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Sample records for comparada con propofol

  1. Anestesia para colonoscopia: anestesia inhalatoria con sevoflurano frente a anestesia intravenosa con propofol Colonoscopic anesthesia: Inhalatory anesthesia with sevoflurane versus intravenous anesthesia with propofol

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    S. De la Torre Carazo

    2012-03-01

    Full Text Available Introducción: Las exploraciones endoscópicas como la colonoscopia son actualmente cada vez más frecuentes, tanto por prescripción clínica, como para despistaje del cáncer de colon, siendo precisa Anestesia/sedación prácticamente en todos los casos. La técnica más frecuentemente usada es la intravenosa con propofol, en algunos casos no puede realizarse, y se plantea una alternativa inhalatoria. Objetivo: comparación de las características de una técnica habitual con propofol (A y de una inhalatoria con Sevoflurano (B. Sujetos y Método: Se estudian las características de ambas técnicas en dos grupos de 150 pacientes cada uno, valorándose las ventajas de cada una, complicaciones, tolerancia, tiempo de recuperación, aceptación por el endoscopista y el paciente de ambas técnicas. Resultados: en ambas técnicas las complicaciones son muy escasas, el grado de tolerancia es buena/muy buena en el 99% del grupo (A, frente a un 97% del grupo (B. Discusión: Aunque no hemos encontrado publicaciones comparando ambas técnicas en anestesia para colonoscopia, el uso de Sevoflurano ha demostrado características similarmente favorables en pacientes contraindicados para el uso de propofol, siempre que cambiemos el esquema de anestésia intravenosa por inhalatoria. Conclusión: Ambas técnicas son igualmente útiles y seguras, pudiendo emplearse la técnica inhalatoria con Sevoflurano en los pacientes en los que el propofol resulte inadecuado, con iguales prestaciones y versatilidad.Introduction: The exploratory endoscopy and colonoscopy are now increasingly common, both clinical prescription, and for colon cancer screening, needing Anesthesia / sedation in virtually all cases. The most commonly used is intravenous propofol, which in some cases cannot be performed, and an alternative is inhaled. Objective: To compare the characteristics of a standard technique with propofol (A and an inhalation with sevoflurane (B. Subjects and Methods: We

  2. PSICOFÍSICA COMPARADA: EFECTOS DE LA PÉRDIDA DE INCENTIVOS EN RATAS NORMALES E INYECTADAS CON ETANOL

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    SANTIAGO PELLEGRINI

    2009-01-01

    Full Text Available Un problema de la Psicofísica particularmente relevante para el estudio de procesos de condicionamiento es el de la re lación entre las propiedades de refuerzo y físicas de los es tímulos. Papi ni y Pellegrini (2006 observaron que el nivel de res puestas de consumo en ratas expuestas a una disminución sor presiva en la con centración de soluciones azucaradas resulta si milar, si la razón de cambio de las soluciones (concentración post-cambio / pre-cambio es la misma. Por ejemplo, una dismi nución de 32 a 4% y una de 16 a 2% produjeron niveles de consumo similares. Estos resultados son acordes a la Ley de Weber y podrían implicar el desarrollo de procesos emocionales; algo que se ha establecido mediante el estudio de drogas ansiolíticas. En situaciones experimentales análogas en las que se estudió el efecto de contraste negativo de incentivo (con una dis minución de 32 a 4% se demostró que la administración de etanol en el segundo ensayo post-cambio produce una recuperación más rápida de las respuestas deprimidas debido a una disminución del refuerzo (Becker & Flaherty, 1982, en com paración con controles que recibieron salina. En el presente trabajo se informa un experimento que involucró ocho grupos de ratas y que buscó replicar ambos fenómenos así como estudiar sus posibles interacciones. Se hallaron resultados compatibles con los datos previos, pero no se pudo concluir si el etanol afecta de manera determinante los niveles de respuesta proporcionales observados durante disminuciones de incentivo. Los resultados se discuten en términos de su implicancia para el estudio de la Psicofísica Comparada.

  3. Comparación de los efectos cardiovasculares del propofol, tiopental y de la mezcla propofol-tiopental en un grupo de caninos sanos premedicados con hidromorfona

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    Camilo Padilla Peñuela

    2013-12-01

    Full Text Available El objetivo de la investigación fue determinar las diferencias en el desempeño cardiovascular de caninos sanos premedicados con hidromorfona e inducidos y mantenidos con tres diferentes protocolos anestésicos. Se evaluaron quince caninos sanos entre uno y seis años de edad, los cuales no presentaban afecciones cardiacas o que generaran dolor, y con un riesgo anestésico clasificado como ASA I. Los pacientes se distribuyeron en tres grupos y cada uno fue inducido y mantenido en un plano anestésico (estadio III, plano 2 con un protocolo según el grupo al que se habían incorporado (tiopental, propofol o la mezcla propofol-tiopental. En cada paciente se realizó ecocardiografía (fracción de acortamiento y fracción de eyección y se midió el lactato plasmático y la presión arterial por el método oscilométrico. Las mediciones se realizaron en tres periodos de tiempo diferentes (T1, antes de premedicar; T2, después de premedicar y T3, después de la inducción. Se observó una diferencia muy significativa en la frecuencia cardiaca de los pacientes anestesiados con propofol (p = 0,0004 con tendencia a la bradicardia, y la presión arterial se mostró disminuida en este grupo; sin embargo, la diferencia no logró ser significativa (p = 0,08. En cuanto a los demás parámetros (fracción de eyección, fracción de acortamiento y lactato tampoco se observaron diferencias.

  4. Safety of continuous propofol sedation for endoscopic procedures in elderly patients Seguridad de la sedación con perfusión continua de propofol en procedimientos endoscópicos en ancianos

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    J. F. Martínez

    2011-02-01

    Full Text Available Objective: to evaluate safety of continuous propofol sedation in elderly patients who undergo endoscopic procedures and investigate risk factors to develop complications in the geriatric population. Material and methods: patients who received endoscopist-directed propofol sedation were classified into two groups according to age. Group I: > 80 years; Group II: Objetivo: evaluar la seguridad de la sedación con perfusión continua de propofol en ancianos a los que se les realizan procedimientos endoscópicos e investigar los factores de riesgo para el desarrollo de complicaciones en la población anciana. Diseño experimental: estudio observacional prospectivo de cohortes. Pacientes: pacientes sedados mediante perfusión continua administrada por el propio endoscopista divididos en dos grupos: Grupo I: ≥ 80 años; Grupo II: < 80 años. El propofol fue administrado mediante perfusión continua para conseguir sedación profunda. Durante la exploración se monitorizó: saturación arterial de oxígeno, presión arterial y registro electrocardiográfico. Se registró además si se realizó terapéutica endoscópica y las complicaciones relacionadas con la sedación que se produjeron. Resultados: se incluyeron 1.295 procedimientos endoscópicos (gastroscopias, colonoscopias y ecoendoscopias. La dosis de propofol fue inferior y la endoscopia fue terapéutica con mayor frecuencia en el Grupo I. No hubo diferencias en la aparición de complicaciones relativas a la sedación entre ambos grupos. (Grupo I: 15,4%, Grupo II: 14%; p:n.s.. Los pacientes del Grupo I tuvieron una mayor tendencia a desarrollar desaturación grave durante la colonoscopia y ecoendoscopia. En el análisis univariante, en los pacientes ancianos, el incremento en la dosis de propofol se asoció con la aparición de complicaciones (157,4 ± 84,4 vs 121,3 ± 89,6 mg pero no con la desaturación grave. Conclusiones: la sedación con perfusión continua de propofol en procedimientos

  5. Sedation with propofol controlled by endoscopists during percutaneous endoscopic gastrostomy Sedación con propofol controlada por endoscopista durante la realización de gastrostomía percutánea

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    C. García-Suárez

    2010-04-01

    Full Text Available Background: propofol is a hypnotic used with increasing frequency for sedation during endoscopic procedures. Most of the reports published related with its employment by non-anaesthesiologists, refers to basic endoscopy, with little reference to its use in advanced endoscopy. Objective: to evaluate the efficacy and safety of propofol sedation administered by endoscopists, while performing percutaneous endoscopic gastrostomy, an advanced technique that is usually performed in high anesthetic level risk patients. Material and methods: prospective study of a series of endoscopic gastrostomy performed consecutively in our department; the sedation was carried out exclusively with propofol. The staff in the room consisted of two medical gastroenterologists, a nurse and a nursing assistant. Propofol was administered by bolus doses adjusted to patient weight. Arterial oxygen saturation, heart rate and blood pressure were monitored; respiratory activity was monitored visually by observing respiratory excursions of the patient. Results: we included 47 patients, with an average age of 82 years. 87% were ASA III and the rest, ASA IV. The mean dose of propofol was 51 mgr. Complications were recorded: 8 cases of desaturation and two of hypotension, all of them minor and quickly reversible. All procedures were carried out successfully, at a median time of 8 minutes. Conclusion: the propofol sedation carried out by non-anaesthesiologist trained staff, seems to appear as a safe and effective procedure while performing percutaneous endoscopic gastrostomy.Introducción: el propofol es un hipnótico usado cada vez con más frecuencia para la sedación durante procedimientos endoscópicos. La mayor parte de los trabajos publicados en relación con su empleo por personal no anestesista se refiere a exploraciones de endoscopia básica, siendo escasas las referencias a su empleo en endoscopia avanzada. Objetivo: valorar la eficacia y la seguridad de la sedaci

  6. PSICOFÍSICA COMPARADA: EFECTOS DE LA PÉRDIDA DE INCENTIVOS EN RATAS NORMALES E INYECTADAS CON ETANOL

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    SANTIAGO PELLEGRINI; LUCAS CUENYA; ALBA ELISABETH MUSTACA; GISELLE VANESA KAMENETZKY

    2009-01-01

    Un problema de la Psicofísica particularmente relevante para el estudio de procesos de condicionamiento es el de la re lación entre las propiedades de refuerzo y físicas de los es tímulos. Papi ni y Pellegrini (2006) observaron que el nivel de res puestas de consumo en ratas expuestas a una disminución sor presiva en la con centración de soluciones azucaradas resulta si milar, si la razón de cambio de las soluciones (concentración post-cambio / pre-cambio) es la misma. Por ejemplo, una dismi ...

  7. La historia comparada

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    Charles S. MAIER

    2010-02-01

    Full Text Available RESUMEN:El presente estudio aborda en sus líneas generales las principales propuestas metodológicas y teóricas de la historiografía comparada, así como el marco normativo que, en sus variadas fórmulas o tendencias, caracteriza el trabajo de los últimos años en este campo de la historia. Desde las aportaciones iniciales de la sociología comparada, pasando por el método histórico comparativo en Tocqueville, Marx y Weber o el debate historiográfico de comienzos de siglo en Francia y Alemania -con especial mención a Marc Bloch y Otto Hintz-, hasta lo que el autor denomina los programas weberiano, tocquevilliano y antropológico, el artículo hace un breve pero denso recorrido por los principales canales por los que ha discurrido la historiografía comparada. A las dificultades metodológicas que han ido surgiendo se sobreponen, según se señala aquí, las ventajas y aún la necesidad que su cultivo supone para el conjunto de la disciplina histórica. ABSTRACT: This study deals with the general lines of the major methodological and theoretical proposals of comparative historiography, as well as with the normative framework which, in its diverse formulae or tendencies, has characterized the work carried out in this field of history during recent years. Starting with the initial contributions of comparative sociology, passing through the comparative history method in Tocqueville, Marx and Weber and the historiographie debate at the beginning of this century in France and Germany -with special mention of Marc Bloch and Otto Hintz- to arrive at what the author calls Weberian, Marxian, Tocquevillian and anthropological programs, the article carries out a brief but dense review of the main channels along which comparative history has passed. The advantages, and indeed the need that history as a whole has for their cultivation, have overcome the methodological difficulties which arisen, as is shown herein.

  8. Efeitos do tratamento prévio com lidocaína, paracetamol e lidocaína-fentanil por via venosa na dor causada pela injeção de propofol: estudo comparativo Efectos del tratamiento previo con lidocaína, paracetamol y lidocaína-fentanil intravenosos en el dolor causado por la inyección de propofol: estudio comparativo Effect of pretreatment with lidocaine, intravenous paracetamol and lidocaine-fentanyl on propofol injection pain: comparative study

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    Khaled M. El-Radaideh

    2007-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Foi realizado estudo duplamente encoberto, aleatório, para avaliar a eficácia do tratamento prévio, por via venosa, com lidocaína, paracetamol (Perfalgan® ou lidocaína associada ao fentanil na redução da dor causada pela injeção de propofol. MÉTODOS: Imediatamente após a oclusão venosa com torniquete de borracha foi feita a administração venosa de 4 mL de lidocaína a 1% (Grupo L, n = 50, 4 mL de paracetamol (Perfalgan® (40 mg (Grupo R, n = 50, lidocaína a 2% associada a 100 µg de fentanil (Grupo LF, n = 50 ou 4 mL de solução fisiológica a 0,9% (Grupo P, n = 50; grupo-controle com placebo a 200 adultos. A liberação da obstrução venosa foi feita após 60 segundos, sendo seguida da administração venosa de propofol, 2,5 mg.kg-1 a uma velocidade de 0,5 mg.s-1 através de cateter 20G inserido na veia do dorso da mão. A avaliação da dor foi feita durante a injeção de propofol. Ela incluiu movimentos da mão, expressão verbal espontânea de dor, caretas e gemidos durante a injeção de propofol. RESULTADOS: Lidocaína-fentanil (70% sem dor e lidocaína (68% sem dor foram mais eficazes na redução da dor causada pela injeção de propofol do que o paracetamol (54% sem dor e o placebo (36% sem dor (p JUSTIFICATIVA Y OBJETIVOS: Se realizó estudio doblemente encubierto, aleatorio, para evaluar la eficacia del tratamiento previo, intravenoso (IV, con lidocaína, paracetamol (Perfalgan® o lidocaína asociada con fentanil en la reducción del dolor causado por la inyección de propofol. MÉTODOS: Inmediatamente después de la oclusión venosa con un torniquete de goma, se hizo la administración intravenosa de 4 mL de lidocaína a 1% (Grupo L, n = 50, 4 mL de paracetamol (Perfalgan® (40 mg (Grupo R, n = 50, lidocaína a 2% asociada con 100 µg de fentanil (Grupo LF, n = 50 o 4 mL de solución fisiológica (Grupo P, n = 50; grupo control con placebo a 200 adultos. La liberación de la obstrucci

  9. Safety of continuous propofol sedation for endoscopic procedures in elderly patients Seguridad de la sedación con perfusión continua de propofol en procedimientos endoscópicos en ancianos

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    Martínez, J.F.; J. R. Aparicio; L. Compañy; Ruiz, F.; L. Gómez-Escolar; I. Mozas; J. A. Casellas

    2011-01-01

    Objective: to evaluate safety of continuous propofol sedation in elderly patients who undergo endoscopic procedures and investigate risk factors to develop complications in the geriatric population. Material and methods: patients who received endoscopist-directed propofol sedation were classified into two groups according to age. Group I: > 80 years; Group II: < 80 years. Propofol was administered by continuous intravenous infusion to achieve deep sedation. Arterial oxygen saturation, heart r...

  10. Propofol anesthesia.

    Science.gov (United States)

    Short, C E; Bufalari, A

    1999-05-01

    Although questions may still remain regarding the use of this unique sedative-hypnotic drug with anesthetic properties in high-risk patients, our studies have provided cardiopulmonary and neurological evidence of the efficacy and safety of propofol when used as an anesthetic under normal and selected impaired conditions in the dog. 1. Propofol can be safely and effectively used for the induction and maintenance of anesthesia in normal healthy dogs. Propofol is also a reliable and safe anesthetic agent when used during induced cardiovascular and pulmonary-impaired conditions without surgery. The propofol requirements to induce the safe and prompt induction of anesthesia prior to inhalant anesthesia with and without surgery have been determined. 2. The favorable recovery profile associated with propofol offers advantages over traditional anesthetics in clinical situations in which rapid recovery is important. Also, propofol compatibility with a large variety of preanesthetics may increase its use as a safe and reliable i.v. anesthetic for the induction and maintenance of general anesthesia and sedation in small animal veterinary practice. Although propofol has proven to be a valuable adjuvant during short ambulatory procedures, its use for the maintenance of general anesthesia has been questioned for surgery lasting more than 1 hour because of increased cost and marginal differences in recovery times compared with those of standard inhalant or balanced anesthetic techniques. When propofol is used for the maintenance of anesthesia in combination with a sedative/analgesic, the quality of anesthesia is improved as well as the ease with which the practitioner can titrate propofol; therefore, practitioners are able to use i.v. anesthetic techniques more effectively in their clinical practices. 3. Propofol can induce significant depression of respiratory function, characterized by a reduction in the rate of respiration. Potent alpha 2 sedative/analgesics (e.g., xylazine

  11. Variabilidad Genética de Líneas Endogámicas de Maíz Comparadas con Progenitores Criollos mediante Microsatélites

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    Jorge Alberto Gutiérrez-Valenzuela

    2016-01-01

    Full Text Available El conocimiento de la diversidad genética en líneas puras de maíz ( Zea mays L., un cereal básico y el más importante en l a dieta de los mexicanos es indispensable en un programa de mejoramiento genético. En la actualidad existe un déficit productivo el cual puede ser reducido con la obtención de mejores genotipos de maíz. Por lo tanto, el objetivo de esta investigación fue seleccionar una colección de marcadores moleculares tipo microsatélites repetidos de secuencia corta (SSRs relacionados con características deseables de líneas endogámicas de maíz generadas a partir de una colección inicial de maíces criollos, y analizar la diversidad genética de la población original y de las líneas endogámicas. De una población inicial de 600 genotipos de maíz derivados en el Instituto Tecnológico de Roque con buenas características agronómicas, se eligieron 80 líneas endogámicas S1, las que se evaluaron durante el ciclo agrícola 2010 para seleccionar genotipos que superaran en rendimiento a los progenitores. Solo siete líneas endogámicas S2 derivadas de este ensayo fueron evaluados en esta investigación, para continuar con el proceso de endogamia. La variabilidad genética detectada muestra la presencia de polimorfismos y una amplia distribución de genotipos en la poblaci ó n, lo que indica la posibilidad de continuar con el proceso de identificación de líneas superiores mediante selección para la explotación de heterosis.

  12. Satisfacci??n laboral, satisfacci??n vital y autoestima en una muestra comparada de sujetos con estudios superiores y no superiores

    OpenAIRE

    2014-01-01

    En la siguiente investigaci??n nos centramos en investigar c??mo la satisfacci??n laboral, satisfacci??n vital y autoestima se ven afectadas por el nivel de estudios de una muestra de trabajadores espa??oles. Siguiendo numerosos estudios como los de Pichler y Wallace (2009), creemos que el nivel educativo superior correlacionar?? con las tres variables evaluadas. Nuestros datos confirman la hip??tesis de que un nivel de estudios superior llevar??a a las personas a un nivel de bienestar m??s e...

  13. Simulación de una Torre de Enfriamiento Mecánica Comparada con Curvas Experimentales Simulation of a Mechanical Cooling Tower Compared with Experimental Curves

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    Jader D Alean

    2009-01-01

    Full Text Available El objetivo del trabajo es modelar y simular una torre de enfriamiento mecánica forzada a escala piloto. Las variables físicas se correlacionaron a partir de la transferencia de calor y materia y los resultados de la simulación son analizados mediante graficas que muestran la variación de la humedad, flujo de agua, calor latente, calor sensible, calor total, temperatura del agua y del aire. El coeficiente de transferencia de materia se obtuvo a partir de los datos experimentales y la solución numérica del modelo se obtuvo con el método Runge-Kutta en Matlab. La verificación de los resultados fue realizada, comparando las curvas simuladas con las curvas experimentales. Se concluye que la cercanía entre las curvas depende del coeficiente de transferencia de materia.The objective of this work was the modeling and simulation of a pilot-scale mechanical enforced cooling tower. The physical variables were correlated from the heat and mass transfer and the simulation results were analyzed using graphs showing the change in humidity, water flow, latent heat, heat sensitive, total heat, water temperature and air. The mass transfer coefficient was obtained from experimental data and the numerical solution of the model was obtained using Runge-Kutta method in Matlab. Comparison between stimulation results and experimental data was done. It is concluded that the shape of the curves and the deviations of the simulated results depend on the mass transfer coefficient.

  14. Anatomía foliar comparada y sistemática del clado-Trichocentrum con énfasis en Cohniella Asparagales: Orchidaceae

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    William Cetzal-Ix

    2013-12-01

    Full Text Available El clado-Trichocentrum incluye los géneros Cohniella, Lophiarella, Lophiaris y Trichocentrum s.s. Estos géneros se distribuyen desde Florida y el Norte de México hasta el Sur de Brasil y Norte de Argentina, creciendo desde bosques caducifolios, bosques húmedos tropicales hasta matorrales espinosos y bosques de pino-encino, desde el nivel del mar hasta los 1 700m. En este estudio se exploró el valor taxonómico y filogenético de la estructura anatómica de las hojas de 23 especies del clado-Trichocentrum, repartidos en 11 especies de Cohniella, tres de Lophiarella, siete de Lophiaris y dos de Trichocentrum s.s., y de otras cuatro especies incluidas como grupo externo. Se realizaron secciones transversales y observaciones paradérmicas de la porción media de hojas frescas para el estudio de los caracteres anatómicos. Doce caracteres anatómico foliares fueron seleccionados y codificados para el análisis filogenético que se realizó mediante el uso de una búsqueda exhaustiva enumeración implícita con el programa TNT. El consenso estricto de 2 692 árboles más parsimoniosos dio lugar a una politomía que recupera dentro del clado-Trichocentrum a Cohniella como un clado monofilético fuertemente apoyado con sinapomorfías de las hojas unifaciales y la presencia de inclusiones celulares en la epidermis.

  15. Estudio de los efectos térmicos de la sedación postoperatoria tras cirugía cardíaca con circulación extracorpórea: Estudio comparativo entre la sedación intravenosa con propofol versus inhalatoria con sevofluorano

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    Arce Ramos, Nuria

    2013-01-01

    Comparamos los efectos térmicos dos tipos de sedación: intravenosa con propofol versus inhalatoria con sevoflurano durante postoperatorio hasta la extubación en pacientes de cirugía cardiaca electiva con circulación extracorpórea. Estudio prospectivo, de cohortes, controlado y aleatorizado, para 100 pacientes adultos. Termometría central-nasofaríngea y cutánea-digital infrarroja fueron múltiples, horarias. Análisis estadístico de los registros (termometría, tiempos sedación-despertar-extubaci...

  16. Protocolo del ensayo clínico: “dopamina comparada con fenilefrina para prevención y manejo de la hipotensión arterial asociada a anestesia subaracnoidea para cesárea segmentaria categoría nice 3-4: un ensayo clínico aleatorizado, ciego, de no inferioridad

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    González Maldonado, Julián Felipe

    2014-01-01

    Antecedentes: La anestesia subaracnoidea en cesárea se asocia hasta en un 90% a hipotensión arterial, la cual puede generar morbilidad materna y fetal. Entre las opciones de prevención y manejo están los vasopresores fenilefrina y efedrina. En Colombia se tiene mayor disponibilidad de otros vasopresores como la dopamina, sin embargo la evidencia sobre su efectividad y seguridad no es definitiva. Objetivo: Establecer la no inferioridad de dopamina, comparada con fenilefrina, par...

  17. Anatomía foliar comparada y relaciones filogenéticas de 11 especies de Laeliinae con énfasis en Brassavola (Orchidaceae

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    Eliana Noguera-Savelli

    2011-09-01

    Full Text Available Brassavola crece en un amplio rango altitudinal y de tipos de hábitat desde el Norte de México hasta el Norte de Argentina. En los sistemas de clasificación de las plantas se utilizan normalmente caracteres vegetativos y florales, pero cuando las especies son muy similares, como es el caso de este género, los conflictos surgen en la delimitación de las especies, por lo tanto deben ser aplicados métodos alternativos de identificación. En este trabajo se exploró el valor taxonómico y filogenético de la estructura anatómica de las hojas de Brassavola, se consideró como grupo interno a siete especies de este género y como grupo externo a Guarianthe skinneri, Laelia anceps, Rhyncholaelia digbyana y Rhyncholaelia glauca. Entonces se realizaron secciones transversales de hojas frescas para el estudio de los caracteres anatómicos. Diez caracteres anatómicosvegetativos fueron seleccionados y codificados para el análisis filogenético. La reconstrucción filogenética se llevó a cabo bajo el principio de máxima parsimonia utilizando el programa NONA a través de WinClada. Todas las especies son anatómicamente similares, no obstante, difieren en algunos rasgos como presencia o no: de papilas epidérmicas, de hipodermis, de células con engrosamientos espiralados en la pared secundaria de las células del mesofilo, de inclusiones cristalinas; además en el tipo de hoja de acuerdo al arreglo del mesofilo; en la organización de los haces vasculares y de los paquetes de fibras extravasculares. En el árbol de consenso estricto se obtuvo una politomía. Asimismo, fue evidente que los caracteres anatómicos analizados son filogenéticamente poco informativos; sin embargo, en conjunción con caracteres morfológicos y/o moleculares, podrían dilucidar las relaciones filogenéticas.Comparative leaf anatomy and phylogenetic relationships of 11 species of Laeliinae with emphasis on Brassavola (Orchidaceae. Brassavola inhabits a wide altitude

  18. Comparison between insufflation with air or carbon dioxide during the colonoscopy in sedated patients with propofol Comparación entre la insuflación con aire ambiente o con dióxido de carbono durante la colonoscopia en pacientes sedados con propofol

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    Pilar Díez-Redondo

    2012-08-01

    Full Text Available Objectives: compare the intensity of pain experienced after colonoscopy with air or with CO2 and evaluate the safety of CO2 in colonoscopies performed with moderate/deep sedation. Materials and methods: individuals undergoing ambulatory colonoscopy without exclusion criteria (severe respiratory disease, morbid obesity were randomized in air or CO2 group. We recorded different variables prior to, during and upon completion of the colonoscopy, performing monitoring using pulse oximetry and capnography. Each patient rated, using a visual numeric scale, the intensity of post-colonoscopy pain at different moments. Results: 141 individuals in the air group (sex M/F 63/78, age 24-83 and 129 in the CO2 group (sex M/F 59/70, age 24-82. No significant differences existed in the recorded variables in both groups except for the greater number of explorations performed by an endoscopist in training (TE in the air group compared to those by a more experienced endoscopist (SE. CO2 in expired air, episodes of oxygen desaturation and of apnoea and dose of propofol, of midazolam were similar in both groups. No episodes of hypercapnea or any complication requiring cardiopulmonary resuscitation measures were recorded. The pain in the air group was significantly higher at 15 minutes and at 1, 3 and 6 hours after the endoscopy, equalising at 24 hours. After multivariant adjustment for type of doctor (TE vs. SE the differences observed in pain intensity for each group were maintained. Conclusions: a the use of CO2 in colonoscopy causes significantly less pain in the first 6 hours after the procedure; b its use in patients with moderate/deep sedation is safe; and c performance of the endoscopic technique is not modified, nor are times reduced.Objetivos: comparar la intensidad del dolor experimentado tras una colonoscopia con aire ambiente o con dióxido de carbono (CO2 y evaluar la seguridad del CO2 en pacientes con sedación moderada o profunda. Materiales y m

  19. Elaboración integral de las aceitunas con autogeneración de electricidad, comparada con el sistema actual de obtención del aceite de oliva virgen

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    Cruz Peragón, F.

    2004-09-01

    Full Text Available A future solution for treatment of the olive and obtaining olive virgin oil is presented. The energy demands for which are supplied by a generation system, that also feeds other phases of manufacture of by-products, such as "orujos" drying or extraction of the residual oil contained in them. For this purpose gasifier equipment is needed, whose major fuel is plain olive stone, although "orujos" with 20% humidity could also be used. This system produces a gas which is introduced in a combustion engine connected to a generator, harnessing the electricity created to supply the plant itself. The thermal energy surplus serves to generate and sell electrical energy to distribution grid.Se pretende plantear una solución de futuro para el proceso de elaboración de las aceitunas y obtención del aceite de oliva virgen, donde se generaría la energía eléctrica consumida en la propia planta, así como en las demás fases de elaboración completa de los subproductos, como el secado de los orujos y la extracción del aceite residual contenido en los mismos.Para esto se dimensiona un equipo gasificador del hueso, separado en el proceso de obtención indicado, con el que se abastece de energía térmica a un motor de gas que acciona un generador eléctrico, que abastece todas las necesidades de la planta integral, más el excedente de energía térmica del hueso y del orujillo resultante, generando una energía con posibilidad de venta a la red de distribución eléctrica de la zona.

  20. Anestesia venosa total com infusão alvo-controlada de remifentanil e propofol para ablação de fibrilação atrial Anestesia venosa total con infusión objeto-controlada de remifentanil y propofol para ablación de la fibrilación atrial Total intravenous anesthesia with target-controlled infusion of remifetanil and propofol for ablation of atrial fibrillation

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    Fernando Squeff Nora

    2009-12-01

    nuestro medio, aunque sea común en otros centros. No han sido descritos la elección de la anestesia, los monitores y los cuidados anestesiológicos para ese procedimiento realizado fuera del bloque quirúrgico. El objetivo de este relato fue describir una técnica de anestesia para la realización de la ablación de FA. RELATO DEL CASO: Paciente femenina, 49 años, 73 kg, 155 cm, ASA II por hipertensión arterial sistémica. El monitoreo tuvo un electrocardiograma con 12 derivaciones, oximetría de pulso, frecuencia cardiaca, electroencefalografía bispectral para medidas de BIS, tasa de supresión (SR y SEF95, y presión arterial promedio (PAM. La inducción anestésica fue realizada con propofol por vía venosa, en infusión objeto-controlada (IAC, con objeto regulado en 4 µg.mL-1, remifentanil por vía venosa, en IAC, con objeto de 3 ng.mL-1, y rocuronio por vía venosa en bolo con dosis de 0,2 mg.kg-1. El modelo farmacocinético de propofol utilizado fue el descrito por Marsh y fue incorporado a la bomba de propofol PFS®. El modelo farmacocinético de remifentanil utilizado fue el descrito por Minto y fue incorporado a la bomba de infusión Alaris PK®. Las concentraciones en el local efector o biofase, correspondieron a informaciones obtenidas a través de las bombas de infusión, y representaron medidas de predicción de las concentraciones de los dos fármacos en los respectivos locales de acción. Las concentraciones de propofol y de remifentanil se regularon a tono con el BIS y la PAM, respectivamente. CONCLUSIONES: La anestesia venosa total para la ablación de FA, puede ser una opción segura si tenemos en cuenta que no hay alteración de la electrofisiología de las vías accesorias. La literatura es escasa en ese sentido, y nuevas publicaciones podrán o no justificar esa modalidad de anestesia durante la ablación de FA.BACKGROUND AND OBJECTIVES: Although ablation of atrial fibrillation (AF is common in other centers, among us it is a new procedure. The

  1. La educación comparada en una sociedad global

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    José Luis García Garrido

    1997-01-01

    Full Text Available Intenta el autor ofrecer un cuadro de referencia de 10 que va a suponer, para la educacion comparada en cuanto disciplina cientifica y academica, el advenimiento del siglo XXI y, con él,el de una sociedad humana globalizada. Se refiere en concreto a los nuevos desafios presentes ya hoy, particularmente los derivados de la globalizacion económica, cultural y social, asi como a los nuevos recursos con que puede y podra contarse, sobre todo los relativos a la tecnologia de la comunicación. Exarnina, a modo de ejemplo, dos enfoques metodológicos defendidos recientemente como especialmente adecuados a las necesidades del momento, estableciendo sus pros y contras. Y finaliza con una llamada de atención hacia la necesidad de que la educacion comparada, en la sociedad giobalizada del siglo XXI, profundice sus planteamientos epistemológicos por la via de una mayor ret1exion histórica, cultural y filosofica de los sistemas educacionales

  2. Eficacia y seguridad de Nitazoxanida comparada con Albendazol en el tratamiento de Giardiasis sintomática en niños de Trujillo, Perú 2008 – 2009

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    Aldo Paz Marchena

    2013-06-01

    Full Text Available Giardiasis constituye un problema de salud pública de mayor prevalencia en países en vías de desarrollo, asociada a la pobreza y un deficiente sistema sanitario con una elevada afección en niños.El objetivo es comparar la eficacia y seguridad de Nitazoxanida y Albendazol en el tratamiento de giardiasis sintomática en niños. La población de estudio estuvo constituida por niños de ambos sexos que acudieron al consultorio de Medicina General del Centro Médico Funegra de Trujillo cuya edad estuvo comprendida entre los 3 a 14 años, con diagnóstico confirmado de giardiasis, divididos en dos grupos: aquellos que recibieron tratamiento A (Albendazol y aquellos con tratamiento B (Nitazoxanida que cumplieron con los criterios de inclusión y exclusión establecidos. El promedio de edad para el grupo A fue de 6,73 ± 3,01 y en el grupo B, 7,04 ± 3,05. Las manifestaciones clínicas al inicio del esquema terapéutico estuvieron lideradas por dolor abdominal. Hubo mayor porcentaje de resolución clínica y coproparasitológico para el grupo Nitazoxanida, no hubo diferencia estadística significativa en este aspecto con el grupo de Albendazol. Nitazoxanida mostró mayor porcentaje de efectos adversos que Albendazol.Se concluyo que Albendazol y Nitazoxanida demostraron ser eficaces y seguros en el tratamiento de giardiasis sintomática en niños. La eficacia de Albendazol fue de 93,8 % y la de Nitazoxanida fue de 96,9 %. Los principales efectos adversos fueron: dolor abdominal, hiporexia y diarrea, siendo más frecuente dolor abdominal en el grupo Nitazoxanida.

  3. Qualidade das anotações de enfermagem relacionadas à ressuscitação cardiopulmonar comparadas ao modelo Utstein Calidad de las anotaciones de enfermería relacionadas a la resucitación cardiopulmonar comparadas con el modelo Utstein Quality of nursing records related to cardiopulmonary resuscitation compared to the Utstein model

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    Ana Paula Fernandes

    2010-01-01

    Full Text Available OBJETIVO: Analisar a qualidade das anotações de enfermagem relacionadas à ressuscitação cardiopulmonar, comparando-as ao protocolo validado Utstein, em um hospital universitário. MÉTODOS: Estudo retrospectivo, exploratório, descritivo, de abordagem quantitativa, realizado por meio de consulta a prontuários de pacientes que sofreram parada cardiorrespiratória (PCR seguida de óbito. A coleta de dados foi realizada no período de 1° de maio a 30 de junho de 2009. RESULTADOS: Dos 144 prontuários consultados, 74 foram dispensados por não haver nenhuma informação registrada dos itens a serem estudados e, 70 constituíram a amostra do estudo. Nestes, não havia anotações referentes à causa imediata da PCR (92%, intervenções realizadas na tentativa de recuperação cardiorrespiratória (RCP (71%, ritmo inicial de PCR (59%, hora dos eventos (16%, drogas utilizadas (50% e profissionais envolvidos na RCP (88%. CONCLUSÕES: As anotações foram escassas e, frequentemente, não realizadas. A utilização do modelo Utstein favorece a anotação sequencial dos eventos, evitando a perda de dados.OBJETIVO: Analizar la calidad de las anotaciones de enfermería relacionadas a la resucitación cardiopulmonar, comparándolas con el protocolo validado Utstein, en un hospital universitario. MÉTODOS: Estudio retrospectivo, exploratorio, descriptivo, de abordaje cuantitativo, realizado por medio de consulta a fichas de pacientes que sufrieron parada cardiorespiratoria (PCR seguida de muerte. Los datos fueron recolectados en el período de 1° de mayo a 30 de junio de 2009. RESULTADOS: Entre las 144 fichas consultadas, 74 fueron liberadas por no haber ninguna información registrada de los ítems a ser estudiados y, 70 constituyeron la muestra del estudio. En estas, no habían anotaciones sobre la causa inmediata de la PCR (92%, intervenciones realizadas tratando de recuperar la parada cardiorespiratoria (RPC (71%, ritmo inicial de PCR (59%, hora de

  4. Enredados en la red: Internet como fuente en la investigación en educación comparada

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    Luis Miguel Lázaro Lorente

    1997-01-01

    Full Text Available EI articulo enumera de forma exhaustiva las direcciones de INTERNET de mayor interes para los investigadores en el ambito de la Educacion Comparada sintetizando, para cada una de elias su contenido mas relevante. Esta valiosisima catalogaci6n dedirecciones viene organizada en: organismos intemacionales, centros de investigaci6n, institutos, universidades, sociedades de educacion comparada, ministerios de educaciony bases de datos. Con ello se permite una facilisima biisqueda de la informacion mas necesaria segiin el tema al que queramos acercamos

  5. Efecto residual de dos rocas fosfóricas puras y parcialmente aciduladas, comparadas con SFT, sobre la aprovechabilidad del P por Panicum maximum L., en un oxisol de los Llanos Orientales de Colombia

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    Alejo M. Doris

    1986-03-01

    Full Text Available Panicum maximum L. se sembró, en condiciones de invernadero, en un Oxisol de los Llanos Orientales de Colombia, 18 meses después de la aplicación de las fuentes (rocas fosfóricas de Pesca - Colombia y Sechura - Perú crudas y aciduladas al 20 % con H3 P04, en dosis de 25, 50 Y 100 ppm de P. La roca fosfórica Sechura cruda y parcialmente acidulada junto con SFT, tuvieron el mejor efecto residual sobre el rendimiento y captación de P y mantuvieron los más altos niveles de P asimilable en el suelo al final del ensayo. Con las dosis superiores se obtuvo un nivel más alto de P asimilable en el suelo y mayor absorción de P por la planta.In order to study the residual effect of the Pesca (Colombia and Sechura (Perú phosphate rocks, both crude and acidulated in 20 % by H3P04, comparatively with SFT, Panicum rnaximum L. was planted under glasshouse conditions, in an Oxisol from the Eastern plains of Colombia, 18 months after sources application, with rates of 25. 50 and 100 ppm of P. Crude and partially acidulated Sechura phosphate rock, together with TSP, had the best residual effect on yield and P absorption and had the highest available P levels in the soil at the end of the trial. The highest available P level in the soil and P uptake by the plant was obtained with higher P rates.

  6. Eficacia y seguridad de Nitazoxanida comparada con Albendazol en el tratamiento de Giardiasis sintomática en niños de Trujillo, Perú 2008 – 2009

    OpenAIRE

    Aldo Paz Marchena; Pablo Albuquerque Fernández; David Rene Rodríguez Díaz; Fary Betsy Bances García

    2013-01-01

    Giardiasis constituye un problema de salud pública de mayor prevalencia en países en vías de desarrollo, asociada a la pobreza y un deficiente sistema sanitario con una elevada afección en niños.El objetivo es comparar la eficacia y seguridad de Nitazoxanida y Albendazol en el tratamiento de giardiasis sintomática en niños. La población de estudio estuvo constituida por niños de ambos sexos que acudieron al consultorio de Medicina General del Centro Médico Funegra de Trujillo cuya edad estuvo...

  7. Gestión estratégica de la comunicación digital en la empresa ecuatoriana. Perspectiva comparada con la realidad Europea / Strategic management of digital communication in the Ecuadorian company. Comparative perspective with the European reality

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    Rosario Puertas Hidalgo

    2015-05-01

    Full Text Available En la era de la convergencia digital, la consecución en las organizaciones de un modelo de relación y gestión de intereses con los públicos simétrico y bidireccional requieren de la construcción de una imagen y una reputación, resultado de una planificación estratégica de la comunicación. Sin embargo, esta perspectiva sistémica -en la que la comunicación se vuelve eje transversal a todos procesos organizacional- y que le asigna al profesional de la comunicación una función directiva –Dircom-, no es una constante en la realidad en las empresas ecuatorianas. Este artículo es resultado de la investigación que lleva adelante el Observatorio de la Comunicación Estratégica del Ecuador de la Universidad Técnica Particular de Loja-Ecuador, el constituido en 2014 para estudiar el perfil profesional de los comunicadores en el ámbito de la comunicación interna, corporativa, digital y la comercial así como la Responsabilidad Social Corporativa. Para este primer año, se ha enfocado en la identificación de la situación actual de la Comunicación Estratégica: profesionales formados para desempeñar esta función, organización, función de la comunicación estratégica en las empresas, estrategias y acciones ejecutadas, y tendencias. Los resultados recogidos en este trabajo se han contrastado con algunos de los resultados del trabajo realizado en el European Communication Monitor 2014. Descubriendo que tanto en Europa como en Ecuador, la tendencia del uso de tecnologías para las diversas tareas y actividades en el área de comunicación se incrementa. Es necesario entonces encontrar un escenario común de diálogo y aportaciones hacia un mismo objetivo: conseguir una experiencia equilibrada de relación simétrica con las personas.

  8. Diez años de educación comparada en España

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    José Luis García Garrido

    2005-01-01

    Full Text Available Comparada ha alcanzado un grado de desarrollo y madurez que asombraría, incluso, a los más optimistas de sus investigadores iniciales, desde Jullien a Sadler. Este artículo se centra principalmente en ir decubriendo al lector el panorama que ha presentado la disciplina de la Educación Comparada durante el último decenio que hemos vivido, coincidente con la existencia de la Revista Española de Educación Comparada (REEC. Ha sido un período de importante expansión cuantitiva y cualitativa en nuestro país, cuyos frutos se han hecho explícitos en la aparición de relevantes trabajos dignos de admiración. En primer lugar, se indica la evolución de la Educación Comparada en cuanto a su desarrollo en el ámbito universitario. A continuación se resaltan todas aquellas investigaciones y tesis doctorales realizadas en esta disciplina durante estos últimos diez años, algunas de las cuales han dado lugar a relevantes publicaciones tanto en universidades como en revistas españolas y extranjeras. Por último se describe brevemente la celebración de congresos y otras actividades científicas que permite completar esa visión del desarrollo de la Educación Comparada en España durante la última década. 

  9. Death by Propofol.

    Science.gov (United States)

    Diaz, James H; Kaye, Alan David

    2017-01-01

    Since its introduction in 1986, propofol ( two, 6-diisopropylphenol) , an intravenous sedative-hypnotic agent, has been utilized for the induction and maintenance of general anesthesia and conscious sedation in over 80 percent of cases; largely replacing thiopental ( sodium pentothal) over a decade ago. Unrestricted as a controlled substance, propofol's abuse potential emerged quickly and was highlighted by the death of pop singer, Michael Jackson, in 2009. In order to assess the epidemiological features of fatal propofol abuse, a descriptive analysis of the scientific literature was conducted using Internet search engines. Well-documented cases of fatal propofol abuse were stratified as unintentional or accidental deaths and as intentional deaths by suicides or homicides. Continuous variables were compared for differences by unpaired, two-tailed t-tests with statistical significance indicated by p-values less than 0.05. Of 21 fatal cases of propofol abuse, 18 (86 percent ) occurred in healthcare workers, mostly anesthesiologists and nurse anesthetists (n=14, 67 percent ). One case occurred in a layman who purchased propofol on the Internet. Seventeen deaths (81 percent ) were accidental; two were suicides (9.5 percent ) and two were homicides (9.5 percent ). Blood levels in intentional death cases were significantly greater than in accidental death cases (p less than 0.0001) all of which reflected initial therapeutic induction-level doses in the ranges of 2.0-2.5 mg/kg. Though lacking in analgesic effects, the abuse of propofol by young healthcare professionals, particularly operating room workers, has been significant; and likely underreported. Propofol is a dangerous drug with an evident abuse potential which often results in fatalities.

  10. Educación comparada. Fuentes para su investigación

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    Ángela Caballero

    1997-01-01

    Full Text Available El presente articulo informa al lector sobre aspectos basicos relacionados con la documentacion en el campo educativo y ofrece las referencias de las mas importantes fuentes documentales y bibliograficas que pueden ser de utilidad para quienes trabajen en el ambito de la Educacion Comparada. Se pretende con ello proporcionar informacion sobre donde y como conseguir datos acerca de la Educación Comparada, con objetivos investigadores. Para su desarrollo se han utilizado las siguintes categorias: libros (obras de conjunto, enciclopedias, diccionarios, tesauros, manuales o tratados..., publicaciones periodicas (revistas y boletines, aetas de congresos (conferencias y seminarios y tesis doctorales. Se incluye una relacion de las mismas en cada uno de los apartados. 

  11. Ganglio centinela en cáncer de mama: biopsia selectiva comparada con linfadenectomía axilar. Seguimiento a largo plazo Sentinel ganglion in breast cancer: selective biopsy compared with axillary lymphadectomy

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    E. Goñi

    2009-12-01

    Full Text Available Fundamento. La biopsia selectiva del ganglio centinela (BSGC ha reemplazado a la linfadenectomía axilar (LA, como procedimiento de elección, en el estadiaje del cáncer de mama en estadios iniciales y axila clínicamente negativa. El objetivo de este trabajo es comparar la supervivencia global y libre de eventos de aquellas pacientes a las que se realizó, en el periodo de validación de la técnica, BSGC seguida de LA respecto a las que se practicó BSGC y LA si el ganglio centinela (GC presentaba metástasis. Material y métodos. Se han incluido 148 pacientes, 81 pertenecientes al periodo de validación y 67 al grupo de aplicación clínica. El radiocoloide se administró intra-peritumoralmente, obteniéndose imágenes hasta la visualización del GC, posteriormente en la intervención quirúrgica se procedió a su identificación y extirpación. Resultados. En el grupo de validación, la eficacia de la técnica ha sido del 92,5%, la sensibilidad del 95,6% y la tasa de falsos negativos del 4%. De las 81 pacientes, 75 se encuentran libres de enfermedad (92,6%. De las 67 pacientes pertenecientes al grupo de aplicación clínica, 63 (94% viven libres de enfermedad. Ninguna paciente ha presentado recurrencia ganglionar axilar. Conclusiones. En la validación de la técnica hemos obtenido unos valores que se hallan dentro de las exigencias de calidad generalmente aceptadas. Con una media de seguimiento de 6 años no hemos observado recurrencia axilar en ninguno de los dos grupos. No existe diferencia estadísticamente significativa en la supervivencia global y libre de eventos entre ambos grupos.Background. Selective biopsy of the sentinel ganglion (SBSG has replaced axillary lymphadectomy (AL as the procedure of choice in staging breast cancer in its initial stages and in clinically negative axilla. The aim of this study is to compare global event-free survival of those patients subjected to SBSG followed by AL, during the period of validation of

  12. Propofol Use in Israeli PICUs.

    Science.gov (United States)

    Rosenfeld-Yehoshua, Noa; Klin, Baruch; Berkovitch, Matitiahu; Abu-Kishk, Ibrahim

    2016-03-01

    In Israel, the recommendation for the use of propofol is age limited. Furthermore, procedural sedations involving propofol must be performed only by anesthesiologists. Propofol is frequently used in the PICUs in Israel. Questionnaire survey. PICUs in Israel. None. None. Physicians from 13 PICUs (86.6%) responded to the questionnaire. Propofol was used for induction, procedural sedation, and ongoing ICU sedation in 100%, 70%, and 12% of cases, respectively. Eighty-eight percent of the participants limited the duration of propofol infusion to 24 hours at a dose of less than or equal to 4 mg/kg/1 hr, but 40% administered propofol as needed without specifying an upper dose limit. Twenty-five percent encountered adverse effects such as apnea, desaturation, and bradycardia, but only two of the participants suspected propofol infusion syndrome, each in one patient. All the participants agreed to expand the indications for propofol use in the pediatric age group. Ketamine was the drug mostly used instead of propofol (50%), followed by fentanyl (30%), midazolam (30%), and remifentanil (5%). Apart from anesthesiologists, PICU physicians support the use of propofol by physicians who have the technical skills for rapid-sequence intubation and advanced airway management. Off-label use of propofol is an accepted practice in Israeli PICUs. Propofol has a unique profile that makes it an attractive sedative agent in many clinical settings. PICU physicians may want to prescribe it, at least for short periods and at low doses.

  13. Historiografía comparada: problemas y perspectivas

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    Chris Lorenz

    2005-12-01

    Full Text Available In this text contributions related are abridged - direct or indirectly - with the historiography of world war two. The comparative historiography is placed as a gender related to a typology that classified historiography theories over an extended sequence from the general and philosophical to the particular and empirical. Resides, it also places the recent debates on the “fragmentation " of the historiography in a comparative perspective. Due that historiography is the history of the written history -and therefore a reconstruction of reconstructions- we find the problem of comparison in historiography twice. The historiographer is not alone confronting with relative comparative judgments of the historic reconstructions themselves but also related to the historiography reconstructions of those historic reconstructions.//En este texto se compendian contribuciones relacionadas - directa o indirectamente - con la historiografía de la segunda guerra mundial. Se ubica a la historiografía comparada como un género en relación a una tipología que clasifica teorías de historiografía sobre una secuencia extendida de lo general y filosófico a lo particular y empírico. Además, coloca los recientes debates sobre la "fragmentación" de la historiografía en una perspectiva comparada. Debido a que la historiografía es la historia de la historia escrita - y por lo tanto una reconstrucción de reconstrucciones - encontramos el problema de la comparación en historiografía dos veces. El historiógrafo no sólo está confrontado con los juicios comparados relativos a las reconstrucciones históricas mismas, sino también relativas a las reconstrucciones historiográficas de aquellas reconstrucciones históricas.

  14. Efeito da administração de solução salina na estabilidade da circulação durante a indução de anestesia geral com propofol em estudo randômico e controlado de procedimentos ginecológicos Efecto de la administración de solución salina normal en la estabilidad de la circulación durante la inducción de anestesia general con propofol en estudio aleatorio y controlado de procedimientos ginecológicos Effect of normal saline administration on circulation stability during general anesthesia induction with propofol in gynecological procedures - randomised-controlled study

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    Daher Rabadi

    2013-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVO: Comparar o efeito da administração profilática de solução salina normal com o efeito hipotensor de propofol em pacientes do sexo feminino programadas para procedimentos ginecológicos. MÉTODO: Foram randomicamente alocadas em dois grupos 69 pacientes, ASA I-II. O Grupo 1 recebeu 5 mL.kg-1 de solução salina a 0,9% 10 minutos antes da indução e o Grupo 2 não recebeu nada (controle. A anestesia foi induzida com propofol e fentanil e depois mantida com propofol e remifentanil. As variáveis hemodinâmicas foram mensuradas pré- e pós-indução da anestesia geral. RESULTADOS: Após a indução, ambos os grupos apresentaram queda significativa da pressão arterial média (p JUSTIFICATIVA Y OBJETIVO: Comparar el efecto de la administración profiláctica de solución salina normal con el efecto hipotensor de propofol en pacientes del sexo femenino programadas para procedimientos ginecológicos. MÉTODO: Sesenta y nueve pacientes con ASA I-II fueron ubicados aleatoriamente en dos grupos. El Grupo 1 recibió 5 mL.kg-1 de solución salina al 0,9% 10 minutos antes de la inducción y el Grupo 2 no recibió nada. La anestesia fue inducida con propofol y fentanilo y después se mantuvo con propofol y remifentanilo. Las variables hemodinámicas fueron mensuradas antes y después de la inducción de la anestesia general. RESULTADOS: Después de la inducción, ambos grupos presentaron una caída significativa de la presión arterial promedio (p BACKGROUND AND OBJECTIVE: To compare the effect of prophylactic administration of normal saline against the hypotensive effect of propofol in female patients booked for gynecological procedures. METHOD: Sixty nine ASA (I, II patients were randomly allocated into two groups, group 1 received 5 mL.kg-1 of 0.9% normal saline 10 minutes before induction, whereas group 2 received nothing (control. Anesthesia was induced with propofol and fentanyl then maintained with propofol and

  15. Caracterização anestésica da nanoemulsão não lipídica de propofol Caracterización anestésica de la nanoemulsión no lipídica de propofol Anesthetic profile of a non-lipid propofol nanoemulsion

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    Roberto Takashi Sudo

    2010-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Uso clínico de formulação lipídica de propofol causa dor durante injeção, reação alérgica e crescimento microbiano. Propofol tem sido reformulado em diferentes apresentações não lipídicas para reduzir os efeitos adversos, mas essas mudanças podem modificar sua farmacocinética e farmacodinâmica. Neste trabalho, investigamos a farmacologia e a toxicologia do propofol lipídico (CLP e da nanoemulsão não lipídica (NLP. MÉTODO: CLP and NLP foram infundidos na veia jugular de ratos sob medida da pressão arterial (PA, frequência cardíaca (FC e frequência respiratória (FR. Ambas as formulações (1% foram infundidas (40 µL.min-1 durante 1 hora. Doses hipnóticas e anestésicas, assim como recuperações, foram determinadas. A dor induzida pelo veículo do CLP e NLP foi comparada por meio da contagem do número de contorções abdominais ("writhing test" após injeção intraperitonial (i.p. em camundongos. Ácido acético (0,6% foi usado como controle positivo. RESULTADOS: As doses hipnóticas e anestésicas com 1% CLP (6,0 ± 1,3 e 17,8 ± 2,6 mg.kg-1, respectivamente e 1% NLP (5,4 ± 1,0 e 16,0 ± 1,4 mg.kg-1, respectivamente não foram significativamente diferentes. A recuperação da hipnose e da anestesia foi mais rápida com NLP do que com CLP. As alterações de FC, PA e FR causadas pelo NLP não foram significativamente diferentes das do CLP. Ácido acético e veículo do CLP provocaram 46,0 ± 2,0 e 12,5 ± 0,6 contorções em 20 min após injeção i.p., respectivamente. Observou-se ausência de contorções abdominais com veículo de NLP. Nenhuma resposta inflamatória abdominal foi notada com a injeção i.p. de ambos os veículos de propofol. CONCLUSÕES: O NLP pode representar melhor alternativa do que o CLP para anestesia venosa com menores efeitos adversosJUSTIFICATIVA Y OBJETIVOS: El uso clínico de la formulación lipídica del propofol, causa dolor durante la inyección, reacci

  16. Psicologia comparada, etologia y salud mental

    OpenAIRE

    Luis Fernández Rios

    1987-01-01

    Después de lo expuesto anteriormente se pueden extraer las si. guientes conclusiones: Más que de etología, psicología animal o psicología comparada, hoy en día se puede hablar de "ciencia del comportamiento animal". Pese a todo, se ha empleado y se continúa haciendo uso deD término "etología" para referirse al estudio objetivo del comportamiento animal (etología animal) o humano (etología humana). Los temas que configuran la etología humana son múltiples y diversos. ...

  17. Síndrome da infusão do propofol Síndrome de la infusión del propofol Propofol infusion syndrome

    Directory of Open Access Journals (Sweden)

    Fabiano Timbó Barbosa

    2007-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A síndrome da infusão do propofol tem sido descrita como uma síndrome rara e quase sempre fatal que ocorre após infusão prolongada desse fármaco. Ela pode resultar em acidose metabólica grave, rabdomiólise, colapso cardiovascular e morte. O objetivo deste artigo foi mostrar aspectos relacionados com a síndrome da infusão do propofol por meio da revisão de literatura. CONTEÚDO: Estão definidas as características da síndrome da infusão do propofol quanto à fisiopatologia, características clínicas, tratamento e recomendações de dose para pacientes gravemente enfermos. CONCLUSÕES: O propofol deve ser usado com cautela quando se planeja seu uso sob regime de infusão contínua por períodos prolongados. O surgimento de sinais sugestivos da síndrome da infusão do propofol indica a suspensão imediata do fármaco e início de medidas de suporte.JUSIFICATIVA Y OBJETIVOS: El síndrome de la infusión del propofol ha sido descrito como un síndrome raro y frecuentemente fatal que ocurre después de la infusión prolongada de ese fármaco. Puede resultar en acidez metabólica grave, rabdomiólisis, colapso cardiovascular y deceso. El objetivo de este artículo fue mostrar aspectos relacionados al síndrome de la infusión del propofol a través de la revisión de la literatura. CONTENIDO: Están definidas las características del síndrome de la infusión del propofol en cuanto a la fisiopatología, características clínicas, tratamiento y recomendaciones de dosis para pacientes gravemente enfermos. CONCLUSIONES: El propofol debe ser usado con cautela cuando se planea su uso bajo el régimen de infusión continua por períodos prolongados. El aparecimiento de señales sugestivas del síndrome de la infusión del propofol indica la suspensión inmediata del fármaco y el inicio de medidas de soporte.BACKGROUND AND OBJECTIVES: Propofol infusion syndrome has been described as a rare, and frequently fatal

  18. Anestesia neuroaxial comparada à anestesia geral para revascularização dos membros inferiores em idosos: revisão sistemática com metanálise de ensaios clínicos aleatórios Anestesia neuroaxial comparada a la anestesia general para la revascularización de los miembros inferiores en ancianos: revisión sistemática con metanálisis de ensayos clínicos aleatorios Neuroaxis block compared to general anesthesia for revascularization of the lower limbs in the elderly: a systematic review with metanalysis of randomized clinical studies

    Directory of Open Access Journals (Sweden)

    Fabiano Timbó Barbosa

    2009-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A controvérsia atual é saber se a anestesia neuroaxial (AN é mais eficiente que a geral (AG em idosos submetidos à cirurgia não-cardíaca. O objetivo foi determinar a eficiência da AN comparada à AG para revascularização de membros inferiores (RMI em idosos. MÉTODO: Utilizada estratégia de busca para as bases de dados: MEDLINE (1955 a 2007, CINHAL ( 1982 a 2007, Embase (1980 a 2007, LILACS (1982 a 2007 e ISI (1945 a 2007. Dois revisores analisaram independentemente os artigos em busca de ensaios clínicos aleatórios (ECA que comparassem a AN com a AG para a RMI. O texto completo dos ECA que atendessem aos critérios de inclusão foram analisados. Discordâncias foram analisadas em reuniões de consenso. A metanálise foi realizada com o software Review Manager, por meio da razão de chances com intervalo de confiança de 95%. RESULTADOS: Foram selecionados três artigos originais envolvendo 465 pacientes. Não houve significância estatística na metanálise das variáveis: mortalidade (OR: 0,90; IC 95%: 0,30 - 2,73; P = 0,85 raquianestesia; OR: 1,30; IC 95%: 0,38 - 4,48; P = 0,68 anestesia peridural, infarto miocárdico (OR: 1,38; IC 95%: 0,29 - 6,46; P = 0,68 e taxa de amputação dos membros inferiores (OR: 0,81; IC 95%: 0,30 - 2,19; P = 0,68 raquianestesia; OR: 0,70; IC 95%: 0,24 - 2,07; P = 0,52 anestesia peridural. Houve significância estatística para pneumonia (OR: 0,37; IC 95%: 0,15 - 0,89; P = 0,03, porém houve heterogeneidade clínica. CONCLUSÕES: As evidências geradas nessa metanálise foram insuficientes para demonstrar que a AN é mais eficiente, equivalente, ou menos eficiente quando comparada a AG para RMI em idosos.JUSTIFICATIVA Y OBJETIVOS: La controversia actual es saber si la anestesia neuroaxial (AN es más eficaz que la anestesia general (AG en ancianos sometidos a la cirugía no cardíaca. El objetivo fue determinar la eficacia de la AN comparada con la AG para revascularizaci

  19. Propofol Anesthesia-Induced Seizures

    OpenAIRE

    J Gordon Millichap

    1994-01-01

    A case of a healthy young man who developed seizures and generalized paroxysmal fast activity in the EEG following use of propofol for anesthesia in minor surgery is reported from the Department of Neurology, University of South Alabama, Mobile, AL.

  20. Computer-assisted propofol administration.

    LENUS (Irish Health Repository)

    O'Connor, J P A

    2012-02-01

    The use of propofol for sedation in endoscopy may allow for better quality of sedation, quicker recovery and facilitate greater throughput in endoscopy units. The cost-effectiveness and utility of propofol sedation for endoscopic procedures is contingent on the personnel and resources required to carry out the procedure. Computer-based platforms are based on the patients response to stimulation and physiologic parameters. They offer an appealing means of delivering safe and effective doses of propofol. One such means is the bispectral index where continuous EEG recordings are used to assess the degree of sedation. Another is the closed-loop target-controlled system where a set of physical parameters, such as muscle relaxation and auditory-evoked potential, determine a level of medication appropriate to achieve sedation. Patient-controlled platforms may also be used. These electronic adjuncts may help endoscopists who wish to adopt propofol sedation to change current practices with greater confidence.

  1. Propofol directly increases tau phosphorylation.

    Directory of Open Access Journals (Sweden)

    Robert A Whittington

    Full Text Available In Alzheimer's disease (AD and other tauopathies, the microtubule-associated protein tau can undergo aberrant hyperphosphorylation potentially leading to the development of neurofibrillary pathology. Anesthetics have been previously shown to induce tau hyperphosphorylation through a mechanism involving hypothermia-induced inhibition of protein phosphatase 2A (PP2A activity. However, the effects of propofol, a common clinically used intravenous anesthetic, on tau phosphorylation under normothermic conditions are unknown. We investigated the effects of a general anesthetic dose of propofol on levels of phosphorylated tau in the mouse hippocampus and cortex under normothermic conditions. Thirty min following the administration of propofol 250 mg/kg i.p., significant increases in tau phosphorylation were observed at the AT8, CP13, and PHF-1 phosphoepitopes in the hippocampus, as well as at AT8, PHF-1, MC6, pS262, and pS422 epitopes in the cortex. However, we did not detect somatodendritic relocalization of tau. In both brain regions, tau hyperphosphorylation persisted at the AT8 epitope 2 h following propofol, although the sedative effects of the drug were no longer evident at this time point. By 6 h following propofol, levels of phosphorylated tau at AT8 returned to control levels. An initial decrease in the activity and expression of PP2A were observed, suggesting that PP2A inhibition is at least partly responsible for the hyperphosphorylation of tau at multiple sites following 30 min of propofol exposure. We also examined tau phosphorylation in SH-SY5Y cells transfected to overexpress human tau. A 1 h exposure to a clinically relevant concentration of propofol in vitro was also associated with tau hyperphosphorylation. These findings suggest that propofol increases tau phosphorylation both in vivo and in vitro under normothermic conditions, and further studies are warranted to determine the impact of this anesthetic on the acceleration of

  2. Menéndez Pelayo y la Literatura Comparada

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    Garrido Gallardo, Miguel Ángel

    2013-12-01

    Full Text Available The birth of literary comparatism takes place between the publication of the first volumes of the History of Aesthetic Ideas and the editing of Origins of the Novel. It is absolutely impossible for the work of Don Marcelino, of restless spirit and a tireless reader, to not be involved in the cultural events taking place in line with his own work. Although he does not use the term comparative literature as the title of any of his works, this article shows, through an analytical review and a brief anthology of his work, Menéndez Pelayo’s relationship with the discipline that marks the renewal of twentieth-century literary studies.El nacimiento del comparatismo literario tiene lugar entre la publicación de los primeros volúmenes de la Historia de las Ideas Estéticas y la edición de Orígenes de la novela. Es absolutamente imposible que la obra de don Marcelino, espíritu inquieto y lector infatigable donde los haya, esté al margen de los acontecimientos culturales que se estaban produciendo al hilo de su propia labor. Aunque no utilice la denominación literatura comparada como título de ninguno de sus trabajos, este artículo muestra, mediante un recorrido analítico y una pequeña antología de textos de su obra, la relación de Menéndez Pelayo con la disciplina que marca la renovación de los estudios literarios del siglo XX.

  3. Géneros literarios y literatura comparada

    Directory of Open Access Journals (Sweden)

    Garrido Miñambres, Germán

    2010-06-01

    Full Text Available In approaching the study of poetic traditions among which established relationships of influence have not mediated, current comparatistics requires a reconsideration of the literary genre as a historic entity. Jean-Marie Schaeffer names as «analogic» those generic terms used in compared literature to designate works that do not share proven historical links. Given that the referent of those generic terms is an ideal model without effective realization in the text, Schaeffer’s proposal does not clarify whether there is a limit for its application, which in reality deprives the analogic genres of all descriptive value. As a solution, the author suggests to turn to the concept of poetic presupposition, already advanced in his time by Jonathan Culler to counteract the effects of intertextuality. Poetic presupposition allows the establishment of an indirect link between the text and the ideal model that acts as a referent of the analogic genres, as illustrates the controversial genre of the german Novelle.Al abordar el estudio de tradiciones poéticas entre las que no han mediado relaciones probadas de influencia, la comparatística actual exige un replanteamiento del género literario como entidad histórica. Jean-Marie Schaeffer denomina «analógicos» a los términos genéricos empleados por la literatura comparada para designar obras que no comparten vínculos históricos probados. Puesto que el referente de estos términos genéricos es un modelo ideal sin realización efectiva en el texto, la propuesta de Schaeffer no esclarece si existe un límite para su aplicación, lo que priva en realidad a los géneros analógicos de todo valor descriptivo. Como solución, el autor propone recurrir al concepto de presuposición poética, avanzada en su momento por Jonathan Culler para contrarrestar los efectos de la intertextualidad. La presuposición poética permite establecer un vínculo indirecto entre el texto y el modelo ideal que actúa como

  4. La educación comparada en América Latina: situación y desafíos para su consolidación académica

    Directory of Open Access Journals (Sweden)

    Norberto Fernández Lamarra

    2005-01-01

    Full Text Available El artículo aborda la evolución en las últimas dos décadas de la Educación comparada en América Latina, como disciplina de estudio, como campo de investigación y desde la perspectiva de los estudios comparados elaborados por organismos internacionales como la UNESCO/CEPAL. Da cuenta de las creaciones de sociedades de Educación Comparada y finaliza con recomendaciones para que el campo de la Educación Comparada se consolide académicamente en América Latina. 

  5. 21 CFR 522.2005 - Propofol injection.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Propofol injection. 522.2005 Section 522.2005 Food... Propofol injection. (a) Specifications. The drug is a sterile, nonpyrogenic, oil-in-water emulsion containing 10 milligrams of propofol per milliliter. (b) Sponsor. See No. 000061 in § 510.600(c) of this...

  6. Propofol Infusion Syndrome Heralded by ECG Changes

    NARCIS (Netherlands)

    Mijzen, Elsbeth J.; Jacobs, Bram; Aslan, Adnan; Rodgers, Michael G. G.

    2012-01-01

    Propofol infusion syndrome (PRIS) is well known, often associated with, lethal complication of sedation with propofol. PRIS seems to be associated with young age, traumatic brain injury (TBI), higher cumulative doses of propofol, and the concomitant use of catecholamines. Known manifestations of

  7. Psicologia comparada, etologia y salud mental

    Directory of Open Access Journals (Sweden)

    Luis Fernández Rios

    1987-01-01

    Full Text Available Después de lo expuesto anteriormente se pueden extraer las si. guientes conclusiones: • Más que de etología, psicología animal o psicología comparada, hoy en día se puede hablar de "ciencia del comportamiento animal". Pese a todo, se ha empleado y se continúa haciendo uso deD término "etología" para referirse al estudio objetivo del comportamiento animal (etología animal o humano (etología humana. • Los temas que configuran la etología humana son múltiples y diversos. Se ha hecho única y exclusivamente referencia a las actividades de sustitución y a las aportaciones que puede hacer la etologia al campo de la salud mental. • Por lo que se refiere a las actividades de sustitución, éstas surgen en situaciones conflictivas, en las cuales el animal en vez de emi. tir las respuestas A ó B, lo que lleva a cabo es una tercera alternativa (respuesta C. Algunos ejemplos de las actividades de sustitución en el hombre son la onicofagia y la tricotilomanía. • Las aportaciones que puede hacer la etología al área de la salud mental son diversas. Se pueden enumerar, por un lado, apor taciones filosóficas, metodológicas, de información y terapéuticas; y, por otro, contribuciones para la construcción de modelos y la aplicación de la perspectiva filogenética para mejor describir, explicar y comprender el comportamiento humano normal y anormal. * Desde la perspectiva etológica se supone que todo comportamiento patológico actual, tal vez pudo haber sido adaptativo en el pasado evolutivo de una determinada especie. Se pone corno ejemplo de explicación etológica del comportamiento patológico, la psicosis maníaco.depresiva, • Se considera que cada enfermedad mental tiene unas implicaciones biológico-evolutivas, pues reduce la probabilidad de adaptación al medio y, como resultado, el sujeto tiene menor probabilidad de propagar sus genes a generaciones futuras. * Existe evidencia para afirmar que más que una evolución bio. l

  8. Interpretación y medición comparada de líneas granulométricas continuas

    Directory of Open Access Journals (Sweden)

    Grinszpan, Pedro Enrique

    1979-12-01

    Full Text Available Not avaible

    Se propone en este trabajo una expresión analítica que vincula al módulo de finura de Abrams con el tamaño límite superior de la serie granulométrica y con el grado de una función parabólica identificable con la analizada a efectos de poder localizar la composición con relación a los dominios de conveniencia establecidos por las normas y de este modo realizar una medición comparada de su aptitud. Se introduce el concepto de coeficiente de aptitud a efectos de medir en términos relativos la bondad de una composición granulométrica continua y se propone una escala de clasificación y calificación, cuya inclusión en los pliegos de especificaciones se recomienda para la recepción de los agregados. Por último, la función adoptada, que se considera una generalización de la distribución dé Gessner, es comparada con las de Bolomey y Ross, estableciéndose la diferencia con éstas.

  9. Accidentel intraarteriel injektion af propofol

    DEFF Research Database (Denmark)

    Kjaergaard, Maj; Rovsing, Marie Louise

    2010-01-01

    We report a case of accidental intra-arterial injection of propofol in a 37-year-old woman admitted for gynaecological surgery. The patient first reported pain and then demonstrated hyperaemia and swelling of the hand lasting for 15 minutes. No specific treatment was required, all symptoms...... disappeared spontaneously and the patient was discharged without any functional deficit. It is, nevertheless, important to prevent or discover accidental intra-arterial cannulation. When infusion is difficult or when strong pain appears during propofol administration, accidental intra-arterial injection must...

  10. A literatura mundial como futuro da literatura comparada

    Directory of Open Access Journals (Sweden)

    Amando Gnisci

    2010-08-01

    Full Text Available Neste breve artigo, proponho repensar o conceito de Literatura Mundial, atribuindo-lhe um papel preponderante no futuro da Literatura Comparada como disciplina.In this brief article I propose to re-think the concept of World Literature, attributing it apreponderant role in the future of Comparative Literature as a discipline.

  11. Prevention of injection pain due to propofol by dezocine: A comparison with lidocaine

    Directory of Open Access Journals (Sweden)

    Yao Lu

    2013-01-01

    Full Text Available Objectives: The aim of this study was to investigate the efficacy of dezocine (DEZ versus placebo control (CON and 2% lidocaine (LID in prevention of injection pain due to DEZ. Materials and Methods: A prospective randomized double-blind, placebo-CON study was conducted in 75 adults, American Society of Anesthesiologists physical status I or II, scheduled to undergo an elective surgery. A total of 25 patients were randomly assigned to one of the three groups, thus CON, group LID and group DEZ. The groups received either 2 ml of normal saline or 2 ml 2% LID or 2 mg/2 ml DEZ, respectively, as pre-treatment. Propofol was injected 1 min later. A blinded researcher assessed the patient′s pain level using a four point verbal rating scale. Results: Less patients experienced pain due to propofol injection in the LID (40% and DEZ (28% groups compared with the CON (84% group (P < 0.05. Six patients (24% in the CON group reported severe pain during propofol injection but none in the other two groups. Conclusion: Pre-treatment with DEZ decreases propofol injection pain as effectively as LID.

  12. Propofol dexmedetomidine versus propofol ketamine for anesthesia of endoscopic retrograde cholangiopancreatography (ERCP (A randomized comparative study

    Directory of Open Access Journals (Sweden)

    Mai W. Abdalla

    2015-04-01

    Conclusion: Dexmedetomidine–propofol combination as TIVA during ERCP showed better intra-and post-procedural hemodynamic stability, less PONV, less postoperative cognitive dysfunctions and shorter recovery time when compared with ketamine–propofol combination.

  13. Circulatory responses to propofol-ketamine combination compared to propofol alone for sedation during spinal anesthesia

    National Research Council Canada - National Science Library

    Nengroo, S; Lone, AQ; Naqash, I

    2011-01-01

    The present study was undertaken to establish the efficacy of low dose propofol-ketamine infusion in maintaining hemodynamic stability when used for sedation as compared to propofol alone during spinal anesthesia...

  14. Transporte forestal con cables

    OpenAIRE

    Anaya L. Héctor J.

    2012-01-01

    La explotación forestal es un problema fundamentalmente de transporte. El apeo y la preparación de las trozas, aunque a veces presentan algunas dificultades, son operaciones fáciles de resolver comparadas con la operación de transporte la cual absorbe del 60% al 70% o más del costo total del aprovechamiento del bosque. El 30% o 40% restante es absorbido por las faenas previas de apeo y troceo.

  15. Etomidate plus propofol versus propofol alone for sedation during gastroscopy: a randomized prospective clinical trial.

    Science.gov (United States)

    Zhou, Xiang; Li, Bi-Xi; Chen, Li-Min; Tao, Jun; Zhang, Sui; Ji, Meng; Wu, Ming-Chun; Chen, Min; Zhang, Yan-Hui; Gan, Guo-Shen; Song, Xiao-Yang

    2016-11-01

    Sedation with propofol alone during gastroscopy has many side effects. Etomidate has advantages in terms of circulation and respiration compared to propofol. We hypothesized that etomidate plus propofol during gastroscopy would be more safe and effective than propofol alone. Four hundred (n = 400) patients were randomly divided into a propofol group (P group) and a etomidate plus propofol group (EP group). The P group was given the first dose of 1 % propofol 1 mg/kg before gastroscopy, and the EP group was given 1 % propofol 0.5 mg/kg plus etomidate 0.1 mg/kg. Repeated doses of 10-20 mg propofol or 5-10 mg propofol plus 1-2 mg etomidate were administered to maintain an adequate level of sedation. The sedation depth was maintained by bispectral index value of 40-60. The EP group had a lower incidence of systolic hypotension (13.0 vs. 32.5 %; P propofol had few effects on respiration and circulation in patients undergoing gastroscopy and was more safe and effective than propofol alone.

  16. Estudio comporativo de efectividad sedativa con propofol vs midazolam-fentanyl en pacientes sometidos a tomografía axial computarizada (TAC) de emergencia en el Hospital Luis Vernaza periodo 2013.

    OpenAIRE

    Murillo García, Rosario Gliceria

    2015-01-01

    La tomografía computarizada es una técnica de imágenes que puede ser fundamental para contribuir con el diagnóstico de un paciente con una patología de emergencia. Sin embargo, muchas veces, estos pacientes se encuentran en condiciones que impiden que este examen se realice de manera adecuada, y es necesario que se realice bajosedación con el propósito de sacarle el máximo de provecho. No existe un acuerdo sobre cuál es el esquema farmacológico más adecuado para brinda...

  17. Heart block following propofol in a child.

    Science.gov (United States)

    Sochala, C; Deenen, D; Ville, A; Govaerts, M J

    1999-01-01

    We present the case of a nine-year-old boy afflicted with Ondine's curse, who developed complete atrioventricular heart block after a single bolus of propofol for induction of anaesthesia for strabismus surgery. Ondine's curse, the other name for congenital central hypoventilation syndrome, is characterized by a generalized disorder of autonomic function. Propofol has no effect on the normal atrioventricular conduction system in humans but it reduces sympathetic activity and can highly potentiate other vagal stimulation factors. Heart block has been documented after propofol bolus use in adults but, to our knowledge, not in children. It would appear that propofol is not a good choice for anaesthesia in congenital central hypoventilation syndrome.

  18. Mecanismos de democracia directa en América Latina: Una revisión comparada

    Directory of Open Access Journals (Sweden)

    Steffan Gómez Campos

    2010-07-01

    Full Text Available Parte de la premisa que concibe a la democracia directa como una forma de reforzar la democracia representativa, en tanto exista una sólida cultura política y un marco institucional arraigado en los principios democráticos fundamentales. Realiza una perspectiva comparada basada fundamentalmente, en las previsiones constitucionales de los 18 países de América Latina. Tiene como objetivo primordial comparar los arreglos institucionales en materia de democracia directa, para establecer las características comunes y diferencias más significativas dentro de la región. Con base en ello se clasifican los mecanismos de democracia directa en las siguientes tres categorías: a el referéndum (y el plebiscito; b la iniciativa popular; y c la revocatoria de mandato.

  19. The High Andean Cordillera of central Argentina and Chile along the Piuquenes Pass-Cordon del Portillo transect: Darwin's pioneering observations compared with modern geology La Alta Cordillera de los Andes del centro de Argentina y Chile a lo largo de la transecta del Paso Piuquenes-Cordón del Portillo: Las observaciones pioneras de Darwin comparadas con la geología moderna

    Directory of Open Access Journals (Sweden)

    Laura Giambiagi

    2009-04-01

    Full Text Available The geological observations made by Darwin in 1835 during his crossing of the Andes from Santiago to Mendoza via the Piuquenes Pass and Cordón del Portillo are compared with the present geological knowledge of the Cordillera Principal and Cordillera Frontal at 33°-34°S. The analysis of the complex stratigraphy of the Cordillera Principal, the imbricated structure of the Aconcagua fold and thrust belt, as well as the stratigraphy and structure of the inter mountain foreland Tunuyán Basin, allows to assess the pioneer observations of Darwin. He recognized the old metamorphic basement and the granitoids and volcanic sequences of late Paleozoic to Triassic age of the Cordillera Frontal, established the Cretaceous age of the marine successions cropping out along the eastern Cordillera Principal and studied the conglomeratic deposits associated with the uplift of the Cordillera in the Alto Tunuyán Basin. Based on the study of clast provenance of the synorogenic deposits of the Alto Tunuyán Basin, Darwin recognized that the Cordillera Frontal was uplifted later than the Cordillera Principal. The present knowledge of this sector of the Andean Cordillera confirms his pioneer observations and show that Darwin was one of the first scientists ever in realizing that in an orogenic system the sequence of uplift and deformation proceeds from hinterland towards foreland, according to a process that is exceptionally well-illustrated along the Piuquenes-Cordón del Portillo transect.Las observaciones geológicas efectuadas por Darwin en 1935 durante su cruce de la Cordillera de Los Andes entre Santiago y Mendoza realizado en 1835 a través de los pasos del Portillo y Piuquenes son examinadas y comparadas con el conocimiento actual existente de las Cordilleras Principal y Frontal entre los 33°-34°S. El análisis de la compleja estratigrafía de la Cordillera Principal, la estructura de las diferentes láminas imbricadas de la faja plegada y corrida del

  20. Galectina-3 mediante técnica citológica de base líquida en el estudio del nódulo tiroideo comparada con histopatología postquirúrgica. Solca-Cuenca. Año 2012

    OpenAIRE

    Astudillo Bravo, María Fernanda

    2013-01-01

    La patología tiroidea es frecuente principalmente en mujeres, la incidencia de cáncer de la glándula es mayor en hombres. El diagnóstico de malignidad mediante citología tiene una sensibilidad y especificidad limitada; con PAAF e inmunohistoquímica (Galectina-3) se ha reportado incremento de las mismas. Se estudió 82 muestras con Galectina-3 en citologías de base líquida obtenidas por PAAF de pacientes diagnosticados clínicamente de nódulos tiroideos posteriormente tiroidectomizados. Las pi...

  1. The antioxidant activity of propofol in chicks

    Directory of Open Access Journals (Sweden)

    A.S. Naser

    2015-06-01

    Full Text Available The aim of this study was to detect the antioxidant effects of propofol in chicks by estimation of glutathione concentration in blood plasma, brain and liver as well as total antioxidant capacity and antioxidant effects of propofol in vitro by using hydrogen peroxide as oxidative stress. Propofol at 20 mg/kg, intraperitoneally significantly increased after 4 hours the concentration of glutathione concentration in plasma and brain compared with the control group and with 5 and 10mg propofol groups. Propofol at 5, 10 and 20 mg/kg, i.p significantly increased glutathione concentration in the liver compared with the control group. Propofol at 5, 10 and 20 mg/kg, i.p increased the efflux rate constant by 882, 1031 and 920 %, increased glutathione turnover rate by 880, 1028, and 917 % and decreased the turnover time by 89, 91 and 90% in the liver. In the brain propofol at 5, 10 and 20 mg/kg, i.p increased efflux rate constant as 26, 600 and 2826 % and increased glutathione turnover rate by 29, 616 and 2894 % and a decreased in the turnover time by 21, 86 and 96%. propofol at 10 and 20 mg/kg, i.p significantly increased after 20 hours the TAC in the serum of the chick by 38 and 48%, respectively compared with the control group. Propofol at concentrations of 25, 50 and 100 micromoles / liter decreased erythrocyte hemolysis induced by hydrogen peroxide in vitro 10 micromoles / liter in a concentration depended manner by 25, 49 and 64 % respectively. In conclusion, propofol have antioxidant effect in vivo and in vitro in the chicks.Propofol have a protection against oxidative stress.

  2. Propofol-ketamine and propofol-fentanyl combinations for nonanesthetist-administered sedation.

    Science.gov (United States)

    Chandar, Rumesh; Jagadisan, Barath; Vasudevan, Arumugam

    2015-06-01

    There is a need to compare propofol requirement between propofol-ketamine (PK) and propofol-fentanyl (PF) given as nonanesthetist-administered propofol sedation during pediatric esophagogastroduodenoscopy (EGD). The study was a parallel-group, randomized, double-blind comparison of the need for additional doses of propofol in the first minute after sedation induction between PK and PF, administered by rotating trainees in pediatrics for sedation during pediatric EGD. A total of 95 children with American Society of Anesthesiologists class I to III between 3 and 12 years undergoing EGD were included and randomized to either of the groups. After midazolam premedication, children received either 0.5 mg/kg ketamine (PK) or 1 μg/kg of fentanyl (PF) followed by a mandatory 1 mg/kg of propofol. Additional doses of propofol of 0.5 mg/kg each were given to achieve sedation induction (modified Ramsay scale level 6), and further doses were administered during the procedure as required. A total of 92 children (PK, n = 47; PF, n = 45) were analyzed. P propofol dose required for successful scope introduction and also in the need for additional propofol doses and the total additional propofol doses required in the first minute after sedation induction. Propofol injection pain was higher in the PF group (odds ratio 1.78). The adverse events and recovery time were similar. There was no escalation of care, airway intubations, death, or disability. Nonanesthetist-administered propofol sedation is feasible in teaching hospitals. Propofol requirement is similar in both PK and PF combination regimens, but the lower frequency of propofol injection pain may favor the use of PK.

  3. Cuando los huesos hablan : Un recorrido por la Sala de Osteología Comparada del Museo de La Plata

    OpenAIRE

    Acosta, Walter

    2010-01-01

    Aquellos visitantes que hayan recorrido la sala de Osteología Comparada del Museo de La Plata ya sea en varias oportunidades o por única vez seguramente pudieron identificar los esqueletos de las especies más características (por ejemplo: elefantes, jirafa, murciélagos, ballenas, etcétera.) por su particular anatomía. Otros quizás se hayan ayudado con las referencias escritas; los más apasionados incluso, recordará la ubicación exacta de muchos de ellos. Pero desde sus respectivas vitrinas y ...

  4. [Target-controlled propofol infusion for general anesthesia in three obese patients].

    Science.gov (United States)

    Kakinohana, M; Tomiyama, H; Matsuda, S; Okuda, Y

    2000-07-01

    We report three cases in which the target-controlled propofol infusion technique was used in obese patients for general anesthesia. General anesthesia was induced by intravenous administration of fentanyl 150-300 micrograms and ketamine 50-80 mg and propofol 2 micrograms.ml-1 to achieve a target blood concentration by target-controlled infusion system. Anesthetic maintenance was achieved by ketamine 1 mg.kg-1.h-1 for 1 hour after the induction, propofol at target blood concentration of 2-3.5 micrograms.ml-1 and the intermittent epidural injection of 1.5% lidocaine through an epidural catheter. The surgical procedures were uneventful. The estimated blood concentrations of propofol at emergence from anesthesia calculated by ConGrace ranged from 1.49-1.69 micrograms.ml-1, and it took 230-300 seconds to emerge from anesthesia. The target-controlled propofol infusion technique appears useful to control the depth of anesthesia in obese patients.

  5. Nurse-administered propofol sedation for endoscopy

    DEFF Research Database (Denmark)

    Jensen, J T; Vilmann, P; Horsted, T

    2011-01-01

    The aim of the present study was to perform a risk analysis during the implementation phase of nurse-administered propofol sedation (NAPS) and to validate our structured training program.......The aim of the present study was to perform a risk analysis during the implementation phase of nurse-administered propofol sedation (NAPS) and to validate our structured training program....

  6. Sedation with alfentanil and propofol for rhizotomies

    African Journals Online (AJOL)

    M Jansen van Rensburg

    alfentanil, in combination with a constant propofol infusion, for optimal pain control ... All of the patients experienced ventilatory depression, but a patent .... placements (observation points 3–11) for lumbar (L) rhizotomies ..... in the infusion, a total of 10 patients (nine females and one male), ... effects before propofol is added.

  7. PROPOFOL-FENTANYL VERSUS PROPOFOL ALONE FOR LUMBAR PUNCTURE SEDATION IN CHILDREN WITH ACUTE HEMATOLOGIC MALIGNANCIES: PROPOFOL DOSING AND ADVERSE EVENTS

    Science.gov (United States)

    Hollman, Gregory A.; Schultz, Meredith M; Eickhoff, Jens C; Christenson, Devon K

    2011-01-01

    Objective We sought to determine whether the combination of propofol and fentanyl results in lower propofol doses and fewer adverse cardiopulmonary events than propofol and placebo for lumbar puncture (LP) in children with acute hematologic malignancies. Design Randomized, controlled, double blind, crossover study. Setting Pediatric Sedation Program Patients Children with acute leukemia or lymphoma receiving sedation for LP. Interventions Each patient received two sedations in random order, one with propofol/placebo and one with propofol/fentanyl. The study investigator and patient/parent were blinded to placebo or fentanyl. Data collected included patient age and diagnosis, propofol dose and adverse events. Adverse events included oxygen saturation propofol was 5.05 mg/kg (range 2.4–10.2 mg/kg) for propofol/placebo versus 3.00 mg/kg (range 1.4–10.5 mg/kg) for propofol/fentanyl (p propofol/placebo compared to 6 of 22 (18.2%) propofol/fentanyl (p= 0.02). The most common adverse event was hypotension. Conclusions The combination of propofol and fentanyl versus propofol alone for LP sedation in children with acute hematologic malignancies resulted in lower propofol doses and fewer adverse events. PMID:18838923

  8. Características epidemiológicas de las nuevas infecciones causadas por el VIH comparadas con los casos de sida: La epidemia de VIH/ sida en el País Vasco Epidemiological characteristics of new HIV infections compared with AIDS cases: The HIV/AIDS epidemic in the Basque Country [Spain

    Directory of Open Access Journals (Sweden)

    Daniel Zulaika

    2004-04-01

    Full Text Available Objetivo: Describir las características epidemiológicas de los nuevos diagnósticos de infección por el VIH en el período 1997-2001 y comparlas con los casos de sida (1991-2001. Métodos: Se han recogido retrospectivamente los datos de las nuevas infecciones por el VIH ocurridas en el País Vasco (1997-2001 y se han comparado con los casos de sida (1991-2001. Resultados: Se han diagnosticado 912 nuevas infecciones por el VIH. El diagnóstico de VIH coincidió con el de sida en 299 (32,8% de las nuevas infecciones. Las relaciones heterosexuales han sido el mecanismo de transmisión más frecuente, seguido de la transmisión por vía parenteral y las relaciones homosexuales y bisexuales, con diferencias significativas (pObjective: To describe the epidemiological characteristics of new cases of HIV infection diagnosed from 1997-2001 and compare them with AIDS cases (1991-2001. Methods: Data were retrospectively collected on new cases of HIV infection detectad in the Basque Country (1997-2001 and were compared with AIDS cases (1991-2001. Results: A total of 912 new cases of HIV infection were diagnosed. In 299 of the new cases (32.8%, HIV and AIDS were diagnosed simultaneously. The most common mechanism of transmission was heterosexual transmission, followed by intravenous and homo/bisexual transmission. Significant epidemiological differences (p<0.001 were found with regard to AIDS cases. Conclusions: Sexual transmission has replaced intravenous drug use as the most common mechanism of HIV transmission. A large percentage of patients were simultaneously diagnosed with HIV and AIDS, indicating the need for new prevention strategies.

  9. Deteccion de amastigotas en Leishmaniasis cutanea y mucocutanea por el metodo de inmunoperoxidasa, usando anticuerpo policlonal: sensibilidad y especificidad comparadas con metodos convencionales de diagnostico Detection of amastigotes in cuteneous and mucocutaneous leishmaniasis by the immunoperoxidase method, using polyclonal antibody sensibility and specifity compared with conventional diagnosis methods

    Directory of Open Access Journals (Sweden)

    Graciela Salinas

    1989-03-01

    Full Text Available Con el objeto de aumentar la sensibilidad del diagnóstico histopatológico de lesiones cutáneas y mucocutáneas causada por subespecies del complejo Leismania braziliensis y para lograr una mejor visualización de los parásitos en las lesiones, se evaluó el método de la inmunoperoxidas indirecta para localizar en forma rápida y específica los amastigotas en biopsia de tejido afectado. Los cortes de tejido se fijaron en formol y se incluyeron en parafina; después se evaluaron por inmunohistoquímica usando un antisuero policlonal producido en conejo, como reactivo primario, Se examinaron 265 biopsias de pacientes con lesiones sospechosas de leishmaniasis de la costa Pacífica y región suroriental colombiana. a 1983 (72.8% pacientes se les estableció el diagnóstico por métodos clínicos y/o poarasitológicos. Los resultados obtenidos por la inmunoperoxidasa en el grupo de pacientes a los cuales se les confirmó la leishmaniasis se compararn con la histopatología convencional, el examen directo de frotis y el aislamiento del parásito por cultivo del aspirado de la lesión. La localización inmunoenzimática de las amastigotas fue más efectivas (61.3% que la histopatología com hematoxilina y eosina (34.6%, y que el frotis (43,9%. En cambio, el cultivo de aspirado fue más sensible (89.8%. La eficiencia del método de inmunoperoxidasa fue mayor en las lesiones recientes (72.5% positivos en los casos con menos de tres meses de evolución que en las lesiones más antiguas (55.6, 37.5 y 21.1% para 3-5.9, 6-11 meses y mayores o iguales a 12 mese, respectivamente. La combinación de frotis e inmunoperoxidasa incrementó el porcentaje de caso diagnosticados a 72.0%, lo que indica la importancia de combinar métodos para obtener una mayor eficiencia de diagnóstico. La especificidad fue de 100% en controles sanos y 92.9% en pacientes con lesiones causadas por agentes etiológicos distintos a leishmania.The indirect immunoperoxidase method

  10. [Neurological examination in patients undergoing sedation with propofol: a descriptive study].

    Science.gov (United States)

    Ordas-Bandera, Carlos M; Sanchez-Marcos, Carolina; Janeiro-Lumbreras, David; Jimenez-Martin, M José; Muniz-Castrillo, Sergio; Cuadrado-Perez, M Luz; Porta-Etessam, Jesús

    2014-06-16

    Introduccion. La exploracion neurologica es un recurso en la evaluacion de los pacientes en coma. La anestesia puede ser un factor influyente en los hallazgos. Evaluamos la exploracion del paciente en coma en pacientes anestesiados con propofol para definir su valor clinico. Pacientes y metodos. Estudio prospectivo en sometidos a cirugia cardiaca en los cuidados intensivos de un hospital terciario durante los meses de abril y mayo de 2011. Se analiza la exploracion del coma anestesico, factores farmacologicos o medicos que pueden influir y exploracion neurologica completa tras la recuperacion. Se excluyeron pacientes con sintomas neurologicos previos. Resultados. Se seleccionan 30 pacientes (16 hombres y 14 mujeres); edad media: 72 ± 10 años. Todos los pacientes estaban sedados con propofol. Durante la sedacion, 17 (46,7%) presentaban pupilas arreactivas. En el 100% no se observaron movimientos espontaneos de los ojos. El 23,3% presentaba alteracion ocular en posicion primaria. Los reflejos oculocefalicos estaban ausentes en el 93,3%, y los oculovestibulares, en el 100%; el reflejo corneal, en el 70% (con asimetria); el espinociliar, en el 83,3%. La respuesta motora algesica estaba ausente en el 93,3%; en un 20%, los reflejos cutaneoplantares extensores; e indiferentes, en el 66,7%. Tras la anestesia, la exploracion neurologica fue normal en el 80%, hubo leves alteraciones de orientacion en un 16,7% y se encontro un sindrome hemisferico en un paciente. Conclusiones. La anestesia con propofol altera los reflejos pupilares, del tronco, respuestas motoras y reflejo cutaneoplantar reversibles al retirar la sedacion. Las alteraciones pueden ser asimetricas. No se deberia utilizar la exploracion neurologica en el paciente sedado con propofol para la toma de decisiones clinicas.

  11. Chitosan Oligosaccharide Reduces Propofol Requirements and Propofol-Related Side Effects.

    Science.gov (United States)

    Li, Zhiwen; Yang, Xige; Song, Xuesong; Ma, Haichun; Zhang, Ping

    2016-12-21

    Propofol is one of the main sedatives but its negative side effects limit its clinical application. Chitosan oligosaccharide (COS), a kind of natural product with anti-pain and anti-inflammatory activities, may be a potential adjuvant to propofol use. A total of 94 patients receiving surgeries were evenly and randomly assigned to two groups: 10 mg/kg COS oral administration and/or placebo oral administration before being injected with propofol. The target-controlled infusion of propofol was adjusted to maintain the values of the bispectral index at 50. All patients' pain was evaluated on a four-point scale and side effects were investigated. To explore the molecular mechanism for the functions of COS in propofol use, a mouse pain model was established. The activities of Nav1.7 were analyzed in dorsal root ganglia (DRG) cells. The results showed that the patients receiving COS pretreatment were likely to require less propofol than the patients pretreated with placebo for maintaining an anesthetic situation (p propofol-pretreated group. The side effects were also more reduced in a COS-treated group than in a placebo-pretreated group. COS reduced the activity of Nav1.7 and its inhibitory function was lost when Nav1.7 was silenced (p > 0.05). COS improved propofol performance by affecting Nav1.7 activity. Thus, COS is a potential adjuvant to propofol use in surgical anesthesia.

  12. VALIDACIÓN DE LA PLACA BRUXCHECKER COMO MEDIO DIAGNÓSTICO DE BRUXISMO, COMPARADA CON MODELOS DE ESTUDIO EN LA CLÍNICA DE LA UNIVERSIDAD COOPERATIVA DE COLOMBIA, SEDE BOGOTÁ, DURANTE EL PERIODO COMPRENDIDO ENTRE FEBRERO Y MAYO DEL 2011

    Directory of Open Access Journals (Sweden)

    Claudia Liliana Cabrera Bello

    2012-12-01

    Full Text Available Introducción: El bruxismo es un trastorno del movimiento del sistema masticatorio, caracterizado por apriete,rechinamiento y golpeteo dentario. La ausencia de un elemento diagnóstico para evaluar el patrón de contactos oclusales y diagnosticar el grado de bruxismo llevó a realizar un estudio investigativo para validar la placa bruxchecker. Objetivos: En este estudio se validó la placa bruxchecker como medio diagnóstico para valorar la presencia y ubicación de las interferencias oclusales durante los episodios de bruxismo. Materiales y métodos: Se realizó un estudio de evaluación de pruebas diagnósticas, en una población de 35 pacientes mayores de 18 años que asistieron por primera vez a la clínica de ortodoncia correctiva de la Universidad Cooperativa de Colombia sede Bogotá entre febrero y mayo de  2011, se compararon las marcas en las placas Bruxchecker con los desgastes de las caras oclusales encontrados en los modelos de estudio para determinar la concordancia entre los diagnósticos. Resultados: La placa bruxchecker clasificó correctamente de cada 100 enfermos a 96 y de cada 100 sanos a 57. El valor predictivo positivo es del 96% y del 57% el valor predictivo negativo. La prevalencia de bruxismo medida con la placa  fue de 80% en la población. Conclusiones: Se concluye que la placa es una adecuada herramienta para diagnosticar bruxismo.

  13. RUPTURA Y CONTINUIDAD: LA CAÍDA DE «MEL» ZELAYA EN PERSPECTIVA COMPARADA

    Directory of Open Access Journals (Sweden)

    Mariana LLANOS

    2010-01-01

    Full Text Available Este artículo analiza y compara la deposición del presidente de Honduras, Manuel Zelaya, con otras crisis presidenciales acontecidas en América Latina durante la tercera ola de democratización. El trabajo indaga sobre los procedimientos, causas y consecuencias en torno de esta caída presidencial con instrumentos de análisis previstos por la teoría de las rupturas presidenciales. La caída de Zelaya fue producto de una escalada de conflictos interinstitucionales, protagonizados por las elites civiles del país. En perspectiva comparada, el caso se distingue por la intervención de los militares como poder moderador a invitación de las instituciones civiles, la falta de movilización popular antes del golpe y la irrupción de una crisis internacional y conflictos callejeros después de que la caída presidencial tuviera lugar. El caso de Honduras contribuye a la teoría de las rupturas presidenciales al poner el acento en el papel de los militares y el estadio de desarrollo en que se encuentra el régimen político democrático al estallar la crisis.

  14. Anatomia comparada das folhas e evolução das Podocarpineae

    Directory of Open Access Journals (Sweden)

    Ph Woltz

    1987-07-01

    Full Text Available En las Podocarpineae actualmente se conocen 184 espécies, de las cuales 120 han sido estudiadas en la anatomia comparada de la hoja. Es propuesto el siguiente sistema evolutivo: en muchos phyla diferentes, evolucionando de manera paralela, un tipo ancestral de hoja corta uninervada, provisto abundantemente de sub-epidermis y de canales resiníferos, pasaría por transformaciones sucesivas a tipos con hojas largas, anchas, uninervadas a pluri-nervadas, con sub-epidermis reducida y canales resiníferos poco numerosos. A veces, en la culminación de phylum, una sobre-evolución conduce a un falso retorno ancestral: hoja corta o en escamas carnosas y multiplicación tardia de los canales separados en el mesófilo. Como en el caso de la evolucion vascular de las plantas cotiladas (WOLTZ, 1986, existe un paralelismo notable entre la anatomia foliar y la latitud geográfica, lo que parece sugerir el origen más antiguo de los taxa más australes.

  15. Propofol alternatives in gastrointestinal endoscopy anesthesia

    Directory of Open Access Journals (Sweden)

    Basavana Gouda Goudra

    2014-01-01

    Full Text Available Although propofol has been the backbone for sedation in gastrointestinal endoscopy, both anesthesiologists and endoscopists are faced with situations where an alternative is needed. Recent national shortages forced many physicians to explore these options. A midazolam and fentanyl combination is the mainstay in this area. However, there are other options. The aim of this review is to explore these options. The future would be, invariably, to move away from propofol. The reason is not in any way related to the drawbacks of propofol as a sedative. The mandate that requires an anesthesia provider to administer propofol has been a setback in many countries. New sedative drugs like Remimazolam might fill this void in the future. In the meantime, it is important to keep an open eye to the existing alternatives.

  16. Las desventajas de la Política Comparada en América Latina: énfasis en el caso Argentino

    Directory of Open Access Journals (Sweden)

    Martín Omar D'Alessandro

    2013-12-01

    Full Text Available La ciencia política de América Latina viene experimentado un debate mal orientado acerca de sus enfoques teóricos y estrategias metodológicas. El artículo recoge parte de ese debate para argumentar que la política comparada regional se ve desfavorecida debido a una serie de creencias erróneas acerca de su relevancia, método y presencia en el campo disciplinar. Se abordan empíricamente las dimensiones más importantes del desarrollo de la política comparada en la región (con énfasis en el caso Argentino para rebatir los argumentos que le adjudican predominio y hegemonía en el campo politológico regional y local.

  17. Efeitos de esmolol, lidocaína e fentanil nos intervalos dispersão da onda P, QT, QTc e respostas hemodinâmicas à intubação endotraqueal durante indução com propofol: um estudo comparativo Efectos del esmolol, de la lidocaína y del fentanilo en los intervalos dispersión de la onda, QT, QTc y respuestas hemodinámicas a la intubación endotraqueal durante inducción con propofol: un estudio comparativo Effects of esmolol, lidocaine and fentanyl on P wave dispersion, QT, QTc intervals and hemodynamic responses to endotracheal intubation during propofol induction: a comparative study

    Directory of Open Access Journals (Sweden)

    Volkan Hancı

    2013-06-01

    grupo controle. Porém, nos grupos L, F e E não houve diferença significativa entre os valores de DP após a intubação em comparação com o grupo controle. A duração do intervalo QTc foi significativamente maior nos grupos C e L após a intubação em comparação com o grupo controle. Porém, não houve diferença significativa na duração do QTc nos grupos F e E após a intubação em comparação com o grupo controle. CONCLUSÃO: Concluímos que a administração de esmolol antes da intubação previne a taquicardia, o aumento da PAM e as durações da onda P e intervalo QTc causados pela laringoscopia e intubação traqueal.JUSTIFICATIVA Y OBJETIVOS: Investigar el efecto del esmolol, lidocaína y fentanilo en la dispersión de la onda P (DOP, duraciones de los intervalos QT y QT corregido (QTc y las respuestas hemodinámicas a la intubación endotraqueal durante la inducción con propofol. MÉTODOS: En este estudio prospectivo, aleatorio y doble ciego, fueron incluidos 80 pacientes adultos, con estado físico ASA I o II, y edad entre 18 y 60 años. Todos los pacientes se sometieron al examen electrocardiográfico (ECG antes de la inducción de la anestesia. Los pacientes fueron aleatoriamente divididos en cuatro grupos iguales. El grupo control (Grupo C recibió 5 mL de solución salina; el grupo esmolol (Grupo E recibió 0,5 mg.kg-1 de esmolol; el grupo fentanilo (Grupo F recibió 2 µg.kg-1 de fentanilo y el grupo lidocaína (Grupo L recibió 1,5 mg.kg-1 de lidocaína antes de la inducción anestésica. La anestesia fue inducida con propofol. El ECG se hizo en todos los pacientes durante el primero y el tercer minuto de inducción, 3 minutos después de la administración del relajante muscular y 5 y 10 minutos después de la intubación. La DOP y los intervalos QT se midieron en todos los ECGs. Los intervalos QTc fueron determinados con el uso de la fórmula de Bazett. La frecuencia cardíaca (FC y la presión arterial promedio (PAP fueron registradas

  18. Propofol and arrhythmias: two sides of the coin

    Science.gov (United States)

    Liu, Qiang; Kong, Ai-ling; Chen, Rong; Qian, Cheng; Liu, Shao-wen; Sun, Bao-gui; Wang, Le-xin; Song, Long-sheng; Hong, Jiang

    2011-01-01

    The hypnotic agent propofol is effective for the induction and maintenance of anesthesia. However, recent studies have shown that propofol administration is related to arrhythmias. Propofol displays both pro- and anti-arrhythmic effects in a concentration-dependent manner. Data indicate that propofol can convert supraventricular tachycardia and ventricular tachycardia and may inhibit the conduction system of the heart. The mechanism of the cardiac effects remains poorly defined and may involve ion channels, the autonomic nervous system and cardiac gap junctions. Specifically, sodium, calcium and potassium currents in cardiac cells are suppressed by clinically relevant concentrations of propofol. Propofol shortens the action potential duration (APD) but lessens the ischemia-induced decrease in the APD. Furthermore, propofol suppresses both sympathetic and parasympathetic tone and preserves gap junctions during ischemia. All of these effects cumulatively contribute to the antiarrhythmic and proarrhythmic properties of propofol. PMID:21642950

  19. Propofol and arrhythmias: two sides of the coin

    Institute of Scientific and Technical Information of China (English)

    Qiang LIU; Ai-ling KONG; Rong CHEN; Cheng QIAN; Shao-wen LIU; Bao-gui SUN; Le-xin WANG; Long-sheng SONG; Jiang HONG

    2011-01-01

    The hypnotic agent propofol is effective for the induction and maintenance of anesthesia. However, recent studies have shown that propofol administration is related to arrhythmias. Propofol displays both pro- and anti-arrhythmic effects in a concentration-dependent manner. Data indicate that propofol can convert supraventricular tachycardia and ventricular tachycardia and may inhibit the conduction system of the heart. The mechanism of the cardiac effects remains poorly defined and may involve ion channels, the autonomic nervous system and cardiac gap junctions. Specifically, sodium, calcium and potassium currents in cardiac cells are suppressed by clinically relevant concentrations of propofol. Propofol shortens the action potential duration (APD) but lessens the ischemia-induced decrease in the APD. Furthermore, propofol suppresses both sympathetic and parasympathetic tone and preserves gap junctions during ischemia. All of these effects cumulatively contribute to the antiarrhythmic and proarrhythmic properties of propofol.

  20. Lornoxicam use to reduce the pain associated with propofol injection

    African Journals Online (AJOL)

    Nihal Başak

    2017-04-28

    Apr 28, 2017 ... mostat, granisetron, oral clonidine, cold saline solution ... the buffering effect of the blood and administration together .... interaction of the propofol active component with .... study between propofol in a long-chain triglyceride.

  1. Propofol infusion syndrome in refractory status epilepticus.

    Science.gov (United States)

    Hwang, Woo Sub; Gwak, Hye Min; Seo, Dae-Won

    2013-06-01

    Propofol is used for treating refractory status epilepticus, which has high rate of mortality. Propofol infusion syndrome is a rare but often fatal syndrome, characterized by lactic acidosis, lipidemia, and cardiac failure, associated with propofol infusion over prolonged periods of time. We investigated the clinical factors that characterize propofol infusion syndrome to know the risk of them in refractory status epilepticus. This retrospective observation study was conducted in Samsung medical center from Jan. 2005 to Dec. 2009. Thirty two patients (19 males, 13 females, aged between 16 and 64 years), with refractory status epilepsy were included. Their clinical findings and treatment outcomes were evaluated retrospectively. We divided our patients into established status epilepticus (ESE) and refractory status epilepticus (RSE). And then the patients with RSE was further subdivided into propofol treatment group (RSE-P) and the other anesthetics treatment group (RSE-O). We analyzed the clinical characteristics by comparison of the groups. There were significant differences of hypotension and lipid change between ESE and RSE (pRSE-P and RSE-O groups. The hospital days were longer in RSE than in ESE (p=0.012) and treatment outcome was also worse in RSE than in ESE (p=0.007) but there were no significant differences of hospital stays and treatment outcome between RSE-P and RSE-O. RSE is very critical disease with high mortality, which may show as many clinical changes as propofol infusion syndrome. Therefore propofol infusion syndrome might be considered as one of the clinical manifestations of RSE.

  2. Efeitos analgésico e hipnótico das associações do sufentanil com o tiopental e com o propofol, em ratos

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    Antonio Mauro Vieira

    1998-04-01

    Full Text Available O objetivo deste estudo foi avaliar a ação analgésica do sufentanil com a ação hipnótica do tiopental e do propofol, os quais foram ministrados por via intraperitoneal, em 60 ratos Wistar. Os animais foram distribuídos em dois grupos de 30 e submetidos a diferentes doses de sufentanil, tiopental e propofol para determinação das doses, analgésica e hipnóticas, médias. A dose do sufentanil foi determinada com estímulos padronizados pelo pinçamento da cauda do animal. Enquanto que com o tiopental e o propofol objetivou-se a dose hipnótica média, onde a resposta foi a perda de postura. Da interação do tiopental com o sufentanil obteve-se uma ação hipnótica aumentada e prolongada. Enquanto, o propofol associado ao sufentanil mostrou um início mais lento, porém com maior duração da ação hipnótica. Com relação à ação analgésica da associação do tiopental e sufentanil, obteve-se um aumento significante. Enquanto, na associação do propofol com sufentanil não se detectou diferença significante. A associação do tiopental com sufentanil apresentou maior potência hipnótica e analgésica quando comparada à associação do propofol com sufentanil. Da mesma forma, quando se observou a presença concomitante de hipnose e analgesia, a associação do tiopental com sufentanil apresentou uma ação mais longa do que o propofol com sufentanil.The aim of this study was to evaluate the interactions of the analgesic action of sufentanil with the hypnotic action of thiopental and propofol, in 60 male rats distributed in two groups of 30 and submitted to different doses of sufentanil and propofol, to determine the analgesic (AMD and hypnotic medium doses (HMD. The AMD of sufentanil was the analgesic dose and HMD of thiopental and propofol was the dose to obtain hypnosis, this is, the lost of righting reflex. There was a prolonged hypnotic action when thiopental with sufentanil and propofol with sufentanil were used together

  3. CO - INDUCTION : A COMPARATIVE STUDY OF MIDAZOLAM KETAMINE AND PROPOFOL AS COINDUCING AGENTS TO PROPOFOL

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    Jyothi

    2015-07-01

    Full Text Available INTRODUCTION : “Co - induction” refers to the administration of a small dose of a sedative or anaesthetic agent prior to the induction of anesthesia, with the aim of achieving more specific ‘target’ responses, while minimizing side effects. Although Propofol is a very po pular IV induction agent, it causes various adverse effects like hypotension and apnoea and it is expensive. So the present study was designed to find whether the concept of co - induction can be used to overcome the above mentioned short comings of Propofol induction. AIM: To compare the effectiveness and evaluate the use of midazolam, ketamine and propofol as co - inducing agents to propofol for general anesthesia. DESIGN : A Prospective Randomized Double blind study was planned. METHOD S : 100 adult patients of ASA grade 1 and 2 aged between 18 – 50 yrs. undergoing elective general, orthopedic or gynecological surgeries under general anesthesia were randomly allocated into four groups of 25 each: Group SP: received normal saline 3 ml IV as co - induction agent. Grou p MP: received inj. Midazolam 0.03mg \\ kg IV Group KP: received inj. Ketamine 0.3mg \\ kg IV . Group PP: received inj. Propofol 0.4mg \\ kg IV (auto - co - induction . All patients received inj. Pentazocine 0.3 mg \\ kg IV followed by blinded pretreatment with either sali ne 3ml IV, (group SP - control, inj.Midazolam.0.03mg \\ kg IV (group M, Inj. Ketamine 0.3mg \\ kg IV (group KP or inj. Propofol 0.4mg \\ kg IV (group PP. Two min later induction was done with inj Propofol until loss of verbal contact or resistance to placement of facemask. Total induction dose of Propofol, associated haemodynamic parameters (HR, MAP at 1min interval for five min after induction and occurrence of significant apnoea (>20 sec or Spo2 < 90% were recorded. The obtained data was analyzed using Chi - squa re test and Students “t” test. RESULTS & CONCLUSION : The mean induction dose of propofol was 1.31mg \\ kg, 1.39mg

  4. Impact of time interval between remifentanil and propofol on propofol injection pain.

    Science.gov (United States)

    Lee, Seong Heon; Lee, Soo Eun; Chung, Shiyoung; Lee, Hyun Jung; Jeong, Seongwook

    2016-11-01

    To determine the most effective time interval between remifentanil and propofol (TimeRP) for the prevention of propofol injection pain in association with remifentanil dosage. Prospective randomized study. Operating room of a university hospital. Sixty American Society of Anesthesiologists physical status 1 and 2 patients scheduled for elective surgery under general anesthesia. Patients were randomly assigned to 1 of 3 groups to receive remifentanil at dosages of 0.25, 0.5, or 0.75 μg/kg over 30 seconds before the injection of 1% propofol 2 mg/kg. TimeRP was defined as the time interval from the initiation of the remifentanil injection to the initiation of the propofol injection. TimeRP for each subsequent patient was determined by the response of the previous patient using an up-and-down sequential allocation method. Injection pain caused by propofol was evaluated using a 4-point scale during the propofol injection. TimeRP50 was defined as the TimeRP at which propofol injection pain was absent in 50% of patients, and it was estimated using isotonic regression for each dose group. TimeRP50 was significantly lower in the remifentanil 0.75 μg/kg group (38.6 seconds, 83% confidence interval [CI], 35.6-45.0) than in the 0.5 μg/kg group (65.0 seconds; 83% CI, 52.5-75.0) or the 0.25 μg/kg group (66.6 seconds; 83% CI, 57.1-76.5). The efficacy of remifentanil pretreatment for preventing propofol injection pain can be influenced by the time interval between remifentanil and propofol as well as the remifentanil dose. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Red social y salud del adulto mayor en perspectiva comparada: Costa Rica, España e Inglaterra

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    Dolores Puga

    2007-01-01

    Full Text Available En el presente trabajo se explora la relación entre la red social más próxima al adulto mayor, los vínculos establecidos con otros miembros del hogar y con los hijos, y las condiciones de salud en la vejez, desde una perspectiva internacional comparada. Para ello se cuenta con evidencias empíricas de una sociedad latinoamericana (costarricense, una sociedad latino-europea (española y una sociedad anglosajona (británica. Los adultos mayores de los tres países analizados han mostrado modelos de redes familiares claramente diferenciados, caracterizados por la corresidencia intergeneracional (caso latinoamericano, por la independencia (caso anglosajón y por la independencia (sólo residencial (caso latino-europeo. La convivencia entre miembros de la misma familia parece tener efectos positivos cuando no es por necesidad. La frecuencia de los contactos con otros miembros de la familia muestra un mayor efecto positivo cuanto mayor es la independencia de los adultos mayores.

  6. Red social y salud del adulto mayor en perspectiva comparada: Costa Rica, España e Inglaterra

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    Castro, Teresa

    2007-07-01

    Full Text Available En el presente trabajo se explora la relación entre la red social más próxima al adulto mayor, los vínculos establecidos con otros miembros del hogar y con los hijos, y las condiciones de salud en la vejez, desde una perspectiva internacional comparada. Para ello se cuenta con evidencias empíricas de una sociedad latinoamericana (costarricense, una sociedad latino-europea (española y una sociedad anglosajona (británica. Los adultos mayores de los tres países analizados han mostrado modelos de redes familiares claramente diferenciados, caracterizados por la corresidencia intergeneracional (caso latinoamericano, por la independencia (caso anglosajón y por la independencia (sólo residencial (caso latino-europeo. La convivencia entre miembros de la misma familia parece tener efectos positivos cuando no es por necesidad. La frecuencia de los contactos con otros miembros de la familia muestra un mayor efecto positivo cuanto mayor es la independencia de los adultos mayores.

  7. Prolonged propofol infusion for mechanically ventilated children.

    Science.gov (United States)

    Sasabuchi, Y; Yasunaga, H; Matsui, H; Lefor, A K; Fushimi, K

    2016-04-01

    We retrospectively analysed 30-day mortality and duration of intubation for 8016 children ventilated for three or more days, sedated with midazolam (n = 7716) or propofol (n = 300). We matched the propensity scores of 263 pairs of children. The propensity-matched 30-day mortality (95% CI) was similar: 17/263 (6.5%) with midazolam vs. 24/263 (9.1%) with propofol, p = 0.26. Weaning from mechanical ventilation of children sedated with midazolam was slower than weaning of children sedated with propofol, subhazard ratio (95% CI) 1.43 (1.18-1.73), p < 0.001. © 2016 The Association of Anaesthetists of Great Britain and Ireland.

  8. [Awareness under remifentanil-propofol anaesthesia].

    Science.gov (United States)

    Andres, A H; Walk, C B; Meywirth, E; Milkereit, E

    2005-10-01

    We report on a 49-year-old female patient suffering from recurrent carcinoma of the rectum, who underwent a palliative Hartmann operation for an anus praeter reconstruction. After a remifentanil bolus of 90 microg and a propofol bolus of 200 mg, anaesthesia was maintained with 0.25 microg/kg/min remifentanil and 4 mg/kg propofol, and after skin incision with 1.0 microg/kg/min remifentanil and 5 mg/kg/h propofol. Throughout the operation, the patient showed a stable blood pressure of 120-130/80 mmHg but 15 min after skin incision the heart rate suddenly rose to 140 beats/min, so remifentanil was increased to 1.8 microg/kg/min and propofol to 8 mg/kg/h. Over a time period of 15 min the heart rate decreased to 90 beats/min. Subsequently vegetative parameters stayed within the normal range (heart rate 90 beats/min, blood pressure 120-130/80 mmHg) so that continuous administration of remifentanil and propofol could be tapered. After completion of skin sutures, administration of remifentanil and propofol was terminated. After extubation the patient reported having heard conversations contributable to the end of the operation and the sentence: "now we're done" was clearly remembered. The patient stated that she had not been able to move any part of her body, that she had perceived the situation as extremely unpleasant and dangerous and that she had felt severe pain. At the postoperative rounds the patient refused any psychological and psychiatric help.

  9. Physical Compatibility of Propofol-Sufentanil Mixtures.

    Science.gov (United States)

    Zbytovská, Jarmila; Gallusová, Jana; Vidlářová, Lucie; Procházková, Kamila; Šimek, Jan; Štěpánek, František

    2017-03-01

    Combined infusions of propofol and sufentanil preparations are frequently used in clinical practice to induce anesthesia and analgesia. However, the stability of propofol emulsions can be affected by dilution with another preparation, sometimes leading to particle coalescence and enlargement. Such unwanted effects can lead to fat embolism syndrome after intravenous application. This study describes the physical stability of 5 commercially available propofol preparations mixed with sufentanil citrate solutions. Two common markers of emulsion stability were used in this study; namely, the zeta potential and size distribution of the emulsion droplets. Both were measured using dynamic light scattering. The data for the pure propofol preparations and their mixtures with sufentanil citrate solution were compared. The absolute value of zeta potential decreased in 4 of the 5 propofol preparations after they had been mixed with sufentanil citrate. This effect indicates a lowering of repulsive interactions between the emulsion droplets. Although this phenomenon tends to cause agglomeration, none of the studied mixtures displayed a substantial increase in droplet size within 24 hours of blending. However, our long-term stability study revealed the instability of some of the propofol-sufentanil samples. Two of the 5 studied mixtures displayed a continual increase in particle size. The same 2 preparations showed the greatest reductions in the absolute value of zeta potential, thereby confirming the correlation of both measurement methods. The increase in particle size was more distinct in the samples stored at higher temperatures and with higher sufentanil concentrations. To ensure the microbial stability of an emulsion infusion preparation, clinical regulations require that such preparations should be applied to patients within 12 hours of opening. In this respect, we can confirm that during this period, none of the studied propofol-sufentanil mixtures displayed any physical

  10. Nurse-administered propofol sedation for endoscopy

    DEFF Research Database (Denmark)

    Jensen, J T; Vilmann, P; Horsted, T

    2011-01-01

    BACKGROUND AND STUDY AIMS: The aim of the present study was to perform a risk analysis during the implementation phase of nurse-administered propofol sedation (NAPS) and to validate our structured training program. PATIENTS AND METHODS: A structured training program was developed both for endosco...... for sedation, and can be used as basis for further comparison. NAPS for endoscopic procedures is safe when performed by personnel properly trained in airway handling and sedation with propofol, and has considerable advantages compared with conventional sedation for endoscopy....

  11. Caveolae and propofol effects on airway smooth muscle

    Science.gov (United States)

    Grim, K. J.; Abcejo, A. J.; Barnes, A.; Sathish, V.; Smelter, D. F.; Ford, G. C.; Thompson, M. A.; Prakash, Y. S.; Pabelick, C. M.

    2012-01-01

    Background The i.v. anaesthetic propofol produces bronchodilatation. Airway relaxation involves reduced intracellular Ca2+ ([Ca2+]i) in airway smooth muscle (ASM) and lipid rafts (caveolae), and constitutional caveolin proteins regulate [Ca2+]i. We postulated that propofol-induced bronchodilatation involves caveolar disruption. Methods Caveolar fractions of human ASM cells were tested for propofol content. [Ca2+]i responses of ASM cells loaded with fura-2 were performed in the presence of 10 µM histamine with and without clinically relevant concentrations of propofol (10 and 30 μM and intralipid control). Effects on sarcoplasmic reticulum (SR) Ca2+ release were evaluated in zero extracellular Ca2+ using the blockers Xestospongin C and ryanodine. Store-operated Ca2+ entry (SOCE) after SR depletion was evaluated using established techniques. The role of caveolin-1 in the effect of propofol was tested using small interference RNA (siRNA) suppression. Changes in intracellular signalling cascades relevant to [Ca2+]i and force regulation were also evaluated. Results Propofol was present in ASM caveolar fractions in substantial concentrations. Exposure to 10 or 30 µM propofol form decreased [Ca2+]i peak (but not plateau) responses to histamine by ∼40%, an effect persistent in zero extracellular Ca2+. Propofol effects were absent in caveolin-1 siRNA-transfected cells. Inhibition of ryanodine receptors prevented propofol effects on [Ca2+]i, while propofol blunted [Ca2+]i responses to caffeine. Propofol reduced SOCE, an effect also prevented by caveolin-1 siRNA. Propofol effects were associated with decreased caveolin-1 expression and extracellular signal-regulated kinase phosphorylation. Conclusions These novel data suggest a role for caveolae (specifically caveolin-1) in propofol-induced bronchodilatation. Due to its lipid nature, propofol may transiently disrupt caveolar regulation, thus altering ASM [Ca2+]i. PMID:22542538

  12. Endoscopist controlled administration of propofol: an effective and safe method of sedation in endoscopic procedures Administración controlada de propofol por el endoscopista: un método efectivo y seguro de sedación en endoscopia

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    S. Sáenz-López

    2006-01-01

    of propofol by the endoscopist and the assistant nurse, is an effective and safe method of sedation in patients of low and high-risk as well as in elderly patients. The doses of propofol required for an adequate sedation were lower in patients over 65 years of age and for colonoscopies in which medication was combined.Objetivos: el propofol es un agente hipnótico de acción rápida utilizado de forma cada vez más frecuente en la endoscopia digestiva. Existen controversias sobre su utilización por no anestesistas, dado su potencial efecto cardiodepresor. Este estudio describe nuestra experiencia en cuanto a efectividad y seguridad del propofol, administrado por el endoscopista y su enfermera, en la endoscopia digestiva. Métodos: en este estudio prospectivo, se incluyeron un total de 102 endoscopias (60 colonoscopias y 42 gastroscopias realizadas bajo sedación con propofol. En 27 (26,47% endoscopias se empleó sólo propofol y en 75 endoscopias (73,53% se asoció midazolam y/o meperidina. Se realizaron 76 (74,51% endoscopias en menores de 65 años y 26 (25,49% en pacientes mayores de 65 años. Fueron realizadas 91 (89,22% endoscopias en pacientes con bajo riesgo quirúrgico (ASA I-II y 11 (10,78% en pacientes con alto riesgo quirúrgico. La sedación fue administrada por el endoscopista que realizaba la exploración y su enfermera asistente. Resultados: las dosis media de propofol fue de 72,14 mg en las gastroscopias y de 71,33 en las colonoscopias (p = 0,92. La dosis media de propofol cuando no se asoció comedicación fue de 84,81 mg y en presencia de comedicación de 66,93 (p = 0,06. Las dosis de propofol requeridas fueron significativamente menores en las colonoscopias en las que se asoció midazolam y/o meperidina y en pacientes mayores de 65 años (p = 0,006 y p = 0,001, respectivamente. Se observaron 11 (10,8% incidencias de carácter leve y resueltas por el propio endoscopista. Ningún paciente guardaba recuerdo de la exploración. La tolerancia registrada

  13. COMPARATIVE EVALUATION OF PROPOFOL KETAMINE AND PROPOFOL FENTANYL IN DAY CARE SURGERIES

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    Brajesh

    2014-09-01

    Full Text Available To find the ideal drug combinations which can be used during day care surgeries and procedures. AIMS: This study was conducted. To evaluate and compare the efficacy, and haemodynamic stability of ketamine and fentanyl combination with propofol. To compare the incidence of side effects. To compare the time of awakening and recovery time. To compare the discharge criteria in both groups. METHODS: The study was conducted in 50 patients of age group 18-50 years of either gender belonging to ASA grade I and II, were divided into two groups of 25 each. They underwent elective surgery of approximately 1 hour duration. Group I received Propofol-ketamine while group II received Propofol-fentanyl for induction and maintenance of anaesthesia. Postoperatively, time for awakening, recovery time ‘(by modified Aldrete scoring system and discharge status (by modified post anaesthetic discharge scoring system were recorded and compared in two groups. RESULTS: Profol-fentanyl combination produced a significantly greater fall in pulse rate and in both systolic and diastolic blood pressure as compared to Propofol-ketamine during induction and maintenance of anaesthesia. Fall in respiratory rate was greater in Propofol-fentanyl group as compared to Propofol-ketamine group. The recovery time in group I was longer than group II. Discharge criteria is significantly earlier in group II. CONCLUSION: Both Profol-ketamine and Propofol-fentanyl combination reduce rapid, pleasant and safe anesthesia with only a few untoward side effects and propofol-ketamine produces better haemodynamic statistic, during anaesthesia.

  14. Perbandingan Kebutuhan Propofol dan Lama Bangun antara Kombinasi Propofol-Ketamin dan Propofol-Fentanil pada Pasien yang Dilakukan Kuretase yang Diukur dengan Bispectral Index (BIS

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    Wirawan Anggorotomo

    2015-12-01

    Full Text Available Adequate administration of safe, easy-to-obtain, and constantly available sedatives and analgesia, is needed for pain reduction throughout curettage procedures. The goal of this study was to examine differences in propofol requirements and emergence time between propofol-ketamine and propofol-fentanyl combinations in patients undergoing curettage. A single-blind randomized controlled trial study was performed on 60 patients who underwent curettage procedures. The patients were divided into two groups: propofol-ketamine (PK and propofol-fentanyl (PF. Blood pressure, pulse rate, respiration rate, and oxygen saturation and BIS data were analysed using a t-test and Mann-Whitney test. This study showed that propofol requirements differ significantly (p<0.001 between the two groups where in PK group where 4/30 subjects received additional propofol, compared to PF group 14/30 subjects received additional propofol. The wake up time for PK group was 25.75±2.47 minutes compared to 21.08±2.52 minutes for the PF group. The difference was statistically significant (p<0.001. The conclusions of this study are propofol requirements for PK group is less compared to PF group and the emergence time for PK group is longer compared to PF group.

  15. [The effects of the fat component of propofol solution of ketogenesis during propofol anesthesia].

    Science.gov (United States)

    Fujiwara, H; Nagata, O; Kitamura, T; Ide, Y; Tagami, M; Hanaoka, K

    2001-09-01

    To examine the effects of the fat component in propofol solution on the fat metabolism during propofol anesthesia, we measured the urine ketone body (UKB) and blood concentrations of 3-hydroxybutyrate (3-OHBA) and glucose. The anesthesia was maintained with propofol, fentanyl, and vecuronium. Infusion fluid without glucose was used while we measured the concentration of 3-OHBA. UKB was detected only when the concentration of 3-OHBA was more than 400 mumol.ml-1. The blood concentration of 3-OHBA increased in proportion to the total amount of propofol solution, while UKB did not show any such relationship. Furthermore, the rate of increase of 3-OHBA was larger in the group whose concentration of 3-OHBA was higher than the normal range. The blood concentration of glucose ranged within the normal fasting level. There were no cases who needed special treatment for hyperketonemia in this study. We concluded that 3-OHBA was a more sensitive indicator of ketogenesis than UKB, and that ketogenesis was accelerated both by propofol anesthesia with the lipidemic solution of propofol and by fasting before surgery. The acceleration of ketogenesis was especially marked in the patients with hyperketonemia.

  16. Didáctica de la Literatura Comparada: Las figuras retóricas en la literatura y en otras semióticas

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    José Enrique Peláez Malagón

    2011-01-01

    Full Text Available Dentro del campo de la teoría literaria nos encontramos con las llamadas figuras retóricas, elemento imprescindible a la hora de abordar cualquier comentario de texto que quiera centrarse en lo estrictamente literario. Una forma de abordar este problema es utilizar la literatura comparada, esto es, buscar en la pintura, la música, el cine o la publicidad, referentes de los mismos recursos estilísticos que ayuden a comprender mejor y a asimilar toda una serie de conceptos, muchas de las veces un tanto oscuros para un alumno cuya lengua materna no es el español.

  17. Dexmedetomidine compared with propofol for pediatric sedation during cerebral angiography.

    Science.gov (United States)

    Peng, Ke; Li, Jian; Ji, Fu-Hai; Li, Zhi

    2014-06-01

    Sedation of pediatric patients undergoing cerebral angiography is challenging. Although dexmedetomidine is used for sedation in various procedures, it has not been reported for pediatric patients undergoing cerebral angiography. This study compared the safety and efficacy of dexmedetomidine with that of propofol for cerebral angiography in pediatric patients. Sixty-two patients (6-15 years) scheduled for elective cerebral angiography were apportioned randomly and equally to receive either propofol or dexmedetomidine sedation. Patients in the propofol group received an initial bolus of intravenous propofol (1 mg/kg) and a maintenance infusion of 100 μg/kg/min. Patients in the dexmedetomidine group received an initial bolus of intravenous dexmedetomidine (1 μg/kg over 10 min) and a maintenance infusion of 1 μg/kg/h. An additional bolus of propofol 0.5 mg/kg or dexmedetomidine 0.25 μg/kg was repeated if needed. Procedure time, time to recovery and adverse events associated with sedation were recorded. All cerebral angiographies were completed successfully under sedation with dexmedetomidine or propofol. Mean cerebral angiography time was 36 ± 10 min in the propofol group and 31 ± 7 min in the dexmedetomidine group (P = 0.047). The percentage of airway events and total adverse events were significantly higher in the propofol group (P propofol group (P propofol or dexmedetomidine, dexmedetomidine may be a better alternative because of fewer respiratory adverse events.

  18. Exploring microsolvation of the anesthetic propofol

    NARCIS (Netherlands)

    Leon, I.; Cocinero, E. J.; Millan, J.; Jaeqx, S.; Rijs, A. M.; Lesarri, A.; Castano, F.; Fernandez, J. A.

    2012-01-01

    Propofol (2,6-diisopropylphenol) is a broadly used general anesthetic. By combining spectroscopic techniques such as 1- and 2-color REMPI, UV/UV hole burning, infrared ion-dip spectroscopy (IRIDS) obtained under cooled and isolated conditions with high-level ab initio calculations, detailed

  19. Comparison of Propofol, Propofol-Remifentanil, and Propofol-Fentanyl Administrations with Each Other Used for the Sedation of Patients to Undergo ERCP

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    Candan Haytural

    2015-01-01

    Full Text Available Introduction. Using single anesthetic agent in endoscopic retrograde cholangiopancreatography (ERCP may lead to inadequate analgesia and sedation. To achieve the adequate analgesia and sedation the single anesthetic agent doses must be increased which causes undesirable side effects. For avoiding high doses of single anesthetic agent nowadays combination with sedative agents is mostly a choice for analgesia and sedation for ERCP. Aim. The aim of this study is to investigate the effects of propofol alone, propofol + remifentanil, and propofol + fentanyl combinations on the total dose of propofol to be administered during ERCP and on the pain scores after the process. Materials and Method. This randomized study was performed with 90 patients (ASA I-II-III ranging between 18 and 70 years of age who underwent sedation/analgesia for elective ERCP. The patients were administered only propofol (1.5 mg/kg in Group Ι, remifentanil (0.05 μg/kg + propofol (1.5 mg/kg combination in Group II, and fentanyl (1 μg/kg + propofol (1.5 mg/kg combination in Group III. All the patients’ sedation levels were assessed with the Ramsey Sedation Scale (RSS. Their recovery was assessed with the Aldrete and Numerical Rating Scale Score (NRS at 10 min intervals. Results. The total doses of propofol administered to the patients in the three groups in this study were as follows: 375 mg in Group I, 150 mg in Group II, and 245 mg in Group III. Conclusion. It was observed that, in the patients undergoing ERCP, administration of propofol in combination with an opioid provided effective and reliable sedation, reduced the total dose of propofol, increased the practitioner satisfaction, decreased the pain level, and provided hemodynamic stability compared to the administration of propofol alone.

  20. Comparison of Propofol, Propofol-Remifentanil, and Propofol-Fentanyl Administrations with Each Other Used for the Sedation of Patients to Undergo ERCP

    Science.gov (United States)

    Haytural, Candan; Aydınlı, Bahar; Demir, Berna; Bozkurt, Elif; Parlak, Erkan; Dişibeyaz, Selçuk; Saraç, Ahmet; Özgök, Ayşegül; Kazancı, Dilek

    2015-01-01

    Introduction. Using single anesthetic agent in endoscopic retrograde cholangiopancreatography (ERCP) may lead to inadequate analgesia and sedation. To achieve the adequate analgesia and sedation the single anesthetic agent doses must be increased which causes undesirable side effects. For avoiding high doses of single anesthetic agent nowadays combination with sedative agents is mostly a choice for analgesia and sedation for ERCP. Aim. The aim of this study is to investigate the effects of propofol alone, propofol + remifentanil, and propofol + fentanyl combinations on the total dose of propofol to be administered during ERCP and on the pain scores after the process. Materials and Method. This randomized study was performed with 90 patients (ASA I-II-III) ranging between 18 and 70 years of age who underwent sedation/analgesia for elective ERCP. The patients were administered only propofol (1.5 mg/kg) in Group Ι, remifentanil (0.05 μg/kg) + propofol (1.5 mg/kg) combination in Group II, and fentanyl (1 μg/kg) + propofol (1.5 mg/kg) combination in Group III. All the patients' sedation levels were assessed with the Ramsey Sedation Scale (RSS). Their recovery was assessed with the Aldrete and Numerical Rating Scale Score (NRS) at 10 min intervals. Results. The total doses of propofol administered to the patients in the three groups in this study were as follows: 375 mg in Group I, 150 mg in Group II, and 245 mg in Group III. Conclusion. It was observed that, in the patients undergoing ERCP, administration of propofol in combination with an opioid provided effective and reliable sedation, reduced the total dose of propofol, increased the practitioner satisfaction, decreased the pain level, and provided hemodynamic stability compared to the administration of propofol alone. PMID:26576424

  1. Cardioversion: What to choose? Etomidate or propofol

    Science.gov (United States)

    Desai, Pushkar M.; Kane, Deepa; Sarkar, Manjula S.

    2015-01-01

    Context: Electrical cardioversion is a short painful procedure to regain normal sinus rhythm requiring anaesthesia for haemodynamic stability, sedation, analgesia and early recovery. Aims: To compare propofol and etomidate as sedatives during cardioversion. Settings and Design: Single centred, prospective and randomized single blind study comprising 60 patients. Subjects and Methods: Patients more than 18 years, American Society of Anesthesiologists I/II/III grades undergoing elective cardioversion, randomly divided to receive propofol 1 mg/kg intravenous (IV) bolus followed by 0.5 mg/kg (Group P, n = 30) or etomidate (Group E, n = 30) 0.1 mg/kg followed by 0.05 mg/kg. All patients received IV fentanyl (1 μg/kg) before procedure. Heart rate, blood pressure (BP) (systolic BP [SBP], diastolic BP [DBP], mean arterial pressure), respiratory rate, Aldrete recovery score (ARS) and Ramsay sedation score (RSS) were assessed at 1, 2, 5, 10, 15, 20 and 30 min post cardioversion. Incidence of hypotension, respiratory depression and side effects were compared. Statistical analysis used: Student's unpaired t-test, Chi-square test and Mann–Whitney test. P < 0.05 was taken as significant. Results: Group P showed significant fall in SBP, DBP, and mean BP at 2 min after cardioversion. Hypotension (33.3% Group P vs. 16.65% Group E) occurred more with propofol (P < 0.05). Group E showed better ARS at 1, 2, 5, 10, 15 and 20 min. Time required to attain RSS = 2 (659.1 s Group P and 435.7 s Group E) indicated longer recovery with propofol. Left atrial size (35.5-42.5 mm) did not affect success rate of cardioversion (80% Group P vs. 83.3% Group E). Incidence of myoclonus (Group E 26.67% vs. Group P 0%) showed significant difference. Conclusions: Etomidate/fentanyl is superior over propofol/fentanyl during cardioversion for quick recovery and haemodynamic stability. PMID:26139733

  2. Herniorrafia ambulatorial comparada à convencional Ambulatory versus conventional herniorraphy

    Directory of Open Access Journals (Sweden)

    Daniel Nunes e Silva

    2004-10-01

    Full Text Available OBJETIVO: O tratamento cirúrgico ambulatorial de hérnias inguinais é uma tendência em muitos serviços de saúde. No entanto, em nosso meio, tal procedimento ainda não perfaz uma rotina. Objetivamos analisar os benefícios e complicações da herniorrafia inguinal ambulatorial comparada à convencional. MÉTODO: Realizamos uma análise retrospectiva envolvendo, inicialmente, 105 pacientes submetidos a herniorrafia inguinal ambulatorial (HIA e internação convencional (IC de fevereiro a outubro de 2002 no Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA. Foram avaliados os benefícios e complicações no 15º, 90º e 180º dias de pós-operatório. Além disso, foi realizada avaliação dos custos hospitalares. Os métodos de análise incluíram o teste t de Fischer e X² . Foram considerados estatisticamente significativos resultados com pBACKGROUND: Ambulatory inguinal herniorraphy is performed worldwide. However, this procedure is not performed routinely in our reality. Our objetive is to analyze the benefits and complications of ambulatory inguinal herniorraphy in comparison to conventional intervention in our Service. METHODS: A retrospective analysis was performed with 105 patients who uwderwent ambulatorial or conventional inguinal herniorraphy between February and October of 2002. Variables, including costs, were analyzed at the 15th, 90th and 180th postoperative days. The Fischer's t test and chi-square test were used. Statistical significance was considered for a p value of p<0.05. RESULTS: From 105 patients, seven were excluded. The total rate complication was 36.08%. There was no significative statistical difference between groups at any time. The most common complication was local pain (24.7%. The costs decreased 20% when surgery was performed in an ambulatory basis as well as the waiting time which was also reduced. CONCLUSION: The ambulatory herniorraphy is a safe procedure, decreases hospital stay, costs and it has a

  3. Craving dominates propofol addiction of an affected physician.

    Science.gov (United States)

    Bonnet, Udo; Scherbaum, Norbert

    2012-01-01

    We report a case of severe dependence on propofol. For over a year, a 30-year-old male resident anesthesiologist injected 100-200 mg of propofol 20 to 40 times a day, reaching a daily total of up to 4 g. Compared to other withdrawal symptoms, craving for propofol was much more pronounced. Tolerance of the desired effects (cloudy and euphoric relaxation at his intravenous self-administration of 100 mg as well as sleep induction at 200 mg propofol) was not noticed by the patient. No other addiction was found in his history before he became dependent on propofol. This emphasizes that, especially with the patient's high injection rate, propofol has a powerful potential to be addictive. In most hospitals, the staff is put at risk by nonregulated dispensation and too easy access to this anesthetic drug.

  4. Endoscopist-Administered Propofol: A Retrospective Safety Study

    Directory of Open Access Journals (Sweden)

    John WI Morse

    2008-01-01

    Full Text Available BACKGROUND: Propofol is an anesthetic agent that is commonly used for conscious sedation. Propofol has advantages as a sedative agent for endoscopic procedures including rapid onset, short half-life and rapid recovery time. However, concerns exist regarding the potential for respiratory depression, hypotension, perforation due to deep sedation and the need for monitoring by an anesthetist. Propofol has been used under endoscopist supervision at the Stanton Territorial Hospital in Yellowknife, Northwest Territories since 1996 (approximately 7000 cases.

  5. Monitoring of propofol and its metabolite during total intravenous anesthesia

    Science.gov (United States)

    Elizarov, A. Yu.; Ershov, T. D.; Levshankov, A. I.

    2011-12-01

    Intravenous hypnotic propofol and its metabolite are detected in real time during total intravenous anesthesia by an electron ionization mass spectrometer. The mass spectrometer is connected directly to the breathing circuit of an apparatus for inhalational anesthesia. Ratios between the propofol concentrations in expired air and blood serum are measured. It is concluded that real-time noninvasive monitoring of the propofol concentration in blood using electron ionization mass spectrometry is feasible.

  6. Ketamine, propofol, and ketofol use for pediatric sedation.

    Science.gov (United States)

    Alletag, Michelle J; Auerbach, Marc A; Baum, Carl R

    2012-12-01

    The use of a combination of ketamine and propofol (ketofol) for procedural sedation and analgesia in the emergency department setting shows promise as an agent that may minimize adverse effects of ketamine or propofol as single agents. This article provides a summary of current literature regarding ketofol. It also reviews the comparative pharmacokinetics, adverse effects, and dosing of ketamine, propofol, and ketofol as agents for procedural sedation and analgesia.

  7. Haemodynamic changes after induction of anaesthesia with sevoflurane vs. propofol

    OpenAIRE

    POTOČNIK, IZTOK; NOVAK JANKOVIĆ, VESNA; Štupnik, Tomaž; Kremžar, Boriana

    2011-01-01

    Inhalation induction with sevoflurane would appear to offer several objective advantages compared to induction with propofol. In our study, the hemodynamic results of sevoflurane vs. propofol induction in patients undergoing thoracotomy were studied. In a prospective, randomized, blinded study 24 patients were randomly allocated to one of 2 groups: sevoflurane (S) and propofol (P) (n=12 each). For hemodynamic monitoring the LIDCO plus system was used. Patients in group S were induced into ana...

  8. Safety of propofol sedation for pediatric outpatient procedures.

    Science.gov (United States)

    Larsen, Reagan; Galloway, David; Wadera, Sheetal; Kjar, Dean; Hardy, David; Mirkes, Curtis; Wick, Lori; Pohl, John F

    2009-10-01

    Propofol sedation is used more frequently in pediatric procedures because of its ability to provide varying sedation levels. The authors evaluated all outpatient pediatric procedures using propofol sedation over a 6-year period. All sedation was provided by pediatric intensivists at a single institution. In all, 4716 procedures were recorded during the study period; 15% of procedures were associated with minor complications, whereas only 0.1% of procedures were associated with major complications. Significantly more major complications associated with propofol occurred during bronchoscopy (P = .001). Propofol administered by a pediatric intensivist is a safe sedation technique in the pediatric outpatient setting.

  9. Emergence agitation after sevoflurane versus propofol in pediatric patients

    National Research Council Canada - National Science Library

    Uezono, S; Goto, T; Terui, K; Ichinose, F; Ishguro, Y; Nakata, Y; Morita, S

    2000-01-01

    .... We tested the hypothesis that maintenance of anesthesia with propofol after sevoflurane induction would reduce the incidence of this excitatory behavior compared with continuing sevoflurane for maintenance...

  10. Acute lung injury probably associated with infusion of propofol emulsion.

    Science.gov (United States)

    Chondrogiannis, K D; Siontis, G C M; Koulouras, V P; Lekka, M E; Nakos, G

    2007-08-01

    We present a case of acute lung injury associated with propofol infusion in a mechanically ventilated patient with intracerebral haemorrhage. Diagnosis was based on the exclusion of other risk factors inducing acute lung injury and on the clinical improvement after discontinuation of the propofol emulsion. Laboratory data such as the increase in total phospholipids, neutral lipids and free fatty acids in the broncho-alveolar lavage fluid, the remarkably high percentage of alveolar macrophages including fat droplets and the similar lipid composition of propofol and broncho-alveolar lavage fluid support the relationship between propofol and acute lung injury.

  11. Acute Pulmonary Edema Associated With Propofol: An Unusual Complication

    Science.gov (United States)

    Waheed, Mian Adnan; Oud, Lavi

    2014-01-01

    Propofol is frequently used in the emergency department to provide procedural sedation for patients undergoing various procedures and is considered to be safe when administered by trained personnel. Pulmonary edema after administration of propofol has rarely been reported. We report a case of a 23-year-old healthy male who developed acute cough, hemoptysis and hypoxia following administration of propofol for splinting of a foot fracture. Chest radiography showed bilateral patchy infiltrates. The patient was treated successfully with supportive care. This report emphasizes the importance of this potentially fatal propofol-associated complication and discusses possible underlying mechanisms and related literature. PMID:25493132

  12. Prevention of Propofol Injection Pain in Children: A Comparison of Pretreatment with Tramadol and Propofol-Lidocaine Mixture

    Directory of Open Access Journals (Sweden)

    Hale Borazan, Osman Sahin, Ahmet Kececioglu, M.Selcuk Uluer, Tayfun Et, Seref Otelcioglu

    2012-01-01

    Full Text Available Background: The pain on propofol injection is considered to be a common and difficult to eliminate problem in children. In this study, we aimed to compare the efficacy of pretreatment with tramadol 1 mg.kg-1and propofol-lidocaine 20 mg mixture for prevention of propofol induced pain in children.Methods: One hundred and twenty ASA I-II patients undergoing orthopedic and otolaryngological surgery were included in this study and were divided into three groups with random table numbers. Group C (n=39 received normal saline placebo and Group T (n=40 received 1 mg.kg-1 tramadol 60 sec before propofol (180 mg 1% propofol with 2 ml normal saline whereas Group L (n=40 received normal saline placebo before propofol-lidocaine mixture (180 mg 1% propofol with 2 ml %1 lidocaine. One patient in Group C was dropped out from the study because of difficulty in inserting an iv cannula. Thus, one hundred and nineteen patients were analyzed for the study. After given the calculated dose of propofol, a blinded observer assessed the pain with a four-point behavioral scale.Results: There were no significant differences in patient characteristics and intraoperative variables (p>0.05 except intraoperative fentanyl consumption and analgesic requirement one hr after surgery among the groups (p<0.05. Both tramadol 1 mg.kg-1 and lidocaine 20 mg mixture significantly reduced propofol pain when compared with control group. Moderate and severe pain were found higher in control group (p<0.05. The incidence of overall pain was 79.4% in the control group, 35% in tramadol group, 25% in lidocaine group respectively (p<0.001.Conclusions: Pretreatment with tramadol 60 sec before propofol injection and propofol-lidocaine mixture were significantly reduced propofol injection pain when compared to placebo in children.

  13. Use of remifentanil to reduce propofol injection pain and the required propofol dose in upper digestive tract endoscopy diagnostic tests

    Directory of Open Access Journals (Sweden)

    Gustavo Nadal Uliana

    2015-12-01

    Full Text Available BACKGROUND AND OBJECTIVES: The introduction of propofol (2,6-diisopropylphenol as a sedative agent has transformed the area of sedation for endoscopic procedures. However, a major drawback of sedation with the use of propofol is its high incidence of injection pain. The most widely used technique in reducing propofol injection pain is through the association of other drugs. The aim of this study was to evaluate the effect of remifentanil-propofol combination on the incidence of propofol injection pain and its influence on the total dose of propofol required for sedation in upper digestive tract endoscopy (UDE diagnostic tests. METHOD: One hundred and five patients undergoing upper digestive tract endoscopy were evaluated and randomly divided into 3 groups of 35 patients each. The Control Group received propofol alone; Study-group 1 received remifentanil at a fixed dose of 0.2 mg/kg combined with propofol; Study-group 2 received remifentanil at a fixed dose of 0.3 mg/kg combined with propofol. The incidence of propofol injection pain and the total dose of propofol required for the test were evaluated. The sample was very similar regarding age, weight, height, sex, and physical status. Statistical analysis was performed according to the nature of the evaluated data. Student'st-test was used to compare the mean of age, weight, height (cm, and dose (mg/kg variables between groups. The χ2 test was used to compare sex, physical status, and propofol injection pain between groups. The significance level was a < 0.05. RESULTS: There was significant statistical difference between the study groups and the control group regarding the parameters of propofol injection pain and total dose of propofol (mg/kg used. However, there were no statistical differences between the two study groups for these parameters. CONCLUSION: We conclude that the use of remifentanil at doses of 0.2 mg/kg and 0.3 mg/kg was effective for reducing both the propofol injection pain and

  14. Propofol effects on atrial fibrillation wavefront delays.

    Science.gov (United States)

    Cervigón, Raquel; Moreno, Javier; Millet, José; Pérez-Villacastín, Julián; Castells, Francisco

    2010-08-01

    Since the cardiac activity during atrial fibrillation (AF) may be influenced by autonomic modulations, in this study, a novel method to quantify the effects of the most common anesthetic agent (propofol) in AF ablation procedures is introduced. This study has two main objectives: first, to assess whether the sedation earlier to radio frequency ablation affects the arrhythmia itself, and second, to provide new information that contributes to a better understanding of the influence of the autonomic nervous system on AF. The methodology presented is based on the measurement of synchronization and delay indexes between two atrial activations at adjacent intracavitary electrodes. These parameters aim to estimate whether two activations at different sites may be caused by the same propagating wavefront, or otherwise, are the consequence of independent wavefronts. The results showed that the mentioned indexes have a different behavior at both atria: the right atrium becomes more synchronized with propofol administration, whereas the synchronization index decreases at the left atrium.

  15. Comparison of dipyrone/propofol versus fentanyl/propofol anaesthesia during surgery in rabbits.

    Science.gov (United States)

    Baumgartner, C; Koenighaus, H; Ebner, J; Henke, J; Schuster, T; Erhardt, W

    2011-01-01

    In this study, the investigation of the intraoperative effects of dipyrone (metamizol) on heart rate (HR), mean arterial pressure (MAP) and analgesic efficacy in rabbits is described for the first time. This was carried out to evaluate the cardiovascular stability achieved using dipyrone compared with fentanyl. In this prospective study, 17 female New Zealand White rabbits were randomly allocated to either one of two groups: dipyrone/propofol (DP) or fentanyl/propofol (FP). Anaesthesia was induced in both groups using propofol to effect (4.0-8.0 mg/kg intravenously) until the swallowing reflex was lost for intubation. After induction, anaesthesia was maintained with continuous infusion of propofol 1.5-1.7 mg/kg/min intravenously. Analgesics were then injected in defined boluses of either dipyrone 65 mg/kg or fentanyl 0.0053 mg/kg. After surgical tolerance, defined as loss of the ear pinch reflex and loss of the anterior and posterior pedal withdrawal reflex, was achieved, two surgical procedures were performed. The surgical procedures (implantation of either a pacemaker or an electrocardiogram transmitter), both require a comparable level of analgesic depth. During and after surgery, clinical variables, such as MAP, HR, peripheral arterial oxygen saturation (SpO₂) and end-tidal CO₂ (P(E')CO₂) were recorded simultaneously every 2 min. Eight time points were chosen for comparison: baseline, surgical tolerance (ST), values at 10, 20 and 30 min after reaching ST, values at the end of propofol infusion (EI) and data at 10 and 20 min after EI. Both FP and DP combinations provided effective anaesthesia and analgesia in rabbits. In both groups a significant decrease of HR and MAP was measured. The results of this study indicate that the non-opioid drug dipyrone produces similar analgesic and even better cardiovascular effects by trend in rabbits. Therefore we conclude that dipyrone in combination with propofol can be used as an alternative to FP for intraoperative

  16. Comparison of dexmedetomidine combined with propofol Vs fentanyl combined with propofol for laryngeal mask insertion

    Directory of Open Access Journals (Sweden)

    A. Sowmya Jayaram

    2014-10-01

    Full Text Available Background: Few studies have assessed adequacy of anaesthesia provided by propofol in combination with dexmedetomidine and propofol in combination with fentanyl for laryngeal mask airway (LMA insertion for minor to moderate elective surgical procedures. Methods: Sixty patients admitted for lower abdominal and lower limb surgery were randomized into Group F (n=30 and Group D (n=30. Thirty seconds  after the study drug (fentanyl1 µg/kg in Group F and dexmedetomidine 1 µg/kg in Group D diluted in 10 mL normal saline over 2 min was administered, induction was done with i.v. propofol 2 mg/kg in both groups. Ninety seconds after propofol injection, jaw relaxation was assessed and LMA of appropriate size was inserted. If the first attempt failed, another attempt was tried after an additional dose of i.v. propofol (0.5 mg/kg. Haemodynamic parameters, namely, heart rate, systolic blood pressure (SBP, mean blood pressure (MBP, diastolic blood pressure (DBP, arterial oxygen saturation measured with pulse oximeter and respiratory rate were recorded before and at the end of 1st, 2nd, 3rd, 5th and 10th minutes after insertion of LMA. Results: Both the groups were comparable in age weight, sex, age wise distribution and insertion conditions. The reductions in SBP, DBP, MAP were greater in Group F (p < 0.001. More patients developed apnoea in Group F than in Group D (p < 0.05. Conclusions: Dexmedetomidine combined with propofol provides the same conditions for LMA insertion as fentanylpropofol combinations with advantage of better maintainance of haemodynamic parameters.

  17. Clio e outras tramas: a nova história cultural e a literatura comparada

    OpenAIRE

    Martins, Ricardo André Ferreira

    2012-01-01

    A “História Cultural” e a “Nova História Cultural” são linhas de reflexão teórica e metodológica que podem oferecer aos estudos em Literatura Comparada novos horizontes e limites interdisciplinares que resultariam na abertura para novos campos de pesquisas comparatistas. A abordagem cultural, na medida em que ela se encontra nas práticas de investigação comparatistas, permitiria ao estudioso ou pesquisador em Literatura Comparada cotejar não somente novos objetos de estudos, mas também novas ...

  18. Anestesia por infusão contínua de propofol associado ao remifentanil em gatos pré-tratados com acepromazina

    Directory of Open Access Journals (Sweden)

    Lukiya Birungi Silva Campos Mata

    2010-04-01

    Full Text Available O presente trabalho avaliou a associação anestésica do propofol, um anestésico geral de ação ultracurta e metabolismo rápido, ao remifentanil, opioide de grande poder analgésico, que potencializa os anestésicos gerais. O objetivo principal foi desenvolver um protocolo anestésico de uso intravenoso, por infusão contínua, que proporcione conforto ao paciente, segurança, com grande relaxamento muscular e analgesia em gatos submetidos a cirurgias eletivas como a ovariosalpingoisterectomia e orquiectomia. Foram utilizados 30 gatos, aleatoriamente distribuídos em 3 grupos de 10 animais. Em todos eles realizou-se a tranquilização com acepromazina (0,1 mg/kg, IM e indução anestésica com propofol (6 mg/kg, IV. No grupo 1, a anestesia foi mantida por infusão contínua de propofol (0,6 mg/kg/min, no grupo 2, com propofol (0,4 mg/kg/min e remifentanil (0,1 µg/kg/min, e no grupo 3, com propofol (0,4 mg/kg/min e remifentanil (0,2 µg/kg/min. As variáveis mensuradas foram: temperatura corporal, frequência cardíaca, frequência respiratória, saturação da oxiemoglobina, pressão arterial sistólica, hemogasometria arterial, analgesia e miorrelaxamento. Após análise dos resultados, pode-se concluir que o remifentanil promoveu incremento da analgesia, permitindo redução de 33% na velocidade de infusão do propofol, entretanto a infusão de 0,2 µg/kg/min de remifentanil determinou maior depressão respiratória quando comparada à infusão de 0,1 µg/kg/min.

  19. Ketamine-propofol sedation in circumcision.

    Science.gov (United States)

    Gulec, Handan; Sahin, Saziye; Ozayar, Esra; Degerli, Semih; Bercin, Fatma; Ozdemir, Osman

    2015-01-01

    To compare the therapeutic effects of ketamine alone or ketamine plus propofol on analgesia, sedation, recovery time, side effects in premedicated children with midazolam-ketamine-atropin who are prepared circumcision operation. 60 American Society of Anaesthesiologists physical status I-II children, aged between 3 and 9 years, undergoing circumcision operations under sedation were recruited according to a randomize and double-blind institutional review board-approved protocol. Patients were randomized into two groups via sealed envelope assignment. Both groups were administered a mixture of midazolam 0.05mg/kg+ketamine 3mg/kg+atropine 0.02mg/kg intramuscularly in the presence of parents in the pre-operative holding area. Patients were induced with propofol-ketamine in Group I or ketamine alone in Group II. In the between-group comparisons, age, weight, initial systolic blood pressure, a difference in terms of the initial pulse rate was observed (p>0.050). Initial diastolic blood pressure and subsequent serial measurements of 5, 10, 15, 20thmin, systolic blood pressure, diastolic blood pressure and pulse rate in ketamine group were significantly higher (pPropofol-ketamine (Ketofol) provided better sedation quality and hemodynamy than ketamine alone in pediatric circumcision operations. We did not observe significant complications during sedation in these two groups. Therefore, ketofol appears to be an effective and safe sedation method for circumcision operation. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  20. Ketamine-propofol sedation in circumcision

    Directory of Open Access Journals (Sweden)

    Handan Gulec

    2015-10-01

    Full Text Available ABSTRACTBACKGROUND AND OBJECTIVE: To compare the therapeutic effects of ketamine alone or ketamine plus propofol on analgesia, sedation, recovery time, side effects in premedicated children with midazolam-ketamine-atropin who are prepared circumcision operation.METHODS: 60 American Society of Anaesthesiologists physical status I-II children, aged between 3 and 9 years, undergoing circumcision operations under sedation were recruited according to a randomize and double-blind institutional review board-approved protocol. Patients were randomized into two groups via sealed envelope assignment. Both groups were administered a mixture of midazolam 0.05 mg/kg + ketamine 3 mg/kg + atropine 0.02 mg/kg intramuscularly in the presence of parents in the pre-operative holding area. Patients were induced with propofol-ketamine in Group I or ketamine alone in Group II.RESULTS: In the between-group comparisons, age, weight, initial systolic blood pressure, a difference in terms of the initial pulse rate was observed (p > 0.050. Initial diastolic blood pressure and subsequent serial measurements of 5, 10, 15, 20th min, systolic blood pressure, diastolic blood pressure and pulse rate in ketamine group were significantly higher (p < 0.050.CONCLUSION: Propofol-ketamine (Ketofol provided better sedation quality and hemodynamy than ketamine alone in pediatric circumcision operations. We did not observe significant complications during sedation in these two groups. Therefore, ketofol appears to be an effective and safe sedation method for circumcision operation.

  1. Estudio farmacocinético de propofol en equinos Pharmacokinetic study of propofol in horses

    Directory of Open Access Journals (Sweden)

    C LÜDERS

    1998-01-01

    Full Text Available Se estudian las características farmacocinéticas de propofol en 6 caballos. Se determinaron parámetros farmacocinéticos de propofol cuantificando sus concentraciones sanguíneas en función del tiempo por HPLC, tras su administración de 2.4 mg/kg por vía endovenosa al grupo de animales. Los datos de concentración se interpretaron por un modelo abierto de 2 compartimentos, obteniéndose, entre otros, los valores de t1/2alfa, t1/2beta,Vd c, Vd ss, Vdbeta, Cl total y MRT. Las variables farmacodinámicas se encuentran acordes a la disposición cinética de este fármaco. El análisisde los parámetros farmacocinéticos del propofol indica que éste posee una rápida y pronta distribución a los tejidos y una rápida eliminación del organismo. El propofol se presenta como una alternativa anestésica factible de ser incorporada dentro de un protocolo anestésico en caballos. Los parámetros farmacocinéticos obtenidos contribuyen para una correcta dosificación ya sea para mantener un estado de anestesia por infusión continua o por inyecciones repetidasPharmacokinetic variables of propofol were studied in 6 horses. Blood concentration of propofol at different times, after a single dose of 2.4mg/kg bw, was determined by HPLC. An open two compartment model was used to evaluate blood concentrations of propofol. Values of t1/2alpha,t1/2beta, Vd c, Vd ss,Vdbeta, Cl total y MRT were obtained.The pharmacodynamic values show a narrow relationship with the pharmacokinetic disposition of this drug. Propofol’s pharmacokinetic disposition presented a rapid distribution and removal from organic tissues. It is concluded that propofol is an alternative to be considered in anaesthetic protocolsin horses, and the pharmacokinetic variables presented contribute to determinethe appropriate dose to be given

  2. SINDICATOS, DIÁLOGO SOCIAL Y EMPLEO EN EUROPA OCCIDENTAL. UNA APROXIMACIÓN AL CASO DE ESPAÑA EN PERSPECTIVA COMPARADA

    OpenAIRE

    Mosquera, Marcial Sánchez; Universidad de Sevilla

    2017-01-01

    Este artículo presenta un estudio preliminar de los sindicatos españoles más representativos como agentes de cambio y regulación de los mercados de trabajo a través del diálogo social entre 1996 y 2013 en perspectiva comparada con el área de Europa Occidental. Para conseguir este propósito, se plantea un estudio la evolución del diálogo social en España desde 1996 a 2013, con especial atención a los cambios operados sobre el mercado de trabajo y su impacto sobre la evolución de las tasas de d...

  3. Literatura comparada feminista y estudios Gender and Genre: recorriendo las fronteras de lo fantástico a través de algunos cuentos escritos por mujeres.

    OpenAIRE

    Lozano de la Pola, Ana

    2010-01-01

    Esta tesis se compone de dos partes: una primera teórica y metodológica (en la que se persigue la posible existencia de una “literatura comparada feminista” como una de las líneas de la comparatística actual) y una segunda más práctica en la que estos presupuestos, especialmente los derivados de los estudios que ponen en relación los géneros identitarios con los géneros literarios (los “Gender and Genre Studies”), son estudiados en relación con algunos relatos fantásticos de las escritoras Pi...

  4. La comunidad de peces de la Laguna de Términos: estructura actual comparada

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    Luis Amado Ayala-Pérez

    2003-09-01

    Full Text Available Se presentan los resultados de investigación sobre la ecología de la comunidad de peces de la Laguna de Términos. Se describe la estructura y se discute de manera comparada con la información publicada. Se realizaron 19 campañas mensuales de campo en 23 sitios de muestreo durante el periodo de septiembre de 1997 a marzo de 1999. Se identificaron 107 especies de peces que se agruparon en 76 géneros y 37 familias. Se capturaron 25588 organismos con un peso total de 601.5 kg. La abundancia de la comunidad en escala temporal osciló de 0.395 a 0.895 ind/m² ; 8.638 a 18.316 g/m² y 18.358 a 34.837 g/ind. La diversidad de la comunidad, estimada por el índice de Shannon y Weaver osciló entre 1.875 y 3.995. El valor de los índices de equitatividad y riqueza de especies presentaron una variación entre 0.519 y 0.993 y 4.94 y 7.88 respectivamente. Se identificaron 18 especies dominantes con base en el análisis de los valores de número de individuos, peso y porcentaje de aparición. La especie más importante tanto por su abundancia numérica como por su frecuencia de aparición es Arius melanopus que representa el 26.5% de la captura total seguida de Diapterus rhombeus con el 18.9%. También como especies dominantes cabe destacar la presencia de aquellas de interés pesquero tanto local como regional y son Bairdiella chrysura, B. ronchus, Archosargus rhomboidalis, Eugerres plumieri, Cynoscion arenarius y Chaetodipterus faberThe structure of the fish community in Terminos Lagoon, Campeche, is analyzed on the base the description of the abundance, distribution, length composition and identification of the dominant species. The results are discussed and compared with the published information. 437 trawl tows were made in 19 monthly collection in 23 sites between September 1997 to March 1999. A total of 25 588 individual with a total weight of 601.5 kg were grouped in 107 species, 76 gender and 37 families. The abundance of the fish community

  5. Cardioversion: What to choose? Etomidate or propofol

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    Pushkar M Desai

    2015-01-01

    Full Text Available Context: Electrical cardioversion is a short painful procedure to regain normal sinus rhythm requiring anaesthesia for haemodynamic stability, sedation, analgesia and early recovery. Aims: To compare propofol and etomidate as sedatives during cardioversion. Settings and Design: Single centred, prospective and randomized single blind study comprising 60 patients. Subjects and Methods: Patients more than 18 years, American Society of Anesthesiologists I/II/III grades undergoing elective cardioversion, randomly divided to receive propofol 1 mg/kg intravenous (IV bolus followed by 0.5 mg/kg (Group P, n = 30 or etomidate (Group E, n = 30 0.1 mg/kg followed by 0.05 mg/kg. All patients received IV fentanyl (1 μg/kg before procedure. Heart rate, blood pressure (BP (systolic BP [SBP], diastolic BP [DBP], mean arterial pressure, respiratory rate, Aldrete recovery score (ARS and Ramsay sedation score (RSS were assessed at 1, 2, 5, 10, 15, 20 and 30 min post cardioversion. Incidence of hypotension, respiratory depression and side effects were compared. Statistical analysis used: Student′s unpaired t-test, Chi-square test and Mann-Whitney test. P < 0.05 was taken as significant. Results: Group P showed significant fall in SBP, DBP, and mean BP at 2 min after cardioversion. Hypotension (33.3% Group P vs. 16.65% Group E occurred more with propofol (P < 0.05. Group E showed better ARS at 1, 2, 5, 10, 15 and 20 min. Time required to attain RSS = 2 (659.1 s Group P and 435.7 s Group E indicated longer recovery with propofol. Left atrial size (35.5-42.5 mm did not affect success rate of cardioversion (80% Group P vs. 83.3% Group E. Incidence of myoclonus (Group E 26.67% vs. Group P 0% showed significant difference. Conclusions: Etomidate/fentanyl is superior over propofol/fentanyl during cardioversion for quick recovery and haemodynamic stability.

  6. [Anesthesia for electroconvulsive therapy: propofol versus thiopental].

    Science.gov (United States)

    Harti, A; Hmamouchi, B; Idali, H; Barrou, L

    2001-01-01

    The anesthesia for sismotherapy is characterized by its briefness and repetitiveness, resulting in several imperatives: anesthesia of short duration, deep narcosis with muscular relaxation and ambulatory character. Thus anesthesic drugs should have a fast onset of action, in order to obtain a rapid and as alert as possible post anesthesia awakening. The objective of this study is to compare two anesthesic drugs: propofol versus thiopentone. We included in this study patients referred to our unit by the psychiatric service for sismotherapy, which was carried on under general anesthesia in the awakening room of the anesthesia department of Ibn Rochd University hospital. 7 of our patients received sismotherapy for schizophrenia, 2 for acute mania and 1 for suicidal depression. A total of 40 sessions of sismotherapy were analyzed, distributed in two groups: group I (n = 20): benefitted of a general anesthesia by thiopentone, the dose was 2 to 3 mg/kg; group II (n = 20): benefitted of general anesthesia by propofol, the dose was 1 to 1.5 mg/kg. Sismotherapy was carried out only once narcosis was considered as deep. To monitor our patients we used electrocardioscope and pulpe oxymeter. We evaluated the quality and especially the time of onset of anesthesia, its duration, the quality of narcosis, the degree of muscular relaxation, respiratory and cardiovascular parameters as well as side effect linked to anesthesia drugs and sismotherapy. Analysis of the results showed that the quality of anesthesia was excellent for both groups. The necessary dose for narcosis was 202 mg for thiopentone and 167 mg for propofol, time of onset of narcosis was 30 seconds for propofol and 45 seconds for thiopentone, anesthesia and the quality of muscular relaxation were considered deep for the two groups. Many authors showed that propofol is the most efficient agent in anesthesia for sismotherapy due to its brief delay of action and faster reversibility. As for thiopentone despite its

  7. Nurse administered propofol sedation for pulmonary endoscopies requires a specific protocol

    DEFF Research Database (Denmark)

    Jensen, Jeppe Thue; Banning, Anne-Marie; Clementsen, Paul

    2012-01-01

    This study provides an evaluation and risk analysis of propofol sedation for endoscopic pulmonary procedures according to our unit's "gastroenterologic nurse-administered propofol sedation (NAPS) guideline".......This study provides an evaluation and risk analysis of propofol sedation for endoscopic pulmonary procedures according to our unit's "gastroenterologic nurse-administered propofol sedation (NAPS) guideline"....

  8. Nurse administered propofol sedation for pulmonary endoscopies requires a specific protocol

    DEFF Research Database (Denmark)

    Jensen, Jeppe Thue; Banning, Anne-Marie; Clementsen, Paul;

    2012-01-01

    This study provides an evaluation and risk analysis of propofol sedation for endoscopic pulmonary procedures according to our unit's "gastroenterologic nurse-administered propofol sedation (NAPS) guideline".......This study provides an evaluation and risk analysis of propofol sedation for endoscopic pulmonary procedures according to our unit's "gastroenterologic nurse-administered propofol sedation (NAPS) guideline"....

  9. Etnocentrismo, xenofobia y migraciones internacionales en una perspectiva comparada

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    Antonio Alaminos

    2010-01-01

    Full Text Available Mediante un análisis comparado de 15 países, tanto desarrollados como en vías de desarrollo y empleando encuestas de opinión pública, se contrastan varias hipótesis relacionales entre etnocentrismo y xenofobia. Los resultados establecen al etnocentrismo como un elemento común a las sociedades analizadas, de forma que los núcleos de opinión etnocéntrica se encuentran tanto en los países emisores de emigración como en las sociedades receptoras. Asimismo, se comprueba la estrecha vinculación entre etnocentrismo y xenofobia, así como que en las sociedades con mayor grado de multiculturalidad de origen inmigratorio son más probables las actitudes xenófobas de origen etnocéntrico. Las conclusiones señalan que esta xenofobia, si bien se activa contextualmente (experiencia de inmigración multicultural, tiene sus raíces emocionales en los prejuicios etnocéntricos, indistintamente de posibles experiencias negativas con los inmigrantes.

  10. Endoscopy: consensus on approving propofol sedation by nonanesthesiologists.

    Science.gov (United States)

    Riphaus, Andrea

    2010-04-01

    Propofol sedation by nonanesthesiologists is still a highly controversial issue despite the fact that numerous studies have approved this sedation regimen for gastrointestinal endoscopy. A new position statement from a collaboration of four different American gastroenterology and hepatology societies outlines the latest recommendations for nonanesthesiologist administration of propofol.

  11. Propofol Reduces the Distribution and Clearance of Midazolam

    NARCIS (Netherlands)

    Lichtenbelt, Bart Jan; Olofsen, Erik; Dahan, Albert; van Kleef, Jack W.; Struys, Michel M. R. F.; Vuyk, Jaap

    2010-01-01

    BACKGROUND: Midazolam, at sedative levels, increases blood propofol concentrations by 25%. We evaluated the reverse interaction and determined the influence of propofol on the pharmacokinetics of midazolam. METHODS: Eight healthy male volunteers were studied on 2 occasions in a random crossover mann

  12. Subhypnotic doses of propofol impair spatial memory retrieval in rats

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    Hu Liu

    2016-01-01

    Full Text Available Abundant evidence indicates that propofol profoundly affects memory processes, although its specific effects on memory retrieval have not been clarified. A recent study has indicated that hippocampal glycogen synthase kinase-3β (GSK-3β activity affects memory. Constitutively active GSK-3β is required for memory retrieval, and propofol has been shown to inhibit GSK-3β. Thus, the present study examined whether propofol affects memory retrieval, and, if so, whether that effect is mediated through altered GSK-3β activity. Adult Sprague-Dawley rats were trained on a Morris water maze task (eight acquisition trials in one session and subjected under the influence of a subhypnotic dose of propofol to a 24-hour probe trial memory retrieval test. The results showed that rats receiving pretest propofol (25 mg/kg spent significantly less time in the target quadrant but showed no change in locomotor activity compared with those in the control group. Memory retrieval was accompanied by reduced phosphorylation of the serine-9 residue of GSK-3β in the hippocampus, whereas phosphorylation of the tyrosine-216 residue was unaffected. However, propofol blocked this retrieval-associated serine-9 phosphorylation. These findings suggest that subhypnotic propofol administration impairs memory retrieval and that the amnestic effects of propofol may be mediated by attenuated GSK-3β signaling in the hippocampus.

  13. Propofol Reduces the Distribution and Clearance of Midazolam

    NARCIS (Netherlands)

    Lichtenbelt, Bart Jan; Olofsen, Erik; Dahan, Albert; van Kleef, Jack W.; Struys, Michel M. R. F.; Vuyk, Jaap

    BACKGROUND: Midazolam, at sedative levels, increases blood propofol concentrations by 25%. We evaluated the reverse interaction and determined the influence of propofol on the pharmacokinetics of midazolam. METHODS: Eight healthy male volunteers were studied on 2 occasions in a random crossover

  14. Propofol Infusion Syndrome in Adults: A Clinical Update

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    Aibek E. Mirrakhimov

    2015-01-01

    Full Text Available Propofol infusion syndrome is a rare but extremely dangerous complication of propofol administration. Certain risk factors for the development of propofol infusion syndrome are described, such as appropriate propofol doses and durations of administration, carbohydrate depletion, severe illness, and concomitant administration of catecholamines and glucocorticosteroids. The pathophysiology of this condition includes impairment of mitochondrial beta-oxidation of fatty acids, disruption of the electron transport chain, and blockage of beta-adrenoreceptors and cardiac calcium channels. The disease commonly presents as an otherwise unexplained high anion gap metabolic acidosis, rhabdomyolysis, hyperkalemia, acute kidney injury, elevated liver enzymes, and cardiac dysfunction. Management of overt propofol infusion syndrome requires immediate discontinuation of propofol infusion and supportive management, including hemodialysis, hemodynamic support, and extracorporeal membrane oxygenation in refractory cases. However, we must emphasize that given the high mortality of propofol infusion syndrome, the best management is prevention. Clinicians should consider alternative sedative regimes to prolonged propofol infusions and remain within recommended maximal dose limits.

  15. Sociedad del conocimiento y globalización : nuevos retos para la educación comparada

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    Francesc Raventós

    2012-09-01

    Full Text Available En una época sin apenas referentes y con explicaciones difíciles de relacionar, de comparar y de comprender, nuestros comportamientos y actuaciones se rigen casi exclusivamente por criterios de eficacia o por emociones enérgicas. Es como si al perder los referentes unificadores se produjera una especie de fragmentación en nuestra vida. Las tendencias globalizadoras no han hecho más que aumentar en la última década y tienen que coexistir con el incremento de otras tendencias generadas por las disputas locales y regionales. El artículo aporta algunos elementos de reflexión acerca de la vigencia de la Educación Comparada en este contexto de incertidumbre epistemológica y de hibridación metodológica. Se apuntan algunos elementos que enmarcan la investigación comparativa desde un contexto de globalización y posmodernidad; se revisan algunos de los fundamentos en la investigación comparativa y se apuesta decididamente por la analogía como herramienta de trabajo para conseguir una cierta aproximación en las tendencias descritas anteriormente; y se profundiza en la necesidad de resituar la investigación comparada en un marco tecnológico donde la web 2.0 y las redes sociales han tomado un protagonismo inédito, incluso en las prácticas profesionales y académicas.In a time when referents are scarce and complex explanations hard to relate to, compare with and learn from, the ways in which we behave and act are governed almost exclusively by our criteria for efficiency or by our emotional impulses. The loss of these unifying referents appears to have made our lives more fragmented. The tendencies towards globalisation have only increased in the last decade and have to coexist alongside an increase in other tendencies that have emerged as a result of local or regional disputes. The article reflects on the validity of some aspects of Comparative Education, in the context of globalisation and postmodernism. Some of the basic tenets upon

  16. Stability of Propofol in Polystyrene-Based Tissue Culture Plates

    Science.gov (United States)

    Sall, Jeffrey W.; Leong, Jason

    2013-01-01

    Propofol has been reported to have high stability in glass and relatively high stability up to 24 hours in polyvinyl chloride-based medical plastics. Recent publications have observed the effects of propofol on cells and tissues grown in culture. Many cell culture plastics are formulated from polystyrene but we could find little information on the stability of propofol exposed to these products. We observed very little change in the concentration of propofol diluted in cell culture medium over 24 hours when exposed to glass, but substantial loss of the drug when exposed to 96-well polystyrene cell culture plates. This decrease was most rapid in the first hour but continued until 24 hours. The type of plastic used in cell and tissue culture experiments with propofol may influence the results by increasing the apparent dose required to see an effect. PMID:23632056

  17. Driving impairment due to propofol at effect-site concentrations relevant after short propofol-only sedation.

    Science.gov (United States)

    Telles, J L; Agarwal, S; Monagle, J; Stough, C; King, R; Downey, L

    2016-11-01

    Australian guidelines state "Following brief surgery or procedures with short acting anaesthetic drugs, the patient may be fit to drive after a normal night's sleep. After long surgery or procedures requiring longer lasting anaesthesia, it may not be safe to drive for 24 hours or more". The increasing use of the short-acting anaesthetic drug propofol as a solitary sedative medication for simple endoscopy procedures suggests a need to review this blanket policy. Thirty patients presenting for elective day surgery were recruited as volunteers for a pre-procedure driving simulation study and randomised to propofol or placebo arms. Driving ability was assessed at baseline and then, in the propofol group, at three effect-site concentrations. Driving impairment at these concentrations of propofol was compared to that of a third group of volunteers with a blood alcohol concentration of 0.05% (g/100 ml). Driving impairment at 0.2 µg/ml propofol effect-site concentration was not statistically different to placebo. Impairment increased with propofol effect-site concentration (P=0.002) and at 0.4 µg/ml it was similar to that found with a blood alcohol concentration of 50 mg/100 ml (0.05%). Plasma propofol concentrations of 0.2 µg/ml, as might be found approximately an hour after short (propofol-only sedation for endoscopy, were not associated with driving impairment in our young cohort of volunteers.

  18. Dexmedetomidine compared with propofol for pediatric sedation during cerebral angiography

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    Ke Peng

    2014-01-01

    Full Text Available Background: Sedation of pediatric patients undergoing cerebral angiography is challenging. Although dexmedetomidine is used for sedation in various procedures, it has not been reported for pediatric patients undergoing cerebral angiography. This study compared the safety and efficacy of dexmedetomidine with that of propofol for cerebral angiography in pediatric patients. Materials and Methods: Sixty-two patients (6-15 years scheduled for elective cerebral angiography were apportioned randomly and equally to receive either propofol or dexmedetomidine sedation. Patients in the propofol group received an initial bolus of intravenous propofol (1 mg/kg and a maintenance infusion of 100 μg/kg/min. Patients in the dexmedetomidine group received an initial bolus of intravenous dexmedetomidine (1 μg/kg over 10 min and a maintenance infusion of 1 μg/kg/h. An additional bolus of propofol 0.5 mg/kg or dexmedetomidine 0.25 μg/kg was repeated if needed. Procedure time, time to recovery and adverse events associated with sedation were recorded. Results: All cerebral angiographies were completed successfully under sedation with dexmedetomidine or propofol. Mean cerebral angiography time was 36 ± 10 min in the propofol group and 31 ± 7 min in the dexmedetomidine group (P = 0.047. The percentage of airway events and total adverse events were significantly higher in the propofol group (P < 0.05. Heart rate decreased in the dexmedetomidine group and mean arterial pressure decreased in the propofol group (P < 0.05, each. Conclusion: Although cerebral angiography can be performed successfully under sedation with either propofol or dexmedetomidine, dexmedetomidine may be a better alternative because of fewer respiratory adverse events.

  19. Mini profile of potential anticancer properties of propofol.

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    Jing Song

    Full Text Available BACKGROUND: Propofol (2, 6-diisopropylphenol is an intravenous sedative-hypnotic agent administered to induce and maintain anesthesia. It has been recently revealed that propofol has anticancer properties including direct and indirect suppression of the viability and proliferation of cancer cells by promoting apoptosis in some cancer cell lines. METHODOLOGY/PRINCIPAL FINDINGS: This study aimed to establish a profile to quantitatively and functionally evaluate the anticancer properties of propofol in three cancer cell lines: non-small cell lung carcinoma cell line A549, human colon carcinoma cell line LoVo, and human breast cancer cell line SK-BR-3. We demonstrated that the expression level of caspase-3, an apoptosis biomarker, significantly increased in a dose-dependent manner after 24-h stimulation with 100 µM propofol in A549 cells, and slightly increased in LoVo cells. However, there was no change in caspase-3 expression in SK-BR-3 cells. High caspase-3 expression in A549 cells may be modulated by the ERK1/2 pathway because phosphorylated ERK1/2 dramatically reduced after propofol treatment. BAX, a major protein that promotes apoptosis in the regulation phase, was highly expressed in A549 cells after treatment with 25 µM propofol. Apoptosis induced by propofol may be associated with cancer cells carrying Kras mutations. CONCLUSIONS/SIGNIFICANCE: Our results suggest that the anti-cancer effects of propofol, which are consistent with those of previous studies, are likely associated with the Kras mutation status. Only Kras mutation in Codon 12 instead of other Kras status has been demonstrated to play an important role in sensitizing the propofol-induced apoptosis in cancer cell lines from our study. These findings may enable us a detailed investigation of propofol/Kras-mediated cancer cell apoptosis in the future.

  20. Injection pain of propofol in children: A comparison of two formulations without added lidocaine

    OpenAIRE

    Serbülent Gökhan Beyaz; Ali Eman

    2012-01-01

    Background: Propofol emulsion in medium and long-chain triglycerides (MCT/LCT) has been reported to cause less injection pain than other propofol solutions in adult studies. The aim of this study was to compare the injection pain of two different propofol emulsions using two different pain scales on the pediatric population. Materials and Methods: 100 children scheduled for general anesthesia were divided into two groups. Patients were randomly assigned to receive propofol LCT or propofol...

  1. Identification of Propofol Binding Sites in a Nicotinic Acetylcholine Receptor with a Photoreactive Propofol Analog*

    Science.gov (United States)

    Jayakar, Selwyn S.; Dailey, William P.; Eckenhoff, Roderic G.; Cohen, Jonathan B.

    2013-01-01

    Propofol, a widely used intravenous general anesthetic, acts at anesthetic concentrations as a positive allosteric modulator of γ-aminobutyric acid type A receptors and at higher concentration as an inhibitor of nicotinic acetylcholine receptors (nAChRs). Here, we characterize propofol binding sites in a muscle-type nAChR by use of a photoreactive analog of propofol, 2-isopropyl-5-[3-(trifluoromethyl)-3H-diazirin-3-yl]phenol (AziPm). Based upon radioligand binding assays, AziPm stabilized the Torpedo nAChR in the resting state, whereas propofol stabilized the desensitized state. nAChR-rich membranes were photolabeled with [3H]AziPm, and labeled amino acids were identified by Edman degradation. [3H]AziPm binds at three sites within the nAChR transmembrane domain: (i) an intrasubunit site in the δ subunit helix bundle, photolabeling in the nAChR desensitized state (+agonist) δM2-18′ and two residues in δM1 (δPhe-232 and δCys-236); (ii) in the ion channel, photolabeling in the nAChR resting, closed channel state (−agonist) amino acids in the M2 helices (αM2-6′, βM2-6′ and -13′, and δM2-13′) that line the channel lumen (with photolabeling reduced by >90% in the desensitized state); and (iii) at the γ-α interface, photolabeling αM2-10′. Propofol enhanced [3H]AziPm photolabeling at αM2-10′. Propofol inhibited [3H]AziPm photolabeling within the δ subunit helix bundle at lower concentrations (IC50 = 40 μm) than it inhibited ion channel photolabeling (IC50 = 125 μm). These results identify for the first time a single intrasubunit propofol binding site in the nAChR transmembrane domain and suggest that this is the functionally relevant inhibitory binding site. PMID:23300078

  2. Una aproximación a la administración municipal comparada. Los casos de los gobiernos locales de Austin y Hermosillo

    Directory of Open Access Journals (Sweden)

    Nicolás Pineda Pablos

    1998-01-01

    Full Text Available Este trabajo hace una breve descripción comparada de los gobiernos y administraciones locales de la ciudad de Austin, Texas, y del municipio de Hermosillo, Sonora. El propósito que mueve la comparación es revisar el grado de autonomía y los lazos y vínculos de control existentes en cada gobierno local tanto con respecto a los niveles estatal y federal de gobierno como con la ciudadanía de cada lugar. De este modo se revisan los aspectos del concepto de gobierno local, de la base legal, de la conformación del máximo órgano de gobierno, del ámbito sustantivo de funciones, la estructura financiera de ingreso y gasto y la participación electoral. La conclusión general es que el municipio de Hermosillo se denota por un lado estrechamente atado y controlado por el gobierno estatal y federal y, por otro, con una débil relación con la ciudadanía local. Se aprecia, sin embargo, en el aspecto electoral una fuerte intencionalidad de cambio con base en la alta participación electoral existente en Hermosillo.

  3. Human physiologically based pharmacokinetic model for propofol

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    Schnider Thomas W

    2005-04-01

    Full Text Available Abstract Background Propofol is widely used for both short-term anesthesia and long-term sedation. It has unusual pharmacokinetics because of its high lipid solubility. The standard approach to describing the pharmacokinetics is by a multi-compartmental model. This paper presents the first detailed human physiologically based pharmacokinetic (PBPK model for propofol. Methods PKQuest, a freely distributed software routine http://www.pkquest.com, was used for all the calculations. The "standard human" PBPK parameters developed in previous applications is used. It is assumed that the blood and tissue binding is determined by simple partition into the tissue lipid, which is characterized by two previously determined set of parameters: 1 the value of the propofol oil/water partition coefficient; 2 the lipid fraction in the blood and tissues. The model was fit to the individual experimental data of Schnider et. al., Anesthesiology, 1998; 88:1170 in which an initial bolus dose was followed 60 minutes later by a one hour constant infusion. Results The PBPK model provides a good description of the experimental data over a large range of input dosage, subject age and fat fraction. Only one adjustable parameter (the liver clearance is required to describe the constant infusion phase for each individual subject. In order to fit the bolus injection phase, for 10 or the 24 subjects it was necessary to assume that a fraction of the bolus dose was sequestered and then slowly released from the lungs (characterized by two additional parameters. The average weighted residual error (WRE of the PBPK model fit to the both the bolus and infusion phases was 15%; similar to the WRE for just the constant infusion phase obtained by Schnider et. al. using a 6-parameter NONMEM compartmental model. Conclusion A PBPK model using standard human parameters and a simple description of tissue binding provides a good description of human propofol kinetics. The major advantage of a

  4. Propofol Pharmacokinetics and Estimation of Fetal Propofol Exposure during Mid-Gestational Fetal Surgery: A Maternal-Fetal Sheep Model

    Science.gov (United States)

    Niu, Jing; Venkatasubramanian, Raja; Vinks, Alexander A.; Sadhasivam, Senthilkumar

    2016-01-01

    Background Measuring fetal drug concentrations is extremely difficult in humans. We conducted a study in pregnant sheep to simultaneously describe maternal and fetal concentrations of propofol, a common intravenous anesthetic agent used in humans. Compared to inhalational anesthesia, propofol supplemented anesthesia lowered the dose of desflurane required to provide adequate uterine relaxation during open fetal surgery. This resulted in better intraoperative fetal cardiac outcome. This study describes maternal and fetal propofol pharmacokinetics (PK) using a chronically instrumented maternal-fetal sheep model. Methods Fetal and maternal blood samples were simultaneously collected from eight mid-gestational pregnant ewes during general anesthesia with propofol, remifentanil and desflurane. Nonlinear mixed-effects modeling was performed by using NONMEM software. Total body weight, gestational age and hemodynamic parameters were tested in the covariate analysis. The final model was validated by bootstrapping and visual predictive check. Results A total of 160 propofol samples were collected. A 2-compartment maternal PK model with a third fetal compartment appropriately described the data. Mean population parameter estimates for maternal propofol clearance and central volume of distribution were 4.17 L/min and 37.7 L, respectively, in a typical ewe with a median heart rate of 135 beats/min. Increase in maternal heart rate significantly correlated with increase in propofol clearance. The estimated population maternal-fetal inter-compartment clearance was 0.0138 L/min and the volume of distribution of propofol in the fetus was 0.144 L. Fetal propofol clearance was found to be almost negligible compared to maternal clearance and could not be robustly estimated. Conclusions For the first time, a maternal-fetal PK model of propofol in pregnant ewes was successfully developed. This study narrows the gap in our knowledge in maternal-fetal PK model in human. Our study confirms

  5. Propofol Pharmacokinetics and Estimation of Fetal Propofol Exposure during Mid-Gestational Fetal Surgery: A Maternal-Fetal Sheep Model.

    Directory of Open Access Journals (Sweden)

    Pornswan Ngamprasertwong

    Full Text Available Measuring fetal drug concentrations is extremely difficult in humans. We conducted a study in pregnant sheep to simultaneously describe maternal and fetal concentrations of propofol, a common intravenous anesthetic agent used in humans. Compared to inhalational anesthesia, propofol supplemented anesthesia lowered the dose of desflurane required to provide adequate uterine relaxation during open fetal surgery. This resulted in better intraoperative fetal cardiac outcome. This study describes maternal and fetal propofol pharmacokinetics (PK using a chronically instrumented maternal-fetal sheep model.Fetal and maternal blood samples were simultaneously collected from eight mid-gestational pregnant ewes during general anesthesia with propofol, remifentanil and desflurane. Nonlinear mixed-effects modeling was performed by using NONMEM software. Total body weight, gestational age and hemodynamic parameters were tested in the covariate analysis. The final model was validated by bootstrapping and visual predictive check.A total of 160 propofol samples were collected. A 2-compartment maternal PK model with a third fetal compartment appropriately described the data. Mean population parameter estimates for maternal propofol clearance and central volume of distribution were 4.17 L/min and 37.7 L, respectively, in a typical ewe with a median heart rate of 135 beats/min. Increase in maternal heart rate significantly correlated with increase in propofol clearance. The estimated population maternal-fetal inter-compartment clearance was 0.0138 L/min and the volume of distribution of propofol in the fetus was 0.144 L. Fetal propofol clearance was found to be almost negligible compared to maternal clearance and could not be robustly estimated.For the first time, a maternal-fetal PK model of propofol in pregnant ewes was successfully developed. This study narrows the gap in our knowledge in maternal-fetal PK model in human. Our study confirms that maternal heart

  6. Anesthetic induction with guaifenesin and propofol in adult horses.

    Science.gov (United States)

    Brosnan, Robert J; Steffey, Eugene P; Escobar, André; Palazoglu, Mine; Fiehn, Oliver

    2011-12-01

    To evaluate whether guaifenesin can prevent adverse anesthetic induction events caused by propofol and whether a guaifenesin-propofol induction combination has brief cardiovascular effects commensurate with rapid drug washout. 8 healthy adult horses. Guaifenesin was administered IV for 3 minutes followed by IV injection of a bolus of propofol (2 mg/kg). Additional propofol was administered if purposeful movement was detected. Anesthesia was maintained for 2 hours with isoflurane or sevoflurane at 1.2 times the minimum alveolar concentration with controlled normocapnic ventilation. Normotension was maintained via a dobutamine infusion. Plasma concentrations of propofol and guaifenesin were measured every 30 minutes. Mean ± SD guaifenesin and propofol doses inducing anesthesia in half of the horses were 73 ± 18 mg/kg and 2.2 ± 0.3 mg/kg, respectively. No adverse anesthetic induction events were observed. By 70 minutes, there was no significant temporal change in the dobutamine infusion rate required to maintain normotension for horses anesthetized with isoflurane or sevoflurane. Mean plasma guaifenesin concentrations were 122 ± 30 μM, 101 ± 33 μM, 93 ± 28 μM, and 80 ± 24 μM at 30, 60, 90, and 120 minutes after anesthetic induction, respectively. All plasma propofol concentrations were below the limit of quantitation. Guaifenesin prevented adverse anesthetic induction events caused by propofol. Guaifenesin (90 mg/kg) followed by propofol (3 mg/kg) should be sufficient to immobilize > 99% of calm healthy adult horses. Anesthetic drug washout was rapid, and there was no change in inotrope requirements after anesthesia for 70 minutes.

  7. Induction Speed Is Not a Determinant of Propofol Pharmacodynamics

    Science.gov (United States)

    Doufas, Anthony G.; Bakhshandeh, Maryam; Bjorksten, Andrew R.; Shafer, Steven L.; Sessler, Daniel I.

    2005-01-01

    Summary We used individual pharmacodynamic modeling to demonstrate that different sedation endpoints occur at the same effect site propofol concentration, independent of the infusion rate of propofol. Background Evidence suggests that the rate at which they are infused may influence plasma-effect site equilibration of intravenous anesthetics. We used 5 different rates of propofol administration to test the hypothesis that different sedation endpoints occur at the same effect site propofol concentration, independent of the infusion rate. We concurrently evaluated the automated responsiveness monitor (ARM) against other sedation measures and the propofol effect site concentration. Methods With Human Studies Committee approval, 18 healthy volunteers received 5 consecutive target-controlled propofol infusions. During each infusion the effect site concentration was increased by a rate of 0.1, 0.3, 0.5, 0.7, or 0.9 μg·ml−1·min−1. Bispectral index and ARM were recorded at frequent intervals. The times of syringe drop and loss and recovery of responsiveness were noted. Pharmacokinetic and pharmacodynamic modeling was performed using NONMEM. Results Once the correct rate of plasma-effect site equilibration (ke0) was determined for each individual (ke0 = 0.17 min−1, time-to-peak effect = 2.7 min), the effect site concentrations associated with each clinical measure were not affected by the rate of rise of effect site propofol concentration. ARM correlated with all clinical measures of drug effect. Subjects invariably stopped responding to ARM at lower effect site propofol concentrations than those associated with loss of responsiveness. Conclusions Population-based pharmacokinetics, combined with real-time electroencephalographic measures of drug effect, may provide a means to individualize pharmacodynamic modeling during target-controlled drug delivery. ARM appears useful as an automated measure of sedation and may provide the basis for automated monitoring and

  8. Comparison of serum triglyceride levels with propofol in long chain triglyceride and propofol in medium and long chain triglyceride after short term anesthesia in pediatric patients

    OpenAIRE

    Ishwar Bhukal; Gokul Thimmarayan; Indu Bala; Sohan Lal Solanki; Tanvir Samra

    2014-01-01

    Background: Significant increase in serum triglyceride (ST) concentration have been described in adult population after prolonged administration of propofol formulation containing long chain triglyceride (LCT). Though, medium chain triglyceride-LCT (MCT-LCT) propofol when compared with LCT propofol for long-term sedation in adults resulted in identical triglyceride levels, the elimination of triglyceride was faster in patients administered MCT-LCT propofol. Materials and Methods: A total of 4...

  9. La reforma del sistema binominal desde una perspectiva comparada

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    Dieter Nohlen

    2006-01-01

    Full Text Available El sistema binominal continúa siendo cuestionado, razón por la cual parece conveniente su reforma, pese a que sus efectos han sido empíricamente bastante beneficiosos. El mismo balance se desprende, a nivel teórico, comparando los efectos del sistema electoral vigente en Chile con criterios de evaluación que se expresan homogénea y universalmente en procesos de reforma electoral. Sin embargo, hay debilidades del sistema binominal en la función de representación que conviene subsanar, tratando de conservar su efectividad respecto a otras funciones. Esto incluye también defenderlo frente a críticas que se centran en fenómenos como el clientelismo, cuyas causas están fuera de su alcance. Respecto al diseño mismo, se sugiere entenderse primero sobre los objetivos de la reforma: formar consenso, sólo después tratar los elementos técnicos de su materialización. Se recuerda, además, que desde una perspectiva comparativa el sistema vigente es a menudo la solución más probable entre las alternativas en debateSince its introduction by the military regime, Chile's binominal system has continuously been questioned. This is the reason for thinking about an electoral reform, although some of its effects empirically have benefited the democratic development of the country. The same result is obtained, if _at a theoretical level- the effects of the binominal system are considered comparatively, applying criteria of evaluation which stem from world wide processes of electoral reform. Nevertheless, some weaknesses of the binominal system concerning the function of representation can be observed. A reform, addressing these weaknesses, should at the same time try to maintain the effectiveness of the system with regard to other functions like concentration and participation. This includes defending the system against critics which focus on phenomena like clientelism, surely caused by other factors than the binominal system. Concerning the design

  10. A COMPARISON OF PROPOFOL WITH SEVOFLURANE AND PROPOFOL ALONE FOR INDUCTION AND INTUBATION

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    Manjunath

    2015-11-01

    Full Text Available STUDY OBJECTIVE: We aimed to study propofol with sevoflurane and propofol alone in evaluating intubating conditions, hemodynamic response during induction and intubation and induction side effects in adult patients undergoing various elective surgical procedures without muscle relaxants. DESIGN: Prospective randomized study. SETTING: Operation theatre of a teaching institute. PATIENTS: The study population consists of 60 ASA I & II, non-obese, adult patients aged between 20-40yrs coming for elective surgical procedures under General Anaesthesia and had Mallampatti class I airway anatomy, 30 of these patients receive propofol alone–“GROUP A” and 30 of who receive propofol with sevoflurane–“GROUP B”. MEASUREMENTS AND RESULTS: The heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure before and after induction and post-intubation at 1, 3 and 5 minutes were recorded. Time to induction in seconds (Start of anaesthetic until loss of eye lash reflex, induction side effects like breath holding, cough, excitatory movements, laryngospasm and others (Bradycardia, hypoxia, hyperthermia, hypothermia and injection site pain were noted. Intubating conditions were better in Group-B than in Group-A, Group-B patients had significantly had more clinically acceptable intubating conditions than Group-A. There was no significant difference in heart rate after induction and intubation between the two groups, except 3min after intubation in Group-A there is significantly low heart rate. There was significant in reduction in systolic blood pressure after induction and intubation in Group-A, however there was no significant difference in diastolic blood pressure and mean arterial pressure between two groups. Induction time is significantly less in Group-A patients when compared to Group-B patients and there was no significant difference in induction side effects between two groups. CONCLUSION: Combination of inhalational 4

  11. Comparison of propofol versus propofol-ketamine combination in pediatric oncologic procedures performed by non-anesthesiologists.

    Science.gov (United States)

    Chiaretti, Antonio; Ruggiero, Antonio; Barbi, Egidio; Pierri, Filomena; Maurizi, Palma; Fantacci, Claudia; Bersani, Giulia; Riccardi, Riccardo

    2011-12-15

    Limited data are available on the best option (short acting sedatives, opioids, or ketamine) in oncologic procedural sedation performed by non-anesthesiologists. The aim of the present prospective study is to compare the safety and efficacy of propofol-ketamine versus propofol alone, managed by trained pediatricians, in children with cancer undergoing painful procedures. Data on 121 children with acute lymphatic leukemia (ALL) undergoing procedural sedations (lumbar punctures and bone marrow aspirations) were prospectively collected and included drug doses, side effects, pain assessment, and sedation degree. Children were randomly assigned to one of the two groups: P (n = 62) receiving propofol alone and K (n = 59) in whom a ketamine-propofol combination was used. In group K, the total dose of propofol required was significantly lower than in group P (3.9 ± 3.6 mg/kg vs. 5.1 ± 3.6 mg/kg; P propofol-ketamine association. No differences were observed in the degree of sedation and in the awakening quality score between the two groups. The combination of propofol and ketamine produced statistically significant clinical advantages combined with a higher profile of safety in children with cancer undergoing painful procedures. Copyright © 2011 Wiley Periodicals, Inc.

  12. Recovery and long-term renal excretion of propofol, its glucuronide, and two di-isopropylquinol glucuronides after propofol infusion during surgery.

    NARCIS (Netherlands)

    Bleeker, C.P.; Vree, T.B.; Lagerwerf, A.J.; Willems-Bree, E. van

    2008-01-01

    BACKGROUND: The metabolism of the short-acting anaesthetic agent propofol has been described over the first 24 h. However, the long-term disposition of propofol and its metabolites is unclear. We describe the pharmacokinetics (renal excretion rates and renal clearance) of propofol and its

  13. [Update on propofol TCI in children].

    Science.gov (United States)

    Constant, I; Rigouzzo, A; Louvet, N

    2013-01-01

    For several years, total intravenous anaesthesia (TIVA) has demonstrated many advantages that allow considering propofol anaesthesia as an interesting alternative in pediatric anaesthesia. TCI in children requires calculation and validation of pharmacokinetic (PK) models specifically adapted to the paediatric population. Several PK models based on a 3-compartement approach have been proposed in children: all these models, which integrate only weight as covariable, show increased distribution volumes with a wide interindividual variability. The particular importance to include physiological covariables, as age and lean body mass, to describe metabolic processes during growth and maturation in pediatric PKPD models is in agreement with recent allometric scaling works in children. However, as pharmacodynamic (PD) parameters are still debated in children, there is up to now, no PKPD model currently available for paediatric anaesthesia. Schnider et al.'s model, a model described in adults that includes numerous covariables, may be adapted and more efficient than the classical paediatric models to describe propofol-PKPD relationship in children over 5years. Whatever the model, a pharmacodynamic feedback such as the bispectral index may be useful to counteract interindividual variability in the paediatric population. Copyright © 2012. Published by Elsevier SAS.

  14. Is propofol a friend or a foe of the pediatric intensivist? Description of propofol use in a PICU*.

    Science.gov (United States)

    Koriyama, Hiromi; Duff, Jonathan P; Guerra, Gonzalo Garcia; Chan, Alice W

    2014-02-01

    The primary objective is to describe the practice patterns of nonprocedural propofol use in a single-center referral PICU. The secondary objective is to describe the rate of concordance of propofol use with the PICU local practice of a maximum mean rate of 4 mg/kg/hr and a maximum duration of 24 hours and to assess for signs and symptoms of propofol infusion syndrome. Retrospective descriptive cohort study. PICU of a tertiary care teaching hospital and referral hospital for the Western Canada. Children 1 month to 17 years old who received a nonprocedural propofol infusion between January 1, 2009, and December 31, 2009. None. Two hundred twenty-three infusions (representing 210 unique patients) were included in the study. The median average infusion rate (interquartile range) including boluses was 2.7 mg/kg/hr (1.9-3.6 mg/kg/hr), and the mean infusion duration (SD) was 10.3 hours (6.7 hr). Eighty-seven percent and 98% of infusions were concordant with PICU intensivists self-reported practice maximum rate and duration, respectively. No cases of propofol-related infusion syndrome or deaths associated with propofol infusions were identified. The use of propofol infusions was in concordance with PICU local practice, and propofol infusion syndrome did not developed in patients. In agreement with previous recommendations, propofol infusions in the PICU appear to be safe when limiting doses to 4 mg/kg/hr and for less than 24 hours; however, appropriate monitoring of adverse effects is still warranted due to absence of robust evidence.

  15. Supervivencia a largo plazo, 3 años, de los pacientes con Tromboembolismo Pulmonar (TEP) (marcadores de gravedad)

    OpenAIRE

    Altadill Bermejo, Antonio

    2016-01-01

    El objetivo de este estudio fue conocer la mortalidad de los pacientes con tromboembolismo de pulmón (TEP) comparada con la de un grupo control, en función de la presencia de edad avanzada, insuficiencia cardiaca, cáncer, insuficiencia renal o insuficiencia hepática. Grado en Medicina

  16. Time course of expiratory propofol after bolus injection as measured by ion molecule reaction mass spectrometry.

    Science.gov (United States)

    Hornuss, Cyrill; Wiepcke, Dirk; Praun, Siegfried; Dolch, Michael E; Apfel, Christian C; Schelling, Gustav

    2012-04-01

    Propofol in exhaled breath can be detected and monitored in real time by ion molecule reaction mass spectrometry (IMR-MS). In addition, propofol concentration in exhaled breath is tightly correlated with propofol concentration in plasma. Therefore, real-time monitoring of expiratory propofol could be useful for titrating intravenous anesthesia, but only if concentration changes in plasma can be determined in exhaled breath without significant delay. To evaluate the utility of IMR-MS during non-steady-state conditions, we measured the time course of both expiratory propofol concentration and the processed electroencephalography (EEG) as a surrogate outcome for propofol effect after an IV bolus induction of propofol. Twenty-one patients scheduled for routine surgery were observed after a bolus of 2.5 mg kg(-1) propofol for induction of anesthesia. Expiratory propofol was measured using IMR-MS and the cerebral propofol effect was estimated using the bispectral index (BIS). Primary endpoints were time to detection of expiratory propofol and time to onset of propofol's effect on BIS, and the secondary endpoint was time to peak effect (highest expiratory propofol or lowest BIS). Expiratory propofol and changes in BIS were first detected at 43 ± 21 and 49 ± 11 s after bolus injection, respectively (P = 0.29). Peak propofol concentrations (9.2 ± 2.4 parts-per-billion) and lowest BIS values (23 ± 4) were reached after 208 ± 57 and 219 ± 62 s, respectively (P = 0.57). Expiratory propofol concentrations measured by IMR-MS have similar times to detection and peak concentrations compared with propofol effect as measured by the processed EEG (BIS). This suggests that expiratory propofol concentrations may be useful for titrating intravenous anesthesia.

  17. Sedação e analgesia em colonoscopia eletiva: propofol-fentanil versus propofol-alfentanil

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    Hacer Şebnem Türk

    2013-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVO: Sedação e analgesia são recomendadas em colonoscopia para propiciar conforto, pois são procedimentos invasivos e podem ser dolorosos. Este estudo teve como objetivo comparar as combinações de propofol-alfentanil e propofol-fentanil para sedação e analgesia em pacientes submetidos à colonoscopia eletiva. MÉTODOS: Estudo prospectivo e randomizado. Participaram do estudo 80 pacientes, ASA I-II, entre 18 e 65 anos. A indução de sedação e a analgesia foram feitas com propofol (1 mg.kg-1 e fentanil (1 µg.kg-1 no grupo propofol-fentanil (PF e com propofol (1 mg.kg-1 e alfentanil (10 µg.kg-1 no grupo propofol-alfentanil (PA. Para manutenção, doses adicionais de propofol foram administradas em bolus de 0,5 mg.kg-1 para obter escores de 3-4 na Escala de Sedação de Ramsey (ESR. Registrados os dados demográficos, a frequência cardíaca, a pressão arterial média (PAM, a saturação de oxigênio da hemoglobina (SpO2, os valores da ESR, o tempo de colonoscopia, a dose total de propofol, as complicações, o tempo de recuperação e o tempo para alta, bem como os escores de satisfação do colonoscopista e do paciente. RESULTADOS: A PAM aos 15 minutos no Grupo PA foi significativamente maior do que no Grupo PF (p = 0,037. A frequência cardíaca média do grupo PA foi maior no início do que nas mensurações subsequentes (p = 0,012, p = 0,002. A média da dose total de propofol do Grupo PA foi significativamente maior do que a do Grupo PF (p = 0,028. O tempo médio de recuperação do grupo PA foi significativamente maior do que o do grupo PF (p = 0,032. CONCLUSÃO: Fentanil proporciona melhores condições de operação e reduz a necessidade de doses adicionais de propofol. Essas vantagens diminuem o tempo de recuperação. Portanto, propofol-fentanil é superior ao propofol-alfentanil para sedação e analgesia em colonoscopia.

  18. "Despedida de la Torre de Marfil". Historia Comparada : una introducción

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    Heidi Rositha Krauss

    2008-01-01

    Full Text Available En este trabajo se hace una introducción a la Historia comparada, un campo de investigación poco presente en la historiografía medievalista española. Se trata de definir los términos más importantes (histoire-croisée, crossnational history, etc., describir la metodología y demostrar las posibilidades y límites de la Historia comparada.The present work is an introduction to a Comparative History, an area of research not frequent in the medieval spanish historiography. The purpose is to define the most important terms (histoire croisée, cross-national history, etc., to describe the methodology and to demonstrate the possiblities and limits of Comparative History.

  19. Caminante, no hay camino... : la Sociedad Española de Educación Comparada, 1998-2002 = Traveller, there is no way… : the Spanish Comparative Education Society, 1998-2002

    Directory of Open Access Journals (Sweden)

    Amalia Ayala

    2014-09-01

    Full Text Available Ángel González Hernández presidió la Sociedad Española de Educación Comparada del 27 de marzo de 1998 al 23 de noviembre de 2002. Un periodo marcado por el fallecimiento de dos de los padres de la Educación Comparada española, los profesores D. Juan Tusquets y D. Ricardo Marín. La experiencia en gestión política universitaria del profesor González contribuyó a su implicación durante este periodo, con la responsabilidad personalmente asumida en la edición del Boletín de la Sociedad, la celebración de las II Jornadas Científicas de Educación Comparada en la Universidad de Murcia en diciembre de 1999 o la organización del VII Congreso Nacional de Educación Comparada. El talante dialogante, respetuoso y abierto del profesor González permitió dar los primeros pasos en el esfuerzo por implicar en las actividades de la Sociedad Española de Educación Comparada a las distintas tradiciones de educación comparada en España e instauró, con la modificación de los Estatutos de nuestra Sociedad, la presencia en la Junta Directiva de los Presidentes anteriores. Es también el primer Catedrático de Educación Comparada que ha presidido la Sociedad Española de Educación Comparada, marcando el comienzo de una tradición que habla ya del peso específico de la disciplina en aquellos contextos universitarios nacionales que han ido apostando paulatinamente por este perfil para sus cátedras.Angel González Fernández was the President of Spanish Comparative Education Society from 27th of March 1998 to 23rd of November 2002. This time was marked by the death of two parents of Comparative Education, professors Mr. Juan Tusquets and Mr. Ricardo Marin. His experience with University Political Management made professor Gonzalez implicated during this time, assuming personally the responsibility of the Society Bulletin and many other activities, like Science Journeys of Comparative Education or the 7th National Congress of Comparative

  20. Rare, potentially fatal, poorly understood propofol infusion syndrome

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    Eva Annen

    2012-09-01

    Full Text Available We present the case of a 7-year old boy with traumatic brain injury who received propofol during 38 h. Thirty-six hours after cessation of propofol infusion asystole occurred. After immediate mechanical and medical resuscitation, unreactive dilated pupils were observed. The following computed tomography scan revealed a generalized brain edema with transtentorial herniation. Prolonged bradyarrhythmia, rhabdomyolysis, and peracute renal failure were observed. Despite immediate craniectomy, barbiturate treatment, hemofiltration, and recovery of appropriate cardiac function, the patient died four days after discontinuation of propofol. In this case, metabolic acidosis, cardiac failure, rhabdomyolysis, and renal failure are in accordance with the symptoms of propofol infusion syndrome (PRIS, while seizure, brain edema, and transtentorial herniation could be caused by traumatic brain injury. However, it may be assumed that the entire clinical picture was caused by PRIS. This view could be explained by a common loss of function of ryanodine receptors in patients presenting with PRIS.

  1. Neurotoxicity of propofol on rat hypoglossal motoneurons in vitro.

    Science.gov (United States)

    Monni, Laura; Ghezzi, Filippo; Corsini, Silvia; Nistri, Andrea

    2017-08-10

    Although propofol is a widely used intravenous general anaesthetic, many studies report its toxic potential, particularly on the developing central nervous system. We investigated its action on hypoglossal motoneurons (HMs) that control two critical functions in neonates, namely tongue muscle activity and airway patency. Thus, clinically relevant concentrations of propofol (1 and 5μM) were applied (4h) to neonatal rat brainstem slices to evaluate the expression of apoptosis-inducing factor (AIF) as biomarker of toxicity. This anaesthetic strongly increased AIF in the cytoplasm and the nucleus, without early loss of HMs. Electrophysiological recordings from HMs showed that propofol (5μM) enhanced GABA- and glycine-evoked current amplitude and lengthened GABAergic current decay time. Propofol also depressed NMDA receptor-mediated responses without affecting AMPA receptors. Since GABA and glycine depolarize neonatal HMs, we propose that the damaging action by propofol on these motoneurons might arise from the facilitated action of these transmitters with subsequent cytoplasmic Ca(2+) overload. This phenomenon, in turn, may trigger cell death mechanisms manifested as increased expression of AIF and its translocation into the nucleus. Since propofol is also employed for induction and maintenance of paediatric surgery, caution is needed because its potential neurotoxicity might negatively impact neurodevelopment. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. The inhibitory effect of propofol on bovine lactoperoxidase.

    Science.gov (United States)

    Sişecioğlu, Melda; Cankaya, Murat; Gülçin, Ilhami; Ozdemir, Hasan

    2009-01-01

    Propofol (2,6-diisopropylphenol) is a hypnotic intravenous agent with in vivo antioxidant properties. This study was undertaken to examine the in vitro effect of propofol on lactoperoxidase (LPO; E.C. 1.11.1.7) obtained from bovine milk. Lactoperoxidase was purified with three purification steps: Amberlite CG-50 resin, CM-Sephadex C-50 ion-exchange chromatography and Sephadex G-100 gel filtration chromatography, respectively. Lactoperoxidase was purified with a yield of 21.6%, a specific activity of 34 EU/mg proteins and 14.7-fold purification. One enzyme unit is defined as the oxidation of 1 micromol ABTS per min under the assay condition (25( degrees )C, pH: 6.0). To determine enzyme purity, sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) was performed and single band was observed. The effect of propofol on lactoperoxidase were determined using 2,2'-azino-bis (3-ethylbenzthiazoline-6 sulfonic acid) diammonium salt (ABTS) as a chromogenic substrate. The IC(50) value of propofol was found as 15.97 microM. Also, K(i) constant for propofol was 3.72 microM and propofol was found as competitive inhibitor.

  3. A retrospective comparison of propofol alone to propofol in combination with dexmedetomidine for pediatric 3T MRI sedation.

    Science.gov (United States)

    Boriosi, Juan P; Eickhoff, Jens C; Klein, Kristi B; Hollman, Gregory A

    2017-01-01

    Both propofol and dexmedetomidine have been found to be safe and effective sedation for magnetic resonance imaging (MRI). Our program experienced an increase in patients arousing and experiencing an adverse airway event during propofol sedation for MRI in the first months of using a new 3T (Tesla) MRI scanner that was found to have a longer reverberation time compared to the previous 1.5 T MRI. In an effort to decrease patient arousal and adverse airway events during MRI, we administered a dexmedetomidine load prior to our standard propofol protocol. The objective was to compare adverse events and other outcome measures of patients sedated with propofol alone (Pro) and propofol preceded by a dexmedetomidine load (D+P). We reviewed a sedation database and medical records for all children undergoing 3T MRI studies while sedated with propofol alone or propofol preceded by a dexmedetomidine load in 2014. Two hundred and fifty-six sedations were performed for MRI (87 Pro and 169 D+P). The two groups were comparable with regard to age, weight, gender, and American Society of Anesthesiologists status. Subjects in the D+P cohort had significantly fewer adverse events (10/169 patients (5.9%) vs 23/87 patients (26.4%) [OR 0.18, 95% CI: 0.08-0.39, P propofol MRI sedation protocol resulted in fewer sedation-related adverse events, particularly upper airway obstruction. Further studies are needed to evaluate the potential for a reduction on adverse events with this drug combination. © 2016 John Wiley & Sons Ltd.

  4. Revisão sistemática sobre antissepsia cirúrgica das mãos com preparação alcoólica em comparação aos produtos tradicionais Revisión sistemática sobre antisepsia quirúrgica de manos con preparación alcohólica comparada a productos tradicionales A systematic review of surgical hand antisepsis utilizing an alcohol preparation compared to traditional products

    Directory of Open Access Journals (Sweden)

    Karen de Jesus Gonçalves

    2012-12-01

    Full Text Available A antissepsia cirúrgica das mãos visa à prevenção de infecções do sítio cirúrgico, importante causa de morbimortalidade pós-operatória e aumento dos custos hospitalares. Este estudo teve como objetivo comparar a eficácia de preparações alcoólicas com os produtos tradicionais na antissepsia cirúrgica das mãos por meio de uma revisão sistemática da literatura. Foram considerados estudos primários ou secundários, tendo como desfecho a contagem microbiana das mãos ou taxas de infecções do sítio cirúrgico. A busca foi realizada no Portal BVS, PubMed, Ask e MEDLINE. Foram selecionados 25 estudos (2 revisões sistemáticas, 19 experimentais e 4 de coorte. As preparações alcoólicas tiveram uma redução microbiana igual e/ou maior aos produtos tradicionais em 17 estudos e inferior em 4; as taxas de infecções do sítio cirúrgico foram similares. Portanto, existem evidências científicas que suportam a segurança das preparações alcoólicas para antissepsia cirúrgica das mãos.La antisepsia quirúrgica de manos apunta a prevenir infecciones en el sitio quirúrgico, causa importante de morbi-mortalidad postoperatoria y aumento de costos hospitalarios. El estudio objetivó comparar la eficacia de preparaciones alcohólicas con los productos tradicionales de la antisepsia quirúrgica de manos, mediante revisión sistemática de la literatura. Fueron considerados estudios primarios o secundarios, teniendo como objetivo el recuento microbiano en manos o tasas de infecciones del sitio quirúrgico. La búsqueda fue realizada en las bases BVS, PubMed, Ask y MEDLINE. Fueron seleccionados 25 estudios (2 revisiones sistemáticas, 19 experimentales y 4 de cohorte. Las preparaciones alcohólicas consiguieron una reducción microbiana igual y/o mayor que los productos tradicionales en 17 estudios, e inferior en 4; las tasas de infección del sitio quirúrgico fueron equivalentes. Por lo tanto, existen evidencias científicas que dan

  5. 75 FR 66195 - Schedules of Controlled Substances: Placement of Propofol Into Schedule IV

    Science.gov (United States)

    2010-10-27

    ... Propofol Into Schedule IV; Proposed Rule #0;#0;Federal Register / Vol. 75, No. 207 / Wednesday, October 27... Schedules of Controlled Substances: Placement of Propofol Into Schedule IV AGENCY: Drug Enforcement... propofol, including its salts, isomers, and salts of isomers whenever the existence of such salts, isomers...

  6. Predictive performance of eleven pharmacokinetic models for propofol infusion in children for long-duration anaesthesia

    NARCIS (Netherlands)

    Hara, M.; Masui, K.; Eleveld, D. J.; Struys, M. M. R. F.; Uchida, O.

    Background. Predictive performance of eleven published propofol pharmacokinetic models was evaluated for long-duration propofol infusion in children. Methods. Twenty-one aged three-11 yr ASA I-II patients were included. Anaesthesia was induced with propofol or sevoflurane, and maintained with

  7. Propofol-induced myoclonic seizures after endoscopic procedure in an elderly woman

    Institute of Scientific and Technical Information of China (English)

    Yasar Tuna; Adnan Ta(s); Seyfettin K(o)klü

    2012-01-01

    To the Editor:Propofol,a gamma-aminobutyric acid (GABA)-mediated inhibitor of excitatory neurotransmitter,is a popular intraveneous agent for gastrointestinal endoscopy sedation in past few years.Propofol is a rapid and short-acting anesthetic because of its high lipid solubility.In this letter,we report a case of propofol-induced seizures after endoscopic procetures.

  8. Comparison of propofol-fentanyl with propofol-fentanyl-ketamine combination in pediatric patients undergoing interventional radiology procedures.

    Science.gov (United States)

    Erden, I Aydin; Pamuk, A Gulsun; Akinci, Seda B; Koseoglu, Ayhan; Aypar, Ulku

    2009-05-01

    With an increase in the frequency of interventional radiology procedures in pediatrics, there has been a corresponding increase in demand for procedural sedation to facilitate them. The purpose of our study was to compare the frequency of adverse effects, sedation level, patient recovery characteristics in pediatric patients receiving intravenous propofol fentanyl combination with or without ketamine for interventional radiology procedures. Our main hypothesis was that the addition of ketamine would decrease propofol/fentanyl associated desaturation. Sixty consenting American Society of Anesthesia physical status I-III pediatric patients undergoing interventional radiology procedures under sedation were studied according to a randomized, double-blinded, institutional review board approved protocol. Group 1 received propofol 0.5 mg.kg(-1) + fentanyl 1 microg.kg(-1) + ketamine 0.5 mg.kg(-1), and group 2 received propofol 0.5 mg.kg(-1) + fentanyl 1 microg.kg(-1) + same volume of %0.9 NaCl intravenously. While apnea was not observed in any of the groups, there were three cases (10%) in group 1, and nine cases (30%) in group 2 with oxygen desaturation (P = 0.052). In group 1, 12 (40%) patients and, in group 2, 21 (70%) patients required supplemental propofol during the procedure (P = 0.021). There was no evidence for difference between groups in terms of other side effects except nystagmus. In conclusion, addition of low dose ketamine to propofol-fentanyl combination decreased the risk of desaturation and it also decreased the need for supplemental propofol dosage in pediatric patients at interventional radiology procedures.

  9. El cambio social y la 'Constitución moderna' en los clásicos de la Sociología. Durkheim y Weber en perspectiva comparada

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    Santiago, José

    2011-08-01

    Full Text Available The aim of this article is to analyse the conception of social change of Durkheim and Weber from a comparative perspective. It proposes a reading of their works attending to the place these authors occupy in what, following Bruno Latour, may be named as “Modern Constitution”. From this metatheoretical level, the comparison brings to light the tools and resources of the “Modern Critique” which they utilise to build their theories of social change. From this comparative perspective, the article examines how Durkheim and Weber theorize on the “fourth guarantee” of the “Modern Constitution”, that refers to God’s presence in modernity. Finally, this “guarantee” is problematized in the frame of the contemporary society attending to current theories.

    El objetivo de este artículo es analizar la concepción del cambio social de Durkheim y Weber desde una perspectiva comparada. Se propone una lectura de sus obras prestando atención al lugar que ambos ocupan en lo que, siguiendo a Bruno Latour, llamaremos “Constitución moderna”. Desde este nivel metateórico, la comparación permitirá mostrar las herramientas y recursos de la “Crítica moderna” de los que estos autores se sirven para construir sus teorías del cambio social. Con esta perspectiva comparada, el artículo examina de qué manera Durkheim y Weber teorizan sobre la “cuarta garantía” de la “Constitución moderna”, que hace referencia al lugar que ocupa Dios en la modernidad. Por último, esta “garantía” es problematizada en el marco de la sociedad contemporánea a partir de las propuestas de algunos teóricos actuales.

  10. Detection of propofol concentrations in blood by Raman spectroscopy

    Science.gov (United States)

    Wróbel, M. S.; Gnyba, M.; UrniaŻ, R.; Myllylä, T. S.; Jedrzejewska-Szczerska, M.

    2015-07-01

    In this paper we present a proof-of-concept of a Raman spectroscopy-based approach for measuring the content of propofol, a common anesthesia drug, in whole human blood, and plasma, which is intended for use during clinical procedures. This method utilizes the Raman spectroscopy as a chemically-sensitive method for qualitative detection of the presence of a drug and a quantitative determination of its concentration. A number of samples from different patients with added various concentrations of propofol IV solution were measured. This is most equivalent to a real in-vivo situation. Subsequent analysis of a set of spectra was carried out to extract qualitative and quantitative information. We conclude, that the changes in the spectra of blood with propofol, overlap with the most prominent lines of the propofol solution, especially at spectral regions: 1450 cm-1, 1250- 1260 cm-1, 1050 cm-1, 875-910 cm-1, 640 cm-1. Later, we have introduced a quantitative analysis program based on correlation matrix closest fit, and a LOO cross-validation. We have achieved 36.67% and 60% model precision when considering full spectra, or specified bands, respectively. These results prove the possibility of using Raman spectroscopy for quantitative detection of propofol concentrations in whole human blood.

  11. Antioxidative effects of propofol vs. ketamin in individuals undergoing surgery.

    Science.gov (United States)

    Khoshraftar, Ebrahim; Ranjbar, Akram; Kharkhane, Behroz; Tavakol Heidary, Shayesteh; Gharebaghi, Zohre; Zadkhosh, Nahid

    2014-07-01

    Propofol (2, 6-diisopropylphenol) is a widely used intravenous sedative-hypnotic agent for both induction/maintenance of anesthesia and sedation of critically ill patients. The present study aimed to evaluate oxidative stress biomarkers in individuals undergoing surgery with propofol and ketamine at doses used to induce anesthesia. The plasma oxidative stress biomarkers such as total antioxidant capacity (TAC), lipid peroxidation (LPO), total thiol molecules (TTM) and antioxidant enzymes activity such as glutathione peroxidase (GPx), superoxidedismutase (SOD) and catalase (CAT) were studied in blood samples obtained from 40 patients with propofol, and compared to samples from 40 patients with ketamine aged 11 - 50 years. The results showed that the ketamine group had significantly higher blood LPO level, GPx and SOD activity while having lower blood TAC and TTM concentrations in comparison to the propofol group. In conclusion, our findings showed that propofol has antioxidant effects in human. Further studies need to be conducted to demonstrate the exact mechanism of oxidative stress caused by anesthesia in surgery patients.

  12. Ondansetron Pretreatment Reduces Pain on Injection of Propofol

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    Anahid Maleki

    2012-04-01

    Full Text Available To assess the effectiveness of ondansetron pretreatment in alleviating propofol injection pain, 135 patients were randomly assigned to one of following three groups. Group 1 who received up to 2 mL pretreatment 50 mg tramadol in the saline, group 2 cases who received up to 2 mL pretreatment 4 mg ondansetron in saline, and group 3 who received up to 2 mL solution saline. A 20 gauge cannula was placed into the largest vein on the dorsum of the hand. Tourniquet was closed to the arm above the cannula and inflates to 70 mmHg, and then drug was injected. After 20 seconds, the tourniquet deflated, and propofol 2mg/kg injected over 10 seconds and pain assessment was made. Results: Tramadol and ondansetron significantly reduced the incidence and severity of propofol injection pain more than placebo (P=0.001. The efficacy of ondansetron in alleviating the pain on injection of propofol was no different from tramadol (P=0.330. Ondansetron pretreatment may be used to reduce the incidence of pain on injection of propofol, an advantage added to the useful prevention of postoperative nausea and vomiting.

  13. The Protective Effect of Propofol on Erythrocytes during Cardiopulmonary Bypass

    Institute of Scientific and Technical Information of China (English)

    张诗海; 姚尚龙

    2001-01-01

    To evaluate the relationship between erythrocyte injury and intracellular calcium ion overload, and the protective effect of propofol on erythrocytes during cardiopulmonary bypass (CPB), 40 children with congenital heart diseases who underwent surgical repair under CPB were studied. The patients were randomly divided into two groups: control group (group C) and propofol group (group P). Anesthesia was maintained in the patients in group P with 6 mg*kg-1*h-1 propofol, and those in the group C inhaled 1 %-2 % isoflurane. The blood samples were taken before CPB, at the 30th min of CPB, at the end of CPB, and 2 h and 24 h after CPB to measure the content of erythrocyte intracellular calcium ion (E-Ca2+), Ca2+-Mg2+-ATPase and Na+-K+-ATPase activities, index filtration of erythrocytes (IF), mean corpuscular volume (MCV) and the concentration of plasma free hemoglobin (F-HB). Results showed that in the control group, E-Ca2+, IF, MCV and F-Hb were gradually increased and Ca2+-Mg2+-ATPase and Na+-K+-ATPase activities were decreased. The increase of E-Ca2+ was linearly paralleled to IF, MCV and F-Hb. In propofol group, all the above-mentioned parameters were significantly improved (P<0.05). This study suggests that erythrocyte injury is related to elevation of intracellular calcium during CPB and propofol has a protective effect on erythrocyte injury.

  14. The Protective Effect of Propofol on Erythrocytes during Cardiopulmonary Bypass

    Institute of Scientific and Technical Information of China (English)

    张诗海; 姚尚龙

    2004-01-01

    To evaluate the relationship between erythrocyte injury and intracellular calcium ion overload, and the protective effect of propofol on erythrocytes during cardiopulmonary bypass (CPB). 40 children with congenital heart diseases who underwent surgical repair under CPB were included. The patients were randomly divided into two groups: control group (group C) and propofol group (group P). Anesthesia was maintained in the patients with 6 mg/kg/h propofol in Group P, and those in the Group C inhaled 1 %-2 % isoflurane. The blood samples were taken before CPB, 30 min after CPB, at the end of CPB, and 2 h and 24 h after CPB to measure the content of erythrocyte intracellular calcium ion (E-Ca2+ ), Ca2+-Mg2+-ATPase and Na+-K+-ATPase activities, index filtration of erythrocytes (IF), mean corpuscular volume (MCV) and the concentration of plasma free hemoglobin (F-Hb). Results showed that in the control group, E-Ca2+ , IF, MCV and F-Hb were gradually increased and Ca2+-Mg2+-ATPase and Na+-K+-ATPase activities were decreased. The increase of E-Ca2+ was linearly paralleled to IF, MCV and F-Hb. In propofol group, all the above-mentioned parameters were significantly improved (P<0. 05). This study suggests that erythrocyte injury is related to elevation of intracellular calcium during CPB and propofol has a protective effect on erythrocyte injury.

  15. Comparison of the Direct Costs, Length of Recovery, and Incidence of Post Operative Anti-Emetic use After Anesthesia Induction with Propofol or a 1:1 Mixture of Thiopental and Propofol

    Science.gov (United States)

    1999-10-01

    et al. (1994) found that Chinese pediatric patients had significantly longer recovery with propofol induction and maintenance versus propofol ...Couchman, & Pollock, 1992). Propofol induction followed by propofol maintenance showed the least hemodynamic changes in pediatric patients versus...COMPARISON OF THE DIRECT COSTS, LENGTH OF RECOVERY, AND INCIDENCE OF POST OPERATIVE ANTI-EMETIC USE AFTER ANESTHESIA INDUCTION WITH PROPOFOL OR A 1:1

  16. Propofol-induced violent coughing in a patient with Becker′s muscular dystrophy

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    Amit Jain

    2011-01-01

    Full Text Available Propofol anesthesia is often associated with decreased incidence of gagging, coughing or laryngospasm, and provides intense suppression on airway reflex during tracheal intubation and laryngeal mask airway insertion. Propofol pretreatment is also effective in reducing the occurrence of opioid-induced coughing. These benefits are often attributed to bronchodilator and sedative effects of propofol. However, severe coughing following sedative doses of 1% propofol has not been reported so far. We report a rare case of violent coughing following low-dose propofol infusion in a patient with Becker′s muscular dystrophy.

  17. Intravenous ketamine, propofol and propofol-ketamine combination used for pediatric dental sedation: A randomized clinical study.

    Science.gov (United States)

    Canpolat, Dilek Gunay; Yildirim, Mustafa Denizhan; Aksu, Recep; Kutuk, Nukhet; Alkan, Alper; Cantekin, Kenan

    2016-01-01

    Dental treatments cannot bealways performed under local anesthesia inpediatric non-cooperative patients. For this purpose, differentanesthetic techniques have been applied to increase patient comport to dental treatments. Sixty children classified as ASA I-II, between aged 3 to 9, who were scheduled to undergo tooth extraction, were enrolled for this randomized study. Group K received 1 mg/kg ketamine, Group P received 1 mg/kg propofol, and Group KP received 0.5 mg/kg propofol plus 0.5 mg/kg ketamine intravenously for anesthesia induction. Recovery time was significantly lower in Group P than Group KP. No significant differences were found between groups regarding HR, before and after the induction, at tenth minute. Fifth minute's HR was higher in Group K than Group KP. Mean arterial pressure (MAP) values were similar at baseline, before and after the induction, and at tenth minute, whereas significantly lower values were found in Group P and Group KP than in Group K at fifth minute. Although ketamine, propofol and ketamine-propofol combination are effective for sedation in tooth extraction in pediatric patients, propofol may be an excellent alternative, with the shortest recovery, no nausea and vomiting, and reasonable surgical satisfaction.

  18. Dexmedetomidina associada a propofol em sedação durante anestesia local para cirurgia plástica Dexmedetomidina asociada a propofol en sedación durante anestesia local para cirugía plástica Dexmedetomidine/propofol association for plastic surgery sedation during local anesthesia

    Directory of Open Access Journals (Sweden)

    José Roberto Nociti

    2003-04-01

    propofol apresenta as seguintes vantagens: redução do consumo de propofol, estabilidade dos parâmetros cardiovasculares, controle adequado do sangramento per-operatório, ausência de efeito importante sobre a ventilação.JUSTIFICATIVA Y OBJETIVOS: La dexmedetomidina es un nuevo agonista alfa2-adrenérgico con propiedades potencialmente útiles en anestesia. Este estudio comparativo tiene por finalidad observar los efectos de la dexmedetomidina sobre el consumo de propofol y la evolución de los parámetros cardiovasculares y respiratorios, cuando incluida en técnica de sedación durante anestesia local en cirugía plástica. MÉTODO: Participaron del estudio 40 pacientes del sexo femenino con edades entre 15 y 60 años, estado físico ASA I ó II, sometidas a cirugías plásticas electivas bajo anestesia local. Fueron distribuidas aleatoriamente en dos grupos de veinte: C (control y D (dexmedetomidina. En ambos, la sedación fue obtenida con propofol en la dosis en bolus inicial de 1,0 mg.kg-1 seguida de infusión continua en velocidad ajustada para obtenerse grado de sedación consciente. En el grupo D, las pacientes recibieron infusión venosa continua de dexmedetomidina a la velocidad de 0,01 µg.kg-1.min-1, concomitante con la de propofol. Fueron evaluados: efecto de la dexmedetomidina sobre el consumo de propofol; variación de los parámetros cardiovasculares (PAS, PAD, PAM, FC y respiratorios (SpO2, P ET CO2; calidad del control del sangramiento per-operatorio y características de la recuperación pós-anestésica. RESULTADOS: La velocidad media de infusión de propofol fue menor en el grupo D (35,2 ± 5,3 µg.kg-1.min-1 de que en el grupo C (72,6 ± 8,5 µg.kg-1.min-1. Los valores medios de PAS, PAD y PAM decrecieron en relación al inicial, a partir de los 30 minutos, en el grupo D, manteniéndose a seguir estables hasta el final; en el grupo C, aumentaron. La FC se mantuvo estable en el grupo D y aumentó significativamente a partir de los 30 minutos en el

  19. Moderate and deep nurse-administered propofol sedation is safe

    DEFF Research Database (Denmark)

    Jensen, Jeppe Thue; Møller, Ann; Hornslet, Pernille

    2015-01-01

    INTRODUCTION: Non-anaesthesiologist-administered propofol sedation (NAPS/NAAP) is increasingly used in many countries. Most regimens aim for light or moderate sedation. Little evidence on safety of deep NAPS sedation is available. The aim of this study was to explore the safety of intermittent deep...... as patients developing an adverse event (oxygen saturation 30% or a drop in systolic blood pressure of > 50 mmHg). The remaining patients served as controls. RESULTS: A total of 6,840 consecutive patients undergoing 7,364 procedures were included. The mean propofol...... dose was 331.6 mg (standard deviation = 179.4 mg). The overall rate of hypoxia was 3.2%, and the rate of hypotension was 3.1%. Assisted ventilation was needed in 0.5%. Age (p propofol dose (p = 0.001) were associated...

  20. Diphenhydramine for Acute Extrapyramidal Symptoms After Propofol Administration.

    Science.gov (United States)

    Sherer, James; Salazar, Tomas; Schesing, Kevin B; McPartland, Shannon; Kornitzer, Jeffrey

    2017-02-01

    Extrapyramidal symptoms are an uncommon but well-recognized side effect after the administration of general anesthesia in patients without a significant neurologic history. Several case reports implicate propofol as the likely causative agent producing these symptoms, which include ballismus, dystonia, choreoathetosis, and opisthotonus. Currently, there is no clear consensus on first-line treatment of these symptoms. In each of the published cases, anticholinergic medications and benzodiazepines were central to initial management, although the speed and extent of symptom resolution were variable. Here we present a case of a 17-year-old boy with ulcerative colitis who presented with ballismus, torticollis, tongue thrusting, and oculogyric movements after colonoscopy under general anesthesia with propofol. The patient responded promptly to treatment with diphenhydramine. This is the first reported case in which diphenhydramine was successfully used as the primary treatment of severe extrapyramidal symptoms in a pediatric patient after propofol administration. Copyright © 2017 by the American Academy of Pediatrics.

  1. Non-anesthesiologist administration of propofol for gastrointestinal endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, Jean-Marc; Riphaus, Andrea; Schreiber, Florian

    2015-01-01

    . Main Recommendations 1 We recommend that the type of endoscopic procedure and the patient's American Society of Anesthesiologists (ASA) physical status, age, body mass index, Mallampati's classification, and risk factors for obstructive sleep apnea (OSA) be assessed before each procedure with non...... deep sedation, and long procedures (weak recommendation, high quality evidence). 4 We suggest propofol monotherapy except in particular situations (weak recommendation, high quality evidence). 5 We recommend administering propofol through intermittent bolus infusion or perfusor systems, including...... evidence). 7 We do not suggest using pharyngeal anesthesia during propofol sedation for upper GI endoscopy (weak recommendation, moderate quality evidence). 8 We suggest using the post-anesthetic discharge scoring system (PADSS) to determine when patient recovery is sufficient to allow discharge (weak...

  2. Tolerability of propofol in Wada testing

    Science.gov (United States)

    Alsallom, Faisal A.; Sinha, Shobhit; Alsenani, Fahmi M.; Bamogaddam, Fawziah A.; Wahass, Saeed H.; Canillo, Aurora B.; Siddiqui, Khurram A.

    2014-01-01

    Objective: To assess the tolerability of propofol (PF) in Wada test in an Arab population with temporal lobe epilepsy (TLE). Methods: This observational study with consecutive sampling took place in King Fahad Medical City, Riyadh, Saudi Arabia. Nine consecutive patients with mean (+SD) age of 26 (+5.8) years, 6 males and 3 females, underwent Wada test between January 2009 and December 2012. Six of them had left TLE, and 3 had right TLE. Each patient received 10 mg of PF in the internal carotid artery (ICA). Right hemispheric injection was followed by left hemisphere injection after 30 minutes. During the procedure, EEG monitoring showed changes within 5-18 seconds of injection as hemispheric delta slowing. Neuropsychological tests were carried out for localization of memory and language. Results: We were able to lateralize speech dominance in 8 patients and memory dominance in 6 patients. Peri-procedural complications included transient euphoria (n=1), transient spasm of ICA (n=1), eye pain (n=1), facial pain (n=1), and generalized tremulousness (n=2). None of the patients exhibited a symptomatic drop in blood pressure. Conclusions: We found that PF is well tolerable for the Wada test, with minimally significant complications, although blood pressure should be closely monitored. PMID:24983284

  3. Comparison of serum triglyceride levels with propofol in long chain triglyceride and propofol in medium and long chain triglyceride after short term anesthesia in pediatric patients

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    Ishwar Bhukal

    2014-01-01

    Full Text Available Background: Significant increase in serum triglyceride (ST concentration have been described in adult population after prolonged administration of propofol formulation containing long chain triglyceride (LCT. Though, medium chain triglyceride-LCT (MCT-LCT propofol when compared with LCT propofol for long-term sedation in adults resulted in identical triglyceride levels, the elimination of triglyceride was faster in patients administered MCT-LCT propofol. Materials and Methods: A total of 40 children were randomized into two groups of 20 each; Group I were induced with 1% LCT propofol (3 mg/kg and Group II with 1% medium and LCT propofol and maintained with descalating dose of 20.15 and 10 mg/kg/h at 10 min intervals. Blood samples for ST concentration were obtained before induction of anesthesia, at the end of propofol infusion and 4 h after terminating propofol infusion. Results: ST levels were raised significantly above the basal values in both the groups but the rise was significantly higher in Group I (P < 0.05. Four hours after stopping propofol infusion the triglyceride levels were similar to the basal values in Group II, whereas in Group I the values were significantly greater than the baseline (P < 0.05 as well as those of Group II (P < 0.05. No clinically significant adverse effect of hypertriglyceridemia was observed. Conclusion: Even short term anesthesia with LCT and MCT-LCT propofol (1% leads to elevated ST levels. The increase in ST levels is less with MCT-LCT propofol and elimination of triglyceride is also rapid after terminating MCT-LCT propofol infusion.

  4. Globalización, cambios en la estructura de poder y nuevas elites empresariales: una mirada comparada de Uruguay

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    Miguel Serna

    2013-06-01

    Full Text Available El artículo tiene como objetivo principal abordar la problemática de los cambios en la composición de las elites empresariales en el último ciclo de globalización económica neoliberal desde la literatura teórica comparada reciente y luego un análisis específico a partir de los estudios existentes en la temática sobre Uruguay. El trabajo desarrolla un análisis comparativo de enfoques y estudios sobre elites económicas que señalan cinco tipos de procesos de cambios en las últimas décadas de hegemonía del ciclo de desarrollo neoliberal. En primer término, procesos de convergencia y divergencia entre las trayectorias de las elites políticas y económicas. En segundo lugar, procesos de especialización funcional y diversificación de grupos dirigentes en las distintas fuentes de poder económico. Tercero, la existencia de mecanismos de reclutamiento y reproducción de las elites económicas que se relacionan con las formas de dominación en la sociedad. Cuarto, la producción nuevos y viejos mecanismos de legitimación del poder económico, que combinan formas de capital económico y simbólico. Por último, la creciente centralidad de las redes globales y modos de transnacionalización del capital en la conformación de los grupos de elites empresariales. El análisis de la literatura y estudios sobre elites empresariales en el Uruguay en las últimas décadas muestra tendencias similares (a escala de una economía y país pequeño donde se está asistiendo a cambios en las composición de las elites empresariales con una creciente importancia del capital transnacional, y de nuevos elencos ejecutivos que se apoyan más en una forma de control y gestión profesionalizada de las empresas, en redes globales y nuevas formas de capital social. Estas transformaciones contrastan con los perfiles clásicos de empresarios reclutados por medio del capital familiar y prestigio heredado y la pertenencia a gremiales tradicionales y c

  5. Piracetam prevents memory deficit induced by postnatal propofol exposure in mice.

    Science.gov (United States)

    Wang, Yuan-Lin; Li, Feng; Chen, Xin

    2016-05-15

    Postnatal propofol exposure impairs hippocampal synaptic development and memory. However, the effective agent to alleviate the impairments was not verified. In this study, piracetam, a positive allosteric modulator of AMPA receptor was administered following a seven-day propofol regime. Two months after propofol administration, hippocampal long-term potentiation (LTP) and long-term memory decreased, while intraperitoneal injection of piracetam at doses of 100mg/kg and 50mg/kg following last propofol exposure reversed the impairments of memory and LTP. Mechanically, piracetam reversed propofol exposure-induced decrease of BDNF and phosphorylation of mTor. Similar as piracetam, BDNF supplementary also ameliorated propofol-induced abnormalities of synaptic plasticity-related protein expressions, hippocampal LTP and long-term memory. These results suggest that piracetam prevents detrimental effects of propofol, likely via activating BDNF synthesis. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. The effects of propofol on cerebral perfusion MRI in children

    Energy Technology Data Exchange (ETDEWEB)

    Harreld, Julie H.; Helton, Kathleen J.; Reddick, Wilburn E.; Glass, John O.; Sansgiri, Rakhee; Ji, Qing; Patay, Zoltan [St. Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States); Kaddoum, Roland N.; Parish, Mary Edna [St. Jude Children' s Research Hospital, Department of Anesthesiology, Memphis, TN (United States); Li, Yimei; Feng, Tianshu [St. Jude Children' s Research Hospital, Department of Biostatistics, Memphis, TN (United States); Gajjar, Amar [St. Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States)

    2013-08-15

    The effects of anesthesia are infrequently considered when interpreting pediatric perfusion magnetic resonance imaging (MRI). The objectives of this study were to test for measurable differences in MR measures of cerebral blood flow (CBF) and cerebral blood volume (CBV) between non-sedated and propofol-sedated children, and to identify influential factors. Supratentorial cortical CBF and CBV measured by dynamic susceptibility contrast perfusion MRI in 37 children (1.8-18 years) treated for infratentorial brain tumors receiving propofol (IV, n = 19) or no sedation (NS, n = 18) were compared between groups and correlated with age, hematocrit (Hct), end-tidal CO{sub 2} (ETCO{sub 2}), dose, weight, and history of radiation therapy (RT). The model most predictive of CBF and CBV was identified by multiple linear regression. Anterior cerebral artery (ACA) and middle cerebral artery (MCA) territory CBF were significantly lower, and MCA territory CBV greater (p = 0.03), in IV than NS patients (p = 0.01, 0.04). The usual trend of decreasing CBF with age was reversed with propofol in ACA and MCA territories (r = 0.53, r = 0.47; p < 0.05). ACA and MCA CBF (r = 0.59, 0.49; p < 0.05) and CBV in ACA, MCA, and posterior cerebral artery territories (r = 0.73, 0.80, 0.52; p < 0.05) increased with weight in propofol-sedated children, with no significant additional influence from age, ETCO{sub 2}, hematocrit, or RT. In propofol-sedated children, usual age-related decreases in CBF were reversed, and increases in CBF and CBV were weight-dependent, not previously described. Weight-dependent increases in propofol clearance may diminish suppression of CBF and CBV. Prospective study is required to establish anesthetic-specific models of CBF and CBV in children. (orig.)

  7. Protective effect of propofol on noise-induced hearing loss.

    Science.gov (United States)

    Wen, Jian; Duan, Na; Wang, Qiang; Jing, Gui-Xia; Xiao, Ying

    2017-02-15

    Iatrogenic noise produced by mastoid or craniotomy drills may cause hearing damage, which is induced by the generation of reactive oxygen species (ROS) and the reduction of cochlear blood flow (CoBF). This study investigated whether propofol could reduce noise-induced hearing loss (NIHL) in a guinea pig model. Sixty-four male pigmented guinea pigs were randomly and equally divided into 4 groups: control, noise, propofol and propofol+noise. Propofol was infused intravenously for 20min prior to noise exposure with a loading dose of 5mg·kg(-1) for 5min and a maintenance infusion of 20mg·kg(-1)·h(-1) for 135min. For noise exposure, an octave band noise at a 124dB sound pressure level (SPL) was administered to animals for 2h. The mean arterial pressure (MAP) and CoBF were monitored continuously. Auditory function was measured by the level of distortion product otoacoustic emission (DPOAE) before and at 1h, 72h and 240h after noise exposure. Cochlear levels of 8-iso-Prostaglandin F2alpha (8-iso-PGF2α) were measured immediately after the termination of noise exposure. Cochlear silver nitrate staining and outer hair cell (OHC) counting were performed after the final functional test. Noise exposure caused decreases in the CoBF and DPOAE amplitudes, over-generation of 8-iso-PGF2α and the loss of OHCs. Pre-treatment with propofol significantly increased the CoBF and DPOAE amplitudes, decreased 8-iso-PGF2α and the loss of OHCs. Propofol exerted protective effects against NIHL in this animal model by suppressing a lipid peroxidation reaction and improving CoBF. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Efeitos do propofol sobre o sistema de condução cardíaca Efectos del propofol sobre el sistema de conducción cardíaco Effects of propofol on the cardiac conduction system

    Directory of Open Access Journals (Sweden)

    Paulo Warpechowski

    2010-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Alguns estudos têm demonstrado que o uso do propofol é, algumas vezes, associado a bradiarritmias ou reversão de arritmias para ritmo sinusal. Essa propriedade do propofol sugere interferência no Sistema de Condução Cardíaco (SCC. CONTEÚDO: Realizou-se revisão com base nos principais artigos contemporâneos que englobam o uso do propofol na presença de arritmias cardía cas. Os autores discorrem sobre os mecanismos fisiopatológicos das taquiarritmias supraventriculares (TSV e as eventuais interferências causadas pelo propofol sobre o SCC. CONCLUSÕES: Os estudos realizados até então parecem indicar que, provavelmente, o propofol interfere nas TSV automáticas (pelo menos em crianças, mas não nas taquiarritmias em que o mecanismo seja de reentrada.JUSTIFICATIVA Y OBJETIVOS: Algunos estudios han demostrado que el uso del propofol es algunas veces, asociado a bradiarritmias o a reversión de arritmias para ritmo sinusal. Esa propiedad del propofol nos sugiere una interferencia en el Sistema de Conducción Cardíaco (SCC. CONTENIDO: Se realizó una revisión en base a los principales artículos contemporáneos que engloban el uso del propofol cuando ocurren arritmias cardíacas. Los autores nos hablan sobre los mecanismos fisiopatológicos de las taquiarritmias supraventriculares y las eventuales interferencias causadas por el propofol sobre el SCC. CONCLUSIÓN: Los estudios realizados hasta ahora parecen indicar que probablemente, el propofol interfiere en las TSV automáticas (por lo menos en niños, pero no en las taquiarritmias en que el mecanismo sea de reentrada.BACKGROUND AND OBJECTIVES: Some studies have demonstrated that the use of propofol is occasionally associated with bradyarrhythmias or reversion of arrhythmias to sinus rhythm. This property of propofol suggests interference with the Cardiac Conduction System (CCS. CONTENTS: A review of the main contemporary articles on the use of propofol in

  9. Moderate and deep nurse-administered propofol sedation is safe

    DEFF Research Database (Denmark)

    Jensen, Jeppe Thue; Møller, Ann; Hornslet, Pernille;

    2015-01-01

    as patients developing an adverse event (oxygen saturation 30% or a drop in systolic blood pressure of > 50 mmHg). The remaining patients served as controls. RESULTS: A total of 6,840 consecutive patients undergoing 7,364 procedures were included. The mean propofol...... with a higher rate of adverse events. CONCLUSION: Safety during intermittent deep sedation with NAPS was good. Age, ASA class 3 and total propofol dose were correlated with a higher rate of adverse events. Patients aged 60 years or more needed more handling during adverse events. FUNDING: Arvid Nilsson...

  10. Use of propofol as adjuvant therapy in refractory delirium tremens

    Directory of Open Access Journals (Sweden)

    Rajiv Mahajan

    2010-01-01

    Full Text Available Delirium tremens is recognized as a potentially fatal and debilitating complication of alcohol withdrawal. Use of sedatives, particularly benzodiazepines, is the cornerstone of therapy for delirium tremens. But sometimes, very heavy doses of benzodiazepines are required to control delirious symptoms. We are reporting one such case of delirium tremens, which required very heavy doses of benzodiazepines and was ultimately controlled by using infusion of propofol. Thus propofol should always be considered as an option to treat patients with resistant delirium tremens.

  11. Confounding factors to predict the awakening effect-site concentration of propofol in target-controlled infusion based on propofol and fentanyl anesthesia.

    Science.gov (United States)

    Chan, Shun-Ming; Lee, Meei-Shyuan; Lu, Chueng-He; Cherng, Chen-Hwan; Huang, Yuan-Shiou; Yeh, Chun-Chang; Kuo, Chan-Yang; Wu, Zhi-Fu

    2015-01-01

    We conducted a large retrospective study to investigate the confounding factors that predict Ce ROC under propofol-based TIVA with TCI. We recorded sex, age, height, weight, Ce LOC, Ce ROC, total propofol and fentanyl consumption dose, and anesthetic time. Simple linear regression models were used to identify potential predictors of Ce ROC, and multiple linear regression models were used to identify the confounding predictors of Ce ROC. We found that Ce ROC correlated with age, sex, Ce LOC, and both total fentanyl and propofol consumption dose. The prediction formula was: Ce ROC = 0.87 - 0.06 × age + 0.18 × Ce LOC + 0.04 (if fentanyl consumption > 150 μg; if not, ignore this value) + 0.07 × (1 or 2, according to the total propofol consumption dose, 1 for a propofol amount 1000-2000 mg and 2 for a propofol amount > 2000 mg). We simplified the formula further as Ce ROC = 0.87 - 0.06 × age + 0.18 × Ce LOC. In conclusion, Ce ROC can be predicted under TCI with propofol- and fentanyl-based TIVA. The confounding factors that predicted propofol Ce ROC are age, sex, Ce LOC, and total consumption dose of propofol and fentanyl.

  12. Anesthetic propofol overdose causes endothelial cytotoxicity in vitro and endothelial barrier dysfunction in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Ming-Chung [Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan, Taiwan (China); Chen, Chia-Ling [Center of Infectious Disease and Signaling Research, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Yang, Tsan-Tzu; Choi, Pui-Ching [Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Hsing, Chung-Hsi [Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan (China); Department of Anesthesiology, College of Medicine, Taipei Medical University, Taipei, Taiwan (China); Lin, Chiou-Feng, E-mail: cflin@mail.ncku.edu.tw [Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Center of Infectious Disease and Signaling Research, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China)

    2012-12-01

    An overdose and a prolonged treatment of propofol may cause cellular cytotoxicity in multiple organs and tissues such as brain, heart, kidney, skeletal muscle, and immune cells; however, the underlying mechanism remains undocumented, particularly in vascular endothelial cells. Our previous studies showed that the activation of glycogen synthase kinase (GSK)-3 is pro-apoptotic in phagocytes during overdose of propofol treatment. Regarding the intravascular administration of propofol, we therefore hypothesized that propofol overdose also induces endothelial cytotoxicity via GSK-3. Propofol overdose (100 μg/ml) inhibited growth in human arterial and microvascular endothelial cells. After treatment, most of the endothelial cells experienced caspase-independent necrosis-like cell death. The activation of cathepsin D following lysosomal membrane permeabilization (LMP) determined necrosis-like cell death. Furthermore, propofol overdose also induced caspase-dependent apoptosis, at least in part. Caspase-3 was activated and acted downstream of mitochondrial transmembrane potential (MTP) loss; however, lysosomal cathepsins were not required for endothelial cell apoptosis. Notably, activation of GSK-3 was essential for propofol overdose-induced mitochondrial damage and apoptosis, but not necrosis-like cell death. Intraperitoneal administration of a propofol overdose in BALB/c mice caused an increase in peritoneal vascular permeability. These results demonstrate the cytotoxic effects of propofol overdose, including cathepsin D-regulated necrosis-like cell death and GSK-3-regulated mitochondrial apoptosis, on endothelial cells in vitro and the endothelial barrier dysfunction by propofol in vivo. Highlights: ► Propofol overdose causes apoptosis and necrosis in endothelial cells. ► Propofol overdose triggers lysosomal dysfunction independent of autophagy. ► Glycogen synthase kinase-3 facilitates propofol overdose-induced apoptosis. ► Propofol overdose causes an increase

  13. Sleep Homeostasis and General Anesthesia: Are Fruit Flies Well-Rested After Emergence From Propofol?

    Science.gov (United States)

    Gardner, Benjamin; Strus, Ewa; Meng, Qing Cheng; Coradetti, Thomas; Naidoo, Nirinjini N.; Kelz, Max B.; Williams, Julie A.

    2015-01-01

    Background Shared neurophysiologic features between sleep and anesthetic-induced hypnosis indicate a potential overlap in neuronal circuitry underlying both states. Previous studies in rodents indicate that pre-existing sleep debt discharges under propofol anesthesia. We explored the hypothesis that propofol anesthesia also dispels sleep pressure in the fruit fly. To our knowledge, this constitutes the first time propofol has been tested in the genetically tractable model, Drosophila melanogaster. Methods Daily sleep was measured in Drosophila using a standard locomotor activity assay. Propofol was administered by transferring flies onto food containing various doses of propofol or equivalent concentrations of vehicle. High-Performance Liquid Chromatography (HPLC) was used to measure tissue concentrations of ingested propofol. To determine if propofol anesthesia substitutes for natural sleep, we subjected flies to 10 hours (h) sleep deprivation (SD), followed by 6h propofol exposure, and monitored subsequent sleep. Results Oral propofol treatment causes anesthesia in flies as indicated by a dose-dependent reduction in locomotor activity (n=11–41 flies from each group) and increased arousal threshold (n=79–137). Recovery sleep in flies fed propofol after SD was delayed until after flies had emerged from anesthesia (n=30–48). SD was also associated with a significant increase in mortality in propofol-fed flies (n=44–46). Conclusions Together, these data indicate that fruit flies are effectively anesthetized by ingestion of propofol, and suggest that homologous molecular and neuronal targets of propofol are conserved in Drosophila. However, behavioral measurements indicate that propofol anesthesia does not satisfy the homeostatic need for sleep, and may compromise the restorative properties of sleep. PMID:26556728

  14. Pain on injection from propofol may be avoided by changing its formulation.

    Science.gov (United States)

    Aldrete, J A; Otero, P; Alcover, J; Parietti, A; Johnson, S C; Montpetit, F H; Torrieri, A; Quiroga, D

    2010-04-01

    After using propofol for a decade, pain on injection had been considered routine by patients and medical personnel. When given propofol from a different manufacturer, patients did not complain. Two preparations of propofol were compared. A comparative, double-blind, randomized study was conducted in 22 adult patients undergoing pain relief procedures; they received sedation by an intravenous injection of 1.7 mg/kg of propofol and then were treated with paravertebral injections. Pain on injection was assessed by verbal complaint, movement of the extremity, of the whole body and recollection of pain at induction, when discharged. Propofol from Baxter Laboratories, mixed with either 5 ml of 2% lidocaine or 5 ml of NaCl 0.9%, was compared with propofol Laboratorios Gray, which was similarly mixed. Injections were randomly administered four times, blindly, to each of 22 patients. Statistical analysis was conducted using the analysis of variance method. A total of 352 propofol injections were given. Each of the four propofol solutions was administered 88 times; of patients receiving Baxter propofol+saline, 74 (84%) had pain; when mixed with 2% lidocaine 45 (50.2%) complained. After propofol Gray with NaCl 0.9% was given, two patients (2.2%) experienced pain. Propofol Gray with 2% lidocaine produced no pain. None of the latter group remembered having pain, whereas, those given propofol Baxter 54 (61.3%) and 26 (29.5%) remembered experiencing pain at injection. Pain on injection was prevented and statistically reduced (<0.01) with the propofol from Laboratorios Gray. By changing the formulation (size of molecules and their dispersion) of propofol, pain on injection was avoided.

  15. Remifentanil associado ao propofol ou sevoflurano para colecistectomia videolaparoscópica: estudo comparativo Remifentanil asociado al propofol o sevoflurano para colecistectomia videolaparoscópica Remifentanil associated to propofol or sevoflurane for videolaparoscopic cholecystectomy: a comparative study

    Directory of Open Access Journals (Sweden)

    Fernanda Fischer Estivalet

    2002-07-01

    . RESULTADOS: As alterações hemodinâmicas (PAS, PAD, PAM e FC e o despertar dos pacientes não tiveram diferenças significativas entre os grupos. O uso de efedrina e atropina foram semelhantes. Entre as complicações somente os vômitos tiveram maior incidência no Grupo 2. CONCLUSÕES: Ambas as técnicas promoveram diminuição da pressão arterial e da freqüência cardíaca. A recuperação anestésica é semelhante para as duas técnicas. A incidência de vômitos é maior quando o remifentanil foi associado ao sevoflurano.JUSTIFICATIVA Y OBJETIVOS: Técnicas de anestesia venosa, inhalatoria o combinadas han sido utilizadas para colecistectomias por videolaparoscopia. El objetivo de este estudio fue comparar la utilización de remifentanil asociado al propofol o sevoflurano con relación a los parámetros hemodinámicos, la recuperación de la anestesia y a los efectos colaterales. MÉTODO: Fueron estudiados 40 pacientes, divididos en 2 grupos: Grupo 1 (G1 - Inducción con propofol en concen:tración plasmática alvo-controlada de 3 µg.ml-1 y remifentanil en la dosis de 0,3 µg.kg-¹.min-¹ en bomba de infusión. Atracúrio (0,5 mg.kg-1 fue administrado para la intubación traqueal. La anestesia fue mantenida con propofol en infusión alvo-controlada de 2,5 a 3 µg.ml-1 y oxígeno a 100%, y remifentanil en infusión continua (0,3 µg.kg-1.min-1. Grupo 2 (G2 - Inducción con sevoflurano en la concentración de 6% y oxígeno a 100% con flujo de 4 L.min-1 y remifentanil en la dosis de 0,3 µg.kg-1.min-1, en bomba de infusión. Después de la perdida de la consciencia, la concentración de sevoflurano fue reducida para 2% con flujo de oxígeno de 2 L.min-1; de la misma forma que el G1, fue administrado atracúrio en la dosis de 0,5 mg.kg-1. La infusión de remifentanil fue mantenida durante toda la cirugía en la dosis de 0,3 µg.kg-1.min-1. La media de la frecuencia cardíaca (FC, y de las presiones arteriales sistólicas (PAS, diastólica (PAD y media (PAM fueron

  16. Método simplificado para manutenção da concentração sangüínea de propofol em nível aproximadamente constante, associado ao óxido nitroso no paciente pediátrico Método simplificado para manutención de la concentración sanguínea de propofol en nivel aproximadamente constante, asociado al óxido nitroso en el paciente pediátrico Simplified method to maintain propofol blood concentration in an approximately constant level associated to nitrous oxide in pediatric patients

    Directory of Open Access Journals (Sweden)

    Pedro Thadeu Galvão Vianna

    2002-06-01

    Performance do Erro (MPE e os valores Medianos Absolutos da Performance do Erro (MAPE mostraram diferenças estatísticas significativas entre os grupos no momento 60. Valores medianos da concentração sangüínea de propofol (µg.kg-1 mostraram diferenças estatísticas significativas entre M e S no momento 60 e entre os momentos 40 e 60 no grupo S. CONCLUSÕES: A anestesia com propofol usando os atributos farmacocinéticos de Marsh (Grupo M apresentou menor erro no cálculo da concentração-alvo de propofol de 4 µg.kg-1. Além disso, utiliza menor quantidade de propofol para obter resultados clínicos semelhantes. Por todas essas qualidades deve ser a preferida para uso em crianças ASA I e com idades entre 4 e 12 anos.JUSTIFICATIVA Y OBJETIVOS: La manutención de concentración sanguínea alvo-controlada en niveles aproximadamente constantes del propofol es una técnica que puede ser empleada de modo simplificado en la sala de cirugía. La finalidad de esta pesquisa es comparar clínica y laboratorialmente la infusión de propofol en niños usando los atributos farmacocinéticos de Short y de Marsh. MÉTODO: Fueron estudiados 41 pacientes con edades entre 4 y 12 años, de ambos sexos, estado físico ASA I ó II, distribuidos en dos grupos S (20 pacientes y M (21 pacientes. En el Grupo S se utilizaron los atributos farmacocinéticos de Short, y en el Grupo M, los atributos farmacocinéticos de Marsh. La inducción anestésica fue hecha con bolus de alfentanil 30 µg.kg-1, propofol 3 mg.kg-1 y pancuronio, 0,08 mg.kg-1 por vía venosa. Se procedió a intubación traqueal y a manutención con N2O/O2 (60% en ventilación controlada mecánica. En el grupo S la infusión de propofol fue de 254 (30 min seguido de 216 µg.kg-1.min-1 por más 30 min. En el grupo M la infusión de propofol fue de 208 (30 min seguido de 170 µg.kg-1.min-1 por más 30 min. A través del atributo farmacocinético específico a cada grupo la meta fue la obtención de la concentración-alvo de 4 µg

  17. La educación comparada: ¿un campo de estudio para políglotas?

    Directory of Open Access Journals (Sweden)

    Henk Van Daele

    1997-01-01

    Full Text Available La educación comparada es un campo dificil a causa, muy especialmente, de los problemas lingüísticos que afronta en su seno. Debe tenerse muy en cuenta tres aspectos: 1. Los especialistas de educación comparada deben ser multilingues. 2. Los terminus relativos a cscuelas, diplomas, etc, son de diffcil traducci6n. Deben, por ello, considerarse nombres propios y evitarse su traducci6n. 3. En Europa tenemos necesidad de un glosario multilingue univoco para la terminologfa de la educacion y la formacion

  18. Effect of Lipid Composition in Propofol Formulations: Decisive Component in Reducing the Free Propofol Content and Improving Pharmacodynamic Profiles.

    Science.gov (United States)

    Darandale, Sharad S; Shevalkar, Ganesh B; Vavia, Pradeep R

    2017-02-01

    Current endeavor was aimed towards studying significance of lipid composition on free propofol concentration in aqueous phase and associated pain on injection. Three different nanoformulations, namely long-chain triglyceride (LCT)/medium-chain glyceride (MCG)-based nanoemulsion (ProNano), MCG-based self-nanoemulsifying formulation (PSNE), and lipid-free nanoformulation (PNS) were accessed for the same. In vitro and in vivo performances of developed formulations were compared with Diprivan®. ProNano showed minimum free propofol concentration (0.13%) and hence lower pain on injection (rat paw-lick test, 6 ± 2 s) compared to Diprivan®, PSNE, and PNS (0.21%, 0.23%, and 0.51% free propofol, respectively, and rat paw-lick test; 12 ± 3, 14 ± 2, and 22 ± 3 s, respectively). These results conjecture the role of MCG in effective encapsulation of propofol. Anesthetic action assessed by measuring duration of loss of righting reflex (LORR), which was found similar in case of ProNano and PSNE (14 ± 3 and 15 ± 3 min, respectively) compared to Diprivan® (13 ± 3 min). In case of lipid-free formulation, PNS, extended anesthetic action (21 ± 2 min) was observed which may be due to sustained release of propofol from nanosponges. Studies on effect of lipoproteins on propofol release highlighted significance of HDL (100% release with maximum concentration of about 1.2 μg/ml of HDL) from all three formulations.

  19. COMPARISON OF INDUCTION, INTUBATION AND RECOVERY CHARACTERISTICS OF HALOTHANE + PROPOFOL V/S SEVOFLURANE + PROPOFOL IN CHILDREN UNDERGOING ADENOTONSILLECTOMY

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    Sarabjit kaur , Veena Chatrath , Gagandeep Kaur , Vishal Jarewal , Kulwinder S Sandhu , Sudha

    2015-04-01

    Full Text Available Purpose: General anaesthesia for oral surgeries in paediatric patients is always challenging for an anaesthesiologist. Aim was to compare halothane+propofol and sevoflurane+propofol in paediatric patients undergoing adenotonsillectomy without muscle relaxant. Method: In a double blind manner, eighty patients of 3-10 years were premedicated with inj. Atropine and randomly divided into two groups of forty each. In Group A, priming was done with 50% oxygen+50% nitrous oxide+4% halothane for 1 minute, after loss of eye lash reflex and centralisation of pupil intravenous cannulation done. Inj. midazolom, lignocaine and Propofol were given and trachea was intubated. Maintenance was done with 1-2% halothane+ nitrous oxide+ oxygen and continuous propofol infusion. Similar technique was used in group B except for priming done with sevoflurane 7% and maintenance with 2-3%. Both groups were compared for induction, intubating conditions, haemodynamics and emergence characteristics. Results: Induction was rapid in group B as time for loss of eye lash reflex and centralisation of pupil was less in group B (21.88±12.6 &114.40±28.8 seconds as compared to group A (33.05±4.0 & 140.05±12.1 sec p<0.001. Intubating conditions were excellent but mean intubation time was less in group B as compared to group A p<0.001. Heart rate and blood pressure remained on lower side in group A. Emergence was significantly rapid in group B. No side effect or complications were noted. Conclusion: Both groups provided excellent intubating conditions but sevoflurane+propofol group was better as it provided faster induction and rapid recovery from anaesthesia with more stable haemodynamics as compared to Halothane+propofol group.

  20. Propofol-ketamine or propofol-remifentanil for deep sedation and analgesia in pediatric patients undergoing burn dressing changes: a randomized clinical trial.

    Science.gov (United States)

    Seol, Tai-Kyung; Lim, Jin-Kyu; Yoo, Eun-Kyung; Min, Seong-Won; Kim, Chong-Soo; Hwang, Jin-Young

    2015-06-01

    In this study, we compared the propofol-ketamine and propofol-remifentanil combinations for deep sedation and analgesia during pediatric burn wound dressing changes. Fifty pediatric patients aged 12-36 months, undergoing burn wound dressing changes, were randomly assigned to receive propofol-remifentanil (group PR) or propofol-ketamine (group PK) for deep sedation and analgesia. Patients in the group PR received 2 mg·kg(-1) propofol and 0.1 μg·kg(-1) remifentanil, and 0.05 μg·kg(-1) ·min(-1) remifentanil was infused continuously until the end of the procedure. Patients in the group PK received 2 mg·kg(-1) propofol and 1 mg·kg(-1) ketamine, and the same volume of isotonic saline was infused continuously until the end of the procedure. Additional propofol with remifentanil or ketamine was administered when required. Hemodynamic variables, drug requirements, occurrence of patient movement, surgeon's satisfaction score, recovery time, and the incidence of adverse events were recorded throughout the procedure and recovery. Recovery time was significantly shorter in the group PR compared to that in the group PK (10.3 [9.1-11.5] min vs 22.5 [20.3-25.6] min, median [interquartile range], respectively; P propofol-ketamine and propofol-remifentanil were effective for sedation and analgesia in pediatric patients undergoing burn dressing changes, but the propofol-remifentanil combination provided faster recovery compared to the propofol-ketamine combination. © 2014 John Wiley & Sons Ltd.

  1. Determination of breath isoprene allows the identification of the expiratory fraction of the propofol breath signal during real-time propofol breath monitoring.

    Science.gov (United States)

    Hornuss, Cyrill; Dolch, Michael E; Janitza, Silke; Souza, Kimberly; Praun, Siegfried; Apfel, Christian C; Schelling, Gustav

    2013-10-01

    Real-time measurement of propofol in the breath may be used for routine clinical monitoring. However, this requires unequivocal identification of the expiratory phase of the respiratory propofol signal as only expiratory propofol reflects propofol blood concentrations. Determination of CO2 breath concentrations is the current gold standard for the identification of expiratory gas but usually requires additional equipment. Human breath also contains isoprene, a volatile organic compound with low inspiratory breath concentration and an expiratory concentration plateau. We investigated whether breath isoprene could be used similarly to CO2 to identify the expiratory fraction of the propofol breath signal. We investigated real-time breath data obtained from 40 study subjects during routine anesthesia. Propofol, isoprene, and CO2 breath concentrations were determined by a combined ion molecule reaction/electron impact mass spectrometry system. The expiratory propofol signal was identified according to breath CO2 and isoprene concentrations and presented as median of intervals of 30 s duration. Bland-Altman analysis was applied to detect differences (bias) in the expiratory propofol signal extracted by the two identification methods. We investigated propofol signals in a total of 3,590 observation intervals of 30 s duration in the 40 study subjects. In 51.4 % of the intervals (1,844/3,590) both methods extracted the same results for expiratory propofol signal. Overall bias between the two data extraction methods was -0.12 ppb. The lower and the upper limits of the 95 % CI were -0.69 and 0.45 ppb. Determination of isoprene breath concentrations allows the identification of the expiratory propofol signal during real-time breath monitoring.

  2. ICU sedation with haloperidol-propofol infusion versus midazolam-propofol infusion after coronary artery bypass graft surgery: A prospective, double-blind randomized study

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    Farhad Etezadi

    2012-01-01

    Full Text Available Combinations of hypnotics with or without opiates are commonly used in agitated patients. We hypothesized that combination of haloperidol-propofol in comparison with midazolam-propofol would lower consumption of propofol and lead to better hemodynamic and respiratory profile during sedation of agitated patients. Among 108 patients admitted in our ICU, 60 patients were agitated according to Ramsay Sedation Score (RSS and randomly divided into two groups. Morphine sulfate (0.05 mg/kg was administered to all patients for relief of postoperative pain. In one group, sedative infusion was started with 1 mg/h of haloperidol plus 25 μg/kg/min of propofol after bolus injection of 2 mg haloperidol. In the other group, midazolam1 mg/h and propofol 25 μg/kg/min were infused after a bolus injection of 2 mg midazolam. Propofol infusion was adjusted to keep bi-spectral index between 61-80 and the RSS between 3-5. Hourly propofol consumption was recorded during 24 h of sedation and compared statistically. We also compared SpO 2 , arterial blood gas variables, hemodynamic parameters and episodes of respiratory depression (SpO 2 ≤85% requiring respiratory support between the groups. Haloperidol, when added to propofol infusion, decreased its consumption at all the measured times (P = 0.001. There was no significant difference in hemodynamic variables between two groups, but the episodes of respiratory depression was significantly higher in propofol-midazolam group (P = 0.02. We conclude that haloperidol-propofol infusion decreases propofol requirements in the agitated patients. Besides, this combination showed a better profile in terms of occurrence of respiratory depression.

  3. Estudios sobre la Primera Guerra Mundial en América Latina. Una mirada comparada

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    Renzo Ramírez Bacca

    2015-07-01

    Full Text Available El autor ofrece un estudio comparado sobre los vacíos y tendencias historiográficas latinoamericanas en torno a la Primera Guerra Mundial —PGM— a partir de las siguientes preguntas: ¿cómo entender dichas tendencias? y ¿cuáles líneas de investigación son las más representativas? El texto tiene en cuenta los casos de los países andinos —Venezuela, Colombia, Ecuador, Perú y Bolivia—, el Cono Sur —Argentina, Chile y Uruguay—, y México. Adicionalmente, incluye las tendencias latinoamericanistas y comparadas de los estudios sobre la guerra realizada por historiadores europeos y norteamericanos.

  4. Las redes Eurydice y Quipu: potencial para la educación comparada

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    Mercedes Muñoz-Repiso Izaguirre

    1997-01-01

    Full Text Available Como ejemplo significative de las posibles aportaciones que los organismosinternacionales pueden ofrecer a quienes trabajan en Educacion Comparada, este articulo presenta un pormenorizado analisis de las dos redes internacionales de informacioneducativa en las que Espana se encuentra actualmente integrada: Eurydice, de la Union Europea y Quipu, de la Organizacion de Estados Iberoamericanos para la Educacion, la Ciencia y la Cultura. En 61 se hace referencia a los origenes de estas redes, su estructuray sufuncionamiento, y se detallan las actividades mas relevantes que desempefian, planteando, al mismo tiempo, reflexiones sobre sus posibilidades para los comparatistas, para los politicos y administradores de la educacion y para el publico en general, as! como sus aspectos mejorables y propuestas para mejorarlos

  5. COLONIZACIÓN Y DESCOLONIZACIÓN EN ÁFRICA Y ASIA EN PERSPECTIVAS COMPARADAS

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    Maguemati Wabgou

    2012-12-01

    Full Text Available En este artículo, se presenta un análisis comparado entre los procesos históricos de colonización y descolonización en Asia y África. Se observa que, aunque la exploración de Asia es globalmente anterior a la de África, desembocó en el colonialismo, marcado por la competencia entre potencias imperialistas y su afán de dominio. Así, el objetivo de este trabajo es traer a la luz algunos elementos clave para reflexiones críticas y comparadas acerca de estas dinámicas de dominación de ambas regiones por parte de los colonizadores en los siglos XVI y XX; igual que las lecciones derivadas de las mismas de cara al actual orden político.

  6. Anatomia comparada do gênero Doris (Mollusca, Nudibranchia, Dorididae) do litoral brasileiro

    OpenAIRE

    2012-01-01

    O gênero Doris está representado no Brasil por quatro espécies: Doris verrucosa, Doris bovena, Doris ilo e Doris kyolis, a maioria delas com um histórico taxonômico confuso. Através da revisão taxonômica do gênero Doris, do estudo da anatomia comparada entre as espécies e com dados da literatura foi possível separar D. verrucosa em duas espécies, mantendo D. verrucosa como a espécie com distribuição para a Europa e Mar Mediterrâneo e Doris januarii, um sinônimo revalidado, com distribuição pa...

  7. Propofol induces proliferation and invasion of gallbladder cancer cells through activation of Nrf2

    Directory of Open Access Journals (Sweden)

    Zhang Lingmin

    2012-08-01

    Full Text Available Abstract Background Propofol is one of the most commonly used intravenous anaesthetic agents during cancer resection surgery, but the effect of propofol on gallbladder cancer is not clear. NF-E2-related factor 2 (Nrf2 is abundantly expressed in cancer cells and relates to proliferation, invasion, and chemoresistance. The aims of the current study were to evaluate effects of propofol on the behavior of human GC cells and role of Nrf2 in these effects. Method The effects of propofol on cell proliferation, apoptosis, and invasion were detected by MTT assays, flow cytometry, and transwell assay. Also, activation of Nrf2 was determined by western blot, RT-PCR, and immunofluorescence assays. Nrf2 was knocked-down in GBC-SD cells by shRNA before evaluating the role of Nrf2 in the influence of propofol on biological behaviors. Results Propofol promoted the proliferation of GBC-SD cells in a dose- and time- dependent manner. After exposure to propofol for 48 h, GBC-SD cells showed decreased apoptosis and increased invasion. Also, propofol over-expressed Nrf2 at both the protein and mRNA levels and induced translocation of Nrf2 into the nucleus. Finally, loss of Nrf2 by shRNA reversed the effect of propofol on cell proliferation, apoptosis, and invasion. Conclusion Propofol induces proliferation and promotes invasion of GC cells through activation of Nrf2.

  8. Neural correlates of successful semantic processing during propofol sedation

    NARCIS (Netherlands)

    Adapa, Ram M.; Davis, Matthew H.; Stamatakis, Emmanuel A.; Absalom, Anthony R.; Menon, David K.

    2014-01-01

    Sedation has a graded effect on brain responses to auditory stimuli: perceptual processing persists at sedation levels that attenuate more complex processing. We used fMRI in healthy volunteers sedated with propofol to assess changes in neural responses to spoken stimuli. Volunteers were scanned awa

  9. Potentiating Action of Propofol at GABAA Receptors of Retinal Bipolar Cells

    Science.gov (United States)

    Yue, Lan; Xie, An; Bruzik, Karol S.; Frølund, Bente; Qian, Haohua

    2011-01-01

    Purpose. Propofol (2,6-diisopropyl phenol), a widely used systemic anesthetic, is known to potentiate GABAA receptor activity in a number of CNS neurons and to produce changes in electroretinographically recorded responses of the retina. However, little is known about propofol's effects on specific retinal neurons. The authors investigated the action of propofol on GABA-elicited membrane current responses of retinal bipolar cells, which have both GABAA and GABAC receptors. Methods. Single, enzymatically dissociated bipolar cells obtained from rat retina were treated with propofol delivered by brief application in combination with GABA or other pharmacologic agents or as a component of the superfusing medium. Results. When applied with GABA at subsaturating concentrations and with TPMPA (a known GABAC antagonist), propofol markedly increased the peak amplitude and altered the kinetics of the response. Propofol increased the response elicited by THIP (a GABAA-selective agonist), and the response was reduced by bicuculline (a GABAA antagonist). The response to 5-methyl I4AA, a GABAC-selective agonist, was not enhanced by propofol. Serial brief applications of (GABA + TPMPA + propofol) led to a progressive increase in peak response amplitude and, at higher propofol concentrations, additional changes that included a prolonged time course of response recovery. Pre-exposure of the cell to perfusing propofol typically enhanced the rate of development of potentiation produced by (GABA + TPMPA + propofol) applications. Conclusions. Propofol exerts a marked and selective potentiation on GABAA receptors of retinal bipolar cells. The data encourage the use of propofol in future studies of bipolar cell function. PMID:21071744

  10. Aplicaciones de las TIC en la docencia en Lingüística Histórica y Comparada

    OpenAIRE

    Luján Martínez, Eugenio Ramón; Álvarez-Pedrosa Núñez, Juan Antonio; Santos Marinas, Enrique; Mendoza Tuñón, Julia; Maldonado, Ricardo; de Miguel García, Elena; Moncó Taracena, Sofía; Palancar, Enrique L.; Pascual, Aránzazu; Álvarez, María Luisa

    2009-01-01

    Comunicaciones presentadas en el Seminario "Aplicaciones de las TIC en la docencia en Lingüística Histórica y Comparada", celebrado en la Facultad de Filología de la Universidad Complutense de Madrid el 10 de diciembre de 2008.

  11. Política habitacional comparada: Mendoza y San Luis en el marco de la descentralización

    Directory of Open Access Journals (Sweden)

    Delia Palero

    2006-01-01

    Full Text Available El artículo plantea un análisis comparado entre las políticas habitacionales desarrolladas por dos provincias argentinas: Mendoza y San Luis. La federalización de los recursos del FONAVI en el país, ocurrida en l992, puso fin a una prolongada etapa de política habitacional centralizada en Argentina. El período analizado abarca la década comprendida entre ese año y el 2002. A nivel internacional se consolida el proceso de globalización que, en el terreno de la vivienda, se tradujo en el predominio del enfoque facilitador. Los casos elegidos representan dos modelos diametralmente distintos que, sin embargo, alcanzaron resultados que podrían calificarse de exitosos en el concierto nacional. Mientras el primero se inscribe en el paradigma central-sectorial, el segundo adhiere en forma predominante al enfoque facilitador. El análisis de política comparada ha sido contextualizado en los escenarios político, social, cultural y económico que le dieron marco, sentido y viabilidad a ambos modelos, que marcaron tanto sus fortalezas como sus debilidades y que explican los resultados alcanzados. Vinculación con la formación universitaria: La Cátedra Problemática de la Vivienda se encuentra en la Facultad de Ciencias Políticas y Sociales (U.N.Cuyo e incluye en su programa unidades referidas a política habitacional en Argentina y en la provincia de Mendoza. En tal sentido, se estima que los resultados obtenidos a partir de este trabajo resultan un insumo de interés para estudiantes de trabajo social, sociología y ciencia política, en tanto permiten analizar en profundidad conceptos como centralizacióndescentralización, participación, articulación de actores, focalización, eficiencia y eficacia en la gestión de la política habitacional, entre otros, y cómo éstos se manifiestan en la práctica política concreta.

  12. The Effects of Propofol on Cerebral Perfusion MRI in Children

    Science.gov (United States)

    Harreld, Julie H.; Helton, Kathleen J.; Kaddoum, Roland N.; Reddick, Wilburn E.; Li, Yimei; Glass, John O.; Sansgiri, Rakhee; Ji, Qing; Feng, Tianshu; Parish, Mary Edna; Gajjar, Amar; Patay, Zoltan

    2013-01-01

    Introduction The effects of anesthesia are infrequently considered when interpreting pediatric perfusion MRI. The objectives of this study were to test for measurable differences in MR measures of cerebral blood flow (CBF) and cerebral blood volume (CBV) between non-sedated and propofol-sedated children, and to identify influential factors. Methods Supratentorial cortical CBF and CBV measured by dynamic susceptibility contrast perfusion MRI in 37 children (1.8–18 years) treated for infratentorial brain tumors receiving propofol (IV, n=19) or no sedation (NS, n=18) were compared between groups and correlated with age, hematocrit, end-tidal CO2 (ETCO2), dose, weight, and history of radiation therapy (RT). The model most predictive of CBF and CBV was identified by multiple linear regression. Results Anterior cerebral artery (ACA) and middle cerebral artery (MCA) territory CBF were significantly lower, and MCA territory CBV greater (p=0.03), in IV than NS patients (p=0.01, 0.04). The usual trend of decreasing CBF with age was reversed with propofol in ACA and MCA territories (r=0.53, r=0.47; ppropofol-sedated children, with no significant additional influence from age, ETCO2, hematocrit, or RT. Conclusion In propofol-sedated children, usual age-related decreases in CBF were reversed, and increases in CBF and CBV were weight-dependent, not previously described. Weight-dependent increases in propofol clearance may diminish suppression of CBF and CBV. Prospective study is required to establish anesthetic-specific models of CBF and CBV in children. PMID:23673874

  13. Balanced propofol sedation administered by nonanesthesiologists: The first Italian experience

    Science.gov (United States)

    Repici, Alessandro; Pagano, Nico; Hassan, Cesare; Carlino, Alessandra; Rando, Giacomo; Strangio, Giuseppe; Romeo, Fabio; Zullo, Angelo; Ferrara, Elisa; Vitetta, Eva; Ferreira, Daniel de Paula Pessoa; Danese, Silvio; Arosio, Massimo; Malesci, Alberto

    2011-01-01

    AIM: To assess the efficacy and safety of a balanced approach using midazolam in combination with propofol, administered by non-anesthesiologists, in a large series of diagnostic colonoscopies. METHODS: Consecutive patients undergoing diagnostic colonoscopy were sedated with a single dose of midazolam (0.05 mg/kg) and low-dose propofol (starter bolus of 0.5 mg/kg and repeated boluses of 10 to 20 mg). Induction time and deepest level of sedation, adverse and serious adverse events, as well as recovery times, were prospectively assessed. Cecal intubation and adenoma detection rates were also collected. RESULTS: Overall, 1593 eligible patients were included. The median dose of propofol administered was 70 mg (range: 40-120 mg), and the median dose of midazolam was 2.3 mg (range: 2-4 mg). Median induction time of sedation was 3 min (range: 1-4 min), and median recovery time was 23 min (range: 10-40 min). A moderate level of sedation was achieved in 1561 (98%) patients, whilst a deep sedation occurred in 32 (2%) cases. Transient oxygen desaturation requiring further oxygen supplementation occurred in 8 (0.46%; 95% CI: 0.2%-0.8%) patients. No serious adverse event was observed. Cecal intubation and adenoma detection rates were 93.5% and 23.4% (27.8% for male and 18.5% for female, subjects), respectively. CONCLUSION: A balanced sedation protocol provided a minimalization of the dose of propofol needed to target a moderate sedation for colonoscopy, resulting in a high safety profile for non-anesthesiologist propofol sedation. PMID:21987624

  14. Balanced propofol sedation administered by nonanesthesiologists: The first Italian experience

    Institute of Scientific and Technical Information of China (English)

    Alessandro Repici; Eva Vitetta; Daniel de Paula Pessoa Ferreira; Silvio Danese; Massimo Arosio; Alberto Malesci; Nico Pagano; Cesare Hassan; Alessandra Carlino; Giacomo Rando; Giuseppe Strangio; Fabio Romeo; Angelo Zullo; Elisa Ferrara

    2011-01-01

    AIM: To assess the efficacy and safety of a balanced approach using midazolam in combination with propofol, administered by non-anesthesiologists, in a large series of diagnostic colonoscopies.METHODS: Consecutive patients undergoing diagnostic colonoscopy were sedated with a single dose of midazolam (0.05 mg/kg) and low-dose propofol (starter bolus of 0.5 mg/kg and repeated boluses of 10 to 20 mg). Induction time and deepest level of sedation, adverse and serious adverse events, as well as recovery times, were prospectively assessed. Cecal intubation and adenoma detection rates were also collected.RESULTS: Overall, 1593 eligible patients were included. The median dose of propofol administered was 70 mg (range: 40-120 mg), and the median dose of midazolam was 2.3 mg (range: 2-4 mg). Median induction time of sedation was 3 min (range: 1-4 min), and median recovery time was 23 min (range: 10-40 min). A moderate level of sedation was achieved in 1561 (98%) patients, whilst a deep sedation occurred in 32 (2%) cases. Transient oxygen desaturation requiring further oxygen supplementation occurred in 8 (0.46%; 95% CI: 0.2%-0.8%) patients. No serious adverse event was observed. Cecal intubation and adenoma detection rates were 93.5% and 23.4% (27.8% for male and 18.5% for female, subjects), respectively.CONCLUSION: A balanced sedation protocol provided a minimalization of the dose of propofol needed to target a moderate sedation for colonoscopy, resulting in a high safety profile for non-anesthesiologist propofol sedation.

  15. Estudo comparativo da anestesia com propofol ou thionembutal em cães Comparative study of the anesthesia in dogs with propofol or thionembutal

    Directory of Open Access Journals (Sweden)

    Jairo Vaidergorn

    2000-12-01

    Full Text Available Os autores compararam o uso de propofol e thionembutal observando as freqüências cardíaca e respiratória e a presença das seguintes intercorrências: apnéia, tremor, bradicardia, taquicardia, taquipnéia e parada cardíaca. Foram randomizados 100 cães para serem anestesiados com propofol ou thionembutal, sendo monitorizados os parâmetros de interesse ao estudo. Foi constatado que existe importância significantemente maior em relação a ocorrência de apnéia e tremor em ambos os grupos, sendo menores com o uso de propofol. O propofol mostrou-se uma droga mais segura para a anestesia em cães do que o thionembutal.The authors compared the use of propofol and thionembutal in dogs with respect to the heart and respiratory rate and the presence of the following occurrences: apnea, tremor, bradycardia, tachycardia, tachypnea and cardiac arrest. A hundred dogs, in good general conditions, were selected and randomly chosen to be anaesthetized with propofol or thionembutal and parameters were monitored according to the objective of the study. There is a significant importance regarding dog’s apnea and tremor in both groups which are, comparatively smaller with propofol. Propofol has showed to be a safer drug to anaesthetize dogs than thionembutal.

  16. Anestesi Infus Gravimetrik Ketamin dan Propofol pada Anjing (THE GRAVIMETRIC INFUSION ANAESTHESIA WITH KETAMINE AND PROPOFOL IN DOGS

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    I Gusti Ngurah Sudisma

    2014-08-01

    Full Text Available This study aim was to evaluate quality of anaesthesia by using gravimetric infusion anaesthesia withketamine and propofol in dogs. The quality of anaesthesia, duration of actions, and the physiological responsseof anaesthesia were evaluated in twenty domestic dogs. Anaesthesia was induced intramuscularly withatropine (0.03 mg/kg-xylazine (2 mg/kg (AX, intravenously ketamine-propofol (KP (4 mg/kg, andmaintained with continuous intravenous infusion with pre-mixed propofol (P and normal saline containing2 mg/ml of propofol and 2 mg/ml of ketamine (K. Domestic stray dogs were randomly divided into fivegroups. Groups AXKP-K2P2, AXKP-K4P4, and AXKP-K6P6 were treated with ketamine-propofol the dose0.2 mg/kg/minute, 0.4 and 0.6 mg/kg/minute respectively, while group AXKP-P4 was given propofol 0.4 mg/kg/minute and group AXKP-I was given isoflurane 1-2%. Heart rate (HR, respiratory rate (RR,electrocardiogram (ECG, blood oxygen saturation (SpO2, end tidal CO2 (ET CO2, and capillary refill time(CRT were measured. No significant difference (P>0.05 found between the groups in anaesthetion times.All groups showed rapid and smooth inductions, prolonged surgical stage, and rapid recovery. Groups AXKPK2P2and AXKP-K4P4 showed minimal physiological effect on the dogs. The HR, RR, ET CO2, SpO2, CRT,and ECG wave were stabl. Combination of AXKP-K6P6 induced SpO2 depression, increased and instabilityof HR, RR and ET CO2. Groups AXKP-P4 showed decreased of HR and respiratory depression. All anaestheticcombinations showed no significant influence (P>0.05 on the electricity of the dog’s heart. The combinationof ketamine-propofol at dose 0.2 and 0.4 mg/kg/minute were found to be better as an application formaintaining anaesthesia by gravimetric continuous intravenous infusion. The method is a suitablealternative for inhalation anaesthesia in dogs.

  17. El fenomen enciclopèdic medieval: una visió comparada del saber The medieval encyclopaedic phenomenon: a shared vision of knowledge El fenómeno enciclopédico medieval: una visión comparada

    Directory of Open Access Journals (Sweden)

    Noemi Barrera

    2011-01-01

    Full Text Available El fenomen enciclopèdic té molta importància a l‘Edat Mitjana. Els estudis, però, tendeixen a ser aïllats. Aquesta visió comparada del gènere enciclopèdic a les tres cultures que presenten una forta tradició –la xinesa, l‘àrab i l‘occidental– ens mostra els seus nexes comuns i les seves divergències: en depèn, en cada cas, de la relació amb el poder, què determina el seu naixement, quina és la seva finalitat i quins factors influeixen en el seu desenvolupament. Tot i que trobem considerables semblances entre l‘enciclopedisme d‘aquestes civilitzacions, només pot localitzar-se una influència: la recepció a Occident de tot un conjunt de textos àrabs, on s‘incloïen enciclopèdies, i que va suposar la modificació del seu pensament i, per tant, també del seu enciclopedisme. ______________________________________________ Le phénomène encyclopédique avait beaucoup d‘importance au Moyen Âge. Les études, cependant, tendent à être isolées. Cette vision comparée du genre encyclopédique dans les trois cultures qui présentent une forte tradition —la culture chinoise, la culture arabe et la culture occidentale— montre ses noyaux communs et ses divergences : il dépend, dans chaque cas, de la relation avec le pouvoir, qui détermine sa naissance, sa finalité et les facteurs qui influent sur son développement. Bien que l‘on trouve de considérables ressemblances entre l‘encyclopédisme de ces civilisations, on ne peut localiser qu‘une influence : la réception en Occident de tout un ensemble de textes arabes, dans lesquels s‘incluent les encyclopédies, qui a impliqué la modification de sa pensée et, par conséquent aussi, de son encyclopédisme.The encyclopaedic phenomenon was very significant in the Middle Ages. Studies on it, however, are few. This shared vision of the encyclopaedic genre in the three cultures which have a strong tradition – the Chinese, Arab and western – reveal their

  18. Effects of Fentanyl-lidocaine-propofol and Dexmedetomidine-lidocaine-propofol on Tracheal Intubation Without Use of Muscle Relaxants

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    Volkan Hancı

    2010-05-01

    Full Text Available The aim of this study was to compare the effects of fentanyl or dexmedetomidine when used in combination with propofol and lidocaine for tracheal intubation without using muscle relaxants. Sixty patients with American Society of Anesthesiologists stage I risk were randomized to receive 1 mg/kg dexmedetomidine (Group D, n = 30 or 2 mg/kg fentanyl (Group F, n = 30, both in combination with 1.5 mg/kg lidocaine and 3 mg/kg propofol. The requirement for intubation was determined based on mask ventilation capability, jaw motility, position of the vocal cords and the patient's response to intubation and inflation of the endotracheal tube cuff. Systolic arterial pressure, mean arterial pressure, heart rate and peripheral oxygen saturation values were also recorded. Rate pressure products were calculated. Jaw relaxation, position of the vocal cords and patient's response to intubation and inflation of the endotracheal tube cuff were significantly better in Group D than in Group F (p < 0.05. The intubation conditions were significantly more satisfactory in Group D than in Group F (p = 0.01. Heart rate was significantly lower in Group D than in Group F after the administration of the study drugs and intubation (p < 0.05. Mean arterial pressure was significantly lower in Group F than in Group D after propofol injection and at 3 and 5 minutes after intubation (p < 0.05. After intubation, the rate pressure product values were significantly lower in Group D than in Group F (p < 0.05. We conclude that endotracheal intubation was better with the dexmedetomidine–lidocaine–propofol combination than with the fentanyl–lidocaine–propofol combination. However, side effects such as bradycardia should be considered when using dexmedetomidine.

  19. Eficácia do propofol e da associação de propofol e dexametasona no controle de náusea e vômito no pós-operatório de laparoscopia ginecológica Eficacia del propofol y de la asociación de propofol y dexametasona en el control de náusea y vómito en el pós-operatorio de laparoscopia ginecológica Efficacy of propofol and propofol plus dexamethasone in controlling postoperative nausea and vomiting of gynecologic laparoscopy

    Directory of Open Access Journals (Sweden)

    Eliana Marisa Ganem

    2002-07-01

    ós-operatorio. Este estudio tuvo por finalidad comparar la eficacia del propofol aisladamente o en asociación con la dexametasona en la prevención de náusea y vómito en pacientes sometidas a laparoscopia ginecológica. MÉTODO: Participaron del estudio 40 pacientes, estado físico ASA I y II, con edades entre 18 y 46 años, sin quejas gástricas previas, sometidas a laparoscopia para diagnóstico o cirugía. Las pacientes fueron divididas en 2 grupos: el grupo 1 recibió (solución fisiológica 2 ml y el grupo 2 dexametasona (8 mg, por vía venosa antes de la inducción de la anestesia. Todas las pacientes recibieron midazolam (7,5 mg por vía oral como medicación pré-anestésica, sufentanil (0,5 µg.kg-1, propofol en infusión continua para inducción y manutención de la anestesia (BIS - 60 y N2O/O2 en fracción inspirada de O2 a 40% y atracúrio (0,5 mg.kg-1 como bloqueador neuromuscular. La analgesia pós-operatoria fue realizada con cetoprofeno (100 mg y buscopan compuesto ®. Las pacientes fueron evaluadas en la sala de recuperación pós-anestésica (SRPA y en la enfermaría 1 h, 2 h 3 h y 12 h después del alta de la SRPA. RESULTADOS: Ambos grupos fueron idénticos cuanto a los datos antropométricos y a la duración de la cirugía y de la anestesia. En el grupo 1 (n=20 una paciente presentó náusea en la SRPA y en la enfermaría y tres pacientes vomitaron en la enfermaría. En el grupo 2 (n=20 ninguna paciente presentó náusea o vómito durante el período de observación clínica, resultados estadísticamente no significativos. CONCLUSIONES: El propofol aisladamente o asociado a la dexametasona fue eficaz en la prevención de náusea y vómito en el pós-operatorio de pacientes sometidas a laparoscopia ginecológica.BACKGROUND AND OBJECTIVES: Gynecological laparoscopy is a procedure associated to a high incidence of postoperative nausea and vomiting (PONV. This study aimed at comparing the efficacy of propofol or propofol plus dexamethasone in preventing PONV in

  20. Current role of non-anesthesiologist administered propofol sedation in advanced interventional endoscopy

    DEFF Research Database (Denmark)

    Burtea, Daniela Elena; Dimitriu, Anca; Maloş, Anca Elena

    2015-01-01

    the patients and medical personnel. Current guidelines support the use of propofol sedation, which has the same rate of adverse effects as traditional sedation with benzodiazepines and/or opioids, but decreases the procedural and recovery time. Non-anesthesiologist administered propofol sedation has become......, improved satisfaction for patients and doctors, as well as decreased recovery and discharge time. Despite the advantages of non-anesthesiologist administered propofol, there is still a continuous debate related to the successful generalization of the procedures....

  1. Onset time and haemodynamic response after thiopental vs. propofol in the elderly: a randomized trial

    DEFF Research Database (Denmark)

    Sørensen, Martin Kryspin; Dolven, T L; Rasmussen, L S

    2011-01-01

    The induction dose of hypnotic agents should be reduced in the elderly, but it is not well studied whether thiopental or propofol should be preferred in this group of patients. The aim of this study was to compare onset time, hypnosis level and the haemodynamic response after thiopental vs....... propofol for induction of anaesthesia. Our primary hypothesis was that in the elderly, thiopental had a shorter onset time than propofol, defined as time to bispectral index (BIS)...

  2. [Safety of Non-anesthesiologist Administration of Propofol for Gastrointestinal Endoscopy].

    Science.gov (United States)

    Lee, Jun Kyu; Jang, Dong Kee; Kim, Won Hee; Kim, Jung Wook; Jang, Byung Ik

    2017-01-25

    Propofol (2,6-diisopropylphenol) is a hypnotic drug with a very rapid onset and offset of action. It has increasingly been used in gastrointestinal endoscopy. Administration of propofol by nurses or endoscopists is commonly referred to as non-anesthesiologist-administered propofol (NAAP). There have been a lot of studies on the safety of NAAP compared with those by anesthesiologists. Safety results of those studies are summarized in this review.

  3. Species-Associated Differences in the Inhibition of Propofol Glucuronidation by Magnolol

    OpenAIRE

    2014-01-01

    Magnolol, a major active constituent in herbal medicine, potently inhibits propofol glucuronidation in human liver microsomes, with inhibition constants in the nanomolar range. This study was conducted to investigate magnolol-induced inhibition of propofol glucuronidation in liver microsomes from Swiss–Hauschka mice, Sprague–Dawley rats, Chinese Bama pigs, and cynomolgus macaques. Results indicated that magnolol (10 μM) inhibited propofol glucuronidation in liver microsomes from Bama pigs and...

  4. Propofol infusion syndrome in a super morbidly obese patient (BMI = 75)

    OpenAIRE

    Ramaiah, Ramesh; Lollo, Loreto; Brannan, Douglas; Bhananker, Sanjay M

    2011-01-01

    Propofol infusion syndrome (PRIS) is a rare but often fatal complication as a result of large doses of propofol infusion (4–5 mg/kg/hr) for a prolonged period (>48 h). It has been reported in both children and adults. Besides large doses of propofol infusion, the risk factors include young age, acute neurological injury, low carbohydrate and high fat intake, exogenous administration of corticosteroid and catecholamine, critical illness, and inborn errors of mitochondrial fatty acid oxidation....

  5. Propofol Inhibits SIRT2 Deacetylase through a Conformation-specific, Allosteric Site*

    Science.gov (United States)

    Weiser, Brian P.; Eckenhoff, Roderic G.

    2015-01-01

    meta-Azi-propofol (AziPm) is a photoactive analog of the general anesthetic propofol. We photolabeled a myelin-enriched fraction from rat brain with [3H]AziPm and identified the sirtuin deacetylase SIRT2 as a target of the anesthetic. AziPm photolabeled three SIRT2 residues (Tyr139, Phe190, and Met206) that are located in a single allosteric protein site, and propofol inhibited [3H]AziPm photolabeling of this site in myelin SIRT2. Structural modeling and in vitro experiments with recombinant human SIRT2 determined that propofol and [3H]AziPm only bind specifically and competitively to the enzyme when co-equilibrated with other substrates, which suggests that the anesthetic site is either created or stabilized in enzymatic conformations that are induced by substrate binding. In contrast to SIRT2, specific binding of [3H]AziPm or propofol to recombinant human SIRT1 was not observed. Residues that line the propofol binding site on SIRT2 contact the sirtuin co-substrate NAD+ during enzymatic catalysis, and assays that measured SIRT2 deacetylation of acetylated α-tubulin revealed that propofol inhibits enzymatic function. We conclude that propofol inhibits the mammalian deacetylase SIRT2 through a conformation-specific, allosteric protein site that is unique from the previously described binding sites of other inhibitors. This suggests that propofol might influence cellular events that are regulated by protein acetylation state. PMID:25666612

  6. Etanercept, an inhibitor of TNF-a, prevents propofol-induced neurotoxicity in the developing brain.

    Science.gov (United States)

    Chen, Bo; Deng, Xiaoyuan; Wang, Bin; Liu, Hongliang

    2016-12-01

    Propofol can induce acute neuronal apoptosis, neuronal loss or long-term cognitive impairment when exposed in neonatal rodents, but the mechanisms by which propofol induces developmental neurotoxicity are unclear. Recent studies have demonstrated that propofol can increase the TNF-α level in the developing brain, but there is a lack of direct evidence to show whether TNF-α is partially or fully involved in propofol-induced neurotoxicity. The present study shows that propofol exposure in neonatal rats induces an increase of TNF-α in the cerebral spinal fluid, hippocampus and prefrontal cortex (PFC). Etanercept, a TNF-α inhibitor, prevents propofol-induced short- or long-term neuronal apoptosis, neuronal loss, synaptic loss and long-term cognitive impairment. Furthermore, mTNF-α (precursor of TNF-α) expression in microglia cells is increased after propofol anaesthesia in either the hippocampus or PFC, but mTNF-α expression in neurons is only increased in the PFC. These findings suggest that TNF-α may mediate propofol-induced developmental neurotoxicity, and etanercept can provide neural protection. Microglia are the main cellular source of TNF-α after propofol exposure, while the synthesis of TNF-α in neurons is brain-region selective. Copyright © 2016 ISDN. Published by Elsevier Ltd. All rights reserved.

  7. Injection pain of propofol in children: A comparison of two formulations without added lidocaine

    Directory of Open Access Journals (Sweden)

    Serbülent Gökhan Beyaz

    2012-01-01

    Full Text Available Background: Propofol emulsion in medium and long-chain triglycerides (MCT/LCT has been reported to cause less injection pain than other propofol solutions in adult studies. The aim of this study was to compare the injection pain of two different propofol emulsions using two different pain scales on the pediatric population. Materials and Methods: 100 children scheduled for general anesthesia were divided into two groups. Patients were randomly assigned to receive propofol LCT or propofol MCT/LCT. Assessment and evaluation of the Ontario Children′s Hospital Pain Scale (mCHEOPS and the Wong-Baker Faces Scale (WBFS were performed at the start of the injection until the patients lose consciousness. Results: There were no significant differences between groups in terms of demographic data. According to the mCHEOPS scale, the pain incidence of propofol LCT was 5%, whereas for propofol MCT/LCT it was 15% (P 0.05. Conclusions: Propofol MCT/LCT does not decrease injection pain; contrary to the general assumption, it causes more pain than propofol LCT in children.

  8. Population pharmacokinetic-pharmacodynamic modeling and dosing simulation of propofol maintenance anesthesia in severely obese adolescents.

    Science.gov (United States)

    Chidambaran, Vidya; Venkatasubramanian, Raja; Sadhasivam, Senthilkumar; Esslinger, Hope; Cox, Shareen; Diepstraten, Jeroen; Fukuda, Tsuyoshi; Inge, Thomas; Knibbe, Catherijne A J; Vinks, Alexander A

    2015-09-01

    Optimal dosing of propofol to maintain appropriate anesthetic depth is challenging in severely obese (SO) adolescents. We previously reported that total body weight (TBW) is predictive of propofol clearance. This study was aimed at characterizing pharmacokinetics (PK) and pharmacodynamics (PD) of propofol in SO adolescents, using bispectral index (BIS), and toward developing PK/PD model-based dosing guidelines. A prospective PK/PD study was conducted in 26 SO children and adolescents aged 9-18 years (body mass index 31-69 kg·m(-2)), undergoing surgery with intravenous propofol anesthesia clinically titrated by providers blinded to BIS. BIS data and propofol infusion schemes were recorded. Venous blood samples collected during and after propofol infusion were assayed for propofol concentrations. A propofol PK/PD model was developed using NONMEM and model-based simulations were performed to determine propofol dosing regimens targeting BIS of 50 ± 10. A three-compartment PK model linked to a sigmoidal inhibitory Emax PD model by a first-order rate constant, adequately described the propofol concentration (n = 375) and BIS (n = 3334) data. TBW was the most predictive covariate for propofol clearance [CL (l·min(-1) ) = 1.65 × (TBW/70)(0.75)]. An effect-site propofol concentration of 3.19 μg·ml(-1) was estimated for half-maximal effect, with no identifiable predictive covariates. The proposed maintenance dosing regimen targeted to a BIS of 50 ± 10, based on our PK/PD model, was able to predict desired propofol concentrations and BIS in a representative obese teen when used in conjunction with accepted PK/PD models for children/obese adults (PK:Eleveld/PD: Cortinez), further supporting evidence for the dosing based on TBW. This is the first study to describe the PK/PD of propofol in SO adolescents. The proposed maintenance dosing regimen for propofol uses TBW in an allometric function as a dosing scalar, with an exponent of 0.75. Our results suggest no relevant

  9. Effect of propofol pretreatment on apoptosis in rat brain cortex after focal cerebral ischemia and reperfusion

    Institute of Scientific and Technical Information of China (English)

    Haiyan Xu; Chengwei Zhang; Chunxiao Zhang

    2011-01-01

    The present study aimed to observe cortical expression of Bcl-2 and Bax, cysteine-dependent aspartate directed proteases-3 activity and apoptotic cell death in a rat model of middle cerebral artery occlusion pretreated with propofol. Results showed that, propofol pretreatment significantly reduced oxidative stress levels and attenuated neuronal apoptosis in the cortex of rats. Propofol pretreatment upregulated Bcl-2 expression, and downregulated Bax expression and cysteine-dependent aspartate directed proteases-3 activity. These findings indicate that propofol pretreatment inhibits cell apoptosis during focal cerebral ischemia/reperfusion injury. This neuroprotective effect is most likely achieved through the Bcl-2/Bax/cysteine-dependent aspartate directed proteases-3 pathway.

  10. Mimicking anesthetic-receptor interactions in jets: the propofol-isopropanol cluster.

    Science.gov (United States)

    León, Iker; Usabiaga, Imanol; Millán, Judith; Cocinero, Emilio J; Lesarri, Alberto; Fernández, José A

    2014-08-28

    The interaction of the general anesthetic propofol with an individual residue of threonine in the membrane receptors has been modeled in the gas phase by examining the adduct of propofol with the isopropanol side-chain. We determined the structural preferences of the cluster using a combination of mass-resolved laser spectroscopy and quantum mechanical calculations. The first electronic transition of propofol-isopropanol was recorded with vibrational resolution using resonant two-photon ionization (R2PI) and ion dip IR spectroscopy. The spectra obtained were compared with density-functional calculations (DFT) using the M06-2X functional in order to obtain the cluster's structure. Three isomers have been detected. The results suggest that propofol acts as a Brønsted acid, donating a proton to the isopropanol molecule in a conformation that resembles that of propofol-water, but displaced towards the aromatic ring, due to the interaction with the aliphatic side of isopropanol. The higher affinity of propofol for isopropanol compared to water may correlate with the biological role of propofol at the protein binding site. On the other hand, propofol shows a similar affinity for isopropanol and phenol, which could explain the mobility that propofol experiences inside the GABAA cavity.

  11. 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.

  12. Propofol Compared to Isoflurane Inhibits Mitochondrial Metabolism in Immature Swine Cerebral Cortex

    Energy Technology Data Exchange (ETDEWEB)

    Kajimoto, Masaki; Atkinson, D. B.; Ledee, Dolena R.; Kayser, Ernst-Bernhard; Morgan, Phil G.; Sedensky, Margaret M.; Isern, Nancy G.; Des Rosiers, Christine; Portman, Michael A.

    2014-01-08

    Anesthetics used in infants and children are implicated in development of neurocognitive disorders. Although propofol induces neuroapoptosis in developing brain, the underlying mechanisms require elucidation and may have an energetic basis. We studied substrate utilization in an immature swine model anesthetized with either propofol or isoflurane for 4 hours. Piglets were infused with 13-Carbon labeled glucose and leucine in the common carotid artery in order to assess citric acid cycle (CAC) metabolism in the parietal cortex. The anesthetics produced similar systemic hemodynamics and cerebral oxygen saturation by near-infrared-spectroscopy. Compared to isoflurane, propofol depleted ATP and glycogen stores. Propofol also decreased pools of the CAC intermediates, citrate and α-ketoglutarate, while markedly increasing succinate along with decreasing mitochondrial complex II activity. Propofol also inhibited acetyl-CoA entry into the CAC through pyruvate dehydrogenase, while promoting glycolytic flux with marked accumulation of lactate. Although oxygen supply appeared similar between the anesthetic groups, propofol yielded a metabolic phenotype which resembled a hypoxic state. Propofol impairs substrate flux through the CAC in the immature cerebral cortex. These impairments occurred without systemic metabolic perturbations which typically accompany propofol infusion syndrome. These metabolic abnormalities may play a role in neurotoxity observed with propofol in the vulnerable immature brain.

  13. Percepción del Riesgo sobre Ataques Terroristas y Consumo de Medios: Una Aproximación Comparada en el Ámbito Europeo

    Directory of Open Access Journals (Sweden)

    Francisco Javier Alarcón González

    2017-05-01

    Full Text Available Este artículo realiza una aproximación empírica sobre los factores individuales que pueden incidir en la percepción de sufrir un ataque terrorista, tomando como caso de estudio el marco europeo. Diversos estudios previos sobre la realidad estadounidense, han mostrado evidencias de cómo el consumo mediático o diferentes condicionantes individuales influyen en dicha percepción. En este trabajo, se examina además la interferencia contextual integrando una aproximación comparada entre países con los datos de la ESS. Los resultados ponen de relieve que, efectivamente, hay algunos factores como la edad o el interés por la política cuya influencia sería importante por encima de muchas fronteras; pero, de la misma forma, se observan interesantes diferencias entre territorios considerando estos y otros factores. Así, aunque el terrorismo sea cada vez más un fenómeno de carácter global, la visión ciudadana de éste mantiene signos de comprensión y enfoque local.

  14. Pharmacokinetics for the solutable type injections of propofol glycoside in rats%葡萄糖基化丙泊酚溶液型注射剂在大鼠体内的药物动力学

    Institute of Scientific and Technical Information of China (English)

    张喆; 居瑞军; 李学涛; 张东晓; 吴仁荣; 陈学军; 吕万良

    2015-01-01

    Objective:To estimate the pharmacokinetics for two solution types of propofol glycoside in-jections in rats .Methods:A high performance liquid chromatography-high resolution mass spectrometry ( HPLC-MS) was established for measuring propofol in rat plasma .Two kinds of propofol glycoside injec-tions were developed and intravenously administered to rats via tail vein , respectively , and a commercial-ly available propofol emulsion injection was intravenously administered as a control .Propofol plasma concentration-time curves were determined , and the pharmacokinetic parameters were estimated .Re-sults:HPLC-MS measurement was performed by using a quadrupole-orbit trap high-resolution mass spec-trometer on a C18 chromatographic column.The mobile phase consisted of water and methanol (20∶80, V/V) .The ion source was an atmospheric pressure chemical ion source , and the negative ion was used for detection with a scanning mode of selective ion monitoring in which m/z 177.127 4 was used for propofol and m/z 149.096 1 used for thymol as an internal standard .A linear correlation between con-centration and peak area ratio was constructed in the range of 50 μg/L-10.0 mg/L propofol.The limit of quantification was 50μg/L propofol .The average recoveries of propofol from plasma were in the range of 93.6% -101.1%, and intra-day or inter-day relative standard deviation for measurement was <14%.The pharmacokinetic results showed that the two kinds of propofol glycoside injections exhibited the same pharmacokinetic behavior .However, the clearance and area under curve values of propofol for the two propofol glycoside injections were evidently increased as compared with those for propofol emulsion injection, respectively.Furthermore, their apparent distribution volumes were increased as well .Never-theless, the propofol elimination half-life (t1/2) value of the newly developed propofol glycoside injections was the same as that of commercial propofol emulsion injection

  15. Efficacy of tramadol and butorphanol pretreatment in reducing pain on propofol injection: A placebo-controlled randomized study

    Directory of Open Access Journals (Sweden)

    Arvinderpal Singh

    2016-01-01

    Conclusion: Pretreatment with both butorphanol and tramadol significantly reduced pain on propofol injection; however, they exhibited comparable efficacy among each other. Thus, either of these two drugs can be considered for pretreatment to reduce propofol injection pain.

  16. Moderate and deep nurse-administered propofol sedation is safe

    DEFF Research Database (Denmark)

    Jensen, Jeppe Thue; Møller, Ann; Hornslet, Pernille

    2015-01-01

    INTRODUCTION: Non-anaesthesiologist-administered propofol sedation (NAPS/NAAP) is increasingly used in many countries. Most regimens aim for light or moderate sedation. Little evidence on safety of deep NAPS sedation is available. The aim of this study was to explore the safety of intermittent deep...... dose was 331.6 mg (standard deviation = 179.4 mg). The overall rate of hypoxia was 3.2%, and the rate of hypotension was 3.1%. Assisted ventilation was needed in 0.5%. Age (p ... with a higher rate of adverse events. CONCLUSION: Safety during intermittent deep sedation with NAPS was good. Age, ASA class 3 and total propofol dose were correlated with a higher rate of adverse events. Patients aged 60 years or more needed more handling during adverse events. FUNDING: Arvid Nilsson...

  17. Comparative study between fast and slow induction of propofol given by target-controlled infusion: expected propofol concentration at the effect site. Randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ricardo Francisco Simoni

    2015-04-01

    Full Text Available BACKGROUND AND OBJECTIVE: Studies have shown that the rate of propofol infusion may influence the predicted propofol concentration at the effect site (Es. The aim of this study was to evaluate the Es predicted by the Marsh pharmacokinetic model (ke0 0.26 min-1 in loss of consciousness during fast or slow induction. METHOD: The study included 28 patients randomly divided into two equal groups. In slow induction group (S, target-controlled infusion (TCI of propofol with plasma, Marsh pharmacokinetic model (ke0 0.26 min-1 with target concentration (Tc at 2.0-µg mL-1 were administered. When the predicted propofol concentration at the effect site (Es reached half of Es value, Es was increased to previous Es + 1 µg mL-1, successively, until loss of consciousness. In rapid induction group (R, patients were induced with TCI of propofol with plasma (6.0 µg mL-1 at effect site, and waited until loss of consciousness. RESULTS: In rapid induction group, Tc for loss of consciousness was significantly lower compared to slow induction group (1.67 ± 0.76 and 2.50 ± 0.56 µg mL-1, respectively, p = 0.004. CONCLUSION: The predicted propofol concentration at the effect site for loss of consciousness is different for rapid induction and slow induction, even with the same pharmacokinetic model of propofol and the same balance constant between plasma and effect site.

  18. Comparison Of The Direct Costs, Length Of Recovery, And Incidence Of Post Operative Anti Emetic Use After Anesthesia Induction With Propofol Or A 1:1 Mixture Of Thiopental And Propofol

    Science.gov (United States)

    1999-10-01

    Caucasian pediatric patients (Runcie, Mackenzie, Arthur, & Morton, 1993). Propofol is associated with a feeling of well being during recovery (Jakobsson...showed the least hemodynamic changes in pediatric patients versus induction with thiopental, propofol , or halothane followed by halothane maintenance...Blagrove, McCallum, & Bromley, 1997). Chinese pediatric patients experienced significantly greater drops in blood pressure with propofol (Aun, Sung

  19. Ketamine versus propofol for strabismus surgery in children

    Directory of Open Access Journals (Sweden)

    Ayse Mizrak

    2010-07-01

    Full Text Available Ayse Mizrak1, Ibrahim Erbagci2, Tulin Arici1, Ibrahim Ozcan1, Gurkan Tatar2, Unsal Oner11Anesthesiology and Reanimation, Gaziantep University School of Medicine, Gaziantep, Turkey; 2The Department of Ophthalmology, Gaziantep University School of Medicine, Gaziantep, TurkeyPurpose: To compare the effects of intravenous infusion of ketamine and propofol anesthesia in children undergoing strabismus surgery. Methods: Sixty pediatric patients aged 4–11 years were enrolled for the study. Patients in Group K were infused ketamine 1–3 mg/kg/hr (n = 30 and patients in Group P were infused with propofol6–9 mg/kg/hr (n = 30. After giving fentanyl 1 µg/kg and rocuronium bromide 0.5 mg/kg, patients were intubated.Results: The consumption of anesthetics (P = 0.0001 and antiemetics (P = 0.004, the incidence of ­oculocardiac reflex (P = 0.02 in Group K were significantly lower than in Group P. The recovery time (P = 0.008, postoperative agitation score (P = 0.005, Face Pain Scale (P = 0.001, Ramsay Sedation Score (P = 0.01 during awakening and at postoperative 30th min (P = 0.02 in Group K were significantly lower than in Group P. The postoperative agitation score ­during awakening was significantly lower than the preoperative values in Group K (P = 0.0001.Conclusions: The infusion of ketamine is more advantageous than the infusion of propofol in children for use in strabismus surgery.Keywords: ketamine, propofol, pediatrics, strabismus, surgery

  20. Spectral entropy for assessing the depth of propofol sedation.

    Science.gov (United States)

    Kwon, Mi-Young; Lee, Seung-Yun; Kim, Tae-Yop; Kim, Duk Kyung; Lee, Kyoung-Min; Woo, Nam-Sik; Chang, Young-Jae; Lee, Myung Ae

    2012-03-01

    For patients in the intensive care unit (ICU) or under monitored anesthetic care (MAC), the precise monitoring of sedation depth facilitates the optimization of dosage and prevents adverse complications from underor over-sedation. For this purpose, conventional subjective sedation scales, such as the Observer's Assessment of Alertness/Sedation (OAA/S) or the Ramsay scale, have been widely utilized. Current procedures frequently disturb the patient's comfort and compromise the already well-established sedation. Therefore, reliable objective sedation scales that do not cause disturbances would be beneficial. We aimed to determine whether spectral entropy can be used as a sedation monitor as well as determine its ability to discriminate all levels of propofol-induced sedation during gradual increments of propofol dosage. In 25 healthy volunteers undergoing general anesthesia, the values of response entropy (RE) and state entropy (SE) corresponding to each OAA/S (5 to 1) were determined. The scores were then analyzed during each 0.5 mcg/ml- incremental increase of a propofol dose. We observed a reduction of both RE and SE values that correlated with the OAA/S (correlation coefficient of 0.819 in RE-OAA/S and 0.753 in SE-OAA/S). The RE and SE values corresponding to awake (OAA/S score 5), light sedation (OAA/S 3-4) and deep sedation (OAA/S 1-2) displayed differences (P < 0.05). The results indicate that spectral entropy can be utilized as a reliable objective monitor to determine the depth of propofol-induced sedation.

  1. Prevention of propofol injection pain: Comparison between lidocaine and ramosetron

    Directory of Open Access Journals (Sweden)

    Dipali Singh

    2014-01-01

    Full Text Available Background: Propofol causes a high incidence of pain during intravenous (IV injection. The aim of this randomized, placebo-controlled, double-blinded study was to determine whether pre-treatment with IV ramosetron, used for prophylaxis of postoperative nausea and vomiting (PONV, would reduce propofol-induced pain as an equivalent to lidocaine. Materials and Methods: Hundred and twenty American Society of Anesthesiologists grade (ASA I and II patients were randomly assigned into three groups (40 in each. Group N received 2 ml of 0.9% saline, Group L received 2 ml of lidocaine, and Group R received 2 ml of ramosetron. Mid forearm was occluded manually before injection and released after 1 min and then propofol was injected over 5 s. Patients were observed and questioned 15 s later if they had pain in the arm and pain was scored on a four-point scale: 0 = no pain, 1 = mild pain, 2 = moderate pain, and 3 = severe pain. Unpaired Student′s t-test and chi-square test/Fisher′ exact test were used to analyze results. Results: The incidence of pain in groups N, L, and R were 65, 35, and 30%, respectively. Pain was reduced significantly in the groups L and R (P < 0.05. Two patients each in Groups L and R (5% each had moderate and severe pain. This difference in pain was statistically insignificant, but when compared to Group N (25 and 30%, respectively it was statistically significant. Conclusion: Pretreatment with ramosetron 0.3 mg and lidocaine 40 mg are equally effective in preventing pain from propofol injection.

  2. Morfologia comparada das terminálias masculina e feminina dos rhagionidae (Diptera, Tabanomorpha neotropicais

    Directory of Open Access Journals (Sweden)

    Daniel D.D. Carmo

    2011-01-01

    Full Text Available Apresentamos uma investigação comparativa da morfologia das terminálias masculina e feminina de gêneros da família Rhagionidae (Diptera, Brachycera, Tabanomorpha com distribuição neotropical. Partindo do plano básico de Brachycera, hipóteses de homologias entre as peças reprodutivas foram analisadas em um contexto comparativo. Os resultados sugerem que as condições presentes em Rhagionidae são no geral muito modificadas quando comparadas com o ancestral comum mais recente de Brachycera. Este trabalho apresenta uma hipótese filogenética heurística cujos resultados podem servir como base para o entendimento da grande diversificação morfológica das terminálias masculina e feminina dos ragionídeos, apontando para a solução de algumas controvérsias a respeito da morfologia das estruturas reprodutivas do grupo.

  3. Federalismo e descentralização em perspectiva comparada: sobre significados e medidas

    Directory of Open Access Journals (Sweden)

    Jonathan Rodden

    2005-06-01

    Full Text Available Este artigo revê e redireciona a literatura empírica comparada sobre as causas e conseqüências da descentralização e do federalismo. A "primeira geração" de estudos concebia a descentralização como um jogo de soma zero, de transferência de autoridade do centro para os governos subnacionais; partia das premissas da economia de bem-estar social e da teoria da escolha pública e empregava formas pouco precisas para medir a descentralização do gasto e o federalismo. Em contraste, ao definir diversas modalidades de federalismo e de descentralizações fiscal, política e de políticas; ao medi-las e ao explorar inte-rrelações entre países e ao longo do tempo, este trabalho apresenta um retrato mais preciso da descentralização e do federalismo, que fornece subsídios para explicar a crescente disjunção entre a teoria e as evidências encontradas em diferentes países. Assim, aponta na direção de uma "segunda geração" de trabalhos empíricos mais sofisticados, que levam a política e as instituições a sério.

  4. comparada - São Paulo e Cidade do México

    Directory of Open Access Journals (Sweden)

    Eunice Helena Sguizzardi Abascal

    2006-01-01

    Full Text Available As cidades contemporâneas apresentam mudanças visíveis, expressas em suas paisagens, manifestas por reconfigurações espaciais, novas morfologias, usos e funções. Com as transformações produtivas, tecnológicas e sociais despontadas na década de 1980, os dois últimos decênios do século XX assistiriam à vinculação desse cenário de mudanças à globalização econômico-cultural. As cidades que constituem a rede iberoamericana encontram-se incluídas no rol de exemplos passíveis de investigação e análise. Nesta pesquisa, tivemos como base um projeto maior denominado “Paradigmas para o estudo de cidades ibero-americanas no século XXI”, da Faculdade de Arquitetura e Urbanismo (FAU da Universidade Presbiteriana Mackenzie. Neste estudo, recortamos o universo de casos, buscando uma perspectiva comparada entre as cidades de São Paulo (Brasil e do México (México.

  5. Propofol Affects Neurodegeneration and Neurogenesis by Regulation of Autophagy via Effects on Intracellular Calcium Homeostasis.

    Science.gov (United States)

    Qiao, Hui; Li, Yun; Xu, Zhendong; Li, Wenxian; Fu, Zhijian; Wang, Yuezhi; King, Alexander; Wei, Huafeng

    2017-09-01

    In human cortical neural progenitor cells, we investigated the effects of propofol on calcium homeostasis in both the ryanodine and inositol 1,4,5-trisphosphate calcium release channels. We also studied propofol-mediated effects on autophagy, cell survival, and neuro- and gliogenesis. The dose-response relationship between propofol concentration and duration was studied in neural progenitor cells. Cell viability was measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and lactate dehydrogenase release assays. The effects of propofol on cytosolic calcium concentration were evaluated using Fura-2, and autophagy activity was determined by LC3II expression levels with Western blot. Proliferation and differentiation were evaluated by bromodeoxyuridine incorporation and immunostaining with neuronal and glial markers. Propofol dose- and time-dependently induced cell damage and elevated LC3II expression, most robustly at 200 µM for 24 h (67 ± 11% of control, n = 12 to 19) and 6 h (2.4 ± 0.5 compared with 0.6 ± 0.1 of control, n = 7), respectively. Treatment with 200 μM propofol also increased cytosolic calcium concentration (346 ± 71% of control, n = 22 to 34). Propofol at 10 µM stimulated neural progenitor cell proliferation and promoted neuronal cell fate, whereas propofol at 200 µM impaired neuronal proliferation and promoted glial cell fate (n = 12 to 20). Cotreatment with ryanodine and inositol 1,4,5-trisphosphate receptor antagonists and inhibitors, cytosolic Ca chelators, or autophagy inhibitors mostly mitigated the propofol-mediated effects on survival, proliferation, and differentiation. These results suggest that propofol-mediated cell survival or neurogenesis is closely associated with propofol's effects on autophagy by activation of ryanodine and inositol 1,4,5-trisphosphate receptors.

  6. Intravenous anesthetic propofol binds to 5-lipoxygenase and attenuates leukotriene B4 production.

    Science.gov (United States)

    Okuno, Toshiaki; Koutsogiannaki, Sophia; Ohba, Mai; Chamberlain, Matthew; Bu, Weiming; Lin, Fu-Yan; Eckenhoff, Roderic G; Yokomizo, Takehiko; Yuki, Koichi

    2017-04-01

    Propofol is an intravenous anesthetic that produces its anesthetic effect, largely via the GABAA receptor in the CNS, and also reduces the N-formyl-methionyl-leucyl-phenylalanine (fMLP)-induced neutrophil respiratory burst. Because fMLP-stimulated neutrophils produce leukotriene (LT)B4, we examined the effect of propofol on LTB4 production in vivo and in vitro Cecal ligation and puncture surgery was performed in mice, with or without exposure to propofol. Propofol attenuated the production of 5-lipoxygenase (5-LOX)-related arachidonic acid (AA) derivatives in the peritoneal fluid. Also, in the in vitro experiments on fMLP-stimulated neutrophils and 5-LOX-transfected human embryonic kidney cells, propofol attenuated the production of 5-LOX-related AA derivatives. Based on these results, we hypothesized that propofol would directly affect 5-LOX function. Using meta-azi-propofol (AziPm), we photolabeled stable 5-LOX protein, which had been used to solve the X-ray crystallographic structure of 5-LOX, and examined the binding site(s) of propofol on 5-LOX. Two propofol binding pockets were identified near the active site of 5-LOX. Alanine scanning mutagenesis was performed for the residues of 5-LOX in the vicinity of propofol, and we evaluated the functional role of these pockets in LTB4 production. We demonstrated that these pockets were functionally important for 5-LOX activity. These two pockets can be used to explore a novel 5-LOX inhibitor in the future.-Okuno, T., Koutsogiannaki, S., Ohba, M., Chamberlain, M., Bu, W., Lin, F.-Y., Eckenhoff, R. G., Yokomizo T., Yuki, K. Intravenous anesthetic propofol binds to 5-lipoxygenase and attenuates leukotriene B4 production. © FASEB.

  7. Propofol ameliorates doxorubicin-induced oxidative stress and cellular apoptosis in rat cardiomyocytes

    Energy Technology Data Exchange (ETDEWEB)

    Lai, H.C. [Cardiovascular Center and Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan (China); Department of Medicine and Cardiovascular Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan (China); Yeh, Y.C. [Graduate Institute of Natural Healing Sciences, Nanhua University, Chiayi, Taiwan (China); Wang, L.C. [Cardiovascular Center and Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan (China); Ting, C.T.; Lee, W.L. [Cardiovascular Center and Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan (China); Department of Medicine and Cardiovascular Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan (China); Lee, H.W. [Cardiovascular Center and Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan (China); Wang, K.Y. [Cardiovascular Center and Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan (China); Department of Medicine, Chung-Shan Medical University, Taichung, Taiwan (China); Wu, A. [College of Biological Science, University of California, Davis (United States); Su, C.S. [Cardiovascular Center and Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan (China); Department of Medicine and Cardiovascular Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan (China); Liu, T.J., E-mail: trliu@vghtc.gov.tw [Cardiovascular Center and Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan (China); Department of Medicine and Cardiovascular Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan (China)

    2011-12-15

    Background: Propofol is an anesthetic with pluripotent cytoprotective properties against various extrinsic insults. This study was designed to examine whether this agent could also ameliorate the infamous toxicity of doxorubicin, a widely-used chemotherapeutic agent against a variety of cancer diseases, on myocardial cells. Methods: Cultured neonatal rat cardiomyocytes were administrated with vehicle, doxorubicin (1 {mu}M), propofol (1 {mu}M), or propofol plus doxorubicin (given 1 h post propofol). After 24 h, cells were harvested and specific analyses regarding oxidative/nitrative stress and cellular apoptosis were conducted. Results: Trypan blue exclusion and MTT assays disclosed that viability of cardiomyocytes was significantly reduced by doxorubicin. Contents of reactive oxygen and nitrogen species were increased and antioxidant enzymes SOD1, SOD2, and GPx were decreased in these doxorubicin-treated cells. Mitochondrial dehydrogenase activity and membrane potential were also depressed, along with activation of key effectors downstream of mitochondrion-dependent apoptotic signaling. Besides, abundance of p53 was elevated and cleavage of PKC-{delta} was induced in these myocardial cells. In contrast, all of the above oxidative, nitrative and pro-apoptotic events could be suppressed by propofol pretreatment. Conclusions: Propofol could extensively counteract oxidative/nitrative and multiple apoptotic effects of doxorubicin in the heart; hence, this anesthetic may serve as an adjuvant agent to assuage the untoward cardiac effects of doxorubicin in clinical application. -- Highlights: Black-Right-Pointing-Pointer We evaluate how propofol prevents doxorubicin-induced toxicity in cardiomyocytes. Black-Right-Pointing-Pointer Propofol reduces doxorubicin-imposed nitrative and oxidative stress. Black-Right-Pointing-Pointer Propofol suppresses mitochondrion-, p53- and PKC-related apoptotic signaling. Black-Right-Pointing-Pointer Propofol ameliorates apoptosis and

  8. Transition to propofol after sevoflurane anesthesia to prevent emergence agitation: a randomized controlled trial.

    Science.gov (United States)

    Costi, David; Ellwood, James; Wallace, Andrew; Ahmed, Samira; Waring, Lynne; Cyna, Allan

    2015-05-01

    Emergence agitation (EA) is a common behavioral disturbance after sevoflurane anesthesia in children. Propofol 1 mg · kg(-1) bolus at the end of sevoflurane anesthesia has had mixed results in reducing the incidence of EA, whereas propofol infusion throughout anesthesia maintenance seems effective but is more complex to administer. If a simple, short transition to propofol anesthesia was found to be effective in reducing EA, this could enhance the recovery of children following sevoflurane anesthesia. We therefore aimed to determine whether transition to propofol over 3 min at the end of sevoflurane anesthesia reduces the incidence of EA in children. In this prospective randomized controlled trial, 230 children aged 1-12 years, undergoing magnetic resonance imaging (MRI) scans under sevoflurane anesthesia were randomized to receive either propofol 3 mg · kg(-1) over 3 min (propofol group), or no propofol (control group), at the end of sevoflurane anesthesia. EA was assessed by a blinded assessor using the Pediatric Emergence Anesthesia Delirium (PAED) scale and the Watcha scale until 30 min after emergence. EA on the PAED scale was defined as a PAED score >12. EA on the Watcha scale was defined as a score ≥ 3. Times to emergence, postanesthesia care unit (PACU) discharge, and discharge home were also recorded. Data were analyzed for 218 children. The incidence of EA was lower in the propofol group on both PAED (29% vs 7%; relative risk = 0.25; 95% confidence interval 0.12-0.52; P propofol group. Preplanned subgroup analyses for midazolam premedication, preexisting cognitive or behavioral disturbance, and age group did not alter our findings. Emergence time and time in PACU were both increased by a mean of 8 min in the propofol group (P propofol at the end of sevoflurane anesthesia reduces the incidence of EA and improves the quality of emergence. There is a small increase in recovery time, but no delay in discharge home. © 2015 John Wiley & Sons Ltd.

  9. Propofol-Related Infusion Syndrome in the Peripartum Period

    Science.gov (United States)

    Eziefule, Akwugo A.; Elshatanoufy, Solafa; Thakur, Mili; Rocha, Frederico G.

    2016-01-01

    Background Propofol is a widely known, commonly used drug. Complications can occur with the use of this drug, including propofol-related infusion syndrome (PRIS). PRIS, in the obstetric population, has not been documented; however, we report a case of a patient who developed PRIS after an emergent cesarean delivery of a preterm infant. Case Study A 35-year-old multigravida woman presented complaining of leakage of fluid and decreased fetal movement. Her pregnancy was complicated by methadone maintenance therapy due to a history of opioid abuse. Complications after admission for prolonged monitoring and a prolonged fetal heart tone deceleration was noted with no recovery despite intrauterine resuscitation. An emergent cesarean delivery was performed using general anesthesia and endotracheal intubation after which she developed aspiration pneumonia. She was admitted to the intensive care unit and reintubation and sedation were required secondary to respiratory distress. Sedation was achieved using propofol infusion. She subsequently developed changes in her electrocardiogram, an increase of her serum creatinine, creatinine protein kinase, lipase, amylase, and triglycerides, making the diagnosis of PRIS. Conclusion PRIS should be included in the differential diagnosis of intubated or postoperative patients in the obstetric population. PMID:27738550

  10. Remifentanil used to supplement propofol does not improve quality of sedation during spontaneous respiration

    NARCIS (Netherlands)

    Moerman, AT; Struys, MMRF; Vereecke, HE; Herregods, LL; De Vos, Martine M.; Mortier, EP

    Study Objective: To evaluate whether the use of remifentanil to supplement propofol during spontaneous respiration confers any benefits in terms of quality of sedation and recovery, or in terms of reduction in Propofol requirements. Design: Prospective, randomized, double-blind study. Setting:

  11. PK-PD modelling of the interaction of propofol and midazolam : implementation and future perspectives

    NARCIS (Netherlands)

    Lichtenbelt, Bart Jan

    2013-01-01

    This thesis describes the day to day interaction between propofol and midazolam as encountered in every day practice. The direct interaction of premedication given to patients before surgery has profound implications. The propofol induction dose can be decreased with respect to the target BIS.

  12. Influence of obesity on propofol pharmacokinetics : derivation of a pharmacokinetic model

    NARCIS (Netherlands)

    Cortinez, L. I.; Anderson, B. J.; Penna, A.; Olivares, L.; Munoz, H. R.; Holford, N. H. G.; Struys, M. M. R. F.; Sepulveda, P.

    2010-01-01

    The objective of this study was to develop a pharmacokinetic (PK) model to characterize the influence of obesity on propofol PK parameters. Nineteen obese ASA II patients undergoing bariatric surgery were studied. Patients received propofol 2 mg kg(-1) bolus dose followed by a 5-20-40-120 min,

  13. Propofol Sedation Exacerbates Kidney Pathology and Dissemination of Bacteria during Staphylococcus aureus Bloodstream Infections.

    Science.gov (United States)

    Visvabharathy, Lavanya; Freitag, Nancy E

    2017-07-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for large numbers of postsurgical nosocomial infections across the United States and worldwide. Propofol anesthesia is widely used in surgery and in intensive care units, and recent evidence indicates that even brief exposure to propofol can substantially increase host susceptibility to microbial infection. Here, we delineate the impact of propofol sedation on MRSA bloodstream infections in mice in the presence and absence of prophylactic antibiotic treatment. Consistent with previous reports, brief periods of anesthesia with propofol were sufficient to significantly increase bacterial burdens and kidney pathology in mice infected with MRSA. Propofol exposure increased neutrophilic infiltrates into the kidney and enhanced bacterial dissemination throughout kidney tissue. Propofol sedation reduced populations of effector phagocytes and mature dendritic cells within the kidney and led to the apparent expansion of myeloid-derived suppressor cell-like populations. When propofol was coadministered with vancomycin prophylaxis, it dramatically increased kidney abscess formation and bacterial dissemination throughout kidney tissue at early times post-S. aureus infection compared to antibiotic-treated but nonsedated animals. Taken together, our data indicate that short-term sedation with propofol significantly increases the severity of bloodstream MRSA infection, even when administered in conjunction with vancomycin prophylaxis. Copyright © 2017 American Society for Microbiology.

  14. Pediatric procedural sedation with propofol using a higher initial bolus dose.

    Science.gov (United States)

    Young, Timothy P; Lim, Jennifer J; Kim, Tommy Y; Thorp, Andrea W; Brown, Lance

    2014-10-01

    We sought to describe the doses of propofol used for sedation in our pediatric emergency department, along with the range of procedures performed under propofol sedation. We also planned to describe clinically important physiologic changes seen and physician satisfaction with propofol at the doses observed. This was a prospective observational case series. Physicians completed a data collection form after the propofol sedation. The physicians were asked to report physiologic changes that occurred during sedation and rate their satisfaction with propofol as a sedation agent on a 100-mm visual analog scale. Eight hundred eighty-six sedation events were reported. The median initial dose of propofol given was 2.0 mg/kg and the median total dose was 3.6 mg/kg. Propofol was used for a wide range of procedures. The most common physiologic change was desaturation/hypoxia (desaturation to propofol for pediatric sedation was well tolerated and useful for a wide range of procedures. Physicians should expect to find a high level of satisfaction with this dose.

  15. Efficiency of propofol versus midazolam and fentanyl sedation at a pediatric teaching hospital: a prospective study.

    Science.gov (United States)

    Lightdale, Jenifer R; Valim, Clarissa; Newburg, Adrienne R; Mahoney, Lisa B; Zgleszewski, Steven; Fox, Victor L

    2008-06-01

    Many pediatric endoscopists are adopting propofol in their practices, with the expectation that propofol will increase their overall efficiency. To compare the efficiency of propofol versus midazolam and fentanyl by measuring elapsed times between initial intravenous administration and patient discharge at a pediatric teaching hospital. Endoscopy times were prospectively collected for consecutive patients who were undergoing either anesthesiologist-administered propofol or endoscopist-administered midazolam and fentanyl. The effect of the type of sedation on these times was assessed by using multiple linear regression by adjusting for other candidate predictors, including concomitant use of other sedatives, endotracheal intubation by anesthesiologists, and the presence of fellow trainees. Time to onset of sedation (time sedation started to scope in), procedure time (endoscope in to endoscope out), discharge time (endoscope out to hospital discharge), and total time (sedation started to hospital discharge). The times for 134 children (mean age 12 +/- 5 years) to receive propofol sedation were compared with those of 195 children (13 +/- 5 years) who received midazolam and fentanyl. Midazolam and fentanyl cases disproportionately included EGDs (P propofol had shorter times until sedated, similar procedure times, longer discharge times, and comparable total times. Multivariate analyses confirmed that fellow participation prolonged the procedure times (P propofol times (P propofol sedation in a pediatric teaching endoscopy unit may not lead to faster hospital times when compared with endoscopist-administered midazolam and fentanyl. These results are not explained by controlling for patient characteristics, the presence of a trainee, the sedative doses, or endotracheal intubation for airway management.

  16. The Utility of Bispectral Index for Titration of Propofol Dosages and Recovery from Anaesthesia

    Directory of Open Access Journals (Sweden)

    Heena Parikh

    2012-08-01

    Full Text Available Background: The use of clinical signs may not be reliable to measure the hypnotic component of anaesthesia. Bispectral Index monitoring provides a direct measurement of the hypnotic effect of the anaesthetic agent used and it may have certain clinical advantages over clinical signs. Objective: This study consists of dose requirement of propofol with bispectral Index monitoring and without bispectral Index monitoring. Material and Methods: In the present study, 100 patients were randomly divided into two groups (50 in each group, one group received Standard dose of propofol while the other received propofol infusion with BIS monitoring. Results: Mean amount of propofol for induction used was 1.6 vs 2.24 mg/kg in bispectral index group and standard group respectively. The inference was that the induction dose of propofol by Bispectral index and by standard practice was statistically highly significant with P<0.001. Similarly mean amount of propofol for maintenance used was 5.70 vs 8.88 mg/kg/hr in bispectral index group and standard group respectively. The inference was that the maintenance dose of propofol by Bispectral index and by standard practice was statistically highly significant with P<0.001. Conclusion: Dose requirement of propofol was less and early recovery from anesthesia with bispectral Index monitoring. [Natl J of Med Res 2012; 2(4.000: 484-487

  17. Propofol Infusion Syndrome in Refractory Status Epilepticus: A Case Report and Topical Review

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    Akil Walli

    2016-01-01

    Full Text Available Propofol infusion syndrome (PRIS is a fatal complication when doses of propofol administration exceed 4 mg/kg/h for more than 48 hours. Propofol overdosage is not uncommon in patients with refractory status epilepticus (RSE. We describe a case of refractory status epilepticus complicated by propofol infusion syndrome and collect from 5 databases all reports of refractory status epilepticus cases that were treated by propofol and developed the syndrome and outline whether refractory status epilepticus treatment with propofol is standardized according to international recommendations, compare it with alternative medications, and discuss how this syndrome can be treated and prevented. A total of 21 patients who developed this syndrome reported arrhythmia in all cases (100%, rhabdomyolysis in 9 cases (42%, lactic acidosis in 13 cases (62%, renal failure in 8 cases (38%, lipemia in 7 cases (33%, and elevated hepatic enzymes in 6 cases (28%. 13 patients died (66%. Propofol is still given in a dosage higher than what is internationally recommended, and new treatment modalities such as renal replacement therapy, blood exchange, and extracorporeal membrane oxygenation seem to be promising. In conclusion, propofol should be carefully titrated, the maximal infusion rate needs to be reassessed, and combination of different sedative agents may be considered.

  18. Propofol Prevents Renal Ischemia-Reperfusion Injury via Inhibiting the Oxidative Stress Pathways

    Directory of Open Access Journals (Sweden)

    Yingjie Li

    2015-08-01

    Full Text Available Background/Aims: Renal ischemia/reperfusion injury (IRI is a risk for acute renal failure and delayed graft function in renal transplantation and cardiac surgery. The purpose of this study is to determine whether propofol could attenuate renal IRI and explore related mechanism. Methods: Male rat right kidney was removed, left kidney was subjected to IRI. Propofol was intravenously injected into rats before ischemia. The kidney morphology and renal function were analyzed. The expression of Bax, Bcl-2, caspase-3, cl-caspase-3, GRP78, CHOP and caspase-12 were detected by Western blot analysis. Results: IR rats with propofol pretreatment had better renal function and less tubular apoptosis than untreated IR rats. Propofol pretreated IR rats had lower Bax/Bcl-2 ratio and less cleaved caspase-3. The protein expression levels of GRP78, CHOP and caspase-12 decreased significantly in propofol pretreated IR rats. In vitro cell model showed that propofol significantly increased the viability of NRK-52E cells that were subjected to hypoxia/reoxygenation (H/R in a dose-dependent manner. The effect of propofol on the expression regulation of Bax, Bcl-2, caspase-3, GRP78, CHOP was consistent in both in vitro and in vivo models. Conclusion: Experimental results suggest that propofol prevents renal IRI via inhibiting oxidative stress.

  19. Evaluation of Pharyngeal Function between No Bolus and Bolus Propofol Induced Sedation for Advanced Upper Endoscopy

    Directory of Open Access Journals (Sweden)

    Shinsuke Kiriyama

    2014-01-01

    Full Text Available This study aimed to assess pharyngeal function between no bolus and bolus propofol induced sedation during gastric endoscopic submucosal dissection. A retrospective study was conducted involving consecutive gastric cancer patients. Patients in the no bolus group received a 3 mg/kg/h maintenance dose of propofol after the initiation of sedation without bolus injection. All patients in the bolus group received the same maintenance dose of propofol with bolus 0.5 mg/kg propofol injection. Pharyngeal functions were evaluated endoscopically for the first 5 min following the initial administration of propofol. Fourteen patients received no bolus propofol induction and 13 received bolus propofol induction. Motionless vocal cords were observed in 2 patients (14% in the no bolus group and 3 (23% in the bolus group. Trachea cartilage was not observed in the no bolus group but was apparent in 6 patients (46% in the bolus group (P<0.01. Scope stimulated pharyngeal reflex was observed in 11 patients (79% in the no bolus group and in 3 (23% in the bolus group (P<0.01. Propofol induced sedation without bolus administration preserves pharyngeal function and may constitute a safer sedation method than with bolus.

  20. Dose requirement and complications of diluted and undiluted propofol for deep sedation in endoscopic retrograde cholangiopancreatography

    Institute of Scientific and Technical Information of China (English)

    SomchaiAmornyotin; WichitSrikureja; WiyadaChalayonnavin; SiripornKongphlay

    2011-01-01

    BACKGROUND: In general, the dose requirement and complications of propofol are lower when used in the diluted form than in the undiluted form. The aim of this study was to determine the dose requirement and complications of diluted and undiluted propofol for deep sedation in endoscopic retrograde cholangiopancreatography. METHODS: Eighty-six patients were randomly assigned to either group D (diluted propofol) or U (undiluted propofol). All patients were sedated with 0.02-0.03 mg/kg midazolam (total dose ≤2 mg for age RESULTS:  All endoscopies were completed successfully. Mean propofol doses per body weight and per body weight per hour in groups D and U were 3.0 mg/kg, 6.2 mg/kg per hour and 4.7 mg/kg, 8.0 mg/kg per hour, respectively. The mean dose of propofol, expressed as total dose, dose/kg or dose/kg per hour and the recovery time were not significantly different between the two groups. Sedation-related adverse events during and immediately after the procedure were higher in group U (42.9%) than in group D (18.2%) (P=0.013). CONCLUSIONS: Propofol requirement and recovery time in the diluted and undiluted propofol groups were comparable. However, the sedation-related hypotension was significantly lower in the diluted group than the undiluted group.

  1. Involvement of CYP2B6 in the biotransformation of propofol by human liver microsomes

    Institute of Scientific and Technical Information of China (English)

    TANG Bing; WANG Jun-ke; FENG Wan-yu

    2008-01-01

    Objective To determine whether the cytochrome P4502B6 (CYP2B6) is involved in the oxidation of propofol by human liver microsomes. Methods The change of propofol concentration in an incubation mixture with human liver microsomes was monitored by the high performance liquid chromatography (HPLC), in order to calculate the rate constants of metabolism of propofol. The correlation between the rate constants and the rate of metabolism of CYP2B6 selective substrate bupropion, and the effect of two different CYP2B6 specific inhibitors on the propofol metabolism were examined. Results The mean rate constant of propofol metabolism by liver microsomes obtained from twelve individuals was 3.9 (95 % confidence intervals 3.3, 4.5) nmol·min-1·mg-1 protein. The rate constants of propofol metabolism by liver microsomes were significantly correlated with bupropion hydroxylation (r=0.888, P<0.001). Both selective chemical inhibitors of CYP2B6, orphenadrine and N, N′, N″-triethylenethiophosphoramide (thioTEPA), reduced the rate constants of propofol metabolism by 37.596 (P<0.001) and 42.796 (P<0.001)in liver microsomes, respectively. Conclusions CYP2B6 is predominantly involved in the oxidation of propofol by human liver microsomes.

  2. PK-PD modelling of the interaction of propofol and midazolam : implementation and future perspectives

    NARCIS (Netherlands)

    Lichtenbelt, Bart Jan

    2013-01-01

    This thesis describes the day to day interaction between propofol and midazolam as encountered in every day practice. The direct interaction of premedication given to patients before surgery has profound implications. The propofol induction dose can be decreased with respect to the target BIS. Besid

  3. Blood gas partition coefficient and pulmonary extraction ratio for propofol in goats and pigs.

    Science.gov (United States)

    Grossherr, M; Hengstenberg, A; Dibbelt, L; Igl, B-W; Noel, R; Knesebeck, A v d; Schmucker, P; Gehring, H

    2009-10-01

    The interpretation of continuously measured propofol concentration in respiratory gas demands knowledge about the blood gas partition coefficient and pulmonary extraction ratio for propofol. In the present investigation we compared both variables for propofol between goats and pigs during a propofol anaesthesia. In ten goats and ten pigs, expired alveolar gas and arterial and mixed venous blood samples were simultaneously drawn during total intravenous anaesthesia with propofol. The blood gas partition coefficient and pulmonary extraction ratio were calculated for both species. Non-parametric methods were used for statistical inference. The blood gas partition coefficient ranged between 7000 and 646,000 for goats and between 17,000 and 267,000 for pigs. The pulmonary extraction ratio ranged between 32.9% and 98.1% for goats and was higher for pigs, which ranged between -106.0% and 39.0%. The blood gas partition coefficient for propofol exceeded those for other known anaesthetic compounds so that it takes longer to develop a steady-state. The different pulmonary extraction rates in two species suggest that there are different ways to distribute propofol during the lung passage on its way from the blood to breathing gas. This species-specific difference has to be considered for methods using the alveolar gas for monitoring the propofol concentration in plasma.

  4. Patient state index vs bispectral index as measures of the electroencephalographic effects of propofol.

    NARCIS (Netherlands)

    Soehle, M.; Kuech, M.; Grube, M.; Wirz, S.; Kreuer, S.; Hoeft, A.; Bruhn, J.; Ellerkmann, R.K.

    2010-01-01

    BACKGROUND: The patient state index (PSI) and the bispectral index (BIS) quantify anaesthetic depth based on the EEG using different algorithms. We compared both indices with regard to the prediction of the depth of propofol anaesthesia. METHODS: In 17 patients, propofol was infused until burst supp

  5. Effects of low-dose midazolam with propofol in patient-controlled sedation (PCS) for apicectomy.

    Science.gov (United States)

    Küçükyavuz, Zuhal; Cambazoğlu, Mine

    2004-06-01

    We studied the effects of low-dose midazolam with propofol for patient control sedation (PCS) in 30 healthy (ASA grade I) patients who were randomly allocated into two equal groups (n = 15 in each). They were given a propofol infusion of 2mg/kg/h after a bolus dose of 0.7 mg/kg. The second group was given the 2mg/kg/h propofol infusion after a dose of midazolam 0.03 mg/kg and a bolus dose of propofol 0.7 mg/kg. The standard dose for PCS was propofol 0.2mg/kg in both groups. Clinical data were taken and haemodynamic variables, and oxygen saturation were recorded before and on the 5th, 10th, 20th, and 30th minutes during the operations. The level of sedation, amnesia and conditions of each patient were evaluated during the study. Patients' satisfaction was recorded using a modified visual analogue scale (VAS). All results were evaluated statistically. We conclude that low-dose midazolam with propofol during PCS neither reduced oxygen saturation nor prolonged the time of discharge. Low-dose midazolam with propofol also improved the acceptability and comfort for patients and made the operation easier, which makes it preferable to propofol alone.

  6. Effect of propofol and dexmedetomidine on pulmonary mechanics in intensive care unit patients

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    Mediha Turktan

    2017-03-01

    Conclusions: Dexmedetomidine causes minimal respiratory depression altough propofol has better ventilator-patient conflict. Therefore dexmedetomidine may preferred during weaning period in ICUs patients. Further studies with larger simple size are warranted to reveal a significant difference in terms of pulmonary compliance between propofol and dexmedetomidine. [Cukurova Med J 2017; 42(1.000: 34-40

  7. The Effect of Propofol Anesthesia on Cutaneous Wound Healing in Rats

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    Alireza Raayat Jahromi

    2016-12-01

    Full Text Available Background & Objective: The present study surveys the effects of propofol on cutaneous wound healing in rats. Materials & Methods: 36 adult female Strague-Dawely rats were divided into three groups randomly; in group one propofol (60 mg/kg and ketamine (40 mg/kg combination; in group two ketamine (50 mg/kg, and in group three propofol (100 mg/kg was injected intraperitoneally. Following routine surgical preparation, 1.5×1.5 cm wounds were created on the back of the rats. Wound size was evaluated daily and then the wound area was calculated by Digimizer software. Following euthanasia on day 21 after wounding, 1×1 cm skin samples were collected for histopathological evaluations and hydroxyproline content. Results: Wound size and hydroxyproline content showed no significant difference in propofol group compared to ketamine and propofol-ketamine groups. Fibroblast content and vascularity revealed no significant difference between groups. Inflammatory cell infiltration in ketamine group, collagen deposition in ketamine-propofol groups, and epithelial regeneration in propofol group were significantly higher in comparison with others. Conclusion: In conclusion, single use of propofol has no adverse effect on cutaneous wound healing in rats compared to ketamine, but evaluation of its positive effects on wound healing necessitates more detailed studies.

  8. Colonoscopy sedation: clinical trial comparing propofol and fentanyl with or without midazolam.

    Science.gov (United States)

    das Neves, Jose Francisco Nunes Pereira; das Neves Araújo, Mariana Moraes Pereira; de Paiva Araújo, Fernando; Ferreira, Clarice Martins; Duarte, Fabiana Baeta Neves; Pace, Fabio Heleno; Ornellas, Laura Cotta; Baron, Todd H; Ferreira, Lincoln Eduardo Villela Vieira de Castro

    2016-01-01

    Colonoscopy is one of the most common procedures. Sedation and analgesia decrease anxiety and discomfort and minimize risks. Therefore, patients prefer to be sedated when undergoing examination, although the best combination of drugs has not been determined. The combination of opioids and benzodiazepines is used to relieve the patient's pain and discomfort. More recently, propofol has assumed a prominent position. This randomized prospective study is unique in medical literature that specifically compared the use of propofol and fentanyl with or without midazolam for colonoscopy sedation performed by anesthesiologists. The aim of this study was to evaluate the side effects of sedation, discharge conditions, quality of sedation, and propofol consumption during colonoscopy, with or without midazolam as preanesthetic. The study involved 140 patients who underwent colonoscopy at the University Hospital of the Federal University of Juiz de Fora. Patients were divided into two groups: Group I received intravenous midazolam as preanesthetic 5min before sedation, followed by fentanyl and propofol; Group II received intravenous anesthesia with fentanyl and propofol. Patients in Group II had a higher incidence of reaction (motor or verbal) to the colonoscope introduction, bradycardia, hypotension, and increased propofol consumption. Patient satisfaction was higher in Group I. According to the methodology used, the combination of midazolam, fentanyl, and propofol for colonoscopy sedation reduces propofol consumption and provides greater patient satisfaction. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  9. Propofol facilitated excitatory postsynaptic currents frequency on nucleus tractus solitarii (NTS) neurons.

    Science.gov (United States)

    Jin, Zhenhua; Choi, Myung-Jin; Park, Cheung-Seog; Park, Young Seek; Jin, Young-Ho

    2012-01-13

    Propofol, an intravenous anesthetic, is broadly used for general anesthesia and diagnostic sedations due to its fast onset and recovery. Propofol depresses respiratory and cardiovascular reflex responses, however, their underlying mechanisms are not well known. Cardiorespiratory information from visceral afferent vagus nerves is integrated in the nucleus tractus solitarii (NTS). Cardiac and respiratory signals transducing vagal afferent neurons release the excitatory neurotransmitter glutamate onto NTS neurons in an activity dependent manner and trigger negative feedback reflex responses. In this experiment, the effects of propofol on glutamatergic synaptic responses at NTS neurons was tested using patch clamp methods. Glutamatergic excitatory postsynaptic currents (EPSC) were recorded at chloride reversal potential (-49mV) without γ-aminobutyric acid type A (GABA(A)) receptor antagonists. Propofol (≥3μM) facilitated frequency of the spontaneous EPSCs in a concentration dependent manner without altering amplitude and decay time. The GABA(A) receptor selective antagonist, gabazine (6μM), attenuated propofol effects on glutamate release. Propofol (10μM) evoked glutamate release was also blocked in the presence of the voltage dependent Na(+) and Ca(2+) channel blockers TTX (0.3μM) and Cd(2+) (0.2mM), respectively. In addition, the Na(+)-K(+)-Cl(-) cotransporter type 1 antagonist bumetanide (10μM) also inhibited propofol evoked increase in sEPSC frequency. These results suggest that propofol evoked glutamate release onto NTS neurons by GABA(A) receptor-mediated depolarization of the presynaptic excitatory terminals.

  10. Influence of obesity on propofol pharmacokinetics : derivation of a pharmacokinetic model

    NARCIS (Netherlands)

    Cortinez, L. I.; Anderson, B. J.; Penna, A.; Olivares, L.; Munoz, H. R.; Holford, N. H. G.; Struys, M. M. R. F.; Sepulveda, P.

    2010-01-01

    The objective of this study was to develop a pharmacokinetic (PK) model to characterize the influence of obesity on propofol PK parameters. Nineteen obese ASA II patients undergoing bariatric surgery were studied. Patients received propofol 2 mg kg(-1) bolus dose followed by a 5-20-40-120 min, 10-8-

  11. Inhibition of bacterial growth by different mixtures of propofol and thiopentone

    Directory of Open Access Journals (Sweden)

    K.E. Joubert

    2005-06-01

    Full Text Available Propofol is, as a result of its formulation, an ideal bacterial and yeast culture medium. An outbreak of sepsis in humans and an increase in wound infections in dogs has been ascribed to the use of propofol. It has been previously reported that a 1:1 mixture of propofol and thiopentone has bactericidal properties. This study was undertaken to determine if further serial mixtures of propofol and thiopentone maintained the bactericidal properties. Mixtures of 1:1 (solution A, 5:1 (solution B, 10:1 (solution C, 50:1 (solution D and 100:1 (solution E of 1 % propofol to 2.5 % thiopentone, 2.5 % thiopentone (solution T, 1 % propofol (solution P and saline (solution S were prepared and inoculated with between 105 and 106 colony-forming units of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Candida albicans. A sample was withdrawn from each solution at 0, 1, 6, 12, 48 and 120 hours after inoculation and a bacterial count was performed. This study showed that thiopentone and solution A behaved in similar fashion by inhibiting bacterial growth and was bactericidal after 48 hours. Solution B was not bactericidal against S. aureus and C. albicans. Propofol and solutions D and E all supported growth of all the organisms tested. These data indicate that mixtures of propofol and thiopentone at a ratio less than 1:1 do not maintain the bactericidal properties.

  12. A propofol binding site on mammalian GABAA receptors identified by photolabeling

    Science.gov (United States)

    Yip, Grace M S; Chen, Zi-Wei; Edge, Christopher J; Smith, Edward H; Dickinson, Robert; Hohenester, Erhard; Townsend, R Reid; Fuchs, Karoline; Sieghart, Werner; Evers, Alex S; Franks, Nicholas P

    2014-01-01

    Propofol is the most important intravenous general anesthetic in current clinical use. It acts by potentiating GABAA receptors, but where it binds to this receptor is not known and has been a matter of some controversy. We have synthesized a novel propofol analogue photolabeling reagent that has a biological activity very similar to that of propofol. We confirmed that this reagent labeled known propofol binding sites in human serum albumin which have been identified using X-ray crystallography. Using a combination of the protiated label and a deuterated version, and mammalian receptors labeled in intact membranes, we have identified a novel binding site for propofol in GABAA receptors consisting of both β3 homopentamers and α1β3 heteropentamers. The binding site is located within the β subunit, at the interface between the transmembrane domains and the extracellular domain, and lies close to known determinants of anesthetic sensitivity in transmembrane segments TM1 and TM2. PMID:24056400

  13. Potentiating action of propofol at GABAA receptors of retinal bipolar cells

    DEFF Research Database (Denmark)

    Yue, Lan; Xie, An; Bruzik, Karol S

    2011-01-01

    Purpose. Propofol (2,6-diisopropyl phenol), a widely used systemic anesthetic, is known to potentiate GABA(A) receptor activity in a number of CNS neurons and to produce changes in electroretinographically recorded responses of the retina. However, little is known about propofol's effects...... on specific retinal neurons. The authors investigated the action of propofol on GABA-elicited membrane current responses of retinal bipolar cells, which have both GABA(A) and GABA(C) receptors. Methods. Single, enzymatically dissociated bipolar cells obtained from rat retina were treated with propofol...... delivered by brief application in combination with GABA or other pharmacologic agents or as a component of the superfusing medium. Results. When applied with GABA at subsaturating concentrations and with TPMPA (a known GABA(C) antagonist), propofol markedly increased the peak amplitude and altered...

  14. Propofol for pediatric colonoscopy: the experience of a large, tertiary care pediatric hospital.

    Science.gov (United States)

    Cohen, Shlomi; Glatstein, Miguel M; Scolnik, Dennis; Rom, Liat; Yaron, Ayala; Otremski, Sorina; Ben-Tov, Amir; Reif, Shimon

    2014-01-01

    Successful colonoscopy includes full visualization of the terminal ileum, especially in inflammatory bowel disease when ileal biopsy is essential. In children, higher levels of anxiety and lack of cooperation often necessitate a deeper level of sedation. The aim of this study was to evaluate the effectiveness of propofol compared with midazolam and fentanyl for colonoscopy, and in accomplishing ileal and cecal intubation in particular. This was a retrospective cohort study comparing the rates of successful colonoscopy in patients receiving propofol with those receiving midazolam/fentanyl. Complete, successful, colonoscopy to the terminal ileum was achieved in 78% of propofol patients compared with 66% of the midazolam/fentanyl group (P=0.004). Endoscopy reaching the cecum, but not the terminal ileum, was achieved in 78% of propofol patients and 66% of midazolam/fentanyl patients. The use of propofol was associated with a statistically significant increase in the rate of successful colonoscopy reaching the terminal ileum.

  15. Combined sedation with midazolam/propofol for gastrointestinal endoscopy in elderly patients

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    Schlief Hans-Eugen

    2010-01-01

    Full Text Available Abstract Background Although gastrointestinal endoscopy with sedation is increasingly performed in elderly patients, data on combined sedation with midazolam/propofol are very limited for this age group. Methods We retrospectively analyzed 454 endoscopic procedures in 347 hospitalized patients ≥ 70 years who had received combined sedation with midazolam/propofol. 513 endoscopic procedures in 397 hospitalized patients Results Elderly patients had a higher level of co-morbidity and needed lower mean propofol doses for sedation. We observed no major complication and no difference in the number of minor complications. The procedure-associated mortality was 0%; the 28-day mortality was significantly higher in the elderly (2.9% vs. 1.0%. Conclusions In this study on elderly patients with high level co-morbidity, a favourable safety profile was observed for a combined sedation with midazolam/propofol with a higher sensitivity to propofol in the elderly.

  16. Propofol inhibits inflammation and lipid peroxidation following cerebral ischemia/ reperfusion in rabbits

    Institute of Scientific and Technical Information of China (English)

    Xiaodong Wei; Xing Wan; Bo Zhao; Jiabao Hou; Min Liu; Bangchang Cheng

    2012-01-01

    The present study established a rabbit model of global cerebral ischemia using the ‘six-vessel' method, which was reperfused after 30 minutes of ischemia. Rabbits received intravenous injection of propofol at 5 mg/kg prior to ischemia and 20 mg/kg per hour after ischemia until samples were prepared. Results revealed that propofol inhibited serum interleukin-8, endothelin-1 and malondialdehyde increases and promoted plasma superoxide dismutase activity after cerebral ischemia/reperfusion. In addition, cerebral cortex edema was attenuated with little neuronal nuclear degeneration and pyknosis with propofol treatment. The cross-sectional area of neuronal nuclei was, however, increased following propofol treatment. These findings suggested that propofol could improve anti-oxidant activity and inhibit synthesis of inflammatory factors to exert a protective effect on cerebral ischemia/reperfusion injury.

  17. Propofol promotes spinal cord injury repair by bone marrow mesenchymal stem cell transplantation

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    Ya-jing Zhou

    2015-01-01

    Full Text Available Propofol is a neuroprotective anesthetic. Whether propofol can promote spinal cord injury repair by bone marrow mesenchymal stem cells remains poorly understood. We used rats to investigate spinal cord injury repair using bone marrow mesenchymal stem cell transplantation combined with propofol administration via the tail vein. Rat spinal cord injury was clearly alleviated; a large number of newborn non-myelinated and myelinated nerve fibers appeared in the spinal cord, the numbers of CM-Dil-labeled bone marrow mesenchymal stem cells and fluorogold-labeled nerve fibers were increased and hindlimb motor function of spinal cord-injured rats was markedly improved. These improvements were more prominent in rats subjected to bone marrow mesenchymal cell transplantation combined with propofol administration than in rats receiving monotherapy. These results indicate that propofol can enhance the therapeutic effects of bone marrow mesenchymal stem cell transplantation on spinal cord injury in rats.

  18. Propofol promotes spinal cord injury repair by bone marrow mesenchymal stem cell transplantation

    Institute of Scientific and Technical Information of China (English)

    Ya-jing Zhou; Jian-min Liu; Shu-ming Wei; Yun-hao Zhang; Zhen-hua Qu; Shu-bo Chen

    2015-01-01

    Propofol is a neuroprotective anesthetic. Whether propofol can promote spinal cord injury repair by bone marrow mesenchymal stem cells remains poorly understood. We used rats to investigate spinal cord injury repair using bone marrow mesenchymal stem cell transplantation combined with propofol administrationvia the tail vein. Rat spinal cord injury was clearly alleviated; a large number of newborn non-myelinated and myelinated nerve ifbers appeared in the spinal cord, the numbers of CM-Dil-labeled bone marrow mesenchymal stem cells and lfuorogold-labeled nerve ifbers were increased and hindlimb motor function of spinal cord-injured rats was mark-edly improved. These improvements were more prominent in rats subjected to bone marrow mesenchymal cell transplantation combined with propofol administration than in rats receiving monotherapy. These results indicate that propofol can enhance the therapeutic effects of bone marrow mesenchymal stem cell transplantation on spinal cord injury in rats.

  19. Use of propofol infusion in alcohol withdrawal-induced refractory delirium tremens

    DEFF Research Database (Denmark)

    Lorentzen, Kristian; Lauritsen, Anne Øberg; Bendtsen, Asger Ole

    2014-01-01

    INTRODUCTION: Delirium tremens is a potentially fatal complication of alcohol withdrawal. In severe delirium, very large dosages of benzodiazepines can be required and in refractory cases, sedation with propofol can be used. Treatment of refractory delirium tremens with propofol is mainly described...... in case reports. We aimed to evaluate the treatment of delirium tremens with propofol infusion for 48 h. MATERIAL AND METHODS: This study was a single-centre retrospective cohort analysis of 15 patient journals covering the period from May 2012 to September 2013. RESULTS: Five women and ten men were......, displaying symptoms of prolonged sedation. Twelve of the 15 patients treated for delirium tremens with propofol for 48 h were successfully treated. Three patients needed further treatment. CONCLUSION: Our study suggests that treatment with propofol is viable. Establishing indication, dose, duration, and long...

  20. EFEITO ANALGÉSICO DO BUTORFANOL NA DOR SOMÁTICA EM GATOS ANESTESIADOS COM PROPOFOL ANALGESIC EFFECT OF BUTORPHANOL ON SOMATIC PAIN IN CATS ANESTHETIZED WITH PROPOFOL

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    Isabela Ciniello Araujo

    2001-02-01

    Full Text Available O propofol é um agente anestésico intravenoso usado para indução e manutenção da anestesia, mas produz analgesia limitada, havendo a necessidade do uso concomitante de analgésicos. Avaliou-se o efeito analgésico do butorfanol na dor somática em gatos anestesiados com doses fracionadas de propofol. Foram utilizados 16 animais, distribuídos aleatoriamente em dois grupos. Os animais do grupo controle foram pré-tratados com 0,2mg/kg de acepromazina por via IM e, após 15 minutos, receberam 6mg/kg de propofol por via IV. Os animais do grupo tratamento foram pré-medicados com uma combinação de acepromazina (0,2mg/kg e butorfanol (0,8mg/kg, administrados na mesma seringa por via IM, e, após 15 minutos, receberam 6mg/kg de propofol por via IV. Em ambos os grupos, a manutenção da anestesia foi feita com administrações de propofol, na dose de 3mg/kg, por via IV, sempre que necessário, durante 60 minutos. A necessidade de readministração de propofol foi verificada pela resposta apresentada ao pinçamento cutâneo, através de uma pinça de Kocher. Avaliaram-se também as freqüências cardíaca e respiratória, pressão arterial média, saturação de oxiemoglobina e temperatura retal. A administração de butorfanol causou apenas redução nas freqüências cardíaca e respiratória e na saturação de oxiemoglobina, em comparação com o grupo controle,sem exercer influência significativa sobre o período hábil, a dose total administrada e o período de recuperação do propofol. Concluiu-se que a adição de butorfanol não produziu analgesia somática em gatos anestesiados com doses fracionadas de propofol.Propofol is an intravenous anesthetic agent used for induction and maintenance of anesthesia but produces limited analgesia, and concomitant use of analgesics is necessary. The analgesic effect of butorphanol in somatic pain in cats anesthetized with intermittent doses of propofol was evaluated. Sixteen animals were randomly

  1. PROPOFOL: A REVIEW OF ITS ROLE IN PEDIATRIC ANESTHESIA AND SEDATION

    Science.gov (United States)

    Chidambaran, Vidya; Costandi, Andrew; D’Mello, Ajay

    2015-01-01

    Propofol is an intravenous agent used commonly for induction and maintenance of anesthesia, procedural and critical care sedation in children. The mechanisms of action on the central nervous system involve interactions at various neurotransmitter receptors, especially gamma-aminobutyric acid A receptor. Approved for use in the United States by the Federal Drugs and Administration (FDA) in 1989, its use for induction of anesthesia in children less than 3 years of age still remains off-label. Despite its wide use in pediatric anesthesia, there is conflicting literature about its safety and serious adverse effects in particular subsets of children. Particularly as children are not “little adults”, in this review, we emphasize the maturational aspects of propofol pharmacokinetics. Despite the myriad of propofol pharmacokinetic-pharmacodynamic studies and the ability to use allometrical scaling to smooth out differences due to size and age, there is no optimal model that can be used in target controlled infusion pumps for providing closed loop total intravenous anesthesia in children. As the commercial formulation of propofol is a nutrient-rich emulsion, the risk for bacterial contamination exist despite the FDA mandating addition of antimicrobial preservative, calling for manufacturers’ directions to discard open vials after six hours. While propofol has advantages over inhalation anesthesia like less postoperative nausea and emergence delirium in children, pain on injection remains a problem even with newer formulations. Propofol is known to depress mitochondrial function by its action as an uncoupling agent in oxidative phosphorylation. This has implications for children with mitochondrial diseases and the occurrence of propofol-related infusion syndrome, a rare but seriously life-threatening complication of propofol. At the time of this review, there is no direct evidence in humans for propofol induced neurotoxicity to the infant brain; however, current

  2. Propofol: a review of its role in pediatric anesthesia and sedation.

    Science.gov (United States)

    Chidambaran, Vidya; Costandi, Andrew; D'Mello, Ajay

    2015-07-01

    Propofol is an intravenous agent used commonly for the induction and maintenance of anesthesia, procedural, and critical care sedation in children. The mechanisms of action on the central nervous system involve interactions at various neurotransmitter receptors, especially the gamma-aminobutyric acid A receptor. Approved for use in the USA by the Food and Drug Administration in 1989, its use for induction of anesthesia in children less than 3 years of age still remains off-label. Despite its wide use in pediatric anesthesia, there is conflicting literature about its safety and serious adverse effects in particular subsets of children. Particularly as children are not "little adults", in this review, we emphasize the maturational aspects of propofol pharmacokinetics. Despite the myriad of propofol pharmacokinetic-pharmacodynamic studies and the ability to use allometrical scaling to smooth out differences due to size and age, there is no optimal model that can be used in target controlled infusion pumps for providing closed loop total intravenous anesthesia in children. As the commercial formulation of propofol is a nutrient-rich emulsion, the risk for bacterial contamination exists despite the Food and Drug Administration mandating addition of antimicrobial preservative, calling for manufacturers' directions to discard open vials after 6 h. While propofol has advantages over inhalation anesthesia such as less postoperative nausea and emergence delirium in children, pain on injection remains a problem even with newer formulations. Propofol is known to depress mitochondrial function by its action as an uncoupling agent in oxidative phosphorylation. This has implications for children with mitochondrial diseases and the occurrence of propofol-related infusion syndrome, a rare but seriously life-threatening complication of propofol. At the time of this review, there is no direct evidence in humans for propofol-induced neurotoxicity to the infant brain; however

  3. Effects of combined midazolam and propofol in anesthesia induction and recovery of cats undergoing ovariohisterectomy

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    Diogo Gorayeb de Castro

    2015-12-01

    Full Text Available The objective of this study was to determine the effects of propofol and midazolam on induction of anesthesia in cats undergoing ovariohysterectomy, measured in terms of the quality of tracheal intubation, anesthesia induction, cardiorespiratory effects, and recuperation period. Thirty healthy adult cats were pretreated with acepromazine and morphine. After 30 min, they were divided into three groups: PG (n = 10, in which induction was performed with only intravenous propofol at doses required for intubation; MPG (n = 8, in which animals received intravenous midazolam (0.3 mg kg-1 administered over 30 s, followed by administration of propofol as in PG; and PMG (n = 9, in which propofol was first administered at a rate of 4 mg kg-1 min-1, after which midazolam was administered (0.3 mg/kg, followed by re-administration of propofol. In order to perform a blinded study, the PG and PMG received a 0.9% NaCl solution volume similar to the midazolam dose before induction (0.06 mL/kg. Similar to the other groups, the PG and MPG received (0.06 mL kg-1 saline 30 s after administration of propofol. In order to mimic the administration of midazolam, the saline solution was administered for 30s. The PG received 11.0 ± 1.38 mg kg-1 propofol, a greater dose than that administered to the PMG (p < 0.001 and MPG (p < 0.01, which received 7.9 ± 1.92 and 9.1 ± 2.20 mg kg-1, respectively. There were no differences in the intubation scores between groups. Previous use of midazolam did not affect agitation or excitement in cats; both sequences of propofol-midazolam administration are feasible, but the propofol-midazolam sequence was superior due to the lower propofol dose.

  4. The use of dexmedetomidine combined with propofol in mechanically ventilated patients

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    Zi-long HU

    2015-07-01

    Full Text Available Objective To estimate and compare the efficacy and safety of midazolam, propofol and dexmedetomidine combined with propofol in sedation for mechanically ventilated patients. Methods Seventy-six patients with mechanical ventilation time >24h in ICU of Navy General Hospital of PLA from Mar. 2012 to Sep. 2014 were randomly divided into midazolam group (n=23, propofol group (n=27 and dexmedetomidine combined with propofol group (n=26, and they were given corresponding drugs for sedation. The proportions in each group which reached the target score of Richmond agitation-sedation scale (RASS and the nonverbal pain assessment scale (Critical-Care Pain Observation Tool, CPOT were accounted and recorded, and the positive rate of delirium was assessed with the confusion assessment method in the intensive care unit (CAM-ICU. The mechanical ventilation time and the effectiveness of sedation among the 3 groups were compared, the frequency of adverse cardiovascular events was recorded, and the frequency of controlled ventilation, daily mean arterial pressure as well as the heart rate range were analyzed. Results The proportion of reaching the target score of RASS was higher in dexmedetomidine combined with propofol group (86.54% than that in midazolam group (69.32%, P0.05. The proportion of reaching the target score of CPOT was higher in dexmedetomidine combined with propofol group (63.1% than in midazolam group (51.2% and propofol group (49.5%, P0.05. The positive rate of delirium and the proportion of controlled ventilation were lower, and the time of mechanical ventilation is shorter in dexmedetomidine combined with propofol group than in the other two groups (P0.05. Conclusion The efficacy and safety of dexmedetomidine combined with propofol is higher than the individual use of midazolam or propofol in producing sedation for mechanically ventilated patients. DOI: 10.11855/j.issn.0577-7402.2015.06.12

  5. Propofol-induced relaxation of rat aorta is altered by aging.

    Science.gov (United States)

    Sakai, Yoko; Kawahito, Shinji; Takaishi, Kazumi; Mita, Naoji; Kinoshita, Hiroyuki; Hatakeyama, Noboru; Azma, Toshiharu; Nakaya, Yutaka; Kitahata, Hiroshi

    2014-01-01

    Propofol causes vasodilation via endothelium-dependent and -independent mechanisms. Because endothelial function is impaired with aging, the effects of propofol on endothelium-dependent vasodilation might be altered by aging. The aim of this study was thus to determine the effects of aging on vascular responses to propofol. Young (4-6 weeks old) or adult (16-25 weeks old) rats were anesthetized with sevoflurane. The thoracic aorta was dissected and cut into pieces 3-4 mm in length. In some rings, the endothelium was deliberately removed. The ring segment of the aorta was mounted for isometric force recording at a resting tension of 0.5-1.0 g in a 2 ml organ bath, containing Krebs-Ringer bicarbonate buffer. Arteries were precontracted with phenylephrine, and the function of endothelium was confirmed with acetylcholine. Then, we studied the concentration-dependent effects of propofol in endothelium-intact (control group) and -denuded aortic rings (denuded group), as well as those treated with N(ω)-nitro-L-arginine methylester (L-NAME group). Relaxation due to propofol was observed in the control groups of both young and adult rats in a concentration-dependent manner, but the magnitude of relaxation was significantly greater in young rats. In addition, in young rats, relaxation due to propofol was significantly and equally reduced in both L-NAME and denuded groups at all propofol concentrations that we studied (10(-6)-10(-3) M). In adult rats, relaxation due to propofol was quite similar between control and L-NAME groups at all propofol concentrations, whereas it was significantly reduced in the denuded group. These results suggest that endothelium-derived nitric oxide plays an important role in propofol-induced vasodilation in young rats, but not in adult rats.

  6. Efficacy of sevoflurane as an adjuvant to propofol-based total intravenous anesthesia for attenuating secretions in ocular surgery.

    Science.gov (United States)

    Lai, Hou-Chuan; Chang, Yun-Hsiang; Huang, Ren-Chih; Hung, Nan-Kai; Lu, Chueng-He; Chen, Jou-Hsiu; Wu, Zhi-Fu

    2017-04-01

    The incidence of nasal secretions into the operative field is as high as 5% in ophthalmic surgery under general anesthesia. It may induce postoperative endophthalmitis. Secretions under propofol-based total intravanous anesthesia (TIVA) are greater than sevoflurane anesthesia during surgery. Postoperative nausea and vomiting (PONV) after inhalational anesthesia is higher than TIVA and may increase intraocluar pressure. We investigated the effect of sevoflurane combination with propofol-based TIVA on nasopharyngeal secretions and PONV in ocular surgery. Fifty patients undergoing ocular operations were randomly assigned for propofol-based TIVA or propofol/sevoflurane anesthesia. In the TIVA group (n = 25), anesthesia was induced and maintained with propofol and fentanyl; in the propofol/sevoflurane group (n = 25), 1% sevoflurane anesthesia was added. Nasopharyngeal excretion volume was significantly higher in the propofol-based TIVA group than in the propofol/sevoflurane group (31.0 ± 18.1 vs 13.7 ± 12.6 ml; P propofol-based TIVA: 6.4 ± 3.6 vs propofol/sevoflurane: 7.4 ± 3.0 minutes; P = .34). No postoperative endophthalmitis or PONV in both groups was observed. Sevoflurane attenuated secretions under propofol-based TIVA and did not increase the incidence of PONV or prolonged extubation in ocular surgery.

  7. Clinical and histologic effects of intracardiac administration of propofol for induction of anesthesia in ball pythons (Python regius).

    Science.gov (United States)

    McFadden, Michael S; Bennett, R Avery; Reavill, Drury R; Ragetly, Guillaume R; Clark-Price, Stuart C

    2011-09-15

    To assess the clinical differences between induction of anesthesia in ball pythons with intracardiac administration of propofol and induction with isoflurane in oxygen and to assess the histologic findings over time in hearts following intracardiac administration of propofol. Prospective randomized study. 30 hatchling ball pythons (Python regius). Anesthesia was induced with intracardiac administration of propofol (10 mg/kg [4.5 mg/lb]) in 18 ball pythons and with 5% isoflurane in oxygen in 12 ball pythons. Induction time, time of anesthesia, and recovery time were recorded. Hearts from snakes receiving intracardiac administration of propofol were evaluated histologically 3, 7, 14, 30, and 60 days following propofol administration. Induction time with intracardiac administration of propofol was significantly shorter than induction time with 5% isoflurane in oxygen. No significant differences were found in total anesthesia time. Recovery following intracardiac administration of propofol was significantly longer than recovery following induction of anesthesia with isoflurane in oxygen. Heart tissue evaluated histologically at 3, 7, and 14 days following intracardiac administration of propofol had mild inflammatory changes, and no histopathologic lesions were seen 30 and 60 days following propofol administration. Intracardiac injection of propofol in snakes is safe and provides a rapid induction of anesthesia but leads to prolonged recovery, compared with that following induction with isoflurane. Histopathologic lesions in heart tissues following intracardiac injection of propofol were mild and resolved after 14 days.

  8. Las reformas electorales en perspectiva comparada en América Latina

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    Jesús Orozco Henríquez

    2010-01-01

    Full Text Available Analiza los avances en relación con la reforma política y electoral que se ha dado en Latinoamérica, para fortalecer la institucionalidad democrática en diferentes países. Destaca que muchas de estas reformas no han dado los resultados esperados debido a dos factores: muchas se han realizado de manera coyuntural y en muchos casos no ha existido un compromiso verdadero con las mismas.

  9. Propofol Shares the Binding Site with Isoflurane and Sevoflurane on Leukocyte Function-Associated Antigen-1

    Science.gov (United States)

    Yuki, Koichi; Bu, Weiming; Xi, Jin; Shimaoka, Motomu; Eckenhoff, Roderic

    2013-01-01

    Background We previously demonstrated that propofol interacted with the leukocyte adhesion molecule leukocyte function–associated antigen-1 (LFA-1) and inhibited the production of interleukin-2 via LFA-1 in a dependent manner. However, the binding site(s) of propofol on LFA-1 remains unknown. Methods First, the inhibition of LFA-1's ligand binding by propofol was confirmed in an ELISA-type assay. The binding site of propofol on LFA-1 was probed with a photolabeling experiment using a photoactivatable propofol analog called azi-propofol-m. The adducted residues of LFA-1 by this compound were determined using liquid chromatography–mass spectrometry. In addition, the binding of propofol to the ligand-binding domain of LFA-1 was examined using 1-aminoanthracene (1-AMA) displacement assay. Furthermore, the binding site(s) of 1-AMA and propofol on LFA-1 was studied using the docking program GLIDE. Results We demonstrated that propofol impaired the binding of LFA-1 to its ligand intercellular adhesion molecule-1. The photolabeling experiment demonstrated that the adducted residues were localized in the allosteric cavity of the ligand-binding domain of LFA-1 called “lovastatin site. ” The shift of fluorescence spectra was observed when 1-AMA was coincubated with the low-affinity conformer of LFA-1 ligand-binding domain (wild-type [WT] αL I domain), not with the high-affinity conformer, suggesting that 1-AMA bound only to WT αL I domain. In the 1-AMA displacement assay, propofol decreased 1-AMA fluorescence signal (at 520 nm), suggesting that propofol competed with 1-AMA and bound to the WT αL I domain. The docking simulation demonstrated that both 1-AMA and propofol bound to the lovastatin site, which agreed with the photolabeling experiment. Conclusions We demonstrated that propofol bound to the lovastatin site in LFA-1. Previously we showed that the volatile anesthetics isoflurane and sevoflurane bound to this site. Taken together, the lovastatin site is an

  10. Leaving More Than Your Fingerprint on the Intravenous Line: A Prospective Study on Propofol Anesthesia and Implications of Stopcock Contamination

    Science.gov (United States)

    Cole, Devon C.; Baslanti, Tezcan Ozrazgat; Gravenstein, Nikolaus L.; Gravenstein, Nikolaus

    2013-01-01

    Introduction Acute care handling of IV stopcocks during anesthesia and surgery may result in contaminated IV tubing sets. In the context of widespread propofol use, a nutrient-rich hypnotic drug, we hypothesized that propofol anesthesia increases bacterial contamination of IV stopcocks and may compromise safety of IV tubing sets when continued to be used after propofol anesthesia. Methods We conducted an in vitro trial by collecting IV tubing sets at the time of patient discharge from same-day ambulatory procedures performed with and without propofol anesthesia. These extension sets were then held at room temperature for 6, 24, or 48 hours. We cultured 50 samples at each interval for both cohorts. Quantitative cultures were done by aspirating the IV stopcock dead space and plating the aspirate on blood agar for colony count and speciation. Results Positive bacterial counts were recovered from 17.3% of propofol anesthesia stopcocks (26/150) and 18.6% of non-propofol stopcocks (28/150). At 6 hours, the average bacterial counts from stopcocks with visible residual propofol was 44 colony forming units (CFU)/mL, compared to 41 CFU/mL with no visible residual propofol and 37 CFU/mL in non-propofol anesthesia stopcocks. There was a 100-fold increase in bacterial number in contaminated stopcock dead spaces at 48 hours after propofol anesthesia. This difference remained significant when comparing positive counts from stopcocks with no visible residual propofol and non-propofol anesthesia (p-value=0.034). Conclusion There is a covert incidence and degree of IV stopcock bacterial contamination during anesthesia which is aggravated by propofol anesthetic. Propofol anesthesia may increase risk for postoperative infection because of bacterial growth in IV stopcock dead spaces. PMID:23749446

  11. Comparison of propofol and ketofol in minor gynecologic interventions

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    Yasemin Işık

    2015-09-01

    Full Text Available Objective: Outpatient anesthesia requires a safe anesthetic method and an anesthetic agent that provides a rapid anesthesia depth and hemodynamic stability. To provide an uneventfully recovery, the anesthetic must also be rapidly metabolized, and its metabolites should not accumulate in the body. This study compared sedo-analgesia effects, recovery times, postoperative complications, Modified Aldrete Scale, Visual Analog Scores, and patient and surgeon satisfaction between propofol and ketofol, administered as anesthetics during the probe curettage procedure. Methods: A total of 60 female patients included in the study. Group P was administered 2 mg/kg of propofol and a 1 μg/kg intravenous bolus of fentanyl for induction and 100 μg/kg/min of propofol for maintenance. Group K was administered a 600 µg/kg IV bolus of ketofol for induction and 100 µg/kg/min of ketofol for maintenance. Additional fentanyl (50 µg was administered to Group P, and 25 µg/kg/min of ketofol was administered to Group K according to autonomic and hemodynamic responses. Results: Demographic data of the 2 groups were similar. A significant decrease in hemodynamic values was detected in patients in Group P after induction. No change in these values was detected during or after induction in Group K. The additional analgesia requirement was 66.6% in Group P. Nausea was detected in 2 patients in Group K. Additionally, hallucination was detected in 2 patients in Group K. Patient and surgeon satisfaction were complete in both groups. Conclusion: According to our findings, ketofol anesthesia may be a good option in uterine curettage, patients recover quickly and comfortably, and ketofol both provides sufficient analgesia for the minor surgical intervention and reduces complications. J Clin Exp Invest 2015; 6 (3: 244-249

  12. Antioxidative effect of propofol during cardiopulmonary bypass in adults

    Institute of Scientific and Technical Information of China (English)

    Shi-hai ZHANG; Shou-yong WANG; Shang-long YAO

    2004-01-01

    AIM: To investigate the antioxidative potential of propofol (an intravenous anesthetic with a chemical structure similar to phenol-based free radical scavengers such as vitamin E) during cardiopulmonary bypass (CPB). METHODS:Thirty adult patients referred for elective cardiac procedure with CPB were included and randomly allocated to a nously for anesthesia maintenance, whereas those allocated to the control group received fentanyl 10 μg/kg intravenously and inhaled enflurane (1%-1.5 %). Blood samples were collected at 7 time points: before the start of CPB,at 30 and 60 min of CPB, at the conclusion of CPB, 10 min after the administration of protamine, and 12 and 24 h after the cessation of CPB. Plasma levels of free F2-isoprostanes (sensitive markers of free radicals production)and complement C5a were determined by mass-spectrometric assay and enzyme immunoassay, respectively. Neutrophil adhesion to endothelial cells was observed at x200 magnification under a light microscope. RESULTS:Levels of F2-isoprostanes, complement C5a and neutrophil adhesion rate increased significantly during and after CPB in both groups. There were significantly higher levels of F2-isoprostanes, C5a, and more neutrophils adhering to endothelial cells in the control group than those in the propofol group, respectively. CONCLUSION: Cardiopulmonary bypass is associated with a great production of damaging free radicals. Propofol may be beneficial both as an anesthetic and as a potent free radical scavenger in patients presenting pathologies associated with free radical reactions during CPB.

  13. Inversion-based propofol dosing for intravenous induction of hypnosis

    Science.gov (United States)

    Padula, F.; Ionescu, C.; Latronico, N.; Paltenghi, M.; Visioli, A.; Vivacqua, G.

    2016-10-01

    In this paper we propose an inversion-based methodology for the computation of a feedforward action for the propofol intravenous administration during the induction of hypnosis in general anesthesia. In particular, the typical initial bolus is substituted with a command signal that is obtained by predefining a desired output and by applying an input-output inversion procedure. The robustness of the method has been tested by considering a set of patients with different model parameters, which is representative of a large population.

  14. Pasado, presente y futuro de la enseñanza de la Educación Comparada en España

    Directory of Open Access Journals (Sweden)

    Luis Mª Naya

    2009-01-01

    Full Text Available El año 2008 celebramos el cuadragésimo aniversario de la incorporación de la Educación Comparada como materia a los estudios universitarios reglados en España. Este aniversario nos da una inmejorable excusa para hacer un breve recorrido por lo ocurrido a lo largo de estos cuatro decenios en este campo. El texto está estructurado en tres apartados, en el primero se desarrollan los difíciles primeros pasos que tuvieron que dar aquellos que comenzaron el camino, allá por los años 60; en el segundo se presenta el panorama actual, que podemos resumir con una presencia obligatoria en todas las facultades donde se imparte la licenciatura en Pedagogía; finalmente, hacemos una serie de reflexiones sobre lo que puede ser su futuro incierto.During 2008 we celebrate the fortieth anniversary of the incorporation of Comparative Education as a subject in university studies regulated in Spain. This anniversary offers us an excellent excuse to make a brief expedition of what has happened over these four decades in this field.The text is divided into three sections: the first developes the initial difficult steps of those who began the trajectory in the seventies. In the second part, the current scene is presented. We can summarize with a compulsory presence in all the universities where is imparted a degree in Pedagogy. Finally, we make a series of reflections on what may be its uncertain future.

  15. Anesthetic Propofol Overdose Causes Vascular Hyperpermeability by Reducing Endothelial Glycocalyx and ATP Production

    Science.gov (United States)

    Lin, Ming-Chung; Lin, Chiou-Feng; Li, Chien-Feng; Sun, Ding-Ping; Wang, Li-Yun; Hsing, Chung-Hsi

    2015-01-01

    Prolonged treatment with a large dose of propofol may cause diffuse cellular cytotoxicity; however, the detailed underlying mechanism remains unclear, particularly in vascular endothelial cells. Previous studies showed that a propofol overdose induces endothelial injury and vascular barrier dysfunction. Regarding the important role of endothelial glycocalyx on the maintenance of vascular barrier integrity, we therefore hypothesized that a propofol overdose-induced endothelial barrier dysfunction is caused by impaired endothelial glycocalyx. In vivo, we intraperitoneally injected ICR mice with overdosed propofol, and the results showed that a propofol overdose significantly induced systemic vascular hyperpermeability and reduced the expression of endothelial glycocalyx, syndecan-1, syndecan-4, perlecan mRNA and heparan sulfate (HS) in the vessels of multiple organs. In vitro, a propofol overdose reduced the expression of syndecan-1, syndecan-4, perlecan, glypican-1 mRNA and HS and induced significant decreases in the nicotinamide adenine dinucleotide (NAD+)/NADH ratio and ATP concentrations in human microvascular endothelial cells (HMEC-1). Oligomycin treatment also induced significant decreases in the NAD+/NADH ratio, in ATP concentrations and in syndecan-4, perlecan and glypican-1 mRNA expression in HMEC-1 cells. These results demonstrate that a propofol overdose induces a partially ATP-dependent reduction of endothelial glycocalyx expression and consequently leads to vascular hyperpermeability due to the loss of endothelial barrier functions. PMID:26023717

  16. Emergency Procedural Sedation With Propofol in Older Teenagers: Any Cause for Concern?

    Science.gov (United States)

    Campbell, Samuel G; MacPhee, Shannon; Butler, Michael; Zed, Peter J; Froese, Patrick; Watson, Mary-Lynn; MacKinley, Robert

    2015-11-01

    Propofol is a standard for adult emergency department procedural sedation (EDPS). Use in pediatric patients remains controversial. Our primary objective was to investigate whether adverse events occurred more frequently in teenage pediatric patients receiving propofol for EDPS. This retrospective study examines records from the Halifax Procedural Sedation Registry, collected between January 1, 2006 and May 31, 2013. Patients undergoing EDPS using propofol were divided into those aged 16 to 19 years (teenagers), 20 to 65 years (adults), and older than 65 years (seniors). The primary outcomes were the incidences of hypotension and hypoxia. Four thousand sixty-three EDPSs were included in the analysis, of which 230 involved teenagers, 2853 adults (mean age, 43.0 years), and 980 seniors (mean age, 77.1). The teenage group was significantly less likely to develop hypotension or hypoxia. These differences were confirmed on multivariate analysis. Patients in the teenage group received higher doses of propofol per kilogram/minute than the other groups. No other differences met statistical significance. Teenage patients receiving EDPS with propofol had a lower incidence of adverse events, and both received and tolerated larger adjusted doses of medication than older patients. Satisfaction and duration of EDPS were similar. Concerns about propofol use in younger patients have not been supported by this study. We believe that these findings support the use of propofol for EDPS in older teenagers.

  17. Pediatric palliative sedation therapy with propofol: recommendations based on experience in children with terminal cancer.

    Science.gov (United States)

    Anghelescu, Doralina L; Hamilton, Hunter; Faughnan, Lane G; Johnson, Liza-Marie; Baker, Justin N

    2012-10-01

    The use of propofol for palliative sedation of children is not well documented. Here we describe our experience with the use of propofol palliative sedation therapy (PST) to alleviate intractable end-of-life suffering in three pediatric oncology patients, and propose an algorithm for the selection of such candidates for PST. We identified inpatients who had received propofol PST within 20 days of death at our institution between 2003 and 2010. Their medical records were reviewed for indicators of pain, suffering, and sedation from 48 hours before PST to the time of death. We also tabulated consumption of opioids and other symptom management medications, pain scores, and adverse events of propofol, and reviewed clinical notes for descriptors of suffering and/or palliation. Three of 192 (1.6%) inpatients (aged 6-15 years) received propofol PST at the end of life. Consumption of opioids and other supportive medications decreased during PST in two cases. In the third case, pain scores remained high and sedation was the only effective comfort measure. Clinical notes suggested improved comfort and rest in all patients. Propofol infusions were continued until the time of death. Our experience demonstrates that propofol PST is a useful palliative option for pediatric patients experiencing intractable suffering at the end of life. We describe an algorithm that can be used to identify such children who are candidates for PST.

  18. A double blind randomized trial of ketofol versus propofol for endodontic treatment of anxious pediatric patients.

    Science.gov (United States)

    Mittal, N; Goyal, A; Gauba, K; Kapur, A; Jain, K

    2013-01-01

    To find out the safe and efficient sedative agent for primary molar pulpectomy in uncooperative pediatric patients. This double blind randomized trial enrolled 40 anxious and healthy 2-6 year olds. All subjects received IV propofol (1-1.5 mg/kg) or ketofol (1-1.5 mg/kg propofol with 0.25 mg/kg ketamine) as per group assignment after oral midazolam premedication (0.5 mg/kg). Sedation maintenance was done with propofol infusion at 25-75 microg/kg/min titrated to a predefined Worse level as per Houpt's sedation rating scale. Additional bolus/es was/were administered in the dosage similar to induction dose in case of inadequate sedation. Primary outcomes were intraoperative and postoperative adverse events. Secondary outcomes were vital signs, success of procedure, operator satisfaction, sedation quality, treatment time, recovery time and total propofol dose. Significantly greater incidence of respiratory depression was reported for ketofol group (11/20; 55%) when compared to propofol group (3/20; 15%) (p = 0.008). Desaturation was the most common adverse respiratory event with significantly greater incidence in ketofol group (9/20; 45%) when compared to propofol only group (3/20; 15%) (p = 0.033). No significant differences regarding secondary outcomes were reported in two groups. Both the regimen exhibited similar sedation profile while propofol alone emerged as a safer option.

  19. Recent Insights Into Molecular Mechanisms of Propofol-Induced Developmental Neurotoxicity: Implications for the Protective Strategies.

    Science.gov (United States)

    Bosnjak, Zeljko J; Logan, Sarah; Liu, Yanan; Bai, Xiaowen

    2016-11-01

    Mounting evidence has demonstrated that general anesthetics could induce developmental neurotoxicity, including acute widespread neuronal cell death, followed by long-term memory and learning abnormalities. Propofol is a commonly used intravenous anesthetic agent for the induction and maintenance of anesthesia and procedural and critical care sedation in children. Compared with other anesthetic drugs, little information is available on its potential contributions to neurotoxicity. Growing evidence from multiple experimental models showed a similar neurotoxic effect of propofol as observed in other anesthetic drugs, raising serious concerns regarding pediatric propofol anesthesia. The aim of this review is to summarize the current findings of propofol-induced developmental neurotoxicity. We first present the evidence of neurotoxicity from animal models, animal cell culture, and human stem cell-derived neuron culture studies. We then discuss the mechanism of propofol-induced developmental neurotoxicity, such as increased cell death in neurons and oligodendrocytes, dysregulation of neurogenesis, abnormal dendritic development, and decreases in neurotrophic factor expression. Recent findings of complex mechanisms of propofol action, including alterations in microRNAs and mitochondrial fission, are discussed as well. An understanding of the toxic effect of propofol and the underlying mechanisms may help to develop effective novel protective or therapeutic strategies for avoiding the neurotoxicity in the developing human brain.

  20. Propofol and magnesium attenuate isoflurane-induced caspase-3 activation via inhibiting mitochondrial permeability transition pore

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    Zhang Yiying

    2012-08-01

    Full Text Available Abstract Background The inhalation anesthetic isoflurane has been shown to open the mitochondrial permeability transition pore (mPTP and induce caspase activation and apoptosis, which may lead to learning and memory impairment. Cyclosporine A, a blocker of mPTP opening might attenuate the isoflurane-induced mPTP opening, lessening its ripple effects. Magnesium and anesthetic propofol are also mPTP blockers. We therefore set out to determine whether propofol and magnesium can attenuate the isoflurane-induced caspase activation and mPTP opening. Methods We investigated the effects of magnesium sulfate (Mg2+, propofol, and isoflurane on the opening of mPTP and caspase activation in H4 human neuroglioma cells stably transfected to express full-length human amyloid precursor protein (APP (H4 APP cells and in six day-old wild-type mice, employing Western blot analysis and flowcytometry. Results Here we show that Mg2+ and propofol attenuated the isoflurane-induced caspase-3 activation in H4-APP cells and mouse brain tissue. Moreover, Mg2+ and propofol, the blockers of mPTP opening, mitigated the isoflurane-induced mPTP opening in the H4-APP cells. Conclusion These data illustrate that Mg2+ and propofol may ameliorate the isoflurane-induced neurotoxicity by inhibiting its mitochondrial dysfunction. Pending further studies, these findings may suggest the use of Mg2+ and propofol in preventing and treating anesthesia neurotoxicity.

  1. Differential involvement of GABAA and GABAB receptors in propofol self-administration in rats

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    Bo YANG; Ben-fu WANG; Miao-jun LAI; Fu-qiang ZHANG; Xiao-wei YANG; Wen-hua ZHOU; Qing-quan LIAN

    2011-01-01

    Propofol has shown abuse potential.The aim of the present study is to investigate the effects of GABAA antagonist and GABAB agonist on propofol reinforcement.Methods:Sprague-Dawley rats were trained to self-administer propofol at a dose of 1.7 mg/kg per infusion under a fixed ratio (FR1) schedule of reinforcement for 14 d.In a separate set of experiments,food-maintained self-administration under a fixed ratio (FR5) schedule and locomotor activities of Sprague-Dawley rats were examined.Results:GABAA receptor antagonist bicuculline (0.25 mg/kg,ip) significantly increased the number of injections and active responses.Pretreatment with GABAB receptor agonist baclofen (3 mg/kg,ip) significantly decreased the number of active responses and total infusions of propofol during the training session.Moreover,microinjection of baclofen (50 and 100 ng/side) into the ventral tegmental area (VTA) significantly decreased the number of active responses and total infusions of propofol.Neither baclofen (1-3 mg/kg,ip) nor bicuculline (0.25-1 mg/kg,ip) affected food-maintained responses or motor activities.Conclusion:Propofol maintains its reward properties partially through GABAA receptor activation.Stimulation of GABA~ receptors in VTA may counteract the reinforcing properties of propofol.

  2. Propofol Sedation for ERCP Procedures: A Dilemna? Observations from an Anesthesia Perspective

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    Davinder Garewal

    2012-01-01

    Full Text Available Propofol sedation for endoscopic retrograde cholangiopancreatography (ERCP procedures is a popular current technique that has generated controversy in the medical field. Worldwide, both anesthetic and nonanesthetic personnel administer this form of sedation. Although the American and Canadian societies of gastroenterologists have endorsed the administration of propofol by nonanesthesia personnel, the US Food and Drug Administration (FDA has not licensed its use in this manner. There is some evidence for the safe use of propofol by nonanesthetic personnel in patients undergoing endoscopy procedures, but there are few randomized trials addressing the safety and efficacy of propofol in patients undergoing ERCP procedures. A serious possible consequence of propofol sedation in patients is that it may result in rapid and unpredictable progression from deep sedation to general anesthesia, and skilled airway support may be required as a rescue measure. Potential complications following deep propofol sedation include hypoxemia and hypotension. Propofol sedation for ERCP procedures is an area of clinical practice where discussion and mutual cooperation between anesthesia and nonanesthesia personnel may enhance patient safety.

  3. Propofol detection and quantification in human blood: the promise of feedback controlled, closed-loop anesthesia.

    Science.gov (United States)

    Kivlehan, Francine; Chaum, Edward; Lindner, Ernő

    2015-01-07

    The performance of a membrane-coated voltammetric sensor for propofol (2,6-diisopropylphenol) has been characterized in long term monitoring experiments using an automated flow analytical system (AFAS) and by analyzing human serum and whole blood samples by standard addition. It is shown that the signal of the membrane-coated electrochemical sensor for propofol is not influenced by the components of the pharmaceutical formulation of propofol (propofol injectable emulsion). The current values recorded with the electrochemical propofol sensor in buffer solutions and human serum samples spiked with propofol injectable emulsion showed excellent correlation with the peak heights recorded with an UV-Vis detector during the HPLC analysis of these samples (R(2) = 0.997 in PBS and R(2) = 0.975 in human serum). However, the determination of propofol using the electrochemical method is simpler, faster and has a better detection limit (0.08 ± 0.05 μM) than the HPLC method (0.4 ± 0.2 μM). As a first step towards feedback controlled closed-loop anesthesia, the membrane-coated electrochemical sensor has been implemented onto surface of an intravenous catheter. The response characteristics of the membrane-coated carbon fiber electrode on the catheter surface were very similar to those seen using a macroelectrode.

  4. Muscarinic M1 receptors regulate propofol modulation of GABAergic transmission in rat ventrolateral preoptic neurons.

    Science.gov (United States)

    Zhang, Yu; Yu, Tian; Liu, Yang; Qian, Kun; Yu, Bu-Wei

    2015-04-01

    GABAergic neurons within the ventrolateral preoptic area (VLPO) play an important role in sleep-wakefulness regulation. Propofol, a widely used systemic anesthetic, has lately been reported to excite noradrenaline (NA)-inhibited type of VLPO neurons. Present study tested if acetylcholine system takes part in the propofol modulation of GABAergic spontaneous miniature inhibitory postsynaptic currents (mIPSCs) in mechanically dissociated rat VLPO neurons using a conventional whole-cell patch clamp technique. Propofol reversibly decreased mIPSC frequency without affecting the current amplitude, indicating that propofol acts presynaptically to decrease the probability of spontaneous GABA release. The propofol action on GABAergic mIPSC frequency was completely blocked by atropine, a nonselective muscarinic acetylcholine (mACh) receptor antagonist, and pirenzepine, a selective M1 receptor antagonist. These results suggest that propofol acts on M1 receptors on GABAergic nerve terminals projecting to VLPO neurons to inhibit spontaneous GABA release. The M1 receptor-mediated modulation of GABAergic transmission onto VLPO neurons may contribute to the regulation of loss of consciousness induced by propofol.

  5. Influence of intralipid on free propofol fraction assayed in human serum albumin solutions and human plasma

    Institute of Scientific and Technical Information of China (English)

    Rafal KALITYNSKI; Andrzej L DAWIDOWICZ; Jacek POSZYTEK

    2006-01-01

    Aim: It is generally assumed that only unbound drugs can reach the site of action by diffusing across the membranes and exerting pharmacological effects by interacting with receptors. Recent research has shown that the percentage of free drugs may depend on the total drug concentration. The aim of the paper is to verify whether the mentioned dependence reported for propofol also takes place in plasma and human serum albumin samples in the presence of intralipid-the medium used as a vehicle for propofol infusions and a parenteral nutrition agent. Methods: Artificial plasma samples and human plasma were spiked with intralipid or ethanolic solutions of propofol. The samples were then assayed for free propofol concentration using ultrafiltration and high performance liquid chromatography with fluorimetric detection. Results: The decrease of the total drug concentration results in free propofol fraction increase, irrespectively of the used type of propofol solvent and sample type. The addition of intralipid causes the lowering of the overall free drug fraction with respect to the samples spiked with ethanolic solutions of the drug. Conclusion: The presence of intralipid does not influence the phenomenon of free propofol fraction rise at low total drug concentration. Such a rise cannot be ignored in clinical conditions when the drug is applied for sedative, antiemetic or other low-dosage purposes.

  6. Comparison of Midazolam and Propofol for BIS-Guided Sedation During Regional Anaesthesia

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    Priyanka Khurana

    2009-01-01

    Full Text Available Regional anaesthesia has become an important anaesthetic technique. Effective sedation is an essential for regional techniques too. This study compares midazolam and propofol in terms of onset& recovery from sedation, dosage and side effects of both the drugs using Bispectral Index monitoring. Ninety eight patients were randomly divided into two groups,one group recieved midazolam infusion while the other recieved propofol infusion until BIS reached 75. We observed Time to reach desired sedation, HR, MABP, time for recovery, dose to reach sedation and for maintenance of sedation and side effects if any. The time to reach required sedation was 11 min in Midazolam group(Group I while it was 6 min in Propofol group(Group II (p=0.0. Fall in MABP was greater with propofol. Recovery in with midazolam was slower than with propofol (18.6 ± 6.5 vs 10.10±3.65 min (p=0.00. We concluded that both midazolam and propofol are effective sedatives, but onset and offset was quicker with propofol, while midazolam was more cardiostable.

  7. Propofol Affects Different Human Brain Regions Depending on Depth of Sedation

    Institute of Scientific and Technical Information of China (English)

    Xiang Quan; Tie-hu Ye; Si-fang Lin; Liang Zou; Shou-yuan Tian

    2015-01-01

    Objective To investigate the effect of propofol on brain regions at different sedation levels and the association between changes in brain region activity and loss of consciousness using blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI) and bispectral index (BIS) monitoring. Methods Forty-eight participants were enrolled at Peking Union Medical College Hospital from October 2011 to March 2012 and randomly assigned to a mild or a deep sedation group using computer- generated random numbers. Preliminary tests were performed a week prior to scanning to determine target effect site concentrations based on BIS and concomitant Observer's Assessment of Alertness/Sedation scores while under propofol. Within one week of the preliminary tests where propofol dose-response was established, BOLD-fMRI was conducted to examine brain activation with the subject awake, and with propofol infusion at the sedation level. Results Mild propofol sedation inhibited left inferior parietal lobe activation. Deep sedation inhibited activation of the left insula, left superior temporal gyrus, and right middle temporal gyrus. Compared with mild sedation, deep propofol sedation inhibited activation of the left thalamus, precentral gyrus, anterior cingulate, and right basal nuclei. Conclusion Mild and deep propofol sedation are associated with inhibition of different brain regions, possibly explaining differences in the respective loss of consciousness processes.

  8. Propofol attenuation of renal ischemia/reperfusion injury involves heme oxygenase-1

    Institute of Scientific and Technical Information of China (English)

    Hui-hua WANG; Hai-yan ZHOU; Cong-cong CHEN; Xiu-lai ZHANG; Gang CHENG

    2007-01-01

    Aim: To examine the protective effect of propofol in renal ischemia/reperfusion (I/R) injury and the role of heme oxygenase-1 (HO-1) in this process. Methods:-Sprague-Dawley rats were randomly divided into 3 groups: (i) sham-operated group; (ii) I/R group; and (iii) propofol group. Bilateral renal warm ischemia for 45 rain was performed. After 2, 6, and 24 h reperfusion, blood samples and kidneys were collected for assessment of renal injury, and HO-1 expressions were ana-lyzed by immunohistochemical analysis, RT-PCR and Western blotting. Results: Blood urea nitrogen and serum creatinine levels in the propofol group were sig-nificantly lower than that in the UR group at 24 h after reperfusion. The mean histological score by Paller's standard showed that propofol significantly attenu-ated renal I/R injury after 6 h reperfusion. Propofol increased HO-1 mRNA and protein levels 2 h after repeffusion, whereas HO-1 expressions were present at exceedingly low levels in the I/R group and the sham-operated group at same time point. Propofol also markedly increased HO- 1 mRNA and protein levels than I/R at 6 and 24 h after reperfusion. Conclusion: These results suggest that propofol mitigates renal I/R injury in rats. This protection may be partly through the induc-tion of the HO- 1 expression.

  9. Evaluation of efficacy and safety of glycopyrrolate - xylazine - propofol anesthesia in buffalo calves

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    Sandeep Potliya

    2015-03-01

    Full Text Available Aim: To evaluate the efficacy and safety of glycopyrrolate - xylazine - propofol anesthesia in buffalo calves. Materials and Methods: The study was conducted on six clinically healthy male buffalo calves, 6-12 months of age, and weighing between 130 and 170 kg. In all the animals; glycopyrrolate (0.01 mg/kg, IM, xylazine (0.1 mg/kg, IM and 1% propofol as single bolus (1.5 mg/kg, intravenous, were administered. The parameters observed included behavioral changes, physiological; hematological and blood biochemical parameters. Results: Muzzle and nostrils became dry in all the animals after glycopyrrolate administration. A decrease in spontaneous activity and mild cutaneous analgesia was noticed after xylazine administration. After administration of propofol, loss of swallowing reflex, palpebral reflex, corneal reflexes, periosteal reflex and complete analgesia was observed. There was no significant change in rectal temperature and heart rate. However, heart rate remained elevated during anesthesia. Respiratory rate decreased significantly after propofol administration. There was a significant increase in plasma glucose after the xylazine and propofol administration which remained elevated till recovery. A significant decrease in chloride level was seen after propofol administration. Conclusions: Glycopyrrolate - xylazine - propofol anesthetic combination may safely be used for short duration anesthesia in buffalo calves.

  10. Propofol attenuates high glucose-induced superoxide anion accumulation in human umbilical vein endothelial cells.

    Science.gov (United States)

    Wang, Jiaqiang; Jiang, Hui; Wang, Jing; Zhao, Yanjun; Zhu, Yun; Zhu, Minmin

    2016-12-01

    Perioperative hyperglycemia is a common clinical metabolic disorder. Hyperglycemia could induce endothelial apoptosis, dysfunction, and inflammation, resulting in endothelial injury. Propofol is a widely used anesthetic drug in clinical settings. Our previous studies indicated that propofol attenuated high glucose-induced endothelial apoptosis, dysfunction, and inflammation via inhibiting reactive oxygen species (ROS) accumulation. However, the mechanisms by which propofol reduces high glucose-induced endothelial ROS accumulation are still obscure. In this study, we examined how propofol attenuates high glucose-induced endothelial ROS accumulation. Compared with 5 mm glucose treatment, 15 mm glucose upregulated the expression of pin-1, phosphatase A2 (PP2A), p66(shc) and mitochondrial p66(shc) expression, increased p66(shc) -Ser(36) phosphorylation, and O2·- accumulation. More importantly, although propofol had no effect on 15 mm glucose-induced p66(shc) -Ser(36) phosphorylation and pin-1 expression, propofol could downregulated PP2A expression and p66(shc) expression in whole-cell and mitochondrion, resulting in the reduction of O2·- accumulation. Moreover, we demonstrated that the antioxidative effect of propofol was similar to that of calyculin A, an inhibitor of PP2A. In contrast, FTY720, an activator of PP2A, antagonized the effect of propofol. Our data indicated that the antioxidative effect of propofol was achieved by downregulating PP2A expression, resulting in the inhibition of p66(shc) -Ser(36) dephosphorylation and mitochondrial p66(shc) expression. © 2016 Société Française de Pharmacologie et de Thérapeutique.

  11. Patient Satisfaction With Propofol for Outpatient Colonoscopy: A Prospective, Randomized, Double-Blind Study.

    Science.gov (United States)

    Padmanabhan, Anantha; Frangopoulos, Christoforos; Shaffer, Lynn E T

    2017-10-01

    Previous literature has shown that propofol has ideal anesthetic properties for patients undergoing colonoscopy, a common procedure at outpatient surgery centers. However, there is a paucity of information regarding patient satisfaction with propofol. The aim of this study was to evaluate patient satisfaction with propofol compared with nonpropofol (fentanyl/midazolam) anesthesia for outpatient colonoscopies. Safety and complications were secondary end points. This study was a double-blind, randomized, parallel-group controlled clinical trial (NCT 02937506). This study was conducted at a single ambulatory surgery center at an urban teaching community health system. Patients were scheduled for outpatient colonoscopy. Those with high-risk cardiac or pulmonary disease were excluded. Anesthesia personnel administered either fentanyl/midazolam (n = 300) or propofol (n = 300) for sedation during outpatient colonoscopy. A single, highly experienced endoscopist performed all colonoscopies. The primary outcomes measured were patient satisfaction (5-point Likert scale) and procedure complications. Data were collected on the day of endoscopy by the nursing staff of the postanesthesia care unit. A subinvestigator blinded to the randomization called patients 24 to 72 hours after discharge to obtain data on postprocedure problems and status of resumption of normal activities. Analysis was intention-to-treat. Fewer patients who received propofol remembered being awake during the procedure (2% vs 17% for fentanyl, p propofol (p propofol group (2.7% vs 11.7%, p propofol over a combination of fentanyl/midazolam as their anesthetic for outpatient colonoscopies. From a patient and provider perspective, propofol appears to be superior to fentanyl/midazolam for outpatient colonoscopy. See Video Abstract at http://links.lww.com/DCR/A445.

  12. Anesthesia with propofol induces insulin resistance systemically in skeletal and cardiac muscles and liver of rats

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    Yasuda, Yoshikazu; Fukushima, Yuji; Kaneki, Masao [Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Shriners Hospitals for Children, Harvard Medical School, Boston, MA 02114 (United States); Martyn, J.A. Jeevendra, E-mail: jmartyn@partners.org [Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Shriners Hospitals for Children, Harvard Medical School, Boston, MA 02114 (United States)

    2013-02-01

    Highlights: ► Propofol, as a model anesthetic drug, induced whole body insulin resistance. ► Propofol anesthesia decreased glucose infusion rate to maintain euglycemia. ► Propofol decreased insulin-mediated glucose uptake in skeletal and cardiac muscles. ► Propofol increased hepatic glucose output confirming hepatic insulin resistance. -- Abstract: Hyperglycemia together with hepatic and muscle insulin resistance are common features in critically ill patients, and these changes are associated with enhanced inflammatory response, increased susceptibility to infection, muscle wasting, and worsened prognosis. Tight blood glucose control by intensive insulin treatment may reduce the morbidity and mortality in intensive care units. Although some anesthetics have been shown to cause insulin resistance, it remains unknown how and in which tissues insulin resistance is induced by anesthetics. Moreover, the effects of propofol, a clinically relevant intravenous anesthetic, also used in the intensive care unit for sedation, on insulin sensitivity have not yet been investigated. Euglycemic hyperinsulinemic clamp study was performed in rats anesthetized with propofol and conscious unrestrained rats. To evaluate glucose uptake in tissues and hepatic glucose output [{sup 3}H]glucose and 2-deoxy[{sup 14}C]glucose were infused during the clamp study. Anesthesia with propofol induced a marked whole-body insulin resistance compared with conscious rats, as reflected by significantly decreased glucose infusion rate to maintain euglycemia. Insulin-stimulated tissue glucose uptake was decreased in skeletal muscle and heart, and hepatic glucose output was increased in propofol anesthetized rats. Anesthesia with propofol induces systemic insulin resistance along with decreases in insulin-stimulated glucose uptake in skeletal and heart muscle and attenuation of the insulin-mediated suppression of hepatic glucose output in rats.

  13. Propofol inhibits high glucose-induced PP2A expression in human umbilical vein endothelial cells.

    Science.gov (United States)

    Wu, Qichao; Zhao, Yanjun; Duan, Wenming; Liu, Yi; Chen, Xiangyuan; Zhu, Minmin

    2017-04-01

    Perioperative hyperglycemia is a common clinical metabolic disorder. Hyperglycemia could induce endothelial apoptosis, dysfunction and inflammation, resulting in endothelial injury. Propofol is a widely used anesthetic drug in clinical settings. Our previous studies indicated that propofol, via inhibiting high glucose-induced phosphatase A2 (PP2A) expression, attenuated high glucose-induced reactive oxygen species (ROS) accumulation, thus improving endothelial apoptosis, dysfunction and inflammation. However, the mechanisms by which propofol attenuated high glucose-induced PP2A expression is still obscure. In the present study, we examined how propofol attenuates high glucose-induced endothelial PP2A expression. Compared with 5mM glucose treatment, 15mM glucose up-regulated expression and activity of PP2A, increased cAMP response element binding protein (CREB), Ca(2+)-calmodulin dependent kinase II (CaMK II) phosphorylation and Ca(2+) accumulation. More importantly, propofol decreased PP2A expression and activity, attenuated CREB, CaMK II phosphorylation and Ca(2+) accumulation in a concentration-dependent manner. Moreover, we demonstrated that the effect of propofol was similar to that of MK801, an inhibitor of NMDA receptor. In contrast, rapastinel, an activator of NMDA receptor, antagonized the effect of propofol. Also, the effect of KN93, an inhibitor of CaMK II, was similar to that of propofol, except KN93 had no effect on 15mM glucose-mediated Ca(2+) accumulation. Our data indicated that propofol, via inhibiting NMDA receptor, attenuated 15mM glucose-induced Ca(2+) accumulation, CaMK II and CREB phosphorylation, thus inhibiting PP2A expression and improving 15mM glucose-induced endothelial dysfunction and inflammation. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Effect of propofol and sevoflurane on acid-base balance during pediatric heart catheterization.

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    Fudickar, A; Smigaj, K; Ensenauer, R; Fischer, G; Dütschke, P; Steinfath, M; Bein, B

    2013-06-01

    Propofol is routinely used for anesthesia during pediatric heart catheterization. Propofol infusion syndrome (PRIS) is a rare, but often fatal complication mainly defined as bradycardia with progress to asystolia during propofol infusion. Metabolic acidosis is regarded as an early warning sign of PRIS. In this study the effect of propofol and sevoflurane on serum base excess, pH and lactate have been examined during pediatric heart catheterization. In this prospective randomised study 42 children have been anesthetised for pediatric heart catheterization with propofol (N.=22) or sevoflurane (N.=20) with ethic committee approval. Base excess, pH and lactate were measured by blood gas analysis at the beginning, during and at the end of the procedure. Changes relative to baseline were analysed by paired t-Test with correction for multiple testing. The study was powered to detect a difference of 1.5 mmol.L-1 for base excess and lactate. Base excess (-2.59 [2.33] vs. -4.48 [2.88], P=0.0004, mean [standard deviation]) and pH (7.39 [0.05] vs. 7.36 [0.06], P=0.0008,) changed significantly in in the propofol group but not in the sevoflurane group. The number of patients with base excess propofol group only from 2 to 10 (P=0.016). Lactate decreased in both groups (1.1 [0.3] vs. 0.9 [0.2], P=0.003 for sevoflurane and 1.0 [0.3] vs. 0.8 [0.3], P=0.0004 for propofol). Propofol but not sevoflurane had an effect on base excess and pH during pediatric heart catheterization.

  15. Propofol versus midazolam/ketamine for procedural sedation in pediatric oncology.

    Science.gov (United States)

    Gottschling, Sven; Meyer, Sascha; Krenn, Thomas; Reinhard, Harald; Lothschuetz, Daniela; Nunold, Holger; Graf, Norbert

    2005-09-01

    Different pharmacologic agents have been used for sedation in children undergoing invasive procedures. The authors prospectively compared the efficacy, the occurrence of adverse effects, cardiovascular parameters, oxygen saturation and induction, and recovery time in propofol with or without morphine versus midazolam/ketamine sedation for procedural sedation in children with malignancies and hematologic disorders. Fifty children received either propofol with or without morphine or ketamine/midazolam sedation for invasive procedures. Intravenous sedation consisted of 0.1 mg midazolam/kg and 1.0 mg ketamine/kg or 2 mg propofol/kg with or without 0.1 mg morphine/kg. Incremental dosages of ketamine or propofol were given, if necessary, to achieve or to maintain adequate sedation levels. Systolic and diastolic blood pressure, heart rate, oxygen saturation, time to induce sedation, recovery time, and adverse effects were recorded. All invasive procedures were successfully completed, with satisfactory sedation levels in all 25 patients in the propofol group and 23 of the 25 patients in the ketamine group. In 14 of the 25 procedures in the propofol group and 4 of the 25 procedures in the ketamine group, sedation was associated with side effects, the most common being oxygen desaturation. There was a significant increase in diastolic blood pressure after ketamine medication and a significant decrease in systolic and diastolic blood pressure and heart rate in the propofol group. Induction and recovery times in the propofol group were significantly shorter. Both regimens for procedural sedation are efficacious in achieving satisfactory sedation levels for invasive procedures. Propofol offers a quicker onset of sedation and a faster, smoother recovery but is associated with a higher rate of side effects. Considering the substantial rate of adverse effects, these procedural sedations should be performed only by physicians trained in advanced airway management and life support.

  16. A comparison of dexmedetomidine versus propofol during drug-induced sleep endoscopy in sleep apnea patients.

    Science.gov (United States)

    Yoon, Byung-Woo; Hong, Jeong-Min; Hong, Sung-Lyong; Koo, Soo-Kweon; Roh, Hwan-Jung; Cho, Kyu-Sup

    2016-03-01

    In this study, we compared the effects of propofol and dexmedetomidine on the upper airway collapse pattern and cardiopulmonary parameters of patients with obstructive sleep apnea (OSA) undergoing drug-induced sleep endoscopy (DISE). Prospective, single center, observational study The 50 patients with OSA underwent 30 minutes of DISE on 2 different days, the first time with propofol target-controlled infusion (TCI) and the second time with dexmedetomidine TCI. Both the characteristics of upper airway obstruction and cardiopulmonary parameters in response to the depth of sedation achieved with each drug were evaluated. The results obtained with propofol and dexmedetomidine DISE were in excellent agreement for all sites of obstruction irrespective of the depth of sedation. Although partial or total obstruction at all areas was consistently observed using both drugs, the degree of upper airway narrowing was slightly lower with dexmedetomidine than with propofol. However, the percentage of patients with a greater than 20% change in blood pressure and heart rate compared to baseline was significantly higher in response to propofol than to dexmedetomidine (P = 0.003 and P < 0.001, respectively). Minimal oxygen saturation was significantly lower in DISE with propofol than with dexmedetomidine (P = 0.004). The percentage of patients with oxygen saturation less than 90% or 80% during DISE was significantly higher in response to propofol than to dexmedetomidine (P = 0.032 and P < 0.001, respectively). The DISE findings achieved with propofol and dexmedetomidine were in excellent agreement. However, during DISE, dexmedetomidine provided greater hemodynamic stability and less respiratory depression than propofol. 4. Laryngoscope, 126:763-767, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Comparison between the effect of propofol and midazolam on picrotoxin-induced convulsions in rat.

    Science.gov (United States)

    Hasan, Zuheir A; Abdel Razzak, Rima L; Alzoubi, Karem H

    2014-04-10

    Propofol is a short acting intravenous anesthetic that has been used in the treatment of status epileptics. However, the occurrence of seizures in epileptic and non-epileptic patients during recovery from propofol induced anesthesia suggests that propofol may have proconvulsant effects. We have previously shown that propofol displays anticonvulsant effects against picrotoxin (PTX) induced seizures during its peak sedative effects. The purpose of the present study was to compare the time course of the effect of intravenous administration of various doses (2.5, 5, and 10 mg/kg) of propofol and midazolam on PTX-induced seizures in adult female Sprague-Dawley rats. The latency to onset of clonic seizures induced by intraperitoneal injection of PTX was significantly increased by the highest dose of propofol and all doses of midazolam, suggesting that both agents display anticonvulsant effects. The anticonvulsant effects of propofol (10 mg/kg) lasted about 20 min and PTX-induced clonic seizures were observed thereafter and peaked within 30 min post drug administration. Clonic seizures progressed rapidly to tonic seizures leading to high rate of PTX-induced mortality. In midazolam (10 mg/kg) treated rats, clonic seizures were observed 25 min after drug administration and the number of rats exhibiting clonic seizures was highest within 40 min. However, clonic seizures did not progress into tonic seizures and thus, PTX-induced seizure related mortality was significantly reduced. In conclusion, this study provides further evidence for the anticonvulsant effects of propofol and midazolam against PTX-induced seizures. Furthermore, the data of the current study showed that midazolam was more effective than propofol against PTX-induced tonic seizures.

  18. PROPOFOL DECREASES 125Ⅰ-β-CIT BINDING TOTHE DOPAMINE TRANSPORTER

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To determine the changes of brain dopamine transporter in mice receiving propofol anesthesia, 125Ⅰ-β-CIT binding sites were observed at different time course. Methods 1. Twenty-seven normal Kunming mice were ran domizedly divided into 3 groups (n=9) and received intraperitoneal injection of propofol 100, 200 mg /kg and 10% intralipid (as control)respectively. The time of losing righting reflex and displaying excitatory symptoms were recorded within 10min after administration. 2. Sixty Kunming mice were randomizedly assigned into 2 groups ( n = 30). The mice were given 125Ⅰ-β-CIT in travenously and propofol 200mg/kg or 10% intralipid (as control) intraperitoneally. Five mice in every group were killed at dif ferent time course and their brain removed to isolate cerebellar, hypothalamus, striatum and cerebral cortex. After weighting brain tissues, the radioactivity of 125Ⅰ-β-CIT in different brain tissue was measured. Results 1. The time of losing righting reflex was reduced from 319. 167 + 88.228s in propofol 100mg/kg group to 231. 667 + 46. 233s in propofol 200mg/kg group, and it fell from 193.75 + 27. 233s to 145. 556 + 27. 437s for presenting excitatory activity. 2. Propofol intraperitoneal groups significantly decreased the combination of 125Ⅰ-β-CIT and dopamine transporter in the striatum (P<0.01) and cerebral cortex (P <0.05) 120min after injection of propofol compared with the control group. But propofol increased the binding (P<0.05) in the striatum 30min after injection. Conclusion The inhibitive effect of propofol on dopamine transporter to uptake dopamine in mice brain may contribute to some anesthetic mechanisms.

  19. COMPARISON OF HAEMODYNAMIC CHANGES WITH PROPOFOL AND SEVOFLURANE ANAESTHESIA DURING LAPAROSCOPIC SURGERY

    Directory of Open Access Journals (Sweden)

    Alka Shah

    2011-04-01

    Full Text Available Sevoflurane is a useful alternative to propofol in providing anesthesia where rapid emergence and recovery of cognitive function are desired. In this randomized study, hemodynamic changes and recovery characteristics of sevoflurane anesthesia were compared with propofol anesthesia in fifty patients of America Society of Anesthesiology (ASA Grade I and II undergoing laparoscopic surgeries of 1-2 hr duration. Injection fentanyl was used as an adjuvant to provide analgesia. In Group-I patients, anesthesia was induced with propofol-2 mg/kg i.v. and maintained with sevoflurane-N2O-O2 and injection vecuronium. The inspired concentration of sevoflurane was kept between 1 to 1.5%. In Group-II patients, anesthesia was induced with propofol-2 mg/kg i.v. and maintained with propofol infusion-N2O-O2 and injection vecuronium. Propofol infusion was given in a range of 75 to 125microgram/kg/min. Induction with propofol was without any untoward hemodynamic changes or episodes of coughing or laryngospasm. Mean heart rate during maintenance was much lower as compared to baseline in group-II than in group-I. There was no episode of sever bradycardia which needed treatment in any of the groups. The incidence of tachycardia could be controlled with increase in inspired concentration of volatile anesthetic agent. Fall in mean blood pressure was more in group-II than in group-I. No undesired event was noted intraoperatively in any group. There was no significant difference in the incidence of Post Operative Nausea and vomiting (PONV in two groups. The use of sevoflurane resulted in greater hemodynamic stability while propofol caused reduction in heart rate and blood pressure. Also the use of sevoflurane resulted in faster emergence from anesthesia as compare to propofol. [National J of Med Res 2011; 1(2.000: 76-79

  20. LA CRECIENTE IMPORTANCIA DE LA MOVILIDAD ESTUDIANTIL TRANSNACIONAL: AMÉRICA LATINA Y LA OCDE EN VISIÓN COMPARADA

    OpenAIRE

    HERMO, JAVIER PABLO; Cecilia PITTELLI

    2011-01-01

    Este artículo se inscribe en el marco del proyecto de investigación UBACyT S439 “Globalización e internacionalización de la educación superior. Estudio de la situación en el área metropolitana de Buenos Aires y Montevideo”, radicado en la Carrera de Sociología de la Facultad de Ciencias Sociales de la Universidad de Buenos Aires. Se busca ofrecer una visión comparada de la importancia creciente de la movilidad transnacional de estudiantes de nivel superior, utilizando las estadísticas disponi...

  1. ATLAS DIGITAL DE MORFOLOGIA COMPARADA: UMA FERRA-MENTA COMPLEMENTAR AO ENSINO DE HISTOLOGIA E HISTO-PATOLOGIA

    OpenAIRE

    2014-01-01

    O objetivo do presente trabalho foi estruturar um atlas de morfologia comparada digital e disponibiliza-lo, como ferramenta digital complementar de auxílio ao estudo dos alunos, junto ao portal acadêmico da Universidade, facilitando o ensino e aprendizagem nas áreas de morfologia. Avaliou-se por meio de grupos comparativos o desempenho dos alunos nas disciplinas relacionadas, de 2009 a 2012, utilizando-se os parâmetros: alunos abaixo da média e o índice de reprovação. Os resultados demonstrar...

  2. Use of propofol infusion in alcohol withdrawal-induced refractory delirium tremens

    DEFF Research Database (Denmark)

    Lorentzen, Kristian; Lauritsen, Anne Øberg; Bendtsen, Asger Ole

    2014-01-01

    in case reports. We aimed to evaluate the treatment of delirium tremens with propofol infusion for 48 h. MATERIAL AND METHODS: This study was a single-centre retrospective cohort analysis of 15 patient journals covering the period from May 2012 to September 2013. RESULTS: Five women and ten men were...... and mechanically ventilated in the intensive care unit. The mean propofol infusion rate was 4.22 mg/kg/h. Thirteen patients received supplemental infusion of opioids, whereas seven required concomitant vasopressor infusion. Once propofol infusion was discontinued after 48 h, 12 patients had a long awakening...

  3. [Effect of noxious stimulation on regional distribution of propofol in canine spinal cord].

    Science.gov (United States)

    Lin, Chun-shui; Xu, Jin-dong; Gu, Miao-ning; Chen, Ying; Zhou, Feng-zhi

    2010-05-01

    To observe the regional distribution of propofol in canine spinal cord under noxious stimulation. Twelve healthy hybrid dogs (12-18 months old, weighing 10-12 kg) were randomly divided into control group (n=6) and stimulation group (n=6). All the dogs were anesthetized with a single bolus dose of propofol (7 mg/kg) in 15 seconds followed by propofol infusion at a constant rate of 70 mg/kg/h via the great saphenous vein of the right posterior limb. In the stimulation group, the tails of the dogs were clamped for 5 min after 45 min of propofol infusion. Blood samples were taken from the internal carotid artery and internal jugular vein at 50 min after propofol infusion to detect plasma propofol concentrations by high-pressure liquid chromatography (HPLC). The dogs were then immediately sacrificed by decapitation and the frontal horn, posterior horn, intermediate zone, frontal funiculus, posterior funiculus and lateral funiculus of the spinal cord were dissected for determination of propol content by HPLC. The plasma concentrations of propofol in the internal carotid artery and internal jugular vein were 5.07-/+0.23 and 5.03-/+0.10 microg/ml in the stimulation group, respectively showing no significant differences from those in the control group (5.09-/+0.03 and 5.08-/+0.03 microg/ml, P>0.05). In the control group, the propofol concentration was 5.09-/+0.08 microg/g in the frontal horm, 5.10-/+0.08 microg/g in the posterior horn, 5.05-/+0.19 microg/g in the intermediate zone, 5.06-/+0.14 microg/g in the frontal funiculus, 5.06-/+0.15 microg/g in the posterior funiculus and 5.06-/+0.41 microg/g in the lateral funiculus, showing no significant differences (P>0.05). The propofol concentrations in the frontal horn (7.65-/+0.47 microg/g) and posterior funiculus (7.06-/+0.82 microg/g) in the stimulation group were significantly higher than those in the other spinal cord tissues (P<0.05) and those in the control group (P<0.05). At 50 min after intravenous injection of

  4. Effect of propofol and remifentanil on cerebral perfusion and oxygenation in pigs

    DEFF Research Database (Denmark)

    Mikkelsen, Mai Louise Grandsgaard; Ambrus, Rikard; Miles, James Edward

    2016-01-01

    -remifentanil anaesthesia, and addition of a single remifentanil bolus did not affect regional cerebral oxygen saturation (rSO2). Even though the pool of evidence suggests that propofol and remifentanil alone or in combination have limited effects on CPO in healthy pigs, confirmative evidence is lacking....... and oxygenation (CPO). The evidence evaluated in this systematic review is limited, not focused on propofol and remifentanil and possibly influenced by factors of potential importance for CPO assessment. In one study of healthy pigs, CPO measures were within normal ranges following propofol...

  5. [Comparative study between fast and slow induction of propofol given by target-controlled infusion: expected propofol concentration at the effect site. Randomized controlled trial].

    Science.gov (United States)

    Simoni, Ricardo Francisco; Miziara, Luiz Eduardo de Paula Gomes; Esteves, Luis Otávio; Silva, Diógenes de Oliveira; Ribeiro, Cristina Alves; Smith, Mariana Oki; Paula, Leonardo Ferreira de; Cangiani, Luis Henrique

    2015-01-01

    studies have shown that rate of propofol infusion may influence the predicted propofol concentration at the effect site (Es). The aim of this study was to evaluate the Es predicted by the Marsh pharmacokinetic model (ke0 0.26min(-1)) in loss of consciousness during fast or slow induction. the study included 28 patients randomly divided into two equal groups. In slow induction group (S), target-controlled infusion (TCI) of propofol with plasma, Marsh pharmacokinetic model (ke0 0.26min(-1)) with target concentration (Tc) at 2.0-μg.mL(-1) were administered. When the predicted propofol concentration at the effect site (Es) reached half of Es value, Es was increased to previous Es + 1μg.mL(-1), successively, until loss of consciousness. In rapid induction group (R), patients were induced with TCI of propofol with plasma (6.0μg.ml(-1)) at Es, and waited until loss of consciousness. in rapid induction group, Tc for loss of consciousness was significantly lower compared to slow induction group (1.67±0.76 and 2.50±0.56μg.mL(-1), respectively, p=0.004). the predicted propofol concentration at the effect site for loss of consciousness is different for rapid induction and slow induction, even with the same pharmacokinetic model of propofol and the same balance constant between plasma and effect site. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  6. Alfentanil versus ketamine combined with propofol for sedation during upper gastrointestinal system endoscopy in morbidly obese patients

    Science.gov (United States)

    Kılıc, Ertugrul; Demiriz, Barıs; Isıkay, Nurgül; Yıldırım, Abdullah E.; Can, Selman; Basmacı, Cem

    2016-01-01

    Objectives: To observe the effects of both propofol/alfentanil and propofol/ketamine on sedation during upper gastrointestinal system endoscopy in morbidly obese patients (UGSEMOP). Methods: In a prospective, double-blinded, randomized clinical study, 52 patients scheduled for UGSEMOP were assigned to either group A (n=26; 10 µg/kg intravenous [IV] alfentanil) or group K (n=26; 0.5 mg/kg IV ketamine). Each patient was administered 0.7 mg/kg propofol for induction. If it was needed, the patients were administered an additional dose of IV propofol. This study was performed in Sehitkamil State Hospital, Gaziantep, Turkey, between January 2014-2015. Total propofol consumption, time to achieve Modified Aldrete Scores (MAS) of 5 and 10 following the procedure, physician and patient satisfaction scores, and instances of side effects, such as bradycardia and hypotension were recorded. Results: Time to onset of sedation and duration of sedation were both significantly shorter in group A. Patients in group A also required less time to achieve an MAS of 5. Total propofol consumption was significantly lower in group A. Conclusion: Both propofol/alfentanil and propofol/ketamine combinations provided appropriate hypnosis and analgesia during UGSEMOP. However, propofol consumption was significantly higher using the propofol/ketamine combination. PMID:27761556

  7. Alfentanil versus ketamine combined with propofol for sedation during upper gastrointestinal system endoscopy in morbidly obese patients.

    Science.gov (United States)

    Kılıc, Ertugrul; Demiriz, Barış; Isıkay, Nurgül; Yıldırım, Abdullah E; Can, Selman; Basmacı, Cem

    2016-11-01

    To observe the effects of both propofol/alfentanil and propofol/ketamine on sedation during upper gastrointestinal system endoscopy in morbidly obese patients (UGSEMOP). In a prospective, double-blinded, randomized clinical study, 52 patients scheduled for UGSEMOP were assigned to either group A (n=26; 10 µg/kg intravenous [IV] alfentanil) or group K (n=26; 0.5 mg/kg IV ketamine). Each patient was administered 0.7 mg/kg propofol for induction. If it was needed, the patients were administered an additional dose of IV propofol. This study was performed in Sehitkamil State Hospital, Gaziantep, Turkey, between January 2014-2015. Total propofol consumption, time to achieve Modified Aldrete Scores (MAS) of 5 and 10 following the procedure, physician and patient satisfaction scores, and instances of side effects, such as bradycardia and hypotension were recorded. Results: Time to onset of sedation and duration of sedation were both significantly shorter in group A. Patients in group A also required less time to achieve an MAS of 5. Total propofol consumption was significantly lower in group A. Both propofol/alfentanil and propofol/ketamine combinations provided appropriate hypnosis and analgesia during UGSEMOP. However, propofol consumption was significantly higher using the propofol/ketamine combination.

  8. Different effects of propofol and nitrosopropofol on DMPC multilamellar liposomes.

    Science.gov (United States)

    Momo, Federico; Fabris, Sabrina; Bindoli, Alberto; Scutari, Guido; Stevanato, Roberto

    2002-02-19

    The mechanisms of reaction of propofol with nitrosoglutathione lead to the formation of an active species which was identified, and then synthesised, as 2,6-diisopropyl-4-nitrosophenol. In the present work, we demonstrate the in vitro formation of 2,6-diisopropyl-4-nitrosophenol, then we discuss the interaction of propofol and 2,6-diisopropyl-4-nitrosophenol with dimyristoylphosphatidylcholine and egg yolk phosphatidylcholine multilamellar liposomes using differential scanning calorimetry and spin labelling techniques. It was demonstrated that both molecules are highly lipophylic and absorb almost entirely in the lipid phase. The thermotropic profiles showed that these molecules affect the temperature and the co-operativity of the gel-to-fluid state transition of the liposomes differently: the effects of 2,6-diisopropylphenol on the lipid organisation are quite similar to phenol and coherently interpretable in terms of the disorder produced in the membrane by a bulky group; 2,6-diisopropyl-4-nitrosophenol is a stronger perturbing agent, and ESR spectra suggest that this is due to a relative accumulation of the molecule into the interfacial region of the bilayer.

  9. Multiple Propofol-binding Sites in a γ-Aminobutyric Acid Type A Receptor (GABAAR) Identified Using a Photoreactive Propofol Analog*♦

    Science.gov (United States)

    Jayakar, Selwyn S.; Zhou, Xiaojuan; Chiara, David C.; Dostalova, Zuzana; Savechenkov, Pavel Y.; Bruzik, Karol S.; Dailey, William P.; Miller, Keith W.; Eckenhoff, Roderic G.; Cohen, Jonathan B.

    2014-01-01

    Propofol acts as a positive allosteric modulator of γ-aminobutyric acid type A receptors (GABAARs), an interaction necessary for its anesthetic potency in vivo as a general anesthetic. Identifying the location of propofol-binding sites is necessary to understand its mechanism of GABAAR modulation. [3H]2-(3-Methyl-3H-diaziren-3-yl)ethyl 1-(phenylethyl)-1H-imidazole-5-carboxylate (azietomidate) and R-[3H]5-allyl-1-methyl-5-(m-trifluoromethyl-diazirynylphenyl)barbituric acid (mTFD-MPAB), photoreactive analogs of 2-ethyl 1-(phenylethyl)-1H-imidazole-5-carboxylate (etomidate) and mephobarbital, respectively, have identified two homologous but pharmacologically distinct classes of intersubunit-binding sites for general anesthetics in the GABAAR transmembrane domain. Here, we use a photoreactive analog of propofol (2-isopropyl-5-[3-(trifluoromethyl)-3H-diazirin-3-yl]phenol ([3H]AziPm)) to identify propofol-binding sites in heterologously expressed human α1β3 GABAARs. Propofol, AziPm, etomidate, and R-mTFD-MPAB each inhibited [3H]AziPm photoincorporation into GABAAR subunits maximally by ∼50%. When the amino acids photolabeled by [3H]AziPm were identified by protein microsequencing, we found propofol-inhibitable photolabeling of amino acids in the β3-α1 subunit interface (β3Met-286 in β3M3 and α1Met-236 in α1M1), previously photolabeled by [3H]azietomidate, and α1Ile-239, located one helical turn below α1Met-236. There was also propofol-inhibitable [3H]AziPm photolabeling of β3Met-227 in βM1, the amino acid in the α1-β3 subunit interface photolabeled by R-[3H]mTFD-MPAB. The propofol-inhibitable [3H]AziPm photolabeling in the GABAAR β3 subunit in conjunction with the concentration dependence of inhibition of that photolabeling by etomidate or R-mTFD-MPAB also establish that each anesthetic binds to the homologous site at the β3-β3 subunit interface. These results establish that AziPm as well as propofol bind to the homologous intersubunit sites in the

  10. Farmacocinética do propofol em nanoemulsão em gatos Pharmacokinetic of propofol in nanoemulsion in cats

    Directory of Open Access Journals (Sweden)

    Martielo Ivan Gehrcke

    2013-04-01

    Full Text Available Os felinos são deficientes na biotransformação do propofol e os dados em relação à farmacocinética nessa espécie são escassos. O objetivo deste estudo foi determinar o perfil farmacocinético da infusão contínua de propofol em nanoemulsão juntamente com a emulsão lipídica em felinos. Utilizaram-se seis gatos sem raça definida (SRD, adultos, machos, castrados, com peso médio de 4,2±0,8kg, em estudo aleatório e de autocontrole. Os animais receberam 10mg kg-1 min-1 de propofol a 1% em emulsão lipídica (EMU ou em nanoemulsão (NANO durante 30 segundos e, imediatamente após, iniciou-se a infusão de 0,3 mg kg-1 min-1 da mesma formulação durante 60 minutos. Após 15 dias, receberam o mesmo tratamento com a formulação oposta. Amostras de 3mL de sangue venoso foram coletadas nos tempos 0 (basal, 2, 5, 10, 15, 30 e 60 minutos de infusão e aos 5, 10, 15, 30, 60, 90, 120, 180, 240, 360, 600 e 1440 minutos após o final da infusão. Os parâmetros farmacocinéticos foram determinados a partir da curva de decaimento da concentração plasmática versus tempo ao final da infusão. A análise estatística foi realizada através de ANOVA-RM com posterior teste t pareado entre os grupos. Não houve diferença entre as formulações em relação a todos os parâmetros. Os volumes de distribuição foram altos com Vdss de 23,23±12,30 litros kg-1 para a nanoemulsão e de 18,12±8,54 litros kg-1 para a emulsão lipídica. Os Cls foram baixos com um Cl central de 22,20±10,83mL kg-1 min-1 para a nanoemulsão e de 23,42±13,50mL kg-1 min-1 para emulsão lipídica. Conclui-se que a farmacocinética do propofol em gatos após infusão contínua caracteriza-se por uma ampla distribuição tecidual e uma lenta eliminação, com possível efeito cumulativo. A formulação em nanoemulsão apresenta características farmacocinéticas semelhantes às da emulsão lipídica.Cats are deficient in the metabolism of propofol and the data on the

  11. Autism-like behavior in the BTBR mouse model of autism is improved by propofol.

    Science.gov (United States)

    Cai, Yulong; Wang, Lian; Xiao, Rui; Li, Xin; He, Xie; Gao, Junwei; Xu, Haiwei; Fan, Xiaotang

    2017-05-15

    Autism spectrum disorder (ASD) is a developmental disorder that is characterized by symptoms of impaired social interactions, restricted interests and repetitive behaviors. Recent studies in humans and animal-models suggest that reduced GABAergic neurotransmission in the brain may underlie autism-related behavioral symptoms. It has been shown that propofol, a commonly used anesthetic, facilitates γ-aminobutyric acid-mediated inhibitory synaptic transmission. The present study investigated whether propofol improved autistic phenotypes in BTBR T + Itpr3tf/J (BTBR) mice, a model of idiopathic autism. We found that i.p. injection of propofol in BTBR mice significantly improved aspects of social approach and repetitive behaviors without affecting reciprocal social interactions and without any detrimental effects in C57BL/6J mice. The ability of propofol to improve autistic phenotypes in BTBR mice through GABAergic neurotransmission suggests a potential pharmacological target for interventions to treat symptoms of autism. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Use of propofol infusion in alcohol withdrawal-induced refractory delirium tremens

    DEFF Research Database (Denmark)

    Lorentzen, Kristian; Lauritsen, Anne Øberg; Bendtsen, Asger Ole

    2014-01-01

    INTRODUCTION: Delirium tremens is a potentially fatal complication of alcohol withdrawal. In severe delirium, very large dosages of benzodiazepines can be required and in refractory cases, sedation with propofol can be used. Treatment of refractory delirium tremens with propofol is mainly described...... in case reports. We aimed to evaluate the treatment of delirium tremens with propofol infusion for 48 h. MATERIAL AND METHODS: This study was a single-centre retrospective cohort analysis of 15 patient journals covering the period from May 2012 to September 2013. RESULTS: Five women and ten men were...... included. Their mean age was 50.9 years. Prior to propofol treatment, conventional treatment with up to 1,500 mg of benzodiazepines, 2,000 mg of chlordiazepoxide or 1,200 mg of phenobarbital was attempted in the medical or psychiatric ward, without effect (sleep). Patients were sedated, intubated...

  13. Effect of propofol and thiopentone on free radical mediated oxidative stress of the erythrocyte

    DEFF Research Database (Denmark)

    Murphy, P G; Davies, Michael Jonathan; Columb, M O

    1996-01-01

    Propofol has free radical scavenging properties similar to those of recognized phenol-based antioxidants. We have examined these properties in an in vitro model of radical-induced cellular injury, comparing its activity with that of thiopentone (which has also been shown to have radical scavenging...... activity). Haemolysis of human erythrocytes was induced using the azo compound 2,2'-azo-bis(2-amidinopropane) dihydrochloride (ABAP). This was achieved by incubating a 10% suspension of erythrocytes with ABAP 100 mmol litre-1 at 37 degrees C. For propofol, at concentrations of 12.5, 25 and 50 mumol litre-1......, with the highest concentrations in the propofol-containing flasks. The formation of methaemoglobin was preceded by the generation of ferrylhaemoglobin (a Fe4+ haemoglobin species). Further experiments examining oxidation of purified methaemoglobin to ferrylhaemoglobin by hydrogen peroxide suggested that propofol...

  14. Sedation med propofol til koloskopi. Gennemgang af et Cochrane-review

    DEFF Research Database (Denmark)

    Høj, Anders Thorsmark; Vilmann, Peter

    2010-01-01

    The Cochrane collaboration metaanalysis of propofol use during colonoscopy found a faster patient recovery, higher patient satisfaction and unchanged complication rate compared to traditional sedatives. Patient groups consisted mostly of ASA I-II-patients, therefore the study is inconclusive...

  15. Addition of a water-soluble propofol formulation to preservation solution in experimental kidney transplantation

    NARCIS (Netherlands)

    Snoeijs, M.G.; Vaahtera, L.; Vries, E.E. de; Schurink, G.W.; Haenen, G.R.; Peutz-Kootstra, C.J.; Buurman, W.A.; Heurn, L.W.E. van; Parkkinen, J.

    2011-01-01

    BACKGROUND: Novel interventions that protect against ischemia and reperfusion injury are needed to improve early graft function after kidney transplantation. Propofol, a widely used anesthetic, has proven an efficient membrane-targeted antioxidant and cytoprotective agent. METHODS: The

  16. Propofol for sedation during colonoscopy- A survey of a Cochrane review

    DEFF Research Database (Denmark)

    Høj, Anders Thorsmark

    2010-01-01

    The Cochrane collaboration metaanalysis of propofol use during colonoscopy found a faster patient recovery, higher patient satisfaction and unchanged complication rate compared to traditional sedatives. Patient groups consisted mostly of ASA I-II-patients, therefore the study is inconclusive...

  17. Isolated fatty liver from prolonged propofol use in a pediatric patient with refractory status epilepticus.

    Science.gov (United States)

    Rison, Richard A; Ko, David Y

    2009-07-01

    Propofol is a widely used rapidly acting sedating or hypnotic agent in the intensive care setting. It is generally considered safe in both pediatric and adult patients and has been used frequently in cases of refractory status epilepticus. The formulation of propofol is highly lipophilic to facilitate central nervous system penetration and has a high fat content, and prolonged infusions have been known to cause both extrahepatic complications and hepatomegaly secondary to fatty liver. Whereas extrahepatic manifestations of prolonged propofol infusions have been well reported in non-neurologic intensive care patients, cases of pathologically confirmed fatty liver in patients with status epilepticus are relatively few. Furthermore, these cases of hepatomegaly and fatty liver have been also in the context of concomitant extrahepatic side effects. We report on a pediatric patient with refractory status epilepticus treated with a prolonged propofol infusion who developed isolated pathologically confirmed fatty liver without the usually reported extrahepatic manifestations.

  18. The additional effect of granisteron over propofol and sevoflurane on prophylaxis of vomiting after pediatric adenotonsillectomy

    Directory of Open Access Journals (Sweden)

    Ibrahim Rezk

    2014-07-01

    Conclusions: On performing adenotonsillectomy in children, the incidence of postoperative vomiting is lower with (i.v. anesthetics propofol than (volatile anesthetics sevoflurane. Use of granisteron significantly reduces the incidence of postoperative vomiting in children undergoing this procedure.

  19. Respiratory Reflex Responses of the Larynx Differ between Sevoflurane and Propofol in Pediatric Patients

    National Research Council Canada - National Science Library

    Oberer, Christine; von Ungern-Sternberg, Britta S; Frei, Franz J; Erb, Thomas O

    2005-01-01

    .... The aim of this study was to compare the laryngeal reflex responses in children anesthetized with either sevoflurane or propofol under two levels of hypnosis using the Bispectral Index score (BIS...

  20. Propofol Use for Sedation during Endoscopy in Adults: A Canadian Association of Gastroenterology Position Statement

    Directory of Open Access Journals (Sweden)

    Michael F Byrne

    2008-01-01

    Full Text Available Over the past decade, multiple clinical reports have demonstrated that the use of propofol sedation for gastrointestinal endoscopy by gastroenterologists and trained endoscopy nurses is safe and effective in appropriately selected patients. Proposed benefits of propofol sedation include rapid onset of action, improved patient comfort and rapid clearance, as well as prompt recovery and discharge from the endoscopy unit. As a result of medical evidence, a number of international professional societies have endorsed the use of propofol in gastrointestinal endoscopy. In Canada, no formal guidelines currently exist. In the present article, the Clinical Affairs Committee of the Canadian Association of Gastroenterology presents a position statement, incorporating updated information on the use of propofol sedation for endoscopy in adult patients.

  1. 75 FR 20268 - Implantation or Injectable Dosage Form New Animal Drugs; Change of Sponsor; Propofol

    Science.gov (United States)

    2010-04-19

    ... change of sponsor for a new animal drug application (NADA) from Intervet, Inc., to Teva Animal Health... and interest in, approved NADA 141-070 for RAPINOVET (propofol), an ] injectable anesthetic, to...

  2. Características sociodemográficas y clínicas de pacientes con infección por Leptospira spp. atendidos en cuatro centros hospitalarios de Medellín, Colombia, 2008-2013

    Directory of Open Access Journals (Sweden)

    Lina María Echeverri-Toro

    2017-01-01

    Conclusiones. La leptospirosis en esta población tuvo manifestaciones clínicas y complicaciones similares a las reportadas en la literatura científica. Se observó una mortalidad general relativamente baja comparada con las estadísticas mundiales.

  3. Mild hypothermia, but not propofol, is neuroprotective in organotypic hippocampal cultures.

    Science.gov (United States)

    Feiner, John R; Bickler, Philip E; Estrada, Sergio; Donohoe, Paul H; Fahlman, Christian S; Schuyler, Jennifer A

    2005-01-01

    The neuroprotective potency of anesthetics such as propofol compared to mild hypothermia remains undefined. Therefore, we determined whether propofol at two clinically relevant concentrations is as effective as mild hypothermia in preventing delayed neuron death in hippocampal slice cultures (HSC). Survival of neurons was assessed 2 and 3 days after 1 h oxygen and glucose deprivation (OGD) either at 37 degrees C (with or without 10 or 100 microM propofol) or at an average temperature of 35 degrees C during OGD (mild hypothermia). Cell death in CA1, CA3, and dentate neurons in each slice was measured with propidium iodide fluorescence. Mild hypothermia eliminated death in CA1, CA3, and dentate neurons but propofol protected dentate neurons only at a concentration of 10 microM; the more ischemia vulnerable CA1 and CA3 neurons were not protected by either 10 microM or 100 microM propofol. In slice cultures, the toxicity of 100 muM N-methyl-D-aspartate (NMDA), 500 microM glutamate, and 20 microM alpha-amino-5-methyl-4-isoxazole propionic acid (AMPA) was not reduced by 100 microM propofol. Because propofol neuroprotection may involve gamma-aminobutyric acid (GABA)-mediated indirect inhibition of glutamate receptors (GluRs), the effects of propofol on GluR activity (calcium influx induced by GluR agonists) were studied in CA1 neurons in HSC, in isolated CA1 neurons, and in cortical brain slices. Propofol (100 and 200 microM, approximate burst suppression concentrations) decreased glutamate-mediated [Ca2+]i increases (Delta[Ca2+]i) responses by 25%-35% in isolated CA1 neurons and reduced glutamate and NMDA Delta[Ca2+]i in acute and cultured hippocampal slices by 35%-50%. In both CA1 neurons and cortical slices, blocking GABAA receptors with picrotoxin reduced the inhibition of GluRs substantially. We conclude that mild hypothermia, but not propofol, protects CA1 and CA3 neurons in hippocampal slice cultures subjected to oxygen and glucose deprivation. Propofol was not

  4. Opposing effects of the anesthetic propofol at pentameric ligand-gated ion channels mediated by a common site

    DEFF Research Database (Denmark)

    Lynagh, Timothy Peter; Laube, Bodo

    2014-01-01

    Propofol is an intravenous general anesthetic that alters neuronal excitability by modulating agonist responses of pentameric ligand-gated ion channels (pLGICs). Evidence suggests that propofol enhancement of anion-selective pLGICs is mediated by a binding site between adjacent subunits, whereas...... propofol inhibition of cation-selective pLGICs occurs via a binding site contained within helices M1-M4 of individual subunits. We considered this idea by testing propofol modulation of homomeric human glycine receptors (GlyRs) and nematode glutamate-gated chloride channels (GluCls) recombinantly expressed...... in Xenopus laevis oocytes with electrophysiology. The Haemonchus contortus AVR-14B GluCl was inhibited by propofol with an IC50 value of 252 ± 48 μM, providing the first example of propofol inhibition of an anion-selective pLGIC. Remarkably, inhibition was converted to enhancement by a single I18'S...

  5. Pharmacokinetics and pharmacodynamics of propofol in cancer patients undergoing major lung surgery.

    Science.gov (United States)

    Przybyłowski, Krzysztof; Tyczka, Joanna; Szczesny, Damian; Bienert, Agnieszka; Wiczling, Paweł; Kut, Katarzyna; Plenzler, Emilia; Kaliszan, Roman; Grześkowiak, Edmund

    2015-04-01

    Despite the growing number of cancer cases and cancer surgeries around the world, the pharmacokinetics (PK) and pharmacodynamics (PD) of anesthetics used in this population are poorly understood. Patients operated due to cancer are usually in severe state and often require chemotherapy. It might affect the PK/PD of drugs used in this population. Therefore, in this study we explored the PK/PD of propofol in cancer patients having a major lung surgery. 23 patients that underwent a propofol-fentanyl total intravenous anesthesia were included in the analysis. A large set of demographic, biochemical and hemodynamic parameters was collected for the purpose of covariate analysis. Nonlinear mixed effect modeling in NONMEM was used to analyze the collected data. A three-compartment model was sufficient to describe PK of propofol. The anesthetic effect (AAI index) was linked to the propofol effect site concentrations through a sigmoidal E max model. A slightly higher value of clearance, a lower value of distribution clearance, and a decreased volume of peripheral compartment were observed in our patients, as compared with the literature values reported for healthy volunteers by Schnider et al. and by Eleveld et al. Despite these differences, both models led to a clinically insignificant bias of -8 and -1 % in concentration predictions, as reflected by the median performance error. The C e50 and propofol biophase concentration at the time of postoperative orientation were low and equaled 1.40 and 1.13 mg/L. The population PK/PD model was proposed for cancer patients undergoing a major lung surgery. The large body of studied covariates did not affect PK/PD of propofol significantly. The modification of propofol dosage in the group of patients under study is not necessary when TCI-guided administration of propofol by means of the Schnider model is used.

  6. Assessing circadian rhythms in propofol PK and PD during prolonged infusion in ICU patients.

    Science.gov (United States)

    Bienert, Agnieszka; Kusza, Krzysztof; Wawrzyniak, Katarzyna; Grześkowiak, Edmund; Kokot, Zenon J; Matysiak, Jan; Grabowski, Tomasz; Wolc, Anna; Wiczling, Paweł; Regulski, Miłosz

    2010-06-01

    This study evaluates possible circadian rhythms during prolonged propofol infusion in patients in the intensive care unit. Eleven patients were sedated with a constant propofol infusion. The blood samples for the propofol assay were collected every hour during the second day, the third day, and after the termination of the propofol infusion. Values of electroencephalographic bispectral index (BIS), arterial blood pressure, heart rate, blood oxygen saturation and body temperature were recorded every hour at the blood collection time points. A two-compartment model was used to describe propofol pharmacokinetics. Typical values of the central and peripheral volume of distribution and inter-compartmental clearance were V(C) = 27.7 l, V(T) = 801 l, and CL(D) = 2.73 l/min. The systolic blood pressure (SBP) was found to influence the propofol metabolic clearance according to Cl (l/min) = 2.65 x (1-0.00714 x (SBP-135)). There was no significant circadian rhythm detected with respect to propofol pharmacokinetics. The BIS score was assessed as a direct effect model with EC(50) equal 1.98 mg/l. There was no significant circadian rhythm detected within the BIS scores. We concluded that the light-dark cycle did not influence propofol pharmacokinetics and pharmacodynamics in intensive care units patients. The lack of night-day differences was also noted for systolic blood pressure, diastolic blood pressure and blood oxygenation. Circadian rhythms were detected for heart rate and body temperature, however they were severely disturbed from the pattern of healthy patients.

  7. Pulse transit time shows vascular changes caused by propofol in children.

    Science.gov (United States)

    Kang, Joo-Eun; Song, In-Kyung; Lee, Ji-Hyun; Hur, Min; Kim, Jin-Tae; Kim, Hee-Soo

    2015-08-01

    Pulse transit time (PTT) is the time that it takes for the arterial pulse pressure wave to travel from the aortic valve to the periphery. It is a simple noninvasive technique for evaluating vascular changes. This study investigated the vascular changes by propofol during the induction of anesthesia in pediatric patients with the measuring of PTT. Without premedication, 2 mg/kg of propofol was administered intravenously with monitoring of electrocardiogram (ECG) and photoplethysmograph (PPG) in 20 pediatric patients aged 3-7 years. The ECG and PPG data were obtained for 1 min before propofol injection (baseline PTT) and 2 min after administration of propofol in the operating room. The PTT was defined as the time interval from the R-wave on the ECG to the maximum upslope of the corresponding PPG. The PTT was calculated off-line after collecting the data. The mean baseline PTT was 166.2 ± 25.9 ms and maximum PTT after propofol injection was 315.9 ± 64.9 ms (the interval between injection and the peak was 17.3 ± 7.6 s). The PTT after the peak changed variously; most of the patients showed no plateau; the PTT decreased progressively after the peak. The PTT after propofol administration prolonged in short time and rapidly recovered toward to the baseline values in pediatric patients. In conclusion, the baseline PTT in children is shorter comparing with adults and the vasodilatory effect of propofol on the vessels as described by the PTT was rapid and the recovery was faster, although the response to propofol was more varied than in adults.

  8. Effects of propofol and isoflurane on haemodynamics and the inflammatory response in cardiopulmonary bypass surgery.

    Science.gov (United States)

    Sayed, S; Idriss, N K; Sayyedf, H G; Ashry, A A; Rafatt, D M; Mohamed, A O; Blann, A D

    2015-01-01

    Cardiopulmonary bypass (CPB) causes reperfusion injury that when most severe is clinically manifested as a systemic inflammatory response syndrome. The anaesthetic propofol may have anti-inflammatory properties that may reduce such a response. We hypothesised differing effects of propofol and isoflurane on inflammatory markers in patients having CBR Forty patients undergoing elective CPB were randomised to receive either propofol or isoflurane for maintenance of anaesthesia. CRP, IL-6, IL-8, HIF-1α (ELISA), CD11 and CD18 expression (flow cytometry), and haemoxygenase (HO-1) promoter polymorphisms (PCR/electrophoresis) were measured before anaesthetic induction, 4 hours post-CPB, and 24 hours later. There were no differences in the 4 hours changes in CRP, IL-6, IL-8 or CD18 between the two groups, but those in the propofol group had higher HIF-1α (P = 0.016) and lower CD11 expression (P = 0.026). After 24 hours, compared to the isoflurane group, the propofol group had significantly lower levels of CRP (P < 0.001), IL-6 (P < 0.001) and IL-8 (P < 0.001), with higher levels CD11 (P = 0.009) and CD18 (P = 0.002) expression. After 24 hours, patients on propofol had increased expression of shorter HO-1 GT(n) repeats than patients on isoflurane (P = 0.001). Use of propofol in CPB is associated with a less adverse inflammatory profile than is isofluorane, and an increased up-regulation of HO-1. This supports the hypothesis that propofol has anti-inflammatory activity.

  9. Effects of propofol on GABAergic and glutamatergic transmission in isolated hippocampal single nerve-synapse preparations.

    Science.gov (United States)

    Wakita, Masahito; Kotani, Naoki; Nonaka, Kiku; Shin, Min-Chul; Akaike, Norio

    2013-10-15

    We evaluated the effects of propofol on synaptic transmission using a mechanically dissociated preparation of rat hippocampal CA3 neurons to allow assays of single bouton responses evoked from retained functional native nerve endings. We studied synaptic and extrasynaptic GABAA and glutamate receptor responses in a preparation in which experimental solutions rapidly accessed synaptic terminals. Whole-cell responses were evoked by bath application of GABA and glutamate. Synaptic inhibitory and excitatory postsynaptic currents (IPSC and EPSC) were measured as spontaneous and evoked postsynaptic responses. Evoked currents were elicited by focal electrical stimulation. Propofol (1-100 μM) enhanced extrasynaptic GABAA-receptor mediated responses but the increase at clinically relevant concentrations (1 μM) were minor. In contrast, 1 μM propofol significantly increased both the amplitude and frequency of spontaneous IPSCs (sIPSCs) and increased the amplitudes of evoked IPSCs (eIPSCs) while decreasing failure rates (Rf) and paired-pulse ratios (PPR). Decay times of sIPSCs and eIPSCs were significantly prolonged. Although propofol had no effect on extrasynaptic glutamate responses, only supra-clinical propofol concentrations (≥ 10 µM) increased the spontaneous EPSCs (sEPSCs, amplitudes and frequencies) but suppressed evoked EPSCs (eEPSCs decreased amplitudes with increased Rf and PPR). The decay phases of sEPSCs and eEPSCs were not changed. The propofol-induced changes in sEPSCs and eEPSCs resulted from presynaptic GABAA receptor-mediated depolarization, because these actions were blocked by bicuculline. These results suggest that propofol acts at presynaptic and postsynaptic GABAA receptors within GABAergic synapses, but also increases extrasynaptic GABA responses. Our results expand the locus of propofol actions to GABAergic and glutamatergic synapses.

  10. Ketamine, propofol and the EEG: a neural field analysis of HCN1-mediated interactions

    Directory of Open Access Journals (Sweden)

    Ingo eBojak

    2013-04-01

    Full Text Available Ketamine and propofol are two well-known, powerful anesthetic agents, yet at first sight this appears to be their only commonality. Ketamine is a dissociative anesthetic agent, whose main mechanism of action is considered to be N-methyl-D-aspartate (NMDA antagonism; whereas propofol is a general anesthetic agent, which is assumed to primarily potentiate currents gated by γ-aminobutyric acid type A (GABA A receptors. However, several experimental observations suggest a closer relationship. First, the effect of ketamine on the electroencephalogram (EEG is markedly changed in the presence of propofol: on its own ketamine increases theta (4–8 Hz and decreases alpha (8–13 Hz oscillations, whereas ketamine induces a significant shift to beta band frequencies (13–30 Hz in the presence of propofol. Second, both ketamine and propofol cause inhibition of the inward pacemaker current Ih, by binding to the corresponding hyperpolarization-activated cyclic nucleotide-gated potassium channel 1 (HCN1 subunit. The resulting effect is a hyperpolarization of the neuron’s resting membrane potential. Third, the ability of both ketamine and propofol to induce hypnosis is reduced in HCN1-knockout mice. Here we show that one can theoretically understand the observed spectral changes of the EEG based on HCN1-mediated hyperpolarizations alone, without involving the supposed main mechanisms of action of these drugs through NMDA and GABA A, respectively. On the basis of our successful EEG model we conclude that ketamine and propofol should be antagonistic to each other in their interaction at HCN1 subunits. Such a prediction is in accord with the results of clinical experiment in which it is found that ketamine and propofol interact in an infra-additive manner with respect to the endpoints of hypnosis and immobility.

  11. MECHANISM OF ANALGESIC EFFECTS OF PROPOFOL ON INCISIONAL PAIN: A RAT MODEL STUDY

    Institute of Scientific and Technical Information of China (English)

    HUANG Zhi-hua; SONG Xiao-xing; HU Jiong; YU Bu-wei

    2009-01-01

    Objective To clarify the role of propofol in controlling incisional pain and its potential effects on the spinal opioid receptor expression.Methods A postoperative model of nociception was established in male Sprague-Dawley rats weighing 200-250 g. A total of 96 rats were randomly divided into 8 groups. All drugs were administered intravenously either 5min pre-operation or 5min post-operation. The analgesic effects of systemic propofol were demonstrated by the measurement of a cumulative pain score (CPS). After that, the lumbar enlargement of the spinal cord was removed to evaluate the mRNA level of the μ-opioid receptor (MOR) and δ-opioid receptor (DOR) by RT-PCR.Results CPS and DOR mRNA expressions significantly increased after the operation. Both propofol post-treatment and propofol pre-treatment groups showed significant suppression of the increased CPS and the expression of DOR mRNA evoked by pain stimulation. Interestingly, propofol pre-treatment had a more pronounced effect in decreasing CPS and the expression of DOR mRNA. Furthermore, these observations were dose-dependent. MOR mRNA expression significantly increased after operation in all animals and propofol treatment had no impact on it.Conclusion Based on these findings, we suggest that propofol can serve as a valuable adjunct in acute postoperative pain management. Systemic propofol induces an analgesic effect on acute incisional pain in a dose-dependant manner, and this effect is mediated in the spinal cord and may be associated with the spinal DOR.

  12. Comparison of Midazolam and Propofol for BIS-Guided Sedation During Regional Anaesthesia

    OpenAIRE

    Priyanka Khurana; Ankit Agarwal; R. K. Verma; Gupta, P K

    2009-01-01

    Summary Regional anaesthesia has become an important anaesthetic technique. Effective sedation is an essential for regional techniques too. This study compares midazolam and propofol in terms of onset & recovery from sedation, dosage and side effects of both the drugs using Bispectral Index monitoring. Ninety eight patients were randomly divided into two groups,one group recieved midazolam infusion while the other recieved propofol infusion until BIS reached 75. We observed Time to reach desi...

  13. Desflurane reinforces the efficacy of propofol target-controlled infusion in patients undergoing laparoscopic cholecystectomy.

    Science.gov (United States)

    Chen, Po-Nien; Lu, I-Cheng; Chen, Hui-Ming; Cheng, Kuang-I; Tseng, Kuang-Yi; Lee, King-Teh

    2016-01-01

    Whether low-concentration desflurane reinforces propofol-based intravenous anesthesia on maintenance of anesthesia for patients undergoing laparoscopic cholecystectomy is to be determined. The aim of this study was to investigate whether propofol-based anesthesia adding low-concentration desflurane is feasible for laparoscopic cholecystectomy. Fifty-two patients undergoing laparoscopic cholecystectomy were enrolled in the prospective, randomized, clinical trial. Induction of anesthesia was achieved in all patients with fentanyl 2 μg/kg, lidocaine 1 mg/kg, propofol 2 mg/kg, and rocuronium 0.8 mg/kg to facilitate tracheal intubation and to initiate propofol target-controlled infusion (TCI) to effect site concentration (Ce: 4 μg/mL with infusion rate 400 mL/h). The patients were then allocated into either propofol TCI based (group P) or propofol TCI adding low-concentration desflurane (group PD) for maintenance of anesthesia. The peri-anesthesia hemodynamic responses to stimuli were measured. The perioperative psychomotor test included p-deletion test, minus calculation, orientation, and alert/sedation scales. Group PD showed stable hemodynamic responses at CO2 inflation, initial 15 minutes of operation, and recovery from general anesthesia as compared with group P. There is no significant difference between the groups in operation time and anesthesia time, perioperative psychomotor functional tests, postoperative vomiting, and pain score. Based on our findings, the anesthetic technique combination propofol and desflurane for the maintenance of general anesthesia for laparoscopic cholecystectomy provided more stable hemodynamic responses than propofol alone. The combined regimen is recommended for patients undergoing laparoscopic cholecystectomy.

  14. Mitochondrial involvement in propofol-induced cardioprotection: An in vitro study in human myocardium

    Science.gov (United States)

    Zhu, Lan; Gress, Steeve; Gérard, Jean-Louis; Allouche, Stéphane; Hanouz, Jean-Luc

    2016-01-01

    Propofol has been shown to exert cardioprotection, but the underlying mechanisms remain incompletely understood. We examined: (1) whether propofol-induced cardioprotection depended on the time and the dose of administration; (2) the role of mitochondrial adenosine triphosphate-sensitive potassium channels, nitric oxide synthase, and mitochondrial respiratory chain activity in propofol-induced cardioprotection. Human right atrial trabeculae were obtained during cardiopulmonary bypass for coronary artery bypass and aortic valve replacement. Isometric force of contraction of human right atrial trabeculae hanged in an oxygenated Tyrode’s solution was recorded during 30-min hypoxia and 60-min reoxygenation (Control). Propofol 0.1, 1, and 10 µM was administered: (1) 5 min before hypoxia until the end of the experiment; (2) 5 min followed by 5-min washout before hypoxia; (3) during the reoxygenation period, propofol 10 µM was administered in presence of 5-hydroxydecanoate (antagonist of mitochondrial adenosine triphosphate-sensitive potassium channels), and NG-nitro-L-arginine methyl ester (inhibitor of nitric oxide synthase). In addition, mitochondria were isolated from human right atrial at 15 min of reoxygenation. The effect of propofol on activity of the mitochondrial respiratory chain complexes was evaluated by spectrophotometry. The force of contraction (% of baseline) and the complex activity between the different groups were compared with an analysis of variance and post hoc test. Propofol 10 µM administered during the reoxygenation period significantly improved the recovery of force of contraction at the end of reoxygenation (82 ± 6% of baseline value vs. 49 ± 6% in Control; P mitochondrial respiratory chain complexes, in reoxygenation period, compared to their respective untreated controls. In conclusion, in human myocardium, propofol-induced cardioprotection was mediated by mitochondrial adenosine triphosphate-sensitive potassium

  15. Potential inhibition of cytochrome P450 3A4 by propofol in human primary hepatocytes

    Institute of Scientific and Technical Information of China (English)

    Li-Qun Yang; Wei-Feng Yu; Yun-Fei Cao; Bin Gong; Qing Chang; Guang-Shun Yang

    2003-01-01

    AIM: Hepatic cytochrome P450 isoenzymes constitute a superfamily of hemoproteins that play a major role in the metabolism of endogenous compounds and in the detoxification of xenobiotic molecules. P450 3A4 is one of the most important forms in human being, and mediates the metabolism of around 70% of therapeutic drugs and endogenous compounds. Propofol, a widely used intravenous anesthetic drug, is known to inhibit cytochrome P450activities in isolated rat hepatocytes. The goal of this study was to evaluate the potential efficacy of propofol on P4503A4 in a dose-dependent manner to understand its drugdrug interaction.METHODS: Hepatocytes were isolated from liver specimens from hepatic angioma patients undergone hepatic surgery.Primary incubated hepatocytes were treated with 0, 0.01,0.05, 0.1, 0.5, and 1.0 mM propofol for 24 hours. P450 3A4activity was measured with Nash′s colorimetry. The protein expression was assessed by Western blot analysis.RESULTS: A dose-dependent inhibitory effect of propofol was observed in cytochrome P450 3A4 activity. A minimal dosage of propofol (0.01 mM) induced a significant inhibition of P450 3A4 activity, although its regular dosages (0.01-0.1mM) showed no inhibitory effect on the cellular protein expression of P450 3A4.CONCLUSION: Propofol may be a potential CYP3A4 inhibitor as this anesthetic can inhibit isoenzyme activity significantly and reduce the metabolic rate of CYP3A4 substrates. This inhibition occurs at post-expression level, and concentration of propofol used clinically does not affect CYP3A4 protein expression. propofol may thus induce drug interaction of cytochrome P450 3A4 activity at the dosage used clinically.

  16. Desflurane reinforces the efficacy of propofol target-controlled infusion in patients undergoing laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Po-Nien Chen

    2016-01-01

    Full Text Available Whether low-concentration desflurane reinforces propofol-based intravenous anesthesia on maintenance of anesthesia for patients undergoing laparoscopic cholecystectomy is to be determined. The aim of this study was to investigate whether propofol-based anesthesia adding low-concentration desflurane is feasible for laparoscopic cholecystectomy. Fifty-two patients undergoing laparoscopic cholecystectomy were enrolled in the prospective, randomized, clinical trial. Induction of anesthesia was achieved in all patients with fentanyl 2 μg/kg, lidocaine 1 mg/kg, propofol 2 mg/kg, and rocuronium 0.8 mg/kg to facilitate tracheal intubation and to initiate propofol target-controlled infusion (TCI to effect site concentration (Ce: 4 μg/mL with infusion rate 400 mL/h. The patients were then allocated into either propofol TCI based (group P or propofol TCI adding low-concentration desflurane (group PD for maintenance of anesthesia. The peri-anesthesia hemodynamic responses to stimuli were measured. The perioperative psychomotor test included p-deletion test, minus calculation, orientation, and alert/sedation scales. Group PD showed stable hemodynamic responses at CO2 inflation, initial 15 minutes of operation, and recovery from general anesthesia as compared with group P. There is no significant difference between the groups in operation time and anesthesia time, perioperative psychomotor functional tests, postoperative vomiting, and pain score. Based on our findings, the anesthetic technique combination propofol and desflurane for the maintenance of general anesthesia for laparoscopic cholecystectomy provided more stable hemodynamic responses than propofol alone. The combined regimen is recommended for patients undergoing laparoscopic cholecystectomy.

  17. A pharmacodynamic analysis of factors affecting recovery from anesthesia with propofol-remifentanil target controlled infusion

    Institute of Scientific and Technical Information of China (English)

    Bon-nyeo KOO; Jeong-rim LEE; Gyu-jeong NOH; Jae-hoon LEE; Young-ran KANG; Dong-woo HAN

    2012-01-01

    Aim:To examine individual patient's demographic parameters and clinical variables related to return of consciousness (ROC) and the pharmacodynamic relationship between propofol effect-site concentration (Ce) and ROC from propofol-remifentanil anesthesia.Methods:Ninety-four patients received propofol-remifentanil anesthesia using the effect-site target-controlled infusion (TCI) system.All clinical events were noted,and variables possibly related to propofol Ce at ROC were examined using linear correlation analyses.Pharmacodynamic modeling incorporating covariates was performed using NONMEM (Nonlinear Mixed Effects Modeling) Ⅶ software.Results:The Ce values of propofol at loss of consciousness (LOC) and ROC were 4.4±1.1 μg/mL and 1.1±0.3 μg/mL respectively.Age was negatively correlated with propofol Ce at ROC (r=-0.48,P<0.01).Including age as a covariate in Ce50 (the effect-site concentration associated with 50% probability of return of consciousness) and λ (the steepness of the concentration-versus-response relationship) significantly improved the performance of the basic model based on the likelihood ratio test,with a significant decrease in the minimum value of the objective function.The Ce50 in 25-,50-,and 75-year-old patients was predicted to be 1.38,1.06,and 0.74 Iμg/mL,respectively.The λ,in 25-,50-,and 75-year-old patients was predicted to be 12.23,8.70,and 5.18,respectively.Conclusion:Age significantly affects the relationship between propofol Ce and ROC,and pharmacodynamic modeling including age could lead to better predictions of ROC during emergence from propofol-remifentanil anesthesia.

  18. Relación entre conducta y activación de áreas cerebrales. empleo de la técnica de agnor en psicología comparada

    Directory of Open Access Journals (Sweden)

    Martín Miguel Puddington

    2016-01-01

    Full Text Available Se presenta una revisión de distintos estudios que emplearon la técnica de AgNOR en el campo de las neurociencias del comportamiento. AgNOR es una técnica histológica que permite estudiar la activación cerebral de una región específica. Esta técnica ha sido utilizada en distintos grupos zoo lógicos que comprenden desde peces y anfibios hasta mamíferos, incluyendo actividad neural tanto en procesos normales como patológicos. En conjunto, la técnica de AgNOR tiene tres notables ventajas con respecto a otras técnicas histológicas como las inmunohistoquímicas. En primer lugar, su bajo costo. En segundo lugar, su robustez. Fi nalmente, la posibilidad de ser aplicada con faci lidad a cualquier especie animal, siendo esto úl timo particularmente relevante en el campo de la Psicología Comparada . Paradójicamente a pesar de estas ventajas, es una técnica poco conocida y empleada. El propósito de este artículo es contri buir a su difusión dentro de la comunidad de científicos del comportamiento.

  19. Bispectral index for monitoring anesthetic depth in patients with severe burns receiving target-controlled infusion of remifentanil and propofol.

    Science.gov (United States)

    Guo, Z G; Jia, X P; Wang, X Y; Li, P; Su, X J; Hao, J H

    2015-07-13

    This study evaluated the feasibility and effectiveness of using the bispectral index (BIS) to monitor anesthetic depth in patients with severe burns receiving intravenous target-controlled infusion (TCI) of remifentanil and propofol. We randomly assigned 80 patients undergoing elective escharectomy (depth in patients with severe burns receiving TCI of remifentanil and propofol during the perioperative period reduces propofol consumption and shortens the consciousness recovery time in patients.

  20. A COMPARISON OF THE EFFECTS OF THE PROPOFOL VERSUS MIDAZOLAM DURING TOTAL INTRAVENOUS ANESTHESIA FOR GYNECOLOGICAL SURGERY PROCEDURES

    Institute of Scientific and Technical Information of China (English)

    叶铁虎; 龚志毅; 金永芳; 王玲; 任洪智; 罗爱伦

    1995-01-01

    The effects of propofol and midazolam as an intravenous anesthetic were compared in 40 ASA Ⅰ - Ⅱ patlents undergoing gynecological surgery during total intravenous anesthesia (TIVA). They were divided into propofol group (P n=20) and rnidazolam group (M n=20) randomly. The anesthesia was designed for each group respectively. Here, we discuss the experimental method and the results, which indicate that propofol is not only an effective anesthetic but also has more rapid and head-cleat recovery properties than midazolam.

  1. A novel system for automated propofol sedation: hybrid sedation system (HSS).

    Science.gov (United States)

    Zaouter, Cedrick; Taddei, Riccardo; Wehbe, Mohamad; Arbeid, Erik; Cyr, Shantale; Giunta, Francesco; Hemmerling, Thomas M

    2017-04-01

    Closed-loop systems for propofol have been demonstrated to be safe and reliable for general anesthesia. However, no study has been conducted using a closed-loop system specifically designed for sedation in patients under spinal anesthesia. We developed an automatic anesthesia sedation system that allows for closed-loop delivery of propofol for sedation integrating a decision support system, called the hybrid sedation system (HSS). The objective of this study is to compare this system with standard practice. One hundred fifty patients were enrolled and randomly assigned to two groups: HSS-Group (N = 75), in which propofol was administered using a closed-loop system; Control Group (N = 75), in which propofol was delivered manually. The clinical performance of the propofol sedation control is defined as efficacy to maintain bispectral index (BIS) near 65. The clinical control was called 'Excellent', 'Good', 'Poor' and 'Inadequate' with BIS values within 10 %, from 11 to 20 %, 21 to 30 %, or greater than 30 % of the BIS target of 65, respectively. The controller performance was evaluated using Varvel's parameters. Data are presented as mean ± standard deviation, groups were compared using t test or Chi square test, P propofol sedation showed better maintenance of the target BIS value compared to manual administration.

  2. Propofol Exposure in Pregnant Rats Induces Neurotoxicity and Persistent Learning Deficit in the Offspring

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    Ming Xiong

    2014-05-01

    Full Text Available Propofol is a general anesthetic widely used in surgical procedures, including those in pregnant women. Preclinical studies suggest that propofol may cause neuronal injury to the offspring of primates if it is administered during pregnancy. However, it is unknown whether those neuronal changes would lead to long-term behavioral deficits in the offspring. In this study, propofol (0.4 mg/kg/min, IV, 2 h, saline, or intralipid solution was administered to pregnant rats on gestational day 18. We detected increased levels of cleaved caspase-3 in fetal brain at 6 h after propofol exposure. The neuronal density of the hippocampus of offspring was reduced significantly on postnatal day 10 (P10 and P28. Synaptophysin levels were also significantly reduced on P28. Furthermore, exploratory and learning behaviors of offspring rats (started at P28 were assessed in open-field trial and eight-arm radial maze. The offspring from propofol-treated dams showed significantly less exploratory activity in the open-field test and less spatial learning in the eight-arm radial maze. Thus, this study suggested that propofol exposure during pregnancy in rat increased cleaved caspsase-3 levels in fetal brain, deletion of neurons, reduced synaptophysin levels in the hippocampal region, and persistent learning deficits in the offspring.

  3. The pharmacokinetics of propofol in ICU patients undergoing long-term sedation.

    Science.gov (United States)

    Smuszkiewicz, Piotr; Wiczling, Paweł; Przybyłowski, Krzysztof; Borsuk, Agnieszka; Trojanowska, Iwona; Paterska, Marta; Matysiak, Jan; Kokot, Zenon; Grześkowiak, Edmund; Bienert, Agnieszka

    2016-11-01

    The aim of this study was to characterize the pharmacokinetics (PK) of propofol in ICU patients undergoing long-term sedation and to assess the influence of routinely collected covariates on the PK parameters. Propofol concentration-time profiles were collected from 29 patients. Non-linear mixed-effects modelling in NONMEM 7.2 was used to analyse the observed data. The propofol pharmacokinetics was best described with a three-compartment disposition model. Non-parametric bootstrap and a visual predictive check were used to evaluate the adequacy of the developed model to describe the observations. The typical value of the propofol clearance (1.46 l/min) approximated the hepatic blood flow. The volume of distribution at steady state was high and was equal to 955.1 l, which is consistent with other studies involving propofol in ICU patients. There was no statistically significant covariate relationship between PK parameters and opioid type, SOFA score on the day of admission, APACHE II, predicted death rate, reason for ICU admission (sepsis, trauma or surgery), gender, body weight, age, infusion duration and C-reactive protein concentration. The population PK model was developed successfully to describe the time-course of propofol concentration in ICU patients undergoing prolonged sedation. Despite a very heterogeneous group of patients, consistent PK profiles were observed. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Propofol Anesthesia Is Reduced in Phospholipase C-Related Inactive Protein Type-1 Knockout Mice.

    Science.gov (United States)

    Nikaido, Yoshikazu; Furukawa, Tomonori; Shimoyama, Shuji; Yamada, Junko; Migita, Keisuke; Koga, Kohei; Kushikata, Tetsuya; Hirota, Kazuyoshi; Kanematsu, Takashi; Hirata, Masato; Ueno, Shinya

    2017-06-01

    The GABA type A receptor (GABAA-R) is a major target of intravenous anesthetics. Phospholipase C-related inactive protein type-1 (PRIP-1) is important in GABAA-R phosphorylation and membrane trafficking. In this study, we investigated the role of PRIP-1 in general anesthetic action. The anesthetic effects of propofol, etomidate, and pentobarbital were evaluated in wild-type and PRIP-1 knockout (PRIP-1 KO) mice by measuring the latency and duration of loss of righting reflex (LORR) and loss of tail-pinch withdrawal response (LTWR). The effect of pretreatment with okadaic acid (OA), a protein phosphatase 1/2A inhibitor, on propofol- and etomidate-induced LORR was also examined. PRIP-1 deficiency provided the reduction of LORR and LTWR induced by propofol but not by etomidate or pentobarbital, indicating that PRIP-1 could determine the potency of the anesthetic action of propofol. Pretreatment with OA recovered the anesthetic potency induced by propofol in PRIP-1 KO mice. OA injection enhanced phosphorylation of cortical the GABAA-R β3 subunit in PRIP-1 KO mice. These results suggest that PRIP-1-mediated GABAA-R β3 subunit phosphorylation might be involved in the general anesthetic action induced by propofol but not by etomidate or pentobarbital. Copyright © 2017 by The American Society for Pharmacology and Experimental Therapeutics.

  5. Anti-inflammatory effects of propofol during cardiopulmonary bypass: A pilot study

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    A Samir

    2015-01-01

    Full Text Available Introduction: Propofol has been suggested as a useful adjunct to cardiopulmonary bypass (CPB because of its potential protective effect on the heart mediated by a decrease in ischemia-reperfusion injury and inflammation at clinically relevant concentrations. In view of these potentially protective properties, which modulate many of the deleterious mechanism of inflammation attributable to reperfusion injury and CPB, we sought to determine whether starting a low dose of propofol infusion at the beginning of CPB would decrease inflammation as measured by pro-inflammatory markers. Materials and Methods: We enrolled 24 patients undergoing elective coronary artery bypass graft (CABG. The study group received propofol at rate of 120 mcg/kg/min immediately after starting CPB and was maintained throughout the surgery and for the following 6 hours in the intensive care unit (ICU. The control group received propofol dose of 30-50 mcg/kg/min which was started at the time of chest closure with wires and continued for the next 6 hours in the ICU. Interleukins (IL -6, -8 and -10 and tumor necrosis factor alpha (TNFalpha were assayed. Result: The most significant difference was in the level of IL-6 which had a P value of less than 0.06. Starting a low dose propofol early during the CPB was not associated with significant hemodynamic instability in comparison with the control group. Conclusion: Our study shows that propofol may be suitable as an anti-inflammatory adjunct for patients undergoing CABG.

  6. Synergistic antinociceptive effects of alfentanil and propofol in the formalin test.

    Science.gov (United States)

    Jia, Na; Zuo, Xiaochun; Guo, Chao; Li, Yuwen; Cui, Jia; Zhao, Chao; Cao, Shanshan; Wang, Chao; Li, Ruili; Wu, Yin; Wen, Aidong

    2017-04-01

    The present study was conducted to determine the combined analgesic effect of alfentanil and propofol in the formalin test. Diluted formalin was injected into the dorsal surface of the right hind paw in rats. Nociceptive behavior was determined by counting the number of flinches of the injected paw for 1 h after injection; a reduction in formalin‑induced flinching was interpreted as an antinociceptive effect. Isobolographic analysis was used to determine the type of antinociceptive interaction (additivity, antagonism or synergism). Extracellular signal‑regulated kinase (ERK) and c‑fos protein levels were also detected by western blot analysis to determine the potential mechanisms of the synergistic effect. Alfentanil, propofol or an alfentanil‑propofol combination had an antinociceptive effect in the formalin test. The median effective dose (ED50), value of the individual drug was also obtained. The derived theoretical ED50 for the antinociceptive effect (4.36 mg/kg) was different from the observed experimental ED50 value (2.51 mg/kg). The interaction between alfentanil and propofol that produced the antinociceptive effect was synergistic according to isobolographic analysis. Furthermore, the combination of alfentanil and propofol treatments may produce synergistically antinociceptive effects by inhibiting the phosphorylation of ERK1/2 and decreasing the expression of c‑fos in the spinal cord. These results demonstrated that combined treatment, with alfentanil and propofol, produced synergistic antinociceptive effects in the formalin test and may have therapeutic potential for the treatment of acute pain.

  7. Low-dose propofol for the abortive treatment of pediatric migraine in the emergency department.

    Science.gov (United States)

    Sheridan, David C; Spiro, David M; Nguyen, Thuan; Koch, Thomas K; Meckler, Garth D

    2012-12-01

    Limited progress has been made in the past decade for abortive treatment of migraine headache in the pediatric emergency department (PED). Propofol, a general anesthetic, has been reported to be effective in the treatment of refractory headaches in adults at subanesthetic doses but never in the pediatric population. The goal of this study was to review our institution's experience with subanesthetic doses of propofol for the abortive treatment of pediatric migraine and compare propofol with standard abortive therapy in the PED. Retrospective review of all patients discharged from the Oregon Health and Science University PED with a diagnosis of migraine headache from January 2010 to July 2011. Patients treated with subanesthetic doses of propofol were compared with matched controls who received standard abortive migraine therapy, defined as the combined use of a nonsteroidal anti-inflammatory medication, diphenhydramine, and prochlorperazine. Outcome variables of interest included reduction of pain as measured on a self-reported visual analog scale and length of stay after administration of initial abortive medication. Patients who received subanesthetic doses of propofol achieved significantly greater reduction in pain scores (80.1% vs 61.1%; P Propofol seems to be effective for the abortive treatment of pediatric migraine headache in the PED. Further prospective trials are warranted to either support or refute these initial findings.

  8. How to control propofol infusion in pediatric patients undergoing gamma knife radiosurgery.

    Science.gov (United States)

    Kamata, Kotoe; Hayashi, Motohiro; Muragaki, Yoshihiro; Iseki, Hiroshi; Okada, Yoshikazu; Ozaki, Makoto

    2013-01-01

    Although Gamma Knife radiosurgery (GKS) is commonly performed under local anesthesia, general anesthesia is sometimes required. The authors previously reported a remote-controlled patient management system consisting of propofol-based general anesthesia with a target-controlled infusion (TCI) that we designed for pediatric GKS. However, a commercially available propofol TCI system has age and weight limitations (propofol appropriate for pediatric GKS. A pharmacokinetic model of the TIVA Trainer© with Paedfusor's parameter was used. A manually controlled infusion scheme to achieve a sufficient level of propofol for pediatric GKS was examined in five models ranging from 10 to 30 kg. Following a loading dose of 3.0 mg/kg, the combination of continuous infusion of 14, 12, 10, and 8 mg/kg/h resulted in a target concentration of 3.0-4.0 μg/ml, the required level for pediatric GKS. Propofol titration is a key issue in GKS. Manual infusion is less accurate than TCI, but the combination of a small bolus and continuous infusion might be a substitute. Considering the characteristics of propofol pharmacokinetics in children, co-administration of opioids is recommended.

  9. Comparative evaluation of propofol in nanoemulsion with solutol and soy lecithin for general anesthesia

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    José Carlos Rittes

    2016-06-01

    Full Text Available ABSTRACT INTRODUCTION: The vehicle for propofol in 1 and 2% solutions is soybean oil emulsion 10%, which may cause pain on injection, instability of the solution and bacterial contamination. Formulations have been proposed aiming to change the vehicle and reduce these adverse reactions. OBJECTIVES: To compare the incidence of pain caused by the injection of propofol, with a hypothesis of reduction associated with nanoemulsion and the occurrence of local and systemic adverse effects with both formulations. METHOD: After approval by the CEP, patients undergoing gynecological procedures were included in this prospective study: control (n = 25 and nanoemulsion (n = 25 groups. Heart rate, noninvasive blood pressure and peripheral oxygen saturation were monitored. Demographics and physical condition were analyzed; surgical time and total volume used of propofol; local or systemic adverse effects; changes in variables monitored. A value of p < 0.05 was considered significant. RESULTS: There was no difference between groups regarding demographic data, surgical times, total volume of propofol used, arm withdrawal, pain during injection and variables monitored. There was a statistically significant difference in pain intensity at the time of induction of anesthesia, with less pain intensity in the nanoemulsion group. CONCLUSIONS: Both lipid and nanoemulsion formulations of propofol elicited pain on intravenous injection; however, the nanoemulsion solution elicited a less intense pain. Lipid and nanoemulsion propofol formulations showed neither hemodynamic changes nor adverse effects of clinical relevance.

  10. Comparative evaluation of propofol in nanoemulsion with solutol and soy lecithin for general anesthesia.

    Science.gov (United States)

    Rittes, José Carlos; Cagno, Guilherme; Perez, Marcelo Vaz; Mathias, Ligia Andrade da Silva Telles

    2016-01-01

    The vehicle for propofol in 1 and 2% solutions is soybean oil emulsion 10%, which may cause pain on injection, instability of the solution and bacterial contamination. Formulations have been proposed aiming to change the vehicle and reduce these adverse reactions. To compare the incidence of pain caused by the injection of propofol, with a hypothesis of reduction associated with nanoemulsion and the occurrence of local and systemic adverse effects with both formulations. After approval by the CEP, patients undergoing gynecological procedures were included in this prospective study: control (n=25) and nanoemulsion (n=25) groups. Heart rate, noninvasive blood pressure and peripheral oxygen saturation were monitored. Demographics and physical condition were analyzed; surgical time and total volume used of propofol; local or systemic adverse effects; changes in variables monitored. A value of p<0.05 was considered significant. There was no difference between groups regarding demographic data, surgical times, total volume of propofol used, arm withdrawal, pain during injection and variables monitored. There was a statistically significant difference in pain intensity at the time of induction of anesthesia, with less pain intensity in the nanoemulsion group. Both lipid and nanoemulsion formulations of propofol elicited pain on intravenous injection; however, the nanoemulsion solution elicited a less intense pain. Lipid and nanoemulsion propofol formulations showed neither hemodynamic changes nor adverse effects of clinical relevance. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  11. Effect of propofol in the immature rat brain on short- and long-term neurodevelopmental outcome.

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    Tanja Karen

    Full Text Available BACKGROUND: Propofol is commonly used as sedative in newborns and children. Recent experimental studies led to contradictory results, revealing neurodegenerative or neuroprotective properties of propofol on the developing brain. We investigated neurodevelopmental short- and long-term effects of neonatal propofol treatment. METHODS: 6-day-old Wistar rats (P6, randomised in two groups, received repeated intraperitoneal injections (0, 90, 180 min of 30 mg/kg propofol or normal saline and sacrificed 6, 12 and 24 hrs following the first injection. Cortical and thalamic areas were analysed by Western blot and quantitative real-time PCR (qRT-PCR for expression of apoptotic and neurotrophin-dependent signalling pathways. Long-term effects were assessed by Open-field and Novel-Object-Recognition at P30 and P120. RESULTS: Western blot analyses revealed a transient increase of activated caspase-3 in cortical, and a reduction of active mitogen-activated protein kinases (ERK1/2, AKT in cortical and thalamic areas. qRT-PCR analyses showed a down-regulation of neurotrophic factors (BDNF, NGF, NT-3 in cortical and thalamic regions. Minor impairment in locomotive activity was observed in propofol treated adolescent animals at P30. Memory or anxiety were not impaired at any time point. CONCLUSION: Exposing the neonatal rat brain to propofol induces acute neurotrophic imbalance and neuroapoptosis in a region- and time-specific manner and minor behavioural changes in adolescent animals.

  12. Inhibitory effects of propofol on excitatory synaptic transmission in supraoptic nucleus neurons in vitro.

    Science.gov (United States)

    Zhang, Huan-Huan; Zheng, Chao; Wang, Bang-An; Wang, Meng-Ya

    2015-12-25

    The present study was designed to investigate the inhibitory effects of intravenous general anesthetic propofol (0.1-3.0 mmol/L) on excitatory synaptic transmission in supraoptic nucleus (SON) neurons of rats, and to explore the underlying mechanisms by using intracellular recording technique and hypothalamic slice preparation. It was observed that stimulation of the dorsolateral region of SON could elicit the postsynaptic potentials (PSPs) in SON neurons. Of the 8 tested SON neurons, the PSPs of 7 (88%, 7/8) neurons were decreased by propofol in a concentration-dependent manner, in terms of the PSPs' amplitude (P EPSPs) of 7 cells increased in the condition of picrotoxin (30 µmol/L, a GABA(A) receptor antagonist) pretreatment. On this basis, the inhibitory effects of propofol on EPSPs were decreased. These data indicate that the presynaptic and postsynaptic mechanisms may be both involved in the inhibitory effects of propofol on excitatory synaptic transmission in SON neurons. The inhibitory effects of propofol on excitatory synaptic transmission of SON neurons may be related to the activation of GABA(A) receptors, but at a high concentration, propofol may also act directly on glutamate receptors.

  13. Propofol vs traditional sedative agents for endoscopic retrograde cholangiopancreatography: A meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Lu-Long Bo; Yu Bai; Jin-Jun Bian; Ping-Shan Wen; Jin-Bao Li; Xiao-Ming Deng

    2011-01-01

    AIM: To investigate the efficacy and safety of propofol sedation for endoscopic retrograde cholangiopancreatography (ERCP). METHODS: Databases including PubMed, Embase, and the Cochrane Central Register of Controlled Trials updated as of October 2010 were searched. Main outcome measures were ERCP procedure duration, recovery time, incidence of hypotension and hypoxia. RESULTS: Six trials with a total of 663 patients were included. The pooled mean difference in ERCP procedure duration between the propofol and traditional sedative agents was -8.05 (95% CI: -16.74 to 0.63), with no significant difference between the groups. The pooled mean difference in the recovery time was -18.69 (95% CI: -25.44 to -11.93), which showed a significant reduction with use of propofol sedation. Compared with traditional sedative agents, the pooled OR with propofol sedation for ERCP causing hypotension or hypoxia was 1.69 (95% CI: 0.82-3.50) and 0.90 (95% CI: 0.55-1.49), respectively, which indicated no significant difference between the groups. CONCLUSION: Propofol sedation during ERCP leads to shorter recovery time without an increase of cardiopulmonary side effects. Propofol sedation can provide adequate sedation during ERCP.

  14. Effect of intravenous anesthetic propofol on synaptic vesicle exocytosis at the frog neuromuscular junction

    Institute of Scientific and Technical Information of China (English)

    Luciana Ferreira LEITE; Renato Santiago GOMEZ; Matheus de Castro FONSECA; Marcus Vinicius GOMEZ; Cristina GUATIMOSIM

    2011-01-01

    Aim: To investigate the presynaptic effects of propofol, a short-acting intravenous anesthetic, in the frog neuromuscular junction. Methods: Frog cutaneous pectoris nerve muscle preparations were prepared. A fluorescent tool (FM1-43) was used to visualize the effect of propofol on synaptic vesicle exocytosos in the frog neuromuscular junction. Results: Low concentrations of propofol, ranging from 10 to 25 μmol/L, enhanced spontaneous vesicle exocytosis monitored by FM1-43 in a Ca2+-dependent and Na+-independent fashion. Higher concentrations of propofol (50, 100, and 200 μmol/L) had no effect on spontaneous exocytosis. By contrast, higher concentrations of propofol inhibited the Na+-dependent exocytosis evoked by 4-aminopyri-dine but did not affect the Na+-independent exocytosis evoked by KCI. This action was similar and non-additive with that observed by tetrodotoxin, a Na+ channel blocker.Conclusion: Our data suggest that propofol has a dose-dependent presynaptic effect at the neuromuscular transmission which mayhelp to understand some of the clinical effects of this agent on neuromuscular function.

  15. Clinical evaluation of total intravenous anesthesia using a combination of propofol and medetomidine following anesthesia induction with medetomidine, guaifenesin and propofol for castration in Thoroughbred horses.

    Science.gov (United States)

    Oku, Kazuomi; Kakizaki, Masashi; Ono, Keiichi; Ohta, Minoru

    2011-12-01

    Seven Thoroughbred horses were castrated under total intravenous anesthesia (TIVA) using propofol and medetomidine. After premedication with medetomidine (5.0 µg/kg, intravenously), anesthesia was induced with guaifenesin (100 mg/kg, intravenously) and propofol (3.0 mg/kg, intravenously) and maintained with constant rate infusions of medetomidine (0.05 µg/kg/min) and propofol (0.1 mg/kg/min). Quality of induction was judged excellent to good. Three horses showed insufficient anesthesia and received additional anesthetic. Arterial blood pressure changed within an acceptable range in all horses. Decreases in respiratory rate and hypercapnia were observed in all horses. Three horses showed apnea within a short period of time. Recovery from anesthesia was calm and smooth in all horses. The TIVA-regimen used in this study provides clinically effective anesthesia for castration in horses. However, assisted ventilation should be considered to minimize respiratory depression.

  16. A randomized controlled trial to compare fentanyl-propofol and ketamine-propofol combination for procedural sedation and analgesia in laparoscopic tubal ligation

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    Ranju Singh

    2013-01-01

    Full Text Available Background: Procedural sedation and analgesia is widely being used for female laparoscopic sterilization using combinations of different drugs at varying doses. This study compared the combination of fentanyl and propofol, and ketamine and propofol in patients undergoing outpatient laparoscopic tubal ligation, with respect to their hemodynamic effects, postoperative recovery characteristics, duration of hospital stay, adverse effects, and patient comfort and acceptability. Settings and Design: Randomized, double blind. Methods: Patients were assigned to receive premixed injection of either fentanyl 1.5 μg/kg + propofol 2 mg/kg (Group PF, n0=50 or ketamine 0.5 mg/kg + propofol 2 mg/kg (Group PK, n=50. Hemodynamic data, peripheral oxygen saturation, and respiratory rate were recorded perioperatively. Recovery time, time to discharge, and comfort score were noted. Statistical Analysis: Chi-square (χ2 test was used for categorical data. Student′s t-test was used for quantitative variables for comparison between the two groups. For intragroup comparison, paired t-test was used. SPSS 14.0 was used for analysis. Results: Although the heart rate was comparable, blood pressures were consistently higher in group PK. Postoperative nausea and vomiting and delay in voiding were more frequent in group PK ( P<0.05. The time to reach Aldrete score ≥8 was significantly longer in group PK (11.14±3.29 min in group PF vs. 17.3±6.32 min in group PK, P<0.01. The time to discharge was significantly longer in group PK (105.8±13.07 min in group PF vs.138.18±13.20 min in group PK, P<0.01. Patient comfort and acceptability was better in group PF, P<0.01. Conclusion: As compared to ketamine-propofol, fentanyl-propofol combination is associated with faster recovery, earlier discharge, and better patient acceptability.

  17. Patient-controlled sedation with propofol/remifentanil versus propofol/alfentanil for patients undergoing outpatient colonoscopy, a randomized, controlled double-blind study

    Directory of Open Access Journals (Sweden)

    Sherif S Sultan

    2014-01-01

    Full Text Available Context: Many techniques are used for sedation of colonoscopies. Patient-controlled sedation (PCS is utilizing many drugs or drug combinations. Aims: The aim of this study is to compare the safety and feasibility of propofol/remifentanil versus propofol/alfentanil given to sedate patients undergoing outpatient colonoscopies through a patient-controlled technique. Settings and Design: Controlled randomized and double-blind study. Materials and Methods: A total of 80 patients were randomly divided into two groups; PA group received a combination of propofol/alfentanil and PR group received propofol/remifentanil combination. Patients were monitored for heart rate (HR, blood pressure (BP, oxygen saturation, and Ramsay sedation scale (RSS. Times of the following events were recorded; initiation of sedation, insertion and removal of the colonoscope, recovery and discharge. Five intervals were calculated; time to sedation, procedure time, postprocedure time, procedure room time, and postanesthesia care unit (PACU time. Endoscopist and patient satisfaction scores were obtained. Statistical Analysis Used: Unpaired Student′s t-test was used to compare between the two groups. Paired Student′s t-test was used to compare baseline readings with readings after 30 min of sedation in the same group when needed. Results: Both groups showed slowing of the HR and decrease in mean arterial BP. HR and mean arterial BP were significantly lower 5 and 10 min after initiation of sedation in PR group when compared with PA group. Both HR and mean arterial BP returned to presedation readings 30 min after initiation of sedation in PR group but not in PA group. No differences between the two groups concerning oxygen saturation, RSS, endoscopist and patient satisfaction scores. Postprocedure and PACU times were significantly prolonged in PA group. Conclusion: PCS with either remifentanil/propofol or alfentanil/propofol for patients undergoing outpatient colonoscopy is safe

  18. Sedative and Analgesic Effects of Propofol-Fentanyl Versus Propofol-Ketamine During Endoscopic Retrograde Cholangiopancreatography: A Double-Blind Randomized Clinical Trial

    Science.gov (United States)

    Bahrami Gorji, Fakhroddin; Amri, Parviz; Shokri, Javad; Alereza, Hakimeh; Bijani, Ali

    2016-01-01

    Background Endoscopic retrograde cholangiopancreatography (ERCP) is a painful procedure that requires analgesia and sedation. Objectives In this study, we compared the analgesic and sedative effects of propofol-ketamine versus propofol-fentanyl in patients undergoing ERCP. Methods In this clinical trial, 72 patients, aged 30 - 70 years old, who were candidates for ERCP were randomly divided into two groups. Before the start of ERCP, both groups received midazolam 0.5 - 1 mg. The intervention group (PK) received ketamine 0.5 mg/kg, and the control group (PF) received fentanyl 50 - 100 micrograms. All patients received propofol 0.5 mg/kg in a loading dose followed by 75 mcg/kg/minute in an infusion. The patients, the anesthesiologist, and the endoscopist were unaware of the medication regimen. Sedation and analgesia quality (based on a VAS), blood pressure, respiratory rate, heart rate, arterial oxygen saturation, recovery time (based on Aldrete scores), and endoscopist and patient satisfation were recorded. Results The sedative effects were equal in the two groups (P > 0.05), but the analgesic effects were higher in the PF group than in the PK group (P 0.05). Endoscopist satisfaction, patient satisfaction, and recovery time showed no significant differences between the two groups (P > 0.05). Conclusions The results showed that the sedative effect of propofol-ketamine was equal to the propofol-fentanyl combination during ERCP. To prevent respiratory and hemodynamic complications during ERCP, the propofol-ketamine combination should be used in patients with underlying disease. PMID:27853681

  19. Awake craniotomy anesthetic management using dexmedetomidine, propofol, and remifentanil.

    Science.gov (United States)

    Prontera, Andrea; Baroni, Stefano; Marudi, Andrea; Valzania, Franco; Feletti, Alberto; Benuzzi, Francesca; Bertellini, Elisabetta; Pavesi, Giacomo

    2017-01-01

    Awake craniotomy allows continuous monitoring of patients' neurological functions during open surgery. Anesthesiologists have to sedate patients in a way so that they are compliant throughout the whole surgical procedure, nevertheless maintaining adequate analgesia and anxiolysis. Currently, the use of α2-receptor agonist dexmedetomidine as the primary hypnotic-sedative medication is increasing. Nine patients undergoing awake craniotomy were treated with refined monitored anesthesia care (MAC) protocol consisting of a combination of local anesthesia without scalp block, low-dose infusion of dexmedetomidine, propofol, and remifentanil, without the need of airways management. The anesthetic protocol applied in our study has the advantage of decreasing the dose of each drug and thus reducing the occurrence of side effects. All patients had smooth and rapid awakenings. The brain remained relaxed during the entire procedure. In our experience, this protocol is safe and effective during awake brain surgery. Nevertheless, prospective randomized trials are necessary to confirm the optimal anesthetic technique to be used.

  20. Québec y Cataluña: redes y profesionales para la acción socioeducativa con familias, infancia y adolescencia en situación de riesgo social

    OpenAIRE

    2006-01-01

    El artículo presenta los resultados de una investigación de campo de pedagogía comparada que se llevó a cabo en Canadá y en España. Concretamente se analizan los resultados en relación a dos objetivos; el primero describir de forma comparada las redes de servicios sociales y las modalidades de acción socioeducativa con familias, infancia y adolescencia en situación de riesgo social; y el segundo analizar los desafíos, retos y dificultades que los profesionales dedicados a la prevención del ma...

  1. Québec y Cataluña: redes y profesionales para la acción socioeducativa con familias, infancia y adolescencia en situación de riesgo social

    OpenAIRE

    María Ángeles Balsells

    2006-01-01

    El artículo presenta los resultados de una investigación de campo de pedagogía comparada que se llevó a cabo en Canadá y en España. Concretamente se analizan los resultados en relación a dos objetivos; el primero describir de forma comparada las redes de servicios sociales y las modalidades de acción socioeducativa con familias, infancia y adolescencia en situación de riesgo social; y el segundo analizar los desafíos, retos y dificultades que los profesionales dedicados a la prevención del ma...

  2. Configuraciones Institucionales de Gobernabilidad: Perspectiva comparada de la toma de decisiones en cuerpos colegiados universitarios

    OpenAIRE

    Olmos, Doctorando Mirtha Tancredi

    2007-01-01

    La reforma del estado en la República Argentina, iniciada luego de la promulgación de la Ley de Educación Superior, impulsó a las instituciones educativas universitarias a emprender esfuerzos importantes para incrementar su capacidad de gestión, por lo cual, los cuerpos colegiados debieron tomar decisiones fundamentadas en respuesta a las nuevas demandas. La exigencia por resultados organizacionales no deriva de un problema de coyuntura, sino de una situación estructural con perspectivas d...

  3. Las relaciones laborales en las PYMES : una visón comparada a nivel europeo

    OpenAIRE

    Medina Chavez, Xavier

    2015-01-01

    A partir del estudio de la evolución histórica de las relaciones laborales y en base al trabajo de investigación realizado en diversos centros de trabajo de Italia, Dinamarca y España, el trabajo revisa algunos de los principales indicadores en materia de relaciones internacionales propuestos desde la sociología de las relaciones laborales: representación laboral, desigualdad salarial y condiciones laborales. Para ello, el trabajo toma la forma de análisis comparativo con la finalidad de obte...

  4. Conducta de enfermedad y niveles de depresión en mujeres embarazadas con diagnóstico de preeclampsia

    Directory of Open Access Journals (Sweden)

    Stefano Vinaccia

    2006-01-01

    Full Text Available El objetivo de este estudio es determinar la conducta de enfermedad en las mujeres que presentan preeclampsia y su relación con la depresión. Un total de 60 mujeres embarazadas con preeclampsia y 60 mujeres con embarazo normal fueron comparadas en conducta de enfermedad y depresión en un diseño transversal. La conducta de enfermedad fue evaluada mediante la versión española del Illness Behaviour Questionaire (IBQ. La depresión fue evaluada con la versión española del CES-D. Los resultados indican que las mujeres embarazadas con preeclampsia, comparadas con las embarazadas sin preeclampsia, presentaron niveles significativamente más altos (p<0,001 en depresión y en las siguientes subescalas del IBQ: hipocondría, convicción de enfermedad, negación del problema, irritabilidad y distorsión afectiva. No se encontraron diferencias significativas en percepción psicológica versus somática de la enfermedad ni tampoco en inhibición afectiva. Los resultados sugieren que las embarazadas con preeclampsia tienen una peor conducta de enfermedad que las embarazadas sin preeclampsia.

  5. Evaluation of efficacy of priming dose of propofol in reducing induction dose requirements in patients undergoing elective surgeries under general anaesthesia

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    Devendra W. Thakare

    2016-09-01

    Conclusions: Propofol produces smooth, rapid, pleasant and safe induction. Priming with propofol can be practiced due to its cost effectiveness and better haemodynamic profile and safety. [Int J Res Med Sci 2016; 4(9.000: 3717-3723

  6. Use of propofol in pediatric intensive care units: a national survey in Germany.

    Science.gov (United States)

    Kruessell, Markus A; Udink ten Cate, Floris E A; Kraus, Anna-Julia; Roth, Bernhard; Trieschmann, Uwe

    2012-05-01

    Propofol is not licensed for sedation in pediatric intensive care medicine mainly due to the risk of propofol infusion syndrome. Nevertheless, it is applied by many pediatric intensive care units. The aim of this national survey was to asses the current use of propofol in pediatric intensive care units in Germany. We performed a nationwide survey. The questionnaire assessed the intensive care unit type, patient numbers, dosing, duration, age and time limits, indications, side effects, and institutional protocols for propofol usage. Pediatric intensive care units in Germany. Questionnaire about routine use of propofol sent to 214 pediatric departments. None. One hundred ninety-four questionnaires (90.7%) were returned, ten had to be censored. The final analysis comprised 184 questionnaires (134 pediatric/neonatal intensive care units, 28 pediatric intensive care units, 22 neonatal intensive care units). Seventy-nine percent of intensive care units (n = 145 of 184) used propofol in children under the age of 16 yrs. Of these, 98% were for bolus application (n = 142 of 145), 78% for infusion ≥3 hrs (n = 113 of 145), and 33% for infusion >3 hrs (n = 48 of 145). A lower age limit was applied by 52% (n = 75 of 145) and a dose limit by 51% (n = 74 of 145). The median dose limit was 4 mg/kg/hr; 48% (n = 70 of 145) used 3 mg/kg/hr or less. A time limit was applied by 98% (n = 46 of 47), 70% (n = 33 of 47) used it for ≤24 hrs, and 30% (n = 15 of 47) for >24 hrs. MAIN INDICATIONS FOR PROPOFOL APPLICATION WERE: difficult sedation (44%), postoperative ventilation (43%), and difficult extubation (30%). Seven cases of propofol infusion syndrome were reported by seven centers. This study shows that propofol is used off-license by many pediatric intensive care units in Ge. The majority of users has adopted tightly controlled regimens for propofol sedation, and limits the dose to ≤3-4 mg/kg/hr and the maximum application time to 24-48 hrs.

  7. Neonatal Propofol and Etomidate Exposure Enhance Inhibitory Synaptic Transmission in Hippocampal Cornus Ammonis 1 Pyramidal Neurons

    Institute of Scientific and Technical Information of China (English)

    Jia-Qiang Zhang; Wan-Ying Xu; Chang-Qing Xu

    2016-01-01

    Background:Propofol and etomidate are the most important intravenous general anesthetics in the current clinical use and that mediate gamma-aminobutyric acid's (GABAergic) synaptic transmission.However,their long-term effects on GABAergic synaptic transmission induced by neonatal propofol or etomidate exposure remain unclear.We investigated the long-term GABAergic neurotransmission alterations,following neonatal propofol and etomidate administration.Methods:Sprague-Dawley rat pups at postnatal days 4 6 were underwent 6-h-long propofol-induced or 5-h-long etomidate-induced anesthesia.We performed whole-cell patch-clamp recording from pyramidal cells in the cornus ammonis 1 area of acute hippocampal slices of postnatal 80-90 days.Spontaneous and miniature inhibitory GABAergic currents (spontaneous inhibitory postsynaptic currents [sIPSCs] and miniature inhibitory postsynaptic currents [mIPSCs]) and their kinetic characters were measured.The glutamatergic tonic effect on inhibitory transmission and the effect of bumetanide on neonatal propofol exposure were also examined.Results:Neonatal propofol exposure significantly increased the frequency of mIPSCs (from 1.87 ± 0.35 Hz to 3.43 ± 0.51 Hz,P < 0.05) and did not affect the amplitude of mIPSCs and sIPSCs.Both propofol and etomidate slowed the decay time of mIPSCs kinetics (168.39 ± 27.91 ms and 267.02 ± 100.08 ms vs.68.18 ± 12.43 ms;P < 0.05).Bumetanide significantly blocked the frequency increase and reversed the kinetic alteration of mIPSCs induced by neonatal propofol exposure (3.01 ± 0.45 Hz and 94.30 ± 32.56 ms).Conclusions:Neonatal propofol and etomidate exposure has long-term effects on inhibitory GABAergic transmission.Propofol might act at pre-and post-synaptic GABA receptor A (GABAA) receptors within GABAergic synapses and impairs the glutamatergic tonic input to GABAergic synapses;etomidate might act at the postsynaptic site.

  8. Teorías del desarrollo capitalista. Una evaluación comparada

    Directory of Open Access Journals (Sweden)

    Ignacio Trucco

    2012-01-01

    Full Text Available Este trabajo tiene por objetivo comparar un conjunto de teorías del desarrollo capitalista indagando las suposiciones que éstas construyen sobre la naturaleza y la dinámica de la sociedad. El trabajo busca mostrar posibles paradojas al momento de intentar interpretar el cambio social suponiendo sociedades estáticas. Para ello, primero se oponen las ideas de la teoría económica convencional con el tratamiento de la teoría del crecimiento desde el modelo Harrod-Domar y la interpretación de la dinámica histórica de Rostow recuperando la crítica de Germani y Medina Echavarría. En una segunda instancia se desarrollan los aportes de Hirschman Myrdal y de Prebisch-Singer, concluyéndose con la crítica dialéctica desarrollada por Furtado. Finalmente se indagan estos aspectos en el giro neoclásico de la teoría del desarrollo basado en los presupuestos de la Nueva Economía Institucional.

  9. Tudo que é cânone desmancha no ar : a rizomática literatura comparada do tempo presente.

    OpenAIRE

    Carvalho, José Reynaldo de Salles

    2010-01-01

    A dissertação trata das reconfigurações epistemológicas recentes, ocorridas na área disciplinar da literatura comparada, analisando-as a partir dos marcos teóricos e metodológicos da nova história cultural. Na pós-modernidade dissemina-se a percepção de que as produções culturais são articuladas em espaços sociais e históricos; uma heterogeneidade enunciativa se afirma e acontece uma desterritorialização dos campos disciplinares, fazendo com que diversas teorias críticas da cultura surjam no ...

  10. La Sociedad Europea de Educación Comparada (CESE en una época de cambios

    Directory of Open Access Journals (Sweden)

    Antonio Luzón Trujillo

    2005-01-01

    Full Text Available Este artículo ofrece una mirada retrospectiva a la significativa contribución del desarrollo de la educación comparada a través del papel desempeñado por la Comparative Education Society in Europe (CESE durante los últimos diez años. La CESE es la sociedad o asociación científica europea de educación comparada más antigua, y aglutina a prestigiosos profesionales de la disciplina, que desempeñan su labor docente e investigadora en acreditadas universidades, no sólo europeas. Como punto de partida, el artículo toma la XVIth Conferencia de Copenhague (Dinamarca de 1994, titulada ¿Education in Europe: the challenges of cultural values, national identities and global responsabilities¿, como el preludio de su andadura en una época de cambios estructurales. Además, el artículo muestra cómo a través de las cinco Conferencias celebradas bianualmente, el peso de la tradición, que alberga una trayectoria de más de cuarenta años, junto a la búsqueda de nuevas identidades, han constituido una señal de distinción y solidez, que indica cómo la organización se ha institucionalizado. El artículo muestra cómo a lo largo de este corto periodo de tiempo, más allá de la legitimidad del ámbito académico que simboliza y de las personas que la representan, la CESE ha adquirido un sentido de memoria institucional para el campo científico y académico que representa en Europa. 

  11. Chronic Treatment with Anesthetic Propofol Improves Cognitive Function and Attenuates Caspase Activation in Both Aged and Alzheimer's Disease Transgenic Mice

    Science.gov (United States)

    Dong, Yuanlin; Yu, Buwei; Xia, Weiming; Xie, Zhongcong

    2014-01-01

    There is a need to seek new treatment(s) for Alzheimer's disease (AD). A recent study showed that AD patients may have decreased levels of functional GABA receptors. Propofol, a commonly used anesthetic, is a GABA receptor agonist. We therefore set out to perform a proof of concept study to determine whether chronic treatment with propofol (50 mg/kg/week) can improve cognitive function in both aged wild-type (WT) and AD transgenic (Tg) mice. Propofol was administrated to the WT and AD Tg mice once a week for 8 or 12 weeks, respectively. Morris water maze was used to assess the cognitive function of the mice following the propofol treatment. Activation of caspase-3, caspase-9, and caspase-8 was investigated using western blot analysis at the end of the propofol treatment. In the mechanistic studies, effects of propofol, amyloid-β protein (Aβ), and GABA receptor antagonist flumazenil on caspase-3 activation and opening of the mitochondrial permeability transition pore were assessed in H4 human neuroglioma and mouse neuroblastoma cells by western blot analysis and flow cytometry. Here we showed that the propofol treatment improved cognitive function and attenuated brain caspase-3 and caspase-9 activation in both aged WT and AD Tg mice. Propofol attenuated Aβ-induced caspase-3 activation and opening of the mitochondrial permeability transition pore in the cells, and flumazenil inhibited the propofol's effects. These results suggested that propofol might improve cognitive function via attenuating the Aβ-induced mitochondria dysfunction and caspase activation, which explored the potential that anesthetic propofol could improve cognitive function in elderly and AD patients. PMID:24643139

  12. Pharmacokinetics and pharmacodynamics of propofol in patients undergoing abdominal aortic surgery.

    Science.gov (United States)

    Wiczling, Paweł; Bienert, Agnieszka; Sobczyński, Paweł; Hartmann-Sobczyńska, Roma; Bieda, Krzysztof; Marcinkowska, Aleksandra; Malatyńska, Maria; Kaliszan, Roman; Grześkowiak, Edmund

    2012-01-01

    Available propofol pharmacokinetic protocols for target-controlled infusion (TCI) were obtained from healthy individuals. However, the disposition as well as the response to a given drug may be altered in clinical conditions. The aim of the study was to examine population pharmacokinetics (PK) and pharmacodynamics (PD) of propofol during total intravenous anesthesia (propofol/fentanyl) monitored by bispectral index (BIS) in patients scheduled for abdominal aortic surgery. Population nonlinear mixed-effect modeling was done with Nonmem. Data were obtained from ten male patients. The TCI system (Diprifusor) was used to administer propofol. The BIS index served to monitor the depth of anesthesia. The propofol dosing was adjusted to keep BIS level between 40 and 60. A two-compartment model was used to describe propofol PK. The typical values of the central and peripheral volume of distribution, and the metabolic and inter-compartmental clearance were V(C) = 24.7 l, V(T) = 112 l, Cl = 2.64 l/min and Q = 0.989 l/min. Delay of the anesthetic effect, with respect to plasma concentrations, was described by the effect compartment with the rate constant for the distribution to the effector compartment equal to 0.240 min(-1). The BIS index was linked to the effect site concentrations through a sigmoidal E(max) model with EC(50) = 2.19 mg/l. The body weight, age, blood pressure and gender were not identified as statistically significant covariates for all PK/PD parameters. The population PK/PD model was successfully developed to describe the time course and variability of propofol concentration and BIS index in patients undergoing surgery.

  13. Propofol inhibits LPS-induced apoptosis in lung epithelial cell line, BEAS-2B.

    Science.gov (United States)

    Lv, Xiang; Zhou, Xuhui; Yan, Jia; Jiang, Jue; Jiang, Hong

    2017-03-01

    Lipopolysaccharide (LPS) plays an important role in lung endothelial apoptosis which is crucial for lung fibrogenesis in ARDS progression. Reactive oxygen species (ROS) has been reported to be involved in LPS-induced lung epithelial cell apoptosis. Propofol is a commonly used intravenous anesthetic agent in clinic and it could attenuate LPS-induced epithelial cells oxidation and apoptosis. However, the mechanisms are still obscure. In this study, we examined whether and how propofol attenuates LPS-induced oxidation and apoptosis in BEAS-2B cells. Compared with control group, LPS up-regulated Pin-1, phosphatase A2 (PP2A) expression, induced p66(Shc)-Ser(36) phosphorylation, and facilitated p66(Shc) mitochondrial translocation, thus leading to superoxide anion (O2(-)) generation, mitochondrial cytochrome c release, active caspase 3 over-expression and cell viability inhibition. Importantly, propofol was shown to down-regulate LPS-induced PP2A expression, limit p66(Shc) mitochondrial translocation, decrease O2(-) generation, inhibit mitochondrial cytochrome c release, reduce active caspase 3 expression, and recover cells viability, while propofol had no effects on LPS-induced Pin-1 expression and p66(Shc)-Ser(36) phosphorylation. Moreover, the protective effects of propofol on LPS-induced BEAS-2B cells apoptosis were similar to that of calyculin A, which is an inhibitor of PP2A. We also found that FTY720, which is an activator of PP2A, can effectively reverse the protective function of propofol. Our data illustrated that propofol could alleviate LPS-induced BEAS-2B cells oxidation and apoptosis through down-regulating PP2A expression, limiting p66(Shc)-Ser(36) dephosphorylation and p66(Shc) mitochondrial translocation, decreasing O2(-) generation, mitochondrial cytochrome c release, activating caspase 3 expression. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. Propofol attenuates pancreatic cancer malignant potential via inhibition of NMDA receptor.

    Science.gov (United States)

    Chen, Xiangyuan; Wu, Qichao; You, Li; Chen, Sisi; Zhu, Minmin; Miao, Changhong

    2017-01-15

    Propofol is a commonly used intravenous anesthetic, and could attenuate cancer cells malignant potential via inhibiting hypoxia-inducible factor-1α (HIF-1α) expression. However, the mechanism is still inclusive. In the present study, we mainly focus on the mechanism by which propofol down-regulated HIF-1α expression and malignant potential in pancreatic cancer cells. Human pancreatic cancer cells (Miapaca-2 and Panc-1) in vitro and murine pancreatic cancer cell (Panc02) in vivo were used to assess the effect of propofol on vascular endothelial growth factor (VEGF) expression and migration of pancreatic cancer cells. Propofol inhibited cells migration, expression of VEGF and HIF-1α, phosphorylation of extracellular regulated protein kinases (ERK), AKT, Ca(2+)/calmodulin dependent protein kinases II (CaMK II), and Ca(2+) concentration in a concentration-dependent manner (5, 25, 50, 100μM). Furthermore, MK801, an inhibitor of NMDA receptor, and KN93, an inhibitor of CaMK II, could inhibit the expression of VEGF, HIF-1a, p-AKT, p-ERK, p-CaMK II in vitro, growth of tumor and VEGF expression in vivo, which were similar to the effect of propofol. In addition, the anti-tumor effect of propofol could be counteracted by rapastinel, an activator of NMDA receptor. Our study indicated that propofol suppressed VEGF expression and migration ability of pancreatic cancer cells in vitro and in vivo, probably via inhibiting NMDA receptor. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Prevention of anesthesia-induced injection pain of propofol in pediatric anesthesia.

    Science.gov (United States)

    Cheng, Dabin; Liu, Lu; Hu, Zheng

    2017-01-01

    Propofol is a new anesthetic agent in clinical practice, but randomized double-blinded prospective studies on its role in pediatric anesthesia remain limited. We aimed to compare the preventive effects of pre-injected lidocaine or ketamine and its pre-mixture on the anesthesia-induced injection pain of propofol using a randomized double-blinded prospective method, and to compare the outcomes with those of medium-/long-chain propofol (M/LCT). A total of 360 pediatric patients (aged 5-12 years old) who received elective surgery were randomly divided into six groups (n= 60) as follows. S group: control group; L group: lidocaine group; L + P group: lidocaine + propofol group; K group: ketamine group; K + P group: ketamine + propofol group; M group: M/LCT group. After the drug fluid completely entered the cubital vein, the venous access was closed. During propofol injection, the injection pain was scored using the VRS 4-point scale. Meanwhile, the heart rates before and during injection were recorded, the adverse reactions during and after injection were observed, and the incidence rate and degree of pain were evaluated. The VRS 4-point scale showed that the incidence rates of injection pain of S group, L group, L + P group, K group, K + P group and M group were 78.3%, 66.67%, 51.66%, 43.33%, 48.33% and 45% respectively. The incidence rates of injection pain of all experimental groups were significantly lower than that of S group (Ppropofol can all significantly reduce the incidence rate of injection pain of propofol.

  16. The use of propofol as a sedative agent in gastrointestinal endoscopy: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Daorong Wang

    Full Text Available OBJECTIVES: To assess the efficacy and safety of propofol sedation for gastrointestinal endoscopy, we conducted a meta-analysis of randomized controlled trials (RCTs comparing propofol with traditional sedative agents. METHODS: RCTs comparing the effects of propofol and traditional sedative agents during gastrointestinal endoscopy were found on MEDLINE, the Cochrane Central Register of Controlled Trials, and EMBASE. Cardiopulmonary complications (i.e., hypoxia, hypotension, arrhythmia, and apnea and sedation profiles were assessed. RESULTS: Twenty-two original RCTs investigating a total of 1,798 patients, of whom 912 received propofol only and 886 received traditional sedative agents only, met the inclusion criteria. Propofol use was associated with shorter recovery (13 studies, 1,165 patients; WMD -19.75; 95% CI -27.65, 11.86 and discharge times (seven studies, 471 patients; WMD -29.48; 95% CI -44.13, -14.83, higher post-anesthesia recovery scores (four studies, 503 patients; WMD 2.03; 95% CI 1.59, 2.46, better sedation (nine studies, 592 patients; OR 4.78; 95% CI 2.56, 8.93, and greater patient cooperation (six studies, 709 patients; WMD 1.27; 95% CI 0.53, 2.02, as well as more local pain on injection (six studies, 547 patients; OR 10.19; 95% CI 3.93, 26.39. Effects of propofol on cardiopulmonary complications, procedure duration, amnesia, pain during endoscopy, and patient satisfaction were not found to be significantly different from those of traditional sedative agents. CONCLUSIONS: Propofol is safe and effective for gastrointestinal endoscopy procedures and is associated with shorter recovery and discharge periods, higher post-anesthesia recovery scores, better sedation, and greater patient cooperation than traditional sedation, without an increase in cardiopulmonary complications. Care should be taken when extrapolating our results to specific practice settings and high-risk patient subgroups.

  17. Comparison of propofol effect with Ketamine for sedation induction in pediatric patients who underwent cardiol catheterization

    Directory of Open Access Journals (Sweden)

    Houshang Shahryari

    2010-04-01

    Full Text Available Background: The goals for sedation in pediatric patients scheduled to undergo cardiac catheterization include immobility, analgesia, cardiovascular and respiratory stability. We investigated the effects of Propofol and Ketamine on hemodynamic, respiratory status, sedation level, pain score and recovery period in pediatric patients undergoing cardiac catheterization. Methods: We preformed a randomized clinical trial study on 40 pediatric patients. The patients were randomly assigned to two groups, so that 20 patients received Ketamine and 20 patients received Propofol. In all patients, sedation was started with Midazolam (0.03mg/kg, then followed by Propofol in the first group and Ketamine in the second one. The hemodynamic responses, respiratory parameters, recovery characteristics (Ramsey scale, pain score VAS and relevant adverse effects of the two groups were recorded. Data was analyzed using Paired T Test, ANOVA and Stearman correlation coefficient. Results: Five patients in the Propofol group andon patients in the Ketamine group experienced a transient decrease in mean systolic blood pressure greater than 10% of baseline(p=0.034. Time to full recovery (mean ± SD was not significantly different in the Propofol group and Ketamine group (1.8 min vs. 2.9 min, P > 0.05. Pain scores were significantly different in both groups (P= 0.010. Patients’ heart rates were significantly higher in Ketamine group(P=0.029. No significant difference in respiratory rate was recorded in both groups(p›0.05. Conclusion: Both Ketamine and Propofol are useful and safe in pediatric patients undergoing cardiac catheterization but it seems that it is better to use Propofol in stable hemodynamic pediatric patients under continuous blood pressure monitoring.

  18. Propofol versus flunitrazepam for inducing and maintaining sleep in postoperative ICU patients

    Directory of Open Access Journals (Sweden)

    Cornelius Engelmann

    2014-01-01

    Full Text Available Context: Sleep deprivation is a common problem on intensive care units (ICUs influencing not only cognition, but also cellular functions. An appropriate sleep-wake cycle should therefore be maintained to improve patients′ outcome. Multiple disruptive factors on ICUs necessitate the administration of sedating and sleep-promoting drugs for patients who are not analgo-sedated. Aims: The objective of the present study was to evaluate sleep quantity and sleep quality in ICU patients receiving either propofol or flunitrazepam. Settings and Design: Monocentric, randomized, double-blinded trial. Materials and Methods: A total of 66 ICU patients were enrolled in the study (flunitrazepam n = 32, propofol n = 34. Propofol was injected continuously (2 mg/kg/h, flunitrazepam as a bolus dose (0.015 mg/kg. Differences between groups were evaluated using a standardized sleep diary and the bispectral index (BIS. Statistical Analysis Used: Group comparisons were performed by Mann-Whitney U-Test. P < 0.05 was considered to be statistically significant. Results: Sleep quality and the frequency of awakenings were significantly better in the propofol group (Pg. In the same group lower BIS values were recorded (median BIS propofol 74.05, flunitrazepam 78.7 [P = 0.016]. BIS values had to be classified predominantly to slow-wave sleep under propofol and light sleep after administration of flunitrazepam. Sleep quality improved in the Pg with decreasing frequency of awakenings and in the flunitrazepam group with increasing sleep duration. Conclusions: Continuous low-dose injection of propofol for promoting and maintaining night sleep in ICU patients who are not analgo-sedated was superior to flunitrazepam regarding sleep quality and sleep structure.

  19. The action sites of propofol in the normal human brain revealed by functional magnetic resonance imaging.

    Science.gov (United States)

    Zhang, Hui; Wang, Wei; Zhao, Zhijing; Ge, Yali; Zhang, Jinsong; Yu, Daihua; Chai, Wei; Wu, Shengxi; Xu, Lixian

    2010-12-01

    Propofol has been used for many years but its functional target in the intact brain remains unclear. In the present study, we used functional magnetic resonance imaging to demonstrate blood oxygen level dependence signal changes in the normal human brain during propofol anesthesia and explored the possible action targets of propofol. Ten healthy subjects were enrolled in two experimental sessions. In session 1, the Observer's Assessment of Alertness/Sedation Scale was performed to evaluate asleep to awake/alert status. In session 2, images with blood oxygen level dependence contrast were obtained with echo-planar imaging on a 1.5-T Philips Gyroscan Magnetic Resonance System and analyzed. In both sessions, subjects were intravenously administered with saline (for 3 min) and then propofol (for 1.5 min) and saline again (for 10.5 min) with a constant speed infusion pump. Observer's Assessment of Alertness/Sedation Scale scoring showed that the subjects experienced conscious–sedative–unconscious–analepsia, which correlated well with the signal decreases in the anesthesia states. Propofol induced significant signal decreases in hypothalamus (18.2%±3.6%), frontal lobe (68.5%±11.2%), and temporal lobe (34.7%±6.1%). Additionally, the signals at these three sites were fulminant and changed synchronously. While in the thalamus, the signal decrease was observed in 5 of 10 of the subjects and the magnitude of decrease was 3.9%±1.6%. These results suggest that there is most significant inhibition in hypothalamus, frontal lobe, and temporal in propofol anesthesia and moderate inhibition in thalamus. These brain regions might be the targets of propofol anesthesia in human brain.

  20. [Initial experiences with propofol (Disoprivan) for anesthesia induction in pediatric anesthesia].

    Science.gov (United States)

    Motsch, J; Must, W; Hutschenreuter, K

    1988-09-01

    Propofol is a new intravenous anesthetic agent that provides smooth and rapid induction of anesthesia. A short elimination half-life guarantees rapid recovery. Since it has been reformulated as an emulsion in soya bean oil, anaphylactoid reactions are unlikely to occur. As compared to adults, there is very little experience with propofol in pediatric anesthesia. The aim of this study was to evaluate propofol as an induction agent in children with respect to cardiovascular and respiratory effects and to investigate the incidence of other side-effects. METHOD. In 25 ASA I children aged 3-12 years (6.4 +/- 2.7 SD) anesthesia was induced with a single dose of propofol, after standard premedication with atropine 0.01 mg/kg and Thalamonal 0.04 ml/kg. Anesthesia was maintained with halothane, nitrous oxide, and oxygen. Blood pressure (BP), heart rate (HR), and arterial oxygen saturation (SaO2) were measured before and each minute for 6 min after propofol administration. The incidence of side-effects during induction of anesthesia as well as during recovery and the postoperative period were recorded. RESULTS. Propofol 2.5 mg/kg produced rapid and smooth induction of anesthesia. Mean arterial pressure decreased after 1 min by 14.3% with a maximum of 16.8% after 3 min. HR was influenced differently by propofol; children with initially high HR had a decrease in HR, whereas in children with a low initial rate, HR increased transiently. After 1 min, no further changes occurred. Although no apnea was observed, respiration was shallow and depressed, as indicated by a decrease in SaO2. Two children complained of pain and 4 of discomfort at the site of the injection; 1 of these developed transient phlebitis.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. El Sistema Electoral Dominicano. En perspectiva comparada, garantías y falacias.

    OpenAIRE

    Lockward Mella, Ángel

    2014-01-01

    República Dominicana, pequeña nación del Caribe, que se convirtió en 1492, en la puerta por la cual la civilización occidental ingresó a un nuevo continente, que luego, se llamaría, América; en 1844 se constituyó en República y desde entonces, su historia cuenta de muchos tumbos a través de diversas formas de dictaduras ¿ algunas de las más largas y recias del continente - y desordenes institucionales, hasta que en 1963 inició, con un gobierno fallido al que siguieron gobiernos de facto, el c...

  2. El Sistema Electoral Dominicano. En perspectiva comparada, garantías y falacias.

    OpenAIRE

    Lockward Mella, Ángel

    2014-01-01

    República Dominicana, pequeña nación del Caribe, que se convirtió en 1492, en la puerta por la cual la civilización occidental ingresó a un nuevo continente, que luego, se llamaría, América; en 1844 se constituyó en República y desde entonces, su historia cuenta de muchos tumbos a través de diversas formas de dictaduras ¿ algunas de las más largas y recias del continente - y desordenes institucionales, hasta que en 1963 inició, con un gobierno fallido al que siguieron gobiernos de facto, el c...

  3. The performance of a target-controlled infusion of propofol in combination with remifentanil : A clinical investigation with two propofol formulations

    NARCIS (Netherlands)

    Wietasch, JKG; Scholz, M; Zinserling, J; Kiefer, N; Frenkel, C; Knufermann, P; Brauer, U; Hoeft, A

    Target-controlled infusion (TCI) incorporates the pharmacokinetic variables of an IV drug to facilitate safe and reliable administration. In this clinical study we investigated the performance of propofol TCI in combination with remifentanil. Fifty-four adult patients scheduled for general surgery

  4. Propofol/dexmedetomidine and propofol/ketamine combinations for anesthesia in pediatric patients undergoing transcatheter atrial septal defect closure: a prospective randomized study.

    Science.gov (United States)

    Koruk, Senem; Mizrak, Ayse; Kaya Ugur, Berna; Ilhan, Osman; Baspinar, Osman; Oner, Unsal

    2010-04-01

    Children undergoing cardiac catheterization usually need general anesthesia or deep sedation. This study was performed to compare the effects of propofol/dexmedetomidine and propofol/ketamine combinations on recovery time and hemodynamic parameters in pediatric patients undergoing transcatheter atrial septal defect (ASD) closure. This was a prospective randomized study. Pediatric patients with ASD were randomly assigned into 2 groups to receive propofol/dexmedetomidine or propofol/ketamine. The dexmedetomidine group received an infusion over 10 minutes of dexmedetomidine 1 microg/kg and propofol 2.0 to 2.5 mg/kg bolus for induction, then an infusion of dexmedetomidine 0.5 microg/kg/h and propofol 4 to 6 mg/kg/h for maintenance. In the ketamine group, patients received the same dose of propofol and ketamine 1 mg/kg for induction and 0.5 mg/kg/h by infusion for maintenance. The procedure was performed using both fluoroscopy and transesophageal echocardiography. Hemodynamic data, respiratory rate, and oxygen saturation were recorded before and after induction, 1 and 5 minutes after intubation, every 10 minutes thereafter during the procedure, and after extubation by researchers blinded to the study drugs. Recovery time, the primary outcome, was evaluated by a modified Steward score; a score of >or=6 means that the patient is awake or responds to verbal stimuli, has purposeful motor activity, and coughs on command. The time to reach a modified Steward score of >or=6 was recorded. The secondary outcome was the effects on the hemodynamic variables. Creatine kinase muscle-brain subunit, myoglobin, cardiac troponin I, and brain natriuretic peptide were the biochemical variables measured. Patients were monitored for respiratory (changes in oxygen status) and hemodynamic adverse effects (heart rate changes, blood pressure changes) until the second hour in the intensive care unit after the operation was concluded. Nine patients each were randomly assigned to propofol

  5. A Comparison of Propofol- and Dexmedetomidine-induced Electroencephalogram Dynamics Using Spectral and Coherence Analysis

    Science.gov (United States)

    Akeju, Oluwaseun; Pavone, Kara J.; Westover, M. Brandon; Vazquez, Rafael; Prerau, Michael J.; Harrell, Priscilla G.; Hartnack, Katharine E.; Rhee, James; Sampson, Aaron L.; Habeeb, Kathleen; Lei, Gao; Pierce, Eric T.; Walsh, John L.; Brown, Emery N.; Purdon, Patrick L.

    2014-01-01

    Background Electroencephalogram patterns observed during sedation with dexmedetomidine appear similar to those observed during general anesthesia with propofol. This is evident with the occurrence of slow (0.1–1 Hz), delta (1–4 Hz), propofol-induced alpha (8–12 Hz), and dexmedetomidine-induced spindle (12–16 Hz) oscillations. However, these drugs have different molecular mechanisms and behavioral properties, and are likely accompanied by distinguishing neural circuit dynamics. Methods We measured 64-channel electroencephalogram under dexmedetomidine (n = 9) and propofol (n = 8) in healthy volunteers, 18–36 years of age. We administered dexmedetomidine with a 1mcg/kg loading bolus over 10 minutes, followed by a 0.7mcg/kg/hr infusion. For propofol, we used a computer controlled infusion to target the effect-site concentration gradually from and 0 µg/mL to 5 µg/mL. Volunteers listened to auditory stimuli and responded by button-press to determine unconsciousness. We analyzed the electroencephalogram using multitaper spectral and coherence analysis. Results Dexmedetomidine was characterized by spindles with maximum power and coherence at ~13 Hz, (mean±std; power, −10.8dB±3.6; coherence, 0.8±0.08), while propofol was characterized with frontal alpha oscillations with peak frequency at ~11 Hz (power, 1.1dB±4.5; coherence, 0.9±0.05). Notably, slow oscillation power during a general anesthetic state under propofol (power, 13.2dB±2.4) was much larger than during sedative states under both propofol (power, −2.5dB±3.5) and dexmedetomidine (power, −0.4dB±3.1). Conclusion Our results indicate that dexmedetomidine and propofol place patients into different brain states, and suggests that propofol enables a deeper state of unconsciousness by inducing large amplitude slow oscillations that produce prolonged states of neuronal silence. PMID:25187999

  6. Efeitos antimicrobianos de cetamina em combinação com propofol: um estudo in vitro

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    Zekine Begec

    2013-12-01

    Full Text Available EXPERIÊNCIA E OBJETIVOS: Cetamina e propofol são os anestésicos gerais que também exibem efeitos antimicrobianos e promotores do crescimento microbiano, respectivamente. Embora esses agentes sejam frequentemente aplicados em combinação durante o uso clínico, não há dados sobre seu efeito total no crescimento microbiano na administração combinada. Nesse estudo, investigamos o crescimento de alguns microrganismos em uma mistura de cetamina e propofol. MÉTODO: Nesse estudo, utilizamos cepas padronizadas: Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa e Candida albicans. Realizamos uma análise de tempo-crescimento para avaliar as taxas de crescimento microbiano em propofol 1%. A atividade antimicrobiana de cetamina, isoladamente e em propofol, foi estudada pelo método de microdiluição. RESULTADOS: Em propofol, as cepas estudadas cresceram de concentrações de 10³-10(4 ufc/mL para > 10(5 ufc/mL, dentro de 8-16 horas, dependendo do tipo de microrganismo. Foram determinadas a concentração inibitória mínima (CIM e a concentração bactericida mínima (CBM (para Candida, concentração fungicida mínima de cetamina, como se segue (CIM, CBM: E. coli 312,5, 312,5 µg/mL; S.aureus 19,5, 156 µg/mL; P. aeruginosa 312,5, 625 µg/mL; e C. albicans 156, 156 µg/mL. Na mistura cetamina + propofol, cetamina exibiu atividade antimicrobiana para E. coli, P. aeruginosa e C. albicans em CBMs a 1250, 625 e 625 µg/mL, respectivamente. O crescimento de S. aureus não foi inibido nessa mistura (concentração de cetamina = 1250 µg/mL. CONCLUSÃO: Cetamina preservou sua atividade antimicrobiana de maneira dose-dependente contra alguns microrganismos em propofol, que é robusta solução promotora de crescimento microbiano. O uso combinado de cetamina e propofol na aplicação clínica de rotina pode diminuir o risco de infecção causada por contaminação acidental. Entretanto, deve-se ter em mente que cetamina não pode reduzir

  7. Propofol-medetomidine-ketamine total intravenous anaesthesia in thiafentanil-medetomidine-immobilized impala (Aepyceros melampus).

    Science.gov (United States)

    Buck, Roxanne K; Meyer, Leith R C; Stegmann, George F; Kästner, Sabine B R; Kummrow, Maya; Gerlach, Christina; Fosgate, Geoffrey T; Zeiler, Gareth E

    2017-01-01

    To characterize a propofol-medetomidine-ketamine total intravenous anaesthetic in impala (Aepyceros melampus). Prospective clinical study. Ten adult female impala. Impala were immobilized at 1253 m above sea level with 2.0 mg thiafentanil and 2.2 mg medetomidine via projectile darts. Propofol was given to effect (0.5 mg kg(-1) boluses) to allow endotracheal intubation, following which oxygen was supplemented at 2 L minute(-1). Anaesthesia was maintained with a constant-rate infusion of medetomidine and ketamine at 5 μg kg(-1) hour(-1) and 1.5 mg kg(-1) hour(-1), respectively, and propofol to effect (initially 0.2 mg kg(-1) minute(-1)) for 120 minutes. The propofol infusion was titrated according to reaction to nociceptive stimuli every 15 minutes. Cardiopulmonary parameters were monitored continuously and arterial blood gas samples were analysed intermittently. After 120 minutes' maintenance, the thiafentanil and medetomidine were antagonized using naltrexone (10:1 thiafentanil) and atipamezole (5:1 medetomidine), respectively. All impala were successfully immobilized. The median dose [interquartile range (IQR)] of propofol required for intubation was 2.7 (1.9-3.3) mg kg(-1). The propofol-medetomidine-ketamine combination abolished voluntary movement and ensured anaesthesia for the 120 minute period. Propofol titration showed a generally downward trend. Median (IQR) heart rate [57 (53-61) beats minute(-1)], respiratory rate [10 (9-12) breaths minute(-1)] and mean arterial blood pressure [101 (98-106) mmHg] were well maintained. Arterial blood gas analysis indicated hypoxaemia, hyper- capnia and acidaemia. Butorphanol (0.12 mg kg(-1)) was an essential rescue drug to counteract thiafentanil-induced respiratory depression. All impala regurgitated frequently during the maintenance period. Recovery was calm and rapid in all animals. Median (IQR) time to standing from antagonist administration was 4.4 (3.2-5.6) minutes. A propofol-medetomidine-ketamine combination could

  8. Comparison of Propofol and Isoflurane Effect on Hemorrhage during Spine Surgery

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    B. Karkhanehie

    2015-01-01

    Full Text Available Introduction & Objective: By prevention of bleeding during spine surgery, we could provide suitable field for the surgeon and also reduce blood loss and the need for transfusion. The purpose of this study was to compare the effects of intravenous administration of propofol and isoflurane for anesthesia maintenance on the amount of blood loss and hemodynamic status during the surgery. Materials & Methods: In this clinical trial single blind study, 100 patients undergoing spinal surgery with ASA I were randomly assigned in two groups P and I; in group P we used intra-venous propofol (100-200 ?/kg/min plus nitrous oxide 50% (50 patients and in group I we applied isoflurane, (MAC 1.5-2 plus nitrous oxide 50% (50 patients for maintenance of an-esthesia. For determining and comparing blood loss in each group, total volume of blood loss during surgery was determined by weighting of blood on gausses and volume of blood in suction bottle. The amount of hemoglobin, the need for blood transfusion and satisfaction of surgeon from operative field during surgery were also assessed. Mean arterial pressure and heart rate were measured every 5 minutes intra operative and were compared in the two groups. The data was analyzed by SPSS and t-test. Results: The total volume of blood loss in propofol and isoflurane groups was 352.7± 303.5 and 450.48±321.8 ml, respectively. Total blood loss, and blood loss per min was significantly lower in the propofol group and isoflurane group (P=0.049, P=0.015. Surgeon satisfaction with bleeding of surgery field based on the Boezzart scale was higher in the propofol group. Decrease in hemoglobin concentration and hematocrit were less in the propofol group com-pared to the isoflurane group. Mean arterial pressure during surgery with the propofol group was 85.71±9.7 versus 80.25±8.04 mmHg in the isoflurane group, which was significantly lower in the isoflurane group (P=0.003. The difference between the heart rate during surgery

  9. The Effects of Two Anesthetics, Propofol and Sevoflurane, on Liver Ischemia/Reperfusion Injury

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    Zhijie Xu

    2016-04-01

    Full Text Available Background: Propofol and sevoflurane are widely used in clinical anesthesia, and both have been reported to exert a protective effect in organ ischemia/reperfusion (IR. This study aims to investigate and compare the effects of propofol and sevoflurane on liver ischemia/reperfusion and the precise molecular mechanism. Methods and Materials: Rats were randomized into four groups: the sham group, I/R group, propofol treatment group (infused with 1% propofol at 500 µg· kg-1· min-1, and sevoflurane treatment group (infused with 3% (2 L/min sevoflurane. The liver ischemia/reperfusion model was used to evaluate the hepatoprotective effect on ischemic injury. Liver enzyme leakage, liver cytokines and histopathological examination were used to evaluate the extent of hepatic ischemia/reperfusion injury. Oxidative stress was investigated by evaluating the levels of Malondialdehyde(MDA, Superoxide Dismutase(SOD and NO. The terminal dexynucleotidyl transferase(TdT-mediated dUTP nick end labeling (TUNEL assay and western blot were applied to detect apoptosis in the ischemic liver tissue and its mechanism. Results: Both propofol and sevoflurane attenuated the extent of hepatic ischemia/reperfusion injury which is evident from the hisopathological studies and alterations in liver enzymes such as AST and LDH by inhibiting Nuclear factor kappa B (NFκB activation and subsequent alterations in inflammatory cytokines interleukin-1(IL-1, interleukin-6(IL-6, tumor necrosis factor-alpha (TNF-a and increased IL10 release. Propofol exhibited a similar protective effect and a lower IL-1 release, while sevoflurane decreased TNF-a leakage more significantly. Meanwhile, oxidative stress was attenuated by reduced MDA and NO and elevated SOD release. The expression of antiapoptotic protein Bcl-2 and Bcl-xl were enhanced while that of apoptotic protein Bax and Bak were reduced by both propofol and sevoflurane to regulate hepatic apoptosis. In addition, propofol

  10. Effective Dosage of Midazolam to Erase the Memory of Vascular Pain During Propofol Administration.

    Science.gov (United States)

    Boku, Aiji; Inoue, Mika; Hanamoto, Hiroshi; Oyamaguchi, Aiko; Kudo, Chiho; Sugimura, Mitsutaka; Niwa, Hitoshi

    Intravenous sedation with propofol is often administered to anxious patients in dental practice. Pain on injection of propofol is a common adverse effect. This study aimed to determine the age-adjusted doses of midazolam required to erase memory of vascular pain of propofol administration and assess whether the Ramsay Sedation Scale (RSS) after the pretreatment of midazolam was useful to predict amnesia of the vascular pain of propofol administration. A total of 246 patients with dental phobia requiring dental treatment under intravenous sedation were included. Patients were classified according to their age: 30s, 40s, 50s, and 60s. Three minutes after administration of a predetermined dose of midazolam, propofol was infused continuously. After completion of the dental procedure, patients were interviewed about the memory of any pain or discomfort in the injection site or forearm. The dosage of midazolam was determined using the Dixon up-down method. The first patient was administered 0.03 mg/kg, and if memory of vascular pain remained, the dosage was increased by 0.01 mg/kg for the next patient, and then if the memory was erased, the dosage was decreased by 0.01 mg/kg. The effective dosage of midazolam in 95% of each age group for erasing the memory of propofol vascular pain (ED95) was determined using logistic analysis. The accuracy of RSS to predict the amnesia of injection pain was assessed by receiver operating characteristic (ROC) analysis. The ED95 of midazolam to erase the memory of propofol vascular pain was 0.061 mg/kg in patients in their 30s, 0.049 mg/kg in patients in their 40s, 0.033 mg/kg in patients in their 50s, and 0.033 mg/kg in patients in their 60s. The area under the ROC curve was 0.31. The ED95 of midazolam required to erase the memory of propofol vascular pain demonstrated a downward trend with age. On the other hand, it was impossible to predict the amnesia of propofol vascular pain using the RSS.

  11. Effects of cardiopulmonary bypass on propofol pharmacokinetics and bispectral index during coronary surgery

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    Ricardo Antonio G. Barbosa

    2009-03-01

    Full Text Available PURPOSE: Cardiopulmonary bypass is known to alter propofol pharmacokinetics in patients undergoing cardiac surgery. However, few studies have evaluated the impact of these alterations on postoperative pharmacodynamics. This study was designed to test the hypothesis that changes in propofol pharmacokinetics increase hypnotic effects after cardiopulmonary bypass. METHODS: Twenty patients scheduled for on-pump coronary artery bypass graft (group, n=10 or off-pump coronary artery bypass graft (group, n=10 coronary artery bypass grafts were anesthetized with sufentanil and a propofol target controlled infusion (2.0 µg/mL. Depth of hypnosis was monitored using the bispectral index. Blood samples were collected from the induction of anesthesia up to 12 hours after the end of propofol infusion, at predetermined intervals. Plasma propofol concentrations were measured using high-performance liquid chromatography, followed by a non-compartmental propofol pharmacokinetic analysis. Data were analyzed using ANOVA, considering p<0.05 as significant. RESULTS: After cardiopulmonary bypass, despite similar plasma propofol concentrations in both groups, bispectral index values were lower in the on-pump coronary artery bypass graft group. Time to extubation after the end of propofol infusion was greater in the on-pump coronary artery bypass graft group (334 ± 117 vs. 216 ± 85 min, p = 0.04. Patients undergoing cardiopulmonary bypass had shorter biological (1.82 ± 0.5 vs. 3.67 ± 1.15h, p < 0.01 and terminal elimination (6.27 ± 1.29 vs. 10.5h ± 2.18, p < 0.01 half-life values, as well as higher total plasma clearance (28.36 ± 11.40 vs.18.29 ± 7.67 mL/kg/min, p = 0.03, compared to patients in the off-pump coronary artery bypass graft group. CONCLUSION: Aside from the increased sensitivity of the brain to anesthetics after cardiopulmonary bypass, changes in propofol pharmacokinetics may contribute to its central nervous system effects.

  12. Propofol Inhibits Neurogenesis of Rat Neural Stem Cells by Upregulating MicroRNA-141-3p.

    Science.gov (United States)

    Jiang, Qiliang; Wang, Yingwei; Shi, Xueyin

    2017-02-01

    Prolonged or high-dose exposure to anesthetics, such as propofol, can cause brain cell degeneration and subsequent long-term learning or memory deficits, particularly in the developing brain. However, the cellular and molecular mechanisms underlying the deleterious effects of propofol at certain stages of development remain unclear. In this study we found that propofol inhibited the proliferation, neuronal differentiation, and migration of neural stem cells (NSCs) while upregulating miR-141-3p. Silencing of miR-141-3p abrogated the effects of propofol on NSC neurogenesis. Propofol treatment downregulated IGF2BP2, a direct target of miR-141-3p, whereas overexpression of IGF2BP2 attenuated the effects of propofol and miR-141-3p on NSC neurogenesis. In short, propofol inhibits NSC neurogenesis through a mechanism involving the miR-141-3p/IGF2BP2 axis. Our results may provide a potential approach for preventing the neurodegenerative effects of propofol in the developing brain.

  13. Quantitative electroencephalographic analysis of the biphasic concentration-effect relationship of propofol in surgical patients during extradural analgesia

    NARCIS (Netherlands)

    Kuizenga, K; Kalkman, CJ; Hennis, PJ

    We studied effects on the EEG of propofol infused at a rate of 0.5 mg kg(-1) min(-1) for 10 min in 10 healthy male surgical patients under extradural analgesia. The EEG amplitude in six frequency bands was related to arterial blood propofol concentrations and responsiveness to verbal commands. The

  14. Propofol Increases Host Susceptibility to Microbial Infection by Reducing Subpopulations of Mature Immune Effector Cells at Sites of Infection

    Science.gov (United States)

    Visvabharathy, Lavanya; Xayarath, Bobbi; Weinberg, Guy; Shilling, Rebecca A.; Freitag, Nancy E.

    2015-01-01

    Anesthetics are known to modulate host immune responses, but separating the variables of surgery from anesthesia when analyzing hospital acquired infections is often difficult. Here, the bacterial pathogen Listeria monocytogenes (Lm) was used to assess the impact of the common anesthetic propofol on host susceptibility to infection. Brief sedation of mice with physiologically relevant concentrations of propofol increased bacterial burdens in target organs by more than 10,000-fold relative to infected control animals. The adverse effects of propofol sedation on immune clearance of Lm persisted after recovery from sedation, as animals given the drug remained susceptible to infection for days following anesthesia. In contrast to propofol, sedation with alternative anesthetics such as ketamine/xylazine or pentobarbital did not increase susceptibility to systemic Lm infection. Propofol altered systemic cytokine and chemokine expression during infection, and prevented effective bacterial clearance by inhibiting the recruitment and/or activity of immune effector cells at sites of infection. Propofol exposure induced a marked reduction in marginal zone macrophages in the spleens of Lm infected mice, resulting in bacterial dissemination into deep tissue. Propofol also significantly increased mouse kidney abscess formation following infection with the common nosocomial pathogen Staphylococcus aureus. Taken together, these data indicate that even brief exposure to propofol severely compromises host resistance to microbial infection for days after recovery from sedation. PMID:26381144

  15. Propofol inhibits T-helper cell type-2 differentiation by inducing apoptosis via activating gamma-aminobutyric acid receptor.

    Science.gov (United States)

    Meng, Jingxia; Xin, Xin; Liu, Zhen; Li, Hao; Huang, Bo; Huang, Yuguang; Zhao, Jing

    2016-12-01

    Propofol has been shown to attenuate airway hyperresponsiveness in asthma patients. Our previous study showed that it may alleviate lung inflammation in a mouse model of asthma. Given the critical role of T-helper cell type-2 (Th2) differentiation in asthma pathology and the immunomodulatory role of the gamma-aminobutyric acid type A (GABAA) receptor, we hypothesized that propofol could alleviate asthma inflammation by inhibiting Th2 cell differentiation via the GABA receptor. For in vivo testing, chicken ovalbumin-sensitized and challenged asthmatic mice were used to determine the effect of propofol on Th2-type asthma inflammation. For in vitro testing, Th2-type cytokines as well as the cell proliferation and apoptosis were measured to assess the effects of propofol on Th2 cell differentiation and determine the underlying mechanisms. We found that propofol significantly decreased inflammatory cell counts and interleukin-4 and inflammation score in vivo. Propofol, but not intralipid, significantly reduced the Th2-type cytokine interleukin-5 secretion and caused Th2 cell apoptosis without obvious inhibition of proliferation in vitro. A GABA receptor agonist simulated the effect of propofol, whereas pretreatment with an antagonist reversed this effect. This study demonstrates that the antiinflammatory effects of propofol on Th2-type asthma inflammation in mice are mediated by inducing apoptosis without compromising proliferation during Th2 cell differentiation via activation of the GABA receptor. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. A comparison of the effects of desflurane versus propofol on transcranial motor-evoked potentials in pediatric patients.

    Science.gov (United States)

    Holdefer, Robert N; Anderson, Corrie; Furman, Michele; Sangare, Yoro; Slimp, Jefferson C

    2014-12-01

    The aim was to compare the effects of propofol and desflurane anesthesia on transcranial motor evoked potentials (MEPs) from pediatric patients undergoing surgery for spinal deformities. Desflurane and propofol cohorts (25 patients each) were obtained retrospectively and matched for patient characteristics and surgical approach. MEPs from the thenar eminence and abductor hallucis were compared during maintenance anesthesia on desflurane (0.6-0.8 MAC) or propofol infusion (150-300 μg/kg/min). MEP amplitudes and durations were obtained for successive 30-min intervals for 150 min, beginning 60 min after maintenance anesthesia. Mean peak to peak amplitudes of MEPs under desflurane anesthesia from the thenar eminence (419 μV) and abductor hallucis (386 μv) were not significantly different from those under propofol (608 μV, 343 μV, thenar, and abductor hallucis, respectively). Stimulation was greater by 42 V and 136 mA, and trains were slightly longer in the desflurane compared to the propofol group (p propofol cohorts remained the same or increased (71 % of cases) when those after 150 min were compared to those in the first 30-min interval. MEPs with good amplitudes were obtained under desflurane only anesthesia that were comparable to propofol only anesthesia in pediatric patients during surgery for spinal deformities. There was no evidence for anesthetic fade over the time period examined. When used by itself, desflurane can be considered a viable alternative to propofol anesthesia.

  17. [The influence of intermittent hemodialysis (HD) on bispectral index (scale) (BIS) and serum propofol concentration under postoperative intravenous sedation].

    Science.gov (United States)

    Tatebayashi, Shigeru; Imai, Yuichiro; Ohgi, Kazuhiko; Tamaki, Shigehiro; Yamamoto, Kazuhiko; Takahashi, Masahiro; Kurehara, Koukichi; Furuya, Hitoshi; Kirita, Tadaaki

    2004-05-01

    We experienced a case of postoperative intravenous sedation with propofol during intermittent hemodialysis (HD), and investigated the correlation between the clinical sedation level based on bispectral index scale (BIS) together with Ramsay score, and the serum concentration of propofol. One adult oral cancer patient (carcinoma of the lower gingiva) with end-stage renal dysfunction needing HD was selected for this study. The day after operation, HD was commenced under intravenous sedation with propofol. Clinical sedation level was assessed using BIS and Ramsay score, and serum propofol concentrations were determined in arterial blood samples. Serum concentrations were measured every 15 times until 51 hours after operation. The initial dose of propofol was set at 3.5 mg x kg(-1) x h(-1) on the basis of clinical symptoms. According to BIS and Ramsay score, sedation level decreased lineally for 1 hour after commencement of HD. In contrast, serum propofol concentration incresed from 1.71 microg x ml(-1) to 2.21 microg x ml(-1). Total serum concentration of propofol was enhanced during HD because of dialytic dehydration, but, according to BIS and Ramsay scores, the possibility was suggested that the fraction of albmin-unbound propofol with pharmacological activities was eliminated or absorbed by membrane during HD.

  18. Propofol-induced neurotoxicity in hESCs involved in activation of miR-206/PUMA signal pathway.

    Science.gov (United States)

    Li, Yu; Jia, Changxin; Zhang, Dianlong; Ni, Guangzhen; Miao, Xia; Tu, Ruirong

    2017-08-23

    Studies in developing animals have demonstrated that when anesthetic agents, such as propofol, are early administered in life, it can lead to neuronal cell death and learning disabilities. However, the mechanisms causing these effects remains unknown. A recent report found that propofol could significantly upregulat miR-206 expression in the human ASCs. miR-206 could also induce apoptosis in human malignant cancers. Therefore, in this study, we hypothesized that propofol induces neurotoxicity in human embryonic stem cells (hESCs). hESCs were exposed to propofol (50 μM) for 6 hr and cell death was assessed using TUNEL staining, and cleaved caspase-3 expression. miR-206 was knocked down using antagomir. PUMA was knocked down using a small interfering RNA. microRNA-206 (miR-206) expression was assessed using quantitative reverse transcription polymerase chain reaction (qRT-PCR). PUMA protein expression was detected using western blot assay. hESCs exposed to propofol showed a significant increase in TUNEL positive cells and cleaved caspase-3 expression, followed by the upregulation of miR-206 and PUMA expression. Targeting PUMA inhibits propofol-induced cell apoptosis; miR-206 knockdown decreased propofol-induced cell apoptosis, cleaved caspase-3 and PUMA expression. Propofol induce s cell death in hESC-derived neurons via activation of miR-206/PUMA signal pathway.

  19. Quantitative electroencephalographic analysis of the biphasic concentration-effect relationship of propofol in surgical patients during extradural analgesia

    NARCIS (Netherlands)

    Kuizenga, K; Kalkman, CJ; Hennis, PJ

    1998-01-01

    We studied effects on the EEG of propofol infused at a rate of 0.5 mg kg(-1) min(-1) for 10 min in 10 healthy male surgical patients under extradural analgesia. The EEG amplitude in six frequency bands was related to arterial blood propofol concentrations and responsiveness to verbal commands. The E

  20. Propofol Increases Host Susceptibility to Microbial Infection by Reducing Subpopulations of Mature Immune Effector Cells at Sites of Infection.

    Directory of Open Access Journals (Sweden)

    Lavanya Visvabharathy

    Full Text Available Anesthetics are known to modulate host immune responses, but separating the variables of surgery from anesthesia when analyzing hospital acquired infections is often difficult. Here, the bacterial pathogen Listeria monocytogenes (Lm was used to assess the impact of the common anesthetic propofol on host susceptibility to infection. Brief sedation of mice with physiologically relevant concentrations of propofol increased bacterial burdens in target organs by more than 10,000-fold relative to infected control animals. The adverse effects of propofol sedation on immune clearance of Lm persisted after recovery from sedation, as animals given the drug remained susceptible to infection for days following anesthesia. In contrast to propofol, sedation with alternative anesthetics such as ketamine/xylazine or pentobarbital did not increase susceptibility to systemic Lm infection. Propofol altered systemic cytokine and chemokine expression during infection, and prevented effective bacterial clearance by inhibiting the recruitment and/or activity of immune effector cells at sites of infection. Propofol exposure induced a marked reduction in marginal zone macrophages in the spleens of Lm infected mice, resulting in bacterial dissemination into deep tissue. Propofol also significantly increased mouse kidney abscess formation following infection with the common nosocomial pathogen Staphylococcus aureus. Taken together, these data indicate that even brief exposure to propofol severely compromises host resistance to microbial infection for days after recovery from sedation.

  1. Effect of sevoflurane versus propofol-based anesthesia on the hemodynamic response and recovery characteristics in patients undergoing microlaryngeal surgery

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    Neerja Bharti

    2012-01-01

    Full Text Available Background: This randomized study was conducted to compare the hemodynamic changes and emergence characteristics of sevoflurane versus propofol anesthesia for microlaryngeal surgery. Methods: Forty adult patients undergoing microlaryngoscopy were randomly allocated into two groups. In propofol group, anesthesia was induced with 2-3 mg/kg propofol and maintained with propofol infusion 50-200 μg/kg/h. In sevoflurane group induction was carried out with 5-8% sevoflurane and maintained with sevoflurane in nitrous oxide and oxygen. The propofol and sevoflurane concentrations were adjusted to maintain the bispectral index of 40-60. All patients received fentanyl 2 μg/kg before induction and succinylcholine 2 mg/kg to facilitate tracheal intubation. The hemodynamic changes during induction and suspension laryngoscopy were compared. In addition, the emergence time, time to extubation, and recovery were assessed. Results: The changes in heart rate were comparable. The mean arterial pressure was significantly lower after induction and higher at insertion of operating laryngoscope in propofol group as compared to sevoflurane group. More patients in propofol group had episodes of hypotension and hypertension than sevoflurane group. The emergence time, extubation times, and recovery time were similar in both groups. Conclusion: We found that sevoflurane showed advantage over propofol in respect of intraoperative cardiovascular stability without increasing recovery time.

  2. A COMPARATIVE STUDY OF IN HALATION AL SEVOFLURANE VERSUS INTRAVENOUS PROPOFOL FOR INSERTION OF LARYNGEAL MASK AIRWAY IN ADULTS

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    Kailash

    2015-10-01

    Full Text Available BACKGROUND: Inhalational sevoflurane and intravenous propofol have been widely used for anesthesia induction. This study compared the efficacies of inhalational sevoflurane and intravenous propofol inductions for laryngeal mask airway (LMA insertion for minor surgical procedures. METHODS: Fifty adult patients of ASA I and II between the ages 18 - 60 years of either sex posted for elective, minor surgeries in general surgery, obstetric, gynecological, urologic and orthopedic surgeries, received anesthesia induction with inhalational sevoflurane and intravenous propofol. Induction time, quality and ease of LMA insertion, hemodynamic changes and complications were observed . RESUL TS: LMA was inserted most rapidly with intravenous propofol (100.8 ± 14.48 s and less rapidly with inhalational sevoflurane (122 ± 15.6 s. Anesthesia induction with intravenous propofol produced statistically significant difference with mean arterial pressur e and heart rate at one minute, when compared with inhalational sevoflurane. The LMA insertion was excellent with intravenous propofol than inhalational sevoflurane. CONCLUSION: Inhalational sevoflurane provides a smoother induction with a stable hemodynam ic profile, but requiring a longer time for LMA insertion in premedicated patients. The quality of anesthesia provided with intravenous propofol is superior. Thus inhalational sevoflurane is an acceptable alternative to intravenous propofol for LMA inserti on in adults

  3. Las transformaciones nacional de la identidad y la cuestión de la territorialidad en perspectiva comparada. Los casos de Québec y el País Vasco Las transformaciones nacional de la identidad y la cuestión de la territorialidad en perspectiva comparada. Los casos de Québec y el País Vasco

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    José A. Santiago García

    2001-01-01

    Full Text Available La centralidad de la cuestión de la territorialidad en el debate sobre el derecho de autodeterminación que reclama el nacionalismo hace especialmente pertinente adoptar una perspectiva comparada con el fin de mostrar las similitudes y particularidades de distintos casos de estudio. El artículo propone una comparación entre el nacionalismo vasco y el quebequense atendiendo a las transformaciones de la identidad nacional y al papel que en ellos desempeña la cuestión de la territorialidad. Tras mostrar los inconvenientes que plantean las categorías étnico/ cíficas como punto de partida para encasillar a estos nacionalismos, se da cuenta de la pertinencia y de las potencialidades de esta comparación, y de los términos que la hacen significativa. El interés se centra en comparar en ambos casos la representación del «territorio nacional», el papel que éste juega en la identidad nacional, la forma en que se ha relacionado y se relaciona con otros rasgos diacríticos, la vinculación que en ambos casos se da entre integridad territorial y soberanía y, por último, el «papel político» que el nacionalismo reserva al territorio para alcanzar la soberanía.The centrality of the question of territoriality for the discussion about selfdetermination in nationalistic movements makes it specially appropriate to adopt a comparative perspective. This will allow us to show the similarities and the particularities among different cases studies. This paper compares Basque and «Québécois» nationalism by focusing on the role that territoriality plays in national identity. Firstly, it is argued that ethnic and civic concepts are unsuitable for classifying these nationalisms. This paper continues by showing the relevance and potentialities of comparing the Basque and «Québécois» cases. In particular we compare the representation of the national territory in each case, as well as its role for the national identity. Other questions are compared

  4. An Analysis of Substandard Propofol Detected in Use in Zambian Anesthesia.

    Science.gov (United States)

    Mumphansha, Hazel; Nickerson, Jason W; Attaran, Amir; Overton, Sean; Curtis, Sharon; Mayer, Paul; Bould, M Dylan

    2017-08-01

    In early 2015, clinicians throughout Zambia noted a range of unpredictable adverse events after the administration of propofol, including urticaria, bronchospasm, profound hypotension, and most predictably an inadequate depth of anesthesia. Suspecting that the propofol itself may have been substandard, samples were procured and sent for testing. Three vials from 2 different batches were analyzed using gas chromatography-mass spectrometry methods at the John L. Holmes Mass Spectrometry Facility. Laboratory gas chromatography-mass spectrometry analysis determined that, although all vials contained propofol, its concentration differed between samples and in all cases was well below the stated quantity. Two vials from 1 batch contained only 44% ± 11% and 54% ± 12% of the stated quantity, whereas the third vial from a second batch contained only 57% ± 9%. The analysis found that there were no hexane-soluble impurities in the samples. None of the analyzed vials contained the stated amount of propofol; however, our analysis did not detect additional contaminants that would explain the adverse events reported by clinicians. Our results confirm the presence of substandard propofol in Zambia; however, anecdotal accounts of substandard anesthetic medicines in other countries abound and warrant further investigation to provide estimates of the prevalence and scope of this global problem.

  5. Hemorheological in vitro action of propofol on erythrocytes from healthy donors and diabetic patients.

    Science.gov (United States)

    Alet, Analía I; Basso, Sabrina S; Castellini, Horacio V; Delannoy, Marcela; Alet, Nicolás; D'Arrigo, Mabel; Riquelme, Bibiana D

    2016-11-25

    Drugs used during anesthesia might induce disturbance on microcirculation due to their systemic cardiovascular actions and to direct hemorheological effects. A comparative investigation of the hemorheological alterations related to in vitro propofol treatment of red blood cells (RBCs) from healthy and diabetic volunteers is presented here. Viscoelasticity and aggregation of RBCs from type 2 diabetic patients (DBT) and healthy donors (HD) were studied from RBCs incubated with propofol near steady-state concentration. 'S parameter', which measures the aggregation degree, was obtained using digital analysis of microscopic images. Erythrocyte viscoelasticity parameters were determined using an Erythrocyte Rheometer. Results obtained from DBT samples showed an increase of 10% or more in aggregation due to the propofol action. The phase shift between erythrocyte response and oscillating shear stress applied at 1 Hz was altered by propofol treatment of erythrocyte from HD and DBT. Propofol could produce slight alterations in the rheological behavior of erythrocyte from HD and DBT, at concentrations near those of steady state. Moreover, this anesthetic could induce an adverse effect in DBT, particularly on erythrocyte aggregation. The observed hemorheologic alteration would increase the possibility of microcapillary obstruction. Hence, this type of study [0] would prove relevant to avoid possible postoperative complications.

  6. Preparation and evaluation of novel mixed micelles as nanocarriers for intravenous delivery of propofol

    Science.gov (United States)

    Li, Xinru; Zhang, Yanhui; Fan, Yating; Zhou, Yanxia; Wang, Xiaoning; Fan, Chao; Liu, Yan; Zhang, Qiang

    2011-12-01

    Novel mixed polymeric micelles formed from biocompatible polymers, poly(ethylene glycol)-poly(lactide) (mPEG-PLA) and polyoxyethylene-660-12-hydroxy stearate (Solutol HS15), were fabricated and used as a nanocarrier for solubilizing poorly soluble anesthetic drug propofol. The solubilization of propofol by the mixed micelles was more efficient than those made of mPEG-PLA alone. Micelles with the optimized composition of mPEG-PLA/Solutol HS15/propofol = 10/1/5 by weight had particle size of about 101 nm with narrow distribution (polydispersity index of about 0.12). Stability analysis of the mixed micelles in bovine serum albumin (BSA) solution indicated that the diblock copolymer mPEG efficiently protected the BSA adsorption on the mixed micelles because the hydrophobic groups of the copolymer were efficiently screened by mPEG, and propofol-loaded mixed micelles were stable upon storage for at least 6 months. The content of free propofol in the aqueous phase for mixed micelles was lower by 74% than that for the commercial lipid emulsion. No significant differences in times to unconsciousness and recovery of righting reflex were observed between mixed micelles and commercial lipid formulation. The pharmacological effect may serve as pharmaceutical nanocarriers with improved solubilization capacity for poorly soluble drugs.

  7. Changes in intraocular pressure during surgery in the lateral decubitus position under sevoflurane and propofol anesthesia.

    Science.gov (United States)

    Yamada, Makiko Hardy; Takazawa, Tomonori; Iriuchijima, Nobuhisa; Horiuchi, Tatsuo; Saito, Shigeru

    2016-12-01

    Intraocular pressure (IOP) has been shown to change with body position. Several studies have shown that the lateral decubitus position (LDP) is associated with a significant increase in IOP in the dependent eye. However, whether anesthetic agents alter IOP in the LDP remains unclear. This study investigated the effect of sevoflurane and propofol anesthesia on IOP in the LDP. A total of 28 patients undergoing surgery in the LDP were included. Patients were randomly allocated to sevoflurane or propofol groups. IOP in both eyes was recorded and compared between groups at five time points: after anesthesia induction, after endotracheal intubation, at 5 min and 1 h after a positional change to the LDP, and 5 min after returning to the supine position. In the sevoflurane group, IOP was significantly increased in both dependent and non-dependent eyes 1 h after changing to the LDP. In the propofol group, IOP decreased in both dependent and non-dependent eyes after tracheal intubation, but did not increase after changing to the LDP. The number of patients in whom IOP increased to ≥28 mmHg was greater in the sevoflurane group than in the propofol group. Propofol may be better than sevoflurane for the maintenance of anesthesia in the LDP. Monitoring of IOP in the LDP might help avoid ophthalmic complications.

  8. Evaluation of SLOG/TCI-III pediatric system on target control infusion of propofol.

    Science.gov (United States)

    Yang, Wan-hua; Gu, Hong-bin; Chen, Bing; Li, Juan; Fan, Qiu-wei; Yuan, Yong-fang; Wang, Xiangdong

    2011-11-01

    The target-controlled infusion-III (SLOG/TCI-III) system was derived from a model set up by the local pediatric population for target control infusion of propofol. The current study aimed at evaluating the difference between target concentrations of propofol and performance, which was measured using the SLOG/TCI-III system in children. Thirty children fulfilling the I-II criteria according to American Society of Anesthesiology were enrolled in the study. The target plasma concentration of propofol was fed into the SLOG/TCI-III system and compared with the measured concentrations of propofol. Blood samples were collected and analyzed by high performance liquid chromatography with fluorescence detector. The performance error (PE) was determined for each measured blood propofol concentration. The performances of the TCI-III system were determined by the median performance error (MDPE), the median absolute performance error (MDAPE), and Wobble (the median absolute deviation of each PE from the MDPE), respectively. Concentration against target concentration showed good linear correlation: concentration = 1.3428 target concentration - 0.2633 (r = 0.8667). The MDPE and MDAPE of the pediatric system were 10 and 22%, respectively, and the median value for Wobble was 24%. MDPE and MDAPE were less than 15 and 30%, respectively. The performance of TCI-III system seems to be in the accepted limits for clinical practice in children.

  9. Evaluation of SLOG/TCI-III pediatric system on target control infusion of propofol

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    Yang Wan-hua

    2011-11-01

    Full Text Available Abstract Background The target-controlled infusion-III (SLOG/TCI-III system was derived from a model set up by the local pediatric population for target control infusion of propofol. Methods The current study aimed at evaluating the difference between target concentrations of propofol and performance, which was measured using the SLOG/TCI-III system in children. Thirty children fulfilling the I-II criteria according to American Society of Anesthesiology were enrolled in the study. The target plasma concentration of propofol was fed into the SLOG/TCI-III system and compared with the measured concentrations of propofol. Blood samples were collected and analyzed by high performance liquid chromatography with fluorescence detector. The performance error (PE was determined for each measured blood propofol concentration. The performances of the TCI-III system were determined by the median performance error (MDPE, the median absolute performance error (MDAPE, and Wobble (the median absolute deviation of each PE from the MDPE, respectively. Results Concentration against target concentration showed good linear correlation: concentration = 1.3428 target concentration - 0.2633 (r = 0.8667. The MDPE and MDAPE of the pediatric system were 10 and 22%, respectively, and the median value for Wobble was 24%. MDPE and MDAPE were less than 15 and 30%, respectively. Conclusions The performance of TCI-III system seems to be in the accepted limits for clinical practice in children.

  10. [Propofol combined with midazolam intravenous sedation anesthesia in pediatric upper gastrointestinal endoscopy].

    Science.gov (United States)

    Xiao, Dinghua; Wang, Fen; Wang, Xiaoyan; Tang, Wuliang; Ouyang, Wen; Shen, Shourong

    2009-07-01

    To explore the application of propofol combined with midazolam intravenous anesthesia in pediatric upper gastrointestinal endoscopy. A total of 497 ASA I~II patients who received sedative upper gastrointestinal endoscopy were assigned to a children group (2-14 years) and an adults group (18-65 years).The 2 groups were treated with midazolam (0.02-0.03 mg/kg, iv) and propofol(0.6-0.7 mg/s,iv) with an interval of 3-5 minutes. Enterscopy was inserted at light sleep, relaxing muscles, and disappearance of eyelash relaxation. Combining of pro-endoscopy, reaction to intravenous administration, dose of propofol, reaction to endoscopy, time of returning to consciousness, changes of SpO2, R, HR, and BP, and sedative quality were evaluated. Good sedation of the 2 groups after intravenous administration was observed. Rate of combining of pro-endoscopy in children was lower (42%) than that in adults(100%). The incidence of restlessness, hyperphasia, temporary decreasing of SpO2, dose of propofol of per kilogram weight, time of returning to consciousness in the children were 82.7%, 17%, 2.4 mg/kg, and (17.5+/-3.2) min, respectively, which were all higher in the adults [9%, 4%, 1.4 mg/kg, and (9.5+/-1.3) min, P0.05). It is safe and effective to use propofol combined with midazolam intravenous sedation anesthesia in pediatric upper gastrointestinal endoscopy.

  11. Remifentanil and propofol for weaning of mechanically ventilated pediatric intensive care patients.

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    Welzing, Lars; Vierzig, Anne; Junghaenel, Shino; Eifinger, Frank; Oberthuer, Andre; Trieschmann, Uwe; Roth, Bernhard

    2011-04-01

    Mechanically ventilated pediatric intensive care patients usually receive an analgesic and sedative to keep them comfortable and safe. However, common drugs like fentanyl and midazolam have a long context sensitive half time, resulting in prolonged sedation and an unpredictable extubation time. Children often awake slowly and struggle against the respirator, although their respiratory drive and their airway reflexes are not yet sufficient for extubation. In this pilot study, we replaced fentanyl and midazolam at the final phase of the weaning process with remifentanil and propofol. Twenty-three children aged 3 months-10 years were enrolled. Remifentanil and propofol revealed throughout excellent or good weaning conditions with rapid transition from hypnosis to the development of regular spontaneous breathing, airway protective reflexes, and an appropriate level of alertness. Extubation time following discontinuation of the remifentanil and propofol infusion was only 24 ± 20 min (5-80 min). We conclude that the combination of remifentanil and propofol is a promising option to improve the weaning conditions of pediatric intensive care patients. Randomized controlled trials are needed to compare remifentanil and propofol with conventional weaning protocols.

  12. Catalytic activation of copper (II) salts on the reaction of peroxynitrite with propofol in alkaline medium.

    Science.gov (United States)

    Kohnen, Stephan; Halusiak, Emilie; Mouithys-Mickalad, Ange; Deby-Dupont, Ginette; Deby, Carol; Hans, Pol; Lamy, Maurice; Noels, Alfred F

    2005-06-01

    We report here on the role of copper (II) salts on the acceleration of peroxynitrite (ONOO-) decomposition and ONOO- reaction with the anaesthetic agent propofol (2,6-diisopropylphenol) in alkaline medium. We observed a strong acceleration of the ONOO- decomposition in alkaline medium in the presence of copper (I and II) salts. After 18 h of ONOO- reaction with propofol, we observed nitrosated, nitrated, and oxidized (quinone and diphenylquinone) derivatives of propofol, but in the presence of Cu(II) (20% molar vs ONOO-), the yields of quinone and nitrosopropofol strongly increased. We also observed that the temperature and the atmosphere influenced the effects of Cu(II) on ONOO- reactions with propofol: low temperatures promoted nitrosation and high temperatures promoted oxidation; O2 atmosphere increased the general reactivity and the yield of nitrated and oxidized products. We highlighted the influence of Cu(II) salts on the radical character of the reaction by direct EPR technique. The exact mechanism of the Cu(II) catalysis remains unexplained, but we suggest the formation of a copper complex with propofol or, more probably, the oxidation of ONOO- into ONOO. by copper ions promoting the formation of quinone and nitrosopropofol according to a previously reported mechanism [M. Cudic, C. Ducrocq, Transformations of 2,6-diisopropylphenol by NO-derived nitrogen oxides, particularly peroxynitrite, Nitric Oxide 4 (2000) 147-156].

  13. [Determining the aortic and renal hemodynamic effects of propofol on rabbits using Doppler ultrasonography].

    Science.gov (United States)

    Apan, Alpaslan; Karadeniz Bilgili, M Yasemin; Cağlayan, Fatma

    2004-03-01

    The hemodynamic effects of propofol-fentanyl anesthesia were known to reduce arterial pressure and heart rate. We aimed to determine the effects of propofol-fentanyl anesthesia on renal artery blood flow and aorta by using Doppler ultrasonography on an animal model. The study was conducted on 8 male New Zaeland White strain rabbits. The initial aortic and renal hemodynamic measurements were determined on animals using ketamin anesthesia. Later the right femoral arteries were cannulated for determining arterial blood pressure and pulse oximetry was followed from the ear. Propofol 5-7 mg/kg with fentanyl 1-2 microg/kg was injected via the ear vein. Doppler parameters (RI, RI, Vmax, Vmin) of the renal artery and aorta were determined after the anesthesia. According to the basal measurements, arterial blood pressure and breath rates declined significantly (27% and 53% respectively, p<0.05); however there were no statistical alteration of aortic and renal artery Doppler parameters. Anesthesia induced by propofol-fentanyl did not induce a statistically significant difference in Doppler parameters obtained from the renal artery and aorta. It is clinically important to know that determining the changes in RI and PI during the postoperative period is not related to the propofol-fentanyl anesthesia.

  14. Perbandingan Efek Induksi Propofol dengan Ketamin terhadap Penurunan Nilai Neutrofil pada Pasien dengan Tindakan Anestesi Umum

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    Angga Permana Putra

    2017-04-01

    Full Text Available Leukocyte is a part of innate immunity elements. Neutrophil impairment of can be used as a simple parameter to measure the severity of stress and systemic inflammation in patients. Some research suggests the influence of anesthetic drugs on leukocytes and other studies look at the effect of anesthetic drugs on leukocyte subset functions, especially neutrophils. This study aimed to reveal the difference in the induction effect of propofol and ketamine against impairment of neutrophils in patients with general anesthesia. This was a double blind randomized control trial conducted in 32 patients ASA I and II who were divided into two groups. These patients underwent general anesthesia at the Central Operating Theater of H. Adam Malik General Hospital during May–June 2016. Group propofol (A received 2 mg/kgBW propofol, while group ketamine (B received 2 mg/kgBW ketamine. Neutrophils were measured before induction (T1, 10 minutes after intubation (T2, and 60 minutes after intubation (T3. By using T-independent and Mann-Whitney U test in SPSS ver.23, it was found that the the p-values for T1. T2, and T3 neutrophils were 0.636,0.846, and 0.403. respectively. In conclusion, there is a difference in induction effect between propofol and ketamine against impairment of neutrophils with no effect is found for propofol.

  15. Comparison of propofol versus sevoflurane on thermoregulation in patients undergoing transsphenoidal pituitary surgery: A preliminary study

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    Tumul Chowdhury

    2012-01-01

    Full Text Available Purpose: General anesthesia causes inhibition of thermoregulatory mechanisms. Propofol has been reported to cause more temperature fall, but in case of deliberate mild hypothermia, both sevoflurane and propofol were comparable. Thermoregulation is found to be disturbed in cases of pituitary tumors. We aimed to investigate which of the two agents, sevoflurane or propofol, results in better preservation of thermoregulation in patients undergoing transsphenoidal excision of pituitary tumors. Methods: Twenty-six patients scheduled to undergo transsphenoidal removal of pituitary adenomas were randomly allocated to receive propofol or sevoflurane anesthesia. Baseline esophageal temperature was noted. Times for temperature to fall by 1°C or 35°C and to return to baseline were also comparable ( P>0.05. After that warmer was started at 43°C and time to rise to baseline was noted. Duration of surgery, total blood loss, and total fluid intake were also noted. If any, side effects such as delayed arousal and recovery from muscle relaxant were noted. Results: The demographics of the patients were comparable. Duration of surgery and total blood loss were comparable in the two groups. The time for temperature to fall by 1°C or 35°C and time to return to baseline was also comparable ( P>0.05. No side effects related to body temperature were noted. Conclusion: Both propofol and sevoflurane show similar effects in maintaining thermal homeostasis in patients undergoing transsphenoidal pituitary surgery.

  16. Measurement of motor evoked potentials following repetitive magnetic motor cortex stimulation during isoflurane or propofol anaesthesia.

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    Rohde, V; Krombach, G A; Baumert, J H; Kreitschmann-Andermahr, I; Weinzierl, M; Gilsbach, J M

    2003-10-01

    Isoflurane and propofol reduce the recordability of compound muscle action potentials (CMAP) following single transcranial magnetic stimulation of the motor cortex (sTCMS). Repetition of the magnetic stimulus (repetitive transcranial magnetic stimulation, rTCMS) might allow the inhibition caused by anaesthesia with isoflurane or propofol to be overcome. We applied rTCMS (four stimuli; inter-stimulus intervals of 3, 4, 5 ms (333, 250, 200 Hz), output 2.5 Tesla) in 27 patients and recorded CMAP from the hypothenar and anterior tibial muscle. Anaesthesia was maintained with fentanyl 0.5-1 microg kg(-1) x h(-1) and either isoflurane 1.2% (10 patients) or propofol 5 mg kg(-1) x h(-1) with nitrous oxide 60% in oxygen (17 patients). No CMAP were detected during isoflurane anaesthesia. During propofol anaesthesia 333 Hz, four-pulse magnetic stimulation evoked CMAP in the hypothenar muscle in 75%, and in the anterior tibial muscle in 65% of the patients. Less response was obtained with 250 and 200 Hz stimulation. In most patients, rTCMS can overcome suppression of CMAP during propofol/nitrous oxide anaesthesia, but not during isoflurane anaesthesia. A train of four magnetic stimuli at a frequency of 333 Hz is most effective in evoking potentials from the upper and lower limb muscles. The authors conclude that rTCMS can be used for evaluation of the descending motor pathways during anaesthesia.

  17. A comparison of sevoflurane versus propofol for tracheal intubation in children

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    Viren Darji

    2014-07-01

    Full Text Available The study was conducted in 60 ASA I Children, 4-12 years of age, of either sex undergoing elective surgery. All patients were premedicated with I.V. Midazolam 0.02 mg/kg, Inj. Fentanyl 2μg/kg and Glycopyrolate 0.05mg/kg. 10 minutes before surgery. Patients were randomly divided into two groups. Group S (SEVOFLURANE 8%+40% O 2 +60%N 2 O and Group P (I.V. Propofol 1%w/v .Centralization of pupils and miosis were used as end points for intubation. Anesthesia was maintained with O 2 , nitrous oxide and sevoflurane. Induction time, Quality of Intubation, Hemodynamic response and complications during endotracheal intubation in children with inhalational induction with Sevoflurane versus and complications during endotracheal intubation studied. Conclusion: In premedicated children both sevoflurane and propofol provides good quality of anesthesia for intubation. Induction time and Hemodynamic response was less in propofol than sevoflurane. Quality of intubating condition was better with propofol than sevoflurane .So Propofol is better than Sevoflurane for tracheal intubation in Children. However Sevoflurane is acceptable alternative in patients with difficult venous access

  18. Synthesis and characterization of novel quick-release propofol prodrug via lactonization.

    Science.gov (United States)

    Yang, Jun; Yin, Wang; Liu, Jin; Wang, Yu; Zhou, Cheng; Kang, Yi; Zhang, Wen-Sheng

    2013-03-15

    The water-soluble derivatives of propofol have gained attention as a method to increase solubility of propofol. According to the principle of lactonization, the lead compound HX0969 was synthesized first and then the pharmacological features of HX0969 were evaluated in a comparison with those of propofol in the SD rats. Then, HX0969 disodium phosphate monoester (HX0969W) and glycine ester trifluoroacetic acid salt (HX101230) were synthesized, and their pharmacological features were compared with those of Lusedra®, which has been recognized and marketed as a water-soluble prodrug of propofol since 2008. The results showed that HX0969 could produce an anesthetic effect within a few seconds (3.6±3.0s) and its therapeutic index was 4.66 in the SD rat. The pharmacodynamic characteristics of HX0969W were similar to those of the Lusedra®. HX101230 could still produce an anesthetic effect within 60s in the rats though its therapeutic index was not so high (TI=2.96). Therefore, our study has indicated that HX0969 is a potentially useful lead compound of propofol derivative. Its rapid anesthetic effect is probably associated with lactonization.

  19. The protective effects of propofol and citicoline combination in experimental head injury in rats.

    Science.gov (United States)

    Menku, Ahmet; Ogden, Mustafa; Saraymen, Recep

    2010-01-01

    Lipid peroxidation (LP) is an important factor in tissue damage following head injury. Reactive oxygen radicals which damage cellular components play an important role in ischemic or hypoxic tissue. They initiate the lipid peroxidation process after head trauma. However, antioxidant agents may protect brain tissue against oxidative damage 39 male Swiss Albino rats (200-250 g) were used in this experimental study. These animals were divided into 3 groups: 1) control group, 2) propofol group (100 mg/kg) and, 3) citicoline (250 mg/kg) and propofol (100 mg/kg) combination group. Oxidant effect in brain tissue content was assessed by measuring the Malonyldialdehyde (MDA), Superoxide Dismutase (SOD) and Gluthatione Peroxidase (GPx) activities. There was no statistically meaningful difference among the groups regarding GPx levels. MDA levels were significantly lower in the citicoline and combination group than those of the control group. As for the levels of SOD, there was an increase both in the propofol and combination groups. Atherapeutic benefit of the propofol and citicolin combination in head trauma has not been previously demonstrated. We examined the possible potential protective effect of propofol and citicolin against oxidative damage in experimental head trauma in the present study.

  20. Is Propofol Safe For Food Allergy Patients? A Review of the Evidence.

    Science.gov (United States)

    Dziedzic, Arkadiusz

    2016-01-01

    Allergic cross-reactivity between propofol and food is frequently considered as a risk factor for perioperative allergic hypersensitivity reactions and anaphylaxis during dental anaesthesia and sedation. Better understanding of of this cross-reactivity is important to providing safe care. There are, however, conflicting assumptions about anaphylactic reactions to propofol in patients reporting allergy to certain type of the food. Egg and/or soya allergy are often cited as contraindications to propofol administration but the evidence remains unclear. The main goal of this article is to review the available advice and evidence about the cross-reactivity between propofol and foods. A literature search was undertaken. The current published evidence does not elucidate that propofol allergy and food allergies are linked directly, but this drug should be used with caution in atopic patients with allergies to egg and/or soya bean oil. Clinical audit projects may gather data on anaphylactic events during anaesthesia and may aid the profession in this dilemma.

  1. Evaluation of the antioxidant properties of propofol and its nitrosoderivative. comparison with homologue substituted phenols.

    Science.gov (United States)

    Rigobello, Maria Pia; Stevanato, Roberto; Momo, Federico; Fabris, Sabrina; Scutari, Guido; Boscolo, Rita; Folda, Alessandra; Bindoli, Alberto

    2004-03-01

    Propofol (2,6-diisopropylphenol), some substituted phenols (2,6-dimethylphenol and 2,6-ditertbutylphenol) and their 4-nitrosoderivatives have been compared for their scavenging ability towards 1,1-diphenyl-2-picrylhydrazyl and for their inhibitory action on lipid peroxidation. These products were also compared to the classical antioxidants butylated hydroxytoluene and butylated hydroxyanisole. When measuring the reactivity of the various phenolic derivatives with 1,1-diphenyl-2-picrylhydrazyl the following order of effectiveness was observed: butylated hydroxyanisole > propofol > 2,6-dimethylphenol > 2,6-di-tertbutylphenol > butylated hydroxytoluene. In cumene hydroperoxide-dependent microsomal lipid peroxidation, propofol acts as the most effective antioxidant, while butylated hydroxyanisole, 2,6-di-tertbutylphenol and butylated hydroxytoluene exhibit a rather similar effect, although lower than propofol. In the iron/ascorbate-dependent lipid peroxidation propofol, at concentrations higher than 10 microM, exhibits antioxidant properties comparable to those of butylated hydroxytoluene and butylated hydroxyanisole, 2,6-Dimethylphenol is scarcely effective in both lipoperoxidative systems. The antioxidant properties of the various molecules depend on their hydrophobic characteristics and on the steric and electronic effects of their substituents. However, the introduction of the nitroso group in the 4-position almost completely removes the antioxidant properties of the examined compounds. The nitrosation of the aromatic ring of antioxidant molecules and the consequent loss of antioxidant capacity can be considered a condition potentially occurring in vivo since nitric oxide and its derivatives are continuously formed in biological systems.

  2. Preparation and evaluation of novel mixed micelles as nanocarriers for intravenous delivery of propofol

    Directory of Open Access Journals (Sweden)

    Li Xinru

    2011-01-01

    Full Text Available Abstract Novel mixed polymeric micelles formed from biocompatible polymers, poly(ethylene glycol-poly(lactide (mPEG-PLA and polyoxyethylene-660-12-hydroxy stearate (Solutol HS15, were fabricated and used as a nanocarrier for solubilizing poorly soluble anesthetic drug propofol. The solubilization of propofol by the mixed micelles was more efficient than those made of mPEG-PLA alone. Micelles with the optimized composition of mPEG-PLA/Solutol HS15/propofol = 10/1/5 by weight had particle size of about 101 nm with narrow distribution (polydispersity index of about 0.12. Stability analysis of the mixed micelles in bovine serum albumin (BSA solution indicated that the diblock copolymer mPEG efficiently protected the BSA adsorption on the mixed micelles because the hydrophobic groups of the copolymer were efficiently screened by mPEG, and propofol-loaded mixed micelles were stable upon storage for at least 6 months. The content of free propofol in the aqueous phase for mixed micelles was lower by 74% than that for the commercial lipid emulsion. No significant differences in times to unconsciousness and recovery of righting reflex were observed between mixed micelles and commercial lipid formulation. The pharmacological effect may serve as pharmaceutical nanocarriers with improved solubilization capacity for poorly soluble drugs.

  3. Propofol infusion syndrome in a super morbidly obese patient (BMI = 75).

    Science.gov (United States)

    Ramaiah, Ramesh; Lollo, Loreto; Brannan, Douglas; Bhananker, Sanjay M

    2011-01-01

    Propofol infusion syndrome (PRIS) is a rare but often fatal complication as a result of large doses of propofol infusion (4-5 mg/kg/hr) for a prolonged period (>48 h). It has been reported in both children and adults. Besides large doses of propofol infusion, the risk factors include young age, acute neurological injury, low carbohydrate and high fat intake, exogenous administration of corticosteroid and catecholamine, critical illness, and inborn errors of mitochondrial fatty acid oxidation. PRIS manifestation include presence of metabolic acidosis with a base deficit of more than 10 mmol/l at least on one occasion, rhabdomyolysis or myoglobinuria, acute renal failure, sudden onset of bradycardia resistant to treatment, myocardial failure, and lipemic plasma. The pathophysiology of PRIS may be either direct mitochondrial respiratory chain inhibition or impaired mitochondrial fatty acid metabolism mediated by propofol. We report a case of supermorbidly obese patient who received propofol infusion by total body weight instead of actual body weight and developed PRIS.

  4. Effect of Propofol on Glutamate and γ-aminobutyric Acid Release from Rat Hippocampal Synaptosomes

    Institute of Scientific and Technical Information of China (English)

    SHANG You; YAO Shanglong; ZENG Yinming; LIU Hongliang; CAO Junli

    2005-01-01

    To investigate the effect of propofol on the release of glutamate and γ-aminobutyric acid (GABA) from rat hippocampal synatosomes, synaptosomes was made from hippocampus and incubated with artificial cerebrospinal fluid (aCSF). With the experiment of Ca2+-dependent release of glutamate and GABA, dihydrokainic acid (DHK) and nipectic acid were added into aCSF. For the observation of Ca2+-independent release of glutamate and GABA, no DHK, nipectic acid and Ca2+were added from aCSF. The release of glutamate and GABA were evoked by 20μmol/L veratridine or 30 mmol/L KCl. The concentration of glutamate and GABA in aCSF was measured by using high-performance liquid chromatography (HPLC). 30, 100 and 300 μmol/L propofol significantly inhibited veratridine-evoked Ca2+-dependent release of glutamate and GABA (P<0.01 or P<0.05). However, propofol showed no effect on elevated KCl-evoked Ca2+-dependent release of glutamate and GABA (P>0.05). Veratridine or elevated KCl evoked Ca2+ -independent release of glutamate and GABA was not affected significantly by propofol (P>0.05). Propofol could inhibit Ca2+-dependent release of glutamate and GABA. However, it has no effect on the Ca2+-independent release ofglutamate and GABA.

  5. Use of a Ketamine-Propofol Combination During Sedation and Analgesia

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    Gökçen Başaranoğlu

    2015-03-01

    Full Text Available Aim: The aim of this study was to evaluate 1:1 mixture of ketamine and propofol for sedative/analgesic efficacy, patient comfort and postoperative complications. Methods: The anesthesia and nursing records of patients who received ketamine-propofol mixture in Bezmialem Vakıf University Hospital between 2009 and 2010 were retrospectively documented. Results: Of the 51 adult patients who received ketamine-propofol sedation, 39 patients had ASA 1-2 score while 12 patients had ASA 3-4 score. No patient had apnea, desaturation, hypotension or vomiting. Two patients who had postoperative agitation received midazolam. All patients were transferred to the surgical ward when Aldrete scores were >8. Surgeon and patient satisfaction were high except in 2 patients. Conclusion: Ketamine and propofol mixture for the purpose of sedation and analgesia is a practical method with minimal negative effects on respiration and hemodynamic variables, however, hallucination associated with ketamine may be observed. We conclude that due to the lack of hypnotic activity, 1/2 or 1/3 instead of 1/1 ketamine and propofol mixture would be more appropriate. (The Medical Bulletin of Haseki 2015; 53:41-6

  6. Estructuras agrarias comparadas: la Puna argentina y el sur boliviano a comienzos del siglo XX

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    Ana A. Teruel

    2005-01-01

    Full Text Available This article expects to be another contribution to the knowledge about the social-economic problems from the Argentine Puna, especifically to its agricultural structure, paying special attention to changes and permanences, concerning to property and land, key to economical and social power and fundamental axis of production relationship of this society. It focuses on the problematical fact of indian lands, making a comparison between the North of Argentina and the South of Bolivia, considering both political state systems about comunity lands and its effects in the agrarian structures in the begining of the XXth century.Este artículo tiene por propósito realizar un aporte más al conocimiento de la problemática socio-económica de la Puna argentina, específicamente a su estructura agraria, atendiendo los cambios y permanencias relativos a la propiedad y tenencia de la tierra, clave del poder económico y social y eje fundamental en las relaciones de producción de esta sociedad agraria. Se trata la cuestión en el marco de la problemática de las tierras indígenas, comparando la situación del Norte argentino con la del Sur boliviano, analizando las políticas de ambos Estados en torno a la tierra de las comunidades y sus efectos en las estructuras agrarias de comienzos del siglo XX.

  7. Spanish firms patenting in the European office. characteristics compared with non-applicant; Las empresas espanolas que patentan en la oficina Europea. Caracteristicas comparadas con las no solicitantes

    Energy Technology Data Exchange (ETDEWEB)

    Barajas, A.; Huergo, E.; Moreno, L.

    2012-07-01

    The objective of this paper is to provide evidence about the features of Spanish firms applying for patents to the European Patent Office between 1998 and 2008. We compare these firms with a control sample of non-applicants during the same period and focus especially on firms that have been awarded public aid for R and D projects by the Centre for the Development of Industrial Technology. (Author) 14 refs.

  8. Estado constitucional e imperio colonial: un análisis histórico de Francia (1871-1931) con referencia comparada a Gran Bretaña

    OpenAIRE

    Rodríguez-Drincourt Álvarez, Juan

    2016-01-01

    Francia y Gran Bretaña constituían, en las últimas décadas del siglo XIX, Estados en tránsito acelerado hacia una democracia moderna. Al mismo tiempo, gestaban también nuevos imperios coloniales conformando una de las categorías más complejas y paradójicas de organización política contemporánea. Así, por ejemplo, el Estado constitucional francés de la Tercera República, uno de los grandes arquetipos del colonialismo moderno, se articula como ¿República imperial¿ o ¿Imperio republicano¿ y, ad...

  9. Envejecimiento biológico óseo en personas adultas con discapacidad intelectual. Un estudio de casos y controles

    OpenAIRE

    2011-01-01

    [ES] El objetivo general de este trabajo es conocer el envejecimiento y los factores determinantes en personas adultas con discapacidad intelectual (PADI) comparada con la población general. Como específico, se han valorado el envejecimiento molecular y celuar, el óseo y neurofisiológico. [EN] The overall objective of this work is to know the age and the determining factors in adults with intellectual incapacity (PADI) compared with the general population. As specific, we evaluated the mol...

  10. Propofol at Clinically Relevant Concentrations Increases Neuronal Differentiation but Is Not Toxic to Hippocampal Neural Precursor Cells In Vitro

    Science.gov (United States)

    Sall, Jeffrey W.; Stratmann, Greg; Leong, Jason; Woodward, Elliott; Bickler, Philip E.

    2012-01-01

    Background Propofol in the early postnatal period has been shown to cause brain cell death. One proposed mechanism for cognitive dysfunction after anesthesia is alteration of neural stem cell function and neurogenesis. We examined the effect of propofol on neural precursor or stem cells (NPCs) grown in vitro. Methods Hippocampal derived NPCs from postnatal day 2 rats were exposed to propofol or to Diprivan. NPCs were then analyzed for bromodeoxyuridine incorporation to measure proliferation. Cell death was measured by lactate dehydrogenase release. Immunocytochemistry was used to evaluate the expression of neuronal and glial markers in differentiating NPCs exposed to propofol. Results Propofol dose dependently increases the release of lactate dehydrogenase from NPCs under both proliferating and differentiating conditions at supraclinical concentrations (> 7.1μM). Both Diprivan and propofol had the same effect on NPCs. Propofol mediated release of lactate dehydrogenase is not inhibited by blocking the γ-aminobutyric acid type A receptor or extracellular calcium influx and is not mediated by caspase-3/7. Direct γ-aminobutyric acid type A receptor activation did not have the same effect. In differentiating NPCs 6 h of propofol at 2.1 μM increased the number neurons but not glial cells 4 days later. Increased neuronal differentiation was not blocked by Bicuculline. Conclusions Only supraclinical concentrations of propofol or Diprivan kill NPCs in culture by a non-γ-aminobutyric acid type A, noncaspase 3 mechanism. Clinically relevant doses of propofol increase neuronal fate choice by a non-γ-aminobutyric acid type A mechanism. PMID:23001052

  11. The General Anesthetic Propofol Excites Nociceptors by Activating TRPV1 and TRPA1 Rather than GABAA Receptors*

    Science.gov (United States)

    Fischer, Michael J. M.; Leffler, Andreas; Niedermirtl, Florian; Kistner, Katrin; Eberhardt, Mirjam; Reeh, Peter W.; Nau, Carla

    2010-01-01

    Anesthetic agents can induce a paradox activation and sensitization of nociceptive sensory neurons and, thus, potentially facilitate pain processing. Here we identify distinct molecular mechanisms that mediate an activation of sensory neurons by 2,6-diisopropylphenol (propofol), a commonly used intravenous anesthetic known to elicit intense pain upon injection. Clinically relevant concentrations of propofol activated the recombinant transient receptor potential (TRP) receptors TRPA1 and TRPV1 heterologously expressed in HEK293t cells. In dorsal root ganglion (DRG) neurons, propofol-induced activation correlated better to expression of TRPA1 than of TRPV1. However, pretreatment with the protein kinase C activator 4β-phorbol 12-myristate 13-acetate (PMA) resulted in a significantly sensitized propofol-induced activation of TRPV1 in DRG neurons as well as in HEK293t cells. Pharmacological and genetic silencing of both TRPA1 and TRPV1 only partially abrogated propofol-induced responses in DRG neurons. The remaining propofol-induced activation was abolished by the selective γ-aminobutyric acid, type A (GABAA) receptor antagonist picrotoxin. Propofol but not GABA evokes a release of calcitonin gene-related peptide, a key component of neurogenic inflammation, from isolated peripheral nerves of wild-type but not TRPV1 and TRPA1-deficient mice. Moreover, propofol but not GABA induced an intense pain upon intracutaneous injection. As both the release of calcitonin gene-related peptide and injection pain by propofol seem to be independent of GABAA receptors, our data identify TRPV1 and TRPA1 as key molecules for propofol-induced excitation of sensory neurons. This study warrants further investigations into the role of anesthetics to induce nociceptor sensitization and to foster postoperative pain. PMID:20826794

  12. Propofol vs pentobarbital for sedation of children undergoing magnetic resonance imaging: results from the Pediatric Sedation Research Consortium.

    Science.gov (United States)

    Mallory, Michael D; Baxter, Amy L; Kost, Susanne I

    2009-06-01

    Pentobarbital and propofol are commonly used to sedate children undergoing magnetic resonance imaging (MRI). The Pediatric Sedation Research Consortium (PSRC) was created in 2003 to improve pediatric sedation process and outcomes. To use PSRC records to compare the effectiveness, efficiency and adverse events of propofol vs pentobarbital for sedation of children undergoing MRI. Pediatric Sedation Research Consortium records of children aged 6 months to 6 years who were primarily sedated with either i.v. pentobarbital or propofol were included. Participating PSRC investigators obtained institutional review board approval before data collection. Of 11 846 sedations for MRI, 7079 met inclusion criteria (propofol: n = 5072; pentobarbital: n = 2007). Demographic details were similar between the two groups. Ideal sedation was produced in 96.45% of the pentobarbital group and in 96.8% of the propofol group (P = 0.478), but pentobarbital was more likely to result in poor sedation cancelling the procedure (OR 5.88; CI 2.24, 15.40). Propofol resulted in physiologic changes more frequently than did pentobarbital (OR 5.69; CI 1.35, 23.97). Pentobarbital was associated with prolonged recovery (OR 16.82; CI 4.98, 56.8), unplanned admission (OR 5.60; CI 1.02, 30.82), vomiting (OR 36.76; CI 4.84, 279.2) and allergic complication (OR 9.15; CI 1.02, 82.34). The incidence of airway complications was not significantly different between the two. The median recovery time for patients receiving propofol was 30 min, whereas for pentobarbital it was 75 min (P propofol provides more efficient and effective sedation than pentobarbital for children undergoing MRI. Although apnea occurred with a greater frequency in patients who received propofol, the rate of apnea and airway complications for propofol was not statistically different from that seen in patients who received pentobarbital.

  13. Los estudios de pedagogía en Europa en el contexto de la implantación del proceso de Bolonia y la situación de la Educación Comparada

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    Joan María Senent Sánchez

    2005-01-01

    Full Text Available El artículo nos presenta un análisis comparativo de la situación de los estudios superiores de carácter pedagógico en 23 países de Europa que han sido agrupados en 5 bloques: a Países anglofónos o de influencia británica: Reino Unido, Irlanda y Malta. b Escandinavia: Noruega, Finlandia, Dinamarca y Holanda. c Países de lengua o influencia alemana: Alemania, Austria y Eslovenia. d Europa del Este: República Checa, Eslovaquia y Polonia. e Países francófonos: Francia, Belgica, Luxemburgo y Suiza romance. . f Países meridionales: Portugal, España, Italia, Grecia y Chipre. El análisis se basa en la presencia de los estudios pedágógicos en los "grados" y "postgrados" de ese país, la estructura adoptada, las características del del programa de formación y su situación respecto a la adaptación al proceso de Bolonia. El artículo termina con la presentación de las conclusiones del informe, así como un breve análisis de la situación de la Educación Comparada en las universidades europeas, tanto como disciplina que como método de trabajo.

  14. La imagen como documento gráfico visual en la enseñanza de la historia en Educación Primaria en perspectiva comparada. Análisis y propuesta didáctica

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    Virginia Gámez-Ceruelo

    2017-01-01

    Full Text Available El desarrollo tecnológico del siglo XXI ha ampliado los estímulos visuales e instala la necesidad de promover una alfabetización visual progresiva. Uno de los soportes más usados en aula y con mayor presencia de imágenes son los libros de texto. Así, este artículo pretende: 1 valorar los aprendizajes promovidos en las actividades de los libros de texto que emplean imágenes en Chile y España y 2 sugerir directrices didácticas para su uso como documento gráfico visual en la enseñanza de las ciencias sociales. Se emplearon dos perspectivas metodológicas, la cualitativa y la comparada. Los resultados indican que existe un creciente desarrollo de facultades de aproximación analítica y crítica a las imágenes en Chile, mientras en Cataluña su desarrollo es muy incipiente.

  15. Organizaciones de partido en Brasil: el PT y el PSDB bajo perspectiva comparada

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    Celso ROMA

    2009-11-01

    Full Text Available RESUMEN: Hay pocos estudios de cómo los partidos brasileños se organizan. Este artículo examina la organización del Partido de los Trabajadores (PT y del Partido de la Social Democracia Brasileña (PSDB, comparando el origen, la estructura interna y la ideología de estos partidos. El PT se originó en el ámbito de la sociedad civil y adoptó un ordenamiento centralizado de comités partidarios y amplia participación de sus afiliados en la toma de decisiones del partido. Mientras, el PSDB surgió en el Parlamento, apoyándose en una constitución interna descentralizada y con autonomía de acción de sus líderes. Los afiliados de estos partidos revelan opiniones diferentes ante una agenda política. Por lo tanto, aunque los partidos se sujetan al mismo sistema político, ellos pueden adoptar organizaciones y estrategias de competencia electoral distintas pero igualmente eficientes.ABSTRACT: There are few studies about the way Brazilian political parties are organized. This article analyzes the organization of the Workers Party (PT and the Brazilian Social Democracy Party (PSDB comparing their origin, internal structure and ideology. The PT was originated in the civil society and adopted a centralized organization of party committees to facilitate a wide participation of its affiliates in the decisions within the party. In turn, the PSDB arose in the Parliament, supporting itself on a decentralized internal organization and with leadership autonomy in decision making. Affiliates of these parties reveal different visions about the political agenda. As a result, even though theses parties are held to the same political system, they can adopt different organizations and strategies of electoral competition with equally efficient outcomes.

  16. Propofol versus thiopental sodium for the treatment of refractory status epilepticus.

    Science.gov (United States)

    Prabhakar, Hemanshu; Kalaivani, Mani

    2017-02-03

    This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (Issue 6, 2015).Failure to respond to antiepileptic drugs in patients with uncontrolled seizure activity such as refractory status epilepticus (RSE) has led to the use of anaesthetic drugs. Coma is induced with anaesthetic drugs to achieve complete control of seizure activity. Thiopental sodium and propofol are popularly used for this purpose. Both agents have been found to be effective. However, there is a substantial lack of evidence as to which of the two drugs is better in terms of clinical outcomes. To compare the efficacy, adverse effects, and short- and long-term outcomes of refractory status epilepticus (RSE) treated with one of the two anaesthetic agents, thiopental sodium or propofol. We searched the Cochrane Epilepsy Group Specialized Register (16 August 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of Studies Online (CRSO, 16 August 2016), MEDLINE (Ovid, 1946 to 16 August 2016), ClinicalTrials.gov (16 August 2016), and the South Asian Database of Controlled Clinical Trials (16 August 2016). Previously we searched IndMED, but this was not accessible at the time of the latest update. All randomised controlled trials (RCTs) or quasi-RCTs (regardless of blinding) assessing the control of RSE using either thiopental sodium or propofol in patients of any age and gender. Two review authors screened the search results and reviewed the abstracts of relevant and eligible trials before retrieving the full-text publications. One study with a total of 24 participants was available for review. This study was a small, single-blind, multicentre trial studying adults with RSE receiving either propofol or thiopental sodium for the control of seizure activity. This study was terminated early due to recruitment problems. For our primary outcome of total control of seizures after the first course of study drug, there were 6

  17. Carbon dioxide accumulation during analgosedated colonoscopy: Comparison of propofol and midazolam

    Institute of Scientific and Technical Information of China (English)

    Ludwig T Heuss; Shajan Peter Sugandha; Christoph Beglinger

    2012-01-01

    AIM:To characterize the profiles of alveolar hypoventilation during colonoscopies performed under sedoanalgesia with a combination of alfentanil and either midazolam or propofol.METHODS:Consecutive patients undergoing routine colonoscopy were randomly assigned to sedation with either propofol or midazolam in an open-labeled design using a titration scheme.All patients received 4 μg/kg per body weight alfentanil for analgesia and 3 L of supplemental oxygen.Oxygen saturation (SpO2) was measured by pulse oximetry (POX),and capnography (PcCO2) was continuously measured using a combined dedicated sensor at the ear lobe.Instances of apnea resulting in measures such as stimulation of the patient,a chin lift,a mask maneuver,or withholding of sedation were recorded.PcCO2 values (as a parameter of sedation-induced hypoventilation) were compared between groups at the following distinct time points:baseline,maximal rise,termination of the procedure and 5 min after termination of the procedure.The number of patients in both study groups who regained baseline PcCO2 values (± 1.5 mmHg) five minutes after the procedure was determined.RESULTS:A total of 97 patients entered this study.The data from 14 patients were subsequently excluded for clinical procedure-related reasons or for technical problems.Therefore,83 patients (mean age 62 ± 13 years) were successfully randomized to receive propofol (n =42) or midazolam (n =41) for sedation.Most of the patients were classified as American Society of Anesthesiologists (ASA) Ⅱ [16 (38%) in the midazolam group and 15 (32%) in the propofol group] and ASA Ⅲ [14 (33%) and 13 (32%) in the midazolam and propofol groups,respectively].A mean dose of 5 (4-7) mg of Ⅳ midazolam and 131 (70-260) mg of Ⅳ propofol was used during the procedure in the corresponding study arms.The mean SpO2 at baseline (%) was 99± 1 for the midazolam group and 99 ± 1 for the propofol group.No cases of hypoxemia (SpO2 < 85%) or apnea were

  18. Protective effect of propofol preconditioning and postconditioning against ischemic spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    Qijing Yu; Ji Hu; Jie Yang; Shuzhou Yin

    2011-01-01

    Propofol preconditioning has been shown to provide neuroprotection against spinal ischemia/reperfusion injury. In this study, spinal cord ischemia/reperfusion injury was induced by blocking the abdominal aorta in rabbits for 40 minutes. Results showed that the co-application of propofol preconditioning and postconditioning regimen ameliorated pathological injury of the ischemic spinal cord and suppressed the elevation of malondialdehyde levels and increased superoxide dismutase activities in the spinal cord tissues. Co-application of propofol preconditioning and postconditioning resulted in potent protective effects against spinal cord ischemia/reperfusion injury and prolonged the spinal cord's tolerance to ischemia. This protection was associated with the anti-lipid peroxidation capacity of the spinal cord tissues.

  19. Effects of propofol on ammonium chloride-exposed astrocyte morphology and aquaporin-4 expression

    Institute of Scientific and Technical Information of China (English)

    Hanjian Chen; Caifei Pan; Peng Guo; Yueying Zheng; Shengmei Zhu

    2011-01-01

    Ammonia induces astrocyte swelling, which is strongly associated with overexpression of aquaporin-4.However, the mechanisms by which ammonia induces astrocyte swelling, and subsequently upregulating aquaporin-4 expression, remain unknown.In the present study,astrocytes were cultured in vitro and exposed to ammonium chloride (NH4CI), followed by propofol,protein kinase C agonist, or antagonist, respectively.Astrocyte morphology was observed by light microscopy, and aquaporin-4 expression was detected by western blot analysis.Results showed that propofol or protein kinase C agonist significantly attenuated the degree of NH4CI-induced astrocyte swelling and inhibited increased aquaporin-4 expression.Propofol treatment inhibited aquaporin-4 overexpression in cultured astrocyte induced by NH4CI; protein kinase C pathway activation is potentially involved.

  20. Comparison of propofol infusion and isoflurane for maintenance of anesthesia for dentistry in mentally retarded patients.

    Science.gov (United States)

    Antila, H.; Valli, J.; Valtonen, M.; Kanto, J.

    1992-01-01

    A continuous infusion of propofol following an induction dose of 2 mg/kg was compared with thiopental/isoflurane for the induction and maintenance of anesthesia in 20 mentally retarded outpatients undergoing routine dental procedures. The infusion rate of propofol and the concentration of isoflurane were adjusted to maintain the heart rate and blood pressure within +/- 25% of the baseline values. Postoperative wakefulness was assessed using a 100-mm visual analogue scale at the time of extubation and at 5, 10, 15, 30, 60, 90, and 120 min after extubation. Both agents provided adequate anesthesia for the treatment, and no major adverse reactions occurred. Recovery was more complete during the first hour after extubation in the propofol group, and these patients were discharged earlier. PMID:1308378

  1. Hyperkalemia during surgery: is it an early warning of propofol infusion syndrome?

    Science.gov (United States)

    Mali, Ashish R; Patil, Vijaya P; Pramesh, C S; Mistry, Rajesh C

    2009-01-01

    We present a case of severe hyperkalemia in a 48-year-old man after short-term infusion of an average dose of propofol. We suspected that the hyperkalemia in this patient was a sign of propofol infusion syndrome. The patient was undergoing a video-assisted esophagectomy, for which one-lung ventilation, with air/oxygen, isoflurane, and continuous epidural analgesia was supplemented with propofol infusion. In the intraoperative period, the patient developed severe hyperkalemia with mild acidosis but no cardiovascular failure. There were no other evident causes of hyperkalemia as documented by laboratory data. The procedure was abandoned and the patient was taken to postoperative recovery, where his potassium levels returned to normal at the end of 10 h.

  2. Awake craniotomy anesthetic management using dexmedetomidine, propofol, and remifentanil

    Directory of Open Access Journals (Sweden)

    Prontera A

    2017-03-01

    Full Text Available Andrea Prontera,1 Stefano Baroni,2 Andrea Marudi,2 Franco Valzania,3 Alberto Feletti,1 Francesca Benuzzi,4 Elisabetta Bertellini,2 Giacomo Pavesi1 1Department of Neurosurgery, Nuovo Ospedale Civile SAgostino-Estense, 2Department of Anesthesiology, Nuovo Ospedale Civile SAgostino-Estense, 3Department of Neurolo