford, Bruce; Rogy, Seigried; Navalta, Laura

    2008-01-01

    Phentolamine mesylate accelerates recovery from oral soft tissue anesthesia in patients who have received local anesthetic injections containing a vasoconstrictor. The proposed mechanism is that phentolamine, an alpha-adrenergic antagonist, blocks the vasoconstriction associated with the epinephrine used in dental anesthetic formulations, thus enhancing the systemic absorption of the local anesthetic from the injection site. Assessments of the pharmacokinetics of lidocaine and phentolamine, a...

  6. Guidelines for administration of local anesthesia for dermatosurgery and cosmetic dermatology procedures

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    Mysore Venkataram

    2009-08-01

    Full Text Available Introduction, definition, rationale and scope: Dermatosurgery and Cosmetic dermatology procedures are being performed by increasing number of dermatologists. Most dermatosurgeries are performed in an outpatient setting and as day care surgeries, under local anesthesia. Hence, it is important to improve patient comfort during all procedures. These guidelines seek to lay down directives in the use of local anesthesia, outline the different local anesthetics, the mode of administration, complications arising out of such procedure and management of the same. Facility for administration of local anesthesia: Local anesthesia is usually administered in the dermatologist′s procedure room. The room should be equipped to deal with any emergencies arising from administration of local anesthesia. Qualifications of local anesthesia administrator: Local anesthesia administrator is a person who applies or injects local anesthetic agent for causing analgesia. Procedures done under local anesthesia are classified as Level I office procedures and require the administrator to have completed a course in Basic Cardiac Life Support (BCLS. Evaluation of patients for topical or infiltrative anesthesia: Details of patient′s past medical history and history of medications should be noted. Allergy to any medications should be specifically enquired and documented. Patients for tumescent anesthesia need additional precautions to be observed as described in these guidelines. Methods of administration of local anesthesia: Different methods include topical anesthesia, field block, ring block, local infiltration and nerve block. Also, it includes use of local anesthetics for anesthetizing oral and genital mucosa. Tumescent anesthesia is a special form of local anesthesia used in liposuction and certain selected procedures. Local anesthetic agents: Different local anesthetics are available such as lignocaine, prilocaine, bupivacaine. The dermatologist should be aware of the

  7. Cardiovascular effects of tramadol in dogs anesthetized with sevoflurane.

    Science.gov (United States)

    Itami, Takaharu; Tamaru, Naomichi; Kawase, Kodai; Ishizuka, Tomohito; Tamura, Jun; Miyoshi, Kenjirou; Umar, Mohammed A; Inoue, Hiroki; Yamashita, Kazuto

    2011-12-01

    Cardiovascular effects of tramadol were evaluated in dogs anesthetized with sevoflurane. Six beagle dogs were anesthetized twice at 7 days interval. The minimum alveolar concentration (MAC) of sevoflurane was earlier determined in each dog. The dogs were then anesthetized with sevoflurane at 1.3 times of predetermined individual MAC and cardiovascular parameters were evaluated before (baseline) and after an intravenous injection of tramadol (4 mg/kg). The administration of tramadol produced a transient and mild increase in arterial blood pressure (ABP) (P=0.004) with prolonged increase in systemic vascular resistance (SVR) (Ppressure, right atrial pressure and pulmonary capillary wedge pressure. In conclusion, the administration of tramadol produces a prolonged peripheral vascular constriction in dogs anesthetized with sevoflurane, which is accompanied with a transient and mild increase in arterial blood pressure. It also indicated that the degree of vasoconstriction might depend on the plasma concentration of tramadol.

  8. Anesthetic issues for robotic cardiac surgery

    Directory of Open Access Journals (Sweden)

    Wendy K Bernstein

    2015-01-01

    Full Text Available As innovative technology continues to be developed and is implemented into the realm of cardiac surgery, surgical teams, cardiothoracic anesthesiologists, and health centers are constantly looking for methods to improve patient outcomes and satisfaction. One of the more recent developments in cardiac surgical practice is minimally invasive robotic surgery. Its use has been documented in numerous publications, and its use has proliferated significantly over the past 15 years. The anesthesiology team must continue to develop and perfect special techniques to manage these patients perioperatively including lung isolation techniques and transesophageal echocardiography (TEE. This review article of recent scientific data and personal experience serves to explain some of the challenges, which the anesthetic team must manage, including patient and procedural factors, complications from one-lung ventilation (OLV including hypoxia and hypercapnia, capnothorax, percutaneous cannulation for cardiopulmonary bypass, TEE guidance, as well as methods of intraoperative monitoring and analgesia. As existing minimally invasive techniques are perfected, and newer innovations are demonstrated, it is imperative that the cardiothoracic anesthesiologist must improve and maintain skills to guide these patients safely through the robotic procedure.

  9. Anesthetic Management of a Patient With Jarcho-Levin Syndrome

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    Gamze Küçükosman

    2016-06-01

    Full Text Available Jarcho-Levin syndrome (JLS is a rare disease involving costovertebral anomalies and is accompanied by hydrocephalus, neural tube defect, and cardiac, renal and gastrointestinal problems. Due to respiratory system pathologies, there is a high mortality rate at young ages. Due to its rarity and little information in the literature related to anesthetic practice for this syndrome, we present our anesthetic experience of inguinal hernia surgery in a patient with JLS.

  10. Anesthetic Management of a Patient with Cornelia De Lange Syndrome

    OpenAIRE

    Takeshita, Takahisa; Akita, Susumu; Kawahara, Michio

    1987-01-01

    Cornelia de Lange syndrome presents various problems for anesthetic management, which include anatomical anomalies of face and extremities, cardiopulmonary and endocrine disorders, renal dysfunction, epileptic EEG waves, and mental retardation. The choice of anesthetic procedure must be carefully considered in view of these abnormalities. We administered halothane anesthesia to an 11-year-old child with this syndrome who needed dental treatment. Anesthesia and postoperative course were uneven...

  11. A hypothesis on the origin and evolution of the response to inhaled anesthetics

    OpenAIRE

    Sonner, James M.

    2008-01-01

    An evolutionary narrative explaining why organisms respond to inhaled anesthetics is proposed. It is conjectured that organisms today respond to inhaled anesthetics because their ion channels are sensitive to inhaled anesthetics by virtue of common descent from ancestral, anesthetic-sensitive ion channels in one-celled organisms (i.e., that the response to anesthetics did not arise as an adaptation of the nervous system, but rather of ion channels that preceded the origin of multicellularity)...

  12. The effect of sub-anesthetic and anesthetic ketamine on water maze memory acquisition, consolidation and retrieval.

    Science.gov (United States)

    Moosavi, Maryam; Yadollahi Khales, Golnaz; Rastegar, Karim; Zarifkar, Asadollah

    2012-02-29

    Ketamine, a non-selective inhibitor of NMDA (N-methyl-D-aspartate) channels is used in anesthetic or sub-anesthetic doses to induce analgesia, amnesia, to suppress fear, anxiety and depression. Although the ketamine's effect on memory acquisition is known, its effects on other aspects of memory are controversial. Morris water maze is a task which assesses spatial learning and memory. This study was aimed to assess the ketamine's differential effect on water maze memory acquisition, consolidation and retrieval. Male Sprague-Dawley rats (250-350 g) were trained in water maze single training session. 24h later a probe trial which was consisted of a single trial without platform was done. To assess the effect of ketamine on water maze memory acquisition it was administered before training; to assess its effect on memory consolidation it was administered immediately after training and to assess its effect on memory retrieval it was injected before probe trial. Ketamine both in sub-anesthetic and anesthetic doses impaired water maze memory acquisition, its anesthetic dose but not sub-anesthetic dose impaired memory consolidation and on retrieval stage, both doses deteriorated memory retrieval. It seems that NMDA receptor activity is not just necessary during water maze memory acquisition but also their post-learning reactivation is required to maintain memory consolidation and retrieval.

  13. Ophthalmologic complications after intraoral local anesthesia: case report and review of literature

    NARCIS (Netherlands)

    Steenen, S.A.; Dubois, L.; Saeed, P.; de Lange, J.

    2012-01-01

    Intraoral administration of local anesthetics is one of the most common dental procedures. Ophthalmologic complications can occur after maxillary as well as mandibular local anesthetic injections and may be underreported and sometimes misinterpreted. A review of the literature from the years 1936-20

  14. Anesthetic management of a patient with Sturge-Weber syndrome undergoing oral surgery.

    Science.gov (United States)

    Yamashiro, Mikiko; Furuya, Hideki

    2006-01-01

    This case involves a possible complication of excessive bleeding or rupture of hemangiomas. Problems and anesthetic management of the patient are discussed. A 35-year-old man with Sturge-Weber syndrome was to undergo teeth extraction and gingivectomy. Hemangiomas covered his face and the inside of the oral cavity. We used intravenous conscious sedation with propofol and N2O-O2 to reduce the patient's emotional stress. It was previously determined that stress caused marked expansion of this patient's hemangiomas. Periodontal ligament injection was chosen as the local anesthesia technique. Teeth were extracted without excessive bleeding or rupture of hemangiomas, but the planned gingivectomies were cancelled. Deep sedation requiring airway manipulation should be avoided because there are possible difficulties in airway maintenance. Because this was an outpatient procedure, propofol was selected as the sedative agent primarily because of its rapid onset and equally rapid recovery. Periodontal ligament injection with 2% lidocaine containing 1: 80,000 epinephrine was chosen for local anesthesia. Gingivectomy was cancelled because hemostasis was challenging. As part of preoperative preparation, equipment for prompt intubation was available in case of rupture of the hemangiomas. The typically seen elevation of blood pressure was suppressed under propofol sedation so that expansion of the hemangiomas and significant intraoperative bleeding was prevented. Periodontal ligament injection as a local anesthetic also prevented bleeding from the injection site.

  15. Hydrogen-1 NMR relaxation time studies in membrane: anesthetic systems; Variacao dos tempos de relaxacao longitudinal de protons em sistemas membranares contendo anestesicos locais

    Energy Technology Data Exchange (ETDEWEB)

    Pinto, L.M.A.; Fraceto, L.; Paula, E. de [Universidade Estadual de Campinas, SP (Brazil). Dept. de Bioquimica; Franzoni, L.; Spisni, A. [Universita degli Studi di Parma, Parma (Italy). Ist. di Chimica Biologica

    1997-12-31

    The study of local anesthetics`(LA) interaction with model phospholipid membranes is justified by the direct correlation between anesthetic`s hydrophobicity and its potency/toxicity. By the same reason, uncharged LA species seems to play a crucial role in anesthesia. Most clinically used LA are small amphiphilics with a protonated amine group (pKa around 8). Although both charged (protonated) and uncharged forms can coexist at physiological pH, it has been shown (Lee, Biochim. Biophys. Acta 514:95, 1978; Screier et al. Biochim. Biophys. Acta 769:231, 1984) that the real anesthetic pka can be down-shifted, due to differential partition into membranes, increasing the ratio of uncharged species at pH 7.4. We have measured {sup 1}H-NMR longitudinal relaxation times (T{sub 1}) for phospholipid and three local anesthetics (tetracaine, lidocaine, benzocaine), in sonicated vesicles at a 3:1 molar ratio. All the LA protons have shown smaller T{sub 1} in this system than in isotropic phases, reflecting LA immobilization caused by insertion in the membrane. T{sub 1} values for the lipid protons in the presence of LA were analyzed, in an attempt to identify specific LA:lipid contact regions. (author) 13 refs., 3 figs., 1 tabs.

  16. Liquid general anesthetics lower critical temperatures in plasma membrane vesicles

    CERN Document Server

    Gray, Ellyn; Machta, Benjamin B; Veatch, Sarah L

    2013-01-01

    A large and diverse array of small hydrophobic molecules induce general anesthesia. Their efficacy as anesthetics has been shown to correlate both with their affinity for a hydrophobic environment and with their potency in inhibiting certain ligand gated ion channels. Here we explore the effects that n-alcohols and other liquid anesthetics have on the two-dimensional miscibility critical point observed in cell derived giant plasma membrane vesicles (GPMVs). We show that anesthetics depress the critical temperature (Tc) of these GPMVs without strongly altering the ratio of the two liquid phases found below Tc. The magnitude of this affect is consistent across n-alcohols when their concentration is rescaled by the median anesthetic concentration (AC50) for tadpole anesthesia, but not when plotted against the overall concentration in solution. At AC50 we see a 4{\\deg}C downward shift in Tc, much larger than is typically seen in the main chain transition at these anesthetic concentrations. GPMV miscibility critic...

  17. Effect of general anesthetics on the developing brain

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    S Velayudha Reddy

    2012-01-01

    Full Text Available Studies on rodents and subhuman primates suggest that prolonged exposure to general anesthetics may induce widespread neuronal cell death and neurological sequelae; seriously questioning the safety of pediatric anesthesia. This review presents recent developments in this rapidly emerging field. There is mounting and convincing preclinical evidence in rodents and nonhuman primates that anesthetics in common clinical use are neurotoxic to the developing brain in vitro and cause long-term neurobehavioral abnormalities in vivo. Prior to the publication of animal data and after the publication of animal data, there are several human cohort studies that demonstrate the association of poor neurodevelopmental outcome in neonates, who underwent major surgery during their neonatal period. This review summarizes our present understanding of some of the key components responsible for anesthesia-induced neuroapoptosis and offers some of neuroprotective strategies that could be beneficial as adjunct therapy in preventing anesthesia-induced death of developing neurons in the neonates. A randomized literature search was carried out using search words apoptosis, general anesthetics, and developing brain from 1979 to 2011 for effects of general anesthetics on developing brain in PUBMED and relevant published literature reviewed. General anesthetics may produce neurotoxicity and enduring cognitive impairment in young and aged animals, but the issue has not been adequately studied in humans. It is premature to recommend a change clinical practice based on the present data.

  18. Intravenous sub-anesthetic ketamine for perioperative analgesia.

    Science.gov (United States)

    Gorlin, Andrew W; Rosenfeld, David M; Ramakrishna, Harish

    2016-01-01

    Ketamine, an N-methyl-d-aspartate antagonist, blunts central pain sensitization at sub-anesthetic doses (0.3 mg/kg or less) and has been studied extensively as an adjunct for perioperative analgesia. At sub-anesthetic doses, ketamine has a minimal physiologic impact though it is associated with a low incidence of mild psychomimetic symptoms as well as nystagmus and double vision. Contraindications to its use do exist and due to ketamine's metabolism, caution should be exercised in patients with renal or hepatic dysfunction. Sub-anesthetic ketamine improves pain scores and reduces perioperative opioid consumption in a broad range of surgical procedures. In addition, there is evidence that ketamine may be useful in patients with opioid tolerance and for preventing chronic postsurgical pain.

  19. Intravenous sub-anesthetic ketamine for perioperative analgesia

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    Andrew W Gorlin

    2016-01-01

    Full Text Available Ketamine, an N-methyl-d-aspartate antagonist, blunts central pain sensitization at sub-anesthetic doses (0.3 mg/kg or less and has been studied extensively as an adjunct for perioperative analgesia. At sub-anesthetic doses, ketamine has a minimal physiologic impact though it is associated with a low incidence of mild psychomimetic symptoms as well as nystagmus and double vision. Contraindications to its use do exist and due to ketamine′s metabolism, caution should be exercised in patients with renal or hepatic dysfunction. Sub-anesthetic ketamine improves pain scores and reduces perioperative opioid consumption in a broad range of surgical procedures. In addition, there is evidence that ketamine may be useful in patients with opioid tolerance and for preventing chronic postsurgical pain.

  20. ANESTHETIC CHALLENGES FACED IN A CHILD WITH TREACHER - COLLINS SYNDROME

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    Sahajananda

    2014-01-01

    Full Text Available Anesthesiologists come across pediatric patients with rare diseases and syndromes scheduled for various operative interventions. Treacher Collins syndrome is a rare genetic disorder characterized by craniofacial deformities , the incidence being 1 in 40 , 000 - 70 , 000 births 1 - 3 . Treacher Collins syndrome (TCS poses serious problem in securing and maintaining airway due to facial deformity. Difficulty in intubation increases as the patient’s age increases. It requires meticulous planning and assessment of the airway prior to each anesthetic technique. Here we describe and discuss successful anesthet ic management of an 8 year old boy posted for cana loplasty of the right ear

  1. Effect of some anesthetics on memory and exploration.

    Science.gov (United States)

    Valzelli, L; Kozak, W; Skorupska, M

    1988-04-01

    A light ether anesthesia in laboratory mice resulted in the complete drop of their memory retrieval to zero for more than three days after the administration. On the contrary, mice that underwent the exploration test after the light ether anesthesia performed as expected, confirming that impairment of memory does not necessarily reflect on exploratory performance. The effect of some anesthetic drugs was then studied on memory retrieval and exploratory behavior. Within this general framework, the anesthetics here studied all worsen memory retrieval, however without inducing clear and long-lasting amnesic effect comparable to that exerted by ether anesthesia. Contrarily, the classically amnesic drug scopolamine, orally administered, enhances memory retrieval and improves exploration.

  2. [The possible secondary effects in cases of local anesthesia].

    Science.gov (United States)

    Malamed, S F

    2000-01-01

    Local anesthetics are the safest and most effective drugs for pain control. Over 300 million local anesthetic cartridges are administered by dentists in the United States of America annually, yet serious complications reported number but a handful. Complications are categorised as localised or systemic. Localised complications arise at the site of needle penetration or anesthetic administration while systemic complications involve the entire organism. Localised complications include needle breakage, paresthesia, trismus, haematoma and facial nerve paralysis, while systemic complications are psychogenic to the act of receiving an injection, allergy and drug overdose (toxic reaction). These potential complications are briefly described in the following paper.

  3. Efficacy of tramadol as a preincisional infiltration anesthetic in children undergoing inguinal hernia repair: a prospective randomized study

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    Numanoğlu KV

    2014-09-01

    Full Text Available Kemal Varim Numanoğlu,1 Hilal Ayoğlu,2 Duygu Tatli,1 Ebubekir Er11Department of Pediatric Surgery, 2Department of Anesthesiology, Faculty of Medicine, Bülent Ecevit University, Kozlu, Zonguldak, TurkeyBackground: Preincisional local anesthetic infiltration at the surgical site is a therapeutic option for postoperative pain relief for pediatric inguinal hernia. Additionally, tramadol has been used as an analgesic for postoperative pain in children. Recently, the local anesthetic effects of tramadol have been reported. The aim of this study was to determine both the systemic analgesic and the local anesthetic effects of tramadol and to determine how it differs from bupivacaine when administered preincisionally.Methods: Fifty-two healthy children, aged 2–7 years, who were scheduled for elective herniorrhaphy were randomly allocated to receive either preincisional infiltration at the surgical site with 2 mg/kg tramadol (Group T, n=26 or 0.25 mL/kg 0.5% bupivacaine (Group B, n=26. At the time of anesthetic administration, perioperative hemodynamic parameters were recorded. The pain assessments were performed 10 minutes after the end of anesthesia and during the first 6-hour period, using pain scores. The time of first dose of analgesia and need for additional analgesia were recorded.Results: Between T and B groups, the anesthesia time, perioperative hemodynamic changes, and pain scores were not statistically different. However, in group B, the postoperative analgesic requirement was higher than in group T.Conclusion: Tramadol shows equal analgesic effect to bupivacaine and decreases additional analgesic requirement, when used for preincisional infiltration anesthesia in children undergoing inguinal herniorrhaphy.Keywords: bupivacaine, postoperative analgesia, pain scores

  4. Development of a behavioral assessment of craniofacial muscle pain in lightly anesthetized rats.

    Science.gov (United States)

    Ro, Jin Y; Capra, Norman; Masri, Radi

    2003-07-01

    In this study, a new behavioral assessment of craniofacial muscle pain in the lightly anesthetized rat is described. Intramuscular injections with algesic agents in lightly anesthetized rats evoked a characteristic ipsilateral hindpaw shaking behavior for several minutes similar to previously described orofacial pain-induced grooming behavior in awake rats (Neurosci Lett 103 (1989) 349, Pain 62 (1995) 295). Eighty-two male Sprague-Dawley rats were used in a series of experiments to study whether this behavior could serve as a valid measure of craniofacial muscle pain. First, we demonstrated that different algesic chemicals, mustard oil (20%), formalin (3%) or hypertonic saline (5%) injected in the mid-region of the masseter muscle effectively elicited the hindpaw shaking behavior. The behavior was only minimally evoked with vehicle injection. Repeated administrations of hypertonic saline, a short duration non-sensitizing algogen, demonstrated reproducibility of the assay. Second, we showed that the peak and overall magnitude of the shaking behavior evoked by injections with different concentrations of mustard oil (1 and 5%) changed in a concentration dependent manner. Finally, we showed that systemic administration of morphine sulfate (3 and 0.3 mg/kg, i.p.) dose dependently attenuated mustard oil induced hindpaw-shaking behavior. Lidocaine injected locally 5 min prior to mustard oil injection also significantly decreased the hindpaw shaking behavior. Based on these results we concluded that ipsilateral hindpaw shaking in lightly anesthetized rats is a stereotypical behavior evoked by noxious muscle stimulation and can be used as a reliable behavioral measure to assess craniofacial muscle pain.

  5. Concentrations of anesthetics across the water-membrane interface; the Meyer-Overton hypothesis revisited

    Science.gov (United States)

    Pohorille, A.; Wilson, M. A.; New, M. H.; Chipot, C.

    1998-01-01

    The free energies of transferring a variety of anesthetic and nonanesthetic compounds across water-oil and water-membrane interfaces were obtained using computer simulations. Anesthetics exhibit greatly enhanced concentrations at these interfaces, compared to nonanesthetics. The substitution of the interfacial solubilites of the anesthetics for their bulk lipid solubilities in the Meyer-Overton relation, was found to give a better correlation, indicating that the potency of an anesthetic is directly proportional to its solubility at the interface.

  6. Assessing the impact on global climate from general anesthetic gases

    DEFF Research Database (Denmark)

    Andersen, Mads P. Sulbæk; Nielsen, Ole John; Wallington, Timothy J.

    2012-01-01

    anthropogenic radiative forcing of climate, as measured relative to the start of the industrial era (approximately 1750). The family of anesthetic gases includes several halogenated organic compounds that are strong greenhouse gases. In this short report, we provide an overview of the state of knowledge...

  7. Differential regional metabolism of glucagon in anesthetized pigs

    DEFF Research Database (Denmark)

    Deacon, Carolyn F; Kelstrup, Mette; Trebbien, Ramona;

    2003-01-01

    Glucagon metabolism under basal (endogenous) conditions and during intravenous glucagon infusion was studied in anesthetized pigs by use of midregion (M), COOH-terminal (C), and NH2-terminal (N)-RIAs. Arteriovenous concentration differences revealed a negative extraction of endogenous glucagon...

  8. Comparison of Two Anesthetic Methods for Intravitreal Ozurdex Injection

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    V. Levent Karabaş

    2015-01-01

    Full Text Available Purpose. To determine whether subconjunctival lidocaine injection maintains additional anesthetic effect during intravitreal Ozurdex injection. Methods. 63 patients who were diagnosed as central or branch retinal vein occlusion and planned to receive Ozurdex injection for macular edema were prospectively included in the study. The patients were randomized into one of the two anesthetic groups. The first group received topical proparacaine drop and lidocaine applied pledget. The second group received subconjunctival lidocaine injection in addition to the anesthetics in group 1. Results. Mean pain score was 1.90±2.39 in group 1 and 1.71 ± 2.09 in group 2 (p=0.746. Mean subconjunctival hemorrhage grade was 1.67±0.17 in group 1 and 0.90±0.14 in group 2 (p=0.001. There was no relationship between the amount of subconjunctival hemorrhage and pain score of the patients. Conclusions. There was no difference in pain scores between the two anesthetic methods. The addition of subconjunctival lidocaine injection offered no advantage in pain relief compared to lidocaine-applied pledgets.

  9. The Anesthetic Effect of Anterior Middle Superior Alveolar Technique (AMSA)

    Science.gov (United States)

    de Souza Tolentino, Lívia; Barbisan Souza, André; Girardi, Ana Alice; Romito, Giuseppe Alexandre; Araújo, Maurício Guimarães

    2015-01-01

    Anesthesia of the soft and hard tissues of the maxilla may require up to 5 injections. Thus, the aim of this study was to evaluate the anesthetic efficacy of the anterior middle superior alveolar (AMSA) and supraperiosteal injection techniques during subgingival scaling and root planing (SRP). Thirty individuals with periodontitis were scheduled for SRP on the buccal aspect of teeth in the anterior maxilla. Before SRP, on a randomly chosen side of the maxilla, the supraperiosteal injection was performed in 1 session, while the AMSA injection was conducted in the contralateral side of the same patient in another session. Immediately after each SRP session, patients rated their pain perception during the procedure with a visual analog scale. No statistically significant differences in mean pain ratings during SRP were found after both anesthetic techniques (P > .05). This preliminary study demonstrated that the AMSA and supraperiosteal injection techniques provided similar anesthetic comfort during SRP. The AMSA injection could be an alternative to anesthetize the buccal aspect of maxilla, without the undesirable effects on facial structures such as the upper lip, nostrils, and lower eyelids. However, further randomized clinical trials with larger samples are necessary to confirm such results. PMID:26650493

  10. Anesthetic keratopathy presenting as bilateral Mooren-like ulcers

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    Khakshoor H

    2012-10-01

    Full Text Available Hamid Khakshoor,1 Majid Moshirfar,2 Rachel G Simpson,3 Hamid Gharaee,1 Amir H Vejdani,1 Steven M Christiansen,2 Jason N Edmonds,2 Nicholas L Behunin21Mashhad University of Medical Sciences, Department of Ophthalmology, Mashad, Iran; 2John A Moran Eye Center, University of Utah, Salt Lake City, UT, 3The University of Arizona College of Medicine, Phoenix, AZ, USAAbstract: This observational case report describes the development of bilateral Mooren-like ulcers in a patient with anesthetic keratopathy. A 42-year-old man with a recent history of minor eye trauma and pain self-treated with tetracaine eye drops presented with complaints of acutely worsening vision and severe pain bilaterally. His visual acuity at presentation was limited to hand motion. Slit-lamp examination revealed bilateral epithelial defects at the center of the cornea, and an area of stromal infiltration and thinning with an undermining leading edge resembling a Mooren's ulcer in both eyes. Corneal haze and hypopyon were visible. Anesthetic use was halted immediately and the patient was started on prednisolone and mycophenolate mofetil (Cellcept®, after which visual acuity gradually improved and pain decreased. Despite improvement of symptoms, residual epithelial defects remained, and the patient was ultimately treated with keratoplasty for recovery of vision. We suggest that anesthetic keratopathy should be included in the differential diagnosis for any patient presenting with ring-shaped stromal infiltrates or nonhealing epithelial defects.Keywords: anesthetic abuse, corneal damage, corneal ulceration

  11. Anesthetic management of a horse with traumatic pneumothorax

    OpenAIRE

    Chesnel, Maud-Aline; Aprea, Francesco; Clutton, R. Eddie

    2012-01-01

    A traumatic pneumothorax and severe hemorrhage were present in a mare with a large thoracic wall defect, lung perforation, and multiple rib fractures. General anesthesia was induced to allow surgical exploration. We describe the anesthetic technique, and discuss the management of the ventilatory, hemodynamic, and metabolic disturbances encountered.

  12. Efficacy of Topical Anesthetics in the Treatment of Ingrown Nail

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    Fatma Gülru Erdoğan

    2011-06-01

    Full Text Available Background and Design: One of the reasons for preferring conservative methods for ingrown nails is lack of local anesthesia for the painful step. Moreover, ingrown nail is a painful condition per se. It may be very difficult to intervene patients with high basal pain levels. Here, we aimed to assess the efficacy of topical anesthetics (2.5% lidocaine, 2.5% prilocaine mixture and 20% benzocaine gel by determining basal pain level and pain during and after manipulation in patients with severe pain who applied with ingrown nail complaint.Material and Method: In this study, we included a total of 29 patients (12 male, 17 female who had complaint of ingrown nail and for whom nail brace treatment was planned. The patients were divided randomly into two groups regardless of the stage of ingrown nail: with lidocain-prilocain mixture application and with benzocaine gel application. Benzocaine gel was applied 10 minutes before the procedure and lidocaine-prilocaine mixture was applied under occlusion, 2 hours prior to the procedure. Pain levels were evaluated on a numerical pain rating scale before and after topical anesthesia as well as during and half an hour after the procedure in both groups.Results: Statistical difference was not detected between the pain levels of the two groups before and after topical anesthesia and during and half an hour after the procedure. Regardless of the stage of ingrown nail, the pain levels after topical anesthesia and half an hour after procedure were found to decrease significantly compared to the levels before topical anesthesia in both groups. Pain levels of both groups increased during the procedure and were similar to the basal levels. Considering the stage of ingrown nail, while lidocaine-prilocaine mixture did not decrease pain significantly in the cases with stage 2-3, benzocaine did. Conclusion: Due to ease of application and especially to efficacy in stage 2-3 ingrown nails, 20% benzocaine gel may help in

  13. Frequency-dependent entrainment of neocortical slow oscillation to repeated optogenetic stimulation in the anesthetized rat.

    Science.gov (United States)

    Kuki, Toshinobu; Ohshiro, Tomokazu; Ito, Shin; Ji, Zhi-Gang; Fukazawa, Yugo; Matsuzaka, Yoshiya; Yawo, Hiromu; Mushiake, Hajime

    2013-01-01

    Local field potential (LFP) slow oscillation (entrained to repeated external sensory stimuli. To better understand the neural mechanism underlying slow-oscillation generation and its entrainment to external stimuli, we delivered optical stimulation to the cortex of anesthetized rats that exogenously expressed the light-sensitive cation channel channelrhodopsin-2 (ChR2) and simultaneously monitored LFPs across cortical layers. We found that the LFPs could be effectively entrained to repeated optical stimulation at 1Hz in deep layers. A stimulus-triggered current-source density (CSD) analysis showed that the evoked oscillation had the same depth and temporal profile as the slow oscillations, indicating that both oscillations have the same neural mechanism. Optical stimulation primarily induced the transition from the cortical up to down state. These results suggest that the anesthetized rat cortex has an intrinsic mechanism that leads to oscillation near 1Hz; effective entrainment to the 1Hz stimulation reflects the resonated state of the cortex to that stimulus. Our study is the first to demonstrate optogenetic manipulation of cortical slow oscillation and provides a mechanistic explanation for slow-oscillation entrainment.

  14. Head cooling with mild systemic hypothermia in anesthetized piglets is neuroprotective.

    Science.gov (United States)

    Tooley, James R; Satas, Saulius; Porter, Helen; Silver, Ian A; Thoresen, Marianne

    2003-01-01

    Hypothermia is potentially therapeutic in the management of neonatal hypoxic-ischemic brain injury. However, not all studies have shown a neuroprotective effect. It is suggested that the stress of unsedated hypothermia may interfere with neuroprotection. We propose that selective head cooling (SHC) combined with mild total-body hypothermia during anesthesia enhances local neuroprotection while minimizing the occurrence of systemic side effects and stress associated with unsedated whole-body cooling. Our objective was to determine whether SHC combined with mild total-body hypothermia while anesthetized for a period of 24 hours reduces cerebral damage in our piglet survival model of global hypoxia-ischemia. Eighteen anesthetized piglets received a 45-minute global hypoxic-ischemic insult. The pigs were randomized either to remain normothermic or to receive SHC. We found that the severity of the hypoxic-ischemic insult was similar in the SHC versus the normothermic group, and that the mean neurology scores at 30 and 48 hours and neuropathology scores were significantly better in the SHC group versus the normothermic group. We conclude that selective head cooling combined with mild systemic hypothermia and anesthesia is neuroprotective when started immediately after the insult in our piglet model of hypoxic-ischemic encephalopathy.

  15. Comparative Evaluation of Pain Scores during Periodontal Probing with or without Anesthetic Gels

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    Ashank Mishra

    2016-01-01

    Full Text Available Context. The initial periodontal examination which includes full-mouth periodontal probing is one of the discomforting procedures for a patient. Aim. To evaluate the efficacy of two local anesthetic gels in the reduction of pain during periodontal probing using Florida probe in CGP patients in comparison with manual probing. Materials and Methods. Ninety systemically healthy patients with moderate to severe CGP patients were recruited. In each patient, the quadrants were randomly assigned to manual probing with UNC-15 probe, probing with Florida probe, and Florida probing with lidocaine 10% gel and with benzocaine 20% gel. In the quadrants undergoing probing with anesthetic gels, the sites were isolated and the gel was injected using syringe and a blunt-end cannula. Pain was measured using 10 mm horizontal VAS. Statistical Analysis. The analysis was carried out using SPSS version 18. The comparison of mean VAS scores was done using repeated measures ANOVA with post hoc Bonferroni test. Results. Mean VAS for manual probing was significantly more than Florida probing. Further, the mean VAS score for Florida probing was higher than the two gels. Conclusion. It is suggested that the gels might be useful in reducing pain experienced during full-mouth periodontal probing in patients with CGP.

  16. A comparison of the anesthetic efficacy of articaine and lidocaine in patients with irreversible pulpitis.

    Science.gov (United States)

    Tortamano, Isabel Peixoto; Siviero, Marcelo; Costa, Carina Gisele; Buscariolo, Inês Aparecida; Armonia, Paschoal Laércio

    2009-02-01

    The purpose of the present study was to compare the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine with that of 2% lidocaine with 1:100,000 epinephrine during pulpectomy in patients with irreversible pulpitis in mandibular posterior teeth. Forty volunteers, patients with irreversible pulpitis admitted to the Emergency Center of the School of Dentistry at the University of São Paulo, randomly received a conventional inferior alveolar nerve block containing 3.6 mL of either 4% articaine with 1:100,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine. During the subsequent pulpectomy, we recorded the patients' subjective assessments of lip anesthesia, the absence/presence of pulpal anesthesia through electric pulp stimulation, and the absence/presence of pain through a verbal analogue scale. All tested patients reported lip anesthesia after the application of either inferior alveolar nerve block. Regarding pulpal anesthesia success as measured with the pulp tester, the lidocaine solution had a higher success rate (70%) than the articaine solution (65%). For patients reporting none or mild pain during pulpectomy, the success rate of the articaine solution (65%) was higher than that of the lidocaine solution (45%). Yet, none of the observed differences between articaine and lidocaine were statistically significant. Apparently, therefore, both local anesthetic solutions had similar effects on the patients with irreversible pulpitis in mandibular posterior teeth. Neither of the solutions, however, resulted in an effective pain control during irreversible pulpitis treatments.

  17. High throughput modular chambers for rapid evaluation of anesthetic sensitivity

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    Eckmann David M

    2006-11-01

    Full Text Available Abstract Background Anesthetic sensitivity is determined by the interaction of multiple genes. Hence, a dissection of genetic contributors would be aided by precise and high throughput behavioral screens. Traditionally, anesthetic phenotyping has addressed only induction of anesthesia, evaluated with dose-response curves, while ignoring potentially important data on emergence from anesthesia. Methods We designed and built a controlled environment apparatus to permit rapid phenotyping of twenty-four mice simultaneously. We used the loss of righting reflex to indicate anesthetic-induced unconsciousness. After fitting the data to a sigmoidal dose-response curve with variable slope, we calculated the MACLORR (EC50, the Hill coefficient, and the 95% confidence intervals bracketing these values. Upon termination of the anesthetic, Emergence timeRR was determined and expressed as the mean ± standard error for each inhaled anesthetic. Results In agreement with several previously published reports we find that the MACLORR of halothane, isoflurane, and sevoflurane in 8–12 week old C57BL/6J mice is 0.79% (95% confidence interval = 0.78 – 0.79%, 0.91% (95% confidence interval = 0.90 – 0.93%, and 1.96% (95% confidence interval = 1.94 – 1.97%, respectively. Hill coefficients for halothane, isoflurane, and sevoflurane are 24.7 (95% confidence interval = 19.8 – 29.7%, 19.2 (95% confidence interval = 14.0 – 24.3%, and 33.1 (95% confidence interval = 27.3 – 38.8%, respectively. After roughly 2.5 MACLORR • hr exposures, mice take 16.00 ± 1.07, 6.19 ± 0.32, and 2.15 ± 0.12 minutes to emerge from halothane, isoflurane, and sevoflurane, respectively. Conclusion This system enabled assessment of inhaled anesthetic responsiveness with a higher precision than that previously reported. It is broadly adaptable for delivering an inhaled therapeutic (or toxin to a population while monitoring its vital signs, motor reflexes, and providing precise control

  18. Regional anesthetic activity of new decahydroquinolinyl derivative by the experimental model of terminal anesthesia

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    Goncharuk V.V.

    2014-09-01

    Full Text Available anesthesia. Material and Methods. Decahydroquinolinyl derivative under laboratory code PAS-68 synthesized in the A. B. Bekturov Institute of Chemical Sciences under the guidance of K. D. Praliev has been studied. Benzocaine, lido-caine and tetracaine were used as the comparison drugs. Male rabbits of 2,0-3,5 kg weight were used as experimental animals. A threshold of corneal sensitivity to tactile effects (Rainier index was determined by the standard method. Computer prognosis of PAS-68 acute toxicity also was made. Results. The local anesthetic activity of 1 %, 0,5% and 0,25% solutions of PAS-68 were identified as higher than that for lidocaine and benzocaine in similar concentrations (p <0,05 but lower than that for tetracaine (p<0,05. PAS-68 has no local irritating action. The duration of anesthesia, 0,5% and 1 % PAS 68 exceeds that for benzocaine and lidocaine at equivalent concentrations (p<0,05. By this kind of activity PAS-68 is a second to the duration of anesthesia by tetracaine (p<0,05. The latent period of anesthesia induced by PAS-68 is shorter than the latent periods induced by benzocaine, lidocaine and tetracaine. On the base of predictive analysis it was concluded that PAS-68 is of low toxicity. Conclusion. PAS-68 exceeds benzocaine and lidocaine by the local anesthetic activity and duration of anesthesia and is second only to tetracaine. The latent period of anesthesia PAC-68 is shorter than the latent period of benzocaine, lidocaine and tetracaine respectively.

  19. Vibrational Infrared Lifetime of the Anesthetic nitrous oxide gas in solution

    CERN Document Server

    Chieffo, Logan; Shattuck, Jeffrey; Hong, Mi K; Ziegler, Lawrence; Erramilli, Shyamsunder

    2006-01-01

    The lifetime of the asymmetric fundamental stretching 2218 cm$^{-1}$ vibration of the anesthetic gas nitrous oxide (N$_2$O) dissolved in octanol and olive oil is reported. These solvents are model systems commonly used to assess anesthetic potency. Picosecond time-scale molecular dynamics simulations have suggested that protein dynamics or membrane dynamics play a role in the molecular mechanism of anesthetic action. Ultrafast infrared spectroscopy with 100 fs time resolution is an ideal tool to probe dynamics of anesthetic molecules on such timescales. Pump-probe studies at the peak of the vibrational band yield a lifetime of $55 \\pm 1$ ps in olive oil and $52 \\pm 1 ps$ in octanol. The similarity of lifetimes suggests that energy relaxation of the anesthetic is determined primarily by the hydrophobic nature of the environment, consistent with models of anesthetic action. The results show that nitrous oxide is a good model system for probing anesthetic-solvent interactions using nonlinear infrared spectroscop...

  20. [Anesthetic Management of Three Patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy].

    Science.gov (United States)

    Maruyama, Naoko; Wakimoto, Mayuko; Inamori, Noriko; Nishimura, Shinya; Mori, Takahiko

    2015-08-01

    Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a chronically progressing or relapsing disease caused by immune-mediated peripheral neuropathy. We report the anesthetic management of three CIDP patients who underwent elective orthopedic surgeries. Owing to the risk of neuraxial anesthetics triggering demyelination, general anesthesia was selected to avoid epidural or spinal anesthesia or other neuraxial blockade. It was also judged prudent to avoid prolonged perioperative immobilization, which might compress vulnerable peripheral nerves. For Patient 1, general anesthesia was induced with propofol, remifentanil, and sevoflurane, and was maintained with sevoflurane and remifentanil. For Patients 2 and 3, general anesthesia was induced and maintained with propofol and remifentanil. For tracheal intubation, under careful monitoring with peripheral nerve stimulators, minimal doses of rocuronium (0.6-0.7 mg x kg(-1)) were administered. When sugammadex was administered to reverse the effect of rocuronium, all patients rapidly regained muscular strength. Postoperative courses were satisfactory without sequelae.

  1. Dissociative anesthetic combination reduces intraocular pressure (IOP in rabbits

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    Ewaldo de Mattos-Junior

    2014-02-01

    Full Text Available The aim of this study was evaluate the effects of three anesthetic combinations, ketamine-midazolam, ketamine-xylazine and tiletamine-zolazepam, on IOP in rabbits. In a experimental, blind, randomized, crossover study, six rabbits were anesthetized with each of 3 treatments in random order. Groups KM (ketamine, 30 mg/kg + midazolam, 1 mg/kg; KX (ketamine, 30 mg/kg + xylazine, 3 mg/kg; and TZ (tiletamine + zolazepam, 20 mg/kg. The drugs were mixed in the same syringe injected intramuscularly (IM into the quadriceps muscle. IOP was measured before drug administration (baseline and at 5-minute intervals for 30 minutes. The data were analyzed by a 2-way repeated measures ANOVA followed by Bonferroni test. All groups had significant decreases in IOP compared to baseline (p 0.05. Administration of either ketamine-midazolam, ketamine-xylazine, or tiletamine-zolazepam similarly decrease IOP in rabbits within 30 minutes of injection.

  2. Efficacy of benzocaine as an anesthetic for salmonid fishes

    Science.gov (United States)

    Gilderhus, P.A.

    1989-01-01

    Benzocaine was tested in the laboratory to determine the effective concentrations for anesthetizing juvenile chinook salmon Oncorhynchus tshawytscha an rainbow trout O. mykiss (formerly Salmo gairdneri ). Tests were conducted at three water temperatures, in waters ranging from very soft to very hard, and with groups of rainbow trout from 5 to 47 cm long and chinook salmon 20 cm long. Effective concentrations were defined as those that rendered the fish fully handleable in 3 min or less, allowed recovery of most fish within 10 min, and caused no mortality after 15-min exposures. Concentrations of 25-45 mg/L anesthetized both species over the entire range of conditions tested. Although efficacy was essentially unrelated to species or water quality, it was related to water temperature and size of fish; the concentrations of benzocaine required were highest at the lowest water temperature and for the largest fish.

  3. Refractometry for quality control of anesthetic drug mixtures.

    Science.gov (United States)

    Stabenow, Jennifer M; Maske, Mindy L; Vogler, George A

    2006-07-01

    Injectable anesthetic drugs used in rodents are often mixed and further diluted to increase the convenience and accuracy of dosing. We evaluated clinical refractometry as a simple and rapid method of quality control and mixing error detection of rodent anesthetic or analgesic mixtures. Dilutions of ketamine, xylazine, acepromazine, and buprenorphine were prepared with reagent-grade water to produce at least 4 concentration levels. The refraction of each concentration then was measured with a clinical refractometer and plotted against the percentage of stock concentration. The resulting graphs were linear and could be used to determine the concentration of single-drug dilutions or to predict the refraction of drug mixtures. We conclude that refractometry can be used to assess the concentration of dilutions of single drugs and can verify the mixing accuracy of drug combinations when the components of the mixture are known and fall within the detection range of the instrument.

  4. Mechanics and Morphology of Silk Drawn from Anesthetized Spiders

    Science.gov (United States)

    Madsen, B.; Vollrath, F.

    CO2 and N2 anesthetized Nephila spiders produced dragline silk with mechanical properties that differed from control silk as a function of time under anesthesia. Silk from CO2 spiders had a significantly lower breaking strain and breaking energy, significantly higher initial modulus, and marginally lower breaking stress. At the onset of anesthesia the silk diameter became highly variable. During deep anesthesia silk either became thinner or retained cross-section but fibrillated.

  5. ANESTHETIC CONSIDERATION S IN CHRONIC OBSTRUCTIVE PULMON ARY DISEASE

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    Awati

    2015-03-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a spectrum of diseases that includes emphysema, chronic bronchitis, and small airway disease. It i s characterized by progressive increased resistance to breathing. Patients with marked obstructive pulmonary disease are at increased risk for both intraoperative and Postoperative pulmonary complications. These patients require thorough preoperative prepa ration, meticulous intraoperative management & postoperative care. This article describes anesthetic considerations in a patient with COPD.

  6. Assessment of patient satisfaction with the preoperative anesthetic evaluation

    Directory of Open Access Journals (Sweden)

    Gebremedhn EG

    2014-09-01

    Full Text Available Endale Gebreegziabher Gebremedhn, Vidhya Nagaratnam Department of Anesthesia, School of Medicine, Gondar College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Background: The evaluation of patient satisfaction is a core aspect of the continuous quality improvement in anesthesia service that can be affected by the preoperative anesthetist visit. This visit enables the anesthetist to know about the patient's general health status and the nature of surgery, to choose the type of anesthesia, and to discuss perioperative complications and their management with the patient. Patients have sometimes complained about the information given during the preoperative anesthetic evaluation in the University of Gondar teaching and referral hospital. The aim of this study was to determine the level of patient satisfaction with the preoperative anesthetist visit. Methods: A cross-sectional study was conducted from February 15 to April 15, 2013. All consecutive elective patients who were operated upon under anesthesia during the study period were interviewed 24 hours after operation. A pretested questionnaire and checklists, which were developed based on the hospital's anesthetic evaluation sheet, were used for data collection. Results: A total of 116 elective patients were operated upon under anesthesia during the study period. Of these, 102 patients were included in our study, with a response rate of 87.9%. Anesthetists introduced themselves to ~24% patients; provided information about anesthesia to ~32%, postoperative complications to ~21%, postoperative analgesia to ~18, and postoperative nausea and vomiting to ~21%; and spent adequate time with ~74%. Patients' questions were answered by the anesthetist in ~65% of cases, and ~65% of patients had reduced anxiety after the anesthetist visit. The patients' overall satisfaction with the preoperative anesthetist visit was ~65%. Conclusion and recommendation: Patient satisfaction with the

  7. Anesthetic Management in a Gravida with Type IV Osteogenesis Imperfecta

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    Elizabeth Vue

    2016-01-01

    Full Text Available Osteogenesis imperfecta (OI is an inherited disorder of the connective tissues caused by abnormalities in collagen formation. OI may present many challenges to the anesthesiologist. A literature review reveals a wide range of implications, from basic positioning to management of the difficult airway. We present the anesthetic management of a 25-year-old gravid woman with OI, fetal demise, and possible uterine rupture, admitted for an exploratory laparotomy.

  8. Neuropathological sequelae of developmental exposure to antiepileptic and anesthetic drugs

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    Chrysanthy eIkonomidou

    2012-08-01

    Full Text Available Glutamate (Glu and aminobutyric acid (GABA are major neurotransmitters in the mammalian brain which regulate brain development at molecular, cellular and systems level. Sedative, anesthetic and antiepileptic drugs interact with glutamate and GABA receptors to produce their desired effects. The question is posed whether such interference with glutamatergic and GABAergic neurotransmission may exert undesired, and perhaps even detrimental effects on human brain development. Preclinical research in rodents and non-human primates has provided extensive evidence that sedative, anesthetic and antiepileptic drugs can trigger suicide of neurons and oligodendroglia, suppress neurogenesis, and inhibit normal synapse development and sculpting. Behavioral correlates in rodents and non-human primates consist of long-lasting cognitive impairment. Retrospective clinical studies in humans exposed to anesthetics or antiepileptic drugs in utero, during infancy or early childhood have delivered conflicting but concerning results in terms of a correlation between drug exposure and impaired neurodevelopmental outcomes. Prospective studies are currently ongoing. This review provides a short overview of the current state of knowledge on this topic.

  9. Effect of anesthetics on bending elasticity of lipid membranes

    Science.gov (United States)

    Yi, Zheng; Michihiro, Nagao; Bossev, Dobrin

    2008-03-01

    Change in physical and chemical properties of bio-membranes is of great interest for understanding the mechanism of anesthetic action on membranes. Hypothetically the anesthetic alters the lipid membrane structure (promoting pore formation across membranes or at least switching transmembrane channels) and therefore the biophysical properties of the membrane. We have used neutron spin echo (NSE) spectroscopy to study the effect of anesthetic molecule, lidocaine, on the bending elasticity (BE) of lipid membranes. BE of lipid bilayers made of (1,2-Dimyristoyl-sn-Glycero-3-Phosphocholine) DMPC and 1,2-Dipalmitoyl-sn-Glycero-3-Phosphocholine (DPPC) have been measured at different temperatures and different in the fluid (Lα) phase. Using Zilman-Granek theory the BE were obtained from the decay of the NSE intermediate scattering function. We have found that in the presence of lidocaine the BE of DMPC and DPPC bilayers increases. The results were correlated with those from differential scanning calorimetry. Increase in the lidocaine concentration leads to decrease in the liquid/crystalline transition temperature.

  10. Near-Infrared Spectroscopy for the Evaluation of Anesthetic Depth

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    Gabriela Hernandez-Meza

    2015-01-01

    Full Text Available The standard-of-care guidelines published by the American Society of Anesthesiologists (ASA recommend monitoring of pulse oximetry, blood pressure, heart rate, and end tidal CO2 during the use of anesthesia and sedation. This information can help to identify adverse events that may occur during procedures. However, these parameters are not specific to the effects of anesthetics or sedatives, and therefore they offer little, to no, real time information regarding the effects of those agents and do not give the clinician the lead-time necessary to prevent patient “awareness.” Since no “gold-standard” method is available to continuously, reliably, and effectively monitor the effects of sedatives and anesthetics, such a method is greatly needed. Investigation of the use of functional near-infrared spectroscopy (fNIRS as a method for anesthesia or sedation monitoring and for the assessment of the effects of various anesthetic drugs on cerebral oxygenation has started to be conducted. The objective of this paper is to provide a thorough review of the currently available published scientific studies regarding the use of fNIRS in the fields of anesthesia and sedation monitoring, comment on their findings, and discuss the future work required for the translation of this technology to the clinical setting.

  11. Post-anesthetic cortical blindness in cats: twenty cases.

    Science.gov (United States)

    Stiles, J; Weil, A B; Packer, R A; Lantz, G C

    2012-08-01

    The medical records of 20 cats with post-anesthetic cortical blindness were reviewed. Information collected included signalment and health status, reason for anesthesia, anesthetic protocols and adverse events, post-anesthetic visual and neurological abnormalities, clinical outcome, and risk factors. The vascular anatomy of the cat brain was reviewed by cadaver dissections. Thirteen cats were anaesthetised for dentistry, four for endoscopy, two for neutering procedures and one for urethral obstruction. A mouth gag was used in 16/20 cats. Three cats had had cardiac arrest, whereas in the remaining 17 cases, no specific cause of blindness was identified. Seventeen cats (85%) had neurological deficits in addition to blindness. Fourteen of 20 cats (70%) had documented recovery of vision, whereas four (20%) remained blind. Two cats (10%) were lost to follow up while still blind. Ten of 17 cats (59%) with neurological deficits had full recovery from neurological disease, two (12%) had mild persistent deficits and one (6%) was euthanased as it failed to recover. Four cats (23%) without documented resolution of neurological signs were lost to follow up. Mouth gags were identified as a potential risk factor for cerebral ischemia and blindness in cats.

  12. Estudo clínico e histológico das pálpebras e conjuntiva hígidas submetidas ao tratamento tópico com soluções anestésicas em coelhos Clinical and histological evaluation of healthy eyelid and conjunctiva subject to local treatment with anesthetic solutions in rabbits

    Directory of Open Access Journals (Sweden)

    A.V.C. Amaral

    2013-02-01

    Full Text Available Avaliaram-se as apresentações comerciais de colírios anestésicos aplicados em 63 coelhos da raça Nova Zelândia, distribuídos em três grupos (G1, G2 e G3 de 21 animais cada e que receberam instilação de uma gota em cada olho seis vezes ao dia. Os animais do G1 foram tratados com colírio de cloridrato de proparacaína a 0,5%; os do G2, com colírio de cloridrato de tetracaína a 1% associado à fenilefrina a 0,1%; e os do G3, com solução fisiológica. Cada grupo foi subdividido em três subgrupos com sete animais cada, os quais foram tratados por três, sete e 15 dias. No final de cada tratamento, dois animais de cada subgrupo foram sacrificados para exame histológico de fragmentos retirados da conjuntiva, da terceira pálpebra e das pálpebras. Observou-se, ao exame clínico, episclerite em graus diversos em 100% dos animais do G1, no terceiro, sétimo e 15º dia, e em apenas 17,8% nos do G2, nestes mesmos dias. Ao exame microscópico, observaram-se aumento do número de células califormes, proliferação de folículos linfoides, aumento do número de eosinófilos e aumento do espaço intersticial nas pálpebras dos animais do G1. Pôde-se concluir que o colírio de tetracaína a 1% associado à fenilefrina a 0,1% promoveu maior toxicidade à conjuntiva ocular e às pálpebras de coelhos quando comparado ao colírio de proparacaína a 0,5%.This work aimed to evaluate commercial presentations of anesthetic eye drops in sixty three New Zealand rabbits which were separated equally in three groups (G1, G2 and G3. The G1 group was treated with 0.5% proparacaine chloridrate eye drop, G2 group with 1% tetracaine chloridrate associated with 0.1% phenylephrine eye drop and G3 group with 0.9% physiologic solution eye drop. All of them received one drop in each eye six times a day. Each group was subdivided into three subgroups (seven rabbits, which are treated for 3, 7 and 15 days. At the end of each treatment, two animals in each subgroup

  13. Anesthetic neuroprotection: antecedents and an appraisal of preclinical and clinical data quality.

    Science.gov (United States)

    Ishida, Kazuyoshi; Berger, Miles; Nadler, Jacob; Warner, David S

    2014-01-01

    Anesthetics have been studied for nearly fifty years as potential neuroprotective compounds in both perioperative and resuscitation medicine. Although anesthetics present pharmacologic properties consistent with preservation of brain viability in the context of an ischemic insult, no anesthetic has been proven efficacious for neuroprotection in humans. After such effort, it could be concluded that anesthetics are simply not neuroprotective in humans. Moreover, pharmacologic neuroprotection with non-anesthetic drugs has also repeatedly failed to be demonstrated in human acute brain injury. Recent focus has been on rectification of promising preclinical neuroprotection data and subsequent failed clinical trials. This has led to consensus guidelines for the process of transferring purported therapeutics from bench to bedside. In this review we first examined the history of anesthetic neuroprotection research. Then, a systematic review was performed to identify major clinical trials of anesthetic neuroprotection. Both the preclinical neuroprotection portfolio cited to justify a clinical trial and the design and conduct of that clinical trial were evaluated using modern standards that include the Stroke Therapy Academic Industry Roundtable (STAIR) and Consolidated Standards of Reporting Trials (CONSORT) guidelines. In publications intended to define anesthetic neuroprotection, we found overall poor quality of both preclinical efficacy analysis portfolios and clinical trial designs and conduct. Hence, using current translational research standards, it was not possible to conclude from existing data whether anesthetics ameliorate perioperative ischemic brain injury. Incorporation of advances in translational neuroprotection research conduct may provide a basis for more definitive and potentially successful clinical trials of anesthetics as neuroprotectants.

  14. Anesthetic management of a case with hereditary spherocytosis for splenectomy and open cholecystectomy

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    Sonal S Khatavkar

    2016-01-01

    Full Text Available Hereditary spherocytosis (HS is a familial hemolytic disorder with marked heterogeneity of clinical features ranging from asymptomatic condition to a fulminant hemolytic anemia. HS is characterized by the strong family history of anemia, jaundice, splenomegaly and cholelithiasis. Anesthetic Management of HS with liver dysfunction is very challenging since most of the anesthetic drugs are metabolized by the liver. Hereby, we report anesthetic management in a case of HS with splenomegaly and gall stones for elective splenectomy and cholecystectomy.

  15. Glutamatergic Neurotransmission Links Sensitivity to Volatile Anesthetics with Mitochondrial Function.

    Science.gov (United States)

    Zimin, Pavel I; Woods, Christian B; Quintana, Albert; Ramirez, Jan-Marino; Morgan, Philip G; Sedensky, Margaret M

    2016-08-22

    An enigma of modern medicine has persisted for over 150 years. The mechanisms by which volatile anesthetics (VAs) produce their effects (loss of consciousness, analgesia, amnesia, and immobility) remain an unsolved mystery. Many attractive putative molecular targets have failed to produce a significant effect when genetically tested in whole-animal models [1-3]. However, mitochondrial defects increase VA sensitivity in diverse organisms from nematodes to humans [4-6]. Ndufs4 knockout (KO) mice lack a subunit of mitochondrial complex I and are strikingly hypersensitive to VAs yet resistant to the intravenous anesthetic ketamine [7]. The change in VA sensitivity is the largest reported for a mammal. Limiting NDUFS4 loss to a subset of glutamatergic neurons recapitulates the VA hypersensitivity of Ndufs4(KO) mice, while loss in GABAergic or cholinergic neurons does not. Baseline electrophysiologic function of CA1 pyramidal neurons does not differ between Ndufs4(KO) and control mice. Isoflurane concentrations that anesthetize only Ndufs4(KO) mice (0.6%) decreased the frequency of spontaneous excitatory postsynaptic currents (sEPSCs) only in Ndufs4(KO) CA1 neurons, while concentrations effective in control mice (1.2%) decreased sEPSC frequencies in both control and Ndufs4(KO) CA1 pyramidal cells. Spontaneous inhibitory postsynaptic currents (sIPSCs) were not differentially affected between genotypes. The effects of isoflurane were similar on evoked field excitatory postsynaptic potentials (fEPSPs) and paired pulse facilitation (PPF) in KO and control hippocampal slices. We propose that CA1 presynaptic excitatory neurotransmission is hypersensitive to isoflurane in Ndufs4(KO) mice due to the inhibition of pre-existing reduced complex I function, reaching a critical reduction that can no longer meet metabolic demands.

  16. Clinical features of pheochromocytoma and perioperative anesthetic management

    Institute of Scientific and Technical Information of China (English)

    罗爱伦; 郭向阳; 易杰; 任洪智; 黄宇光; 叶铁虎

    2003-01-01

    Objective To investigate clinical features of pheochromocytoma and summarize experiences of anesthetic management during the perioperative period. Methods Two hundred and fifty eight patients who were diagnosed with pheochromocytoma in our hospital were reviewed retrospectively for clinical features. According to different preoperative pharmalogical preparations, perioperative mortalities were analyzed in three periods (Period 1: January 1955-December 1975; Period 2: January 1976-December 1994; Period 3: January 1995-July 2001). In Period 3, hemodynamic changes in the patients undergoing different anesthetic methods were analyzed. Results About 5.8% (15/258) of pheochromocytoma was an integral part of multiple endocrine neoplasia (MEN) type Ⅱ or mixed type. Sixty percent (149/249) of the patients who had undergone surgery possessed evidence of catecholamine cardiac toxicity preoperatively. Impaired glucose tolerance was found in 59% (147/249) of the patients before surgery. Perioperative mortality was significantly decreased from 8% (5/60) in Period 1 to 1.2% (1/75) in Period 2 (P<0.01). No perioperative deaths occurred in Period 3. The volume infused during the operation was significantly higher both in the epidural anesthesia group (3474 ml±624 ml, P<0.01) and in the epidural plus general anesthesia group (3654 ml±475 ml, P<0.01) than in the general anesthesia group (2534 ml±512 ml). There were favorable hemodynamic characteristics in patients before removal of the tumor in the epidural anesthesia group and in the epidural plus general anesthesia group, as compared with the general anesthesia group. Conclusions A positive surgical outcome of the excision of pheochromocytoma depends on multiple factors, including careful assessment of potential vital organ damage before surgery and restoration of blood volume by establishing α-blockade preoperatively, meticulous anesthetic management of patients during surgery, and appropriate circulatory support after

  17. Anesthetic Considerations in a Patient with Myotonic Dystrophy for Hip Labral Repair

    Science.gov (United States)

    Wang, David; Ludwin, Danielle

    2017-01-01

    Myotonic Dystrophy (DM) affects multiple organ systems. Disorders such as hyperthyroidism, progressive musculoskeletal weakness, cardiac dysrhythmias, hypoventilation, and cognitive-behavioral disorders may be present in these patients. Thorough preoperative assessment and anesthetic planning are required to minimize the risk of anesthetic complications. Patients with DM can exhibit exquisite sensitivity to sedatives, neuromuscular blocking agents, and volatile anesthetics, resulting in potential postoperative complications. There is limited literature available on successful anesthetic techniques for the DM patient. We present this case report to add to our current fund of knowledge. PMID:28316843

  18. Update on administration of anesthetics and psychoactive drugs for pain management in China.

    Science.gov (United States)

    Gu, Weiping

    2015-06-01

    Anesthetics and psychoactive drugs could relieve diseases, if used properly. However, they can cause dependency, and their misuse or abuse could adversely affect people's health and social stability. For a long time, the Chinese government has been reinforcing the regulation on anesthetics and psychoactive drugs to ensure their legal and proper usage, and to prevent abuse. The state council issued 'the regulations on the administration of anesthetic drugs and psychotropic drugs' in 2005, based on which a legal system was established for administration of anesthetics and psychoactive drugs with the objectives of ensuring their legitimate medical utilization, and preventing illegal abuse.

  19. Multiple anesthetics for a patient with stiff-person syndrome.

    Science.gov (United States)

    Cassavaugh, Jessica M; Oravitz, Todd M

    2016-06-01

    Stiff-person syndrome is a progressive disease of muscle rigidity and spasticity due to a deficiency in the production of γ-aminobutyric acid. Because of the rarity of the condition, little is known about effects of anesthesia on patients with stiff-person syndrome. This report describes the clinical course for a single patient with stiff-person syndrome who received general anesthesia on 3 separate occasions. Her anesthetics included use of both neuromuscular blockade and volatile agents. Unlike several previous reports regarding anesthesia and stiff-person syndrome, the postoperative period for this patient did not require prolonged intubation or result in any residual weakness.

  20. Cimetidine as pre-anesthetic agent for cesarean section

    DEFF Research Database (Denmark)

    Qvist, N; Storm, K; Holmskov, A

    1985-01-01

    In a prospective randomized study of 39 consecutive cesarean sections, 20 patients received cimetidine 400 mg intramuscularly as a pre-anesthetic, an 19 control patients were given NaCl. No perinatal effects on the infants were observed by cardiotocography before delivery, and K, Na, pH, PCO2, HCO......-3 and glucose values in capillary blood were nearly identical in the two groups 2 hours after birth, the difference being non-significant (p greater than 0.05). No respiratory effects or arrhythmias were observed. In another study comprising 8 elective cesarean sections in patients...

  1. Anesthetic management of a pediatric patient with neuroleptic malignant syndrome.

    Science.gov (United States)

    Bhalla, Tarun; Maxey, Douglas; Sawardekar, Amod; Tobias, Joseph D

    2012-04-01

    Neuroleptic malignant syndrome (NMS) is a rare disorder which is clinically similar to malignant hyperthermia (MH). It is characterized by hyperthermia, autonomic instability, muscle rigidity, coma, rhabdomyolysis, and acidosis. Without immediate and appropriate therapy, mortality may result. NMS is associated with administration of antipsychotic medications, anti-emetic medications, and changes in the dosage of anti-parkinsonian drugs. As several similarities exist between NMS and MH, differentiating between them can be a challenge for the clinician. We report anesthetic care during magnetic resonance imaging of the brain of a 14-year-old female with bipolar and schizoaffective disorders and the recent onset of NMS.

  2. Anesthetic management of a child with Hunter′s syndrome

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    Jasmeet Kaur

    2012-01-01

    Full Text Available Hunter′s syndrome is a member of a group of recessively inherited metabolic disorders termed mucopolysaccharidoses, caused by deficiency of lysosomal enzymes required for degradation of mucopolysaccharides or glycosaminoglycans, leading to accumulation of partially degraded glycosaminoglycans in various tissues. This leads to various anatomical abnormalities and systemic involvement, posing a challenge to an anesthetist. We present the anesthetic management of a 4-year old child with Hunter′s disease with anticipated difficult airway, who presented for adenotonsillectomy and repair of umbilical and inguinal hernia.

  3. Central bronchial carcinoid: Management of a case and anesthetic perspectives

    Science.gov (United States)

    Goswami, D; Kashyap, L; Batra, RK; Bhagat, C

    2016-01-01

    Obstructing lesions of the central airways present with a variety of symptoms and are often associated with pneumonia or asthma-like states. Anesthesia to these patients often presents challenges right from the preoperative stabilization of underlying lung condition, mask ventilation in the supine position to maintaining oxygenation and ventilation in the intraoperative and postoperative period. We present here a case of a young woman with a central bronchial tumor with significant airway obstruction with potential for major bleeding and subsequent anesthetic management without lung sacrificing measures and cardiopulmonary bypass assistance. PMID:26955320

  4. Central bronchial carcinoid: Management of a case and anesthetic perspectives

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    D Goswami

    2016-01-01

    Full Text Available Obstructing lesions of the central airways present with a variety of symptoms and are often associated with pneumonia or asthma-like states. Anesthesia to these patients often presents challenges right from the preoperative stabilization of underlying lung condition, mask ventilation in the supine position to maintaining oxygenation and ventilation in the intraoperative and postoperative period. We present here a case of a young woman with a central bronchial tumor with significant airway obstruction with potential for major bleeding and subsequent anesthetic management without lung sacrificing measures and cardiopulmonary bypass assistance.

  5. The anesthetic management in the patient with Kabuki makeup syndrome

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    İsmail Aydın Erden

    2013-03-01

    Full Text Available Kabuki makeup syndrome is characterized by mentalretardation, characteristic facial appearance (ektropion,skeletal abnormalities, joint laxity, short stature. The syndromeis thought to be a consequence of otosomal dominantmutation. Important factors in anesthetical managementof these patients include; difficult airway, cardiologicproblems, obstructive sleeps apne, hypotoni and malignshyperthermia risks. In this case report we aimed to discussanesthesic management of a patient with Kabukisyndrome -a rare clinical entity in our country- . J Clin ExpInvest 2013; 4 (1: 116-118Key words: kabuki makeup, tympanoplasty, general anesthesia

  6. Volatile anesthetic for the control of posthypoxic refractory myoclonic status

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    Vivek Rayadurg

    2016-01-01

    Full Text Available Posthypoxic myoclonus (Lance-Adams syndrome is characterized by myoclonus involving multiple muscle groups which is resistant to most conventional antiepileptic drugs. We present a case of hypoxic brain injury-induced myoclonic status epilepticus successfully controlled with isoflurane. The antimyoclonic effects of isoflurane are likely due to potentiation of inhibitory postsynaptic GABA A receptor-mediated currents and its effects on thalamocortical pathways. It is effective even when intravenous agents fail to control myoclonus. It may be a useful alternative to intravenous anesthetics as a third tier therapy in patients with refractory status myoclonus.

  7. Precise determination of refractometric parameters for anesthetic agent vapors.

    Science.gov (United States)

    Allison, J M; Birch, K P; Crowder, J G

    1994-05-01

    The absolute refractive indices of the anesthetic agent vapors isoflurane, sevoflurane, enflurane, halothane, and desflurane are determined to a typical uncertainty of 1 part in 10(7) over the respective temperature and pressure ranges of 15-40 °C and 5-45% of their saturated vapor pressures at wavelengths of 632.99, 594.10, and 543.52 nm. The specific refraction, second virial coefficients, and dispersion constants are also derived for each agent, from which an equation for the calculation of agent refractivity is established that is in agreement with the measured data to within 2 × 10(-8).

  8. [Anesthetic management of a patient with suspected pseudothrombocytopenia].

    Science.gov (United States)

    Hashimoto, Manabu; Kouchi, Akira; Inaba, Shin; Motomura, Yuji; Takahashi, Minoru

    2003-10-01

    A 74-year-old male was operated for sigmoid colon cancer. Because of an agglutination of the patient's platelet, it was difficult to measure his platelet count under ethylene diamine tetra acetate (EDTA), heparin or citrate as anticoagulants with an automated cell counter. Even though there was a strong possibility of pseudothrombocytopenia, anesthetic management for the patient was safely conducted. His condition was stable throughout the perioperative course and no bleeding tendency was observed. Nitrous oxide, oxygen, sevoflurane, propofol and pancuronium were useful in this case.

  9. Anesthetic considerations in Leigh disease: Case report and literature review

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    Abdullah Sulieman Terkawi

    2012-01-01

    Full Text Available Leigh disease is an extremely rare disorder, characterized by a progressive neurodegenerative course, with subacute necrotizing encephalomyelopathy. It usually presents in infancy with developmental delay, seizures, dysarthria, and ataxia. These patients may also develop episodes of lactic acidosis that usually lead to respiratory failure and death. Due to the rarity of the condition, the most appropriate anesthetic plan remains unclear. We present a patient with Leigh disease, who required general anesthesia. The pathogenesis of the disease is discussed and previous reports of perioperative care from the literature are reviewed.

  10. The environmental impact of the Glostavent® anesthetic machine.

    Science.gov (United States)

    Eltringham, Roger J; Neighbour, Robert C

    2015-06-01

    Because anesthetic machines have become more complex and more expensive, they have become less suitable for use in the many isolated hospitals in the poorest countries in the world. In these situations, they are frequently unable to function at all because of interruptions in the supply of oxygen or electricity and the absence of skilled technicians for maintenance and servicing. Despite these disadvantages, these machines are still delivered in large numbers, thereby expending precious resources without any benefit to patients. The Glostavent was introduced primarily to enable an anesthetic service to be delivered in these difficult circumstances. It is smaller and less complex than standard anesthetic machines and much less expensive to produce. It combines a drawover anesthetic system with an oxygen concentrator and a gas-driven ventilator. It greatly reduces the need for the purchase and transport of cylinders of compressed gases, reduces the impact on the environment, and enables considerable savings. Cylinder oxygen is expensive to produce and difficult to transport over long distances on poor roads. Consequently, the supply may run out. However, when using the Glostavent, oxygen is normally produced at a fraction of the cost of cylinders by the oxygen concentrator, which is an integral part of the Glostavent. This enables great savings in the purchase and transport cost of oxygen cylinders. If the electricity fails and the oxygen concentrator ceases to function, oxygen from a reserve cylinder automatically provides the pressure to drive the ventilator and oxygen for the breathing circuit. Consequently, economy is achieved because the ventilator has been designed to minimize the amount of driving gas required to one-seventh of the patient's tidal volume. Additional economies are achieved by completely eliminating spillage of oxygen from the breathing system and by recycling the driving gas into the breathing system to increase the Fraction of Inspired Oxygen

  11. Anesthetic management of schwannoma of the base of the tongue

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    Upma B Batra

    2011-01-01

    Full Text Available Schwannoma arising from the base of the tongue are very rare and only a few cases have been reported so far. Definitive diagnosis is always made after a histological examination. Apart from an anticipated difficult airway with a risk of airway obstruction upon induction of general anesthesia, anesthetic concerns also include possibility of trauma to the growth and bleeding with attendant risks. We discuss the awake fiberoptic technique used for endotracheal intubation in such a case. This case report highlights the importance of detailed history taking and clinical examination, with emphasis on airway assessment and preoperative planning.

  12. Anesthetic management of schwannoma of the base of the tongue.

    Science.gov (United States)

    Batra, Upma B; Usha, G; Gogia, Anoop R

    2011-04-01

    Schwannoma arising from the base of the tongue are very rare and only a few cases have been reported so far. Definitive diagnosis is always made after a histological examination. Apart from an anticipated difficult airway with a risk of airway obstruction upon induction of general anesthesia, anesthetic concerns also include possibility of trauma to the growth and bleeding with attendant risks. We discuss the awake fiberoptic technique used for endotracheal intubation in such a case. This case report highlights the importance of detailed history taking and clinical examination, with emphasis on airway assessment and preoperative planning.

  13. Local anesthesia part 2: technical considerations.

    Science.gov (United States)

    Reed, Kenneth L; Malamed, Stanley F; Fonner, Andrea M

    2012-01-01

    An earlier paper by Becker and Reed provided an in-depth review of the pharmacology of local anesthetics. This continuing education article will discuss the importance to the safe and effective delivery of these drugs, including needle gauge, traditional and alternative injection techniques, and methods to make injections more comfortable to patients.

  14. INTRATHECAL PETHIDINE AS A SOLE ANESTHETIC AGENT FOR LOWER LIMB SURGERIES

    Directory of Open Access Journals (Sweden)

    Pandu Naik

    2015-09-01

    Full Text Available BACKGROUND : The discovery of opioid receptors and ligand in the brain and spinal cord lead to the feasibility of their intrathecal use. Pethidine is the only narcotic that has been shown to be effective intrathecally for surgery. This is because it as a phenyl - piperidine derivative and has a structure and action similar to that of local anesthetic. METHODS : It is a prospective study of 50 patients belonging to ASA grade I and II physical status were administered intra thecal Pethidine (preservative free 1mg/kg body weight for lower limb surgeries. The time of onset and level of sensory blockade, onset and degree of motor blockade, hemodynamic parameters, time for regression of sensory and motor blockade, duration of po stoperative analgesia and side effects were assessed in the patients. RESULTS : Majority of the procedures performed were below knee amputation or external fixation. The mean duration of onset of sensory block was 6.55 mins (SD: ± 0.79 and onset of motor blo ck was 8.39mins (SD: ± 0.83. Peak level of sensory block was attained at L1 level in majority of patients (82%. Degree of motor block was II degree in 66% of patients. Mean time required for motor recovery was 62.2 mins (SD: ±5.0. This was followed by sen sory regression at 94.6mins (SD:±7.3. Mean duration of postoperative analgesia was 333 minutes (SD: ±29.9. Side effects observed were hypotension, nausea, vomiting, sedation, and pruritus. CONCLUSION : Pethidine (preservative free 1mg/kg body weight can b e used intrathecally as a sole anesthetic agent to provide prolonged postoperative analgesia associated with hemodynamic stability and early ambulation in patients undergoing lower limb surgeries.

  15. Randomized study of phentolamine mesylate for reversal of local anesthesia.

    Science.gov (United States)

    Laviola, M; McGavin, S K; Freer, G A; Plancich, G; Woodbury, S C; Marinkovich, S; Morrison, R; Reader, A; Rutherford, R B; Yagiela, J A

    2008-07-01

    Local anesthetic solutions frequently contain vasoconstrictors to increase the depth and/or duration of anesthesia. Generally, the duration of soft-tissue anesthesia exceeds that of pulpal anesthesia. Negative consequences of soft-tissue anesthesia include accidental lip and tongue biting as well as difficulty in eating, drinking, speaking, and smiling. A double-blind, randomized, multicenter, Phase 2 study tested the hypothesis that local injection of the vasodilator phentolamine mesylate would shorten the duration of soft-tissue anesthesia following routine dental procedures. Participants (122) received one or two cartridges of local anesthetic/vasoconstrictor prior to dental treatment. Immediately after treatment, 1.8 mL of study drug (containing 0.4 mg phentolamine mesylate or placebo) was injected per cartridge of local anesthetic used. The phentolamine was well-tolerated and reduced the median duration of soft-tissue anesthesia in the lip from 155 to 70 min (p < 0.0001).

  16. [Anesthetic consideration in patients undergoing catheter ablation for atrial fibrillation].

    Science.gov (United States)

    Oda, Toshiyuki; Takahama, Yutaka

    2012-11-01

    This chapter describes anesthetic consideration in patients undergoing catheter ablation for atrial fibrillation (AF) based on electrophysiologic or pharmacological aspects. In the 2011 guidelines of the Japanese Circulation Society for non-pharmacotherapy of cardiac arrhythmias, catheter ablation is recommended as Class I therapeutic modality for the patients with drug-refractory paroxysmal AF. Catheter ablation of AF is an invasive and long-lasting procedure necessitating sedation during treatment. However, in the most of the patients, sedation or anesthesia is possibly performed by cardiologists using propofol, midazolam or dexmedetomidine. Deep sedation accompanies a high risk of ventilatory or circulatory derangement. Furthermore, life-threatening complications, such as cerebral infarction or cardiac tamponade, can occur during ablation. Patients with AF are increasing in number as a trend in the aging society, resulting in an increase in catheter ablation in high risk patients. To accomplish safe anesthetic management of the patients for catheter ablations, anesthesiologists are required to have fundamental knowledge and skill in the performance of the catheter ablation.

  17. Achieving pulpal anesthesia with a topical anesthetic paste

    Directory of Open Access Journals (Sweden)

    Bradley Carn

    2015-01-01

    Full Text Available Aim: The efficacy of a topically applied formulation of tetracaine base (6% was investigated against benzocaine in achieving pulpal anesthesia in a randomized, placebo-controlled, double-blind study. Materials and Methods: Subjects′ baseline pulpal responses to an electric pulp tester were measured, followed by a 10 min application of either tetracaine anesthetic paste (TAP, benzocaine (20%, or placebo. Treatments were removed and pulp testing was performed at 10 min, 15 min, and 20 min postapplication. Results: TAP produced significant pulpal anesthesia at 184% ± 7.2% above baseline versus 14% ± 1.7% above baseline for benzocaine at 15 min (P < 0.03. Differences between treatments were tested with the Wilcoxon test and the Steel-Dwass test, which is the nonparametric version of the all-pairs Tukey′s honestly significant difference test. Conclusion: Achieving profound anesthesia with a topical anesthetic paste could lead to injection less procedure, improved postsurgical incisional pain management, and ameliorate pain associated with a variety of lesions.

  18. Electrocardiographic effects of toluene in the anesthetized rat.

    Science.gov (United States)

    Vidrio, H; Magos, G A; Lorenzana-Jimenez, M

    1986-01-01

    The influence of inhalation of near lethal quantities of toluene on some ECG parameters, as well as the possible cardiac sensitizing effect of the solvent, were determined in chloralose-anesthetized rats. These actions were compared with those of its close analogue benzene. Both solvents produced tachycardia; toluene increased the duration of QRS and specially PR, while benzene decreased P wave duration. No other systematic changes in ECG morphology or evidence of arrhythmia were observed. Toluene appeared to decrease the number of ectopic beats induced by epinephrine, in contrast to benzene, which increased it markedly. These results suggest that toluene administered by inhalation up to near lethal doses is devoid of untoward ECG effect in the chloralose-anesthetized rat, its only action being a decrease in intraventricular and particularly AV conduction. It does not share the myocardial sensitizing properties of benzene and in fact appears to elicit some protection from the arrhythmogenic effects of epinephrine, although no definite conclusions as to this action can be derived due to limitations in the experimental model used.

  19. An emphasis on the wide usage and important role of local anesthesia in dentistry: A strategic review

    OpenAIRE

    Preetinder Singh

    2012-01-01

    Local anesthesia forms the major part of pain-control techniques in dentistry. The prevention and elimination of pain during dental treatment has benefited patients, their doctors and dental hygienists, enabling the dental profession to make tremendous therapeutic advances that would otherwise have been impossible. Introduced in the late 1940s, the amide local anesthetics represent the most used drugs in dentistry. Local anesthetics also represent the safest and most effective drugs in all of...

  20. Tolerability of NGX-4010, a capsaicin 8% patch, in conjunction with three topical anesthetic formulations for the treatment of neuropathic pain

    Directory of Open Access Journals (Sweden)

    Webster LR

    2012-01-01

    , and could be adequately managed by local cooling or short-acting oral opioid analgesics. Although slightly more patients used medication for treatment-related discomfort following pretreatment with Topicaine compared with L.M.X.4 or Betacaine, there were no statistical differences between the topical anesthetics. Neuropathic pain reduction from baseline to weeks 2 through 12 was approximately 30% and was similar among the topical anesthetics; the proportion of responders ranged from 45% to 50%.Conclusion: Treatment with NGX-4010 following pretreatment with any of the three topical anesthetics was generally safe and well tolerated; no significant differences in the parameters measured were noted between the pretreatment groups.Keywords: neuropathic pain, capsaicin patch, tolerability, topical anesthetics

  1. Clinical observation on the efficacy of local injection of anesthetic and corticosteroid combined with rehabilitation training in treatment of patients with external humeral epicondylitis%局部注射麻醉药及皮质类固醇复合康复训练治疗肱骨外上髁炎的临床观察

    Institute of Scientific and Technical Information of China (English)

    李德刚; 李彦平; 罗克金

    2016-01-01

    目的:观察局部注射麻醉药及皮质类固醇复合康复训练治疗肱骨外上髁炎的临床效果。方法选择40例疼痛时间在1~4周的肱骨外上髁炎患者,随机分成局部注射组(B 组,n =20)和局部注射复合康复训练组(BR 组,n=20)。B 组仅接受肱骨外上髁0.5%利多卡因+甲强龙20 mg 注射治疗(1次/周,共2周)治疗。BR 组接受肱骨外上髁同样药物注射治疗(1次/周,共2周)复合康复训练(3次/天,5分钟/次,共2周)治疗。观察两组治疗后第1、2、4、8周的局部疼痛感、局部压痛、屈肘负重的疼痛视觉模拟评分。观察两组治疗后4周和8周时疼痛症状复发率。结果两组治疗后第1周和第2周时疼痛程度较治疗前显著降低( P 0.05)。治疗后第4周和第8周时 BR 组疼痛程度明显低于 B 组( P 0. 05). The intensity of pain in patients of group BR in 4 and 8 weeks after treatment was significantly lower than that of patients in group B( P < 0. 05). The recurrence rates of LA,LPP,and EFWBP at 4 and 8 weeks after the treatment in group BR were significantly lower than those in group B( P < 0. 05). Conclusion Local injection of anesthethetic combined with rehabilitation training is effective in controlling the local pain,improving the movement and keeping a long - term stable therapeutic effect in patients with external hu-meral epicondylitis.

  2. Anesthetic success of 1.8ml lidocaine 2% for mandibular tooth extraction. A pilot study

    Directory of Open Access Journals (Sweden)

    Pedro Aravena

    2013-04-01

    Full Text Available Aim: To determine the anesthetic effect of a 1.8ml cartridge of anesthetic lidocaine 2% with epinephrine 1:100,000 in inferior alveolar nerve block (NAI for the extraction in mandibular teeth. Material and methods: A pilot study with analitic design. Participating patients of Dental Emergency Service volunteers from Valdivia-Chile for mandibular teeth extractions attending between May and July of 2010. The anesthetic technique was performed by a dentist using only one cartridge of anesthetic to the NAI. After 15 minutes, the effect was considered effective when anesthetic not require reinforcement with additional anesthesia during extraction of teeth. We analyzed the relationship between success anesthetic effect with sex, age, diagnosis of tooth and type and level of pain observed (chi-square and logistic regression, p<0.05. Results: 62 patients were selected, of which only 47(75.8% was achieved anesthetic success. There was no statistical association with sex, age, type or dental diagnosis and perceived pain. Conclusion: Using a 1.8ml cartridge of anesthesia was effective in three of four patients treated by extraction of mandibular teeth. It suggests further research in relation to the clinical effectiveness of other anesthetics with the same dose in NAI.

  3. [Anesthetic machine leakage from vaporizer by external force derived from keyboard of electronic medical records].

    Science.gov (United States)

    Ikegami, Hiromi; Goto, Ryokichi; Sakamoto, Syotarou; Kohama, Hanako

    2012-11-01

    We experienced the leakage from the vaporizer of the anesthetic machine despite the normalities on performing the initial leak test. The vaporizer of the anesthetic machine was compressed by computer keyboard of EMR which caused a leak from vaporizer. After computer keyboard and the vaporizer were set at normal position, the leak stopped.

  4. Bupivacaine Lozenge Compared with Lidocaine Spray as Topical Pharyngeal Anesthetic before Unsedated Upper Gastrointestinal Endoscopy

    DEFF Research Database (Denmark)

    Salale, Nesrin; Treldal, Charlotte; Mogensen, Stine;

    2014-01-01

    Unsedated upper gastrointestinal endoscopy (UGE) can induce patient discomfort, mainly due to a strong gag reflex. The aim was to assess the effect of a bupivacaine lozenge as topical pharyngeal anesthetic compared with standard treatment with a lidocaine spray before UGE. Ninety-nine adult...... with a lidocaine spray proved to be a superior option as topical pharyngeal anesthetic before an UGE....

  5. A Comparison of Hamster Anesthetics and Their Effect on Mosquito Blood Feeding

    Science.gov (United States)

    Hamsters or mice are often anesthetized when they are used as the hosts for insect feeding experiments. An experiment was done to determine if there was a difference in mosquito blood feeding success when fed on hamsters anesthetized using two commonly used protocols. The number of blood-fed females...

  6. Nonpreserved amniotic membrane transplantation for bilateral toxic keratopathy caused by topical anesthetic abuse: a case report

    Directory of Open Access Journals (Sweden)

    Altinok Ayse

    2010-08-01

    Full Text Available Abstract Introduction Corneal damage associated with abuse of topical anesthetics is a rare clinic entity. Topical anesthetic abuse is one of the causes of ring keratitis. Ring keratitis is easily overlooked because it can mimic acanthamoeba keratitis or other infectious keratitis. The outcome is often poor, leading to persistent epithelial defects, corneal scarring, and perforations. Case presentation We report the clinical presentation, diagnosis, and treatment of a 65-year-old Caucasian man, who worked as a health care worker, with bilateral toxic keratopathy caused by topical anesthetic abuse. Nonpreserved amniotic membrane transplantation was performed for both eyes of the patient. Conclusion It is important to identify and treat patients who abuse topical anesthetics before permanent vision loss ensues. Nonpreserved amniotic membrane transplantation may be useful in relieving pain and improving corneal surface in anesthetic agent abusers.

  7. Effect of a training model in local anesthesia teaching

    NARCIS (Netherlands)

    Brand, H.S.; Baart, J.A.; Maas, N.E.; Bachet, I.

    2010-01-01

    The aim of this study was to evaluate the preclinical use of a training model in local anesthesia teaching on the subsequent clinical administration of a local anesthetic. Sixty-five dental students gave their first injection to a fellow dental student: twenty-two students after previous experience

  8. Anesthetic management of Morgagni hernia repair in an elderly woman.

    Science.gov (United States)

    Nama, Rajnish K; Butala, Bina P; Shah, Veena R; Patel, Hiren R

    2015-01-01

    Adult onset congenital diaphragmatic hernia (CDH) is uncommon but not rare. Morgagni hernia is a rare variant of CDH. The defect tends to be small and patients may remain asymptomatic and diagnosed incidentally. When these patients become symptomatic, they usually present with gastrointestinal and cardiorespiratory symptoms or sometimes as an emergency due to obstruction or strangulation of herniated viscera. Chest radiograph, computed tomography scan, and magnetic resonance imaging are the imaging modalities used for diagnosis of CDH. Cardiopulmonary compromise due to mass effect of hernial contents on lungs, heart and great vessels, and obstruction or strangulation of herniated viscera poses the special challenge before anesthesiologists. Our patient was diagnosed to have Morgagni hernia, at the age of 72 years and underwent laparotomy for the same. This case highlights the key feature of the successful anesthetic management of adult onset CDH.

  9. Dental anesthetic management of a patient with ventricular arrhythmias.

    Science.gov (United States)

    Miller, R A; Siegelman, L I

    1998-01-01

    During routine deep sedation for endodontic therapy, a dentist-anesthesiologist observed premature ventricular contractions (PVCs) on a 62-yr-old woman's electrocardiogram (EKG) tracing. The dentist was able to complete the root canal procedure under intravenous (i.v.) sedation without any problems. The dentist-anesthesiologist referred the patient for medical evaluation. She was found to be free from ischemic cardiac disease with normal ventricular function. The patient was cleared to continue her dental treatment with deep sedation. She subsequently continued to undergo dental treatment with deep intravenous sedation without incident, although her EKG exhibited frequent PVCs, up to 20 per minute, including couplets and episodes of trigeminy. This article will review indications for medical intervention, antiarrhythmic medications, and anesthetic interventions for perioperative PVCs.

  10. Neurotoxicity of general anesthetics: A modern view of the problem

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    A. M. Ovezov

    2015-01-01

    Full Text Available All general anesthetics routinely used in clinical practice are noted to have a neurotoxic effect on the brain in different animal species including primates. The negative effects observed both in young and sexually mature animals include apoptotic neuronal cell death, suppression of neurogenesis and gliogenesis, neuroinflammation, as well as learning and memory impairments. A number of epidemiologic surveys have established an association between anesthesia in patients younger than 3 to 4 years and subsequent learning disabilities and language disorders whereas others have not found this link. In middle-aged and elderly patients, anesthesia is frequently associated with the development of postoperative cognitive dysfunction. The key component of its pathogenesis (general anesthesia itself or other factors, such as operative injury, an inflammatory response, pain syndrome, intraoperative complications, underlying disease in a patient remains unelucidated. It is concluded that there is a need for additional experimental and clinical studies of the pathogenesis of these undesirable phenomena to be prevented and corrected.

  11. Eugenol as an anesthetic for juvenile common snook

    Directory of Open Access Journals (Sweden)

    Jurandir Joaquim Bernardes Júnior

    2013-08-01

    Full Text Available The objective of this work was to evaluate the efficacy of eugenol as an anesthetic for juvenile common snook, and to determine the minimum effective concentration for use in handling procedures. In the first trial, juvenile common snook were subjected to immersion baths at 25, 50, 75, 100, 125, and 150 mg L-1 eugenol concentrations, after which induction and recovery times were evaluated. In the second experiment, the lethal exposure time (LT50 at 75 mg L-1 was estimated. Minimum effective eugenol concentration was 50 mg L-1, andthe stage of deep anesthesia and recovery were, respectively, reached at 126.3 and 208.8 s. At 75 mg L-1, LT50 was 1,314 s, and induction time and recovery were also satisfactory; however, fish cannot tolerate over 229 s exposure.

  12. Electrocardiographic evaluation of two anesthetic combinations in dogs

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    Tárraga K.M.

    2000-01-01

    Full Text Available This study aimed to investigate electrocardiographic changes in dogs aged 5 years or more submitted to two anesthetic combinations: atropine, levomeprazine, thiopental and halothane (ALTH, and atropine, tiletamine and zolazepam (ATZ. Forty dogs (24 males/16 females weighing 5-24kg, were used. Dogs had no cardiac problems and were submitted to tartarectomy. All animals were submitted to two electrocardiograms (ECG, one before anesthesia and other immediately before surgery. The dogs were divided into two groups: group 1 received ALTH and group 2 received ATZ. Alterations in the ST segment, T wave, cardiac rhythm and a significant reduction of vagal tonus index were observed in both groups, but in group 2 a significant reduction of the PR and QT intervals and an increase in heart rate were also observed. These data suggest that the ALTH combination caused fewer changes in the ECG than the ATZ combination.

  13. Carcinoid tumors: Challenges and considerations during anesthetic management

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    Sukhminder Jit Singh Bajwa

    2015-01-01

    Full Text Available Carcinoid tumors are rare, slow-growing neoplasms of neuroendocrine tissues from enterochromaffin or kulchitsky cells, which have the potential to metastasize. The mediators released from these tumors when bypass the hepatic metabolism, can lead to the possible development of carcinoid syndrome. This is a life-threatening complication, which can lead to profound hemodynamic instability, especially in a peri-operative period, when the patient is exposed to various types of noxious stimuli. Off late, use of octreotide, a synthetic analog of somatostatin, has significantly reduced the peri-operative morbidity and mortality. The current review discusses the various anesthetic challenges and considerations during peri-operative management of carcinoid tumors.

  14. Anesthetic management of robot-assisted thoracoscopic thymectomy

    Directory of Open Access Journals (Sweden)

    Anil Karlekar

    2016-01-01

    Full Text Available Myasthenia gravis (MG is a rare disorder involving neuromuscular junction. In conjunction with medical therapy, thymectomy is a known modality of treatment of MG and has shown to increase the probability of remission and overall symptomatic improvement. For minimally invasive thymectomy, video-.assisted thoracoscopic surgery has been the preferred surgical approach till recently. The robotic surgical procedure must necessarily bring new challenges to the anesthesiologists to effectively meet the specific requirements of the technique. At present, there is a paucity of literature regarding the anesthetic concerns of robotic assisted thymectomy, patient in question specifically posed a challenge since different maneuvers and techniques had to be tried to obtain optimum surgical conditions with stable ventilatory and hemodynamic parameters. Concerns of patient positioning and hemodynamic monitoring have also been discussed.

  15. Epidermolysis Bullosa, Dental and Anesthetic Management: A Case Report

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    Katayoun Esfahanizadeh

    2014-09-01

    Full Text Available Epidermolysis bullosa (EB is a group of rare inherited skin and mucous membrane disorders in which blister formation may arise spontaneously or following a minor friction. Various patterns of inheritance are explicated for the disease. The disease has a profound effect on oral mucosa and may result in high prevalence of dental caries. General anesthesia is sometimes the only choice for dental treatments in patients with EB. The following case report describes the dental and anesthetic management of an 12.5 -year-old girl with dystrophic type of EB. The patient was followed up every 6 months. New carious lesions were detected one year after the treatment, on the last visit. Presenting a perfect dental care to children with this disorder can be challenging for the in charge specialist, both pediatric dentist and anesthesiologist.

  16. Epidermolysis bullosa, dental and anesthetic management: a case report.

    Science.gov (United States)

    Esfahanizade, Katayoun; Mahdavi, Ali Reza; Ansari, Ghassem; Fallahinejad Ghajari, Masoud; Esfahanizadeh, Abdolreza

    2014-09-01

    Epidermolysis bullosa (EB) is a group of rare inherited skin and mucous membrane disorders in which blister formation may arise spontaneously or following a minor friction. Various patterns of inheritance are explicated for the disease. The disease has a profound effect on oral mucosa and may result in high prevalence of dental caries. General anesthesia is sometimes the only choice for dental treatments in patients with EB. The following case report describes the dental and anesthetic management of an 12.5 -year-old girl with dystrophic type of EB. The patient was followed up every 6 months. New carious lesions were detected one year after the treatment, on the last visit. Presenting a perfect dental care to children with this disorder can be challenging for the in charge specialist, both pediatric dentist and anesthesiologist.

  17. Anticholeretic effect of substance P in anesthetized dogs.

    Science.gov (United States)

    Holm, I; Thulin, L; Hellgren, M

    1978-03-01

    Nine anesthetized dogs were provided with acute common duct fistulas after exclusion of the gallbladder. Synthetic Substance P was administered as caval infusions in a dosage of 0.5-20 ng x kg-1 x min-1, duration 10 min. The output of hepatic bile, sodium and amylase decreased during infusion by 40-52 per cent at the highest doses. After termination of infusion all 3 parameters increased by 19-60 per cent above the basal level. The biliary concentration of sodium was constant, while that of amylase increased during infusion. The responses were dose-related. The anticholeresis induced by substance P might be due to inhibition of the canalicular bile fraction, which presumably is mediated by active sodium transport and independent of bile salt excretion.

  18. The effects of anesthetic agents on oxidative stress

    Science.gov (United States)

    Yakan, Selvinaz; Düzgüner, Vesile

    2016-04-01

    Oxidative stress can be defined as the instability between antioxidant defense of the body and the production of free radical that causes peroxydation on the lipid layer. Free radicals are reactive oxygen species that are produced in the course of normal metabolisms of aerobe organisms and they may cause disorders in cell structure and organelles by interacting macromolecules, like lipid, protein, nucleic acids. Therefore, they may cause cardiovascular, immune system, liver, kidney illnesses and many other illnesses like cancer, aging, cataract, diabetes. It is known that many drugs used for the purpose of anesthetizing may cause lipid peroxidation in organism. For these reasons, determining the Oxidative stress index of anaesthetic stress chosen in the ones that are exposed to long term anaesthetic agents and anaesthesia appliccations, is so substantial.

  19. Anesthetic Sevoflurane Causes Rho-Dependent Filopodial Shortening in Mouse Neurons.

    Directory of Open Access Journals (Sweden)

    Jeffrey H Zimering

    Full Text Available Early postnatal anesthesia causes long-lasting learning and memory impairment in rodents, however, evidence for a specific neurotoxic effect on early synaptogenesis has not been demonstrated. Drebrin A is an actin binding protein whose localization in dendritic protrusions serves an important role in dendritic spine morphogenesis, and is a marker for early synaptogenesis. We therefore set out to investigate whether clinically-relevant concentrations of anesthetic sevoflurane, widely- used in infants and children, alters dendritic morphology in cultured fetal day 16 mouse hippocampal neurons. After 7 days in vitro, mouse hippocampal neurons were exposed to four hours of 3% sevoflurane in 95% air/5% CO2 or control condition (95% air/5% CO2. Neurons were fixed in 4% paraformaldehyde and stained with Alexa Fluor555-Phalloidin, and/or rabbit anti-mouse drebrin A/E antibodies which permitted subcellular localization of filamentous (F-actin and/or drebrin immunoreactivity, respectively. Sevoflurane caused acute significant length-shortening in filopodia and thin dendritic spines in days-in-vitro 7 neurons, an effect which was completely rescued by co-incubating neurons with ten micromolar concentrations of the selective Rho kinase inhibitor Y27632. Filopodia and thin spine recovered in length two days after sevoflurane exposure. Yet cluster-type filopodia (a precursor to synaptic filopodia were persistently significantly decreased in number on day-in-vitro 9, in part owing to preferential localization of drebrin immunoreactivity to dendritic shafts versus filopodial stalks. These data suggest that sevoflurane induces F-actin depolymerization leading to acute, reversible length-shortening in dendritic protrusions through a mechanism involving (in part activation of RhoA/Rho kinase signaling and impairs localization of drebrin A to filopodia required for early excitatory synapse formation.

  20. Spike Timing Rigidity Is Maintained in Bursting Neurons under Pentobarbital-Induced Anesthetic Conditions

    Science.gov (United States)

    Kato, Risako; Yamanaka, Masanori; Yokota, Eiko; Koshikawa, Noriaki; Kobayashi, Masayuki

    2016-01-01

    Pentobarbital potentiates γ-aminobutyric acid (GABA)-mediated inhibitory synaptic transmission by prolonging the open time of GABAA receptors. However, it is unknown how pentobarbital regulates cortical neuronal activities via local circuits in vivo. To examine this question, we performed extracellular unit recording in rat insular cortex under awake and anesthetic conditions. Not a few studies apply time-rescaling theorem to detect the features of repetitive spike firing. Similar to these methods, we define an average spike interval locally in time using random matrix theory (RMT), which enables us to compare different activity states on a universal scale. Neurons with high spontaneous firing frequency (>5 Hz) and bursting were classified as HFB neurons (n = 10), and those with low spontaneous firing frequency (<10 Hz) and without bursting were classified as non-HFB neurons (n = 48). Pentobarbital injection (30 mg/kg) reduced firing frequency in all HFB neurons and in 78% of non-HFB neurons. RMT analysis demonstrated that pentobarbital increased in the number of neurons with repulsion in both HFB and non-HFB neurons, suggesting that there is a correlation between spikes within a short interspike interval (ISI). Under awake conditions, in 50% of HFB and 40% of non-HFB neurons, the decay phase of normalized histograms of spontaneous firing were fitted to an exponential function, which indicated that the first spike had no correlation with subsequent spikes. In contrast, under pentobarbital-induced anesthesia conditions, the number of non-HFB neurons that were fitted to an exponential function increased to 80%, but almost no change in HFB neurons was observed. These results suggest that under both awake and pentobarbital-induced anesthetized conditions, spike firing in HFB neurons is more robustly regulated by preceding spikes than by non-HFB neurons, which may reflect the GABAA receptor-mediated regulation of cortical activities. Whole-cell patch-clamp recording in

  1. Spike timing rigidity is maintained in bursting neurons under pentobarbital-induced anesthetic conditions

    Directory of Open Access Journals (Sweden)

    Risako Kato

    2016-11-01

    Full Text Available Pentobarbital potentiates γ-aminobutyric acid (GABA-mediated inhibitory synaptic transmission by prolonging the open time of GABAA receptors. However, it is unknown how pentobarbital regulates cortical neuronal activities via local circuits in vivo. To examine this question, we performed extracellular unit recording in rat insular cortex under awake and anesthetic conditions. Not a few studies apply time-rescaling theorem to detect the features of repetitive spike firing. Similar to these methods, we define an average spike interval locally in time using random matrix theory (RMT, which enables us to compare different activity states on a universal scale. Neurons with high spontaneous firing frequency (> 5 Hz and bursting were classified as HFB neurons (n = 10, and those with low spontaneous firing frequency (< 10 Hz and without bursting were classified as non-HFB neurons (n = 48. Pentobarbital injection (30 mg/kg reduced firing frequency in all HFB neurons and in 78% of non-HFB neurons. RMT analysis demonstrated that pentobarbital increased in the number of neurons with repulsion in both HFB and non-HFB neurons, suggesting that there is a correlation between spikes within a short interspike interval. Under awake conditions, in 50% of HFB and 40% of non-HFB neurons, the decay phase of normalized histograms of spontaneous firing were fitted to an exponential function, which indicated that the first spike had no correlation with subsequent spikes. In contrast, under pentobarbital-induced anesthesia conditions, the number of non-HFB neurons that were fitted to an exponential function increased to 80%, but almost no change in HFB neurons was observed. These results suggest that under both awake and pentobarbital-induced anesthetized conditions, spike firing in HFB neurons is more robustly regulated by preceding spikes than by non-HFB neurons, which may reflect the GABAA receptor-mediated regulation of cortical activities. Whole-cell patch

  2. Occupational disease in dentistry and chronic exposure to trace anesthetic gases.

    Science.gov (United States)

    Cohen, E N; Gift, H C; Brown, B W; Greenfield, W; Wu, M L; Jones, T W; Whitcher, C E; Driscoll, E J; Brodsky, J B

    1980-07-01

    A mail survey of 30,650 dentists and 30,547 chairside assistants grouped according to occupational exposure to inhalation anesthetic and sedatives in the dental operatory indicated increased general health problems and reproductive difficulties among respondents exposed to anesthetics. For male dentists who were heavily exposed to anesthetics, the increase in liver disease was 1.7-fold, kidney disease was 1.2-fold, and neurological disease was 1.9-fold. For wives of male dentists who were heavily exposed to anesthetics, the increase in spontaneous abortion rate was 1.5-fold. Among female chairside assistants who were heavily exposed to anesthetics, the increase in liver disease was 1.6-fold, kidney disease was 1.7-fold, and neurological disease was 2.8-fold. The increase in spontaneous abortion rate among assistants who were heavily exposed was 2.3-fold. Cancer rates in women heavily exposed to inhalation anesthetics were increased 1.5-fold but this finding was not statistically significant (P = .06). Separate analysis of the data for disease rates and birth difficulties by type of inhalation anesthetic indicates that in both dentists and chairside assistants chronic exposure to nitrous oxide alone is associated with an increase rate of adverse response.

  3. Advanced techniques and armamentarium for dental local anesthesia.

    Science.gov (United States)

    Clark, Taylor M; Yagiela, John A

    2010-10-01

    Computer-controlled local anesthetic delivery (C-CLAD) devices and systems for intraosseous (IO) injection are important additions to the dental anesthesia armamentarium. C-CLAD using slow infusion rates can significantly reduce the discomfort of local anesthetic infusion, especially in palatal tissues, and facilitate palatal approaches to pulpal nerve block that find special use in cosmetic dentistry, periodontal therapy, and pediatric dentistry. Anesthesia of single teeth can be obtained using either C-CLAD intraligamentary injections or IO injections. Supplementary IO anesthesia is particularly suited for providing effective pain control of teeth diagnosed with irreversible pulpitis.

  4. Anesthetic effects of a three-drugs mixture--comparison of administrative routes and antagonistic effects of atipamezole in mice.

    Science.gov (United States)

    Kirihara, Yumiko; Takechi, Mayumi; Kurosaki, Kaoru; Kobayashi, Yuta; Saito, Yoji; Takeuchi, Takashi

    2015-01-01

    The anesthetic mixture of medetomidine (MED), midazolam (MID) and butorphanol (BUT) produced anesthetic duration of around 40 minutes (min) in ICR mice. We reported that this anesthetic mixture produced almost the same anesthetic effects in both male and female BALB/c and C57BL/6J strains. Intraperitoneal (IP) administration of drugs has been widely used in mice. However, various injectable routes of the anesthetic mixture may cause different anesthetic effects. First, we examined effects of the anesthetic mixture by subcutaneous (SC) and intravenous (IV) injection compared to IP injection. After injection of the anesthetic mixture, administration of atipamezole (ATI) induced mice recovery from anesthesia. Secondly, we examined how different dosage and optimum injection timing of ATI affected mice recovery from anesthesia. We used an anesthetic score to measure anesthetic duration and a pulse oximeter to monitor vital signs under anesthesia. Usually, drugs from SC injection work more weakly than IP or IV injection. However, we found no significant differences of anesthetic duration among the three different injection routes. Antagonistic effects of ATI (0.3 mg/kg and 1.5 mg/kg) worked equally when administered at 30 min after injection of the anesthetic mixture. Antagonistic effects of ATI (1.5 mg/kg) were stronger than ATI (0.3 mg/kg) at 10 min after injection of the anesthetic mixture. The anesthetic mixture is a useful drug to induce nearly the same anesthetic effects by different injection routes and has an antagonist of ATI which helps mice quickly recover from anesthesia. These results may contribute to the welfare of laboratory animals.

  5. [Mini-invasive technologies in treatment of acute cholecystitis in patients with high operational and anesthetic risk].

    Science.gov (United States)

    Ermolov, A S; Guliaev, A A; Ivanov, P A; Samsonov, V T; Rogal', M L; Timerbaev, V Kh; Trofimova, E Iu; Kudriashova, N E; Tlibekova, M A

    2014-01-01

    The treatment results of 769 patients with acute calculous cholecystitis and high operational and anesthetic risk at admission are presented in the retrospective study. High risk was determined by expressed comorbidities, diseases' terms, the complications of acute cholecystitis, age, which was more than 60 years in most cases. The patients were divided into 2 groups depending on the severity of comorbidity and the possible effects of its correction. The first group included 617 perspective patients for cholecystectomy. And the second group included 152 patients unpromising for this. Concept of stage treatment was used in the first group including primary decompression of the gallbladder by using of percutaneous transhepatic micro-cholecystostomy under ultrasound guidance. Cholecystectomy was performed after correction of comorbidities, complications of acute cholecystitis, and readjustment of extrahepatic bile ducts by endoscopy if necessary. Laparoscopic cholecystectomy was successfully performed in 587 patients. There was open cholecystectomy in 11 cases. Cholecystectomy was done in 19 patients as a result of conversion. Cholecystostomy from minimal access with extraction of stones under local anesthesia was performed in the second group for decompression and as definitive treatment. There was not observed deaths in patients with high operational and anesthetic risk as a result of such tactics. Postoperatively 1.7% of patients had complications that were successfully resolved.

  6. Comparison of O2 saturation, heart and respiratory rate following injection of vasoconstrictor containing anesthetic (lidocaine 2% and without vasoconstrictor anesthetic (Mepivacaine

    Directory of Open Access Journals (Sweden)

    Bayat M.

    2005-07-01

    Full Text Available Background and Aim: Along with higher usage of dental local anesthesia with risks to people health together with their positive role, the important goal of dentistry, patients’ health, has been stressed repeatedly nowadays. This study was conducted to compare O2 saturation, respiratory rate and heart rate of patients following injection of anesthetic containing vasoconstrictor (lidocaine 2% and without vasoconstrictor (Mepivacaine. Materials and Methods: This experimental study was conducted on 32 healthy humans (16 females and 16 males with 25-50 years age range and no history of drug usage. Cases were classified into two matched groups. O2 saturation, heart and respiratory rate were recorded before extraction of a mandibular posterior tooth. In the first group, 3.6 ml lidocaine 2% with 1:80,000 epinephrine and in the second group Mepivacaine 3% was injected, using inferior alveolar dental nerve block with aspiration. Variables were measured and recorded. Tooth extraction was performed and the mentioned variables were recorded again. Data were analyzed with SPSS software using t and Paired t-test with P<0.05 as the limit of significance. Results: After injection of lidocaine, the heart rate was increased (12.25±1.75 bpm, and the time to reach the maximum rate was 64.75±11.26 seconds. After extraction of tooth, heart rate in both groups was increased not considering the type of injection. Conclusion: The study showed that the injection of lidocaine (containing epinephrine in patients without contraindication has no risk. Also, possible increase in heart rate is not risky and is not associated with O2 saturation decrease and respiratory interruption.

  7. Anesthetic management of a parturient with Guillain-Barre syndrome posted for emergency caesarian section

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    Abhijit Paul

    2012-01-01

    Full Text Available We report the anesthetic management of a case of Guillain-Barre syndrome in the 34 th week of gestation coming for an emergency Cesarean section. The perioperative anesthetic challenges have been discussed with emphasis on the medical and anesthetic management which includes the use of plasma-pheresis, intravenous gamma-globulin, and the safety of preservative free 0.75% isobaric ropivacaine, which was administered intrathecally in this difficult medical condition with excellent hemodynamic, maternal, and fetal outcome. The sensory and motor blocks achieved were well suited to the clinical risks and conditions.

  8. Anesthetic management of a large mediastinal mass for tracheal stent placement

    Directory of Open Access Journals (Sweden)

    Suman Rajagopalan

    2016-04-01

    Full Text Available ABSTRACT The anesthetic management of patients with large mediastinal masses can be complicated due to the pressure effects of the mass on the airway or major vessels. We present the successful anesthetic management of a 64-year-old female with a large mediastinal mass that encroached on the great vessels and compressed the trachea. A tracheal stent was placed to relieve the tracheal compression under general anesthesia. Spontaneous ventilation was maintained during the perioperative period with the use of a classic laryngeal mask airway. We discuss the utility of laryngeal mask airway for anesthetic management of tracheal stenting in patients with mediastinal masses.

  9. An improved method for lifting and transporting anesthetized pigs within an animal facility

    DEFF Research Database (Denmark)

    Schumacher-Petersen, Camilla; Hammelev, Karsten Pharao; Flescher, Jens Erik

    2014-01-01

    Transporting anesthetized pigs in a laboratory setting often requires strenuous manual lifting, posing a hazard to the safety of animal care personnel and to the welfare of the pigs. The authors developed an improved approach to lifting and transporting anesthetized pigs weighing up to 350 kg using...... mechanical lifts. Different equipment was used to accommodate pigs of different sizes as well as the building designs of three animal facilities. Using the lifts, anesthetized pigs are carried on sheets to maintain their comfort while being transported. The approach refines previous methods for handling...

  10. Tolerability of NGX-4010, a capsaicin 8% patch, in conjunction with three topical anesthetic formulations for the treatment of neuropathic pain

    Science.gov (United States)

    Webster, Lynn R; Peppin, John F; Murphy, Frederick T; Tobias, Jeffrey K; Vanhove, Geertrui F

    2012-01-01

    Background The objective of this study was to assess the safety, tolerability, and preliminary efficacy of NGX-4010, a capsaicin 8% patch, following pretreatment with three different topical anesthetics in patients with peripheral neuropathic pain. Methods This open-label, multicenter study enrolled 117 patients with post-herpetic neuralgia, HIV-associated distal sensory polyneuropathy, or painful diabetic neuropathy. Patients received pretreatment with one of three lidocaine 4%-based topical anesthetics (L.M.X.4® [Ferndale Laboratories Inc, Ferndale, MI], Topicaine® Gel [Estela Basso, Jupiter, FL], or Betacaine Enhanced Gel 4 [Tiberius Inc, Tampa, FL]) for 60 minutes followed by a single 60- or 90-minute NGX-4010 application, and were followed for 12 weeks. Tolerability and safety measures included “pain now” Numeric Pain Rating Scale (NPRS) scores, dermal assessments, medication use for treatment-related pain, adverse events (AEs), clinical laboratory parameters, physical examinations, and vital signs. The primary efficacy variable was the percentage change in mean NPRS scores for “average pain for the past 24 hours” from baseline to weeks 2 through 12. Results Treatment with NGX-4010 following pretreatment with any of the three topical anesthetics was generally safe and well tolerated. Nearly all patients completed ≥90% of the planned NGX-4010 application duration. The most common treatment-related AEs, application-site burning and application-site pain, were transient, mostly mild or moderate, and could be adequately managed by local cooling or short-acting oral opioid analgesics. Although slightly more patients used medication for treatment-related discomfort following pretreatment with Topicaine compared with L.M.X.4 or Betacaine, there were no statistical differences between the topical anesthetics. Neuropathic pain reduction from baseline to weeks 2 through 12 was approximately 30% and was similar among the topical anesthetics; the proportion of

  11. Effect of a local anesthetic lozenge in relief of symptoms in burning mouth syndrome

    DEFF Research Database (Denmark)

    Treldal, Charlotte; Jacobsen, C B; Mogensen, Stine;

    2016-01-01

    . Assessment of oral mucosal pain, xerostomia, and taste alterations was performed in a patient diary on a visual analog scale (ranging from 0 to 100 mm) before and after the lozenge was dissolved. RESULTS: The bupivacaine lozenge significantly reduced the burning oral pain (P ...OBJECTIVE: Patients with burning mouth syndrome (BMS) often represent a clinical challenge as available agents for symptomatic treatment are few and often ineffective. The aim was to evaluate the effect of a bupivacaine lozenge on oral mucosal pain, xerostomia, and taste alterations in patients...... of taste disturbances (P taste...

  12. The Effect of Topical Local Anesthetics on Thermal Pain Sensitivity in Patients with Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Anthony Rodrigues

    2012-01-01

    Full Text Available Generalized hypersensitivity that extends into somatic areas is common in patients with irritable bowel syndrome (IBS. The sensitized state, particularly assessed by experimental methods, is known to persist even during remissions of clinical pain. It was hypothesized that disease-related nociceptive activity in the gut maintains a systemic-sensitized state. The present study evaluated responses to prolonged thermal stimuli maintained at constant temperature or constant pain intensity during stimulation. The effect of topically applied rectal lidocaine on heat sensitivity was also evaluated. The question is whether silencing potential intestinal neural activity (which may not always lead to a conscious pain experience with lidocaine attenuates sensitization of somatic areas. Tests were also performed where lidocaine was applied orally to control for systemic or placebo effects of the drug. The IBS subjects exhibited a greater sensitivity to somatic heat stimuli compared to controls; however, lidocaine had no discernible effect on sensitization in this sample of IBS patients, where most of the individuals did not have clinical pain on the day of testing.

  13. A Case of Transient Local Anesthetic Induced Bilateral Vocal Cord Palsy

    Directory of Open Access Journals (Sweden)

    M. Rafiq

    2015-01-01

    Full Text Available We report a rare case of bilateral vocal cord palsy following total thyroidectomy with successful extubation within 12 hours. The patient is a 33-year-old lady who underwent uneventful total thyroidectomy for compressive symptoms. Thirty minutes after extubation, she developed stridor and the flexible laryngoscopy showed bilaterally adducted vocal cords. The patient, thus, was reintubated and after 12 hours she met the extubation parameters and so she was extubated successfully. The repeated flexible laryngoscopy showed normal vocal cords. A review of the literature revealed limited information on this transient condition.

  14. A Case of Transient Local Anesthetic Induced Bilateral Vocal Cord Palsy

    Science.gov (United States)

    Rafiq, M.; Al-Zoraigi, U.; Alzahrani, S.; Alabdulkarim, Y.

    2015-01-01

    We report a rare case of bilateral vocal cord palsy following total thyroidectomy with successful extubation within 12 hours. The patient is a 33-year-old lady who underwent uneventful total thyroidectomy for compressive symptoms. Thirty minutes after extubation, she developed stridor and the flexible laryngoscopy showed bilaterally adducted vocal cords. The patient, thus, was reintubated and after 12 hours she met the extubation parameters and so she was extubated successfully. The repeated flexible laryngoscopy showed normal vocal cords. A review of the literature revealed limited information on this transient condition. PMID:26167326

  15. Systematic review of the effect of intravenous lipid emulsion therapy for local anesthetic toxicity

    DEFF Research Database (Denmark)

    Høgberg, Lotte Christine Groth; Bania, Theodore C; Lavergne, Valéry

    2016-01-01

    of toxicity (83 patients) including CNS depression or agitation (n = 45, 54%), seizures (n = 49, 59%), hypotension, hypertension, EKG changes, arrhythmias (n = 39, 47%), cardiac arrest (n = 18, 22%), cardiopulmonary resuscitation, and/or requirement for endotracheal intubation and/or mechanical ventilation (n...

  16. In Vitro Effect of Local Anesthetics on Candida albicans Germ Tube Formation

    Directory of Open Access Journals (Sweden)

    Acácio Rodrigues

    1994-01-01

    Full Text Available Objective: This study was planned to clarify the in vitro effect of lidocaine and bupivacaine on germ tube formation by Candida albicans isolates from cases of clinical vaginal candidiasis.

  17. [Local anesthetic effect and subjective tolerance of 0.5% levobunolol in normal eyes].

    Science.gov (United States)

    Höh, H

    1990-07-01

    In a randomized, prospective, parallel double-blind clinical trial with positive and negative placebo control, the corneal sensitivity of 30 subjects with normal eyes was measured using the Cochet & Bonnet esthesiometer prior to and 1, 3, 6, 10, 15, and 30 minutes after topical application of levobunolol 0.5% (Vistagan 0.5% Liquifilm, Pharm-Allergan Vertrieb GmbH, Karlsruhe; 20 eyes). Proxymetacain 0.5% (proparacaine 0.5%, Ursapharm, Saarbrücken; 10 eyes) served as a positive, NaCl 0.9% as a negative control substance (placebo). Indomethacin 1% (Chibro-Amuno 3, Chibret Pharmazeutische GmbH, Munich; 10 eyes) was tested as a further control substance. The subjects assessed the subjective tolerance of the test substances on a 4-point scale. Levobunolol 0.5% caused a statistically significant reduction in corneal sensitivity, attaining its maximum effect in the first minute after application and lasting on average for 6 minutes. The reduction was greater than that caused by timolol 0.5% and approximately one-half of that caused by betaxolol 0.5%. Proxymetacain 0.5% reduced corneal sensitivity to below the upper limit of the Cochet & Bonnet esthesiometer (200 mg) for up to 10 minutes. After 30 minutes, corneal sensitivity reverted to its initial value in all subjects. NaCl 0.9% eye drops did not decrease corneal sensitivity. After one minute an increase in corneal sensitivity (exercise effect) was observed which was significant as compared to the initial value as of the 15th minute after application. Indomethacin 1% likewise failed to reduce corneal sensitivity. In subjects with normal eyes, levobunolol 0.5% causes only a slight reduction in sensitivity.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Oral mucosal injection of a local anesthetic solution containing epinephrine enhances muscle relaxant effects of rocuronium.

    Science.gov (United States)

    Ninomiya, Asako; Terakawa, Yui; Matsuura, Nobuyuki; Ichinohe, Tatsuya; Kaneko, Yuzuru

    2012-01-01

    The purpose of this study was to examine how submucosal injection of a clinically relevant dose of a lidocaine hydrochloride solution containing epinephrine affects the muscle relaxant effects of rocuronium bromide. Sixteen patients scheduled for orthognathic surgery participated in this study. All patients were induced with fentanyl citrate, a target-controlled infusion of propofol and rocuronium bromide. Anesthesia was maintained by total intravenous anesthesia. After nasotracheal intubation, an infusion of rocuronium bromide was started at 7 µg/kg/min, and the infusion rate was then adjusted to maintain a train of four (TOF) ratio at 10 to 15%. The TOF ratio just prior to oral mucosal injection of a 1% lidocaine hydrochloride solution containing 10 µg/mL epinephrine (LE) was taken as the baseline. TOF ratio was observed for 20 minutes, with 1-minute intervals following the start of injection. Mean epinephrine dose was 85.6 ± 18.6 µg and mean infusion rate of rocuronium bromide was 6.3 ± 1.6 µg/kg/min. TOF ratio began to decrease 2 minutes after the injection of LE, reached the minimum value at 3.1 ± 3.6% 12 minutes after the injection, and then began to recover. We conclude that oral mucosal injection of LE enhances the muscle relaxant effects of rocuronium bromide.

  19. [Pediatric anesthetic during brain immaturity and neurodevelopment disorders].

    Science.gov (United States)

    Catré, Dora; Lopes, Maria Francelina; Cabrita, António Silvério; Silva Viana, Joaquim

    2014-01-01

    Introdução: Diversos estudos experimentais e clínicos sugerem que fármacos usados em anestesia pediátrica podem exercer efeitos indesejáveis sobre o sistema nervoso central imaturo. O objetivo desta revisão consistiu em avaliar os resultados e conclusões de estudos publicados na literatura sobre perturbações persistentes do neurodesenvolvimento após exposição a anestésicos de crianças em fase de imaturidade cerebral. Material e Métodos: Realizámos uma pesquisa bibliográfica em diversas bases de dados (PubMed, SciELO e Cochrane Library), utilizando os termos ‘Pediatric anesthesia OR Pediatric anesthetic OR Developing brain anesthetic OR Developing brain anesthesia AND behavior disorders’ e foram incluídos os estudos em humanos, referentes a efeitos persistentes no neurodesenvolvimento após exposição a anestésicos nos primeiros quatro anos de idade. Resultados: Dez estudos retrospetivos cumpriram os critérios de inclusão. Destes, sete sugerem alteração do neurodesenvolvimento por exposição de criança pequena à anestesia, por oposição aos resultados obtidos pelos restantes três. Discussão: Embora maioritariamente utilizem bases de dados amplas, os estudos encontrados são retrospetivos, variam nos grupos teste, incluem variáveis de confusão por vezes contornáveis e alguns apresentam incorreções na escolha da população teste e controlo que podem comprometer a fiabilidade dos resultados. Conclusão: As numerosas limitações dos poucos estudos clínicos disponíveis fazem com que a informação reportada ainda se considere insuficiente para mudar a prática clínica atual. No entanto, sendo indiscutível que se mantêm as recomendações para providenciar anestesia quando necessária, independentemente da idade, os alertas encontrados na literatura são preocupantes, existindo indicação para que sempre que possível sejam ponderadas alternativas que possam contribuir para diminuir os riscos da exposição anestésica.

  20. A 22-channel receive array with Helmholtz transmit coil for anesthetized macaque MRI at 3 T.

    Science.gov (United States)

    Janssens, Thomas; Keil, Boris; Serano, Peter; Mareyam, Azma; McNab, Jennifer A; Wald, Lawrence L; Vanduffel, Wim

    2013-11-01

    The macaque monkey is an important model for cognitive and sensory neuroscience that has been used extensively in behavioral, electrophysiological, molecular and, more recently, neuroimaging studies. However, macaque MRI has unique technical differences relative to human MRI, such as the geometry of highly parallel receive arrays, which must be addressed to optimize imaging performance. A 22-channel receive coil array was constructed specifically for rapid high-resolution anesthetized macaque monkey MRI at 3 T. A local Helmholtz transmit coil was used for excitation. Signal-to-noise ratios (SNRs) and noise amplification for parallel imaging were compared with those of single- and four-channel receive coils routinely used for macaque MRI. The 22-channel coil yielded significant improvements in SNR throughout the brain. Using this coil, the SNR in peripheral brain was 2.4 and 1.7 times greater than that obtained with single- or four-channel coils, respectively. In the central brain, the SNR gain was 1.5 times that of both the single- and four-channel coils. Finally, the performance of the array for functional, anatomical and diffusion-weighted imaging was evaluated. For all three modalities, the use of the 22-channel array allowed for high-resolution and accelerated image acquisition.

  1. Recording large-scale neuronal ensembles with silicon probes in the anesthetized rat.

    Science.gov (United States)

    Schjetnan, Andrea Gomez Palacio; Luczak, Artur

    2011-10-19

    Large scale electrophysiological recordings from neuronal ensembles offer the opportunity to investigate how the brain orchestrates the wide variety of behaviors from the spiking activity of its neurons. One of the most effective methods to monitor spiking activity from a large number of neurons in multiple local neuronal circuits simultaneously is by using silicon electrode arrays. Action potentials produce large transmembrane voltage changes in the vicinity of cell somata. These output signals can be measured by placing a conductor in close proximity of a neuron. If there are many active (spiking) neurons in the vicinity of the tip, the electrode records combined signal from all of them, where contribution of a single neuron is weighted by its 'electrical distance'. Silicon probes are ideal recording electrodes to monitor multiple neurons because of a large number of recording sites (+64) and a small volume. Furthermore, multiple sites can be arranged over a distance of millimeters, thus allowing for the simultaneous recordings of neuronal activity in the various cortical layers or in multiple cortical columns (Fig. 1). Importantly, the geometrically precise distribution of the recording sites also allows for the determination of the spatial relationship of the isolated single neurons. Here, we describe an acute, large-scale neuronal recording from the left and right forelimb somatosensory cortex simultaneously in an anesthetized rat with silicon probes (Fig. 2).

  2. Spontaneous sleep-like brain state alternations and breathing characteristics in urethane anesthetized mice.

    Directory of Open Access Journals (Sweden)

    Silvia Pagliardini

    Full Text Available Brain state alternations resembling those of sleep spontaneously occur in rats under urethane anesthesia and they are closely linked with sleep-like respiratory changes. Although rats are a common model for both sleep and respiratory physiology, we sought to determine if similar brain state and respiratory changes occur in mice under urethane. We made local field potential recordings from the hippocampus and measured respiratory activity by means of EMG recordings in intercostal, genioglossus, and abdominal muscles. Similar to results in adult rats, urethane anesthetized mice displayed quasi-periodic spontaneous forebrain state alternations between deactivated patterns resembling slow wave sleep (SWS and activated patterns resembling rapid eye movement (REM sleep. These alternations were associated with an increase in breathing rate, respiratory variability, a depression of inspiratory related activity in genioglossus muscle and an increase in expiratory-related abdominal muscle activity when comparing deactivated (SWS-like to activated (REM-like states. These results demonstrate that urethane anesthesia consistently induces sleep-like brain state alternations and correlated changes in respiratory activity across different rodent species. They open up the powerful possibility of utilizing transgenic mouse technology for the advancement and translation of knowledge regarding sleep cycle alternations and their impact on respiration.

  3. Auditory cortical and hippocampal-system mismatch responses to duration deviants in urethane-anesthetized rats.

    Directory of Open Access Journals (Sweden)

    Timo Ruusuvirta

    Full Text Available Any change in the invariant aspects of the auditory environment is of potential importance. The human brain preattentively or automatically detects such changes. The mismatch negativity (MMN of event-related potentials (ERPs reflects this initial stage of auditory change detection. The origin of MMN is held to be cortical. The hippocampus is associated with a later generated P3a of ERPs reflecting involuntarily attention switches towards auditory changes that are high in magnitude. The evidence for this cortico-hippocampal dichotomy is scarce, however. To shed further light on this issue, auditory cortical and hippocampal-system (CA1, dentate gyrus, subiculum local-field potentials were recorded in urethane-anesthetized rats. A rare tone in duration (deviant was interspersed with a repeated tone (standard. Two standard-to-standard (SSI and standard-to-deviant (SDI intervals (200 ms vs. 500 ms were applied in different combinations to vary the observability of responses resembling MMN (mismatch responses. Mismatch responses were observed at 51.5-89 ms with the 500-ms SSI coupled with the 200-ms SDI but not with the three remaining combinations. Most importantly, the responses appeared in both the auditory-cortical and hippocampal locations. The findings suggest that the hippocampus may play a role in (cortical manifestation of MMN.

  4. Amperometric cell for subcutaneous detection of hydrogen sulfide in anesthetized experimental animals.

    Science.gov (United States)

    Nagy, L; Filotás, D; Boros, M; Pozsgai, G; Pintér, E; Nagy, G

    2014-12-01

    Hydrogen sulfide (H2S) is a toxic gas. It has been recognized that H2S evolving in biochemical reactions in living organisms has an important role in different physiologic processes. Nowadays, H2S is known as an endogenous messenger molecule. Natural sulfurous spring water has been proved beneficial in the therapy of diseases of the skin and other organs (Boros et al 2013). In vivo real-time detection of local H2S concentration is an important but challenging task.We developed a two-electrode amperometric cell for selective subcutaneous detection of H2S in anesthetized mice. The cell is a small size implantable gas sensor containing a platinum disc anode and a silver cathode. The selectivity is provided by a membrane permeable only by gases. There is a buffered reversible electrochemical mediator solution in an oxidized form inside the cell. As gaseous H2S penetrates into the cell the mediator is reduced, and +0.4 V versus the reference is employed on the platinum working electrode. The reduced mediator is oxidized on the anode surface. The current provides an analytical signal representing the concentration of H2S.Appropriate shape, size and membrane material were selected, and optimal working parameters--such as mediator concentration, pH and cell voltage--were determined in vitro. The lower limit of detection in the stirred sample solution at pH = 5.5 was as small as 9.4 × 10(-7) M and a dynamic concentration range of 0-6 × 10(-4) M could be achieved.The detecting surfaces of the cell were covered with freshly dissected mouse skin to test dermal H2S permeability. In other experiments, the cell was implanted subcutaneously in an anesthetized mouse and the animal was submerged in a buffer solution containing different concentrations of H2S so that the skin surface over the sensor was covered by the solution. Measurements of subcutaneous H2S concentration were taken. The experiments clearly proved that H2S diffuses through the skin of the live mouse.

  5. Ocular complications associated with local anesthesia administration in dentistry.

    Science.gov (United States)

    Boynes, Sean G; Echeverria, Zydnia; Abdulwahab, Mohammad

    2010-10-01

    The most widely used method for controlling pain during dental procedures is the intraoral administration of local anesthetics in close proximity to a specific nerve or fiber to obtund nerve conduction. The most commonly anesthetized nerves in dentistry are branches or nerve trunks associated with the maxillary and mandibular divisions of the trigeminal nerve (cranial nerve V). However, other nerves may be inadvertently affected by intraoral local anesthesia injections, resulting in anesthetic complications of structures far from the oral cavity. Practitioners should be aware of potential ocular complications following intraoral injections in dentistry. These complications include oculomotor paralysis and vision loss. The knowledge of these conditions and their potential cause should alert the dentist to the importance of appropriate injection techniques and an understanding of management protocol.

  6. Hernioplastías inguinales con anestesia exclusivamente local / Inguinal Hernioplasties With Local Anesthesia

    OpenAIRE

    2015-01-01

    Lichtenstein inguinal hernia repair was described in 1974 by Irving Lichestein, who proposed a free tension surgical treatment. Currently this technique is performed anesthetic spinal block. However, many studies marke benefits of local anesthesia: prolonged postoperative analgesia, inexpensive, easy to perform and safe in patients at high risk. A retrospective observational study was performed. The inguinal hernia repair with only local anesthesia is a feasible technique, with similar res...

  7. Anesthetic efficacy of the supplemental X-tip intraosseous injection using 4% articaine with 1:100,000 adrenaline in patients with irreversible pulpitis: An in vivo study

    Directory of Open Access Journals (Sweden)

    Atool Chandra Bhuyan

    2014-01-01

    Full Text Available Introduction: Pain management remains the utmost important qualifying criteria in minimizing patient agony and establishing a strong dentist-patient rapport. Symptomatic irreversible pulpitis is a painful condition necessitating immediate attention and supplemental anesthetic techniques are often resorted to in addition to conventional inferior alveolar nerve block. Aim: The purpose of the study was to evaluate the anesthetic efficacy of X-tip intraosseous injection in patients with symptomatic irreversible pulpitis, in mandibular posterior teeth, using 4% Articaine with 1:100,000 adrenaline as local anesthetic, when the conventional inferior alveolar nerve block proved ineffective. Materials and Methods: X-tip system was used to administer 1.7 ml of 4% articaine with 1:100,000 adrenaline in 30 patients diagnosed with irreversible pulpitis of mandibular posterior teeth with moderate to severe pain on endodontic access after administration of an inferior alveolar nerve block. Results: The results of the study showed that 25 X-tip injections (83.33% were successful and 5 X-tip injections (16.66% were unsuccessful. Conclusion: When the inferior alveolar nerve block fails to provide adequate pulpal anesthesia, X-tip system using 4% articaine with 1:100,000 adrenaline was successful in achieving pulpal anesthesia in patients with irreversible pulpitis.

  8. The Effects of Anesthetic Technique on Postoperative Opioid Consumption in Ankle Fracture Surgery

    DEFF Research Database (Denmark)

    Christensen, Kristian P; Møller, Ann M; Nielsen, Jesper Kjær;

    2015-01-01

    OBJECTIVES: To investigate the impact of common anesthetic techniques on postoperative opioid consumption in ankle fracture surgery. MATERIALS AND METHODS: We performed a retrospective cohort study on 622 patients with isolated ankle fractures undergoing primary reconstructive surgery. Patients...

  9. Anesthetic implications for video assisted thoracoscopic thymectomy in myasthenia gravis.

    Science.gov (United States)

    El-Dawlatly, Abdelazeem A; Al Kattan, Khaled; Hajjar, Waseem; Essa, Mohamed; Delvi, Bilal; Khoja, Abdulaziz

    2005-06-01

    Thymectomy is an established therapy in the management of generalized myasthenia gravis (MG). However, the optimal surgical approach to thymectomy has remained controversial. There are advocates for transternal, transcervical approaches for "maximal" thymectomy. Video-assisted thoracoscopic thymectomy (VATT) presents new approach to thymectomy. By minimizing chest wall trauma, VATT not only causes less postoperative pain, shortens hospital stay, gives better cosmetic results but also leads to wider acceptance by patients for earlier surgery. Anesthesia for thymectomy in MG is challenging. Currently we are using non-muscle relaxant technique (NMRT) which we adopted in 1994, for maximal thymectomy. In this paper, we present our limited experience with two cases of VATT using two different NMRTs. Two cases of MG underwent VATT under general anesthesia (GA) and one lung ventilation (OLV) using double lumen tube (DLT). In both cases NMRT was used which encompass, light GA plus thoracic epidural analgesia (TEA) in one case and without TEA in the other case. We believe that the use of NMRT provides good operative and postoperative conditions. In this report we have described two different NMRTs, one with TEA and the other without. Further studies are needed on large number of cases to establish an anesthetic protocol for VATT.

  10. Urotensin Ⅱ inhibits carotid sinus baroreflex in anesthetized male rats

    Institute of Scientific and Technical Information of China (English)

    Yu-ming WU; Hong-mei XUE; Lin XIAO; Rui-rong HE

    2007-01-01

    Aim: To study the effects of urotensin Ⅱ (UV) on the carotid sinus baroreflex (CSB). Methods: The functional curve of carotid sinus baroreflex was measured by recording changes in arterial pressure in anesthetized male rats with perfused isolated carotid sinus. Results: UⅡ at the concentration of 3 nmol/L had no effect on the CSB, while at the concentration of 30, 300 and 3000 nmol/L inhibited the CSB, shifting the functional curve of the baroreflex upward and to the right. There was a marked decrease in peak slope and reflex decrease in blood pressure. These effects of UⅡ were concentration-dependent. Pretreatment with verapamil (an antagonist of the L-type calcium channel, 10 μmol/L) partially eliminated the above effects of UⅡ (300 nmol/L) on the CSB. Pretreatment with BIM-23127 (3 μmol/L),an antagonist of human and rat UⅡ receptors, abolished the actions of UⅡ on the CSB. Pretreatment with, NG-nitro-L-arginine methyl ester (L-NAME) 100 μmol/L did not affect the inhibitory effects of UⅡ (300 nmol/L) on the CSB. Conclusion: These data suggest that UⅡ exerts an inhibitory action on the isolated CSB. Such an action of UV is predominantly mediated by the UⅡ receptors in vascular smooth muscles, resulting in the opening of L-type calcium channels.

  11. Congenital lobar emphysema: A modified approach to anesthetic management

    Directory of Open Access Journals (Sweden)

    Malathi C Nandihalli

    2015-01-01

    Full Text Available Congenital lobar emphysema (CLE is a potentially reversible, though life-threatening cause of respiratory distress in neonates. It is a rare developmental anomaly of the lower respiratory tract. A 10-month-old child presented with fever, cough and difficulty in breathing. Respiratory system examination revealed tachypnea with intercostal retraction, decreased breath sounds over the left upper lobe and room air saturation of 95%. Chest radiograph and computed tomography showed hyperinflated left upper zones with mediastinal shift. Left thoracotomy, followed by left upper lobectomy was performed under general anesthesia with one lung ventilation. Oxygen saturation, blood pressure, electrocardiogram and capnogram were continuously monitored. During anesthesia, conventionally positive pressure ventilation is avoided until the diseased lobe is isolated, however we adopted gentle manual ventilation maintaining the airway pressure before thoracotomy as described by Cotι and Payne et al. Successful anesthetic management of CLE can be achieved by proper understanding of pathophysiology, good perioperative monitoring, and adopting novel management strategies.

  12. A Comparison of Intramuscular Anesthetic Techniques in Chickens

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    Shahin Hajighahramani

    2017-02-01

    Full Text Available Background & Objective: Administration of anesthetic substances to chickens requires careful consideration for the safe delivery of the agent to the bird. The research objective was to evaluate several drug combinations for intramuscular anesthesia in chickens for physiologic, nutritional, pharmacological and other investigations. Meterial & Methods: Sixty healthy chickens were randomly assigned in six treatment groups and received Ketamine in combination with Xylazine, Midazolam or Acepromazine. Heart and respiratory rate, induction time, duration of surgical anesthesia and light anesthesia were measured. Results: Induction of anesthesia was significantly longer following Acepromazine- Ketamine and Midazolam- Ketamine compared to other groups (P<0.05. Duration of surgical anesthesia was longest with Xylazine- Midazolam- Ketamine and shortest with Midazolam-Ketamine and Acepromazine- Ketamine (P<0.05. Conclusion: In conclusion, the most effective drug combinations resulting in longer duration of surgical anesthesia, were Xylazine- Acepromazine- Ketamine and Xylazine- Midazolam- Ketamine. Other combinations did not produce appropriate surgical anesthesia, but they make slight changes in physiological data.

  13. Anesthetic and surgical complications in 219 cases of myotonic dystrophy.

    Science.gov (United States)

    Mathieu, J; Allard, P; Gobeil, G; Girard, M; De Braekeleer, M; Bégin, P

    1997-12-01

    The objective of this study was to assess the frequency, type, and severity of perioperative complications after a first surgery under general anesthesia in patients with myotonic dystrophy (DM) and to measure the association with suspected risk factors. Numerous cases of perioperative complications in DM patients have been reported. Hazards have been associated with the use of thiopentone, suxamethonium, neostigmine, and halothane. A retrospective study of perioperative complications was conducted for 219 DM patients who had their first surgery under general anesthesia at the Chicoutimi Hospital. The overall frequency of complications was 8.2% (18 of 219). Most complications (16 of 18) were pulmonary, including five patients with acute ventilatory failure necessitating ventilatory support, four patients with atelectasis, and three patients with pneumonia. Using multivariate analysis, we found that the risk of perioperative pulmonary complications (PPC) was significantly higher after an upper abdominal surgery (odds ratio (OR), 24.4; 95% CI, 4.0 to 149.3) and for patients with a severe muscular disability, as assessed by the presence of proximal limb weakness (OR, 14.1; 95% CI, 1.5 to 134.4). The likelihood of PPC was not related to any specific anesthetic drug. Because of the increased risk of PPC, careful monitoring during the early postoperative period, protection of upper airways, chest physiotherapy, and incentive spirometry are mandatory in all symptomatic DM patients, particularly those with a severe muscular disability or those who have undergone an upper abdominal surgery.

  14. Anesthetic Management of a Pediatric Patient With Wilsons Disease

    Science.gov (United States)

    Baykal, Mehmet; Karapolat, Sami

    2010-01-01

    Wilsons disease, characterized by cirrhosis, extrapyramidal symptoms and Kayser-Fleischer corneal rings, is a rare hereditary disease of human copper metabolism. Clinical findings in Wilsons disease are complex and neurological symptoms such as tremor, dysarthria, rigid dystonia, seizures, psychiatric disorders, acute liver failure, chronic hepatitis or cirrhosis may develop. A 4-year-old male patient was operated for traumatic depressed skull fracture and intracerebral hematoma. He was diagnosed with Wilsons disease at the age of 2.5 years and treated with zinc sulphate and D-penicillamine. General anesthesia was induced with propofol, fentanyl, atracurium, and maintained with isoflurane, and oxygen. No complications were encountered during the operation or in the postoperative period. We concluded that general anesthesia can successfully be given to Wilsons disease patients using an anesthetic agent, the metabolism of which is least affected by the liver disease, one that induces least hepatic toxicity. By close follow-up of patients clinically and biochemically, it is possible to reduce the complication rates to a minimum. Keywords Wilson's Disease; Craniocerebral trauma; Thoracic injuries; General anesthesia; Surgery PMID:21811529

  15. Anesthetic Management of a Pediatric Patient with Arginase Deficiency

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    Abdulkadir Atım

    2011-09-01

    Full Text Available Arginase deficiency is an autosomal recessive disorder of the urea cycle in which a defect in conversion of arginine to urea and ornithine leads to hyperammonemia. Patients with urea cycle disorders may show increased protein catabolism due to inadequate intake of energy, protein and essential amino acids; infections, fever and surgery. A 12-year-old girl with arginase deficiency, ASA II who weighed 40 kg was scheduled for bilateral adductor, quadriceps and gastrocnemius tenotomies. She had mental retardation, spasticity and flexion posture of thelower limbs. Metabolic homeostasis was restored with appropriate diet. Successful anesthetic management allowed the patient to be discharged 48 hours after surgery. Increased levels of arginine and ammonia during or after surgery may lead to serious complications such as hypotension, cerebral edema, convulsions, hypothermia and spasticity. Thus special attention must be given to metabolic homeostasis and nutrition of the patients with arginase deficiency in the perioperative period. Primary goals should be to minimize stress levels by effective anxiolysis, provide an adequate amount of protein-free energy with proper fluid management and to obtain an effective preemptive and postoperative analgesia. In addition to a high level of knowledge, successful anesthesia requires professional communication among nursing staff, dietitians, pediatric metabolism specialist, surgeon and anesthesiologist.

  16. Severe preeclampsia: anesthetic implications of the disease and its management.

    Science.gov (United States)

    Turner, Judi A

    2009-01-01

    Preeclampsia is a significant, multifactorial, multiorgan disease affecting 6%-8% of all pregnancies in the United States and is the third leading cause of maternal mortality. As such, it is incumbent upon any anesthesia provider involved in obstetric cases to be familiar with the varied manifestations of the disease, management goals from an obstetric standpoint, and the implications for provision of anesthesia in this patient group. Despite improvements in the diagnosis and management of preeclampsia, severe complications can occur in both the mother and the fetus. A systematic approach to the anesthetic evaluation is therefore necessary to reduce morbidity and mortality and to improve outcomes. The potential pitfalls of general anesthesia, including failed intubation, in these complicated patients make regional anesthesia the preferred choice in many cases. Recent studies have shown that spinal anesthesia is often appropriate for preeclamptic patients, even in severe cases. Nevertheless, it is important to be aware of the potential contraindications to neuraxial anesthesia and to prepare for the possibility of encountering a difficult airway.

  17. The articulo-cardiac sympathetic reflex in spinalized, anesthetized rats.

    Science.gov (United States)

    Nakayama, Tomohiro; Suzuki, Atsuko; Ito, Ryuzo

    2006-04-01

    Somatic afferent regulation of heart rate by noxious knee joint stimulation has been proven in anesthetized cats to be a reflex response whose reflex center is in the brain and whose efferent arc is a cardiac sympathetic nerve. In the present study we examined whether articular stimulation could influence heart rate by this efferent sympathetic pathway in spinalized rats. In central nervous system (CNS)-intact rats, noxious articular movement of either the knee or elbow joint resulted in an increase in cardiac sympathetic nerve activity and heart rate. However, although in acutely spinalized rats a noxious movement of the elbow joint resulted in a significant increase in cardiac sympathetic nerve activity and heart rate, a noxious movement of the knee joint had no such effect and resulted in only a marginal increase in heart rate. Because this marginal increase was abolished by adrenalectomy suggests that it was due to the release of adrenal catecholamines. In conclusion, the spinal cord appears to be capable of mediating, by way of cardiac sympathetic nerves, the propriospinally induced reflex increase in heart rate that follows noxious stimulation of the elbow joint, but not the knee joint.

  18. “Robo-Tripping”: Dextromethorphan Abuse and its Anesthetic Implications

    Science.gov (United States)

    Linn, Kelly A; Long, Micah T; Pagel, Paul S

    2014-01-01

    Introduction: We describe a patient scheduled for elective surgery who regularly consumed approximately 12 to 15 times the maximum recommended daily dose of dextromethorphan. We describe the clinical pharmacology of dextromethorphan and discuss its anesthetic implications. Case Presentation: A 30-year-old man with a history of a nasal fracture was scheduled to undergo an elective septorhinoplasty. He reported daily consumption of large quantities (1440 to 1800 mg) of dextromethorphan for six years. He was previously treated for dextromethorphan dependency on several occasions with urine dextromethorphan levels exceeding 2000 ng/mL. He described marked dissociative effects when abusing the drug, but had abstained from use for 48 hours before his elective surgery. Considering that dextromethorphan has a relatively short half-life and that the patient did not suffer major withdrawal symptoms after voluntarily discontinuing the drug, the authors proceeded with the case while recognizing that the drug has significant neuropsychiatric and sympathetic nervous system stimulant effects resulting from its actions as a N-methyl-D-aspartate receptor antagonist. Conclusions: Anesthesiologists need to be aware of dextromethorphan’s clinical pharmacology because recreational abuse of the drug has become increasingly common in adolescents and young adults. PMID:25793175

  19. Antimicrobial effects of liquid anesthetic isoflurane on Candida albicans

    Science.gov (United States)

    Barodka, Viachaslau M; Acheampong, Edward; Powell, Garry; Lobach, Ludmila; Logan, David A; Parveen, Zahida; Armstead, Valerie; Mukhtar, Muhammad

    2006-01-01

    Candida albicans is a dimorphic fungus that can grow in yeast morphology or hyphal form depending on the surrounding environment. This ubiquitous fungus is present in skin and mucus membranes as a potential pathogen that under opportunistic conditions causes a series of systemic and superficial infections known as candidiasis, moniliasis or simply candidiasis. There has been a steady increase in the prevalence of candidiasis that is expressed in more virulent forms of infection. Although candidiasis is commonly manifested as mucocutaneous disease, life-threatening systemic invasion by this fungus can occur in every part of the body. The severity of candidal infections is associated with its morphological shift such that the hyphal morphology of the fungus is most invasive. Of importance, aberrant multiplication of Candida yeast is also associated with the pathogenesis of certain mucosal diseases. In this study, we assessed the anti-candidal activity of the volatile anesthetic isoflurane in liquid form in comparison with the anti-fungal agent amphotericin B in an in vitro culture system. Exposure of C. albicans to isoflurane (0.3% volume/volume and above) inhibited multiplication of yeast as well as formation of hyphae. These data suggest development of potential topical application of isoflurane for controlling a series of cutaneous and genital infections associated with this fungus. Elucidiation of the mechanism by which isoflurane effects fungal growth could offer therapeutic potential for certain systemic fungal infections. PMID:17094810

  20. Antimicrobial effects of liquid anesthetic isoflurane on Candida albicans

    Directory of Open Access Journals (Sweden)

    Armstead Valerie

    2006-11-01

    Full Text Available Abstract Candida albicans is a dimorphic fungus that can grow in yeast morphology or hyphal form depending on the surrounding environment. This ubiquitous fungus is present in skin and mucus membranes as a potential pathogen that under opportunistic conditions causes a series of systemic and superficial infections known as candidiasis, moniliasis or simply candidiasis. There has been a steady increase in the prevalence of candidiasis that is expressed in more virulent forms of infection. Although candidiasis is commonly manifested as mucocutaneous disease, life-threatening systemic invasion by this fungus can occur in every part of the body. The severity of candidal infections is associated with its morphological shift such that the hyphal morphology of the fungus is most invasive. Of importance, aberrant multiplication of Candida yeast is also associated with the pathogenesis of certain mucosal diseases. In this study, we assessed the anti-candidal activity of the volatile anesthetic isoflurane in liquid form in comparison with the anti-fungal agent amphotericin B in an in vitro culture system. Exposure of C. albicans to isoflurane (0.3% volume/volume and above inhibited multiplication of yeast as well as formation of hyphae. These data suggest development of potential topical application of isoflurane for controlling a series of cutaneous and genital infections associated with this fungus. Elucidiation of the mechanism by which isoflurane effects fungal growth could offer therapeutic potential for certain systemic fungal infections.

  1. Anesthetic management of a patient with multiple sclerosis - case report

    Directory of Open Access Journals (Sweden)

    Eduardo Barbin Zuccolotto

    Full Text Available Abstract Background and objectives: Multiple sclerosis is a demyelinating disease of the brain and spinal cord, characterized by muscle weakness, cognitive dysfunction, memory loss, and personality disorders. Factors that promote disease exacerbation are stress, physical trauma, infection, surgery, and hyperthermia. The objective is to describe the anesthetic management of a case referred to urological surgery. Case report: A female patient, 44 years of age, with multiple sclerosis, diagnosed with nephrolithiasis, referred for endoscopic ureterolythotripsy. Balanced general anesthesia was chosen, with midazolam, propofol and remifentanil target-controlled infusion; sevoflurane via laryngeal mask airway; and spontaneous ventilation. Because the patient had respiratory difficulty presenting with chest wall rigidity, it was decided to discontinue the infusion of remifentanil. There was no other complication or exacerbation of disease postoperatively. Conclusion: The use of neuromuscular blockers (depolarizing and non-depolarizing is a problem in these patients. As there was no need for muscle relaxation in this case, muscle relaxants were omitted. We conclude that the combination of propofol and sevoflurane was satisfactory, not resulting in hemodynamic instability or disease exacerbation.

  2. Hydrogen sulfide facilitates carotid sinus baroreflex in anesthetized rats

    Institute of Scientific and Technical Information of China (English)

    Lin XIAO; Yu-ming WU; Hao ZHANG; Yi-xian LIU; Rui-rong HE

    2006-01-01

    Aim:To study effects of hydrogen sulfide (H2S)on the carotid sinus baroreflex (CSB).Methods:The functional curve of the carotid sinus baroreflex was measured by recording changes in arterial pressure in anesthetized male rats with perfused carotid sinus.Results:H2S(derived from sodium hydrosulfide)at concentrations of 25,50,and 100 μmol/L facilitated the CSB,shifting the functional curve of the baroreflex downward and to the left.There was a marked increase in peak slope(PS)and reflex decrease in blood pressure(RD).Effects were concentration-dependent.Pretreatment with glibenclamide(20 μmol/L),a KATP channel blocker,abolished the above effects of H2S on CSB.Pretreatment with Bay K8644 (an agonist of calcium channels;500 nmol/L)eliminated the effect of H2S on CSB.An inhibitor of cystathionine γ-lyase(CSE),DL-propargylglycine(PPG;200 μmol/L),inhibited CSB in male rats and shifted the functional curve of the baroreflex upward and to the right.Conclusion:These data suggest that exogenous H2S exerts a facilitatory role on isolated CSB through opening KATP channels and further closing the calcium channels in vascular smooth muscle.Endogenous H2S may activate the activity of the CSB in vivo.

  3. Anterior and posterior tibial anesthetic block in diabetic foot surgery.

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    José Julio Ojeda González

    2004-12-01

    Full Text Available Fundament: Diabetes Mellitus is a disease of high and increasing prevalence and its complications follow a parallel course. Its morbidity is derived from its own complications which are produced at a long or short term and peripheral vascular disease hihglights among them.Objective: to check the usefulness of the anterior and posterior blockade of the tibia for the surgery of the diabetic foot. Method: Prospective study carried out from January to December 2003 at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ to patients who are carriers of a diabetic foot and who were initially assisted at the service of Angiology and later at the service of Anesthesiology when the surgical procedures were decided. All the patients were applied an anterior and posterior blockade of the tibial nerve . The variables measured were: age, weight, height, surgical time, type of surgery, cardiac frequency medium arterial pressure, and classification of patients according to the American Association of Anesthesiology All the patients were applied a scale for assessing pain in three different moments.Result: There was a predominance of females . The blockade of the posterior tibial nerve with lidocaine 1 % in different points permitted the performance of the surgical techniques proposed. The anesthetic procedure was favorable, and economic since the patients did not requiere of the use of analgesic in the post operatory stage.

  4. Goalpha regulates volatile anesthetic action in Caenorhabditis elegans.

    Science.gov (United States)

    van Swinderen, B; Metz, L B; Shebester, L D; Mendel, J E; Sternberg, P W; Crowder, C M

    2001-06-01

    To identify genes controlling volatile anesthetic (VA) action, we have screened through existing Caenorhabditis elegans mutants and found that strains with a reduction in Go signaling are VA resistant. Loss-of-function mutants of the gene goa-1, which codes for the alpha-subunit of Go, have EC(50)s for the VA isoflurane of 1.7- to 2.4-fold that of wild type. Strains overexpressing egl-10, which codes for an RGS protein negatively regulating goa-1, are also isoflurane resistant. However, sensitivity to halothane, a structurally distinct VA, is differentially affected by Go pathway mutants. The RGS overexpressing strains, a goa-1 missense mutant found to carry a novel mutation near the GTP-binding domain, and eat-16(rf) mutants, which suppress goa-1(gf) mutations, are all halothane resistant; goa-1(null) mutants have wild-type sensitivities. Double mutant strains carrying mutations in both goa-1 and unc-64, which codes for a neuronal syntaxin previously found to regulate VA sensitivity, show that the syntaxin mutant phenotypes depend in part on goa-1 expression. Pharmacological assays using the cholinesterase inhibitor aldicarb suggest that VAs and GOA-1 similarly downregulate cholinergic neurotransmitter release in C. elegans. Thus, the mechanism of action of VAs in C. elegans is regulated by Goalpha, and presynaptic Goalpha-effectors are candidate VA molecular targets.

  5. Abdominal expiratory muscle activity in anesthetized vagotomized neonatal rats.

    Science.gov (United States)

    Iizuka, Makito

    2009-05-01

    The pattern of respiratory activity in abdominal muscles was studied in anesthetized, spontaneously breathing, vagotomized neonatal rats at postnatal days 0-3. Anesthesia (2.0% isoflurane, 50% O(2)) depressed breathing and resulted in hypercapnia. Under this condition, abdominal muscles showed discharge late in the expiratory phase (E2 activity) in most rats. As the depth of anesthesia decreased, the amplitude of discharges in the diaphragm and abdominal muscles increased. A small additional burst frequently occurred in abdominal muscles just after the termination of diaphragmatic inspiratory activity (E1 or postinspiratory activity). Since this E1 activity is not often observed in adult rats, the abdominal respiratory pattern likely changes during postnatal development. Anoxia-induced gasping after periodic expiratory activity without inspiratory activity, and in most rats, abdominal expiratory activity disappeared before terminal apnea. These results suggest that a biphasic abdominal motor pattern (a combination of E2 and E1 activity) is a characteristic of vagotomized neonatal rats during normal respiration.

  6. Neonatal inhalatory anesthetic exposure: reproductive changes in male rats.

    Science.gov (United States)

    Arena, A C; Pereira, O C M

    2002-12-01

    We investigated the effects of an inhalatory anesthetic (ethyl ether) during the neonatal period of brain sexual differentiation on the later fertility and sexual behavior of male rats. Animals were exposed to ethyl ether immediately after birth. At adulthood, body weight, testes wet weight, and plasma testosterone levels were not affected; however, neonatal exposure to ether showed alterations on male fertility: a decrease in the number of spermatids and spermatozoa, an increase in the transit time of cauda epididymal spermatozoa and a decrease in daily sperm production. An alteration of sexual behavior was also observed: decreased male sexual behavior and appearance of homosexual behavior when the male rats were castrated and pretreated with exogenous estrogen. Probably, the ether delayed or reduced the testosterone peak of the sexual differentiation period, altering the processes of masculinization and defeminization of the hypothalamus. Our results indicate that perinatal exposure to ethyl ether during the critical period of male brain sexual differentiation, acting as endocrine disruptors, has a long-term effect on the fertility and sexual behavior of male rats, suggesting endocrine disruption through incomplete masculinization and defeminization of the central nervous system.

  7. Cimethidine pre-anesthetic. A prophylactic method against Mendelson's syndrome in cesarean section

    DEFF Research Database (Denmark)

    Qvist, N; Storm, K

    1983-01-01

    Twenty patients undergoing cesarean section received cimethidine 400 mg intramuscularly as pre-anesthetic approximately 70 minutes prior to gastric aspiration. The average pH was 5.05, as against 2.97 in the control group (p less than 0.01). No significant reduction in the aspirated volumes...... in the infants. Hence, cimethidine is a safe and useful pre-anesthetic for patients undergoing cesarean section, irrespective of indication and, consequently, much to be preferred to oral antacids....

  8. Anesthetic gases and global warming: Potentials, prevention and future of anesthesia.

    Science.gov (United States)

    Gadani, Hina; Vyas, Arun

    2011-01-01

    Global warming refers to an average increase in the earth's temperature, which in turn causes changes in climate. A warmer earth may lead to changes in rainfall patterns, a rise in sea level, and a wide range of impacts on plants, wildlife, and humans. Greenhouse gases make the earth warmer by trapping energy inside the atmosphere. Greenhouse gases are any gas that absorbs infrared radiation in the atmosphere and include: water vapor, carbon dioxide (CO2), methane (CH4), nitrous oxide (N2O), halogenated fluorocarbons (HCFCs), ozone (O3), perfluorinated carbons (PFCs), and hydrofluorocarbons (HFCs). Hazardous chemicals enter the air we breathe as a result of dozens of activities carried out during a typical day at a healthcare facility like processing lab samples, burning fossil fuels etc. We sometimes forget that anesthetic agents are also greenhouse gases (GHGs). Anesthetic agents used today are volatile halogenated ethers and the common carrier gas nitrous oxide known to be aggressive GHGs. With less than 5% of the total delivered halogenated anesthetic being metabolized by the patient, the vast majority of the anesthetic is routinely vented to the atmosphere through the operating room scavenging system. The global warming potential (GWP) of a halogenated anesthetic is up to 2,000 times greater than CO2. Global warming potentials are used to compare the strength of different GHGs to trap heat in the atmosphere relative to that of CO2. Here we discuss about the GWP of anesthetic gases, preventive measures to decrease the global warming effects of anesthetic gases and Xenon, a newer anesthetic gas for the future of anesthesia.

  9. Precautionary practices for administering anesthetic gases: A survey of physician anesthesiologists, nurse anesthetists and anesthesiologist assistants.

    Science.gov (United States)

    Boiano, James M; Steege, Andrea L

    2016-10-02

    Scavenging systems and administrative and work practice controls for minimizing occupational exposure to waste anesthetic gases have been recommended for many years. Anesthetic gases and vapors that are released or leak out during medical procedures are considered waste anesthetic gases. To better understand the extent recommended practices are used, the NIOSH Health and Safety Practices Survey of Healthcare Workers was conducted in 2011 among members of professional practice organizations representing anesthesia care providers including physician anesthesiologists, nurse anesthetists, and anesthesiologist assistants. This national survey is the first to examine self-reported use of controls to minimize exposure to waste anesthetic gases among anesthesia care providers. The survey was completed by 1,783 nurse anesthetists, 1,104 physician anesthesiologists, and 100 anesthesiologist assistants who administered inhaled anesthetics in the seven days prior to the survey. Working in hospitals and outpatient surgical centers, respondents most often administered sevoflurane and, to a lesser extent desflurane and isoflurane, in combination with nitrous oxide. Use of scavenging systems was nearly universal, reported by 97% of respondents. However, adherence to other recommended practices was lacking to varying degrees and differed among those administering anesthetics to pediatric (P) or adult (A) patients. Examples of practices which increase exposure risk, expressed as percent of respondents, included: using high (fresh gas) flow anesthesia only (17% P, 6% A), starting anesthetic gas flow before delivery mask or airway mask was applied to patient (35% P; 14% A); not routinely checking anesthesia equipment for leaks (4% P, 5% A), and using a funnel-fill system to fill vaporizers (16%). Respondents also reported that facilities lacked safe handling procedures (19%) and hazard awareness training (18%). Adherence to precautionary work practices was generally highest among

  10. Latency of auditory evoked potential monitoring the effects of general anesthetics on nerve fibers and synapses

    OpenAIRE

    Bowan Huang; Feixue Liang; Lei Zhong; Minlin Lin; Juan Yang; Linqing Yan; Jinfan Xiao; Zhongju Xiao

    2015-01-01

    Auditory evoked potential (AEP) is an effective index for the effects of general anesthetics. However, it’s unknown if AEP can differentiate the effects of general anesthetics on nerve fibers and synapses. Presently, we investigated AEP latency and amplitude changes to different acoustic intensities during pentobarbital anesthesia. Latency more regularly changed than amplitude during anesthesia. AEP Latency monotonically decreased with acoustic intensity increase (i.e., latency-intensity curv...

  11. Evaluation of Waste Anesthetic Gas in the Postanesthesia Care Unit within the Patient Breathing Zone

    Science.gov (United States)

    Hiller, Kenneth N.; Altamirano, Alfonso V.; Cai, Chunyan; Tran, Stephanie F.; Williams, George W.

    2015-01-01

    Potential health hazards from waste anesthetic gases (WAGs) have been a concern since the introduction of inhalational anesthetics into clinical practice. The potential to exceed recommended exposure levels (RELs) in the postanesthesia care unit (PACU) exists. The aim of this pilot study was to assess sevoflurane WAG levels while accounting for factors that affect inhalational anesthetic elimination. In this pilot study, 20 adult day surgery patients were enrolled with anesthesia maintained with sevoflurane. Following extubation, exhaled WAG from the patient breathing zone was measured 8 inches from the patient's mouth in the PACU. Maximum sevoflurane WAG levels in the patient breathing zone exceeded National Institute for Occupational Safety and Health (NIOSH) RELs for every 5-minute time interval measured during PACU Phase I. Observed WAGs in our study were explained by inhalational anesthetic pharmacokinetics. Further analysis suggests that the rate of washout of sevoflurane was dependent on the duration of anesthetic exposure. This study demonstrated that clinically relevant inhalational anesthetic concentrations result in sevoflurane WAG levels that exceed current RELs. Evaluating peak and cumulative sevoflurane WAG levels in the breathing zone of PACU Phase I and Phase II providers is warranted to quantify the extent and duration of exposure. PMID:26693222

  12. Anesthetic management in a patient with Kindler′s syndrome

    Directory of Open Access Journals (Sweden)

    Sohan Lal Solanki

    2011-01-01

    Full Text Available A 35-year-old male with pan-anterior urethral stricture was scheduled to undergo perineal urethrostomy. He was a known case of Kindler′s syndrome since infancy. He was having a history of blister formation, extensive poikiloderma and progressive cutaneous atrophy since childhood. He had a tendency of trauma-induced blisters with clear or hemorrhagic contents that healed with scarring. The fingers were sclerodermiform with dystrophic nails and inability to completely clench the fist. Airway examination revealed thyromental distance of 7 cm with limited neck extension, limited mouth opening and mallampatti class III with a fixed large tongue. He was reported as grade IV Cormack and Lehane laryngoscopic on previous anesthesia exposure. We described the anesthetic management of such case on guidelines for epidermolysis bullosa. In the operating room, an 18-G cannula was secured in the right upper limb using Coban TM Wrap. The T-piece of the cannula was than inserted into the slit and the tape was wrapped around the extremity. The ECG electrodes were placed on the limbs and fixed with Coban TM . Noninvasive blood pressure cuff was applied over the wrap after wrapping the arm with Webril® cotton. Oral fiberoptic tracheal intubation was done after lubricating the laryngoscope generously with a water-based lubricant with 7-mm endotracheal tube. Surgery proceeded without any complication. After reversing the residual neuromuscular block, trachea was extubated once the patient became awake. He was kept in the postanesthesia care unit for 2 hours and then shifted to urology ward.

  13. Cardiovascular responses to intrathecal administration of endomorphins in anesthetized rats.

    Science.gov (United States)

    Wang, Chang-Lin; Yu, Ye; Lai, Lu-Hao; Cui, Yun; Wang, Xiang; Wang, Rui

    2007-04-01

    Endomorphins (EMs), the endogenous, potent and selective mu-opioid receptor agonists, have been shown to decrease systemic arterial pressure (SAP) in rats after intravenous (i.v.) administration. In the present study, cardiovascular responses to intrathecal (i.t.) injection of EMs were investigated in urethane-anesthetized rats. It is noteworthy that EMs elicited decreases in SAP and heart rate (HR) in a dose-dependent manner; 10-300nmol/kg were injected intrathecally. Furthermore, these vasodepressor and bradycardic effects were significantly antagonized by naloxone (0.5mg/kg, i.t.). Interestingly, i.t. (5mg/kg) or i.v. (50mg/kg) administrations of N(omega)-nitro-l-arginine methylester (l-NAME) attenuated the vasodepressor and bradycardic effects. Moreover, pretreatment of the rats with muscarinic receptor antagonist atropine (2mg/kg, i.v.) and alpha-adrenoceptor antagonist phentolamine (1mg/kg, i.v.) significantly reduced the vasodepressor effects of EMs. Nevertheless, pretreatment with beta-adrenoceptor antagonist propranolol (2mg/kg, i.v.) could only block the bradycardia effects induced by EMs, but had no significant effects on the hypotension. In summary, all the results suggested that i.t. administration of EMs decreased SAP and HR which were possibly mediated by the activation of opioid receptors in the rat spinal cord. In addition, nitric oxide (NO) release in both the spinal cord and in peripheral tissues might regulate the cardiovascular activities of EMs, and the muscarinic receptor and adrenoceptor played an important role in the regulation of the cardiovascular responses to i.t. administration of EMs.

  14. Capsaicin facilitates carotid sinus baroreceptor activity in anesthetized rats

    Institute of Scientific and Technical Information of China (English)

    HaoZHANG; Yi-xianLIU; Yu-mingWU; Ze-minWANG; Rui-rongHE

    2004-01-01

    AIM: To study the effect of capsaicin on carotid sinus baroreceptor activity (CBA). METHODS: The functional curve of carotid baroreceptor (FCCB) was constructed and the functional parameters of carotid sinus baroreceptor were measured by recording sinus nerve afferent discharge in anesthetized rats with perfused isolated carotid sinus. RESULTS: Low-concentration of capsaicin (0.2μmol/L) had no significant effect on CBA, while perfusion of the isolated carotid sinus with middle-concentration of capsaicin (1μmol/L) could shift FCCB to the left and upward,with peak slope (PS) increased from (2.47%±0.14%)/mmHg to (2.88%±0.10%)/mmHg (P<0.05) and peak integral value of carotid sinus nerve discharge (PIV) enhanced from 211%±5% to 238%±6% (P<0.01). The threshold pressure (TP) and saturation pressure (SP) were significantly decreased from 68.0±1.1 to 62.7±1.0mmHg (P<0.01) and from 171.0±1.6 to 165.0±0.6 mmHg (P<0.01). By perfusing with high-concentration of capsaicin (5μmol/L), FCCB was shifted to the left and upward further and the changes of the functional parameters such as PS, TP, and SP were concentration-dependent. Pretreatment with ruthenium red (100μmol/L), an antagonist of vanilloid receptor subtype 1 (VR1), blocked the effect of capsaicin on CBA. Preperfusion with glibenclamide(20μmol/L), a KATP channel blocker, could eliminate the effect of capsaicin on CBA. CONCLUSION: Capsaicin exerts a facilitatory role on the isolated carotid baroreceptor in a concentration-dependent manner. The facilitatory action of capsaicin may be attributed to the opening of KATP channels mediated by VR1.

  15. Capsaicin facilitates carotid sinus baroreceptor activity in anesthetized rats

    Institute of Scientific and Technical Information of China (English)

    Hao ZHANG; Yi-xian LIU; Yu-ming WU; Ze-min WANG; Rui-rong HE

    2004-01-01

    AIM: To study the effect of capsaicin on carotid sinus baroreceptor activity (CBA). METHODS: The functional curve of carotid baroreceptor (FCCB) was constructed and the functional parameters of carotid sinus baroreceptor were measured by recording sinus nerve afferent discharge in anesthetized rats with perfused isolated carotid sinus.RESULTS: Low-concentration of capsaicin (0.2 μmol/L) had no significant effect on CBA, while perfusion of the isolated carotid sinus with middle-concentration of capsaicin (1 μmol/L) could shift FCCB to the left and upward,with peak slope (PS) increased from (2.47 %±0.14 %)/mmHg to (2.88 %±0.10 %)/mmHg (P<0.05) and peak integral value of carotid sinus nerve discharge (PIV) enhanced from 211%±5 % to 238 %±6 % (P<0.01). The threshold pressure (TP) and saturation pressure (SP) were significantly decreased from 68.0±1.1 to 62.7±1.0mmHg (P<0.01) and from 171.0±1.6 to 165.0±0.6 mmHg (P<0.01). By perfusing with high-concentration of capsaicin (5 μmol/L), FCCB was shifted to the left and upward further and the changes of the functional parameters such as PS, TP, and SP were concentration-dependent. Pretreatment with ruthenium red (100 μmol/L), an antagonist of vanilloid receptor subtype 1 (VR1), blocked the effect of capsaicin on CBA. Preperfusion with glibenclamide(20 μmol/L), a KATp channel blocker, could eliminate the effect of capsaicin on CBA. CONCLUSION: Capsaicin exerts a facilitatory role on the isolated carotid baroreceptor in a concentration-dependent manner. The facilitatory action of capsaicin may be attributed to the opening of KATP channels mediated by VR1.

  16. Perioperative anesthetic documentation: Adherence to current Australian guidelines

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    Islam Elhalawani

    2013-01-01

    Full Text Available Purpose: The lack of adequate perioperative documentation has legal implications and can potentially affect the quality and safety of patient care. Despite the presence of guidelines, the adequacy of perioperative documentation in Australasia has not been adequately assessed. The aim of this study is to assess the adequacy of anesthetic documentation on the pre and intraoperative encounters and to test the hypotheses that documentation is incomplete in the settings of emergency vs. elective procedures, regional vs. general anesthesia, and manual vs. electronic documentation. Materials and Methods: The study was an observational retrospective study in the setting of a 250-bed teaching hospital in metropolitan Adelaide, Australia. The perioperative records of 850 patients were analyzed. A scoring system was designed, based on a policy statement from the Australian and New Zealand College of Anesthetists and a survey of the hospital anesthetists. Scored and categorical data was analyzed using Chi-square test. Numerical data was analyzed using student t-test. The null hypothesis was accepted or rejected at 0.05 significance. Results: There were significant deficiencies in the adequacy of preanesthetic and intraoperative records. This has been shown to be true in all cases. Documentation was found to be poorer in the emergency setting when compared to elective cases (median scores 15 vs. 21 P = 0.03 as well as documentation of airway assessment for cases done solely under regional anesthesia (42 vs. 85%, P = 0.05. There were no significant differences in the adequacy of electronic vs. manual records ( P = 0.92. Conclusion: There are significant deficiencies in the adequacy of perioperative records. This has been shown to be true in all cases, but is especially so in emergency cases and for patients having only regional anesthesia.

  17. Local anesthesia for endovascular abdominal aortic aneurysm repair

    NARCIS (Netherlands)

    Verhoeven, ELG; Cina, CS; Tielliu, IFJ; Zeebregts, CJ; Prins, TR; Eindhoven, GB; Span, MM; Kapma, MR; van den Dungen, JJAM

    2005-01-01

    Objectives: This study reports the results of a prospective continuous cohort of patients treated for endovascular aneurysm repair (EVAR) with a unified anesthetic strategy based on the use of local anesthesia (LA) in all patients, while reserving regional (RA) or general anesthesia (GA) only for th

  18. Volatile Anesthetics Influence Blood-Brain Barrier Integrity by Modulation of Tight Junction Protein Expression in Traumatic Brain Injury

    OpenAIRE

    Thal, Serge C.; Clara Luh; Eva-Verena Schaible; Ralph Timaru-Kast; Jana Hedrich; Luhmann, Heiko J.; Kristin Engelhard; Zehendner, Christoph M.

    2012-01-01

    Disruption of the blood-brain barrier (BBB) results in cerebral edema formation, which is a major cause for high mortalityrnafter traumatic brain injury (TBI). As anesthetic care is mandatory in patients suffering from severe TBI it may be importantrnto elucidate the effect of different anesthetics on cerebral edema formation. Tight junction proteins (TJ) such as zonularnoccludens-1 (ZO-1) and claudin-5 (cl5) play a central role for BBB stability. First, the influence of the volatile anesthet...

  19. Dexmedetomidine as the primary anesthetic agent during cardiac surgery in an infant with a family history of malignant hyperthermia

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    Aymen Naguib

    2011-01-01

    Full Text Available Malignant hyperthermia (MH is an acute hypermetabolic crisis triggered in susceptible patients by the administration of succinylcholine or a volatile anesthetic agent. When providing anesthetic care for MH-susceptible agents, a total intravenous anesthetic (TIVA technique is frequently chosen. When choosing the components for TIVA, several options exist including the combination of propofol or dexmedetomidine with an opioid. We present our experience with the use of dexmedetomidine as a key component of the anesthetic regimen in a 5-month-old infant with a family history of MH. Previous reports of the use of dexmedetomidine in MH-susceptible patients are reviewed and its benefits in such patients discussed.

  20. Hypnosis control based on the minimum concentration of anesthetic drug for maintaining appropriate hypnosis.

    Science.gov (United States)

    Furutani, Eiko; Nishigaki, Yuki; Kanda, Chiaki; Takeda, Toshihiro; Shirakami, Gotaro

    2013-01-01

    This paper proposes a novel hypnosis control method using Auditory Evoked Potential Index (aepEX) as a hypnosis index. In order to avoid side effects of an anesthetic drug, it is desirable to reduce the amount of an anesthetic drug during surgery. For this purpose many studies of hypnosis control systems have been done. Most of them use Bispectral Index (BIS), another hypnosis index, but it has problems of dependence on anesthetic drugs and nonsmooth change near some particular values. On the other hand, aepEX has an ability of clear distinction between patient consciousness and unconsciousness and independence of anesthetic drugs. The control method proposed in this paper consists of two elements: estimating the minimum effect-site concentration for maintaining appropriate hypnosis and adjusting infusion rate of an anesthetic drug, propofol, using model predictive control. The minimum effect-site concentration is estimated utilizing the property of aepEX pharmacodynamics. The infusion rate of propofol is adjusted so that effect-site concentration of propofol may be kept near and always above the minimum effect-site concentration. Simulation results of hypnosis control using the proposed method show that the minimum concentration can be estimated appropriately and that the proposed control method can maintain hypnosis adequately and reduce the total infusion amount of propofol.

  1. Advanced Pre-clinical Research Approaches and Models to Studying Pediatric Anesthetic Neurotoxicity

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    Cheng eWang

    2012-10-01

    Full Text Available Advances in pediatric and obstetric surgery have resulted in an increase in the duration and complexity of anesthetic procedures. A great deal of concern has recently arisen regarding the safety of anesthesia in infants and children. Because of obvious limitations, it is not possible to thoroughly explore the effects of anesthetic agents on neurons in vivo in human infants or children. However, the availability of some advanced pre-clinical research approaches and models, such as imaging technology both in vitro and in vivo, stem cell and nonhuman primate experimental models, have provided potentially invaluable tools for examining the developmental effects of anesthetic agents. This review discusses the potential application of some sophisticaled research approaches, e.g., calcium imaging, in stem cell-derived in vitro models, especially human embryonic neural stem cells, along with their capacity for proliferation and their potential for differentiation, to dissect relevant mechanisms underlying the etiology of the neurotoxicity associated with developmental exposures to anesthetic agents. Also, this review attempts to discuss several advantages for using the developing rhesus monkey models (in vivo, when combined with dynamic molecular imaging approaches, in addressing critical issues related to the topic of pediatric sedation/anesthesia. These include the relationships between anesthetic-induced neurotoxicity, dose response, time-course and developmental stage at time of exposure (in vivo studies, serving to provide the most expeditious platform toward decreasing the uncertainty in extrapolating pre-clinical data to the human condition.

  2. Recognition of anesthetic barbiturates by a protein binding site: a high resolution structural analysis.

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    Simon Oakley

    Full Text Available Barbiturates potentiate GABA actions at the GABA(A receptor and act as central nervous system depressants that can induce effects ranging from sedation to general anesthesia. No structural information has been available about how barbiturates are recognized by their protein targets. For this reason, we tested whether these drugs were able to bind specifically to horse spleen apoferritin, a model protein that has previously been shown to bind many anesthetic agents with affinities that are closely correlated with anesthetic potency. Thiopental, pentobarbital, and phenobarbital were all found to bind to apoferritin with affinities ranging from 10-500 µM, approximately matching the concentrations required to produce anesthetic and GABAergic responses. X-ray crystal structures were determined for the complexes of apoferritin with thiopental and pentobarbital at resolutions of 1.9 and 2.0 Å, respectively. These structures reveal that the barbiturates bind to a cavity in the apoferritin shell that also binds haloalkanes, halogenated ethers, and propofol. Unlike these other general anesthetics, however, which rely entirely upon van der Waals interactions and the hydrophobic effect for recognition, the barbiturates are recognized in the apoferritin site using a mixture of both polar and nonpolar interactions. These results suggest that any protein binding site that is able to recognize and respond to the chemically and structurally diverse set of compounds used as general anesthetics is likely to include a versatile mixture of both polar and hydrophobic elements.

  3. Impact of Anesthetics on Immune Functions in a Rat Model of Vagus Nerve Stimulation.

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    Chloé A Picq

    Full Text Available Vagus nerve stimulation (VNS has been successfully performed in animals for the treatment of different experimental models of inflammation. The anti-inflammatory effect of VNS involves the release of acetylcholine by vagus nerve efferent fibers inhibiting pro-inflammatory cytokines (e.g. TNF-α produced by macrophages. Moreover, it has recently been demonstrated that splenic lymphocytic populations may also be involved. As anesthetics can modulate the inflammatory response, the current study evaluated the effect of two different anesthetics, isoflurane and pentobarbital, on splenic cellular and molecular parameters in a VNS rat model. Spleens were collected for the characterization of lymphocytes sub-populations by flow cytometry and quantification of cytokines secretion after in vitro activation. Different results were observed depending on the anesthetic used. The use of isoflurane displayed a non-specific effect of VNS characterized by a decrease of most splenic lymphocytes sub-populations studied, and also led to a significantly lower TNF-α secretion by splenocytes. However, the use of pentobarbital brought to light immune modifications in non-stimulated animals that were not observed with isoflurane, and also revealed a specific effect of VNS, notably at the level of T lymphocytes' activation. These differences between the two anesthetics could be related to the anti-inflammatory properties of isoflurane. In conclusion, pentobarbital is more adapted than isoflurane in the study of the anti-inflammatory effect of VNS on an anesthetized rat model in that it allows more accurate monitoring of subtle immunomodulatory processes.

  4. Anesthetic activity of Brazilian native plants in silver catfish (Rhamdia quelen

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    Lenise de Lima Silva

    Full Text Available There is an increasing demand for inexpensive and safe anesthetics that can reduce fish stress caused by some procedures such as capture and handling. In this context, the present study evaluated the potential of essential oils (EO of three Brazilian native plants (Hesperozygis ringens, Lippia sidoides and Ocotea acutifolia as anesthetics for the silver catfish - Rhamdia quelen. Moreover, an analysis was made of the chemical composition of these oils and their influence on stress parameter. EO of H. ringens and O. acutifolia were effective as anesthetics, without behavioral side effects. EO of O. acutifolia (150 µL L-1 promoted an increase in blood glucose level. Regarding to the composition, pulegone accounts for 96.63% of the EO of H. ringens, and caryophyllene oxide amounts to 56.90% of the EO of O. acutifolia. Two chemotypes, thymol and carvacrol (68.40% and 67.89%, respectively were verified for EO of L. sidoides. Both samples of EO of L. sidoides showed anesthetic activity in silver catfish, but exposure also caused loss of mucus and mortality. Thus, only the EO of H. ringens and O. acutifolia are advised for anesthetic use

  5. Inhibition of gastric emptying and intestinal transit in anesthetized rats by a Tityus serrulatus scorpion toxin

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    Troncon L.E.A.

    2000-01-01

    Full Text Available The effects of a fraction (T1 of Tityus serrulatus scorpion venom prepared by gel filtration on gastric emptying and small intestinal transit were investigated in male Wistar rats. Fasted animals were anesthetized with urethane, submitted to tracheal intubation and right jugular vein cannulation. Scorpion toxin (250 µg/kg or saline was injected iv and 1 h later a bolus of saline (1.0 ml/100 g labeled with 99m technetium-phytate (10 MBq was administered by gavage. After 15 min, animals were sacrificed and the radioactivity remaining in the stomach was determined. Intestinal transit was evaluated by instillation of a technetium-labeled saline bolus (1.0 ml through a cannula previously implanted in the duodenum. After 60 min, the progression of the marker throughout 7 consecutive gut segments was estimated by the geometric center method. Gastric retention of the liquid test meal in rats injected with scorpion toxin (median: 88%; range: 52-95% was significantly higher (P<0.02 than in controls (54%; 21-76%, an effect which was not modified by gastric secretion blockade with ranitidine. The progression of the isotope marker throughout the small intestine was significantly slower (P<0.05 in rats treated with toxin (1.2; 1.0-2.5 than in control animals (2.3; 1.0-3.2. Inhibition of both gastric emptying and intestinal transit in rats injected with scorpion toxin suggests an increased resistance to aboral flow, which might be caused by abnormal neurotransmitter release or by the local effects of venom on smooth muscle cells.

  6. Brainstem stimulation augments information integration in the cerebral cortex of desflurane-anesthetized rats.

    Science.gov (United States)

    Pillay, Siveshigan; Vizuete, Jeannette; Liu, Xiping; Juhasz, Gabor; Hudetz, Anthony G

    2014-01-01

    States of consciousness have been associated with information integration in the brain as modulated by anesthesia and the ascending arousal system. The present study was designed to test the hypothesis that electrical stimulation of the oral part of the pontine reticular nucleus (PnO) can augment information integration in the cerebral cortex of anesthetized rats. Extracellular unit activity and local field potentials were recorded in freely moving animals from parietal association (PtA) and secondary visual (V2) cortices via chronically implanted microwire arrays at three levels of anesthesia produced by desflurane: 3.5, 4.5, and 6.0% (where 4.5% corresponds to that critical for the loss of consciousness). Information integration was characterized by integration (multiinformation) and interaction entropy, estimated from the statistical distribution of coincident spike patterns. PnO stimulation elicited electrocortical activation as indicated by the reductions in δ- and θ-band powers at the intermediate level of anesthesia. PnO stimulation augmented integration from 1.13 ± 0.03 to 6.12 ± 1.98 × 10(3) bits and interaction entropy from 0.44 ± 0.11 to 2.18 ± 0.72 × 10(3) bits; these changes were most consistent in the PtA at all desflurane concentrations. Stimulation of the retina with discrete light flashes after PnO stimulation elicited an additional 166 ± 25 and 92 ± 12% increase in interaction entropy in V2 during light and intermediate levels. The results suggest that the PnO may modulate spontaneous ongoing and sensory stimulus-related cortical information integration under anesthesia.

  7. Electrophysiological evidence for change detection in speech sound patterns by anesthetized rats.

    Science.gov (United States)

    Astikainen, Piia; Mällo, Tanel; Ruusuvirta, Timo; Näätänen, Risto

    2014-01-01

    Human infants are able to detect changes in grammatical rules in a speech sound stream. Here, we tested whether rats have a comparable ability by using an electrophysiological measure that has been shown to reflect higher order auditory cognition even before it becomes manifested in behavioral level. Urethane-anesthetized rats were presented with a stream of sequences consisting of three pseudowords carried out at a fast pace. Frequently presented "standard" sequences had 16 variants which all had the same structure. They were occasionally replaced by acoustically novel "deviant" sequences of two different types: structurally consistent and inconsistent sequences. Two stimulus conditions were presented for separate animal groups. In one stimulus condition, the standard and the pattern-obeying deviant sequences had an AAB structure, while the pattern-violating deviant sequences had an ABB structure. In the other stimulus condition, these assignments were reversed. During the stimulus presentation, local-field potentials were recorded from the dura, above the auditory cortex. Two temporally separate differential brain responses to the deviant sequences reflected the detection of the deviant speech sound sequences. The first response was elicited by both types of deviant sequences and reflected most probably their acoustical novelty. The second response was elicited specifically by the structurally inconsistent deviant sequences (pattern-violating deviant sequences), suggesting that rats were able to detect changes in the pattern of three-syllabic speech sound sequence (i.e., location of the reduplication of an element in the sequence). Since all the deviant sound sequences were constructed of novel items, our findings indicate that, similarly to the human brain, the rat brain has the ability to automatically generalize extracted structural information to new items.

  8. Electrophysiological evidence for change detection in speech sound patterns by anesthetized rats

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    Piia eAstikainen

    2014-11-01

    Full Text Available Human infants are able to detect changes in grammatical rules in a speech sound stream. Here, we tested whether rats have a comparable ability by using an electrophysiological measure that has been shown to reflect higher order auditory cognition even before it becomes manifested in behavioural level. Urethane-anesthetized rats were presented with a stream of sequences consisting of three pseudowords carried out at a fast pace. Frequently presented ‘standard’ sequences had 16 variants which all had the same structure. They were occasionally replaced by acoustically novel ‘deviant’ sequences of two different types: structurally consistent and inconsistent sequences. Two stimulus conditions were presented for separate animal groups. In one stimulus condition, the standard and the pattern-obeying deviant sequences had an AAB structure, while the pattern-violating deviant sequences had an ABB structure. In the other stimulus condition, these assignments were reversed. During the stimulus presentation, local-field potentials were recorded from the dura, above the auditory cortex. Two temporally separate differential brain responses to the deviant sequences reflected the detection of the deviant speech sound sequences. The first response was elicited by both types of deviant sequences and reflected most probably their acoustical novelty. The second response was elicited specifically by the structurally inconsistent deviant sequences (pattern-violating deviant sequences, suggesting that rats were able to detect changes in the pattern of three-syllabic speech sound sequence (i.e. location of the reduplication of an element in the sequence. Since all the deviant sound sequences were constructed of novel items, our findings indicate that, similarly to the human brain, the rat brain has the ability to automatically generalize extracted structural information to new items.

  9. Brainstem stimulation augments information integration in the cerebral cortex of desflurane-anesthetized rats

    Directory of Open Access Journals (Sweden)

    Siveshigan ePillay

    2014-02-01

    Full Text Available States of consciousness have been associated with information integration in the brain as modulated by anesthesia and the ascending arousal system. The present study was designed to test the hypothesis that electrical stimulation of the oral part of the pontine reticular nucleus (PnO can augment information integration in the cerebral cortex of anesthetized rats. Extracellular unit activity and local field potentials were recorded in freely moving animals from parietal association (PtA and secondary visual (V2 cortices via chronically implanted microwire arrays at three levels of anesthesia produced by desflurane: 3.5%, 4.5%, and 6.0% (where 4.5% corresponds to that critical for the loss of consciousness. Information integration was characterized by integration (multiinformation and interaction entropy, estimated from the statistical distribution of coincident spike patterns. PnO stimulation elicited electrocortical activation as indicated by the reductions in δ- and θ-band powers at the intermediate level of anesthesia. PnO stimulation augmented integration from 1.13 ± 0.03 to 6.12 ± 1.98 x103 bits and interaction entropy from 0.44 ± 0.11 to 2.18 ± 0.72 x103 bits; these changes were most consistent in the PtA at all desflurane concentrations. Stimulation of the retina with discrete light flashes after PnO stimulation elicited an additional 166 ± 25 and 92 ± 12% increase in interaction entropy in V2 during light and intermediate levels. The results suggest that the PnO may modulate spontaneous ongoing and sensory stimulus-related cortical information integration under anesthesia.

  10. Evaluation of the community structure of a rockpool fish assemblage from Peniche (Portugal using clove oil as an anesthetic

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    Francisco Mattioli

    2014-06-01

    Full Text Available The goal of this study was to provide the first scientific data of the intertidal ichthyofauna community of Peniche. In order to have an accurate assessment, anesthetics were used, since this method is more effective than visual census. Therefore, the ideal concentration of clove oil to be used as anesthetics for local rock pool fish was tested. Through laboratory experiments with some of the most common species in the area, the concentration 30 mg.L-1was considered ideal. A total of 4 rockpools were sampled between May and July 2012, in two different locations (2 in Praia da Gamboa and 2 in Portinho da Areia Norte, in Peniche (West of Portugal. A total of 508 fishes belonging to 17 different species were registered. Fish abundance, occurrence frequencies and sizes were registered and compared for the two beaches and for the respective tide pools. The most abundant species was Gobius n.sp. while the most frequent was Gobius paganellus. These two species represent 59.1% of all captured species. Praia da Gamboa was the location with the highest abundance of individuals while Portinho da Areia Norte was the location where larger individuals were collected. It was observed that the size of rockpools affects abundance and density of individuals. Substrate, number and type of shelters also affect density, abundance and the mean size of individuals. Considering the studies focusing on intertidal ichthyofauna worldwide are relatively scarce, and being this ecosystem absolutely crucial both for biological but also socio-economic reasons worldwide, a better understanding of this unique ecosystem is mandatory, so it is possible to understand it, in order to preserve it.

  11. [Emergencies evolving from local anesthesia].

    Science.gov (United States)

    Kaufman, E; Garfunkel, A; Findler, M; Elad, S; Zusman, S P; Malamed, S F; Galili, D

    2002-01-01

    Local anesthesia is without doubt the most frequently used drug in dentistry and in medicine. In spite of records of safety set by using these drugs, there is evidence to adverse reactions ranging from 2.5%-11%. Most of the reactions originate from the autonomic system. A recent, well-planned study indicates that adverse reactions are highly correlated to the medical status of the patient: the higher the medical risk, the greater the chance to experience an adverse reaction. This study also found that adverse reactions highly correlated to the concentration of adrenalin. Another recent study found a direct relationship between adverse reactions and the level of anxiety experienced by the patient and to the dental procedure. Most of the reactions in this study occurred either immediately at injection time and within 2 hours following the injection. Since the beginning of last century, vasoconstrictors have been added to local anesthesia solutions in order to reduce toxicity and prologue activity of the LA. However, today it is commonly agreed that this addition to local anesthesia should not be administered to cardiac patients especially those suffering from refractory dysrhythmias, angina pectoris, post myocardial infarction (6 months) and uncontrolled hypertension. Other contraindications to vasoconstrictors are endocrine disorders such as hyperthyroidism, hyperfunction of the medullary adrenal (pheochromocytoma) and uncontrolled diabetes mellitus. Cross reactivity of local anesthetic solutions can occur with MAO inhibitors, non specific beta adrenergic blockers, tricyclic antidepressants, phenothiazides and cocaine abusers. Noradrenaline added to local anesthetics as a vasoconstrictor has been described as a trigger to a great increase in blood pressure and therefore has been forbidden for use in many countries. This paper describes 4 cases of severe complications following the injections of local anesthesia of which three ended in fatality.

  12. A high-throughput approach for identification of novel general anesthetics.

    Science.gov (United States)

    Lea, Wendy A; Xi, Jin; Jadhav, Ajit; Lu, Louis; Austin, Christopher P; Simeonov, Anton; Eckenhoff, Roderic G

    2009-09-24

    Anesthetic development has been a largely empirical process. Recently, we described a GABAergic mimetic model system for anesthetic binding, based on apoferritin and an environment-sensitive fluorescent probe. Here, a competition assay based on 1-aminoanthracene and apoferritin has been taken to a high throughput screening level, and validated using the LOPAC(1280) library of drug-like compounds. A raw hit rate of approximately 15% was reduced through the use of computational filters to yield an overall hit rate of approximately 1%. These hits were validated using isothermal titration calorimetry. The success of this initial screen and computational triage provides feasibility to undergo a large scale campaign to discover novel general anesthetics.

  13. A high-throughput approach for identification of novel general anesthetics.

    Directory of Open Access Journals (Sweden)

    Wendy A Lea

    Full Text Available Anesthetic development has been a largely empirical process. Recently, we described a GABAergic mimetic model system for anesthetic binding, based on apoferritin and an environment-sensitive fluorescent probe. Here, a competition assay based on 1-aminoanthracene and apoferritin has been taken to a high throughput screening level, and validated using the LOPAC(1280 library of drug-like compounds. A raw hit rate of approximately 15% was reduced through the use of computational filters to yield an overall hit rate of approximately 1%. These hits were validated using isothermal titration calorimetry. The success of this initial screen and computational triage provides feasibility to undergo a large scale campaign to discover novel general anesthetics.

  14. The relation between the duty cycle and anesthetic effect in lidocaine iontophoresis using alternating current.

    Science.gov (United States)

    Wakita, Ryo; Nakajima, Atsushi; Haida, Yu; Umino, Masahiro; Fukayama, Haruhisa

    2011-01-01

    We assessed the effect of the duty cycle on the anesthetic effect during lidocaine alternating current (AC) iontophoresis. A solution of 2% lidocaine was delivered to the medial antecubital skin for 20 minutes using AC iontophoresis with a duty cycle of 60%, 70%, or 80%. The von Frey test was then performed to evaluate the anesthetic effect. In the groups treated with a duty cycle of 80% or 70% the touch thresholds (TT) were significantly elevated from 0 minutes to 30 minutes and from 0 minutes to 20 minutes. TT were significantly elevated at 0 minutes in the group treated with a 60% duty cycle. The anesthetic effect was significantly enhanced in a duty cycle-dependent manner.

  15. Laparoscopic colectomy in an adult with single ventricle physiology: Anesthetic implications and management

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    Kelly J Zach

    2015-01-01

    Full Text Available Increasing numbers of adult patients with complex congenital heart conditions are presenting for noncardiac surgery later in life. These disorders can present challenges for surgical and anesthesia providers. Specifically, single ventricle lesions offer anatomic and physiologic concerns during the perioperative period. Single ventricle physiology represents a delicate balance between systemic and pulmonary blood flow. Any alterations in blood flow through these systems can produce undesirable hemodynamic changes, especially during the perioperative period. We present a case of an adult patient with a single left ventricle who presented for laparoscopic total colectomy due to inflammatory bowel disease. His abnormal anatomy coupled with the hemodynamic disruptions caused by laparoscopy presented significant anesthetic challenges. We highlight the anesthetic concerns of single ventricle physiology, specifically pertaining to laparoscopic surgery. We provide recommendations for safely managing these patients perioperatively. With detailed preoperative evaluation and close hemodynamic monitoring during the perioperative period, these patients can experience successful surgical and anesthetic outcomes.

  16. Anesthetic Management of a Patient With Charcot-Marie-Tooth Disease.

    Science.gov (United States)

    Ohshita, Naohiro; Oka, Saeko; Tsuji, Kaname; Yoshida, Hiroaki; Morita, Shosuke; Momota, Yoshihiro; Tsutsumi, Yasuo M

    2016-01-01

    Charcot-Marie-Tooth disease (CMTD) is a hereditary peripheral neuropathy and is characterized by progressive muscle atrophy and motor-sensory disorders in all 4 limbs. Most reports have indicated that major challenges with general anesthetic administration in CMTD patients are the appropriate use of nondepolarizing muscle relaxants and preparation for malignant hyperthermia in neuromuscular disease. Moderate sedation may be associated with the same complications as those of general anesthesia, as well as dysfunction of the autonomic nervous system, reduced perioperative respiratory function, difficulty in positioning, and sensitivity to intravenous anesthetic agents. We decided to use intravenous sedation in a CMTD patient and administered midazolam initially and propofol continuously, with total doses of 1.5 mg and 300 mg, respectively. Anesthesia was completed in 3 hours and 30 minutes without adverse events. We suggest that dental anesthetic treatment with propofol and midazolam may be effective for patients with CMTD.

  17. [Perioperative risk factors and anesthetic management of patients for carotid endarterectomy].

    Science.gov (United States)

    Niinai, H; Nakagawa, I; Shima, T; Kubota, M; Yamada, K; Kamiya, T; Yoshida, A; Yasuda, T

    1997-05-01

    Data from the records of 142 patients for carotid endarterectomy at Chugoku Rosai General Hospital between 1983 and 1995, were evaluated concerning perioperative risk factors and anesthetic management. As a preoperative anesthetic risk, the incidence of hypertension was the commonest (76%), and there was a significant incidence of ischemic heart disease (18%). Fentanyl and isoflurane have been used for anesthesia recently and the patients were closely observed and cared in the intensive care unit postoperatively. In order to prevent cerebral ischemia during the occlusion of the internal carotid artery, we measured somatosensory evoked potential as well as jugular venous oxygen saturation, and used near infrared spectophotometry. As a result, postoperative mortality and morbidity were 0% and 2%, respectively. The candidates for CEA have potentially high perioperative risks, and it is important to evaluate the coexisting diseases and to select proper anesthetic technic and monitors.

  18. Combined use of intravenous anesthetics and hypothermia in treating refractory status epilepticus

    Directory of Open Access Journals (Sweden)

    Guo-ping REN

    2015-11-01

    Full Text Available The primary choice of treating refractory status epilepticus (RSE is intravenous anesthetics, but the seizures of some patients can not get a good control. Thus, other therapies must be combined. Hypothermia not only can terminate seizures, but also play a part in brain protection. Though combined use of intravenous anesthetics and hypothermia is not a regular clinical scheme, the favorable effect has been proved by a lot of clinical research. This paper mainly focuses on the dose of intravenous anesthetics, the time, temperature and procedure of hypothermia, the indications and contraindications of combined therapy, and so on. DOI: 10.3969/j.issn.1672-6731.2015.11.006

  19. Radiofrequency-assisted Liposuction for Arm Contouring: Technique under Local Anesthesia

    Directory of Open Access Journals (Sweden)

    Spero Theodorou, MD

    2013-08-01

    Conclusions: In appropriately selected patients, RFAL arm contouring under local anesthesia represents an alternative procedure with acceptably low morbidity and high patient satisfaction. To achieve consistent results while minimizing complications, consideration to anatomic details, infiltration of the local anesthetic, and application of the radiofrequency energy must be given.

  20. Development of three Drosophila melanogaster strains with different sensitivity to volatile anesthetics

    Institute of Scientific and Technical Information of China (English)

    LIU Jin; HU Zhao-yang; YE Qi-quan; DAI Shuo-hua

    2009-01-01

    Background The mechanisms of action for volatile anesthetics remain unknown for centuries partly owing to the insufficient or ineffective research models. We designed this study to develop three strains derived from a wild-type Drosophila melanogaster with different sensitivities to volatile anesthetics, which may ultimately facilitate molecular and genetic studies of the mechanism involved.Methods Median effective doses (ED50) of sevoflurane in seven-day-old virgin female and male wild-type Drosophila melanogaster were determined. The sensitive males and females of percentile 6-10 were cultured for breeding sensitive offspring (S1). So did median ones of percentile 48-52 for breeding median offspring (M1), resistant ones of percentile 91-95 for breeding resistant offspring (R1). Process was repeated through 31 generations, in the 37th generation, S37,M37 and R37 were used to determine ED50 for enflurane, isoflurane, sevoflurane, desflurane, halothane, methoxyflurane,chloroform and trichloroethylene, then ED50 values were correlated with minimum alveolar concentration (MAC) values in human.Results From a wild-type Drosophila melanogaster we were able to breed three strains with high, median and low sevoflurane requirements. The ratio of sevoflurane requirements of three strains were 1.20:1.00:0.53 for females and 1.22:1.00:0.72 for males. Strains sensitive, median and resistant to sevoflurane were also sensitive, median and resistant to other volatile anesthetics. For eight anesthetics, ED50 values in three strains correlated directly with MAC values in human.Conclusions Three Drosophila me/anogaster strains with high, median and low sensitivity to volatile anesthetics, but with same hereditary background were developed. The ED50 are directly correlated with MAC in human for eight volatile anesthetics.

  1. General anesthetics have differential inhibitory effects on gap junction channels and hemichannels in astrocytes and neurons.

    Science.gov (United States)

    Liu, Xinhe; Gangoso, Ester; Yi, Chenju; Jeanson, Tiffany; Kandelman, Stanislas; Mantz, Jean; Giaume, Christian

    2016-04-01

    Astrocytes represent a major non-neuronal cell population actively involved in brain functions and pathologies. They express a large amount of gap junction proteins that allow communication between adjacent glial cells and the formation of glial networks. In addition, these membrane proteins can also operate as hemichannels, through which "gliotransmitters" are released, and thus contribute to neuroglial interaction. There are now reports demonstrating that alterations of astroglial gap junction communication and/or hemichannel activity impact neuronal and synaptic activity. Two decades ago we reported that several general anesthetics inhibited gap junctions in primary cultures of astrocytes (Mantz et al., (1993) Anesthesiology 78(5):892-901). As there are increasing studies investigating neuroglial interactions in anesthetized mice, we here updated this previous study by employing acute cortical slices and by characterizing the effects of general anesthetics on both astroglial gap junctions and hemichannels. As hemichannel activity is not detected in cortical astrocytes under basal conditions, we treated acute slices with the endotoxin LPS or proinflammatory cytokines to induce hemichannel activity in astrocytes, which in turn activated neuronal hemichannels. We studied two extensively used anesthetics, propofol and ketamine, and the more recently developed dexmedetomidine. We report that these drugs have differential inhibitory effects on gap junctional communication and hemichannel activity in astrocytes when used in their respective, clinically relevant concentrations, and that dexmedetomidine appears to be the least effective on both channel functions. In addition, the three anesthetics have similar effects on neuronal hemichannels. Altogether, our observations may contribute to optimizing the selection of anesthetics for in vivo animal studies.

  2. Effect of buprenorphine on total intravenous anesthetic requirements during spine surgery.

    Science.gov (United States)

    Khelemsky, Yury; Schauer, Jacob; Loo, Nathaniel

    2015-01-01

    Buprenorphine is a partial mu receptor agonist and kappa/delta antagonist commonly used for the treatment of opioid dependence or as an analgesic. It has a long plasma half-life and a high binding affinity for opioid receptors. This affinity is so high, that the effects are not easily antagonized by competitive antagonists, such as naloxone. The high affinity also prevents binding of other opioids, at commonly used clinical doses, to receptor sites - preventing their analgesic and likely minimum alveolar concentration (MAC) reducing benefits. This case report contrasts the anesthetic requirements of a patient undergoing emergency cervical spine surgery while taking buprenorphine with anesthetic requirements of the same patient undergoing a similar procedure after weaning of buprenorphine. Use of intraoperative neurophysiological monitoring prevented use of paralytics and inhalational anesthetics during both cases, therefore total intravenous anesthesia (TIVA) was maintained with propofol and remifentanil infusions. During the initial surgery, intraoperative patient movement could not be controlled with very high doses of propofol and remifentanil. The patient stopped moving in response to surgical stimulation only after the addition of a ketamine. Buprenorphine-naloxone was discontinued postoperatively. Five days later the patient underwent a similar cervical spine surgery. She had drastically reduced anesthetic requirements during this case, suggesting buprenorphine's profound effect on anesthetic dosing. This case report elegantly illustrates that discontinuation of buprenorphine is likely warranted for patients who present for major spine surgery, which necessitates the avoidance of volatile anesthetic and paralytic agents. The addition of ketamine may be necessary in patients maintained on buprenorphine in order to ensure a motionless surgical field.

  3. Myocardial perfusion of infarcted and normal myocardium in propofol-anesthetized minipigs using 82Rubidium PET

    DEFF Research Database (Denmark)

    Rasmussen, Thomas; Larsen, Bjarke Follin; Kastrup, Jens;

    2016-01-01

    challenges. Animals, which have been anesthetized during PET acquisition, might react differently to used stress medications, and therefore difficulties might exist while evaluating the resulting PET images using standard software packages from commercial vendors optimized for human hearts. Furthermore...... propofol, used for anesthesia, can influence myocardial perfusion and coronary flow reserve due to its vasorelaxant effect, and interactions might exist between propofol and used stress agents, potentially affecting the result of the examination. We present cardiac 82Rb-PET studies performed in propofol-anesthetized...

  4. Anesthetic management of a patient with Kimura′s disease for superficial parotidectomy

    Directory of Open Access Journals (Sweden)

    Dalim Kumar Baidya

    2011-01-01

    Full Text Available Kimura′s disease is a rare form of chronic eosinophilic inflammatory disease with vascular proliferation involving salivary gland, skin, lymph node, and kidney. Important anesthetic concerns include increased surgical bleeding due to its vascular nature, airway involvement by the mass leading to a possible difficult airway, allergic symptoms associated with high eosinophil count and elevated IgE level and nephrotic syndrome due to involvement of kidney by the inflammatory process. There is paucity of information in the literature on the anesthetic management of Kimura′s disease. We describe the anesthesia technique and review the literature of such a case posted for superficial parotidectomy.

  5. Algorithmic complexity as an index of cortical function in awake and pentobarbital-anesthetized rats.

    Science.gov (United States)

    Shaw, F Z; Chen, R F; Tsao, H W; Yen, C T

    1999-11-15

    This study introduces algorithmic complexity to measure characteristics of brain functions. The EEG of the rat was recorded with implanted electrodes. The normalized complexity value was relatively independent of data length, and it showed a simpler and easier calculation characteristic than other non-linear indexes. The complexity index revealed significant differences among awake, asleep, and anesthetized states. It may be useful in tracking short-term and long-term changes in brain functions, such as anesthetized depth, drug effects, or sleep-wakefulness.

  6. Comparison of Intravenous Anesthetic Agents for the Treatment of Refractory Status Epilepticus

    Directory of Open Access Journals (Sweden)

    Michael E. Reznik

    2016-05-01

    Full Text Available Status epilepticus that cannot be controlled with first- and second-line agents is called refractory status epilepticus (RSE, a condition that is associated with significant morbidity and mortality. Most experts agree that treatment of RSE necessitates the use of continuous infusion intravenous anesthetic drugs such as midazolam, propofol, pentobarbital, thiopental, and ketamine, each of which has its own unique characteristics. This review compares the various anesthetic agents while providing an approach to their use in adult patients, along with possible associated complications.

  7. Anesthetic management of a neonate with arthrogryposis multiplex congenita for emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Rajat Chowdhuri

    2011-01-01

    Full Text Available Arthrogryposis multiplex congenita is a rare disease, characterized by non-progressive, multiple joint contractures since birth. Anesthetic issues include difficult intravenous access, difficult airway management and regional anesthesia. We report the anesthetic management of a six-day-old neonate presenting to the emergency with features of intestinal obstruction, who was detected for the first time to have arthrogryposis multiplex congenita. General anesthesia along with caudal analgesia for peroperative and postoperative pain relief was used. There was an episode of intraoperative hyperthermia, which was tackled successfully. The child had an uneventful post-anesthesia recovery.

  8. An update on local anesthesia for pediatric dental patients

    OpenAIRE

    Peedikayil, Faizal C.; Vijayan, Ajoy

    2013-01-01

    Pain control is an important part of dentistry, particularly in the management of children. Behavior guidance, and dose and technique of administration of the local anesthetic are important considerations in the successful treatment of a pediatric patient. The purpose of the present review is to discuss the relevant data on topics involved, and on the current methods available in the administration of local anesthesia used for pediatric dental patients.

  9. Local anesthesia selection algorithm in patients with concomitant somatic diseases.

    Science.gov (United States)

    Anisimova, E N; Sokhov, S T; Letunova, N Yu; Orekhova, I V; Gromovik, M V; Erilin, E A; Ryazantsev, N A

    2016-01-01

    The paper presents basic principles of local anesthesia selection in patients with concomitant somatic diseases. These principles are history taking; analysis of drugs interaction with local anesthetic and sedation agents; determination of the functional status of the patient; patient anxiety correction; dental care with monitoring of hemodynamics parameters. It was found that adhering to this algorithm promotes prevention of urgent conditions in patients in outpatient dentistry.

  10. The application of a non-linear analysis technique to the monitoring of anesthetic effects in the rat

    NARCIS (Netherlands)

    Broek, P.L.C. van den; Egmond, J. van; Rijn, C.M. van; Dirksen, R.; Coenen, A.M.L.; Booij, L.H.D.J.

    2000-01-01

    To find a new measure from the EEG that quantifies the effects of anesthetics during surgery, the correlation dimension (CD) of the EEG of eight rats was estimated. To get informed about the anesthetic state, the noxious induced withdrawal reflex (NIWR) was measured, i.e. the force elicited by trans

  11. Isoflurane anesthetic hypersensitivity and progressive respiratory depression in a mouse model with isolated mitochondrial complex I deficiency

    NARCIS (Netherlands)

    Roelofs, S.; Manjeri, G.R.; Willems, P.H.G.M.; Scheffer, G.J.; Smeitink, J.A.M.; Driessen, J.J.

    2014-01-01

    BACKGROUND: Children with mitochondrial disorders are frequently anesthetized for a wide range of operations. These disorders may interfere with the response to surgery and anesthesia. We examined anesthetic sensitivity to and respiratory effects of isoflurane in the Ndufs4 knockout (KO) mouse model

  12. Anesthetic management of a patient with stiff-person syndrome and thymoma: a case report

    Institute of Scientific and Technical Information of China (English)

    QIN Xiang; WANG Dong-xin; WU Xin-min

    2006-01-01

    @@ Stiff-person syndrome (SPS, also called stiff-man syndrome) is a rare neurological disease with autoimmune features. It is characterized by fluctuating and progressive muscle rigidity, and episodic spasm that prominently involve axial and limb musculature.1,2 Herein we report a case of anesthetic management of a patient with SPS for thymectomy and review several other cases.

  13. Evaluation of transpulmonary thermodilution as a method to measure cardiac output in anesthetized cats.

    Science.gov (United States)

    Beaulieu, Kim E; Kerr, Carolyn L; McDonell, Wayne N

    2009-01-01

    The objectives of this study were to evaluate the use of a transpulmonary thermodilution (Trans) technique for the measurement of cardiac output, and to determine the agreement between Trans and conventional thermodilution (TD) in anesthetized cats. Using each technique, cardiac output was measured in 5 mature cats (weights 2.4 to 5.6 kg) anesthetized with isoflurane. To induce different levels of cardiac output in each cat, anesthesia was maintained at > 1.5x end-tidal minimum alveolar concentration (MAC) of isoflurane, and at 1.3x end-tidal isoflurane MAC with and without administration of dobutamine. At least 2 comparisons between TD and Trans values were made at each cardiac output rate. Thirty-two of the 42 recorded comparisons were analyzed. Linear regression analysis (TD vs Trans) yielded an r(2) value of 0.83. The mean bias (TD-Trans) was -3.7 mL/kg/min with limits of agreement of -35.9 to 28.5 mL/kg/min. The concordance coefficient was 0.91. The Trans method showed good relationship and good agreement with TD in anesthetized cats. The Trans method is a relatively noninvasive, practical, and safe method to measure cardiac output in anesthetized cats.

  14. 静脉麻醉药的研究进展%Research progress of intravenous anesthetics

    Institute of Scientific and Technical Information of China (English)

    浦鹏飞

    2012-01-01

    Intravenous anesthetics is classified into the barbiturates and non-barbiturates. Although great progress has been made in the intravenous anesthetic pharmacokinetic-pharmacodynamic knowledge and intravenous anesthesia, no intravenous anesthetics at the present is considered to be ideal in all respects. Therefore, it is still urgent to find approaches to create an ideal anesthetic state, which is secure, smooth and easy to control.%静脉麻醉药主要分为巴比妥类药物和非巴比妥类药物,虽然静脉麻醉药药代动力学-药效学知识和静脉麻醉技术均取得了长足进步,但目前还无一种在各方面都十分理想的静脉麻醉药,所以实现安全、易控、平稳和苏醒迅速的理想麻醉状态仍是摆在我们面前最严峻的问题.

  15. Child with Saethre-Chotzen syndrome: anesthetic management and literature review.

    Science.gov (United States)

    Sharma, A; Patel, N; Arora, S; Ramachandran, R

    2014-01-01

    Saethre-Chotzen syndrome (SCS) is a type of acro-cephalo-syndactyly (ACS) syndrome, characterized by premature fusion of the coronal sutures, facial dysmorphism, syndactyly, skeletal deformity, and congenital heart malformations. We here describe a child with diagnosed SCS, who underwent squint surgery under general anesthesia, and review the anesthetic concerns thereof.

  16. Evaluation of the aesthetics of physical methods of euthanasia of anesthetized rats.

    Science.gov (United States)

    Hickman, Debra L; Johnson, Steven W

    2011-09-01

    Dissection of living brain tissue for in vitro experiments requires the use of a rapid euthanasia method. However, the method must not subject animals to unnecessary pain and must be aesthetically acceptable to experimenters. The purposes of the current study were to assess the aesthetics of 6 euthanasia methods, measure the procedure duration, and evaluate brain for pathology after each procedure. We digitally recorded euthanasia of isoflurane-anesthetized rats by 6 physical methods: anesthetic overdose, cardiac exsanguination, decapitation, closed intrathoracic transection of the great vessels and heart, thoracic percussion, and thoracotomy with rupture of great vessels. Volunteer researchers and animal caretakers watched the video and completed an associated questionnaire. Anesthetic overdose and cardiac exsanguinations were rated most aesthetically pleasing, although these procedures took the longest to complete. In contrast, decapitation and thoracic percussion were the least aesthetically pleasing, but these methods were the quickest. No demographic factor was identified that could predict whether a given euthanasia procedure would be favored for aesthetic reasons, and participants provided a wide variety of rationales for the aesthetic ratings they assigned. Although all of these euthanasia methods meet the criteria of approved methods of euthanasia of anesthetized rats as defined by the AVMA, aesthetic features and the scientific need for rapid euthanasia are both considerations in selecting a method.

  17. Popliteal pterygium syndrome (PPS) with intra-alveolar syngnathia: a discussion of anesthetic and surgical considerations.

    Science.gov (United States)

    Gahm, Caroline; Kuylenstierna, Richard; Papatziamos, Georgios

    2007-10-01

    Popliteal pterygium syndrome (PPS) is a rare genetic disorder that involves the association of a popliteal web with a combination of craniofacial, genitourinary and extremity malformations. In this article, we describe a patient with PPS complicated with multiple intra-alveolar syngnathia. We discuss the anesthetic and the surgical management of this case and review the literature regarding PPS and intra-alveolar syngnathia.

  18. An Anesthetic Drug Demonstration and an Introductory Antioxidant Activity Experiment with "Eugene, the Sleepy Fish"

    Science.gov (United States)

    Barcena, Homar; Chen, Peishan

    2016-01-01

    Students are introduced to spectrophotometry in comparing the antioxidant activity of pure eugenol and oil of cloves from a commercial source using a modified ferric reducing antioxidant power (FRAP) assay. The extraction of the essential oil from dried cloves is demonstrated to facilitate discussions on green chemistry. The anesthetic properties…

  19. Noxious Stimulation Response Index A Novel Anesthetic State Index Based on Hypnotic-Opioid Interaction

    NARCIS (Netherlands)

    Luginbuehl, Martin; Schumacher, Peter M.; Vuilleumier, Pascal; Vereecke, Hugo; Heyse, Bjoern; Bouillon, Thomas W.; Struys, Michel M. R. F.

    2010-01-01

    Background: The noxious stimulation response index (NSRI) is a novel anesthetic depth index ranging between 100 and 0, computed from hypnotic and opioid effect-site concentrations using a hierarchical interaction model. The authors validated the NSRI on previously published data. Methods: The data e

  20. Comparative analysis of assessment methods for operational and anesthetic risks in ulcerative gastroduodenal bleeding

    Directory of Open Access Journals (Sweden)

    Potakhin S.N.

    2015-09-01

    Full Text Available Aim of the investigation: to conduct a comparative analysis of methods of evaluation of surgical and anesthetic risks in ulcerative gastroduodenal bleeding. Materials and methods. A retrospective analysis ofthe extent of the surgical and anesthetic risks and results of treatment of 71 patients with peptic ulcer bleeding has been conducted in the study. To evaluate the surgical and anesthetic risks classification trees are used, scale ТА. Rockall and prognosis System of rebleeding (SPRK, proposed by N. V. Lebedev et al. in 2009, enabling to evaluate the probability of a fatal outcome. To compare the efficacy ofthe methods the following indicators are used: sensitivity, specificity and prediction of positive result. Results. The study compared the results ofthe risk assessment emergency operation by using these methods with the outcome ofthe operation. The comparison ofthe prognosis results in sensitivity leads to the conclusion that the scales ТА. Rockall and SPRK are worse than the developed method of classification trees in recognizing patients with poor outcome of surgery. Conclusion. The method of classification trees can be considered as the most accurate method of evaluation of surgical and anesthetic risks in ulcerative gastroduodenal bleeding.

  1. Anesthetic exposure and health of dental personnel, 1 June 1978-30 November 1980

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, E.N.

    1980-01-01

    An epidemiologic survey was conducted to determine possible health hazards in the dental profession, with particular attention being given to the results of exposure to anesthetic gases. The survey contacted 30,650 dentists and 30,547 chairside assistants who were subsequently grouped according to exposure to inhalation anesthetics in the dental operatory during the course of their employment experience. An increase in liver disease 1.7 above that expected was noted in male dentists heavily exposed to anesthetics, combined with a 1.2 fold increase for kidney disease and 1.9-fold increase for neurological disease. The spontaneous abortion rate in wives of male dentists was 1.5-fold higher than expected. Occupational exposure to anesthetics, either direct or indirect, was associated with significant increases in spontaneous abortion over control levels during the first and second trimester of pregnancy. Women who smoked during pregnancy showed increased risk of spontaneous abortion, with a 27% increase occurring in dental assistants and a 21% increase in wives of dentists. A 34% increased risk of babies having congenital abnormalities was noted among smoking dental assistants.

  2. Allyl m-Trifluoromethyldiazirine Mephobarbital: An Unusually Potent Enantioselective and Photoreactive Barbiturate General Anesthetic

    Energy Technology Data Exchange (ETDEWEB)

    Savechenkov, Pavel Y.; Zhang, Xi; Chiara, David C.; Stewart, Deirdre S.; Ge, Rile; Zhou, Xiaojuan; Raines, Douglas E.; Cohen, Jonathan B.; Forman, Stuart A.; Miller, Keith W.; Bruzik, Karol S. (Harvard-Med); (Mass. Gen. Hosp.); (UIC)

    2012-12-10

    We synthesized 5-allyl-1-methyl-5-(m-trifluoromethyl-diazirynylphenyl)barbituric acid (14), a trifluoromethyldiazirine-containing derivative of general anesthetic mephobarbital, separated the racemic mixture into enantiomers by chiral chromatography, and determined the configuration of the (+)-enantiomer as S by X-ray crystallography. Additionally, we obtained the {sup 3}H-labeled ligand with high specific radioactivity. R-(-)-14 is an order of magnitude more potent than the most potent clinically used barbiturate, thiopental, and its general anesthetic EC{sub 50} approaches those for propofol and etomidate, whereas S-(+)-14 is 10-fold less potent. Furthermore, at concentrations close to its anesthetic potency, R-(-)-14 both potentiated GABA-induced currents and increased the affinity for the agonist muscimol in human {alpha}1{beta}2/3{gamma}2L GABA{sub A} receptors. Finally, R-(-)-14 was found to be an exceptionally efficient photolabeling reagent, incorporating into both {alpha}1 and {beta}3 subunits of human {alpha}1{beta}3 GABAA receptors. These results indicate R-(-)-14 is a functional general anesthetic that is well-suited for identifying barbiturate binding sites on Cys-loop receptors.

  3. Left atrial ball thrombus with acute mesenteric ischemia: Anesthetic management and role of transesophageal echocardiography

    Directory of Open Access Journals (Sweden)

    Neeti Makhija

    2014-01-01

    Full Text Available A 62 year old female with severe mitral stenosis, large left atrial ball thrombus and acute mesenteric ischemia emergently underwent mitral valve replacement, left atrial clot removal and emergency laparotomy for mesenteric ischemia. Peri-operative management issues, particularly, the anesthetic challenges and the role of transesophageal echocardiography are discussed.

  4. Risk of acquired methemoglobinemia with different topical anesthetics during endoscopic procedures

    Directory of Open Access Journals (Sweden)

    Vallurupalli S

    2011-07-01

    Full Text Available Srikanth Vallurupalli1, Shalini Manchanda21Division of General Internal Medicine, Department of Medicine, Southern Illinois University School of Medicine, Springfield, IL, USA; 2Division of Pulmonary, Allergy, Critical Care, and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USAIntroduction: Methemoglobinemia is a recognized complication of the use of topical anesthetic sprays. The true scope of the problem or the risk with different topical anesthetic sprays and endoscopic procedures is unknown.Methods: We retrospectively identified all cases of methemoglobinemia that occurred in a university affiliated community hospital from 2001 to 2007.Results: Eleven cases of methemoglobinemia were identified over the 6-year period. Nine (82% occurred with use of benzocaine spray during transesophageal echocardiography (TEE. Patients who developed methemoglobinemia secondary to the topical anesthetic spray compared to other causes were more likely to be older, have lower mean hemoglobin levels (10.5 ± 0.5 g/dL vs 11.3 ± 0.0 g/dL, and a higher mean methemoglobin concentration at diagnosis (40.8% ± 5.2% vs 24% ± 10%. However, only age reached statistical significance (P = 0.004.Conclusion: In a university-affiliated community hospital, topical anesthetic sprays account for most of the burden of methemoglobinemia. Benzocaine use in the context of TEE caused more methemoglobinemia compared to lidocaine and other endoscopic procedures. This observation supports previous data and findings deserve further study.Keywords: methemoglobinemia, benzocaine, lidocaine, transesophageal echocardiography, endoscopy

  5. An emphasis on the wide usage and important role of local anesthesia in dentistry: A strategic review.

    Science.gov (United States)

    Singh, Preetinder

    2012-03-01

    Local anesthesia forms the major part of pain-control techniques in dentistry. The prevention and elimination of pain during dental treatment has benefited patients, their doctors and dental hygienists, enabling the dental profession to make tremendous therapeutic advances that would otherwise have been impossible. Introduced in the late 1940s, the amide local anesthetics represent the most used drugs in dentistry. Local anesthetics also represent the safest and most effective drugs in all of medicine for the prevention and management of pain. They are also accompanied by various adverse effects which should be well known and be able to be controlled by the clinician. The article reviews the types of agents used as local anesthetics and their effects on the human body.

  6. A New Era of Local Anaesthetic Agent: Centbucridine

    Directory of Open Access Journals (Sweden)

    Swapnil S. Bumb

    2013-11-01

    Full Text Available One century after the clinical introduction of cocaine,local anesthesia remains the most important method of pain control in dentistry. Many local anesthetics have been marketed since 1884, and it is likely that attempts to produce drugs that enhance anesthetic efficacy, reduce systemic and local toxicity, and increase nociceptive selectivity, will continue.Centbucridine is a non-ester, non-amide group LA and has not been comprehensively studied in the dental setting and the objective was to compare it to Lignocaine. This was a randomized study comparing the onset time, duration, depth and cardiovascular parameters between Centbucridine (0.5% and Lignocaine (2%.The study was conducted in the department of oral and maxillofacial surgery of our dental college in on patients attending for the extraction of lower molars.

  7. A cyclodextrin formulation to improve use of the anesthetic tribromoethanol (Avertin ®

    Directory of Open Access Journals (Sweden)

    Arlene McDowell

    2014-01-01

    Full Text Available Objective: Efficacy and safety concerns have been raised in the literature with the use of tribromoethanol (TBE (Avertin ® for anesthesia in rats and mice when administered by intraperitoneal (IP injection. Despite the controversy, it remains in common usage as an anesthetic agent in laboratory rodents for short-term surgical procedures. Cyclodextrins have been shown to improve drug solubility and were investigated here as an improved anesthetic formulation for mice. Materials and Methods: The phase solubility of TBE with hydroxypropyl-β-cyclodextrin (HP-β-CD was estimated. The efficacy of two anesthetic regimens was compared in this study; the conventional TBE formulation solubilized in tert-amyl alcohol and a HP-β-CD formulation containing TBE. Mice (n = 6 were administered the formulations by IP injection and the pharmacodynamic parameters of time to induction of anesthesia, duration of anesthesia and recovery time were measured using a combined reflex score (CRS. Results and Discussion: Phase solubility studies showed a linear increase in the solubility of TBE with increasing HP-β-CD concentration and suggested >1:1 binding of the drug in the cyclodextrin complex. At a dose of 260 mg/kg the standard TBE formulation appeared to produce deeper anesthesia than the cyclodextrin formulation, with a minimum average CRS of 1.8 compared with 5.2. No post-mortem pathology was observed in mice that received either the conventional or cyclodextrin formulation. Conclusion: The cyclodextrin TBE formulation did not conclusively provide an improved anesthetic response at a dose of 260 mg/kg compared with the conventional formulation. The improved solubility of TBE with HP-β-CD and the reduced variability in anesthetic response warrants the further investigation of this formulation. This study has also identified the value of using the anticholinergic atropine in association with TBE for anesthesia.

  8. General anesthetics inhibit LPS-induced IL-1β expression in glial cells.

    Directory of Open Access Journals (Sweden)

    Tomoharu Tanaka

    Full Text Available BACKGROUND: Glial cells, including microglia and astrocytes, are considered the primary source of proinflammatory cytokines in the brain. Immune insults stimulate glial cells to secrete proinflammatory cytokines that modulate the acute systemic response, which includes fever, behavioral changes, and hypothalamic-pituitary-adrenal (HPA axis activation. We investigated the effect of general anesthetics on proinflammatory cytokine expression in the primary cultured glial cells, the microglial cell line BV-2, the astrocytic cell line A-1 and mouse brain. METHODOLOGY/PRINCIPAL FINDINGS: Primary cultured glial cells were exposed to lipopolysaccharide (LPS in combination with general anesthetics including isoflurane, pentobarbital, midazolam, ketamine, and propofol. Following this treatment, we examined glial cell expression of the proinflammatory cytokines interleukin (IL-1β, IL-6, and tumor necrosis factor-alpha (TNF-α. LPS-induced expression of IL-1β mRNA and protein were significantly reduced by all the anesthetics tested, whereas IL-6 and TNF-α mRNA expression was unaffected. The anesthetics suppressed LPS-induced extracellular signal-regulated kinase 1/2 (ERK 1/2 phosphorylation, but did not affect nuclear factor-kappaB and activator protein-1 activation. The same effect was observed with BV-2, but not with A-1 cells. In the mouse experiments, LPS was injected intraperitoneally, and isoflurane suppressed IL-1β in the brain and adrenocorticotropic hormone in plasma, but not IL-1β in plasma. CONCLUSIONS/SIGNIFICANCE: Taken together, our results indicate that general anesthetics inhibit LPS-induced IL-1β upregulation in glial cells, particularly microglia, and affects HPA axis participation in the stress response.

  9. Prophylactic Antiarrhythmic Effect of Anesthetics at Subanesthetic Concentration on Epinephrine-Induced Arrhythmias in Rats after Brain Death

    Directory of Open Access Journals (Sweden)

    Yuka Miyata

    2015-01-01

    Full Text Available The present study using brain death model of rats was designed to examine whether prophylactic administration of volatile anesthetics and propofol prevent the epinephrine-induced arrhythmias. A Fogarty catheter was placed intracranially for induction of brain death. After brain death, the rats were randomly assigned to five groups: the control group (no anesthetics, the sevoflurane group (0.8%, the isoflurane group (0.5%, the halothane group (0.3%, and the propofol group (195 μg·kg−1·min−1. These anesthetics were about 30% of ED50 of each anesthetic. The arrhythmogenic dose of epinephrine was determined in each anesthetic group. In addition, we examined left ventricular levels of connexin 43 phosphorylation 30 min after administration of each anesthetic with Western blot analysis. The arrhythmogenic dose of epinephrine in the sevoflurane group was significantly higher than that in the control group, while the arrhythmogenic dose of epinephrine in any other anesthetic group was not different. On the other hand, the ratio of phosphorylated-connexin 43/total connexin 43 was also similar among the study groups. Thus, prophylactic administration of subanesthetic dose of sevoflurane is effective in preventing epinephrine-induced arrhythmias after brain death, but phosphorylation of connexin is not involved in the antiarrhythmic property of sevoflurane.

  10. Prophylactic antiarrhythmic effect of anesthetics at subanesthetic concentration on epinephrine-induced arrhythmias in rats after brain death.

    Science.gov (United States)

    Miyata, Yuka; Iwasaki, Mitsuo; Yamanaka, Hiroo; Sato, Masanori; Kamibayashi, Takahiko; Fujino, Yuji; Hayashi, Yukio

    2015-01-01

    The present study using brain death model of rats was designed to examine whether prophylactic administration of volatile anesthetics and propofol prevent the epinephrine-induced arrhythmias. A Fogarty catheter was placed intracranially for induction of brain death. After brain death, the rats were randomly assigned to five groups: the control group (no anesthetics), the sevoflurane group (0.8%), the isoflurane group (0.5%), the halothane group (0.3%), and the propofol group (195 μg·kg(-1) ·min(-1)). These anesthetics were about 30% of ED50 of each anesthetic. The arrhythmogenic dose of epinephrine was determined in each anesthetic group. In addition, we examined left ventricular levels of connexin 43 phosphorylation 30 min after administration of each anesthetic with Western blot analysis. The arrhythmogenic dose of epinephrine in the sevoflurane group was significantly higher than that in the control group, while the arrhythmogenic dose of epinephrine in any other anesthetic group was not different. On the other hand, the ratio of phosphorylated-connexin 43/total connexin 43 was also similar among the study groups. Thus, prophylactic administration of subanesthetic dose of sevoflurane is effective in preventing epinephrine-induced arrhythmias after brain death, but phosphorylation of connexin is not involved in the antiarrhythmic property of sevoflurane.

  11. Inhibitory Effects of 658 nm Laser Irradiation on Skin Temperature in Anesthetized Rats: Preliminary Results from a Controlled Study

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    Daniela Litscher

    2014-01-01

    Full Text Available Red laser light stimulation can have many physiological effects. The goal of this animal experimental study was to investigate how red laser stimulation influences the temperature of anesthetized rats at different acupuncture points and nonacupoints. For that reason 12 adult male Wistar Han rats (300–380 g were investigated. Six anesthetized rats underwent red laser stimulation (wavelength 658 nm, output power 40 mW, diameter 500 µm, and duration 10 min at the Baihui (GV20 acupoint, the Zusanli acupoint (ST36, bilateral, and a control point on the forelimb. The other six rats underwent the same procedure; however, the laser remained switched off. Significant decreases in temperature were found at the acupoints Baihui, Zusanli left, and Zusanli right. In addition there was no significant temperature effect at a control point. During placebo laser irradiation (deactivated laser there were also significant temperature changes. The mechanism underlying the results is currently unknown, but brain stimulation (via laser or mechanical pressure and mainly direct central mechanisms may be responsible for the local and peripheral temperature decrease.

  12. The effect of a new multimodal perioperative anesthetic regimen on postoperative pain, side effects, rehabilitation, and length of hospital stay after total joint arthroplasty.

    Science.gov (United States)

    Peters, Christopher L; Shirley, Brayton; Erickson, Jill

    2006-09-01

    This study evaluated the effect of a new multimodal perioperative anesthetic and pain management strategy for primary total hip (THA) and total knee arthroplasty (TKA). Two cohorts of 50 consecutive THA and 50 TKA patients from before and after initiation of the new protocol were compared. The protocol involved scheduled oral narcotics, cyclooxygenase-2 inhibitors, no intrathecal narcotics, femoral nerve catheters for TKAs, and local anesthetic wound infiltration. Use of patient-controlled analgesia was discouraged. Physical therapy was attempted on the day of surgery. The demographic data, surgical procedure, and implants were similar. There were statistically significant improvements after the protocol regarding rest-pain scores post-operative day (POD) 1 and 2, total narcotic consumption, distance walked POD 1 and 2, and length of stay. There were no significant differences in complications. Implementation of this new multimodal perioperative protocol combined with early mobilization for TKA and THA patients has shortened length of stay, improved pain control, and accomplished therapy goals sooner with less narcotic consumption.

  13. Volatile anesthetics influence blood-brain barrier integrity by modulation of tight junction protein expression in traumatic brain injury.

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    Serge C Thal

    Full Text Available Disruption of the blood-brain barrier (BBB results in cerebral edema formation, which is a major cause for high mortality after traumatic brain injury (TBI. As anesthetic care is mandatory in patients suffering from severe TBI it may be important to elucidate the effect of different anesthetics on cerebral edema formation. Tight junction proteins (TJ such as zonula occludens-1 (ZO-1 and claudin-5 (cl5 play a central role for BBB stability. First, the influence of the volatile anesthetics sevoflurane and isoflurane on in-vitro BBB integrity was investigated by quantification of the electrical resistance (TEER in murine brain endothelial monolayers and neurovascular co-cultures of the BBB. Secondly brain edema and TJ expression of ZO-1 and cl5 were measured in-vivo after exposure towards volatile anesthetics in native mice and after controlled cortical impact (CCI. In in-vitro endothelial monocultures, both anesthetics significantly reduced TEER within 24 hours after exposure. In BBB co-cultures mimicking the neurovascular unit (NVU volatile anesthetics had no impact on TEER. In healthy mice, anesthesia did not influence brain water content and TJ expression, while 24 hours after CCI brain water content increased significantly stronger with isoflurane compared to sevoflurane. In line with the brain edema data, ZO-1 expression was significantly higher in sevoflurane compared to isoflurane exposed CCI animals. Immunohistochemical analyses revealed disruption of ZO-1 at the cerebrovascular level, while cl5 was less affected in the pericontusional area. The study demonstrates that anesthetics influence brain edema formation after experimental TBI. This effect may be attributed to modulation of BBB permeability by differential TJ protein expression. Therefore, selection of anesthetics may influence the barrier function and introduce a strong bias in experimental research on pathophysiology of BBB dysfunction. Future research is required to investigate

  14. Hernioplastías inguinales con anestesia exclusivamente local / Inguinal Hernioplasties With Local Anesthesia

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    Coturel A

    2015-11-01

    Full Text Available Lichtenstein inguinal hernia repair was described in 1974 by Irving Lichestein, who proposed a free tension surgical treatment. Currently this technique is performed anesthetic spinal block. However, many studies marke benefits of local anesthesia: prolonged postoperative analgesia, inexpensive, easy to perform and safe in patients at high risk. A retrospective observational study was performed. The inguinal hernia repair with only local anesthesia is a feasible technique, with similar results regarding recurrence. It has no specific complications of spinal anesthesia. Performed a randomized missing on costs, pain and quality of life postoperatively prospective analysis

  15. The cochlear implantation surgery: A review of anesthetic considerations and implications

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    Sukhminder Jit Singh Bajwa

    2013-01-01

    Full Text Available The advancement in the technology of the cochlear implants has resulted in increasing trend of cochlear implantation in both the children and elderly population. The anesthesiologist is faced with the task of smoothly conducting the surgery without any interference in the stimulation techniques used. The preoperative evaluation is mainly focused on the presence of any congenital anomalies in these patients which may affect anesthetic technique. The reduction of anxiety of the patient as well as the parents of small children is an important aspect of the preoperative visit. Intraoperatively the anesthetic technique chosen should not interfere with the stimulation of the cochlear implant electrode assembly. The postoperative management is mainly focused at prevention of agitation and good analgesia. A close cooperation between the surgeon and the anesthesiologist is essential for a positive outcome in this surgery. The current review focuses on the important anesthesia aspects related to cochlear implant surgery.

  16. Heightened motor and sensory (mirror-touch) referral induced by nerve block or topical anesthetic.

    Science.gov (United States)

    Case, Laura K; Gosavi, Radhika; Ramachandran, Vilayanur S

    2013-08-01

    Mirror neurons allow us to covertly simulate the sensation and movement of others. If mirror neurons are sensory and motor neurons, why do we not actually feel this simulation- like "mirror-touch synesthetes"? Might afferent sensation normally inhibit mirror representations from reaching consciousness? We and others have reported heightened sensory referral to phantom limbs and temporarily anesthetized arms. These patients, however, had experienced illness or injury of the deafferented limb. In the current study we observe heightened sensory and motor referral to the face after unilateral nerve block for routine dental procedures. We also obtain double-blind, quantitative evidence of heightened sensory referral in healthy participants completing a mirror-touch confusion task after topical anesthetic cream is applied. We suggest that sensory and motor feedback exist in dynamic equilibrium with mirror representations; as feedback is reduced, the brain draws more upon visual information to determine- perhaps in a Bayesian manner- what to feel.

  17. Rapid automated classification of anesthetic depth levels using GPU based parallelization of neural networks.

    Science.gov (United States)

    Peker, Musa; Şen, Baha; Gürüler, Hüseyin

    2015-02-01

    The effect of anesthesia on the patient is referred to as depth of anesthesia. Rapid classification of appropriate depth level of anesthesia is a matter of great importance in surgical operations. Similarly, accelerating classification algorithms is important for the rapid solution of problems in the field of biomedical signal processing. However numerous, time-consuming mathematical operations are required when training and testing stages of the classification algorithms, especially in neural networks. In this study, to accelerate the process, parallel programming and computing platform (Nvidia CUDA) facilitates dramatic increases in computing performance by harnessing the power of the graphics processing unit (GPU) was utilized. The system was employed to detect anesthetic depth level on related electroencephalogram (EEG) data set. This dataset is rather complex and large. Moreover, the achieving more anesthetic levels with rapid response is critical in anesthesia. The proposed parallelization method yielded high accurate classification results in a faster time.

  18. Anesthetic management of a child with relapsing polychondritis:a case report

    Institute of Scientific and Technical Information of China (English)

    JI Cun-liang; ZHANG Bing-xi; HU Gui-zhi

    2009-01-01

    @@ Relapsing polychondritis (RP) is a rare disorder of unknown cause.It is characterized by recurrent inflammation of cartilage and connective tissue.Airway complications are the most serious manifestations.1,2 The anesthetic management of patients with RP is challenging.Airway management is of primary importance because of the potential for collapse of supporting airway structures with resulting inability to intubate and ventilate the patient) Although it tends to occur in middle age (>40 years),it has been reported in younger individuals.Herein we report a case of anesthetic management of a child with RP for tracheotomy combined with insertion of T tube stent and review several other cases.

  19. Benzocaine as a fish anesthetic: efficacy and safety for spawning-phase salmon

    Science.gov (United States)

    Gilderhus, P.A.

    1990-01-01

    The anesthetic benzocaine was tested for efficacy and safety for spawning-phase chinook salmon (Oncorhynchus tshawytscha) and Atlantic salmon (Salmo salar) at federal fish hatcheries. Tests were conducted in the existing hatchery water supplies (soft water; temperatures, 10–13 °C. Crystalline benzocaine was dissolved in ethanol (1 g/30 mL), and aliquots of that stock solution were added to the water in test tanks. Benzocaine concentrations of 25–30 mg/L anesthetized most fish in less than 3.5 min, and most fish recovered in less than 10 min after 15 min of exposure. Safety margins were narrow; both species tolerated 30 mg/L for about 20 min, but 25 min of exposure caused deaths. For 15 min exposures, concentrations of 35 mg/L for chinook salmon and 40 mg/L for Atlantic salmon were lethal.

  20. Anesthetic Approach to a Patient with Epidermolysis Bullosa: A Case Report

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    Ersin KOKSAL

    2015-09-01

    Full Text Available Epidermolysis Bullosa (EB is characterized by fragility and formation of blisters in the skin and mucosal membranes. Due to blisters on the airway and occurring new blisters as a result of anesthetic or surgical procedures may complicate anesthesia management. In this case report, we present the anesthetic approach of a 6 years old case with EB who underwent reconstructive surgery. After premedication and optimal monitorization, intravenous (IV anesthesia and analgesia was administered. Associated with the oropharyngeal lesions and limitation to reach an adequate mouth opening, we preferred the facemask to maintain ventilation. Neither new lesions nor complications were detected during or after surgery. [J Contemp Med 2015; 5(3.000: 192-195

  1. [Anesthetic management of a pediatric patient with non-Fukuyama type congenital muscular dystrophy].

    Science.gov (United States)

    O'Higashi, T; Kato, S; Shirakami, G; Hirota, K; Suzuki, S; Sasai, S

    1997-01-01

    Non-Fukuyama type congenital muscular dystrophy (n-FCMD), a subtype of progressive muscular dystrophy (PMD), is a very rare autosomal recessive disorder. N-FCMD is characterized by severe and progressive motor weakness and atrophies of proximal muscles during the infant period. A 9-year-old boy with n-FCMD underwent elective surgery for muscle release around the hip joints bilaterally. As many perioperative complications related with volatile anesthetics and muscle relaxants had been reported in the anesthetic management of PMD, these drugs were thought to be contraindicated in patients with n-FCMD. Because n-FCMD seemed to have very similar pathogenesis with PMD, caudal epidural block was chosen, supplemented with the administration of diazepam, pentazocine and nitrous oxide. The operation and anesthesia were conducted uneventfully. No complications occurred postoperatively.

  2. [The individual and integral effects of brief simulated descents and anesthetic pharmacological preparations on human metabolism].

    Science.gov (United States)

    Deviatova, N V; Buravkova, L B

    1999-01-01

    In short-term chamber (GVK-250) "descents" by three healthy male volunteers mechanisms of hyperbaric narcosis against high partial pressures of indifferent nitrogen and argon were compared with anesthetic ketamine and sibason. Clinical biochemistry was engaged to determine any possible changes in metabolism due to the "descents" up to 0.4-0.6 MPa. Cubital vein blood was sampled prior to and following decompression. Plasma spectrophotometry was performed using biochemical analyzer EPAC-6140 (Eppendorf, Germany) and standard sets of reagents by Raichem (USA) and Biocon (Germany). On the whole, shifts in albumin, total protein, uric acid, lactate, and the creatine kinase activity were found to be within the physiological norm. However, several cases of excursion outside the boundaries of the clinical norm (A/T, AT, lactate dehydrogenase, triglycerides, lipase) could be associated with changes in the functional state of the liver caused by administration of the anesthetics during the hyperbaric exposure.

  3. [Body temperature, Aldrete-Kroulik index, and patient discharge from the post-anesthetic recovery unit].

    Science.gov (United States)

    de Castro, Fernanda Salim Ferreira; Peniche, Aparecida de Cássia Giani; Mendoza, Isabel Yovana Quispe; Couto, Andréa Tamancoldi

    2012-08-01

    Patient discharge from post-anesthetic recovery (PAR) depends, among other factors, on normothermia and the patient's score on the Aldrete-Kroulik index. The objective of this study was to verify the relationship between the Aldrete-Kroulik index and body temperature in patients. This study was performed at the University of São Paulo University Hospital. Convenience sampling was used, and the sample consisted of 60 patients of ages between 18 and 60 years who underwent general anesthesia. The patients' body temperature was obtained by tympanic measurement, and the Aldrete-Kroulik index was measured on admission and at discharge from post-anesthetic recovery. The data were processed using SPSS, considering a significance level of 5%, and the Spearman and Wilcoxon tests were applied. In conclusion, no significant correlation was found between the two parameters for discharge.

  4. Anesthetic considerations of an emergency decompressive craniotomy complicated with Ebstein's anomaly and atrial septal defect

    Institute of Scientific and Technical Information of China (English)

    XIN Xin; TANG Shuai; WANG Ling; ZHAO Jing; LI Gui-lin; GUO Li-lin; HUANG Yu-guang

    2011-01-01

    Despite considerable published papers regarding Ebstein's anomaly (EA) patients receiving open-heart tricuspid valve replacement, non-cardiac emergency surgeries were rarely reported. We report a case of emergency decormpressive craniotormy in a patient with EA. Anesthesiologists should pay special attention to the complications and anesthetic management during the non-cardiac surgeries performed in EA patients.hile papers regarding Ebstein's anomaly (EA)patients receiving open-heart tricuspid valve replacement are numerous, the reports of non-cardiac emergency surgeries have not been to the same degree.We report a case of emergency decompressive craniotomy in a patient with EA. This case report describes the symptoms and anesthetic management during the surgery.

  5. A Novel and Innovative Way of Nasogastric Tube Insertion in Anesthetized Intubated Patient

    Science.gov (United States)

    Sahu, Sandeep; Kishore, Kamal; Sachan, Vertika; Chatterjee, Arnidam

    2017-01-01

    Nasogastric tube (NGT) placement in anesthetized and intubated is sometimes very challenging with more than 50% failure rate in the first attempt. We describe a newer innovative Sahu's three in one, technique with use of GlideScope and forward placement of intubated trachea by external laryngeal maneuver, these both techniques lead to separation of trachea from esophagus so that endoscopic jejunal feeding tube guide wire strengthen NGT can be guided and manipulated to esophagus under direct vision. After informed consent, we used Sahu's three in one combo technique to insert NGT in adult anesthetized and intubated patients of both the sexes with high success in the first attempt. We found this technique easy, helpful, less time consuming with high success rate.

  6. [Anesthetic management of a Dialysis Patient with Chronic Inflammatory Demyelinating Polyneuropathy].

    Science.gov (United States)

    Takahashi, Yoshihiro; Hara, Koji; Sata, Takeyoshi

    2015-11-01

    We report the successful management of anesthesia in a 46-year-old male dialysis patient with chronic inflammatory demyelinating polyneuropathy (CIDP). He underwent an osteosynthesis of the ankle joint using general anesthesia combined with epidural anesthesia. The anesthetic concerns in patients with CIDP are the possibility of postoperative respiratory dysfunction due to anesthetics or muscle relaxants and that of postoperative neurological deterioration due to spinal or epidural anesthesia. In this case, sevoflurane (1.5-2%) did not cause respiratory dysfunction postoperatively and muscle relaxant effect of rocuronium was effectively reversed by sugammadex. Epidural anesthesia using ropivacaine (0.2-0.375%) and fentanyl did not worsen the neurological symptoms of CIDP post-operatively.

  7. [Local invasive treatment of chronic pain].

    Science.gov (United States)

    Medvedeva, L A; Zagorul'ko, O I; Gnezdilov, A V

    2014-01-01

    The literature on methods of invasive local treatment of chronic pain was analyzed. We reviewed 14 publications including meta-analyses and systematic reviews. The use of regional anesthesia conducted by anesthesiologists in pain clinics demonstrated the evidence based efficacy of different types of peridural injections of local anesthetics with steroids in patients with root pain syndromes at cervical and lumbar levels. Therapeutic blockades of the occipital nerve is effective method of treatment of cervicogenic and cluster headache as well as occipital nerve neuralgia. There are clear indications of the efficacy of local injections in primary chronic cephalgia (migraine and headache of tension). The possibility of the abortion of the pain information flow in peripheral nociceptive pathways and, as a consequence, breaking the vicious circle is emphasized. Issues on the efficacy of local injections at trigger points in the treatment of chronic pain are highlighted.

  8. Influência de anestésicos locais sobre o bloqueio neuromuscular produzido pelo rocurônio: ação da lidocaína e da mistura enantiomérica em excesso de 50% de bupivacaína na junção neuromuscular Influencia de anestésicos locales sobre el bloqueo neuromuscular producido por el rocuronio: acción de la lidocaína y de la mezcla enantiomérica en exceso de 50% de bupivacaína en la junción neuromuscular Influence of local anesthetics on the neuromuscular blockade produced by rocuronium: effects of lidocaine and 50% enantiomeric excess bupivacaine on the neuromuscular junction

    Directory of Open Access Journals (Sweden)

    Angélica de Fátima de Assunção Braga

    2009-12-01

    acción presináptica y postsináptica.BACKGROUND AND OBJECTIVES: The effects of local anesthetics (LA on neuromuscular transmission and their influence on the neuromuscular blockade produced by competitive neuromuscular blockers have not been fully investigated. The objective of this study was to evaluate, in vitro, the effects of lidocaine and 50% enantiomeric excess bupivacaine (S75-R25 on the neuromuscular blockade produced by rocuronium. METHODS: The rats were divided in five groups (n = 5 according to the drug used: isolated lidocaine, bupivacaine (S75-R25, or rocuronium (groups I, II, and II; and rocuronium in preparations previously exposed to LAs (groups IV and V. The concentrations used were as follows: 20 µg.mL-1, 5 µg.mL-1, and 4 µg.mL-1 of lidocaine, bupivacaine (S75-R25, and rocuronium, respectively. The following parameters were evaluated: 1 the strength of muscular contraction of the diaphragm to indirect electrical stimulations, before and 60 minutes after the isolated addition of the LAs and rocuronium, and the association AL-rocuronium; and 2 the effects of LAs on membrane potential (MP and miniature end-plate potentials (MEPP. The effect of LAs on muscle contraction in response to acetylcholine was evaluated in chick biventer cervicis preparations. RESULTS: Isolated lidocaine and bupivacaine (S75-R25 did not change the muscular response and the levels of MPs. In preparations exposed to LAs, rocuroniuminduced blockade was significantly greater than that produced by rocuronium alone. In chick biventer cervicis preparations, lidocaine and bupivacaine (S75R25 decreased contraction in response to acetylcholine. Lidocaine increased the frequency of MEPPs, which was followed by the blockade; bupivacaine (S75R25 caused a reduction in MEPPs followed by blockade. CONCLUSIONS: Local anesthetics caused a potentiation of the neuromuscular blockade produced by rocuronium. The results showed pre- and post-synaptic effects.

  9. The effects of anesthetics and misonidazole on the development of radiation-induced lung damage in mice

    Energy Technology Data Exchange (ETDEWEB)

    Down, J.D. (Inst. of Cancer Research, Surrey, England); Collis, C.H.; Jeffery, P.K.; Steel, G.G.

    1983-02-01

    The measurement of breathing frequency as a functional end-point of radiation-induced lung injury in mice allowed two phases of damage to be discerned; the first was manifest at 12-20 weeks after irradiation, the second beyond 28 weeks. Anesthesia by pentobarbitone sodium or steroids gave significant radioprotection of the lung during the early pneumonitic phase. Addition of the hypoxic cell sensitizer misonidazole removed the protective influence of the anesthetics but did not sensitize the lungs of unanesthetized mice. No anesthetic protection was detected for the late response, showing evidence for dissociation between early and late lung damage. The degree of epilation was measured on the dorsal thoracic region of the same mice. Protection by anesthetics and its reversal by misonidazole was also demonstrated. These results provide a warning of potential hazards in the laboratory evaluation of chemical radiosensitizers. The use of anesthetics at the time of irradiation could lead to an exaggerated enhancement of normal tissue damage.

  10. Radiofrequency ablation of hepatocellular carcinomas: A new spectrum of anesthetic experience at a tertiary care hospital in Pakistan

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    Faisal Shamim

    2017-01-01

    Conclusions: Percutaneous RFA is a safe treatment of hepatocellular cancer. The procedure required good anesthetic support in the form of sedation-analgesia or complete GA that ensures maximum patient comfort and technical success of the procedure.

  11. Standardization of 2-phenoxyethanol as anesthetic for juvenile Brycon cephalus (Gunther, 1869: the use in field procedures

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    Inoue Luis Antônio Kioshi Aoki

    2004-01-01

    Full Text Available Hyper motility is a negative factor in fish handling procedures due to the risks of damages to the animals. Chemicals are widely used to anesthetize fish during biometry and many other handling procedures. 2-Phenoxyethanol is largely employed, but many studies are necessary about tropical fish responses. The present research evaluated the anesthesia induction time for juvenile matrinxã submitted to eight different levels of 2-phenoxyethanol. The range of 2-phenoxyethanol concentration was 250-600mg liter-1. Induction time of anesthesia decreased as a function of 2-phenoxyethanol concentrations. Fish were safely anesthetized approximately after one minute of exposure to 2-phenoxyethanol batches in concentrations above 400mg/liter, and the recover period was about one minute for all anesthetic concentrations. 2-Phenoxyethanol is a safe anesthetic for juvenile matrinxã even in exposures up to 600mg liter-1 being recommended for many field procedures of fish handling.

  12. Anesthetic drug wastage in the operation room: A cause for concern

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    Kapil Chaudhary

    2012-01-01

    Full Text Available Context: The cost of anesthetic technique has three main components, i.e., disposable supplies, equipments, and anesthetic drugs. Drug budgets are an easily identifiable area for short-term savings. Aim: To assess and estimate the amount of anesthetic drug wastage in the general surgical operation room. Also, to analyze the financial implications to the hospital due to drug wastage and suggest appropriate steps to prevent or minimize this wastage. Settings and Design: A prospective observational study conducted in the general surgical operation room of a tertiary care hospital. Materials and Methods: Drug wastage was considered as the amount of drug left unutilized in the syringes/vials after completion of a case and any ampoule or vial broken while loading. An estimation of the cost of wasted drug was made. Results: Maximal wastage was associated with adrenaline and lignocaine (100% and 93.63%, respectively. The drugs which accounted for maximum wastage due to not being used after loading into a syringe were adrenaline (95.24%, succinylcholine (92.63%, lignocaine (92.51%, mephentermine (83.80%, and atropine (81.82%. The cost of wasted drugs for the study duration was 46.57% (Rs. 16,044.01 of the total cost of drugs issued/loaded (Rs. 34,449.44. Of this, the cost of wastage of propofol was maximum being 56.27% (Rs. 9028.16 of the total wastage cost, followed by rocuronium 17.80% (Rs. 2856, vecuronium 5.23% (Rs. 840, and neostigmine 4.12% (Rs. 661.50. Conclusions: Drug wastage and the ensuing financial loss can be significant during the anesthetic management of surgical cases. Propofol, rocuronium, vecuronium, and neostigmine are the drugs which contribute maximally to the total wastage cost. Judicious use of these and other drugs and appropriate prudent measures as suggested can effectively decrease this cost.

  13. Development of transmucosal patch loaded with anesthetic and analgesic for dental procedures and in vivo evaluation

    OpenAIRE

    Nidhi M; Patro MN; Kusumvalli S; Kusumdevi V

    2016-01-01

    Malviya Nidhi,1 M Nagaraju Patro,1 Somisetty Kusumvalli,2 Vemula Kusumdevi1 1Department of Pharmaceutics, Al-Ameen College of Pharmacy, 2Department of Endodontics and Conservative Dentistry, Sri Rajiv Gandhi College of Dental Sciences, Bengaluru, Karnataka, India Abstract: Most of the dental surgeries require preoperative anesthetic and postoperative analgesic for painless procedures. A multidrug transmucosal drug delivery system loaded with lignocaine (Lig) base for immediate release and s...

  14. Chiral selective effects of doxazosin enantiomers on blood pressure and urinary bladder pressure in anesthetized rats

    Institute of Scientific and Technical Information of China (English)

    Shi-ping MA; Lei-ming REN; Ding ZHAO; Zhong-ning ZHU; Miao WANG; Hai-gang LU; Li-hua DUAN

    2006-01-01

    Aim: To study chiral selective effects of doxazosin enantiomers on blood pressure and urinary bladder pressure in anesthetized rats. Methods: In anesthetized rats, the carotid blood pressure, left ventricular pressure of the heart and the urinary bladder pressure were recorded. Results: Administration of S-doxazosin at 0.25, 2.5, 25, and 250 nmol/kg iv produced a dose-dependent decrease in blood pressure, but its depressor effect was significantly weaker than that induced by R-doxazosin and racemic-doxazosin (rac-doxazosin), and the ED30 values (producing a 30% decrease in mean arterial pressure) of R-doxazosin, rac-doxazosin and S-doxazosin were 15.64,45.93, and 128.81, respectively. Rac-doxazosin and its enantiomers administered cumulatively in anesthetized rats induced a dose-dependent decrease in the left ventricular systolic pressure and ±dp/dtmax, and the potency order of the 3 agents was R-doxazosin >rac-doxazosin >S-doxazosin. Rac-doxazosin and its enantiomers decreased the vesical micturition pressure dose-dependently at 2.5,25, and 250 nmol/kg, and the inhibitory potency among the 3 agents was not significantly different. Conclusion: S-doxazosin decreases the carotid blood pressure and left ventricular pressure of the heart less than R-doxazosin and rac-doxazosin, but its effect on the vesical micturition pressure is similar to R-doxazosin and rac-doxazosin, indicating that S-doxazosin has chiral selectivity between cardiovascular system and urinary system in anesthetized rats.

  15. Comparison of pneumotachography and anemometery for flow measurement during mechanical ventilation with volatile anesthetics.

    Science.gov (United States)

    Mondoñedo, Jarred R; Herrmann, Jacob; McNeil, John S; Kaczka, David W

    2016-11-14

    Volatile anesthetics alter the physical properties of inhaled gases, such as density and viscosity. We hypothesized that the use of these agents during mechanical ventilation would yield systematic biases in estimates of flow ([Formula: see text]) and tidal volume (V T) for two commonly used flowmeters: the pneumotachograph (PNT), which measures a differential pressure across a calibrated resistive element, and the hot-wire anemometer (HWA), which operates based on convective heat transfer from a current-carrying wire to a flowing gas. We measured [Formula: see text] during ventilation of a spring-loaded mechanical test lung, using both the PNT and HWA placed in series at the airway opening. Delivered V T was estimated from the numerically-integrated [Formula: see text]. Measurements were acquired under baseline conditions with room air, and during ventilation with increasing concentrations of isoflurane, sevoflurane, and desflurane. We also evaluated a simple compensation technique for HWA flow, which accounted for changes in gas mixture density. We found that discrepancies in estimated V T between the PNT and HWA occurred during ventilation with isoflurane (6.3 ± 3.0%), sevoflurane (10.0 ± 7.3%), and desflurane (25.8 ± 17.2%) compared to baseline conditions. The magnitude of these discrepancies increased with anesthetic concentration. A simple compensation factor based on density reduced observed differences between the flowmeters, regardless of the anesthetic or concentration. These data indicate that the choice and concentration of anesthetic agents are primary factors for differences in estimated V T between the PNT and HWA. Such discrepancies may be compensated by accounting for alterations in gas density.

  16. Assessment of occupational exposure of medical personnel to inhalatory anesthetics in Poland

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    Małgorzata Kucharska

    2014-02-01

    Full Text Available Objectives: Despite common use of inhalatory anesthetics, such as nitrous oxide (N2O, halothane, sevoflurane, and the like, occupational exposure to these substances in operating theatres was not monitored in Poland until 2006. The situation changed when maximum admissible concentration (MAC values for anesthetics used in Poland were established in 2005 for N2O, and in 2007 for sevoflurane, desflurane and isoflurane. The aim of this work was to assess occupational exposure in operating rooms on the basis of reliable and uniform analytical procedures. Material and Methods: The method for the determination of all anesthetics used in Poland, i.e. nitrous oxide, sevoflurane, isoflurane, desflurane, and halothane, was developed and validated. The measurements were performed in 2006-2010 in 31 hospitals countrywide. The study covered 117 operating rooms; air samples were collected from the breathing zone of 146 anesthesiologists, and 154 nurses, mostly anaesthetic. The measurements were carried out during various surgical operations, mostly on adult patients but also in hospitals for children. Results: Time weighted average concentrations of the anesthetics varied considerably, and the greatest differences were noted for N2O (0.1-1438.5 mg/m3; 40% of the results exceeded the MAC value. Only 3% of halothane, and 2% of sevoflurane concentrations exceeded the respective MAC values. Conclusions: Working in operating theatres is dangerous to the health of the operating staff. The coefficient of combined exposure to anesthesiologists under study exceeded the admissible value in 130 cases, which makes over 40% of the whole study population. Most of the excessive exposure values were noted for nitrous oxide. Med Pr 2014;65(1:43–54

  17. Brainstem Stimulation Increases Functional Connectivity of Basal Forebrain-Paralimbic Network in Isoflurane-Anesthetized Rats

    OpenAIRE

    Pillay, Siveshigan; Liu, Xiping; Baracskay, Péter; Hudetz, Anthony G.

    2014-01-01

    Brain states and cognitive-behavioral functions are precisely controlled by subcortical neuromodulatory networks. Manipulating key components of the ascending arousal system (AAS), via deep-brain stimulation, may help facilitate global arousal in anesthetized animals. Here we test the hypothesis that electrical stimulation of the oral part of the pontine reticular nucleus (PnO) under light isoflurane anesthesia, associated with loss of consciousness, leads to cortical desynchronization and sp...

  18. Analysis on the factors associated with treatment failure of using anesthetics in refractory status epilepticus

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    Ying-ying SU

    2015-11-01

    Full Text Available Objective To analyze the related factors associated with immediate treatment failure of using anesthetics in refractory status epilepticus (RSE.  Methods Thirty patients derived from Neurocritical Care Unit of Xuanwu Hospital from January 2004 to December 2013 were divided into 2 groups (acute treatment failure group and acute treatment success group based on the treatment outcome 6 h after intravenous injection of anesthetics. Univariate and multivariate forward Logistic regression analyses were used to analyze and screen the risk factors associated with immediate treatment failure, and calculate the failure rate of final outcome.  Results According to the results of univariate and multivariate Logistic regression analyses, among influencing factors such as sex, age, etiology, Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ, type of status epilepticus (SE, type of antiepileptic drugs (AEDs, total duration of primary treatment, duration of prehospital primary treatment, duration of posthospital primary treatment, type of RSE and primary choice of anesthetics, only total duration of primary treatment was the independent risk factor for immediate treatment failure (OR = 1.007, 95%CI: 1.000-1.014; P = 0.047. The rate of immediate treatment failure of RSE by using anesthetics was 50% (15/30, and the rate of final treatment failure was 43.33% (13/30. The ratio of final treatment failure was much higher in acute treatment failure group than that in acute treatment success group (10/15 vs 3/15, P = 0.025.  Conclusions The acute treatment result of RSE depends on the total duration of primary treatment, and determinates the final result of treatment. On the basis of treating primary disease, the therapy to terminate SE or RSE should be started as early as possible. DOI: 10.3969/j.issn.1672-6731.2015.11.008

  19. Induction of burst suppression or coma using intravenous anesthetics in refractory status epilepticus.

    Science.gov (United States)

    Kang, Bong Su; Jung, Keun-Hwa; Shin, Jeong-Won; Moon, Jang Sup; Byun, Jung-Ick; Lim, Jung-Ah; Moon, Hye Jin; Kim, Young-Soo; Lee, Soon-Tae; Chu, Kon; Lee, Sang Kun

    2015-05-01

    General anesthetic-induced coma therapy has been recommended for the treatment of refractory status epilepticus (RSE). However, the influence of electroencephalographic (EEG) burst suppression (BS) on outcomes still remains unclear. This study investigated the impact of intravenous anesthetic-induced BS on the prognosis of RSE using a retrospective analysis of all consecutive adult patients who received intravenous anesthetic treatment for RSE at the Seoul National University Hospital between January 2006 and June 2011. Twenty-two of the 111 episodes of RSE were enrolled in this study. Of the 22 RSE patients, 12 (54.5%) were women and 18 (81.4%) exhibited generalized convulsive status epilepticus. Sixteen patients (72.7%) were classified as having acute symptomatic etiology, including three patients with anoxic encephalopathy, and others with remote symptomatic etiology. Only two patients (9.1%) had a favorable Status Epilepticus Severity Score (0-2) at admission. All patients received midazolam (MDZ) as a primary intravenous anesthetic drug for RSE treatment; three (13.6%) received MDZ and propofol, and one (4.5%) received MDZ and pentobarbital. The rates of mortality and poor outcome at discharge were 13.6% (n=3) and 54.5% (n=12), respectively. While BS was achieved in six (27.5%) patients, it was not associated with mortality or poor outcome. Induced BS was associated with prolonged hospital stay in subgroup analysis when excluding anoxic encephalopathy. Our results suggest that induction of BS for treating RSE did not affect mortality or outcome at discharge and may lead to an increased length of hospital stay.

  20. The usage of Bupivacaina as anesthetic agent in knee arthroscopy.

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    José Julio Ojeda González

    2003-12-01

    Full Text Available Introduction: Artroscopy of the knee is a procedure that is frequently developed as a diagnostic and therapeutic means in patients who suffer among other diseases, from chronic sinuvitis, lesions of the meniscus and adherence . A great number of these patients receive medical assistance at the outpatient department of the orthopaedic department where the need of its use is assessed. It is a relatively short procedure that has few risks when it is performed with the appropriate technique. Objective: To show the use of intra articular Bupivacaine 0,25 % in the artroscopy of the knee. Method: Retrospective study carried out at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ from Cienfuegos province from September 2002 to February 2003. This study was developed with 20 patients who were initially assisted at the service of Orthopaedics in which a group of therapeutic procedures were decided. Bupivacaine 0,25 % together with Epinephrine 0,1 % in a dose of 0,1 ml were injected in the intra articular space in a volume of 20 ml distributed in 4 sections with 5 ml each. At the level of the section where the artroscope was inserted , 5 ml of Bupivacaine 0,25 % was applied. Result: the age of the patient ranged 30 to 61 years of age with a media of 44,6 years and a standard deviation of 12,6 years. The introduction and application of the procedure throughout artroscopy was possible in al patients. Conclusion: Bupivacaine is a good local anaesthetic because of its slow action since the onset of application and its prolonged duration, and because of the intensity and the duration of the sensorial block that is superior to the motor block.

  1. Ketamine-Based Anesthetic Protocols and Evoked Potential Monitoring: A Risk/Benefit Overview

    Science.gov (United States)

    Stoicea, Nicoleta; Versteeg, Gregory; Florescu, Diana; Joseph, Nicholas; Fiorda-Diaz, Juan; Navarrete, Víctor; Bergese, Sergio D.

    2016-01-01

    Since its discovery, ketamine, a non-competitive N-methyl D-aspartate (NMDA) receptor antagonist related to phencyclidine, has been linked to multiple adverse reactions sometimes described as “out of body” and “near death experiences,” including emergence phenomena, delusions, hallucinations, delirium, and confusion. Due to these effects, ketamine has been withdrawn from mainstream anesthetic use in adult patients. Evoked potentials (EPs) are utilized to monitor neural pathways during surgery, detect intraoperative stress or damage, detect and define the level of neural lesions, and define abnormalities. Unfortunately, many of the volatile anesthetics commonly used during spinal and neurologic procedures suppress EP amplitude and monitoring. Ketamine has been found in several preclinical and clinical studies to actually increase EP amplitude and thus has been used as an analgesic adjunct in procedures where EP monitoring is critical. Once the gap in our knowledge of ketamine's risks has been sufficiently addressed in animal models, informed clinical trials should be conducted in order to properly incorporate ketamine-based anesthetic regimens during EP-monitored neurosurgeries. PMID:26909017

  2. Does chronic occupational exposure to volatile anesthetic agents influence the rate of neutrophil apoptosis?

    LENUS (Irish Health Repository)

    Goto, Y

    2012-02-03

    PURPOSE: The purpose of this preliminary investigation was to determine whether the rate of neutrophil apoptosis in health care workers is influenced by exposure to volatile anesthetic agents. METHODS: Percentage neutrophil apoptosis (Annexin-V FITC assay) was measured in health care workers (n = 20) and unexposed volunteers (n = 10). For the health care workers, time weighted personal exposure monitoring to N2O, sevoflurane and isoflurane was carried out. RESULTS: The sevoflurane and isoflurane concentrations to which health care workers were exposed were less than recommended levels in all 20 cases. Percent apoptosis was less at 24 (but not at one and 12) hr culture in health care workers [50.5 (9.7)%; P = 0.008] than in unexposed volunteers [57.3 (5.1)%]. CONCLUSION: Inhibition of neutrophil apoptosis at 24 hr culture was demonstrated in health care workers chronically exposed to volatile anesthetic agents. Exposure was well below recommended levels in the both scavenged and unscavenged work areas in which the study was carried out. Further study is required to assess the effect of greater degrees of chronic exposure to volatile anesthetic agents on neutrophil apoptosis.

  3. Qualitative evaluation of coronary flow during anesthetic induction using thallium-201 perfusion scans

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    Kleinman, B.; Henkin, R.E.; Glisson, S.N.; el-Etr, A.A.; Bakhos, M.; Sullivan, H.J.; Montoya, A.; Pifarre, R.

    1986-02-01

    Qualitative distribution of coronary flow using thallium-201 perfusion scans immediately postintubation was studied in 22 patients scheduled for elective coronary artery bypass surgery. Ten patients received a thiopental (4 mg/kg) and halothane induction. Twelve patients received a fentanyl (100 micrograms/kg) induction. Baseline thallium-201 perfusion scans were performed 24 h prior to surgery. These scans were compared with the scans performed postintubation. A thallium-positive scan was accepted as evidence of relative hypoperfusion. Baseline hemodynamic and ECG data were obtained prior to induction of anesthesia. These data were compared with the data obtained postintubation. Ten patients developed postintubation thallium-perfusion scan defects (thallium-positive scan), even though there was no statistical difference between their baseline hemodynamics and hemodynamics at the time of intubation. There was no difference in the incidence of thallium-positive scans between those patients anesthetized by fentanyl and those patients anesthetized with thiopental-halothane. The authors conclude that relative hypoperfusion, and possibly ischemia, occurred in 45% of patients studied, despite stable hemodynamics, and that the incidence of these events was the same with two different anesthetic techniques.

  4. Cardioprotective effects of anesthetic preconditioning in rats with ischemia-reperfusion injury: propofol versus isoflurane

    Institute of Scientific and Technical Information of China (English)

    Xing TAO; Ling-qiao LU; Qing XU; Shu-ren LI; Mao-tsun LIN

    2009-01-01

    Objective: We compare the cardioprotective effects of anesthetic preconditioning by propofol and/or isoflurane in rats with ischemia-reperfusion injury. Methods: Male adult Wistar rats were subjected to 60 min of anterior descending coronary artery occlusion followed by 120 min of reperfusion. Before the long ischemia, anesthetics were administered twice for 10 min followed by 5 min washout. Isoflurane was inhaled at I MAC (0.016) in I group, whereas propofol was inhaled intravenously at 37.5 mg/(kg.h) in P group. A combination ofisoflurane and propofol was administered simultaneously in I+P group. Results: In control (without anesthetic preconditioning, C group), remarkable myocardial infarction and apoptosis accompanied by an increased level of cardiac troponin T were noted 120 rain after ischemia-reperfusion. As compared to those of control group, I and P groups had comparable cardioprotection. In addition, I+P group shares with I and P groups the comparable cardioprotective effects in terms of myocardial infarction and cardiac troponin T elevation. Conclusion: A combination of isoflurane and propofol produced no ad-ditional cardioprotection.

  5. Effect of four-alpha-helix bundle cavity size on volatile anesthetic binding energetics.

    Science.gov (United States)

    Manderson, Gavin A; Michalsky, Stuart J; Johansson, Jonas S

    2003-09-30

    Currently, it is thought that inhalational anesthetics cause anesthesia by binding to ligand-gated ion channels. This is being investigated using four-alpha-helix bundles, small water-soluble analogues of the transmembrane domains of the "natural" receptor proteins. The study presented here specifically investigates how multiple alanine-to-valine substitutions (which each decrease the volume of the internal binding cavity by 38 A(3)) affect structure, stability, and anesthetic binding affinity of the four-alpha-helix bundles. Structure remains essentially unchanged when up to four alanine residues are changed to valine. However, stability increases as the number of these substitutions is increased. Anesthetic binding affinities are also affected. Halothane binds to the four-alpha-helix bundle variants with 0, 1, and 2 substitutions with equivalent affinities but binds to the variants with 3 and 4 more tightly. The same order of binding affinities was observed for chloroform, although for a particular variant, chloroform was bound less tightly. The observed differences in binding affinities may be explained in terms of a modulation of van der Waals and hydrophobic interactions between ligand and receptor. These, in turn, could result from increased four-alpha-helix bundle binding cavity hydrophobicity, a decrease in cavity size, or improved ligand/receptor shape complementarity.

  6. Anesthetic ketamine counteracts repetitive mechanical stress-induced learning and memory impairment in developing mice.

    Science.gov (United States)

    Peng, Sheng; Zhang, Yan; Wang, Hua; Ren, Bingxu; Zhang, Jiannan

    2011-10-01

    The aim of this study is to investigate whether ketamine, a noncompetitive N-methyl-D: -aspartate receptor (NMDAR) antagonist, had an influence on learning and memory in developing mice. Fifty Kunming mice aged 21 days were randomly divided into 5 subgroups (n = 10 for each) to receive intraperitoneal injection of equal volume of saline (S group) or ketamine (25, 50 or 100 mg/kg of body weight/day) for 7 consecutive days, or to be left untreated (C group). A step-down passive avoidance test was performed to evaluate learning and memory in these mice on days 8 and 9. Additionally, the expression of brain-derived neurotrophic factor (BDNF) in the hippocampus was determined. Rats receiving saline or sub-anesthetic dose of ketamine (25 mg/kg) showed significantly decreased abilities of learning and memory and reduced expression of BDNF, compared to the normal controls (P learning and memory and expression of BDNF were found for anesthetic doses of ketamine (50 or 100 mg/kg)-treated rats and controls (P > 0.05). Repetitive mechanical stress impairs learning and memory performance in developing mice, which may be associated with decreased BDNF expression. The stress-induced learning and memory impairment can be prevented by anesthetic doses of ketamine.

  7. Effects of anesthetic agents on brain blood oxygenation level revealed with ultra-high field MRI.

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    Luisa Ciobanu

    Full Text Available During general anesthesia it is crucial to control systemic hemodynamics and oxygenation levels. However, anesthetic agents can affect cerebral hemodynamics and metabolism in a drug-dependent manner, while systemic hemodynamics is stable. Brain-wide monitoring of this effect remains highly challenging. Because T(2*-weighted imaging at ultra-high magnetic field strengths benefits from a dramatic increase in contrast to noise ratio, we hypothesized that it could monitor anesthesia effects on brain blood oxygenation. We scanned rat brains at 7T and 17.2T under general anesthesia using different anesthetics (isoflurane, ketamine-xylazine, medetomidine. We showed that the brain/vessels contrast in T(2*-weighted images at 17.2T varied directly according to the applied pharmacological anesthetic agent, a phenomenon that was visible, but to a much smaller extent at 7T. This variation is in agreement with the mechanism of action of these agents. These data demonstrate that preclinical ultra-high field MRI can monitor the effects of a given drug on brain blood oxygenation level in the absence of systemic blood oxygenation changes and of any neural stimulation.

  8. Physiological and hematological responses of Nile tilapia (Oreochromis Niloticus to different anesthetics during simulated transport conditions

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    Rodrigo Diana Navarro

    2016-06-01

    Full Text Available Minimization of stress during the transportation of live fish is essential in maintaining the welfare and performance of the animals. In order to test the hypothesis that stress during transport of fingerlings of Nile tilapia (Oreochromis niloticus can be reduced with the aid of the anesthetics menthol, eugenol or benzocaine, we have assessed the effects of these agents at various concentrations on the physiological parameters and survival rates of fish subjected to conditions simulating those normally used in transportation. Fingerlings (N = 1200 were fasted for 24 hours and distributed in 20 L polyethylene bags (N = 50 per bag containing 5 L of water and an anesthetic at the appropriate concentration. Fingerlings treated with menthol at 75 mg L-1, or eugenol or benzocaine at 20 mg L-1, maintained levels of plasma cortisol and glucose that were lower than those of the stressed but untreated controls and within the physiological limits of the baseline values for this species. Under these conditions, the survival rate was 100%, suggesting that stress was substantially reduced despite dense consignment. Treatments involving higher doses of the studied agents induced significant anesthetic toxicity.

  9. Temporal changes in ventricular function assessed echocardiographically in conscious and anesthetized mice.

    Science.gov (United States)

    Rottman, Jeffrey N; Ni, Gemin; Khoo, Michelle; Wang, Zhizhang; Zhang, Wei; Anderson, Mark E; Madu, Ernest C

    2003-11-01

    The mouse is an important model system for cardiovascular biology, with echocardiography a critical tool for noninvasive measurement of cardiac morphology and function. The feasibility and short-term temporal consistency of repeated echocardiographic measurements in conscious mice has not been previously evaluated. We performed serial 2-dimensional guided M-mode transthoracic echocardiographic measurements at 5- to 10-minute intervals over 60 minutes in conscious mice and in mice treated with 1 of 3 anesthetic regimens: ketamine and acepromazine (n = 14); pentobarbital (n = 14); and ketamine and xylazine (n = 13). Unanesthetized mice received intraperitoneal saline (n = 6) or no injection (n = 7). In sequentially repeated measurements over 1 hour in conscious mice, none of the measured or derived echocardiographic parameters differed from baseline, whereas all 3 anesthetic regimens produced significant, prolonged, and temporally variable decreases in heart rate and fractional shortening. The relationship between heart rate and fractional shortening was not altered by anesthetic choice. Serial echocardiographic assessments of cardiac function, dimension, and mass can be performed with high reproducibility in conscious mice.

  10. Benzocaine and clove oil as anesthetics for pejerrey (Odontesthes bonariensis fingerlings

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    J. Morato-Fernandes

    2013-10-01

    Full Text Available Pejerrey (Odontesthes bonariensis is a native species from Rio Grande do Sul, Uruguay and Argentina where it is of great economic importance for artisanal fishing. One difficulty in laboratory research with pejerrey is related to its sensitivity, as it presents higher basal cortisol levels than other freshwater species. For this reason, the aim of this work was to evaluate the efficiency of benzocaine and clove oil as anesthetics for pejerrey fingerlings. Two experiments were done where fingerlings (57±7.8mm and 1.1±0.44g were exposed to benzocaine with concentrations between 40mgL-1 and 120mgL-1 and to clove oil with concentrations between 12mgL-1 and 75mgL-1. Survival, anesthesia induction time and recovery time for each pharmaceutics were evaluated. Both benzocaine and clove oil pharmaceutics showed efficiency as anesthetics for pejerrey fingerlings, with negative correlation between the dose of anesthetics and the anesthesia induction time. For benzocaine, the concentrations between 80mgL-1 and 100mgL-1 showed better results, as for clove oil the optimal concentrations were between 25mgL-1 and 50mgL-1. On the other hand, the anesthesia recovery time did not present significant variation on the different concentrations of the tested products. The tested products are highly metabolizable by pejerrey.

  11. Usefulness of permutation entropy as an anesthetic depth indicator in children.

    Science.gov (United States)

    Kim, Pil-Jong; Kim, Hong-Gee; Noh, Gyu-Jeong; Koo, Yong-Seo; Shin, Teo Jeon

    2015-04-01

    Permutation entropy (PE) as a complexity measure has been introduced to monitor anesthetic depth for adult. However, PE has not yet been evaluated for its clinical applicability as an indicator of anesthetic depth in children. Therefore, in order to investigate the validity of PE, we compared PE with BIS using pharmacodynamic (PD) modeling in children. Electroencephalogram (EEG) was obtained from BIS monitor during sevoflurane deepening and lightening protocol. End-tidal sevoflurane concentration (Etsevo) and BIS were measured simultaneously. PE was calculated from the processed EEG with the scale ranging from 0 to 100. NONMEM software was used to investigate the PD relationship between Etsevo with BIS and PE. Adjusted PE (APE) values were decreased as anesthesia deepened. APE and BIS showed significant linear correlation (P Emax model which describes the relationship between Etsevo and APE/BIS (E o : 78, E max : 17.6, C e50 : 2.5 vol%; γ: 13.1, k eo : 0.47 min(-1) for APE; E o : 89.4; E max : 15.7; C e50 : 2.2 vol%; γ: 6.6, keo: 0.52 min(-1) for BIS). PE seems to be a useful indicator of anesthetic depth, which is comparable to BIS in children.

  12. Efficiency of eugenol as anesthetic for the early life stages of Nile tilapia (Oreochromis niloticus).

    Science.gov (United States)

    Ribeiro, Paula A P; Miranda-Filho, Kleber C; Melo, Daniela C de; Luz, Ronald K

    2015-03-01

    In aquaculture, activities with anesthetic compounds are usually used in order to ensure the welfare of farmed fish, allowing handling out of water with decreased trauma by stress. Presently, there is no information about anesthetic action of eugenol in early life stages of Nile tilapia (Oreochromis niloticus). The objective of this study was to evaluate different concentrations of eugenol for larvae and juveniles of Nile tilapia. Sixty animals were used for each group of weight, group I = 0.02 g; group II = 0.08 g; group III = 0.22 g; group IV = 2.62 g; and group V = 11.64 g. The eugenol concentrations tested were 50, 75, 100, 125, 150 and 175 mg L-1. No mortality was reported during the tests with eugenol. Tilapia larvae with 0.02 g and juveniles around 11.64 g can be anesthetized with eugenol concentrations between 150 and 175 mg L-1, since they determine the shortest sedation time (23 and 72 seconds, for the group of lowest and highest weights, respectively).

  13. General anesthetics inhibit erythropoietin induction under hypoxic conditions in the mouse brain.

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    Tomoharu Tanaka

    Full Text Available BACKGROUND: Erythropoietin (EPO, originally identified as a hematopoietic growth factor produced in the kidney and fetal liver, is also endogenously expressed in the central nervous system (CNS. EPO in the CNS, mainly produced in astrocytes, is induced under hypoxic conditions in a hypoxia-inducible factor (HIF-dependent manner and plays a dominant role in neuroprotection and neurogenesis. We investigated the effect of general anesthetics on EPO expression in the mouse brain and primary cultured astrocytes. METHODOLOGY/PRINCIPAL FINDINGS: BALB/c mice were exposed to 10% oxygen with isoflurane at various concentrations (0.10-1.0%. Expression of EPO mRNA in the brain was studied, and the effects of sevoflurane, halothane, nitrous oxide, pentobarbital, ketamine, and propofol were investigated. In addition, expression of HIF-2α protein was studied by immunoblotting. Hypoxia-induced EPO mRNA expression in the brain was significantly suppressed by isoflurane in a concentration-dependent manner. A similar effect was confirmed for all other general anesthetics. Hypoxia-inducible expression of HIF-2α protein was also significantly suppressed with isoflurane. In the experiments using primary cultured astrocytes, isoflurane, pentobarbital, and ketamine suppressed hypoxia-inducible expression of HIF-2α protein and EPO mRNA. CONCLUSIONS/SIGNIFICANCE: Taken together, our results indicate that general anesthetics suppress activation of HIF-2 and inhibit hypoxia-induced EPO upregulation in the mouse brain through a direct effect on astrocytes.

  14. Anesthetic induction and recovery of Hippocampus reidi exposed to the essential oil of Lippia alba

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    Mauro Alves da Cunha

    Full Text Available The aim of this study was to identify the times of anesthetic induction and recovery in slender seahorses (Hippocampus reidi that were exposed to the essential oil of Lippia alba (EO, as well as the efficacy of EO as a stress-reducing agent in the transport of this species. Slender seahorses were placed in 1-L aquaria containing different concentrations of EO (0, 10, 20, 50, 150, 300 and 450 µL L-1, and after induction, fish were transferred to aquaria that were free of anesthetic to evaluate their recovery time. In an additional experiment, slender seahorses were transported in plastic bags with 15 µL L-1 of EO for 4 or 24 h. The increased concentration of EO proportionally decreased the time required for the induction of anesthesia. EO treatment (15 µL L-1 inhibited the increase in blood glucose levels that was provoked by transportation for 4 or 24 h. Transportation for 24 h also decreased the number of lymphocytes and increased the neutrophil count, and these effects were avoided with the addition of EO to the water. These results demonstrate that EO was effective as an anesthetic at concentrations of 10-20 µL L-1 for slight sedation and transport and at 150 µL L-1 for deep anesthesia in the slender seahorse.

  15. Anesthetics rapidly promote synaptogenesis during a critical period of brain development.

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    Mathias De Roo

    Full Text Available Experience-driven activity plays an essential role in the development of brain circuitry during critical periods of early postnatal life, a process that depends upon a dynamic balance between excitatory and inhibitory signals. Since general anesthetics are powerful pharmacological modulators of neuronal activity, an important question is whether and how these drugs can affect the development of synaptic networks. To address this issue, we examined here the impact of anesthetics on synapse growth and dynamics. We show that exposure of young rodents to anesthetics that either enhance GABAergic inhibition or block NMDA receptors rapidly induce a significant increase in dendritic spine density in the somatosensory cortex and hippocampus. This effect is developmentally regulated; it is transient but lasts for several days and is also reproduced by selective antagonists of excitatory receptors. Analyses of spine dynamics in hippocampal slice cultures reveals that this effect is mediated through an increased rate of protrusions formation, a better stabilization of newly formed spines, and leads to the formation of functional synapses. Altogether, these findings point to anesthesia as an important modulator of spine dynamics in the developing brain and suggest the existence of a homeostatic process regulating spine formation as a function of neural activity. Importantly, they also raise concern about the potential impact of these drugs on human practice, when applied during critical periods of development in infants.

  16. Sevoflurane Induces DNA Damage Whereas Isoflurane Leads to Higher Antioxidative Status in Anesthetized Rats

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    Thalita L. A. Rocha

    2015-01-01

    Full Text Available Taking into account that there are controversial antioxidative effects of inhalational anesthetics isoflurane and sevoflurane and absence of comparison of genotoxicity of both anesthetics in animal model, the aim of this study was to compare DNA damage and antioxidant status in Wistar rats exposed to a single time to isoflurane or sevoflurane. The alkaline single-cell gel electrophoresis assay (comet assay was performed in order to evaluate DNA damage in whole blood cells of control animals (unexposed; n = 6 and those exposed to 2% isoflurane (n = 6 or 4% sevoflurane (n = 6 for 120 min. Plasma antioxidant status was determined by 3-(4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide (MTT assay. There was no statistically significant difference between isoflurane and sevoflurane groups regarding hemodynamic and temperature variables (P > 0.05. Sevoflurane significantly increased DNA damage compared to unexposed animals (P = 0.02. In addition, Wistar rats anesthetized with isoflurane showed higher antioxidative status (MTT than control group (P = 0.019. There were no significant differences in DNA damage or antioxidant status between isoflurane and sevoflurane groups (P > 0.05. In conclusion, our findings suggest that, in contrast to sevoflurane exposure, isoflurane increases systemic antioxidative status, protecting cells from DNA damage in rats.

  17. Risk Management Status of Waste Anesthetic Gases Using ECRI Institute Standards

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    S Asefzadeh

    2012-11-01

    Full Text Available Background: The aim of this study was assessment the risk management status of waste anesthetic gases in academicals hospitals in Iran to prevent from harmful effects of these gases on employees' health.Methods: A descriptive-analytic study was designed in 2011. Standard structured checklist developed by ECRI institute (Emergency Care Research Institute was applied. Checklists were filled onsite through direct observation and interviews with anesthesia personnel in 46 operating rooms at 4 hospitals from all of the hospitals under affiliation of Isfahan University of Medical Sciences. These hospitals were selected based on the number of surgical beds.Results: Total means score of WAGs risk management status was 1.72 from the scale of 3. In the studied operating rooms, only 28% complied with predetermined standards, 16% needed improvement and 56% had no compliance. Total mean scores of compliance in planning, training and evaluation and monitoring of waste anesthetic gases were weak and equipment and work activity was at medium level.Conclusion: The risk management status of waste anesthetic gases in the hospitals to be weak, therefore operating room personnel are exposed to medium to high level of these gases. The hospital mangers should prepare and apply scavenging equipment, development of control program, quality improvement, risk management and maintenance of anesthesia equipment. Finally, ongoing monitoring and evaluation, education to personnel and modification of policy and procedures and improvement of work activities should be considered.

  18. Effects of Injectable Anesthetic Combinations on Left Ventricular Function and Cardiac Morphology in Sprague–Dawley Rats

    OpenAIRE

    Sabatini, Carla F; O'Sullivan, M. Lynne; Valcour, James E.; Sears, William; Johnson, Ron J

    2013-01-01

    Novel anesthetic agents or combinations may provide superior general anesthesia for echocardiography in rodents with the potential for reduced adverse effects. This study sought to characterize the effects of 3 injectable anesthetics on left ventricular (LV) systolic function and cardiac morphology in healthy male and female rats. Rats underwent echocardiographic assessment after general anesthesia via pentobarbital or combinations of ketamine and medetomidine (KME) and ketamine and midazolam...

  19. Super obese 33-week parturient undergoing an urgent laparoscopic bowel resection: A case report and review of anesthetic implications

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    Yury Khelemsky

    2011-01-01

    Full Text Available Approximately two percent of women undergo non-obstetric surgery during their pregnancies. The following case report describes the anesthetic management of a super obese parturient in her third trimester of pregnancy undergoing urgent laparoscopic (converted to open bowel resection. Such a case, which has not been previously reported, has multiple clinical implications for both mother and fetus and was further complicated by super obesity (BMI>50 and laparoscopy. The anesthetic implications for this patient population are reviewed.

  20. ANESTHETIC MANAGEMENT OF ATONIC POST - PARTUM HEMORRHAGE WITH HEMORRHAGIC SHOCK AND IMPENDING CARDIAC ARREST FOR EMERGENCY PERIPARTUM HYSTERECTOMY

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    Ravishankar

    2015-07-01

    Full Text Available Post - partum hemorrhagic complication is a critical situation for an anesthesiologist, which requires timely and skillful anesthetic management. A massive post - partum bleeding leading to severe hypovolemic shock may result in life threatening cardio - pulmonary arrest. Here is a case report of 25 year old with atonic post - partum hemorrhage resulting in hypovolemic shock & impending cardiac arrest and successful anesthetic management for emergency peripartum hysterectomy to save the life of the patient.

  1. Percutaneous nephrolithotripsy under assisted local anaesthesia for high risk patients: Is it effective?

    Directory of Open Access Journals (Sweden)

    T.KH. Fathelbab

    2013-12-01

    Conclusion: Our results demonstrated that PNL under local anesthesia with narcotics and sedatives seems to be a satisfying solution for the treatment of a selected group of patients with renal pelvic stones and who have high anesthetic risk. However, additional studies with different groups of patients are required to validate our results.

  2. Intracranial hemorrhagic infarct after local anesthesia on nasal mucosa: A case report

    Directory of Open Access Journals (Sweden)

    Murat Koçyiğit

    2015-01-01

    Conclusion: We want to emphasize that all surgeons especially the ENT surgeons should be careful while using local anesthetic medicines which contains adrenaline for rare complication of intracranial hemorrhagic infarction. Another fact is that the patients must sign an informed consent form including those situations even for all minor surgical procedures to avoid a medicolegal problem.

  3. MULTICOMPONENT SOLUTION FOR LOCAL ANAESTHESIA IN OPERATIONS ON EXTREMITIES

    Directory of Open Access Journals (Sweden)

    V.I. Sobolev

    2008-03-01

    Full Text Available The analysis of the results of local anaesthesia (LA in 89 patients aged 18 to 68 years with trauma and diseases of extremities has been carried out. The efficiency of perineural injected multicomponent solution of clonidine added to conventional mixture oflidocaine and phentanyl has been assessed. The multicomponent method has significantly prolonged the duration of local anaesthesia of 1% lidocaine solution providing reliable anaesthesia of plexus and peripheral nerves alongside the sufficient regional myoplegia and prolonged postoperative anesthetization. When there is no need of deep myoplegia Hallows to lower the concentration of lidocaine solution twofold, maintaining its efficiency, and to realize local anaesthesia of patients with high risk.

  4. Examination of cardiovascular function variables in tooth extraction under local anesthesia

    Directory of Open Access Journals (Sweden)

    Životić-Vanović Mirjana

    2006-01-01

    Full Text Available Background/Aim. Local anesthesia is the one of the most used procedures in surgical practice. It is used for toot extraction to produce analgesic and anesthetic effects. However, there is a question if it is equally safe to apply a local anesthetic combined with a vasoconstrictor (adrenaline in healthy persons, and in the patients with a certain cardiovascular system disease. The aim of this study was to determine whether there were differences in cardiovascular variables during tooth extraction in healthy persons, and in cardiovascular patients when an anesthetic was applyted with adrenaline, or without it. Methods. The examinees were divided into the group with cardiovascular diseases (CV, n = 57 of II and III type, according to the American Society of Anesthesiologists (ASA qualification, and healthy persons (H, n = 55. Both groups were randomly divided into two subgroups: CVa and Ha - where the anesthetic solution had the vasoconstrictor (3% lidocaine, and 1 : 100 000 adrenaline; CVb and Hb - where the anesthetic solution was without the vasoconstrictor (3% lidocaine. During the preparation for tooth extraction, the application of anesthetics, extraction and relaxation puls (fc, systolic (TAs and diastolic arterial blood pressure (TAd and ECG were registered. Results. The values of fc did not significantly differ among the groups in any measured term. The values of systolic and diastolic blood pressure in the groups CVa and CVb were significantly higher in all the terms of measuring (p < 0.05 from the values in the groups Ha and Hb. A significant increase of TAs was registered only in the phase of tooth extraction in the CVa and CVb group (< 0.05. The values of TAd did not significantly differ between the groups in all the measured terms. Extrasystolic beats were registered in 11 patients of the CV group and in 7 patients of the H group in the phase of anesthetic application or tooth extraction. Conclusion. This research shoved that tooth

  5. Participation of the GABAergic system in the anesthetic effect of Lippia alba (Mill.) N.E. Brown essential oil

    Energy Technology Data Exchange (ETDEWEB)

    Heldwein, C.G.; Silva, L.L. [Departamento de Farmácia Industrial, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil); Reckziegel, P. [Departamento de Fisiologia e Farmacologia, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil); Barros, F.M.C. [Departamento de Farmácia Industrial, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil); Bürger, M.E.; Baldisserotto, B. [Departamento de Fisiologia e Farmacologia, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil); Mallmann, C.A. [Departamento de Medicina Veterinária Preventiva, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil); Schmidt, D.; Caron, B.O. [Departamento de Ciências Agronômicas e Ambientais, Universidade Federal de Santa Maria, Campus de Frederico Westphalen, Frederico Westphalen, RS (Brazil); Heinzmann, B.M. [Departamento de Farmácia Industrial, Universidade Federal de Santa Maria, Santa Maria, RS (Brazil)

    2012-04-05

    The objective of this study was to identify the possible involvement of the GABAergic system in the anesthetic effect of Lippia alba essential oil (EO). We propose a new animal model using silver catfish (Rhamdia quelen) exposed to an anesthetic bath to study the mechanism of action of EO. To observe the induction and potentiation of the anesthetic effect of EO, juvenile silver catfish (9.30 ± 1.85 g; 10.15 ± 0.95 cm; N = 6) were exposed to various concentrations of L. alba EO in the presence or absence of diazepam [an agonist of high-affinity binding sites for benzodiazepinic (BDZ) sites coupled to the GABA{sub A} receptor complex]. In another experiment, fish (N = 6) were initially anesthetized with the EO and then transferred to an anesthetic-free aquarium containing flumazenil (a selective antagonist of binding sites for BDZ coupled to the GABA{sub A} receptor complex) or water to assess recovery time from the anesthesia. In this case, flumazenil was used to observe the involvement of the GABA-BDZ receptor in the EO mechanism of action. The results showed that diazepam potentiates the anesthetic effect of EO at all concentrations tested. Fish exposed to diazepam and EO showed faster recovery from anesthesia when flumazenil was added to the recovery bath (12.0 ± 0.3 and 7.2 ± 0.7, respectively) than those exposed to water (9.2 ± 0.2 and 3.5 ± 0.3, respectively). In conclusion, the results demonstrated the involvement of the GABAergic system in the anesthetic effect of L. alba EO on silver catfish.

  6. Participation of the GABAergic system in the anesthetic effect of Lippia alba (Mill. N.E. Brown essential oil

    Directory of Open Access Journals (Sweden)

    C.G. Heldwein

    2012-05-01

    Full Text Available The objective of this study was to identify the possible involvement of the GABAergic system in the anesthetic effect of Lippia alba essential oil (EO. We propose a new animal model using silver catfish (Rhamdia quelen exposed to an anesthetic bath to study the mechanism of action of EO. To observe the induction and potentiation of the anesthetic effect of EO, juvenile silver catfish (9.30 ± 1.85 g; 10.15 ± 0.95 cm; N = 6 were exposed to various concentrations of L. alba EO in the presence or absence of diazepam [an agonist of high-affinity binding sites for benzodiazepinic (BDZ sites coupled to the GABA A receptor complex]. In another experiment, fish (N = 6 were initially anesthetized with the EO and then transferred to an anesthetic-free aquarium containing flumazenil (a selective antagonist of binding sites for BDZ coupled to the GABA A receptor complex or water to assess recovery time from the anesthesia. In this case, flumazenil was used to observe the involvement of the GABA-BDZ receptor in the EO mechanism of action. The results showed that diazepam potentiates the anesthetic effect of EO at all concentrations tested. Fish exposed to diazepam and EO showed faster recovery from anesthesia when flumazenil was added to the recovery bath (12.0 ± 0.3 and 7.2 ± 0.7, respectively than those exposed to water (9.2 ± 0.2 and 3.5 ± 0.3, respectively. In conclusion, the results demonstrated the involvement of the GABAergic system in the anesthetic effect of L. alba EO on silver catfish.

  7. Participation of the GABAergic system in the anesthetic effect of Lippia alba (Mill.) N.E. Brown essential oil.

    Science.gov (United States)

    Heldwein, C G; Silva, L L; Reckziegel, P; Barros, F M C; Bürger, M E; Baldisserotto, B; Mallmann, C A; Schmidt, D; Caron, B O; Heinzmann, B M

    2012-05-01

    The objective of this study was to identify the possible involvement of the GABAergic system in the anesthetic effect of Lippia alba essential oil (EO). We propose a new animal model using silver catfish (Rhamdia quelen) exposed to an anesthetic bath to study the mechanism of action of EO. To observe the induction and potentiation of the anesthetic effect of EO, juvenile silver catfish (9.30 ± 1.85 g; 10.15 ± 0.95 cm; N = 6) were exposed to various concentrations of L. alba EO in the presence or absence of diazepam [an agonist of high-affinity binding sites for benzodiazepinic (BDZ) sites coupled to the GABA A receptor complex]. In another experiment, fish (N = 6) were initially anesthetized with the EO and then transferred to an anesthetic-free aquarium containing flumazenil (a selective antagonist of binding sites for BDZ coupled to the GABA A receptor complex) or water to assess recovery time from the anesthesia. In this case, flumazenil was used to observe the involvement of the GABA-BDZ receptor in the EO mechanism of action. The results showed that diazepam potentiates the anesthetic effect of EO at all concentrations tested. Fish exposed to diazepam and EO showed faster recovery from anesthesia when flumazenil was added to the recovery bath (12.0 ± 0.3 and 7.2 ± 0.7, respectively) than those exposed to water (9.2 ± 0.2 and 3.5 ± 0.3, respectively). In conclusion, the results demonstrated the involvement of the GABAergic system in the anesthetic effect of L. alba EO on silver catfish.

  8. Inmunoterapia local Local immunotherapy

    Directory of Open Access Journals (Sweden)

    E. Lasa

    2003-01-01

    Full Text Available La inmunoterapia específica, junto con la evitación del alergeno y el tratamiento sintomático, forma parte del tratamiento de la patología alérgica. La modalidad más antigua, más conocida y mejor estudiada es la inmunoterapia subcutánea (ITSC, cuya eficacia tanto a corto como a largo plazo, ha sido ampliamente demostrada en numerosos estudios. Sin embargo, a pesar de haberse demostrado segura, no está exenta de efectos adversos y precisa ser administrada bajo supervisión de personal médico. Esto ha animado a buscar nuevas vías de administración de eficacia similar, con un buen perfil de seguridad, y de buena cumplimentación por parte del paciente. De las distintas alternativas estudiadas la más relevante es la inmunoterapia sublingual (ITSL. En ésta, se administra el antígeno en forma de gotas debajo de la lengua. Existen diferentes pautas de administración en función del alergeno implicado. La dosis óptima de tratamiento está aún sin determinar, hallándose en este momento en un rango amplio de dosis respecto a la inmunoterapia subcutánea. Su mecanismo de acción es poco conocido aunque en diversos estudios se han observado cambios inmunológicos. La ITSL ha mostrado un buen perfil de seguridad con escasos efectos secundarios, habitualmente de carácter local. Asimismo se han realizado distintos ensayos clínicos en los que se ha demostrado su eficacia en el tratamiento de la alergia respiratoria tanto en niños como en adultos. Por ello, aunque aún existen datos sin resolver respecto a esta vía de administración de inmunoterapia, ha sido propuesta por la OMS como una alternativa válida a la ITSC.Specific immunotherapy, together with avoidance of the allergen and symptomatic treatment, forms part of the treatment of allergic pathology. The oldest, best known and most studied form is subcutaneous immunotherapy (SCIT, whose efficacy, both in the short and the long term, has been widely demonstrated in numerous studies

  9. Documenting localities

    CERN Document Server

    Cox, Richard J

    1996-01-01

    Now in paperback! Documenting Localities is the first effort to summarize the past decade of renewed discussion about archival appraisal theory and methodology and to provide a practical guide for the documentation of localities.This book discusses the continuing importance of the locality in American historical research and archival practice, traditional methods archivists have used to document localities, and case studies in documenting localities. These chapters draw on a wide range of writings from archivists, historians, material culture specialists, historic preservationists

  10. Effects of different general anesthetics on serum hemolysis and hepatic and muscular glycogenolysis in rats

    Directory of Open Access Journals (Sweden)

    E.F.A. Machado

    2009-11-01

    Full Text Available Anesthetics can affect the structure and biological function of tissues and systems differentially. The aim of the present study was to compare three injectable anesthetics generally used in experiments with animals in terms of the degree of hemolysis and glycogenolysis occurring after profound anesthesia. Twenty-four male Wistar rats (330-440 g were divided into three groups (N = 8: chloral hydrate (CH, ketamine + xylazine (KX, Zoletil 50® (zolazepam and tiletamine + xylazine (ZTX. After deep anesthesia, total blood was collected. The liver and white (WG and red gastrocnemius (RG muscles were also immediately removed. The degree of serum hemolysis was quantified on the basis of hemoglobin concentration (g/L. Hepatic and muscular glycogen concentrations (mmol/kg wet tissue were quantified by the phenol-sulfuric method. The CH and KX groups exhibited serum hemolysis (4.0 ± 2.2 and 1.9 ± 0.9 g/L, respectively; P < 0.05 compared to the ZTX group, which presented none. Only KX induced elevated glycogenolysis (mmol/kg wet tissue in the liver (86.9 ± 63.2 and in WG (18.7 ± 9.0 and RG (15.2 ± 7.2; P < 0.05. The CH and ZTX groups exhibited no glycogenolysis in the liver (164.4 ± 41.1 and 176.8 ± 54.4, respectively, WG (28.8 ± 4.4, 32.0 ± 6.5, respectively or RG (29.0 ± 4.9; 25.3 ± 8.6, respectively. Our data indicate that ZTX seems to be an appropriate general anesthetic for studies that seek to simultaneously quantify the concentration of glycogen and serum biochemical markers without interferences. ZTX is reasonably priced, found easily at veterinary markets, quickly induces deep anesthesia, and presents a low mortality rate.

  11. Effects of different general anesthetics on serum hemolysis and hepatic and muscular glycogenolysis in rats.

    Science.gov (United States)

    Machado, E F A; Normand, A C R; Nunes, L A S; Brenzikofer, R; Macedo, D V

    2009-11-01

    Anesthetics can affect the structure and biological function of tissues and systems differentially. The aim of the present study was to compare three injectable anesthetics generally used in experiments with animals in terms of the degree of hemolysis and glycogenolysis occurring after profound anesthesia. Twenty-four male Wistar rats (330-440 g) were divided into three groups (N = 8): chloral hydrate (CH), ketamine + xylazine (KX), Zoletil 50(R) (zolazepam and tiletamine) + xylazine (ZTX). After deep anesthesia, total blood was collected. The liver and white (WG) and red gastrocnemius (RG) muscles were also immediately removed. The degree of serum hemolysis was quantified on the basis of hemoglobin concentration (g/L). Hepatic and muscular glycogen concentrations (mmol/kg wet tissue) were quantified by the phenol-sulfuric method. The CH and KX groups exhibited serum hemolysis (4.0 +/- 2.2 and 1.9 +/- 0.9 g/L, respectively; P glycogenolysis (mmol/kg wet tissue) in the liver (86.9 +/- 63.2) and in WG (18.7 +/- 9.0) and RG (15.2 +/- 7.2; P glycogenolysis in the liver (164.4 +/- 41.1 and 176.8 +/- 54.4, respectively), WG (28.8 +/- 4.4, 32.0 +/- 6.5, respectively) or RG (29.0 +/- 4.9; 25.3 +/- 8.6, respectively). Our data indicate that ZTX seems to be an appropriate general anesthetic for studies that seek to simultaneously quantify the concentration of glycogen and serum biochemical markers without interferences. ZTX is reasonably priced, found easily at veterinary markets, quickly induces deep anesthesia, and presents a low mortality rate.

  12. Clonidine as an adjuvant to local anesthetic in supraclavicular brachial plexus block: a randomized, double blinded placebo controlled study

    Directory of Open Access Journals (Sweden)

    Preeti Rustagi

    2016-10-01

    Conclusions: Clonidine 2 and micro;g / kg added to 10 ml of 0.5 % Bupivacaine + 20 ml of 2% lignocaine with adrenaline (1:200000 is a good option for improving the quality and duration of supraclavicular brachial plexus block. [Int J Basic Clin Pharmacol 2016; 5(5.000: 1892-1897

  13. Effects of helium-neon laser irradiation and local anesthetics on potassium channels in pond snail neurons.

    Science.gov (United States)

    Ignatov, Yu D; Vislobokov, A I; Vlasov, T D; Kolpakova, M E; Mel'nikov, K N; Petrishchev, I N

    2005-10-01

    Intracellular dialysis and membrane voltage clamping were used to show that He-Ne laser irradiation of a pond snail neuron at a dose of 0.7 x 10(-4) J (power density 1.5 x 10(2) W/m2) increases the amplitude of the potential-dependent slow potassium current, while a dose of 0.7 x 10(-3) J decreases this current. Bupivacaine suppresses the potassium current. Combined application of laser irradiation at a dose of 0.7 x 10(-3) J increased the blocking effect of 10 microM bupivacaine on the slow potassium current, while an irradiation dose of 0.7 x 10(-4) J weakened the effect of bupivacaine.

  14. Serum Ropivacaine Concentrations and Systemic Local Anesthetic Toxicity in Trauma Patients Receiving Long-Term Continuous Peripheral Nerve Block Catheters

    Science.gov (United States)

    2010-02-01

    was assayed after ultrafiltration of samples (0.5–1 mL) using Amicon Cen- tricon YM-30 centrifugal filtration devices (Millipore, Billerica, MA...in this complex patient population. Because of extensive traumatic injury, catheters remain in vivo for a prolonged period.12 The mean catheter

  15. Dexmedetomidine as an additive to local anesthetics compared with intravenous dexmedetomidine in peribulbar block for cataract surgery

    Directory of Open Access Journals (Sweden)

    A M Abdelhamid

    2016-01-01

    Full Text Available Background: No studies compared parenteral dexmedetomidine with its use as an adjuvant to ophthalmic block. We compared between adding dexmedetomidine to bupivacaine in peribulbar block and intravenous (IV dexmedetomidine during peribulbar block for cataract surgery. Materials and Methods: A prospective, randomized, double-blind study on 90 patients for cataract surgery under peribulbar anesthesia. Study included three groups; all patients received 10 ml of peribulbar anesthesia and IV infusion of drugs as follows: Group I: Received a mixture of bupivacaine 0.5% (4.5 ml + lidocaine 2% (4.5 ml + normal saline (1 ml + 150 IU hyaluronidase + IV infusion of normal saline, Group II: Received mixture of bupivacaine 0.5% (4.5 ml + lidocaine 2% (4.5 ml + dexmedetomidine 50 μg (1 ml +150 IU hyaluronidase + IV infusion of normal saline and Group III: Received mixture of bupivacaine 0.5% (4.5 ml + lidocaine 2% (4.5 ml + normal saline (1 ml +150 IU hyaluronidase + IV dexmedetomidine 1 μg/kg over 10 min; followed by 0.4 μg/kg/h IV infusion. We recorded onset, duration of block, Ramsay Sedation Score, intra-ocular pressure (IOP, hemodynamics, and adverse effects. Results: There was a significant decrease in the onset of action and increase in the duration of block in Group II as compared with the Group I and Group III. Mean Ramsay Sedation Score was higher in Group III. The IOP showed a significant decrease in Group II and Group III 10 min after injection (P < 0.01. Heart rate showed a significant decrease in Group III in comparison with the two other groups (P < 0.05. Only two patients in Group III developed bradycardia. Conclusion: Dexmedetomidine as an additive shortens onset time, prolong block durations and significantly decreases the IOP with minimal side effects. IV dexmedetomidine, in addition, produces intra-operative sedation with hemodynamic stability.

  16. The effects of local anesthetics on the neuromuscular transmission and on the blockade produced by rocuronium : experimental study

    OpenAIRE

    Vanessa Henriques Carvalho

    2009-01-01

    Resumo: Os anestésicos locais podem interagir com os bloqueadores neuromusculares e modificar as suas propriedades farmacocinéticas e farmacodinâmicas, no entanto o mecanismo dessa interação é controverso. Este estudo experimental, realizado em preparação nervo frênico - diafragma de ratos e musculo biventer cervicis de pintainhos, teve por objetivo avaliar o efeito de diferentes anestésicos locais na transmissão neuromuscular e sua influência no bloqueio produzido pelo rocurônio. Foram avali...

  17. No antiinflammatory effect of short-term topical and subcutaneous administration of local anesthetics on postburn inflammation

    DEFF Research Database (Denmark)

    Møiniche, S; Dahl, J B; Brennum, J;

    1993-01-01

    , development of blister and ulcerations, or the intensity of inflammation after burn injury between the control legs and EMLA- or bupivacaine-treated legs, respectively. CONCLUSION. No antiinflammatory effect of short-term preinjury and postinjury topical 5% EMLA or subcutaneous 0.5% bupivacaine could...

  18. Transdermal delivery of hydrophobic and hydrophilic local anesthetics from o/w and w/o Brij 97-based microemulsions

    DEFF Research Database (Denmark)

    Junyaprasert, Varaporn Buraphacheep; Boonme, Prapaporn; Songkro, Sarunyoo;

    2007-01-01

    To characterize the physicochemical properties of drug-loaded oil-in-water (o/w) and water-in-oil (w/o) Brij 97-based microemulsions in comparison to their blank counterparts and to investigate the influence of microemulsion type on in vitro skin permeation of model hydrophobic drugs and their hy......To characterize the physicochemical properties of drug-loaded oil-in-water (o/w) and water-in-oil (w/o) Brij 97-based microemulsions in comparison to their blank counterparts and to investigate the influence of microemulsion type on in vitro skin permeation of model hydrophobic drugs...

  19. [Iontophoresis - local anesthesia at the ear canal and tympanic membrane (author's transl)].

    Science.gov (United States)

    Tolsdorff, P

    1980-02-01

    Operations to the external ear canal and tympanic membrane necessitate sufficient local anesthesia. General sedation followed by infiltration anestesia, is rather time-consumming, can be painful due to the injection, and is not particularly satisfactory for the treatment of outpatients. The iontophorese-technique, however, of local anesthesia, is applicable particularly for the treatment of outpatients. Principally, the local anesthetic is transported in ionisised form to the nerve membrane, by means of calvanic currents through the healthy surface epithelial tissue of the external ear canal or the eardrum. The technique described for the first time in 1911 no longer shows toxic sides-effects since the introduction of improved electrodes and more modern local anesthetic. The anatomic, pharmacological, chemical and physical basics of the technique will be described. The lecture will be based on personal experience of the method, taken from large groups of patients over a period of more than two years, using equipment specially designed for this purpose.

  20. Anesthetic Management of Urgent Cesarean Section with Undiagnosed Transposition of Great Arteries.

    Science.gov (United States)

    Yilmaz, Nurullah; Koksal, Ersin; Ozgen, Gokce Ultan; Ozen, Ersan; Dilek, Ahmet; Karakaya, Deniz; Ulger, Fatma

    2016-06-01

    We consider that general anesthesia will be an appropriate and safe method as regional methods could lead to significant time loss in the prevention or minimization of complications. High blockage required for regional anesthetic methods in pregnant women with TGA and the maintenance of hemodynamic stability may become difficult due to neuroaxial sympathectomy even if a successful neuroaxial block has been provided. Agents with minimal effect on cardiovascular functions should be preferred for anesthesia induction and maintenance and close hemodynamic monitoring should be done during intraoperative and postoperative periods.