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Sample records for general anesthetic isoflurane

  1. Tracheal extubation in children: halothane versus isoflurane, anesthetized versus awake.

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    Pounder, D R; Blackstock, D; Steward, D J

    1991-04-01

    The authors compared the incidence of respiratory complications and arterial hemoglobin desaturation during emergence from anesthesia in children whose tracheas were extubated while they were anesthetized or after they were awake and to whom halothane or isoflurane had been administered. One hundred children 1-4 yr of age undergoing minor urologic surgery were studied. After a standard induction technique, patients were randomized to receive either isoflurane or halothane. In 50 patients tracheal extubation was performed while they were breathing 2 MAC of either halothane or isoflurane in 100% oxygen. The remaining 50 patients received 2 MAC (volatile agent plus nitrous oxide) during the operation, but tracheal extubation was delayed until they were awake. A blinded observer recorded the incidence of respiratory complications and continuously measured hemoglobin saturation for 15 min after extubation. When tracheal extubation occurred in deeply anesthetized patients, no differences were found between the two volatile agents. When tracheal extubation of awake patients was performed, the use of isoflurane was associated with more episodes of coughing and airway obstruction than was halothane (P less than 0.05). Awake tracheal extubation following either agent was associated with significantly more episodes of hemoglobin desaturation than was tracheal extubation while anesthetized.

  2. Cerebral autoregulation in awake versus isoflurane-anesthetized rats.

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    Hoffman, W E; Edelman, G; Kochs, E; Werner, C; Segil, L; Albrecht, R F

    1991-12-01

    We evaluated regional cerebral and spinal cord blood flow in rats during isoflurane anesthesia. Tissue blood flow was measured in cerebral cortex, subcortex, midbrain, and spinal cord using radioactive microspheres. Blood flow autoregulation was measured within the following arterial blood pressure ranges (mm Hg): 1 = less than 50, 2 = 50-90, 3 = 90-130, 4 = 130-170, 5 = greater than 170. Arterial blood pressure was increased using phenylephrine infusion and decreased with ganglionic blockade and hemorrhage. Three treatment groups were studied: 1 = awake control, 2 = 1.0 minimum alveolar anesthetic concentration (MAC) isoflurane, 3 = 2.0 MAC isoflurane. Autoregulation was seen in awake rats from 50 to 170 mm Hg in all tissues. The autoregulatory coefficient (change in blood flow/change in blood pressure) was increased in midbrain and spinal cord during 1.0 MAC isoflurane and in all tissues during 2.0 MAC isoflurane (P less than 0.05). Within the arterial blood pressure range of 90-130 mm Hg, isoflurane produced the following changes in tissue blood flow (percent of awake control): 1.0 MAC isoflurane: cortex = 87% +/- 8% (P greater than 0.30), subcortex = 124% +/- 11% (P greater than 0.05), midbrain = 263% +/- 20% (P less than 0.001), spinal cord = 278% +/- 19% (P less than 0.001); 2.0 MAC isoflurane: cortex = 137% +/- 13% (P less than 0.05), subcortex = 272% +/- 24% (P less than 0.001), midbrain = 510% +/- 53% (P less than 0.001), spinal cord = 535% +/- 50% (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

  3. Antimicrobial effects of liquid anesthetic isoflurane on Candida albicans

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

    2006-01-01

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

  4. Antimicrobial effects of liquid anesthetic isoflurane on Candida albicans

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    Armstead Valerie

    2006-11-01

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

  5. Effect of mepivacaine in an infraorbital nerve block on minimum alveolar concentration of isoflurane in clinically normal anesthetized dogs undergoing a modified form of dental dolorimetry.

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    Snyder, Christopher J; Snyder, Lindsey B C

    2013-01-15

    To evaluate the effects of a routinely used infraorbital nerve block, performed for dental procedures, on the anesthetic requirement for isoflurane in dogs. Prospective controlled study. 8 healthy adult Beagles. Dogs were anesthetized with isoflurane, and the minimum alveolar concentration (MAC) of isoflurane was established. A modification of a well-established method of stimulating the dental pulp, dental dolorimetry, was used to deliver a noxious stimulus (electrical stimulation) for isoflurane MAC determination. Once the isoflurane MAC was established, an infraorbital nerve block was performed with mepivacaine. The isoflurane MAC was then determined with the addition of the nerve block. Measurements of heart rate and mean arterial blood pressure were obtained at specified time points (baseline and prevention and elicitation of purposeful movement) during the determination of MAC and in response to the noxious stimulus. The mean ± SD isoflurane MAC without an infraorbital nerve block was 1.12 ± 0.13%. Isoflurane MAC with the regional mepivacaine anesthesia was 0.86 ± 0.11%. A significant reduction in isoflurane MAC (23%) was seen after the infraorbital nerve block, compared with results before the nerve block. With the exception of baseline measurements, no significant differences were found between treatments (isoflurane alone vs isoflurane with regional mepivacaine anesthesia) in heart rate or mean arterial blood pressure before or after the noxious stimulus. The significant reduction in MAC of isoflurane supported the practice of the addition of regional anesthesia for painful dental procedures to reduce the dose-dependent cardiorespiratory effects of general anesthesia.

  6. Crystal structure of isoflurane bound to integrin LFA-1 supports a unified mechanism of volatile anesthetic action in the immune and central nervous systems

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    Zhang, Hongmin; Astrof, Nathan S.; Liu, Jin-Huan; Wang, Jia-huai; Shimaoka, Motomu; (Harvard-Med); (DFCI)

    2009-09-15

    Volatile anesthetics (VAs), such as isoflurane, induce a general anesthetic state by binding to specific targets (i.e., ion channels) in the central nervous system (CNS). Simultaneously, VAs modulate immune functions, possibly via direct interaction with alternative targets on leukocytes. One such target, the integrin lymphocyte function-associated antigen-1 (LFA-1), has been shown previously to be inhibited by isoflurane. A better understanding of the mechanism by which isoflurane alters protein function requires the detailed information about the drug-protein interaction at an atomic level. Here, we describe the crystal structure of the LFA-1 ligand-binding domain (I domain) in complex with isoflurane at 1.6 {angstrom}. We discovered that isoflurane binds to an allosteric cavity previously implicated as critical for the transition of LFA-1 from the low- to the high-affinity state. The isoflurane binding site in the I domain involves an array of amphiphilic interactions, thereby resembling a 'common anesthetic binding motif' previously predicted for authentic VA binding sites. These results suggest that the allosteric modulation of protein function by isoflurane, as demonstrated for the integrin LFA-1, might represent a unified mechanism shared by the interactions of volatile anesthetics with targets in the CNS. Crystal structure of isoflurane bound to integrin LFA-1 supports a unified mechanism of volatile anesthetic action in the immune and central nervous systems.

  7. Pattern recognition analysis of proton nuclear magnetic resonance spectra of brain tissue extracts from rats anesthetized with propofol or isoflurane.

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    Hiroshi Kawaguchi

    Full Text Available BACKGROUND: General anesthesia is routinely used as a surgical procedure and its safety has been endorsed by clinical outcomes; however, its effects at the molecular level have not been elucidated. General anesthetics influence glucose metabolism in the brain. However, the effects of anesthetics on brain metabolites other than those related to glucose have not been well characterized. We used a pattern recognition analysis of proton nuclear magnetic resonance spectra to visualize the changes in holistic brain metabolic phenotypes in response to the widely used intravenous anesthetic propofol and the volatile anesthetic isoflurane. METHODOLOGY/PRINCIPAL FINDINGS: Rats were randomized into five groups (n = 7 each group. Propofol and isoflurane were administered to two groups each, for 2 or 6 h. The control group received no anesthesia. Brains were removed directly after anesthesia. Hydrophilic compounds were extracted from excised whole brains and measured by proton nuclear magnetic resonance spectroscopy. All spectral data were processed and analyzed by principal component analysis for comparison of the metabolite profiles. Data were visualized by plotting principal component (PC scores. In the plots, each point represents an individual sample. The propofol and isoflurane groups were clustered separately on the plots, and this separation was especially pronounced when comparing the 6-h groups. The PC scores of the propofol group were clearly distinct from those of the control group, particularly in the 6-h group, whereas the difference in PC scores was more subtle in the isoflurane group and control groups. CONCLUSIONS/SIGNIFICANCE: The results of the present study showed that propofol and isoflurane exerted differential effects on holistic brain metabolism under anesthesia.

  8. Sevoflurane Induces DNA Damage Whereas Isoflurane Leads to Higher Antioxidative Status in Anesthetized Rats

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    Thalita L. A. Rocha

    2015-01-01

    Full Text Available Taking into account that there are controversial antioxidative effects of inhalational anesthetics isoflurane and sevoflurane and absence of comparison of genotoxicity of both anesthetics in animal model, the aim of this study was to compare DNA damage and antioxidant status in Wistar rats exposed to a single time to isoflurane or sevoflurane. The alkaline single-cell gel electrophoresis assay (comet assay was performed in order to evaluate DNA damage in whole blood cells of control animals (unexposed; n = 6 and those exposed to 2% isoflurane (n = 6 or 4% sevoflurane (n = 6 for 120 min. Plasma antioxidant status was determined by 3-(4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide (MTT assay. There was no statistically significant difference between isoflurane and sevoflurane groups regarding hemodynamic and temperature variables (P > 0.05. Sevoflurane significantly increased DNA damage compared to unexposed animals (P = 0.02. In addition, Wistar rats anesthetized with isoflurane showed higher antioxidative status (MTT than control group (P = 0.019. There were no significant differences in DNA damage or antioxidant status between isoflurane and sevoflurane groups (P > 0.05. In conclusion, our findings suggest that, in contrast to sevoflurane exposure, isoflurane increases systemic antioxidative status, protecting cells from DNA damage in rats.

  9. Effects of Methadone on the Minimum Anesthetic Concentration of Isoflurane, and Its Effects on Heart Rate, Blood Pressure and Ventilation during Isoflurane Anesthesia in Hens (Gallus gallus domesticus).

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    Escobar, André; da Rocha, Rozana Wendler; Pypendop, Bruno Henri; Zangirolami Filho, Darcio; Sousa, Samuel Santos; Valadão, Carlos Augusto Araújo

    2016-01-01

    The aim of this study was to measure the temporal effects of intramuscular methadone administration on the minimum anesthetic concentration (MAC) of isoflurane in hens, and to evaluate the effects of the isoflurane-methadone combination on heart rate and rhythm, blood pressure and ventilation. Thirteen healthy adult hens weighing 1.7 ± 0.2 kg were used. The MAC of isoflurane was determined in each individual using the bracketing method. Subsequently, the reduction in isoflurane MAC produced by methadone (3 or 6 mg kg(-1), i.m.) was determined by the up-and-down method. Stimulation was applied at 15 and 30 minutes, and at 45 minutes if the bird had not moved at 30 minutes. Isoflurane MAC reduction was calculated at each time point using logistic regression. After a washout period, birds were anesthetized with isoflurane and methadone, 6 mg kg(-1) i.m. was administered. Heart rate and rhythm, respiratory rate, blood gas values and invasive blood pressure were measured at 1.0 and 0.7 isoflurane MAC, and during 45 minutes after administration of methadone once birds were anesthetized with 0.7 isoflurane MAC. Fifteen minutes after administration of 3 mg kg(-1) of methadone, isoflurane MAC was reduced by 2 (-9 to 13)% [logistic regression estimate (95% Wald confidence interval)]. Administration of 6 mg kg(-1) of methadone decreased isoflurane MAC by 29 (11 to 46)%, 27 (-3 to 56)% and 10 (-8 to 28)% after 15, 30 and 45 minutes, respectively. Methadone (6 mg kg(-1)) induced atrioventricular block in three animals and ventricular premature contractions in two. Methadone caused an increase in arterial blood pressure and arterial partial pressure of carbon dioxide, while heart rate and pH decreased. Methadone, 6 mg kg(-1) i.m. significantly reduced isoflurane MAC by 30% in hens 15 minutes after administration. At this dose, methadone caused mild respiratory acidosis and increase in systemic blood pressure.

  10. EFFECTS OF TRAMADOL ON THE MINIMUM ANESTHETIC CONCENTRATION OF ISOFLURANE IN WHITE-EYED PARAKEETS (PSITTACARA LEUCOPHTHALMUS).

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    Escobar, André; da Rocha, Rozana Wendler; Midon, Monica; de Almeida, Ricardo Miyasaka; Filho, Darcio Zangirolami; Werther, Karin

    2017-06-01

    The aim of this study was to determine the minimum anesthetic concentration (MAC) of isoflurane, and to investigate if tramadol changes the isoflurane MAC in white-eyed parakeets (Psittacara leucophthalmus). Ten adult birds weighing 157 ± 9 g were anesthetized with isoflurane in oxygen under mechanical ventilation. Isoflurane concentration for the first bird was adjusted to 2.2%, and after 15 min an electrical stimulus was applied in the thigh area to observe the response (movement or nonmovement). Isoflurane concentration for the subsequent bird was increased by 10% if the previous bird moved, or decreased by 10% if the previous bird did not move. This procedure was performed serially until at least four sequential crossover events were detected. A crossover event was defined as a sequence of two birds with different responses (positive or negative) to the electrical stimulus. Isoflurane MAC was calculated as the mean isoflurane concentration value at the crossover events. After 1 wk, the same birds were reanesthetized with isoflurane and MAC was determined at 15 and 30 min after intramuscular administration of 10 mg/kg of tramadol using the same method. A paired t-test (P tramadol administration were indistinguishable from each other (pooled value was 2.50 ± 0.18%); they were also indistinguishable from isoflurane MAC without tramadol. The isoflurane MAC value in white-eyed parakeets is higher than reported for other bird species. Tramadol (10 mg/kg, i.m.) does not change isoflurane MAC in these birds.

  11. Brainstem Stimulation Increases Functional Connectivity of Basal Forebrain-Paralimbic Network in Isoflurane-Anesthetized Rats

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    Pillay, Siveshigan; Liu, Xiping; Baracskay, Péter; Hudetz, Anthony G.

    2014-01-01

    Brain states and cognitive-behavioral functions are precisely controlled by subcortical neuromodulatory networks. Manipulating key components of the ascending arousal system (AAS), via deep-brain stimulation, may help facilitate global arousal in anesthetized animals. Here we test the hypothesis that electrical stimulation of the oral part of the pontine reticular nucleus (PnO) under light isoflurane anesthesia, associated with loss of consciousness, leads to cortical desynchronization and sp...

  12. Cardioprotective effects of anesthetic preconditioning in rats with ischemia-reperfusion injury: propofol versus isoflurane

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    Xing TAO; Ling-qiao LU; Qing XU; Shu-ren LI; Mao-tsun LIN

    2009-01-01

    Objective: We compare the cardioprotective effects of anesthetic preconditioning by propofol and/or isoflurane in rats with ischemia-reperfusion injury. Methods: Male adult Wistar rats were subjected to 60 min of anterior descending coronary artery occlusion followed by 120 min of reperfusion. Before the long ischemia, anesthetics were administered twice for 10 min followed by 5 min washout. Isoflurane was inhaled at I MAC (0.016) in I group, whereas propofol was inhaled intravenously at 37.5 mg/(kg.h) in P group. A combination ofisoflurane and propofol was administered simultaneously in I+P group. Results: In control (without anesthetic preconditioning, C group), remarkable myocardial infarction and apoptosis accompanied by an increased level of cardiac troponin T were noted 120 rain after ischemia-reperfusion. As compared to those of control group, I and P groups had comparable cardioprotection. In addition, I+P group shares with I and P groups the comparable cardioprotective effects in terms of myocardial infarction and cardiac troponin T elevation. Conclusion: A combination of isoflurane and propofol produced no ad-ditional cardioprotection.

  13. Isoflurane anesthetic hypersensitivity and progressive respiratory depression in a mouse model with isolated mitochondrial complex I deficiency

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    Roelofs, S.; Manjeri, G.R.; Willems, P.H.G.M.; Scheffer, G.J.; Smeitink, J.A.M.; Driessen, J.J.

    2014-01-01

    BACKGROUND: Children with mitochondrial disorders are frequently anesthetized for a wide range of operations. These disorders may interfere with the response to surgery and anesthesia. We examined anesthetic sensitivity to and respiratory effects of isoflurane in the Ndufs4 knockout (KO) mouse model

  14. Isoflurane anesthetic hypersensitivity and progressive respiratory depression in a mouse model with isolated mitochondrial complex I deficiency

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    Roelofs, S.; Manjeri, G.R.; Willems, P.H.G.M.; Scheffer, G.J.; Smeitink, J.A.M.; Driessen, J.J.

    2014-01-01

    BACKGROUND: Children with mitochondrial disorders are frequently anesthetized for a wide range of operations. These disorders may interfere with the response to surgery and anesthesia. We examined anesthetic sensitivity to and respiratory effects of isoflurane in the Ndufs4 knockout (KO) mouse

  15. Development of a Physiologically Based Pharmacokinetic Model for the Anesthetics Halothane, Isoflurane, and Desflurane in the Pig (SUS SCROFA)

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    1999-08-01

    HALOTHANE, ISOFLURANE, AND DESFLURANE IN THE PIG ( SUS SCROFA ) / Allen Vinegar MANTECH-GEO CENTER JOINT VENTURE PO BOX 31009 ~ DAYTON, OH 45437-0009...Pharmacokinetic Model for the Anesthetics Contract F41624-96-C-9010 Halothane, Isoflurane, and Desfiurane in the Pig ( Sus Scrofa ) PE 62202F PR 7757 6. AUTHOR(S) TA...PFA) " CA Figure I - Physiologicallly Based Pharmacokinetic Model of the Pig ( Sus scrofa ). Abbreviations: CA, arterial concentration; CX, exhaled

  16. Effects of inhaled anesthetic isoflurane on long-term potentiation of CA3 pyramidal cell afferents in vivo

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    Ballesteros KA

    2012-11-01

    Full Text Available Kristen A Ballesteros,1 Angela Sikorski,2 James E Orfila,3 Joe L Martinez Jr41Department of Biology, The University of Texas at San Antonio, San Antonio, TX, USA; 2Texas A&M University Texarkana, Texarkana, TX, USA; 3University of Colorado in Denver, Denver, CO, USA; 4University of Illinois in Chicago, Chicago, IL, USAAbstract: Isoflurane is a preferred anesthetic, due to its properties that allow a precise concentration to be delivered continually during in vivo experimentation. The major mechanism of action of isoflurane is modulation of the γ-amino butyric acid (GABAA receptor-chloride channel, mediating inhibitory synaptic transmission. Animal studies have shown that isoflurane does not cause cell death, but it does inhibit cell growth and causes long-term hippocampal learning deficits. As there are no studies characterizing the effects of isoflurane on electrophysiological aspects of long-term potentiation (LTP in the hippocampus, it is important to determine whether isoflurane alters the characteristic responses of hippocampal afferents to cornu ammonis region 3 (CA3. We investigated the effects of isoflurane on adult male rats during in vivo induction of LTP, using the mossy fiber pathway, the lateral perforant pathway, the medial perforant pathway, and the commissural CA3 (cCA3 to CA3, with intracranial administration of Ringer’s solution, naloxone, RS-aminoindan-1, 5-dicarboxylic acid (AIDA, or 3-[(R-2-carboxypiperazin-4-yl]-propo-2-enyl-1-phosphonic acid (CPP. Then, we compared these responses to published electrophysiological data, using sodium pentobarbital as an anesthetic, under similar experimental conditions. Our results showed that LTP was exhibited in animals anesthetized with isoflurane under vehicle conditions. With the exception of AIDA in the lateral perforant pathway, the defining characteristics of the four pathways appeared to remain intact, except for the observation that LTP was markedly reduced in animals

  17. Dose-dependent effects of the clinical anesthetic isoflurane on Octopus vulgaris: a contribution to cephalopod welfare.

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    Polese, Gianluca; Winlow, William; Di Cosmo, Anna

    2014-12-01

    Recent progress in animal welfare legislation relating to invertebrates has provoked interest in methods for the anesthesia of cephalopods, for which different approaches to anesthesia have been tried but in most cases without truly anesthetizing the animals. For example, several workers have used muscle relaxants or hypothermia as forms of "anesthesia." Several inhalational anesthetics are known to act in a dose-dependent manner on the great pond snail Lymnaea stagnalis, a pulmonate mollusk. Here we report, for the first time, on the effects of clinical doses of the well-known inhalational clinical anesthetic isoflurane on the behavioral responses of the common octopus Octopus vulgaris. In each experiment, isoflurane was equilibrated into a well-aerated seawater bath containing a single adult O. vulgaris. Using a web camera, we recorded each animal's response to touch stimuli eliciting withdrawal of the arms and siphon and observed changes in the respiratory rate and the chromatophore pattern over time (before, during, and after application of the anesthetic). We found that different animals of the same size responded with similar behavioral changes as the isoflurane concentration was gradually increased. After gradual application of 2% isoflurane for a maximum of 5 min (at which time all the responses indicated deep anesthesia), the animals recovered within 45-60 min in fresh aerated seawater. Based on previous findings in gastropods, we believe that the process of anesthesia induced by isoflurane is similar to that previously observed in Lymnaea. In this study we showed that isoflurane is a good, reversible anesthetic for O. vulgaris, and we developed a method for its use.

  18. Comparison of the effects of xylazine bolus versus medetomidine constant rate infusion on the stress response, urine production, and anesthetic recovery characteristics in horses anesthetized with isoflurane.

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    Creighton, Catherine M; Lemke, Kip A; Lamont, Leigh A; Horney, Barbara S; Doyle, Aimie J

    2012-04-15

    To compare the effect of xylazine bolus versus medetomidine constant rate infusion (MCRI) on serum cortisol and glucose concentrations, urine production, and anesthetic recovery characteristics in dorsally recumbent, spontaneously breathing, isoflurane-anesthetized horses. Prospective, randomized crossover study. 10 healthy Standardbreds. Horses were premedicated with xylazine or medetomidine IV. Anesthesia was induced with diazepam and ketamine and maintained with isoflurane for 150 minutes. For the xylazine treatment, end-tidal isoflurane concentration was maintained at 1.7% and xylazine (0.2 mg/kg [0.09 mg/lb]), IV) was administered as a bolus at the end of anesthesia. For the MCRI treatment, end-tidal isoflurane concentration was maintained at 1.4% and medetomidine (0.005 mg/kg/h [0.0023 mg/lb/h], IV) was infused throughout anesthesia. Serum cortisol and glucose concentrations were measured before, during, and after anesthesia. Urine specific gravity and volume were measured during anesthesia. Unassisted anesthetic recoveries were recorded by a digital video camera for later evaluation by 2 observers who were blinded to treatment. Serum cortisol concentration was lower and serum glucose concentration was higher with MCRI treatment, compared with xylazine treatment. Time to sternal recumbency was longer with MCRI treatment, but no difference was seen between treatments for times to extubation, first movement, or standing. Objective (mean attempt interval) and subjective (visual analog score) recovery scores were significantly better with MCRI treatment, compared with xylazine treatment. In isoflurane-anesthetized horses, premedication and administration of medetomidine as a constant rate infusion resulted in decreased serum cortisol concentration, increased serum glucose concentration, and superior anesthetic recovery characteristics, compared with conventional treatment with xylazine.

  19. Plasma concentration and cardiovascular effects of lidocaine during continuous epidural administration in dogs anesthetized with isoflurane.

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    Sakonju, Iwao; Maeda, Kenichi; Karasawa, Koichi; Tadokoro, Toshiyuki; Kakuta, Tomoko; Takase, Katsuaki

    2011-03-01

    The cardiovascular effects of continuous epidural administration (CEA) of lidocaine were investigated in anesthetized dogs. Loading epidural injections of 2, 4, or 6 mg/kg of lidocaine were followed by CEA with 1, 2, or 3 mg/kg/hr lidocaine, respectively, for 2 hr under 2.0% isoflurane anesthesia. Heart rate, direct blood pressure, cardiac index, and stroke volume decreased dose-dependently during CEA, whereas systemic vascular resistance did not significantly differ with dose, and no characteristic changes were observed in any groups. Plasma lidocaine concentration reached a steady state during CEA and increased in a dose-dependent manner. Circulatory suppression caused by lidocaine CEA was not attributable to peripheral vasodilation, but rather to the direct cardiac action of systemic lidocaine absorption from the peridural space.

  20. Inhibition of firefly luciferase by general anesthetics: effect on in vitro and in vivo bioluminescence imaging.

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    Marleen Keyaerts

    Full Text Available UNLABELLED: Bioluminescence imaging is routinely performed in anesthetized mice. Often isoflurane anesthesia is used because of its ease of use and fast induction/recovery. However, general anesthetics have been described as important inhibitors of the luciferase enzyme reaction. AIM: To investigate frequently used mouse anesthetics for their direct effect on the luciferase reaction, both in vitro and in vivo. MATERIALS AND METHODS: isoflurane, sevoflurane, desflurane, ketamine, xylazine, medetomidine, pentobarbital and avertin were tested in vitro on luciferase-expressing intact cells, and for non-volatile anesthetics on intact cells and cell lysates. In vivo, isoflurane was compared to unanesthetized animals and different anesthetics. Differences in maximal photon emission and time-to-peak photon emission were analyzed. RESULTS: All volatile anesthetics showed a clear inhibitory effect on the luciferase activity of 50% at physiological concentrations. Avertin had a stronger inhibitory effect of 80%. For ketamine and xylazine, increased photon emission was observed in intact cells, but this was not present in cell lysate assays, and was most likely due to cell toxicity and increased cell membrane permeability. In vivo, the highest signal intensities were measured in unanesthetized mice and pentobarbital anesthetized mice, followed by avertin. Isoflurane and ketamine/medetomidine anesthetized mice showed the lowest photon emission (40% of unanesthetized, with significantly longer time-to-peak than unanesthetized, pentobarbital or avertin-anesthetized mice. We conclude that, although strong inhibitory effects of anesthetics are present in vitro, their effect on in vivo BLI quantification is mainly due to their hemodynamic effects on mice and only to a lesser extent due to the direct inhibitory effect.

  1. Effects of dobutamine hydrochloride on cardiovascular function in horses anesthetized with isoflurane with or without acepromazine maleate premedication.

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    Schier, Mara F; Raisis, Anthea L; Secombe, Cristy J; Hosgood, Giselle; Musk, Gabrielle C; Lester, Guy D

    2016-12-01

    OBJECTIVE To determine the effects of acepromazine maleate premedication on cardiovascular function before and after infusion of dobutamine hydrochloride for 30 minutes in isoflurane-anesthetized horses. ANIMALS 6 healthy adult horses. PROCEDURES Each horse was anesthetized once following premedication with acepromazine (0.02 mg/kg, IV) administered 30 minutes prior to anesthetic induction (ACP+ treatment) and once without premedication (ACP- treatment). Anesthesia was induced with IV administration of xylazine hydrochloride (0.8 mg/kg), ketamine hydrochloride (2.2 mg/kg), and diazepam (0.08 mg/kg). Horses were positioned in right lateral recumbency, and anesthesia was maintained via inhalation of isoflurane delivered in oxygen. End-tidal isoflurane concentration was adjusted to achieve a target mean arterial blood pressure of 60 mm Hg (interquartile range [25th to 75th percentile], 57 to 63 mm Hg) for at least 15 minutes. Cardiac index, oxygen delivery index, and femoral arterial blood flow indices were determined 60 minutes after anesthetic induction (baseline). Dobutamine was then infused to achieve a target mean arterial blood pressure of 80 mm Hg (interquartile range, 76 to 80 mm Hg). Data collection was repeated 30 minutes after the start of dobutamine infusion for comparison with baseline values. RESULTS Complete data sets were available from 5 of the 6 horses. Dobutamine administration resulted in significant increases in oxygen delivery and femoral arterial blood flow indices but no significant change in cardiac index for each treatment. However, at baseline or 30 minutes after the start of dobutamine infusion, findings for the ACP+ and ACP- treatments did not differ. CONCLUSIONS AND CLINICAL RELEVANCE In isoflurane-anesthetized horses, dobutamine administration increased oxygen delivery and femoral arterial blood flow indices, but these changes were unaffected by premedication with acepromazine.

  2. General anesthetics inhibit erythropoietin induction under hypoxic conditions in the mouse brain.

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    Tomoharu Tanaka

    Full Text Available BACKGROUND: Erythropoietin (EPO, originally identified as a hematopoietic growth factor produced in the kidney and fetal liver, is also endogenously expressed in the central nervous system (CNS. EPO in the CNS, mainly produced in astrocytes, is induced under hypoxic conditions in a hypoxia-inducible factor (HIF-dependent manner and plays a dominant role in neuroprotection and neurogenesis. We investigated the effect of general anesthetics on EPO expression in the mouse brain and primary cultured astrocytes. METHODOLOGY/PRINCIPAL FINDINGS: BALB/c mice were exposed to 10% oxygen with isoflurane at various concentrations (0.10-1.0%. Expression of EPO mRNA in the brain was studied, and the effects of sevoflurane, halothane, nitrous oxide, pentobarbital, ketamine, and propofol were investigated. In addition, expression of HIF-2α protein was studied by immunoblotting. Hypoxia-induced EPO mRNA expression in the brain was significantly suppressed by isoflurane in a concentration-dependent manner. A similar effect was confirmed for all other general anesthetics. Hypoxia-inducible expression of HIF-2α protein was also significantly suppressed with isoflurane. In the experiments using primary cultured astrocytes, isoflurane, pentobarbital, and ketamine suppressed hypoxia-inducible expression of HIF-2α protein and EPO mRNA. CONCLUSIONS/SIGNIFICANCE: Taken together, our results indicate that general anesthetics suppress activation of HIF-2 and inhibit hypoxia-induced EPO upregulation in the mouse brain through a direct effect on astrocytes.

  3. Brainstem stimulation increases functional connectivity of basal forebrain-paralimbic network in isoflurane-anesthetized rats.

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    Pillay, Siveshigan; Liu, Xiping; Baracskay, Péter; Hudetz, Anthony G

    2014-09-01

    Brain states and cognitive-behavioral functions are precisely controlled by subcortical neuromodulatory networks. Manipulating key components of the ascending arousal system (AAS), via deep-brain stimulation, may help facilitate global arousal in anesthetized animals. Here we test the hypothesis that electrical stimulation of the oral part of the pontine reticular nucleus (PnO) under light isoflurane anesthesia, associated with loss of consciousness, leads to cortical desynchronization and specific changes in blood-oxygenation-level-dependent (BOLD) functional connectivity (FC) of the brain. BOLD signals were acquired simultaneously with frontal epidural electroencephalogram before and after PnO stimulation. Whole-brain FC was mapped using correlation analysis with seeds in major centers of the AAS. PnO stimulation produced cortical desynchronization, a decrease in δ- and θ-band power, and an increase in approximate entropy. Significant increases in FC after PnO stimulation occurred between the left nucleus Basalis of Meynert (NBM) as seed and numerous regions of the paralimbic network. Smaller increases in FC were present between the central medial thalamic nucleus and retrosplenium seeds and the left caudate putamen and NBM. The results suggest that, during light anesthesia, PnO stimulation preferentially modulates basal forebrain-paralimbic networks. We speculate that this may be a reflection of disconnected awareness.

  4. ANESTHETIC INDUCTION AND RECOVERY PARAMETERS IN BEARDED DRAGONS (POGONA VITTICEPS): COMPARISON OF ISOFLURANE DELIVERED IN 100% OXYGEN VERSUS 21% OXYGEN.

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    O, Odette; Churgin, Sarah M; Sladky, Kurt K; Smith, Lesley J

    2015-09-01

    Inland bearded dragons (Pogona vitticeps, n=6) were anesthetized for 1 hr using isoflurane in either 100% oxygen or 21% oxygen (FI 21; medical-grade room air). Parameters of anesthetic depth were recorded throughout both induction and recovery by an observer blinded to the fraction of inspired oxygen (FiO2), including the loss and return of withdrawal and righting reflexes, muscle tone, ability to intubate or extubate, and return to spontaneous respiration. Physiologic data were recorded every 5 min throughout the anesthetic procedures, including heart rate, body temperature, end-tidal CO2, hemoglobin oxygen saturation (SpO2), and percent expired isoflurane. Lizards were subjected to application of a noxious stimulus (needle stick) at 0, 30, and 60 min, and responses recorded. Following a minimum 7-day washout period, the experiment was repeated with each lizard subjected to the other protocol in a randomized, complete crossover design. The only statistically significant difference was a lower mean SpO2 in the group inspiring 21% oxygen (P<0.0020). No statistically significant differences were detected in any parameters during induction or recovery; however, all values were uniformly shorter for the FI 21 group, indicating a possible clinically significant difference. A larger sample size may have detected statistically significant differences. Further studies are needed to evaluate these effects in other reptile species and with the concurrent use of injectable anesthetic and analgesic drugs.

  5. Effect of 50% and maximal inspired oxygen concentrations on respiratory variables in isoflurane-anesthetized horses

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    Lerche Phillip

    2011-06-01

    dorsally recumbent isoflurane anesthetized horses does not improve oxygenation or oxygen delivery.

  6. Influence of nociception and stress-induced antinociception on genetic variation in isoflurane anesthetic potency among mouse strains.

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    Mogil, Jeffrey S; Smith, Shad B; O'Reilly, Meghan K; Plourde, Gilles

    2005-10-01

    Genetic background influences anesthetic potency to suppress motor response to noxious stimulation (minimum alveolar concentration [MAC]) as well as nociceptive sensitivity in unmedicated animals. However, the influence on MAC of baseline sensitivity to the noxious stimuli used to assess MAC has virtually never been studied. The authors assessed room air nociceptive sensitivity and isoflurane MAC in multiple mouse strains. Isoflurane requirement for loss of righting response (MACLORR) was also measured. One outbred and 10 inbred mouse strains were tested for latency to respond (in room air) to a tail clip (either 500 g or 2,000 g). Naive mice of the same 11 strains were tested for isoflurane MAC and MACLORR. To assess the role of opioid-mediated stress-induced antinociception, mice were also tested for nociceptive sensitivity after injection of naloxone (10 mg/kg) or saline. Robust strain differences were observed for all measures. The authors found that tail-clip latency (using a 500-g or 2,000-g clip, respectively) correlated significantly with MAC (r = -0.76 and -0.58, respectively) but not MACLORR (r = -0.10 and -0.26). Naloxone produced strain-dependent reductions in open air tail-clip latencies, and these reductions were also strongly correlated with MAC (r = -0.67 and -0.71). The authors suggest that genetic variability in isoflurane MAC (but not MACLORR) may reflect genetic variability in the underlying sensitivity to the noxious stimulus being used to measure MAC. This variable sensitivity to nociception in the awake state is at least partially mediated by endogenous antinociceptive mechanisms activated by the tail-clip stimulus itself.

  7. General anesthetic conditions induce network synchrony and disrupt sensory processing in the cortex

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    Thomas eLissek

    2016-04-01

    Full Text Available General anesthetics are commonly used in animal models to study how sensory signals are represented in the brain. Here, we used two-photon (2P calcium activity imaging with cellular resolution to investigate how neuronal activity in layer 2/3 of the mouse barrel cortex is modified under the influence of different concentrations of chemically distinct general anesthetics. Our results show that a high isoflurane dose induces synchrony in local neuronal networks and these cortical activity patterns closely resemble those observed in EEG recordings under deep anesthesia. Moreover, ketamine and urethane also induced similar activity patterns. While investigating the effects of deep isoflurane anesthesia on whisker and auditory evoked responses in the barrel cortex, we found that dedicated spatial regions for sensory signal processing become disrupted. We propose that our isoflurane-2P imaging paradigm can serve as an attractive model system to dissect cellular and molecular mechanisms that induce the anesthetic state, and it might also provide important insight into sleep-like brain states and consciousness.

  8. General Anesthetic Conditions Induce Network Synchrony and Disrupt Sensory Processing in the Cortex.

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    Lissek, Thomas; Obenhaus, Horst A; Ditzel, Désirée A W; Nagai, Takeharu; Miyawaki, Atsushi; Sprengel, Rolf; Hasan, Mazahir T

    2016-01-01

    General anesthetics are commonly used in animal models to study how sensory signals are represented in the brain. Here, we used two-photon (2P) calcium activity imaging with cellular resolution to investigate how neuronal activity in layer 2/3 of the mouse barrel cortex is modified under the influence of different concentrations of chemically distinct general anesthetics. Our results show that a high isoflurane dose induces synchrony in local neuronal networks and these cortical activity patterns closely resemble those observed in EEG recordings under deep anesthesia. Moreover, ketamine and urethane also induced similar activity patterns. While investigating the effects of deep isoflurane anesthesia on whisker and auditory evoked responses in the barrel cortex, we found that dedicated spatial regions for sensory signal processing become disrupted. We propose that our isoflurane-2P imaging paradigm can serve as an attractive model system to dissect cellular and molecular mechanisms that induce the anesthetic state, and it might also provide important insight into sleep-like brain states and consciousness.

  9. Expression of anion exchanger 3 influences respiratory rate in awake and isoflurane anesthetized mice.

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    Meier, S; Hübner, C A; Groeben, H; Peters, J; Bingmann, D; Wiemann, M

    2007-11-01

    The anion exchanger 3 (AE3) is involved in neuronal pH regulation of which may include chemosensitive neurons. Here we examined the effect of AE3 expression on respiratory rate (RR) in vivo. AE3 knockout (KO, n=5) and wild type (WT, n=6) mice were subjected to body plethysmography, both while awake and during isoflurane anesthesia. RR was significantly lower in awake AE3 KO (162+/-7SE min(-1)) than in WT mice (212+/-20 min(-1), P=0.036). The same was found during isoflurane anesthesia at 0.5 MAC (KO: 123+/-9 min(-1), WT: 168+/-15 min(-1), P=0.026) and 1.0 MAC (KO: 51+/-6 min(-1), WT: 94+/-6 min(-1), P=0.001). Hypercapnia (5% CO2) increased RR in awake and decreased RR in nesthetized (1.0 MAC) mice, whereby relative changes were larger in AE3 KO mice. Recovery from isoflurane anesthesia in respect to RR regaining baseline values was more pronounced in AE3 KO. Results show that AE3 expression profoundly influences control of breathing in mice.

  10. Effect of dexmedetomidine bolus dose on isoflurane consumption in surgical patients under general anesthesia

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    Muniyappa, Reshma B.; Rajappa, Geetha C.; Govindswamy, Suresh; Thamanna, Prathima P.

    2016-01-01

    Background and Objective: Various adjuvants have been introduced to decrease the dose of volatile agents and their side effects. Dexmedetomidine a potent alpha-2 adrenoreceptor agonist is one such agent. Our objective is to assess the effect of preanesthetic dexmedetomidine on isoflurane consumption and its effect on intraoperative hemodynamic stability and recovery profile. Setting and Design: This prospective, randomized controlled, double-blind study was done in a tertiary care hospital. Materials and Methods: One hundred patients were randomly allocated into two groups. Group 1 received saline infusion and Group 2 received dexmedetomidine infusion in a dose of 1 μg/kg over 10 min given 15 min before induction. Vital parameters and bispectral index (BIS) values were noted throughout the surgery. Patients were induced and intubated as per the standard protocol and maintained with N2O: O2 = 1:1 mixture at 2 L/min and isoflurane concentration adjusted to achieve BIS values of 45–60. Demographic profile, hemodynamic variables, total isoflurane consumption, and recovery profile data were collected. Statistics: Independent t-test and Mann–Whitney U-test were used to compare the average anesthetic consumption, hemodynamics, and recovery profile between two groups. Results: End-tidal concentration and total isoflurane consumption in Group 2 were 0.56 ± 0.11 and 10.69 ± 3.01 mL, respectively, with P Preanesthetic bolus dose of dexmedetomidine is a useful adjuvant to reduce isoflurane consumption. PMID:27746567

  11. Comparison of the effects of xylazine bolus versus medetomidine constant rate infusion on cardiopulmonary function and depth of anesthesia in horses anesthetized with isoflurane.

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    Creighton, Catherine M; Lemke, Kip A; Lamont, Leigh A; Horney, Barbara S; Riley, Christopher B

    2012-04-15

    To compare the effects of xylazine bolus versus medetomidine constant rate infusion (MCRI) on cardiopulmonary function and depth of anesthesia in dorsally recumbent, spontaneously breathing, isoflurane-anesthetized horses. Prospective, randomized crossover study. 10 healthy adult Standardbreds. Horses were premedicated with xylazine or medetomidine IV. Anesthesia was induced with diazepam and ketamine and maintained with isoflurane for 150 minutes. For the xylazine treatment, end-tidal isoflurane concentration was maintained at 1.7%, and xylazine (0.2 mg/kg [0.09 mg/lb], IV) was administered as a bolus at the end of anesthesia. For the MCRI treatment, end-tidal isoflurane concentration was maintained at 1.4%, and medetomidine (0.005 mg/kg/h [0.0023 mg/lb/h], IV) was infused throughout anesthesia. Physiologic data (ie, heart rate, respiratory rate, rectal temperature, bispectral index, and electromyographic values) were compared between treatments with xylazine bolus versus MCRI. Heart rate was lower, but mean arterial blood pressure was higher from 20 to 40 minutes with MCRI treatment, compared with conventional treatment with xylazine. Respiratory rate and rectal temperature were greater with MCRI treatment. Bispectral index was lower with MCRI treatment from 80 to 150 minutes, and electromyographic values were lower with MCRI treatment from 30 to 150 minutes. In isoflurane-anesthetized horses, premedication with medetomidine followed by administration of medetomidine as a constant rate infusion resulted in decreased heart rate, higher arterial blood pressure from 20 through 40 minutes after induction of anesthesia, and better preserved body temperature, compared with conventional treatment with xylazine. Greater depth of anesthesia and muscle relaxation were seen with MCRI treatment, despite the lower isoflurane concentration.

  12. General anesthetics inhibit LPS-induced IL-1β expression in glial cells.

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    Tomoharu Tanaka

    Full Text Available BACKGROUND: Glial cells, including microglia and astrocytes, are considered the primary source of proinflammatory cytokines in the brain. Immune insults stimulate glial cells to secrete proinflammatory cytokines that modulate the acute systemic response, which includes fever, behavioral changes, and hypothalamic-pituitary-adrenal (HPA axis activation. We investigated the effect of general anesthetics on proinflammatory cytokine expression in the primary cultured glial cells, the microglial cell line BV-2, the astrocytic cell line A-1 and mouse brain. METHODOLOGY/PRINCIPAL FINDINGS: Primary cultured glial cells were exposed to lipopolysaccharide (LPS in combination with general anesthetics including isoflurane, pentobarbital, midazolam, ketamine, and propofol. Following this treatment, we examined glial cell expression of the proinflammatory cytokines interleukin (IL-1β, IL-6, and tumor necrosis factor-alpha (TNF-α. LPS-induced expression of IL-1β mRNA and protein were significantly reduced by all the anesthetics tested, whereas IL-6 and TNF-α mRNA expression was unaffected. The anesthetics suppressed LPS-induced extracellular signal-regulated kinase 1/2 (ERK 1/2 phosphorylation, but did not affect nuclear factor-kappaB and activator protein-1 activation. The same effect was observed with BV-2, but not with A-1 cells. In the mouse experiments, LPS was injected intraperitoneally, and isoflurane suppressed IL-1β in the brain and adrenocorticotropic hormone in plasma, but not IL-1β in plasma. CONCLUSIONS/SIGNIFICANCE: Taken together, our results indicate that general anesthetics inhibit LPS-induced IL-1β upregulation in glial cells, particularly microglia, and affects HPA axis participation in the stress response.

  13. Anesthetic management of ostriches.

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    Cornick, J L; Jensen, J

    1992-06-01

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

  14. The effect of midazolam on the recovery quality, recovery time and the minimum alveolar concentration for extubation in the isoflurane-anesthetized pig.

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    Kleine, S A; Quandt, J E; Hofmeister, E H; Peroni, J

    2015-04-01

    There are no reported studies evaluating the effect of midazolam on recovery quality, recovery time or minimum alveolar concentration (MAC) at which extubation occurs (MAC extubation). Our hypotheses were that midazolam administered prior to recovery would decrease MAC extubation, prolong recovery time but provide a smoother recovery. Sixteen Yorkshire pigs were anesthetized with isoflurane for approximately 5 h. The end-tidal isoflurane concentration was then stabilized at 1.4% for 20 min. Pigs were randomly assigned to receive midazolam or saline. The vaporizer was decreased by 10% every 10 min until extubation. Pigs were declared awake by a blinded observer and were assigned a recovery score by the same observer. Mean MAC extubation was not significantly different for pigs receiving saline prior to recovery compared with those pigs receiving midazolam. The overall mean MAC extubation for both groups was 0.6 ± 0.4 vol%. Time to extubation was not significantly longer with midazolam (124 ± 36 min) compared with the saline group (96 ± 61 min; P = 0.09). Recovery score was not significantly different between groups (midazolam, 0.86 ± 1.1; saline 0.5 ± 0.5; P = 0.26). In conclusion, midazolam did not affect MAC extubation. There was no advantage of administering midazolam in the recovery period when performing step-down titration of isoflurane anesthesia.

  15. Evaluation of cardiopulmonary parameters and recovery from anesthesia in cougars (Puma concolor anesthetized with detomidine/ketamine and isoflurane or sevoflurane

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    Verônica B. Albuquerque

    2016-01-01

    Full Text Available Abstract: The aim of this study was to assess the cardiopulmonary effects, the onset time after the administration of a detomidine/ketamine combination, and the recovery from anesthesia of cougars (Puma concolor anesthetized with detomidine/ketamine and isoflurane or sevoflurane for abdominal ultrasound imaging. Fourteen animals were randomly allocated into two experimental groups: GISO (n=7 and GSEVO (n=7. Chemical restraint was performed using 0.15mg/kg detomidine combined with 5mg/kg ketamine intramuscularly; anesthesia induction was achieved using 2mg/kg propofol intravenously and maintenance with isoflurane (GISO or sevoflurane (GSEVO. The following parameters were assessed: heart rate, respiratory rate, systolic and diastolic arterial blood pressure, mean arterial blood pressure, oxyhemoglobin saturation, rectal temperature, central venous pressure, and end-tidal carbon dioxide. The time to sternal recumbency (TSR and time to standing position (TSP were also determined. There was not statistically significant difference for the cardiopulmonary variables or TSP whereas TSR was significantly shorter in GSEVO. The time to onset of anesthesia was 11.1±1.2 minutes and 11.3±1.8 minutes for GISO and GSEVO, respectively. The anesthesia of cougars with detomidine/ketamine and isoflurane or sevoflurane was conducted with safety, cardiopulmonary stability, and increased time to sternal recumbency in the GISO group.

  16. Isoflurane reversibly destabilizes hippocampal dendritic spines by an actin-dependent mechanism.

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    Jimcy Platholi

    Full Text Available General anesthetics produce a reversible coma-like state through modulation of excitatory and inhibitory synaptic transmission. Recent evidence suggests that anesthetic exposure can also lead to sustained cognitive dysfunction. However, the subcellular effects of anesthetics on the structure of established synapses are not known. We investigated effects of the widely used volatile anesthetic isoflurane on the structural stability of hippocampal dendritic spines, a postsynaptic structure critical to excitatory synaptic transmission in learning and memory. Exposure to clinical concentrations of isoflurane induced rapid and non-uniform shrinkage and loss of dendritic spines in mature cultured rat hippocampal neurons. Spine shrinkage was associated with a reduction in spine F-actin concentration. Spine loss was prevented by either jasplakinolide or cytochalasin D, drugs that prevent F-actin disassembly. Isoflurane-induced spine shrinkage and loss were reversible upon isoflurane elimination. Thus, isoflurane destabilizes spine F-actin, resulting in changes to dendritic spine morphology and number. These findings support an actin-based mechanism for isoflurane-induced alterations of synaptic structure in the hippocampus. These reversible alterations in dendritic spine structure have important implications for acute anesthetic effects on excitatory synaptic transmission and synaptic stability in the hippocampus, a locus for anesthetic-induced amnesia, and have important implications for anesthetic effects on synaptic plasticity.

  17. Effects of constant rate infusion of anesthetic or analgesic drugs on general anesthesia with isoflurane: A retrospective study in 200 dogs Efeitos da infusão intravenosa contínua de fármacos anestésicos ou analgésicos sobre a anestesia geral com isoflurano: Estudo retrospectivo em 200 cães

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    Sofia de Amorim Cerejo

    2013-09-01

    Full Text Available Constant rate infusion (CRI shows several advantages in balanced anesthesia, such as reduction of requirement for inhaled anesthetics and control of pain. The most commonly used drugs in these protocols are local anesthetics, dissociative, and opioids, which may be administered alone or in combinations. We evaluated the records of 200 dogs that underwent various surgical procedures with anesthetic or analgesic CRI in the perioperative period during 2011 and 2012 at the Veterinary Hospital of Franca University (Unifran, and identified possible complications during the transoperative period. Records evaluated included clinical state, laboratory tests, drugs used in premedication and induction, and CRI protocol. Acepromazine and morphine were the main drugs used in premedication. Propofol was used to induce anesthesia alone or in combination with other agents. We evaluated records of the 25 different CRI protocols. Fentanyl was the main drug employed in CRI, either alone or in combination. There were 128 episodes of anesthetic complications during CRI;the most common were hypotension, hypertension, and tachycardia, which occurred in 43 (32%, 35 (26.3%, and 19 (14.2% dogs, respectively. Cardiac arrhythmia was reported in only 4 dogs. Signs of respiratory depression were present in dogs treated with 6 different CRI protocols. The consumption of isoflurane (vol % reduced between 15.7% and 21.05% after 30minutes of the CRI in the fentanyl and fentanyl–lidocaine–ketamine CRI groups (pO uso de técnicas de infusão contínua (IC possui inúmeras vantagens na anestesia balanceada, como a redução do requerimento de anestésicos inalatórios e controle da dor. Os fármacos mais comumente utilizados nestes protocolos são os anestésicos locais, dissociativos e opioides, que podem ser administrados isoladamente ou em associações. Foram avaliados os prontuários de 200 cães que foram submetidos a diversos procedimentos cirúrgicos com IC de anest

  18. Effects of rocuronium bromide on globe position and respiratory function in isoflurane-anesthetized dogs: a comparison between three different dosages.

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    Briganti, Angela; Barsotti, Giovanni; Portela, Diego A; Di Nieri, Camilla; Breghi, Gloria

    2015-03-01

    To evaluate the effect on globe position and respiration of three dosages of intravenous rocuronium in isoflurane-anesthetized dogs. Thirty-two dogs anesthetized for ophthalmic procedures. The dogs were divided into four groups, each of eight animals (G1-G4). G1, G2, G3 received 0.075, 0.05, 0.03 mg/kg of IV rocuronium, respectively; G4 received 0.9% NaCl IV; all the treatments were administered when an end-tidal isoflurane of 1.1-1.2% was reached. Anesthesia was obtained with dexmedetomidine (2.5 mcg/kg IV), methadone (0.1 mg/kg IV), propofol (2 mg/kg IV), and isoflurane in oxygen. Neuromuscular function was assessed with acceleromyography by stimulation of the peroneal nerve using the train-of-four (ToF) and the ToF ratio (ToFR). Monitoring of cardiovascular and respiratory functions was performed. Changes in globe position were recorded. All three dosages of rocuronium produced centralization of the globe. Duration was 24.3 ± 4.2, 23.4 ± 3.6, and 8.7 ± 2.8 min, for G1, G2, and G3, respectively. The control group did not show globe centralization. No significant differences were found among the four groups in cardiovascular and respiratory parameters. Minute volume and ToFR were significantly lower in G1 compared with baseline values. All doses of rocuronium resulted in globe centralization. The higher dose provoked a transient respiratory depression and some degree of skeletal muscular blockade detectable with ToFR. No alterations in respiratory activity were present when 0.05 mg/kg was used. The 0.03 mg/kg dosage could be useful for very short ophthalmic procedures. © 2013 American College of Veterinary Ophthalmologists.

  19. Postanesthetic effects of isoflurane on behavioral phenotypes of adult male C57BL/6J mice.

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    Kumiko Yonezaki

    Full Text Available Isoflurane was previously the major clinical anesthetic agent but is now mainly used for veterinary anesthesia. Studies have reported widespread sites of action of isoflurane, suggesting a wide array of side effects besides sedation. In the present study, we phenotyped isoflurane-treated mice to investigate the postanesthetic behavioral effects of isoflurane. We applied comprehensive behavioral test batteries comprising sensory test battery, motor test battery, anxiety test battery, depression test battery, sociability test battery, attention test battery, and learning test battery, which were started 7 days after anesthesia with 1.8% isoflurane. In addition to the control group, we included a yoked control group that was exposed to the same stress of handling as the isoflurane-treated animals before being anesthetized. Our comprehensive behavioral test batteries revealed impaired latent inhibition in the isoflurane-treated group, but the concentration of residual isoflurane in the brain was presumably negligible. The yoked control group and isoflurane-treated group exhibited higher anxiety in the elevated plus-maze test and impaired learning function in the cued fear conditioning test. No influences were observed in sensory functions, motor functions, antidepressant behaviors, and social behaviors. A number of papers have reported an effect of isoflurane on animal behaviors, but no systematic investigation has been performed. To the best of our knowledge, this study is the first to systematically investigate the general health, neurological reflexes, sensory functions, motor functions, and higher behavioral functions of mice exposed to isoflurane as adults. Our results suggest that the postanesthetic effect of isoflurane causes attention deficit in mice. Therefore, isoflurane must be used with great care in the clinical setting and veterinary anesthesia.

  20. Effect of general anesthetics on the developing brain

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    S Velayudha Reddy

    2012-01-01

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

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

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

    2013-01-01

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

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

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

    2017-01-01

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

  3. Gamma-aminobutyric acid-mediated neurotransmission in the pontine reticular formation modulates hypnosis, immobility, and breathing during isoflurane anesthesia.

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    Vanini, Giancarlo; Watson, Christopher J; Lydic, Ralph; Baghdoyan, Helen A

    2008-12-01

    Many general anesthetics are thought to produce a loss of wakefulness, in part, by enhancing gamma-aminobutyric acid (GABA) neurotransmission. However, GABAergic neurotransmission in the pontine reticular formation promotes wakefulness. This study tested the hypotheses that (1) relative to wakefulness, isoflurane decreases GABA levels in the pontine reticular formation; and (2) pontine reticular formation administration of drugs that increase or decrease GABA levels increases or decreases, respectively, isoflurane induction time. To test hypothesis 1, cats (n = 5) received a craniotomy and permanent electrodes for recording the electroencephalogram and electromyogram. Dialysis samples were collected from the pontine reticular formation during isoflurane anesthesia and wakefulness. GABA levels were quantified using high-performance liquid chromatography. For hypothesis 2, rats (n = 10) were implanted with a guide cannula aimed for the pontine reticular formation. Each rat received microinjections of Ringer's (vehicle control), the GABA uptake inhibitor nipecotic acid, and the GABA synthesis inhibitor 3-mercaptopropionic acid. Rats were then anesthetized with isoflurane, and induction time was quantified as loss of righting reflex. Breathing rate was also measured. Relative to wakefulness, GABA levels were significantly decreased by isoflurane. Increased power in the electroencephalogram and decreased activity in the electromyogram caused by isoflurane covaried with pontine reticular formation GABA levels. Nipecotic acid and 3-mercaptopropionic acid significantly increased and decreased, respectively, isoflurane induction time. Nipecotic acid also increased breathing rate. Decreasing pontine reticular formation GABA levels comprises one mechanism by which isoflurane causes loss of consciousness, altered cortical excitability, muscular hypotonia, and decreased respiratory rate.

  4. The effects of general anesthetics on ESR spectra of spin labels in phosphatidylcholine vesicles containing purified Na,K-ATPase or microsomal protein

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    Shibuya, Makiko, E-mail: shibu@den.hokudai.ac.jp [Department of Dental Anesthesiology, Graduate School of Dental Medicine, Hokkaido University (Japan); Hiraoki, Toshifumi [Division of Applied Physics, Graduate School of Engineering, Hokkaido University (Japan); Kimura, Kunie; Fukushima, Kazuaki [Department of Dental Anesthesiology, Graduate School of Dental Medicine, Hokkaido University (Japan); Suzuki, Kuniaki [Department of Molecular Cell Pharmacology, Graduate School of Dental Medicine, Hokkaido University (Japan)

    2012-12-01

    Highlights: Black-Right-Pointing-Pointer We studied the effects of general anesthetics on liposome using ESR spectra. Black-Right-Pointing-Pointer Two spin labels, 5-DSA and 16-DSA, were located in different position in liposome. Black-Right-Pointing-Pointer Anesthetics did not change the environment around the spin labels in the liposome. Black-Right-Pointing-Pointer Anesthetics remained on the surface of the lipid bilayer of liposome. Black-Right-Pointing-Pointer Proteins in the liposome did not change the effects of anesthetics on liposome. - Abstract: We investigated the effects of general anesthetics on liposome containing spin labels, 5-doxyl stearic acid (5-DSA) and 16-doxyl stearic acid (16-DSA), and purified Na,K-ATPase or membrane protein of microsome using an electron spin resonance (ESR) spectroscopy. The spectra of 16-DSA in liposomes with both proteins showed three sharp signals compared with 5-DSA. The difference in the order parameter S value of 5-DSA and 16-DSA suggested that the nitroxide radical location of 5-DSA and 16-DSA were different in the membrane bilayer. The results were almost the same as those obtained in liposomes without proteins. The addition of sevoflurane, isoflurane, halothane, ether, ethanol and propofol increased the intensity of the signals, but the clinical concentrations of anesthetics did not significantly alter the S and {tau} values, which are indices of the fluidity of the membrane. These results suggest that anesthetics remain on the surface of the lipid bilayer and do not act on both the inside hydrophobic area and the relatively hydrophilic area near the surface. These results and others also suggest that the existence of Na,K-ATPase and microsomal proteins did not affect the environment around the spin labels in the liposome and the effects of anesthetics on liposome as a model membrane.

  5. Comparison of Hemodynamic Changes during General Anesthesia with Low-dose Isoflurane or Propofol in Elderly Patients Undergoing Upper Femoral Surgery

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    Mir Mohammad Taghi Mortazavi

    2016-01-01

    Full Text Available Background & objectives: Surgery of upper part of femor in elderly patients can be due to the fracture of femoral neck, shaft and arthroplasty. Hemodynamic changes and complications of the anesthesia are among the major concerns. The aim of this study was to compare the hemodynamic changes in low dose isoflurane with propofol in upper femoral surgeries in elderly patients. Methods: This prospective clinical trial study was done on 60 patients over 65 year-old elderly patients with ASA physical status of I and II that were candidate for upper femoral surgery in two groups (inhalational: isoflurane 0.5-0.6 MAC and (total intravenous anesthesia with propofol 50-100 mic/kg/min. Hemodynamic changes were compared in these groups with the same anesthetic depth (HR-SBP-DBP-MBP-SaO₂. Results: There was no significant difference in heart rate, age or sex between two groups. In isoflurane group SBP on 20 and 25th minutes and DBP and MBP on 20, 25 and 35th minutes were significantly higher than propofol group. In propofol group SaO₂ was significantly more than isoflurane group on induction, start of surgery and on 5, 25, 35 and 45th minutes of surgery. Conclusion: In anesthesia with the same Bi-Spectral Index, isoflurane provides more stable hemodynamic parameters than propofol.

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

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    A. M. Ovezov

    2015-01-01

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

  7. Influence of isoflurane on Immediate-Early Gene expression

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    Kristopher M Bunting

    2016-01-01

    Full Text Available Background: Anterograde amnesia is a hallmark effect of volatile anesthetics. Isoflurane is known to affect both the translation and transcription of plasticity-associated genes required for normal memory formation in many brain regions. What is not known is whether isoflurane anesthesia prevents the initiation of transcription or whether it halts transcription already in progress. We tested the hypothesis that general anesthesia with isoflurane prevents learning-induced initiation of transcription of several memory-associated immediate-early genes (IEGs correlated with amnesia; we also assessed whether it stops transcription initiated prior to anesthetic administration.Methods: Using a Tone Fear Conditioning paradigm, rats were trained to associate a tone with foot-shock. Animals received either no anesthesia, anesthesia immediately after training, or anesthesia before, during, and after training. Animals were either sacrificed after training or tested 24 hours later for memory. Using Cellular Compartment Analysis of Temporal Activity by Fluorescence in situ Hybridization (catFISH, we examined the percentage of neurons expressing the IEGs Arc/Arg3.1 and Zif268/Egr1/Ngfi-A/Krox-24 in the dorsal hippocampus, primary somatosensory cortex, and primary auditory cortex.Results: On a cellular level, isoflurane administered at high doses (general anesthesia prevented initiation of transcription, but did not stop transcription of Arc and Zif268 mRNA initiated prior to anesthesia. On a behavioral level, the same level of isoflurane anesthesia produced anterograde amnesia for fear conditioning when administered before and during training, but did not produce retrograde amnesia when administered immediately after training. Conclusions: General anesthesia with isoflurane prevents initiation of learning-related transcription but does not stop ongoing transcription of two plasticity-related IEGs, Arc and Zif268, a pattern of disruption that parallels the

  8. Interaction of anesthetics with neurotransmitter release machinery proteins.

    Science.gov (United States)

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

    2013-02-01

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

  9. The effect of different anesthetics on tumor cytotoxicity by natural killer cells.

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    Tazawa, Kazumasa; Koutsogiannaki, Sophia; Chamberlain, Matthew; Yuki, Koichi

    2017-01-15

    A number of retrospective studies have suggested that choice of anesthetic drugs during surgical tumor resection might affect tumor recurrence/metastasis, or outcome of patients. The recent study showed that volatile anesthetics-based general anesthesia was associated with the worse outcomes than intravenous anesthetics-based general anesthesia. However, the underlying mechanism is yet to be determined. Because natural killer (NK) cells are implicated as important immune cells for tumor recurrence/metastasis in the perioperative period, we examined the effect of different anesthetics on NK cell-mediated tumor cytotoxicity. Because adhesion molecule leukocyte function-associated antigen-1 (LFA-1) is functionally important in NK cells and is inhibited by commonly used volatile anesthetics isoflurane and sevoflurane, we hypothesized that these anesthetics would attenuate NK cell-mediated cytotoxicity. Using human NK cell line NK92-MI cells and tumor cell line K562 cells as a model system, we performed cytotoxicity, proliferation, conjugation and degranulation assays. Lytic granule polarization was also assessed. We showed that isoflurane, sevoflurane and LFA-1 inhibitor BIRT377 attenuated cytotoxicity, and reduced conjugation and polarization, but not degranulation of NK cells. Our data suggest that isoflurane and sevoflurane attenuated NK cell-mediated cytotoxicity at least partly by their LFA-1 inhibition in vitro. Whether or not isoflurane and sevoflurane attenuate NK cell-mediated tumor cytotoxicity in patients needs to be determined in the future. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Hydrogen-rich saline attenuates isoflurane-induced caspase-3 activation and cognitive impairment via inhibition of isoflurane-induced oxidative stress, mitochondrial dysfunction, and reduction in ATP levels

    Science.gov (United States)

    Li, Cheng; Hou, Lengchen; Chen, Dan; Lin, Fuqing; Chang, Tao; Li, Mengzhu; Zhang, Lingling; Niu, Xiaoyin; Wang, Huiying; Fu, Shukun; Zheng, Junhua

    2017-01-01

    Objectives: The inhaled general anesthetic isoflurane has been shown to induce caspase-3 activation in vitro and in vivo. The underlying mechanisms and functional consequences of this activity remain unclear. Isoflurane can induce caspase-3 activation by causing accumulation of reactive oxygen species (ROS), mitochondrial dysfunction, and reduction in adenosine triphosphate (ATP) levels. This study aimed to investigate the protective effect of hydrogen, a novel antioxidant, against isoflurane-induced caspase-3 activation and cognitive impairment. Methods: H4 human neuroglioma cells overexpressing human amyloid precursor protein were treated with saline or hydrogen-rich saline (HS, 300 μM), with or without 2% isoflurane, for 6 h or 3 h. Western blot analysis, fluorescence assays, and a mitochondrial swelling assay were used to evaluate caspase-3 activation, levels of ROS and ATP, and mitochondrial function. The effect of the interaction of isoflurane (1.4% for 2 h) and HS (5 mL/kg) on cognitive function in mice was also evaluated using a fear conditioning test. Results: We found that HS attenuated isoflurane-induced caspase-3 activation. Moreover, HS treatment mitigated isoflurane-induced ROS accumulation, opening of mitochondrial permeability transition pores, reduction in mitochondrial membrane potential, and reduction in cellular ATP levels. Finally, HS significantly alleviated isoflurane-induced cognitive impairment in mice. Conclusions: Our results suggest that HS attenuates isoflurane-induced caspase-3 activation and cognitive impairment via inhibition of isoflurane-induced oxidative stress, mitochondrial dysfunction, and reduction in ATP levels. These findings warrant further research into the underlying mechanisms of this activity, and indicate that HS has the potential to attenuate anesthesia neurotoxicity.

  11. Fluorescence anisotropy of diphenylhexatriene and its cationic Trimethylamino derivative in liquid dipalmitoylphosphatidylcholine liposomes: opposing responses to isoflurane

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    Nelson Steven C

    2012-03-01

    Full Text Available Abstract Background The mechanism of action of volatile general anesthetics has not yet been resolved. In order to identify the effects of isoflurane on the membrane, we measured the steady-state anisotropy of two fluorescent probes that reside at different depths. Incorporation of anesthetic was confirmed by shifting of the main phase transition temperature. Results In liquid crystalline dipalmitoylphosphatidylcholine liposomes, isoflurane (7-25 mM in the bath increases trimethylammonium-diphenylhexatriene fluorescence anisotropy by ~0.02 units and decreases diphenylhexatriene anisotropy by the same amount. Conclusions The anisotropy data suggest that isoflurane decreases non-axial dye mobility in the headgroup region, while increasing it in the tail region. We propose that these results reflect changes in the lateral pressure profile of the membrane.

  12. Shaker-Related Potassium Channels in the Central Medial Nucleus of the Thalamus Are Important Molecular Targets for Arousal Suppression by Volatile General Anesthetics

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    Birch, Alexandra M.; Tanaka, Brian S.; Sokolov, Yuri; Goldin, Alan L.; Chandy, K. George; Hall, James E.; Alkire, Michael T.

    2013-01-01

    The molecular targets and neural circuits that underlie general anesthesia are not fully elucidated. Here, we directly demonstrate that Kv1-family (Shaker-related) delayed rectifier K+ channels in the central medial thalamic nucleus (CMT) are important targets for volatile anesthetics. The modulation of Kv1 channels by volatiles is network specific as microinfusion of ShK, a potent inhibitor of Kv1.1, Kv1.3, and Kv1.6 channels, into the CMT awakened sevoflurane-anesthetized rodents. In heterologous expression systems, sevoflurane, isoflurane, and desflurane at subsurgical concentrations potentiated delayed rectifier Kv1 channels at low depolarizing potentials. In mouse thalamic brain slices, sevoflurane inhibited firing frequency and delayed the onset of action potentials in CMT neurons, and ShK-186, a Kv1.3-selective inhibitor, prevented these effects. Our findings demonstrate the exquisite sensitivity of delayed rectifier Kv1 channels to modulation by volatile anesthetics and highlight an arousal suppressing role of Kv1 channels in CMT neurons during the process of anesthesia. PMID:24107962

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    Although present in the atmosphere with a combined concentration approximately 100,000 times lower than carbon dioxide (i.e., the principal anthropogenic driver of climate change), halogenated organic compounds are responsible for a warming effect of approximately 10% to 15% of the total...... regarding the impact of anesthetic gas release on the environment, with particular focus on its contribution to the radiative forcing of climate change....... anthropogenic radiative forcing of climate, as measured relative to the start of the industrial era (approximately 1750). The family of anesthetic gases includes several halogenated organic compounds that are strong greenhouse gases. In this short report, we provide an overview of the state of knowledge...

  14. Automated, real-time fresh gas flow recommendations alter isoflurane consumption during the maintenance phase of anesthesia in a simulator-based study.

    Science.gov (United States)

    Luria, Isaac; Lampotang, Samsun; Schwab, Wilhelm; Cooper, Lou Ann; Lizdas, David; Gravenstein, Nikolaus

    2013-11-01

    The Low Flow Wizard (LFW) provides real-time guidance for user optimization of fresh gas flow (FGF) settings during general inhaled anesthesia. The LFW can continuously inform users whether it determines their FGF to be too little, efficient, or too much, and its color-coded recommendations respond in real time to changes in FGF performed by users. Our study objective was to determine whether the LFW feature, as implemented in the Dräger Apollo workstation, alters FGF selection and thereby volatile anesthetic consumption without affecting patient care. To reduce potentially confounding variables, we used a human patient simulator that consumes and exhales volatile anesthetics. Standard monitoring was provided for the patient initially with invasive arterial blood pressure added after anesthetic induction. In this within-group study, each of 17 participants acted as his or her own control. Each participant was asked to anesthetize an identical simulated patient twice using a Dräger Apollo workstation, first with the LFW feature disabled and subsequently enabled. The volatile anesthetic was isoflurane. Both simulation runs were set up to have similar time durations for the different phases of anesthesia: induction, incision, and maintenance. Emergence was not simulated. The isoflurane vaporizer was weighed before and after each simulation run on a digital scale to verify total computed volatile liquid anesthetic consumption. In addition, the product of FGF (reported by the Apollo) times the isoflurane volumetric concentration (sampled by a multigas analyzer at the equivalent of the FGF hose for the Apollo) was integrated over time to obtain isoflurane consumption rate (on-the-fly anesthetic consumption rate measurement). The maintenance isoflurane consumption rate and FGF were significantly lower with the LFW display enabled than without (P = 0.005). The mean reduction in FGF was 53.6% (95% confidence interval, 39.2%-67.9%). There was no significant difference in

  15. Latency of auditory evoked potential monitoring the effects of general anesthetics on nerve fibers and synapses

    OpenAIRE

    Bowan Huang; Feixue Liang; Lei Zhong; Minlin Lin; Juan Yang; Linqing Yan; Jinfan Xiao; Zhongju Xiao

    2015-01-01

    Auditory evoked potential (AEP) is an effective index for the effects of general anesthetics. However, it’s unknown if AEP can differentiate the effects of general anesthetics on nerve fibers and synapses. Presently, we investigated AEP latency and amplitude changes to different acoustic intensities during pentobarbital anesthesia. Latency more regularly changed than amplitude during anesthesia. AEP Latency monotonically decreased with acoustic intensity increase (i.e., latency-intensity curv...

  16. Insulin secretion and glucose utilization are impaired under general anesthesia with sevoflurane as well as isoflurane in a concentration-independent manner.

    Science.gov (United States)

    Tanaka, Tadashi; Nabatame, Hideki; Tanifuji, Yasumasa

    2005-01-01

    The dose-dependent effects of sevoflurane and isoflurane anesthesia on glucose tolerance were compared in humans. A prospective, randomized clinical study was conducted in 30 patients. The 30 patients were divided randomly into three sevoflurane anesthesia groups (0.5, 1.0, and 1.5 minimum alveolar concentration [MAC]) and three isoflurane anesthesia groups (0.5, 1.0, and 1.5 MAC). Induction of anesthesia was accomplished by inhalation of the volatile agent and nitrous oxide. After induction, anesthesia was maintained at the designated MAC for 15 min without surgical stimulation. The intravenous glucose tolerance test (IVGTT) was performed in these 30 patients while they were under general anesthesia and again several days after surgery in 5 of these patients while they were awake, as a control. The insulinogenic index (change in concentration of immunoreactive insulin/change in glucose concentration), the acute insulin response, and rates of glucose disappearance were significantly lower in all anesthesia groups than in the control group. However, the insulinogenic index, acute insulin response, and the glucose disappearance rate did not differ significantly among the six anesthesia groups. Sevoflurane anesthesia impairs glucose tolerance to the same degree as does isoflurane anesthesia. Glucose intolerance during sevoflurane or isoflurane anesthesia is independent of agent and dosage up to 1.5 MAC.

  17. Design, Synthesis, and Evaluation of Novel 2,6-Disubstituted Phenol Derivatives as General Anesthetics.

    Science.gov (United States)

    Qin, Linlin; Ren, Lei; Wan, Songlin; Liu, Guoliang; Luo, Xinfeng; Liu, Zhenhong; Li, Fangqiong; Yu, Yan; Liu, Jianyu; Wei, Yonggang

    2017-05-11

    A novel series of optically active 2,6-disubstituted alkylphenols with improved anesthetic profiles compared to widely used propofol were synthesized. The incorporation of the cyclopropyl group not only increased the steric effect but also introduced stereoselective effects over their anesthetic properties. Compounds 1, 2, and 6 were selected as potential candidates for further preclinical development including studies of their water-soluble prodrugs. Clinical studies of candidate compound 6 (Haisco HSK3486) as a general anesthetic are being performed in Australia and China.

  18. Overexpression cdc42 attenuates isoflurane-induced neurotoxicity in developmental brain of rats.

    Science.gov (United States)

    Fang, Xi; Li, Shiyong; Han, Qiang; Zhao, Yilin; Gao, Jie; Yan, Jing; Luo, Ailin

    2017-08-26

    Nowadays many children receive operations with general anesthesia. Isoflurane is a commonly-used general anesthetic. Numbers of studies demonstrated that isoflurane induced neurotoxicity and neurobehavioral deficiency in young rats, however, the underlying mechanism remained unknown. Cell division cycle 42 (cdc42) played an important role in regulating synaptic vesicle trafficking and actin dynamics in neuron, which closely linked to synaptic plasticity and dendritic spine formation. Meanwhile, cdc42 also involved in many neurodegenerative diseases. However, whether cdc42 provided a protective role in isoflurane induced synaptogenesis dysfunction still unknown. As the upstream of cdc42, calcium/Calmodulin-dependent protein kinase II (CaMKII) interacts with ion channels such as VDCCs and N-methyl-d-aspartate receptors (NMDARs), which closely associated with neuroapoptosis and cognitive deficiency in developing brain. The phosphorylation of CaMKIIα at Thr 286 plays an important role in introduction and maintenance of long-term potentiation (LTP). Therefore, we investigated the effect of isoflurane on cdc42 and its upstream Calcium/Calmodulin-dependent protein kinase II (CaMKII) and its downstream p21 activated kinase 3 (PAK3), then determined whether CaMKIIα/cdc42/PAK3 signaling pathway was involved in neurotoxicity and cognitive deficiency induced by isoflurane. Our study found that isoflurane induced neurotoxicity and resulted in cognitive impairment in young rats through suppressed CaMKIIα/cdc42/PAK3 signaling pathway. Cdc42 over-expression could reverse neurotoxicity and improve cognitive impairment induced by isoflurane. Copyright © 2017. Published by Elsevier Inc.

  19. Paradoxical Emergence: Administration of Subanesthetic Ketamine during Isoflurane Anesthesia Induces Burst Suppression but Accelerates Recovery.

    Science.gov (United States)

    Hambrecht-Wiedbusch, Viviane S; Li, Duan; Mashour, George A

    2017-03-01

    Promoting arousal by manipulating certain brain regions and/or neurotransmitters has been a recent research focus, with the goal of trying to improve recovery from general anesthesia. The current study tested the hypothesis that a single subanesthetic dose of ketamine during isoflurane anesthesia would increase cholinergic tone in the prefrontal cortex and accelerate recovery. Adult male rats were implanted with electroencephalography electrodes (frontal, parietal, and occipital cortex) and a microdialysis guide cannula targeted for the prefrontal cortex. After establishing general anesthesia with isoflurane, animals were randomly assigned to receive a saline control or ketamine injection. When isoflurane was discontinued nearly 90 min after drug or saline administration, recovery from anesthesia was measured by experimenters and blinded observers. During the entire experiment, electrophysiologic signals were recorded and acetylcholine was quantified by high-performance liquid chromatography with electrochemical detection. A single dose of subanesthetic ketamine caused an initial 125% increase in burst suppression ratio (last isoflurane sample: 37.48 ± 24.11% vs. isoflurane after ketamine injection: 84.36 ± 8.95%; P ketamine: 494 ± 108 s; P = 0.0005; n = 10 per treatment). Furthermore, ketamine caused a significant 317% increase in cortical acetylcholine release (mean after ketamine injection: 0.18 ± 0.16 pmol vs. ketamine recovery: 0.75 ± 0.41 pmol; P = 0.0002) after isoflurane anesthesia was discontinued. Administration of subanesthetic doses of ketamine during isoflurane anesthesia increases anesthetic depth but-paradoxically-accelerates the recovery of consciousness, possibly through cholinergic mechanisms.

  20. Effect of Acetaminophen Alone and in Combination with Morphine and Tramadol on the Minimum Alveolar Concentration of Isoflurane in Rats.

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    Julio R Chavez

    Full Text Available It has been observed that acetaminophen potentiates the analgesic effect of morphine and tramadol in postoperative pain management. Its capacity as an analgesic drug or in combinations thereof to reduce the minimum alveolar concentration (MAC of inhalational anesthetics represents an objective measure of this effect during general anesthesia. In this study, the effect of acetaminophen with and without morphine or tramadol was evaluated on the isoflurane MAC.Forty-eight male Wistar rats were anesthetized with isoflurane in oxygen. MACISO was determined from alveolar gas samples at the time of tail clamping without the drug, after administering acetaminophen (300 mg/kg, morphine (3 mg/kg, tramadol (10 mg/kg, acetaminophen (300 mg/kg + morphine (3 mg/kg, and acetaminophen (300 mg/kg + tramadol (10 mg/kg.The control and acetaminophen groups did not present statistically significant differences (p = 0.98. The values determined for MACISO after treatment with acetaminophen + morphine, acetaminophen + tramadol, morphine, and tramadol were 0.98% ± 0.04%, 0.99% ± 0.009%, 0.97% ± 0.02%, and 0.99% ± 0.01%, respectively.The administration of acetaminophen did not reduce the MAC of isoflurane and did not potentiate the reduction in MACISO by morphine and tramadol in rats, and therefore does not present a sparing effect of morphine or tramadol in rats anesthetized with isoflurane.

  1. Effect of Acetaminophen Alone and in Combination with Morphine and Tramadol on the Minimum Alveolar Concentration of Isoflurane in Rats

    Science.gov (United States)

    Chavez, Julio R.; Ibancovichi, José A.; Sanchez-Aparicio, Pedro; Acevedo-Arcique, Carlos M.; Moran-Muñoz, Rafael; Recillas-Morales, Sergio

    2015-01-01

    Background It has been observed that acetaminophen potentiates the analgesic effect of morphine and tramadol in postoperative pain management. Its capacity as an analgesic drug or in combinations thereof to reduce the minimum alveolar concentration (MAC) of inhalational anesthetics represents an objective measure of this effect during general anesthesia. In this study, the effect of acetaminophen with and without morphine or tramadol was evaluated on the isoflurane MAC. Methods Forty-eight male Wistar rats were anesthetized with isoflurane in oxygen. MACISO was determined from alveolar gas samples at the time of tail clamping without the drug, after administering acetaminophen (300 mg/kg), morphine (3 mg/kg), tramadol (10 mg/kg), acetaminophen (300 mg/kg) + morphine (3 mg/kg), and acetaminophen (300 mg/kg) + tramadol (10 mg/kg). Results The control and acetaminophen groups did not present statistically significant differences (p = 0.98). The values determined for MACISO after treatment with acetaminophen + morphine, acetaminophen + tramadol, morphine, and tramadol were 0.98% ± 0.04%, 0.99% ± 0.009%, 0.97% ± 0.02%, and 0.99% ± 0.01%, respectively. Conclusions The administration of acetaminophen did not reduce the MAC of isoflurane and did not potentiate the reduction in MACISO by morphine and tramadol in rats, and therefore does not present a sparing effect of morphine or tramadol in rats anesthetized with isoflurane. PMID:26605541

  2. Bottom-Up and Top-Down Mechanisms of General Anesthetics Modulate Different Dimensions of Consciousness.

    Science.gov (United States)

    Mashour, George A; Hudetz, Anthony G

    2017-01-01

    There has been controversy regarding the precise mechanisms of anesthetic-induced unconsciousness, with two salient approaches that have emerged within systems neuroscience. One prominent approach is the "bottom up" paradigm, which argues that anesthetics suppress consciousness by modulating sleep-wake nuclei and neural circuits in the brainstem and diencephalon that have evolved to control arousal states. Another approach is the "top-down" paradigm, which argues that anesthetics suppress consciousness by modulating the cortical and thalamocortical circuits involved in the integration of neural information. In this article, we synthesize these approaches by mapping bottom-up and top-down mechanisms of general anesthetics to two distinct but inter-related dimensions of consciousness: level and content. We show how this explains certain empirical observations regarding the diversity of anesthetic drug effects. We conclude with a more nuanced discussion of how levels and contents of consciousness interact to generate subjective experience and what this implies for the mechanisms of anesthetic-induced unconsciousness.

  3. Bottom-Up and Top-Down Mechanisms of General Anesthetics Modulate Different Dimensions of Consciousness

    Science.gov (United States)

    Mashour, George A.; Hudetz, Anthony G.

    2017-01-01

    There has been controversy regarding the precise mechanisms of anesthetic-induced unconsciousness, with two salient approaches that have emerged within systems neuroscience. One prominent approach is the “bottom up” paradigm, which argues that anesthetics suppress consciousness by modulating sleep-wake nuclei and neural circuits in the brainstem and diencephalon that have evolved to control arousal states. Another approach is the “top-down” paradigm, which argues that anesthetics suppress consciousness by modulating the cortical and thalamocortical circuits involved in the integration of neural information. In this article, we synthesize these approaches by mapping bottom-up and top-down mechanisms of general anesthetics to two distinct but inter-related dimensions of consciousness: level and content. We show how this explains certain empirical observations regarding the diversity of anesthetic drug effects. We conclude with a more nuanced discussion of how levels and contents of consciousness interact to generate subjective experience and what this implies for the mechanisms of anesthetic-induced unconsciousness. PMID:28676745

  4. INTRATHECAL GLYCINE SIGNIFICANTLY DECREASES THE MINIMUM ALVEOLAR CONCENTRATION OF ISOFLURANE IN RATS

    Institute of Scientific and Technical Information of China (English)

    Jing Zhao; Yi Zhang; Edmond Ⅰ. Eger Ⅱ; James Sonner

    2008-01-01

    Objective To evaluate the effect of intrathecal administration of glycine on the minimum alveolar concentration (MAC) of isoflurane in rats.Methods Intrathecal catheters were implanted in 40 adult male rats anesthetized with isoflurane. Baseline MAC of isoflurane was measured during the infusion of artificial cerebrospinal fluid (CSF) alone. Subsequently, 10, 40, 80,160, and 300 mmol/L of glycine dissolved in artificial CSF were infused for two hours at the same rate as under control conditions, and MAC for isoflurane was re-determined.Results Intrathecal administration of glycine produced a significant, dose-dependent decrease in MAC for isoflu-rane (upto -65.2% ±16.2%).Conclusisons Intrathecal administration of glycine decreases anesthetic requirement. This result supports the idea that glycine receptors may be important to the immobilizing effect of anesthetics that enhance glycine receptor function such as isoflurane.

  5. Isoflurane preconditioning confers cardioprotection by activation of ALDH2.

    Directory of Open Access Journals (Sweden)

    Xiao-E Lang

    Full Text Available The volatile anesthetic, isoflurane, protects the heart from ischemia/reperfusion (I/R injury. Aldehyde dehydrogenase 2 (ALDH2 is thought to be an endogenous mechanism against ischemia-reperfusion injury possibly through detoxification of toxic aldehydes. We investigated whether cardioprotection by isoflurane depends on activation of ALDH2.Anesthetized rats underwent 40 min of coronary artery occlusion followed by 120 min of reperfusion and were randomly assigned to the following groups: untreated controls, isoflurane preconditioning with and without an ALDH2 inhibitor, the direct activator of ALDH2 or a protein kinase C (PKCε inhibitor. Pretreatment with isoflurane prior to ischemia reduced LDH and CK-MB levels and infarct size, while it increased phosphorylation of ALDH2, which could be blocked by the ALDH2 inhibitor, cyanamide. Isolated neonatal cardiomyocytes were treated with hypoxia followed by reoxygenation. Hypoxia/reoxygenation (H/R increased cardiomyocyte apoptosis and injury which were attenuated by isoflurane and forced the activation of ALDH2. In contrast, the effect of isoflurane-induced protection was almost abolished by knockdown of ALDH2. Activation of ALDH2 and cardioprotection by isoflurane were substantially blocked by the PKCε inhibitor. Activation of ALDH2 by mitochondrial PKCε plays an important role in the cardioprotection of isoflurane in myocardium I/R injury.

  6. A high-throughput approach for identification of novel general anesthetics.

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    Lea, Wendy A; Xi, Jin; Jadhav, Ajit; Lu, Louis; Austin, Christopher P; Simeonov, Anton; Eckenhoff, Roderic G

    2009-09-24

    Anesthetic development has been a largely empirical process. Recently, we described a GABAergic mimetic model system for anesthetic binding, based on apoferritin and an environment-sensitive fluorescent probe. Here, a competition assay based on 1-aminoanthracene and apoferritin has been taken to a high throughput screening level, and validated using the LOPAC(1280) library of drug-like compounds. A raw hit rate of approximately 15% was reduced through the use of computational filters to yield an overall hit rate of approximately 1%. These hits were validated using isothermal titration calorimetry. The success of this initial screen and computational triage provides feasibility to undergo a large scale campaign to discover novel general anesthetics.

  7. A high-throughput approach for identification of novel general anesthetics.

    Directory of Open Access Journals (Sweden)

    Wendy A Lea

    Full Text Available Anesthetic development has been a largely empirical process. Recently, we described a GABAergic mimetic model system for anesthetic binding, based on apoferritin and an environment-sensitive fluorescent probe. Here, a competition assay based on 1-aminoanthracene and apoferritin has been taken to a high throughput screening level, and validated using the LOPAC(1280 library of drug-like compounds. A raw hit rate of approximately 15% was reduced through the use of computational filters to yield an overall hit rate of approximately 1%. These hits were validated using isothermal titration calorimetry. The success of this initial screen and computational triage provides feasibility to undergo a large scale campaign to discover novel general anesthetics.

  8. General anesthetics have differential inhibitory effects on gap junction channels and hemichannels in astrocytes and neurons.

    Science.gov (United States)

    Liu, Xinhe; Gangoso, Ester; Yi, Chenju; Jeanson, Tiffany; Kandelman, Stanislas; Mantz, Jean; Giaume, Christian

    2016-04-01

    Astrocytes represent a major non-neuronal cell population actively involved in brain functions and pathologies. They express a large amount of gap junction proteins that allow communication between adjacent glial cells and the formation of glial networks. In addition, these membrane proteins can also operate as hemichannels, through which "gliotransmitters" are released, and thus contribute to neuroglial interaction. There are now reports demonstrating that alterations of astroglial gap junction communication and/or hemichannel activity impact neuronal and synaptic activity. Two decades ago we reported that several general anesthetics inhibited gap junctions in primary cultures of astrocytes (Mantz et al., (1993) Anesthesiology 78(5):892-901). As there are increasing studies investigating neuroglial interactions in anesthetized mice, we here updated this previous study by employing acute cortical slices and by characterizing the effects of general anesthetics on both astroglial gap junctions and hemichannels. As hemichannel activity is not detected in cortical astrocytes under basal conditions, we treated acute slices with the endotoxin LPS or proinflammatory cytokines to induce hemichannel activity in astrocytes, which in turn activated neuronal hemichannels. We studied two extensively used anesthetics, propofol and ketamine, and the more recently developed dexmedetomidine. We report that these drugs have differential inhibitory effects on gap junctional communication and hemichannel activity in astrocytes when used in their respective, clinically relevant concentrations, and that dexmedetomidine appears to be the least effective on both channel functions. In addition, the three anesthetics have similar effects on neuronal hemichannels. Altogether, our observations may contribute to optimizing the selection of anesthetics for in vivo animal studies.

  9. Allyl m-Trifluoromethyldiazirine Mephobarbital: An Unusually Potent Enantioselective and Photoreactive Barbiturate General Anesthetic

    Energy Technology Data Exchange (ETDEWEB)

    Savechenkov, Pavel Y.; Zhang, Xi; Chiara, David C.; Stewart, Deirdre S.; Ge, Rile; Zhou, Xiaojuan; Raines, Douglas E.; Cohen, Jonathan B.; Forman, Stuart A.; Miller, Keith W.; Bruzik, Karol S. (Harvard-Med); (Mass. Gen. Hosp.); (UIC)

    2012-12-10

    We synthesized 5-allyl-1-methyl-5-(m-trifluoromethyl-diazirynylphenyl)barbituric acid (14), a trifluoromethyldiazirine-containing derivative of general anesthetic mephobarbital, separated the racemic mixture into enantiomers by chiral chromatography, and determined the configuration of the (+)-enantiomer as S by X-ray crystallography. Additionally, we obtained the {sup 3}H-labeled ligand with high specific radioactivity. R-(-)-14 is an order of magnitude more potent than the most potent clinically used barbiturate, thiopental, and its general anesthetic EC{sub 50} approaches those for propofol and etomidate, whereas S-(+)-14 is 10-fold less potent. Furthermore, at concentrations close to its anesthetic potency, R-(-)-14 both potentiated GABA-induced currents and increased the affinity for the agonist muscimol in human {alpha}1{beta}2/3{gamma}2L GABA{sub A} receptors. Finally, R-(-)-14 was found to be an exceptionally efficient photolabeling reagent, incorporating into both {alpha}1 and {beta}3 subunits of human {alpha}1{beta}3 GABAA receptors. These results indicate R-(-)-14 is a functional general anesthetic that is well-suited for identifying barbiturate binding sites on Cys-loop receptors.

  10. [Effects of halothane and isoflurane on the canine duodenal paraneurons].

    Science.gov (United States)

    Sato, K; Noguchi, R; Taga, K; Shimoji, K; Fujita, T

    1988-05-01

    Administration of amino acid solution (50 mM tryptophane and phenylalanine in saline) into the canine duodenum is known to cause an increase in pancreatic secretion. This response is mediated by the excitation of duodenal endocrine cells, paraneurons, which release cholecystokinin (CCK) into the systemic circulation in response to intraluminal amino acid stimuli. Pancreatic secretory cells are then evoked by the CCK in the blood to secrete the juice into the duodenum. The authors investigated the effects of two general anesthetics, halothane and isoflurane, on this response. Nine mongrel dogs were subjected to this study. Each dog underwent laparotomy under nitrous oxide (75%)-oxygen (25%) anesthesia with pancuronium (GO-Pb). The duodenal loop was exposed and two polyethylene cannulae (18Fr) were introduced into the loop. Proximal cannula was for the administration of the amino acid solution into the loop, and distal one was for drainage of the solution. The pancreatic duct was inserted with a polyethylene catheter, through which pancreatic juice was collected and measured for the volume and protein output by spectrophotometry. After these surgical procedures, the pancreatic secretory response to intraluminal amino acid stimuli was examined under GO-Pb (Control). Then halothane (1.0%) (Group 1, four dogs) or isoflurane (2.0%) (Group 2, five dogs) was administered for 30 min and the same response was tested. The pancreatic secretory response to intraluminal amino acid stimulus was suppressed by the surgical concentrations of both halothane (1.0%) and isoflurane (2.0%). Neither halothane nor isoflurane suppressed the pancreatic secretory response evoked by intravenous CCK infusion (10 Ivy Dog Units.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

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    Mahmoud, Mohamed [Cincinnati Children' s Hospital Medical Center, Department of Anesthesiology, Cincinnati, OH (United States); Towe, Christopher [Cincinnati Children' s Hospital Medical Center, Department of Pulmonary Medicine, Cincinnati, OH (United States); Fleck, Robert J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2015-07-15

    Today's practice of medicine involves ever more complex patients whose care is coordinated with multidisciplinary teams. Caring for these patients can challenge all members of the health care team. Sedation/anesthesia in infants/toddlers as well as uncooperative or intellectually or emotionally impaired children who require imaging studies of the chest are ongoing challenges. High-quality computed tomography (CT) chest imaging studies in children under general anesthesia are extremely important for accurate interpretation and subsequent medical decision-making. Anesthesia-induced atelectasis may obscure or mimic true pathology creating a significant quality issue. Obtaining a high-quality, motion-free chest imaging study in infants and children under general anesthesia remains a difficult task in many institutions. Meticulous attention to anesthesia and imaging techniques and specialized knowledge are required to properly perform and interpret chest imaging studies. In this commentary, we discuss the continuous struggle to obtain high-quality CT chest imaging under general anesthesia. We will also discuss the major concerns of the anesthesiologist, radiologist and pulmonologist and why cooperation and coordination among these providers are critical for an optimal quality study.

  12. Awareness and apgar score in elective Cesarean section under general anesthesia with propofol or Isoflurane: A prospective, randomized, double-blinded clinical trial study

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    Somayeh Khanjani

    2014-01-01

    Full Text Available Background: Awareness is a postoperative recall of events experienced under general anesthesia. In this study, we compared the incidence of awareness between two routine methods used, inhalation (Isoflurane and intravenous protocol (Propofol, in elective Cesarean section, and also evaluated the effect of these two different methods on the apgar score of newborns. Materials and Methods: In this prospective, clinical trial study, 90 pregnant women candidates for elective Cesarean section were randomly enrolled, after taking written consent. Induction of anesthesia in both groups was provided by propofol and succinylcholine in the same manner, and maintenance of anesthesia in Group 1 was provided by propofol 100 μg/kg/minute and in Group 2 with isoflurane 1 MAC, to maintain the bispectral index (BIS between 45 and 60. Blood pressure, heart rate, electrocardiography (ECG, and also Etco2 and o2sat were recorded throughout the surgery and finally analyzed and compared. Results: From 90 patients, four cases of confirmed awareness were found in the propofol group and three cases in the Isoflurane group (8/9% vs. 6/7%, but the apgar scores were comparable between the two groups. Meanwhile there were no significant differences between the two groups in basic information, neonatal apgar scores, hemodynamic changes, and BIS, Electromyography (EMG, and signal quality index (SQI values. Conclusion: According to the patient′s state, diagnosis of the anesthesiologist, and other criteria like price and its availability, we could use these drugs in general anesthesia during Cesarean section, although it is recommended that more studies be done to compare the effect of these two drugs in larger groups.

  13. Awareness and apgar score in elective Cesarean section under general anesthesia with propofol or Isoflurane: A prospective, randomized, double-blinded clinical trial study.

    Science.gov (United States)

    Khanjani, Somayeh; Naghibi, Khosrou; Azarnoush, Hamed

    2014-01-01

    Awareness is a postoperative recall of events experienced under general anesthesia. In this study, we compared the incidence of awareness between two routine methods used, inhalation (Isoflurane) and intravenous protocol (Propofol), in elective Cesarean section, and also evaluated the effect of these two different methods on the apgar score of newborns. In this prospective, clinical trial study, 90 pregnant women candidates for elective Cesarean section were randomly enrolled, after taking written consent. Induction of anesthesia in both groups was provided by propofol and succinylcholine in the same manner, and maintenance of anesthesia in Group 1 was provided by propofol 100 μg/kg/minute and in Group 2 with isoflurane 1 MAC, to maintain the bispectral index (BIS) between 45 and 60. Blood pressure, heart rate, electrocardiography (ECG), and also Etco2 and o2sat were recorded throughout the surgery and finally analyzed and compared. From 90 patients, four cases of confirmed awareness were found in the propofol group and three cases in the Isoflurane group (8/9% vs. 6/7%), but the apgar scores were comparable between the two groups. Meanwhile there were no significant differences between the two groups in basic information, neonatal apgar scores, hemodynamic changes, and BIS, Electromyography (EMG), and signal quality index (SQI) values. According to the patient's state, diagnosis of the anesthesiologist, and other criteria like price and its availability, we could use these drugs in general anesthesia during Cesarean section, although it is recommended that more studies be done to compare the effect of these two drugs in larger groups.

  14. Determination of minimum alveolar concentration of isoflurane in dogs and cats using the up-and-down method. A preliminary study.

    Science.gov (United States)

    Barletta, Michele; Quandt, Jane; Hofmeister, Erik

    2016-06-01

    Minimum alveolar concentration (MAC) is a reliable measurement of the potency of inhaled anesthetic agents. The determination of MAC in different species has followed a fairly consistent methodology. In people, MAC is determined with the up-and-down method, whereas in animal the bracketing technique is commonly used. The objectives of this study were to determine the MAC value of isoflurane in dogs and cats using the up-and-down method and to determine the MAC value of isoflurane at extubation (MACex). General anesthesia was induced in 13 dogs and 5 cats with 5% isoflurane in oxygen. An initial end-tidal isoflurane concentration of 1.3% was used for the first dog and of 1.6% for the first cat and maintained constant for ≥20min. A noxious stimulus in the form of Carmalt forceps was applied to the base of the tail for no more than one minute or until movement was noticed. After stimulation, the response was recorded as positive (movement) or negative (no movement) and the animal was recovered. The end-tidal isoflurane concentration of the following animal was increased or decreased by 0.1% if the response of the previous animal to the stimulus was negative or positive, respectively. Isoflurane MAC values in dogs were 1.27% and 1.23%. Isoflurane MAC value in cats was 1.58%. MACex value was 0.45% in dogs and in cats. The up-and-down method for MAC determination achieved similar results when compared to MAC values of isoflurane in dogs and cats reported in the literature using the bracketing technique. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2013-01-01

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

  16. Comparison of sevoflurane and isoflurane in domestic ferrets (Mustela putorius furo).

    Science.gov (United States)

    Lawson, A K; Lichtenberger, M; Day, T; Ko, J; Kirby, R

    2006-01-01

    Isoflurane anesthesia is commonly used in ferrets for routine examinations and diagnostics. Sevoflurane is now being used as well, but there have been no studies to date directly comparing these agents in domestic ferrets. A prospective study was designed to evaluate the quality and speed of anesthetic induction and recovery using isoflurane and sevoflurane in ferrets. In addition effects on heart rate, blood pressure and packed cell volume were also recorded. No significant differences were noted between anesthetic agents.

  17. Isoflurane anesthesia in the African clawed frog (Xenopus laevis).

    Science.gov (United States)

    Smith, J M; Stump, K C

    2000-11-01

    Isoflurane is one of the safest and most accepted anesthetic agents for reptiles, birds, and mammals. It has also been used in terrestrial amphibians. The use of inhalation agents in an entirely aquatic frog presents a new dilemma for delivery in contrast to terrestrial species. The African Clawed Frog respires by using both transcutaneous gas exchange and air breathing. These frogs remain submerged for long periods of time, thus making standard inhalation techniques impractical. We tested five methods for delivering isoflurane: 1) bubbling isoflurane and oxygen in the water, 2) intracoelomic injection, 3) subcutaneous injection, 4) intramuscular injection, and 5) topical application. For the topical application, we developed a simple technique by using an absorptive pad with a vapor-barrier backing, saturating the pad with the liquid isoflurane, and placing the pad on the back of the frog while it was confined in a plastic bowl. Although two of the three injectable routes induced anesthesia, only the topical route produced rapid induction with consistent, safe recovery. Bubbling isoflurane with oxygen into water was unsuccessful. Topical application of isoflurane was most successful and appears to be a safe and practical method that can be used as an alternative to tricaine methylsulphonate, hypothermia, or other methods for anesthetizing African Clawed Frogs.

  18. Influence of acepromazine on the cardiovascular actions of dobutamine in isoflurane-anesthetized horses Influência da acepromazina sobre os efeitos cardiovasculares da dobutamina em cavalos anestesiados com isofluorano

    Directory of Open Access Journals (Sweden)

    Eduardo Raposo Monteiro

    2011-03-01

    Full Text Available The influence of acepromazine (ACP on the effectiveness of dobutamine (DBT in increasing blood pressure during isoflurane (ISO anesthesia was evaluated in six horses. On separate occasions, the horses were randomly assigned to receive NaCl 0.9% (Control, ACP 0.025mg kg-1 and ACP 0.05mg kg-1. The experimental treatment was administered prior to induction of anesthesia. Maintenance of anesthesia was performed under conditions of normocapnia with ISO in oxygen. Dobutamine was administered at progressively increasing infusion rates until mean arterial pressure (MAP reached 70mmHg or until a maximum infusion rate of 5.0µg kg-1 min-1. Compared with baseline, DBT increased heart rate, systolic, diastolic and mean blood pressures in all treatments. However, these variables did not differ among treatments. The target MAP (70mmHg was not reached in 2/6, 2/5 and 0/6 horses in the Control, ACP0.025 and ACP0.05 treatments, respectively. The mean dose of DBT to achieve target MAP was 3.5±1.8, 3.7±1.6 and 2.7±1.4µg kg-1 min-1 in the Control, ACP0.025 and ACP0.05 treatments, respectively (P>0.05. Under the conditions of this study, premedication with ACP does not interfere with the effectiveness of DBT in increasing blood pressure in horses anesthetized with ISO.A influência da acepromazina (ACP sobre a capacidade da dobutamina (DBT em elevar a pressão arterial durante a anestesia com isofluorano (ISO foi avaliada em seis equinos. Em ocasiões diferentes, os animais receberam aleatoriamente NaCl 0,9% (Controle, ACP 0,025mg kg-1 e ACP 0,05mg kg-1. O tratamento experimental foi administrado previamente à indução da anestesia. A manutenção da anestesia foi realizada em condições de normocapnia com ISO em oxigênio. A administração de DBT foi iniciada em doses progressivamente crescentes até que o valor de pressão arterial média (PAM atingisse 70mmHg ou até a dose máxima de 5,0µg kg-1 min-1. Comparado ao basal, a administração da DBT

  19. Effect of isoflurane on neuronal apoptosis in rats subjected to focal cerebral ischemia.

    Science.gov (United States)

    Kawaguchi, Masahiko; Drummond, John C; Cole, Daniel J; Kelly, Paul J; Spurlock, Mark P; Patel, Piyush M

    2004-03-01

    Although isoflurane can reduce ischemic neuronal injury after short postischemic recovery intervals, this neuroprotective efficacy is not sustained. Neuronal apoptosis can contribute to the gradual increase in infarct size after ischemia. This suggests that isoflurane, although capable of reducing early neuronal death, may not inhibit ischemia-induced apoptosis. We investigated the effects of isoflurane on markers of apoptosis in rats subjected to focal ischemia. Fasted Wistar-Kyoto rats were anesthetized with isoflurane and randomly allocated to awake (n = 40) or isoflurane (n = 40) groups. Animals in both groups were subjected to focal ischemia by filament occlusion of the middle cerebral artery for 70 min. Pericranial temperature was servo-controlled at 37 degrees C +/- 0.2 degrees C throughout the experiment. In the awake group, isoflurane was discontinued and the animals were allowed to awaken. In the isoflurane group, isoflurane anesthesia was maintained at 1.5 MAC (minimum alveolar anesthetic concentration). Animals were killed 7 h, 1 day, 4 days, or 7 days after reperfusion (n = 10/group/time point). The area of cerebral infarction was measured by image analysis in a hematoxylin and eosin stained section. In three adjacent sections, apoptotic neurons were identified by TUNEL staining and immunostaining for active caspase-9 and caspase-3. Infarct size was smaller in the isoflurane group than the awake group 7 h, 1 day, and 4 days after reperfusion (P awake versus isoflurane group. After a recovery period of 4 or 7 days, the number of apoptotic cells in the isoflurane group was more than in the awake group. After 7 days, the number of caspase-3 and -9 positive neurons was more in the isoflurane group (P < 0.05). The data indicate that isoflurane delays but does not prevent the development of cerebral infarction caused by ischemia. Isoflurane reduced the development of apoptosis early after ischemia but did not prevent it at later stages of postischemic

  20. Neonatal Repeated Exposure to Isoflurane not Sevoflurane in Mice Reversibly Impaired Spatial Cognition at Juvenile-Age.

    Science.gov (United States)

    Liu, Jianhui; Zhao, Yanhong; Yang, Junjun; Zhang, Xiaoqing; Zhang, Wei; Wang, Peijun

    2017-02-01

    Inhalation anesthetics facilitate surgical procedures in millions of children each year. However, animal studies demonstrate that exposure to the inhalation anesthetic isoflurane may cause neuronal cell death in developing brains. The long-term cytotoxic effects of sevoflurane, the most popular pediatric anesthetic, have not been compared with isoflurane. Thus, this study was designed to compare the effects of equipotent doses of these two anesthetics on neonatal long-term neurotoxicity. Postnatal 7-day-old (P7) C57/BL male mice were exposed to 1.5% isoflurane or 2.2% sevoflurane 2 h a day for 3 days. Non-anesthetized mice served as controls. The effects of anesthesia on learning and memory were assessed using the Morris Water Maze (MWM) at Postnatal days 30 (P30) and P60 respectively. The hippocampal content of N-methyl-D-aspartate receptor subunits (NMDA), brain-derived neurotrophic factor (BDNF), and synaptophysin (Syn) were determined by Western Blot. Neuron structure and apoptosis were assessed via Nissl and TUNEL staining, respectively. The isoflurane group exhibited cognitive impairment at P30. Repeated inhalation of isoflurane or sevoflurane caused different degrees of apoptosis and damaged hippocampal neurons in neonatal mice, particularly isoflurane. In neonatal mice, repeated exposure to isoflurane, but not sevoflurane, caused spatial cognitive impairments in juvenile mice. Our findings suggest that isoflurane induces significantly greater neurodegeneration than an equipotent minimum alveolar concentration of sevoflurane.

  1. Effects of different general anesthetics on serum hemolysis and hepatic and muscular glycogenolysis in rats

    Directory of Open Access Journals (Sweden)

    E.F.A. Machado

    2009-11-01

    Full Text Available Anesthetics can affect the structure and biological function of tissues and systems differentially. The aim of the present study was to compare three injectable anesthetics generally used in experiments with animals in terms of the degree of hemolysis and glycogenolysis occurring after profound anesthesia. Twenty-four male Wistar rats (330-440 g were divided into three groups (N = 8: chloral hydrate (CH, ketamine + xylazine (KX, Zoletil 50® (zolazepam and tiletamine + xylazine (ZTX. After deep anesthesia, total blood was collected. The liver and white (WG and red gastrocnemius (RG muscles were also immediately removed. The degree of serum hemolysis was quantified on the basis of hemoglobin concentration (g/L. Hepatic and muscular glycogen concentrations (mmol/kg wet tissue were quantified by the phenol-sulfuric method. The CH and KX groups exhibited serum hemolysis (4.0 ± 2.2 and 1.9 ± 0.9 g/L, respectively; P < 0.05 compared to the ZTX group, which presented none. Only KX induced elevated glycogenolysis (mmol/kg wet tissue in the liver (86.9 ± 63.2 and in WG (18.7 ± 9.0 and RG (15.2 ± 7.2; P < 0.05. The CH and ZTX groups exhibited no glycogenolysis in the liver (164.4 ± 41.1 and 176.8 ± 54.4, respectively, WG (28.8 ± 4.4, 32.0 ± 6.5, respectively or RG (29.0 ± 4.9; 25.3 ± 8.6, respectively. Our data indicate that ZTX seems to be an appropriate general anesthetic for studies that seek to simultaneously quantify the concentration of glycogen and serum biochemical markers without interferences. ZTX is reasonably priced, found easily at veterinary markets, quickly induces deep anesthesia, and presents a low mortality rate.

  2. Effects of different general anesthetics on serum hemolysis and hepatic and muscular glycogenolysis in rats.

    Science.gov (United States)

    Machado, E F A; Normand, A C R; Nunes, L A S; Brenzikofer, R; Macedo, D V

    2009-11-01

    Anesthetics can affect the structure and biological function of tissues and systems differentially. The aim of the present study was to compare three injectable anesthetics generally used in experiments with animals in terms of the degree of hemolysis and glycogenolysis occurring after profound anesthesia. Twenty-four male Wistar rats (330-440 g) were divided into three groups (N = 8): chloral hydrate (CH), ketamine + xylazine (KX), Zoletil 50(R) (zolazepam and tiletamine) + xylazine (ZTX). After deep anesthesia, total blood was collected. The liver and white (WG) and red gastrocnemius (RG) muscles were also immediately removed. The degree of serum hemolysis was quantified on the basis of hemoglobin concentration (g/L). Hepatic and muscular glycogen concentrations (mmol/kg wet tissue) were quantified by the phenol-sulfuric method. The CH and KX groups exhibited serum hemolysis (4.0 +/- 2.2 and 1.9 +/- 0.9 g/L, respectively; P glycogenolysis (mmol/kg wet tissue) in the liver (86.9 +/- 63.2) and in WG (18.7 +/- 9.0) and RG (15.2 +/- 7.2; P glycogenolysis in the liver (164.4 +/- 41.1 and 176.8 +/- 54.4, respectively), WG (28.8 +/- 4.4, 32.0 +/- 6.5, respectively) or RG (29.0 +/- 4.9; 25.3 +/- 8.6, respectively). Our data indicate that ZTX seems to be an appropriate general anesthetic for studies that seek to simultaneously quantify the concentration of glycogen and serum biochemical markers without interferences. ZTX is reasonably priced, found easily at veterinary markets, quickly induces deep anesthesia, and presents a low mortality rate.

  3. Comparative pharmacodynamic modeling of desflurane, sevoflurane and isoflurane.

    NARCIS (Netherlands)

    Kreuer, S.; Bruhn, J.; Wilhelm, W.; Grundmann, U.; Rensing, H.; Ziegeler, S.

    2009-01-01

    BACKGROUND: We compared dose-response curves of the hypnotic effects of desflurane, sevoflurane and isoflurane. In addition, we analyzed the k(e0) values of the different anesthetics. The EEG parameters Bispectral index (BIS, Aspect Medical Systems, Natick, MA, version XP) and Narcotrend index (Moni

  4. Isoflurane induces learning impairment that is mediated by interleukin 1β in rodents.

    Directory of Open Access Journals (Sweden)

    Lin Cao

    Full Text Available Postoperative cognitive decline is a clinical syndrome. Volatile anesthetics are commonly used during surgery. It is conceivable that volatile anesthetics may contribute to postoperative cognitive decline. Isoflurane can impair cognitive functions of animals under certain conditions. However, the mechanisms for this impairment are not clear. Here, male 18-month old Fisher 344 rats or 10-week old mice were exposed to 1.2 or 1.4% isoflurane for 2 h. Our studies showed that isoflurane impaired the cognitive functions of the rats in Barnes maze. Isoflurane-exposed rats had reduced freezing behavior during the training sessions in the fear conditioning test. This isoflurane effect was attenuated by lidocaine, a local anesthetic with anti-inflammatory property. Rats that had training sessions and were exposed to isoflurane 30 min later had freezing behavior similar to that of control animals. Isoflurane increased the expression of interleukin 1β (IL-1β, interleukin-6 and activated caspase 3 in the hippocampus of the 18-month old rats. IL-1β positive staining was co-localized with that of NeuN, a neuronal marker. The increase of IL-1β and activated caspase 3 but not interleukin-6 was attenuated by lidocaine. Isoflurane also impaired the cognitive functions of 10-week old C57BL/6J mice and increased IL-1β in their hippocampi. However, isoflurane did not affect the cognitive functions of IL-1β deficient mice. Our results suggest that isoflurane impairs the learning but may not affect the recall of the aged rats. IL-1β may play an important role in this isoflurane effect.

  5. General anesthetic and the risk of dementia in elderly patients: current insights

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    Hussain M

    2014-09-01

    Full Text Available Maria Hussain,1 Miles Berger,2 Roderic G Eckenhoff,3 Dallas P Seitz1 1Division of Geriatric Psychiatry, Department of Psychiatry, Queen’s University; 2Anesthesiology Department, Duke University Medical Center, Durham, NC, USA; 3Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Abstract: In this review, we aim to provide clinical insights into the relationship between surgery, general anesthesia (GA, and dementia, particularly Alzheimer’s disease (AD. The pathogenesis of AD is complex, involving specific disease-linked proteins (amyloid-beta [Aß] and tau, inflammation, and neurotransmitter dysregulation. Many points in this complex pathogenesis can potentially be influenced by both surgery and anesthetics. It has been demonstrated in some in vitro, animal, and human studies that some anesthetics are associated with increased aggregation and oligomerization of Aß peptide and enhanced accumulation and hyperphosphorylation of tau protein. Two neurocognitive syndromes that have been studied in relation to surgery and anesthesia are postoperative delirium and postoperative cognitive dysfunction, both of which occur more commonly in older adults after surgery and anesthesia. Neither the route of anesthesia nor the type of anesthetic appears to be significantly associated with the development of postoperative delirium or postoperative cognitive dysfunction. A meta-analysis of case-control studies found no association between prior exposure to surgery utilizing GA and incident AD (pooled odds ratio =1.05, P=0.43. The few cohort studies on this topic have shown varying associations between surgery, GA, and AD, with one showing an increased risk, and another demonstrating a decreased risk. A recent randomized trial has shown that patients who received sevoflurane during spinal surgery were more likely to have progression of preexisting mild cognitive impairment compared to

  6. Atmospheric chemistry of isoflurane, desflurane, and sevoflurane

    DEFF Research Database (Denmark)

    Andersen, Mads P. Sulbæk; Nielsen, Ole John; Karpichev, Boris

    2012-01-01

    (sevoflurane) are estimated at 3.2, 14, and 1.1 years, respectively. The 100 year time horizon global warming potentials of isoflurane, desflurane, and sevoflurane are 510, 2540, and 130, respectively. The atmospheric degradation products of these anesthetics are not of environmental concern.......The smog chamber/Fourier-transform infrared spectroscopy (FTIR) technique was used to measure the rate coefficients k(Cl + CF(3)CHClOCHF(2), isoflurane) = (4.5 ± 0.8) × 10(-15), k(Cl + CF(3)CHFOCHF(2), desflurane) = (1.0 ± 0.3) × 10(-15), k(Cl + (CF(3))(2)CHOCH(2)F, sevoflurane) = (1.1 ± 0.1) × 10...

  7. YKL-40 Gene Expression and Plasma Levels of CD30 are not Affected by Isoflurane or Propofol: Pilot Study

    Directory of Open Access Journals (Sweden)

    Shirin Lak

    2016-10-01

    Full Text Available Background: It has been hypothesized that the body's response to anesthesia techniques can increase risk of cancer recurrence and metastatic disease after surgery and also can modulate immune responses. Some acute inflammatory markers have been measured to survey the immunomodulatory effect of anesthesia, but in this research, we studied the plasma level of CD30 and YKL-40 gene expression which can present major changes of the immune system.Materials and Methods: Our study was a controlled before and after study. 34 women with biopsy-proven breast cancer were randomized to receive either propofol general anesthesia (n=17 or standard isoflurane general anesthesia (n=17. There were no significant differences between the two patient groups in age, body weight, and height, length of general anesthesia, operative time and group of surgery. The blood samples were collected in two different sets, before anesthesia and 72-h postoperatively. Soluble CD30 (sCD30 plasma level was measured by ELISA and YKL-40/CHI3L1 gene expression was evaluated by real-time-PCR.Results: The results showed that the anesthetics, propofol and isoflurane, have no effect on the expression of YKL-40. Despite increased in the expression of YKL-40 that was observed in patients receiving isoflurane, this increase was not statistically significant. There was no significant increase or decrease in plasma concentrations of sCD30.Conclusion: YKL-40 and sCD30 are not affected by isoflurane or propofol.  So, in immunological perspective, there is no preference in use of isoflurane or propofol in breast cancer patients.

  8. 全身麻醉药在脊髓内的作用机制%Subcortical mechanisms of general anesthetics

    Institute of Scientific and Technical Information of China (English)

    杨静; 张宏

    2008-01-01

    The spinal cord plays an important role in two general anesthetic end-points: analgesia and immobility in response to a noxious stimulus. The spinal components that may contribute to anesthetic actions include the central termination of sensory primary afferent neurons, interneurones and the cell bodies and initial axon segments of motor neurons, which are contained in dorsal horn and ventral horn respectively. Different general anesthetics have both presynaptic and postsynaptic effects to produce analgesia and immobility via multitude of cellular and subcellular sites identified as potential targets of anaesthetic action, such as diverse ligand-gated ion channels etc. This review will focus on anesthetic targets and molecular mechanisms mediated analgesia and immobility of general anesthetics in spinal cord.%脊髓是全身麻醉药抑制伤害性刺激体动反应和抗伤害效应的重要作用部位,含有不同配体门控离子受体等多个可能介导麻醉效应的靶点.不同药物在脊髓内经各自特异靶点通过多种分子机制发挥作用.现就全身麻醉药制动和镇痛效应在脊髓内的作用位点和分子机制作一综述.

  9. Halothane, isoflurane, xenon, and nitrous oxide inhibit calcium ATPase pump activity in rat brain synaptic plasma membranes

    National Research Council Canada - National Science Library

    Franks, J J; Horn, J L; Janicki, P K; Singh, G

    1995-01-01

    .... For studies of anesthetic effects on PMCA activity, Ca2+ uptake or Pi release was measured in SPM exposed to halothane, isoflurane, xenon, and nitrous oxide at partial pressures ranging from 0 to 1.6 MAC equivalents...

  10. Stereoselectivity of isoflurane in adhesion molecule leukocyte function-associated antigen-1.

    Directory of Open Access Journals (Sweden)

    Weiming Bu

    Full Text Available BACKGROUND: Isoflurane in clinical use is a racemate of S- and R-isoflurane. Previous studies have demonstrated that the effects of S-isoflurane on relevant anesthetic targets might be modestly stronger (less than 2-fold than R-isoflurane. The X-ray crystallographic structure of the immunological target, leukocyte function-associated antigen-1 (LFA-1 with racemic isoflurane suggested that only S-isoflurane bound specifically to this protein. If so, the use of specific isoflurane enantiomers may have advantage in the surgical settings where a wide range of inflammatory responses is expected to occur. Here, we have further tested the hypothesis that isoflurane enantioselectivity is apparent in solution binding and functional studies. METHODS: First, binding of isoflurane enantiomers to LFA-1 was studied using 1-aminoanthracene (1-AMA displacement assays. The binding site of each enantiomer on LFA-1 was studied using the docking program GLIDE. Functional studies employed the flow-cytometry based ICAM binding assay. RESULTS: Both enantiomers decreased 1-AMA fluorescence signal (at 520 nm, indicating that both competed with 1-AMA and bound to the αL I domain. The docking simulation demonstrated that both enantiomers bound to the LFA-1 "lovastatin site." ICAM binding assays showed that S-isoflurane inhibited more potently than R-isoflurane, consistent with the result of 1-AMA competition assay. CONCLUSIONS: In contrast with the x-ray crystallography, both enantiomers bound to and inhibited LFA-1. S-isoflurane showed slight preference over R-isoflurane.

  11. Isoflurane does not cause neuroapoptosis but reduces astroglial processes in young adult mice

    Directory of Open Access Journals (Sweden)

    Dallasen Renee M

    2011-11-01

    Full Text Available Abstract Background Isoflurane, a volatile anesthetic widely used clinically, has been implicated to be both neuroprotective and neurotoxic. The claim about isoflurane causing neural apoptosis remains controversial. In this study, we investigated the effects of isoflurane exposures on apoptotic and anti-apoptotic signals, cell proliferation and neurogenesis, and astroglial processes in young adult mouse brains. Methods Sixty 6-week-old mice were randomly assigned to four anesthetic concentration groups (0 as control and 0.6%, 1.3%, and 2% with four recovery times (2 h and 1, 6, and 14 d after 2-h isoflurane exposure. Immunohistochemistry measurements of activated caspase-3 and Bcl-xl for apoptotic and anti-apoptotic signals, respectively, glial fibrillary acidic protein (GFAP and vimentin for reactive astrocytosis, doublecortin (Dcx for neurogenesis, and BrdU for cell proliferation were performed. Results Contrary to the previous conclusion derived from studies with neonatal rodents, we found no evidence of isoflurane-induced apoptosis in the adult mouse brain. Neurogenesis in the subgranule zone of the dentate gyrus was not affected by isoflurane. However, there is a tendency of reduced cell proliferation after 2% isoflurane exposure. VIM and GFAP staining showed that isoflurane exposure caused a delayed reduction of astroglial processes in the hippocampus and dentate gyrus. Conclusion Two-hour exposure to isoflurane did not cause neuroapoptosis in adult brains. The delayed reduction in astroglial processes after isoflurane exposure may explain why some volatile anesthetics can confer neuroprotection after experimental stroke because reduced glial scarring facilitates better long-term neuronal recoveries.

  12. Selective breeding of mice strains with different sensitivity to isoflurane

    Institute of Scientific and Technical Information of China (English)

    WANG Qian; ZHENG Yi; LU Jing; CHEN Lü; WANG Ju; ZHOU Jian-xin

    2010-01-01

    Background The mechanisms of action of volatile anesthetics are still unknown.Recently, the use of genetics as a means to investigate anesthetic action has increased in scale.However, only limited forward genetic approach studies were performed in mammals, especially with volatile anesthetics as the selection agent.In the present study, a selective breeding process was designed to produce strains of mice with different sensitivity to isoflurane.Methods One hundred and sixty male and female virgin outbred ICR/CD-1 mice at 65-70 days of age were selected as original generation, and the median effective dose (ED50) of inhaled isoflurane were measured by probit analysis with the loss of righting reflex as the endpoint of anesthesia.The most sensitive males and females were selected and mated one another randomly, as with the most resistant males and females.Thus two branches of mice (sensitive and resistant to isoflurane) were created and allowed to produce the next generation.At 65-70 days of age, screening experiment was performed in offspring, by selecting the most sensitive mice in sensitive branch and the most resistant mice in resistant branch.Selected males and females within each branch were mated one another randomly to produce the following generation.The same procedure was performed in the offspring.The process of screening and breeding was repeated for 8 generations, and then strains were conserved by mating the offspring one another randomly within each branch for 3 generations.Each pair of mice was allowed to produce the second litters as a backup, and isoflurane ED50 was measured in mice from the second litters.Results Isoflurane righting reflex ED50s (95% confidence limit (CL)) in original mice were 0.65% (0.58%-0.72%) in females and 0.63% (0.56%-0.69%) in males.After the 4th generation, isoflurane ED50s in resistant branch were significantly higher than those in sensitive branch (P <0.05), for both in females and males.In the 11th generation

  13. Influence of general anesthetics on brain development%全身麻醉药对脑发育的影响

    Institute of Scientific and Technical Information of China (English)

    蒋燕; 陈萍

    2008-01-01

    The mortality of neonatal anesthesia is decreasing with the development of anestheisia. Pharmacological blockade of Nmethyl-D-aspartate (NMDA) type glutamate receptors or over stimulation of γ-aminobutyric acid type A receptors has been reported to induce neuron apoptosis in the period of brain peak development. In view of the mechanisms of general anesthetics on central nervous system, the influence of anesthetic agents on brain development becomes the researching focus. Clarifying the mechanisms of anesthetics affecting brain development is very important for the rational use of anesthetics in neonates, as well as for the exploitation of new anesthetics.%随着麻醉领域的不断发展,新生儿麻醉的死亡率明显下降.一系列的研究表明,在脑发育高峰期,药物性阻断N-甲基-D-天(门)冬氨酸受体或过度激动γ-氨基丁酸A型受体会诱发神经细胞凋亡.鉴于全麻药在中枢神经系统的作用机制,麻醉药物对脑发育的影响成为人们研究的热点,其机制的阐明可能对新生儿麻醉用药的合理选用及新药的开发具有指导意义.

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

    Directory of Open Access Journals (Sweden)

    Vlassakov KV

    2014-12-01

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

  15. Paired assessment of volatile anesthetic concentrations with synaptic actions recorded in vitro.

    Directory of Open Access Journals (Sweden)

    Stuart J McDougall

    Full Text Available The volatile anesthetic isoflurane poses a number of experimental challenges in the laboratory. Due to its rapid evaporation, the open conditions of most in vitro electrophysiological recording systems make the determination of actual isoflurane concentrations a challenge. Since the absolute anesthetic concentration in solution is directly related to efficacy, concentration measurements are important to allow comparisons between laboratory and clinical studies. In this study we quantify the sources of isoflurane loss during experimentation and describe a method for the measurement of isoflurane concentrations using gas chromatography and mass spectrometry simultaneous to in vitro electrophysiological measurements. Serial samples of perfused bath solution allowed correlation of isoflurane concentrations with ongoing biological effects. Saturated physiological solutions contained 13.4 +/- 0.2 mM isoflurane and were diluted to desired "nominal" concentrations for experiments. The perfusion system established stable isoflurane concentrations within the bath by 2 minutes. However, bath isoflurane concentrations varied substantially and unpredictably between experiments. The magnitudes of such discrepancies in isoflurane concentrations spanned clinically important levels. Our studies suggest that, despite countermeasures, solution handling significantly impacted the isoflurane content in the tissue bath. The magnitude of these discrepancies appears to necessitate systematic direct measurement of bath isoflurane concentrations during most in vitro conditions.

  16. Avaliação comparativa entre a anestesia geral com halotano e isoflurano sobre a pressão arterial em cães Comparartive evaluation of the general anesthesia with halothane and isoflurane on the arterial pressure in dogs

    Directory of Open Access Journals (Sweden)

    Cláudio Corrêa Natalini

    2000-06-01

    isoflurane in group II. In both groups, nitrous oxide and oxygen in a 2:1 ratio was used as diluent for the inhalant. After 15 minutes of inhalation anesthesia, arterial blood pressures were recorded with a noninvasive blood pressure monitor in 15 minutes intervals for 90 minutes. Statistical analyses showed that there was a significant difference in systolic and diastolic pressures after 45 minutes. Differences in heart rate were not significant. In dos, general anesthesia with isoflurane maintained higher arterial blood pressures than those anesthetized with halothane which produced arterial hipotension from 45 to 75 minutes of anesthesia.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Enflurane, isoflurane and cyclopropane.

    NARCIS (Netherlands)

    Maclaine Pont, M.A.

    1998-01-01

    The committee recommends the following health based occupational exposure limits: - enflurane: 20 ppm (153 mg/m3) TWA 8 h - isoflurane: 20 ppm (153 mg/m3) TWA 8 h. For cyclopropane no exposure limit can be recommended. For simultaneous exposure to a combination of anaesthetic gases the sum of each s

  19. The minimum alveolar concentration (MAC) of isoflurane in preterm neonates.

    Science.gov (United States)

    LeDez, K M; Lerman, J

    1987-09-01

    Studies in fetal lambs suggested that the minimum alveolar concentration (MAC) in preterm neonates may be less than that in full-term neonates and older infants. To determine the MAC of isoflurane in preterm neonates, 20 patients less than 32 weeks gestation at birth and 16 patients 32-37 weeks gestation at birth, all less than 1 month post-natal age, were studied. Following tracheal intubation, the neonates were anesthetized with a predetermined end-tidal concentration of isoflurane in oxygen and air. The move-no move responses to skin incision were recorded, and MAC was determined using the "up-and-down" technique. Heart rate and systolic arterial pressure were recorded awake, before skin incision, and after skin incision. MAC (mean +/- SD) of isoflurane in preterm neonates less than 32 weeks gestation was 1.28 +/- 0.17%, and MAC in neonates 32-37 weeks gestation was 1.41 +/- 0.18% (P less than 0.05). Although heart rate did not decrease significantly in either group during the study, systolic arterial pressure decreased between 20 and 30% below awake values both before and after skin incision in both age groups (P less than 0.01). We conclude that the MAC of isoflurane in preterm neonates less than 32 weeks gestation is significantly less than that in preterm neonates 32-37 weeks gestation, and that systolic arterial pressure decreases to a similar extent at approximately 1 MAC isoflurane in both age groups.

  20. [Perioperative risk factors and anesthetic management of patients for carotid endarterectomy].

    Science.gov (United States)

    Niinai, H; Nakagawa, I; Shima, T; Kubota, M; Yamada, K; Kamiya, T; Yoshida, A; Yasuda, T

    1997-05-01

    Data from the records of 142 patients for carotid endarterectomy at Chugoku Rosai General Hospital between 1983 and 1995, were evaluated concerning perioperative risk factors and anesthetic management. As a preoperative anesthetic risk, the incidence of hypertension was the commonest (76%), and there was a significant incidence of ischemic heart disease (18%). Fentanyl and isoflurane have been used for anesthesia recently and the patients were closely observed and cared in the intensive care unit postoperatively. In order to prevent cerebral ischemia during the occlusion of the internal carotid artery, we measured somatosensory evoked potential as well as jugular venous oxygen saturation, and used near infrared spectophotometry. As a result, postoperative mortality and morbidity were 0% and 2%, respectively. The candidates for CEA have potentially high perioperative risks, and it is important to evaluate the coexisting diseases and to select proper anesthetic technic and monitors.

  1. The cardiovascular effects of sevoflurane and isoflurane after premedication of healthy dogs undergoing elective surgery.

    Science.gov (United States)

    Abed, Janan M; Pike, Fred S; Clare, Monica C; Brainard, Benjamin M

    2014-01-01

    Sevoflurane and isoflurane are commonly used in veterinary anesthesia. The objective of this prospective, randomized, open-label clinical study was to compare the cardiovascular effects of sevoflurane and isoflurane via direct arterial blood pressure measurements and the lithium dilution cardiac output (LDCO) on premedicated healthy dogs undergoing elective tibial plateau leveling osteotomy (TPLO). Nineteen client-owned dogs were included. All dogs were premedicated with hydromorphone (0.05 mg/kg IV and glycopyrrolate 0.01 mg/kg subcutaneously). Ten dogs were anesthetized with sevoflurane and nine dogs were anesthetized with isoflurane. Eighteen dogs were instrumented with a dorsal pedal arterial catheter, and one dog had a femoral arterial catheter. All dogs had continuous, direct systolic (SAP), diastolic (DAP), and mean arterial (MAP) blood pressure readings as well as heart rate (HR), cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR), systemic vascular resistance index (SVRI), stroke volume variation (SVV), and pulse pressure variation (PPV) recorded q 5 min during the surgical procedure. There was no significant statistical difference in all parameters between the sevoflurane and isoflurane treatment groups. Both sevoflurane and isoflurane inhalant anesthetics appear to have similar hemodynamic effects when used as part of a multimodal anesthetic protocol in premedicated healthy dogs undergoing an elective surgical procedure.

  2. [New anesthetics].

    Science.gov (United States)

    Malamed, S F

    2000-01-01

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

  3. The anesthetic agent as an extra-integumentary foreign body in the respiratory tract. A new theory of general anesthesia.

    Science.gov (United States)

    Baggot, M G

    1977-01-01

    Two cases are cited of patients who sometimes exhibited a condition of temporary unconsciousness which proceeded to spontaneous recovery without harmful sequelae. This type of cerebral arrest is frequently called general anesthesia:however, these patients had not received any drugs. What they did have was an irritant in the respiratory passages as shown by coughing. Three cases of general anesthesia are described wherein the duration of the phenomenon appeared to be partly due to the presence of an extra-integumentary foreign body, confined to the respiratory passages. In this trio there was evidence that the drugs did not affect the patients in any unusual way, whatever their effects on whichever side of the alveolar walls. Many anesthetic agents act like unabsorbable foreign bodies, in that they enter and leave the body unchanged, despite the fact that they do pierce the integument. Of course, almost everything, except inspirable and expirable air, but including anesthetic agents, is a foreign body in the respiratory tract. On the basis of these considerations, I suggest that one way, in which general anesthetic agents work, is an extra-integumentary foreign bodies, causing Reflex Coma by irritating or stimulating the trigger points in the walls of the respiratory tract, thereby arresting the cerebrum.

  4. Relationship of feline bispectral index to multiples of isoflurane minimum alveolar concentration.

    Science.gov (United States)

    Lamont, Leigh A; Greene, Stephen A; Grimm, Kurt A; Tranquilli, William J

    2005-06-01

    The study reported here was done to determine the relationship between bispectral index (BIS) values and minimum alveolar concentration (MAC) multiples of isoflurane in cats. Isoflurane MAC was determined using the tail-clamp method in eight domestic cats. Ten days later, the cats were anesthetized a second time with isoflurane at each of five MAC multiples administered in random order. Ventilation was controlled and, after a 20-min equilibration period at each MAC multiple of isoflurane, BIS data were collected for 5 min and the median BIS value calculated. Data from each isoflurane MAC multiple were compared using analysis of variance for repeated measures, and statistical significance was set at P MAC of isoflurane (mean +/- 1 standard deviation) was 1.8% +/- 0.2%. BIS values at 0.5 MAC could not be recorded due to spontaneous movement in all eight cats. BIS values at 2.0 MAC were confounded by burst suppression in seven of the eight cats. Over the range of 0.8 to 1.5 MAC, BIS values decreased significantly with increasing end-tidal isoflurane concentrations. Mean (+/- 1 standard deviation) BIS measurements were 32 +/- 3 at 0.8 MAC, 20 +/- 4 at 1.0 MAC, and 5 +/- 3 at 1.5 MAC. Therefore, BIS values are inversely and linearly related to end-tidal isoflurane concentrations in anesthetized cats. However, the consistently low BIS values recorded in this study suggest that clinical BIS endpoints used to titrate anesthetic agents in humans may not be applicable to cats.

  5. Isoflurane Use in the Treatment of Super-Refractory Status Epilepticus is Associated with Hippocampal Changes on MRI.

    Science.gov (United States)

    Ikeda, Kristin M; Connors, Robert; Lee, Donald H; Khandji, Alexander G; Claassen, Jan; Young, G Bryan

    2017-06-01

    Refractory status epilepticus (RSE) is associated with high morbidity and mortality. Experts recommend aggressive management with continuous intravenous infusions or inhaled anesthetics such as isoflurane. However, there is concern that MRI changes in RSE reflect isoflurane neurotoxicity. We performed a case-control study to determine whether isoflurane is neurotoxic, based on MRI signal changes. We performed a retrospective case-control study of the incidence of MRI changes in RSE treated with and without isoflurane. Charts were reviewed for demographic and treatment information. T1, T2, and FLAIR sequences of MRIs were reviewed independently by two neuroradiologists blinded to treatment group for presence or absence of signal change or atrophy in the meninges, cortex, white matter, basal ganglia, thalamus, hippocampus, brainstem, and cerebellum. Eight cases of RSE receiving treatment with isoflurane were identified and double-matched with 15 controls who received only intravenous anesthetics. Baseline characteristics were similar. Hippocampal signal change was observed more frequently in cases receiving isoflurane (p = 0.026). Hippocampal signal changes were associated with isoflurane use in patients with RSE. They were also associated with number of seizure days prior to MRI and the use of multiple anesthetic agents. Similar changes have been seen as a result of RSE itself, and one cannot rule out the possibility these changes represent seizure-related effects. If isoflurane-related, these hippocampal signal changes may be the result of a direct neurotoxic effect of prolonged isoflurane use or failure of isoflurane to protect the hippocampus from seizure-induced injury despite achieving electrographic burst-suppression.

  6. 全身麻醉药的安全性研究%The Security Study of General Anesthetics

    Institute of Scientific and Technical Information of China (English)

    赖延锦

    2012-01-01

      全身麻醉药是抑制中枢系统的药物,分为吸入和静脉麻醉药,能使患者意识、感觉和反射暂时消失,有利于外科手术的进行,其临床使用安全性越来越受到人们的关注。本文对几种常见全麻药的安全性进行探讨,确保广大医务人员能合理有效使用该类药品,保证人民的生命健康。%  General anesthetics is the inhibition of central nervous system drugs, it is divided into the inhalation anesthesia and intravenous anesthetics, it can make the patient consciousness, sensation and a reflex disappear temporarily, and it is advantageous to make surgical operation ,people pay more and more attention to the clinical use of security. This paper discusses several common general anesthetics security, it ensures that the medical staff can effectively use the drugs and keep the people healthy.

  7. Analysis of pulmonary surfactant by Fourier transform infrared spectroscopy after exposure to sevoflurane and isoflurane.

    Science.gov (United States)

    Vrbanović Mijatović, Vilena; Šerman, Ljiljana; Gamulin, Ozren

    2017-02-21

    Pulmonary surfactant, consisting primarily of phospholipids and four surfactant-specific proteins, is among the first structures that is exposed to inhalation anesthetics. Consequently, changes of pulmonary surfactant due to this exposure could cause respiratory complications after long anesthetic procedures. Fourier transform infrared (FTIR) spectroscopy was used to explore the effects of two inhalation anesthetics, sevoflurane and isoflurane, on a commercially available pulmonary surfactant. The research was primarily focused on the effect of anesthetics on the lipid component of the surfactant. Four different concentrations of anesthetics were added, and the doses were higher from the low clinical doses typically used. Recorded spectra were analyzed using principal component analysis, and the Student's t-test was performed to confirm the results. The exposure to both anesthetics induced similar changes, consistent with the increase of the anesthetic concentration. The most pronounced effect was on the hydrophilic head group of phospholipids, which is in agreement with the disruption of the hydrogen bond, caused by the anesthetics. A change in the band intensities of CH2 stretching vibrations, indicative of a disordering effect of anesthetics on the hydrophobic tails of phospholipids, was also observed. Changes induced by isoflurane appear to be more pronounced than those induced by sevoflurane. Furthermore, our results suggest that FTIR spectroscopy is a promising tool in studying anesthetic effects on pulmonary surfactant.

  8. A comparison of sevoflurane and isoflurane for short-term anesthesia in polecats (Mustela eversmanni)

    Science.gov (United States)

    Gaynor, J. S.; Wimsatt, J.; Mallinckrodt, C.; Biggins, D. E.

    1997-01-01

    Twenty-four Siberian polecats (Mustela eversmanni) from 12 litters were anesthetized with either inhaled sevoflurane or isoflurane. With 7% delivered sevoflurane and 5% delivered isoflurane, time to loss of righting reflex (mean +/- SE) with sevoflurane (1.9 +/- 0.1 min) was significantly shorter compared with isoflurane (2.6 +/- 0.1 min). During maintenance at a light plane of anesthesia, systolic arterial pressure was significantly higher with sevoflurane (83 +/- 2 mm Hg) compared with isoflurane (66 +/- 2 mm Hg), and heart rate was significantly lower with sevoflurane (191 +/- 3 beats/min) compared with isoflurane (204 +/- 3 beats/min). There was no difference in respiratory rate jugular venous pH, pCO3, HCO3-, base excess, or recovery of righting reflex. Induction of anesthesia is more rapid and blood pressure is better maintained with sevoflurane compared with isoflurane; therefore, sevoflurane may be less stressful and safer. Inhaled sevoflurane should be an appropriate anesthetic for black-footed ferrets (Mustela nigripes) in laboratory and field conditions.

  9. Isoflurane-induced spatial memory impairment in mice is prevented by the acetylcholinesterase inhibitor donepezil.

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    Diansan Su

    Full Text Available Although many studies have shown that isoflurane exposure impairs spatial memory in aged animals, there are no clinical treatments available to prevent this memory deficit. The anticholinergic properties of volatile anesthetics are a biologically plausible cause of cognitive dysfunction in elderly subjects. We hypothesized that pretreatment with the acetylcholinesterase inhibitor donepezil, which has been approved by the Food and Drug Administration (FDA for the treatment of Alzheimer's disease, prevents isoflurane-induced spatial memory impairment in aged mice. In present study, eighteen-month-old mice were administered donepezil (5 mg/kg or an equal volume of saline by oral gavage with a feeding needle for four weeks. Then the mice were exposed to isoflurane (1.2% for six hours. Two weeks later, mice were subjected to the Morris water maze to examine the impairment of spatial memory after exposure to isoflurane. After the behavioral test, the mice were sacrificed, and the protein expression level of acetylcholinesterase (AChE, choline acetylase (ChAT and α7 nicotinic receptor (α7-nAChR were measured in the brain. Each group consisted of 12 mice. We found that isoflurane exposure for six hours impaired the spatial memory of the mice. Compared with the control group, isoflurane exposure dramatically decreased the protein level of ChAT, but not AChE or α7-nAChR. Donepezil prevented isoflurane-induced spatial memory impairments and increased ChAT levels, which were downregulated by isoflurane. In conclusions, pretreatment with the AChE inhibitor donepezil prevented isoflurane-induced spatial memory impairment in aged mice. The mechanism was associated with the upregulation of ChAT, which was decreased by isoflurane.

  10. Isoflurane induced cognitive impairment in aged rats through hippocampal calcineurin/NFAT signaling

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    Ni, Cheng; Li, Zhengqian; Qian, Min; Zhou, Yang; Wang, Jun; Guo, Xiangyang, E-mail: puthmzk@163.com

    2015-05-15

    Calcineurin (CaN) over-activation constrains synaptic plasticity and memory formation. Upon CaN activation, NFAT imports into the nucleus and guides its downstream genes, which also affect neuronal and synaptic function. Aberrant CaN/NFAT signaling involves in neurotoxicity and cognitive impairment in neurological disorders such as Alzheimer's disease, but its role in postoperative cognitive dysfunction (POCD) remains uninvestigated. Inhaled anesthetic isoflurane facilitates the development of POCD, and the present study investigated the role of CaN/NFAT signaling in isoflurane induced cognitive impairment of aged rats, and the therapeutic effects of CaN inhibitor cyclosporine A (CsA). The results indicated that hippocampal CaN activity increased and peaked at 6 h after isoflurane exposure, and NFAT, especially NFATc4, imported into the nucleus following CaN activation. Furthermore, phamacological inhibition of CaN by CsA markedly attenuated isoflurane induced aberrant CaN/NFATc4 signaling in the hippocampus, and rescued relevant spatial learning and memory impairment of aged rats. Overall, the study suggests hippocampal CaN/NFAT signaling as the upstream mechanism of isoflurane induced cognitive impairment, and provides potential therapeutic target and possible treatment methods for POCD. - Highlights: • Isoflurane induces hippocampal calcineurin activation. • Isoflurane induces hippocampal NFAT, especially NFATc4, nuclear import. • Cyclosporine A attenuates isoflurane induced aberrant calcineurin/NFAT signaling. • Cyclosporine A rescues isoflurane induced cognitive impairment. • Calcineurin/NFAT signaling is the upstream mechanism of isoflurane induced synaptic dysfunction and cognitive impairment.

  11. Hyperglycolysis is exacerbated after traumatic brain injury with fentanyl vs. isoflurane anesthesia in rats.

    Science.gov (United States)

    Statler, Kimberly D; Janesko, Keri L; Melick, John A; Clark, Robert S B; Jenkins, Larry W; Kochanek, Patrick M

    2003-12-19

    Despite common use of narcotics in the clinical management of severe traumatic brain injury (TBI), in experimental models rats treated with fentanyl have exhibited worse functional outcome and more CA1 hippocampal death than rats treated with standard isoflurane anesthesia. We hypothesized that greater post-traumatic excitotoxicity, reflected by cerebral glucose utilization (CMRglu), may account for detrimental effects of fentanyl vs. isoflurane. Rats were anesthetized with either isoflurane (1% by inhalation) or fentanyl (10 mcg/kg iv bolus then 50 mcg/kg/h infusion). 14C-deoxyglucose autoradiography was performed 45 min after controlled cortical impact (CCI) to left parietal cortex (n=4 per anesthetic group) or in uninjured rats after 45 min of anesthesia (n=3 per anesthetic group). Uninjured rats treated with fentanyl vs. isoflurane showed 35-45% higher CMRglu in all brain structures (panesthesia. This post-traumatic hyperglycolysis suggests greater excitotoxicity and concurs with reports of worse functional outcome and more CA1 hippocampal death after TBI with fentanyl vs. isoflurane anesthesia.

  12. Maternal anesthesia via isoflurane or ether differentially affects pre-and postnatal behavior in rat offspring.

    Science.gov (United States)

    Ronca, April E; Abel, Regina A; Alberts, Jeffrey R

    2007-11-01

    Our understanding of prenatal behavior has been significantly advanced by techniques for direct observation and manipulation of unanesthetized, behaving rodent fetuses with intact umbilical connections to the mother. These techniques involve brief administration of an inhalant anesthesic, enabling spinal transection of the rat or mouse dam, after which procedures can continue with unanesthetized dams and fetuses. Because anesthetics administered to the mother can cross the placental barrier, it is possible that fetuses are anesthetized to varying degrees. We compared in perinatal rats the effects of prenatal maternal exposure to two inhalant anesthetics: ether and isoflurane. Fewer spontaneous fetal movements and first postpartum nipple attachments were observed following maternal exposure to ether as compared to isoflurane. Neonatal breathing frequencies and oxygenation did not account for group differences in nipple attachment. Our results provide evidence that the particular inhalant anesthetic employed in prenatal manipulation studies determines frequencies of perinatal behavior. Copyright 2007 Wiley Periodicals, Inc.

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

    Science.gov (United States)

    Simonsen, Claus Z; Sørensen, Leif H; Juul, Niels; Johnsen, Søren P; Yoo, Albert J; Andersen, Grethe; Rasmussen, Mads

    2016-12-01

    Endovascular therapy after acute ischemic stroke due to large vessel occlusion is now standard of care. There is equipoise as to what kind of anesthesia patients should receive during the procedure. Observational studies suggest that general anesthesia is associated with worse outcomes compared to conscious sedation. However, the findings may have been biased. Randomized clinical trials are needed to determine whether the choice of anesthesia may influence outcome. The objective of GOLIATH (General or Local Anestesia in Intra Arterial Therapy) is to examine whether the choice of anesthetic regime during endovascular therapy for acute ischemic stroke influence patient outcome. Our hypothesis is that that conscious sedation is associated with less infarct growth and better functional outcome. GOLIATH is an investigator-initiated, single-center, randomized study. Patients with acute ischemic stroke, scheduled for endovascular therapy, are randomized to receive either general anesthesia or conscious sedation. The primary outcome measure is infarct growth after 48-72 h (determined by serial diffusion-weighted magnetic resonance imaging). Secondary outcomes include 90-day modified Rankin Scale score, time parameters, blood pressure variables, use of vasopressors, procedural and anesthetic complications, success of revascularization, radiation dose, and amount of contrast media. Choice of anesthesia may influence outcome in acute ischemic stroke patients undergoing endovascular therapy. The results from this study may guide future decisions regarding the optimal anesthetic regime for endovascular therapy. In addition, this study may provide preliminary data for a multicenter randomized trial. © 2016 World Stroke Organization.

  14. Intraocular pressure and its correlation with blood gas parameters in crested caracaras (Caracara plancus anesthetized with isoflurane and sevoflurane Pressão intra-ocular e sua correlação com parâmetros hemogasométricos em caracarás (Caracara plancus anestesiados com isofluorano e sevofluorano

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    A.P. Ribeiro

    2008-12-01

    Full Text Available The intraocular pressure (IOP and its correlations with arterial carbon dioxide partial pressure (PaCO2 and arterial pH were studied in five crested caracaras (Caracara plancus anesthetized with isoflurane (ISO and sevoflurane (SEV. Baseline IOP values were measured in both eyes (M0. Brachial artery was previously catheterized to obtain blood gas and cardiorespiratory analysis. Anesthesia was induced with 5% ISO and maintained with 2.5% for 40 minutes. IOP measurements and blood samples were evaluated in different moments until the end of the procedure. After recovering, a second anesthesia was induced with 6% SEV and maintained with 3.5%. Parameters were evaluated at the same time points of the previous procedure. IOP reduced significantly (P= 0.012 from M0 at all time points and no significative changes were observed between ISO and SEV anesthesias. Correlation between IOP and PaCO2 and between PIO and blood pH were found only for SEV. IOP and blood pH decreased in parallel with IOP, whereas values of PaCO2 increased in caracaras anesthetized with isoflurane and sevoflurane.Avaliou-se a pressão intra-ocular (PIO e estimaram-se as correlações entre PIO e pressão de dióxido de carbono (PaCO2 e pH arterial de cinco caracarás (Caracara plancus, anestesiados com isofluorano (ISO ou sevofluorano (SEV. Valores basais da PIO foram aferidos em ambos os olhos (M0. Cateterizou-se previamente a artéria braquial para obtenção de parâmetros hemogasométricos e cardiorrespiratórios. Anestesia foi induzida com ISO a 5V% e mantida por 40 minutos com 2,5V%. PIO e amostras de sangue foram avaliadas em diferentes momentos até o final do procedimento. Após recuperação, uma segunda anestesia foi realizada com SEV a 6% e mantida com 3,5%. Os parâmetros foram aferidos nos mesmos momentos estabelecidos previamente. A PIO decresceu significativamente (P=0,012 de M0 em todos os momentos e não houve diferença estatística entre ISO e SEV. Correla

  15. The effect of sevoflurane and isoflurane anesthesia on interictal spike activity among patients with refractory epilepsy.

    Science.gov (United States)

    Watts, A D; Herrick, I A; McLachlan, R S; Craen, R A; Gelb, A W

    1999-11-01

    The electrophysiologic effects of sevoflurane are not well characterized in humans. Among patients with refractory epilepsy, this study compared 1) electroencephalographic (EEG) interictal spike activity during wakefulness and sevoflurane anesthesia, and 2) electrocorticographically (ECoG) recorded interictal spike activity during sevoflurane and isoflurane anesthesia. We studied 12 patients undergoing insertion of subdural electrodes. Before commencing anesthesia, awake (baseline) EEG recordings were obtained. After inhaled induction, EEG interictal spike activity was evaluated during stable, normocapnic, and hypocapnic (Paco2 = 28-30 mm Hg), sevoflurane anesthesia administered at 1.5 times the minimum alveolar anesthetic concentration (1.5 MAC). Immediately after surgery, ECoG recordings were obtained from subdural electrodes during 1) 1.5 MAC isoflurane, 2) 0.3 MAC isoflurane, and 3) 1.5 MAC sevoflurane anesthesia. EEG spike frequency increased in all patients during sevoflurane anesthesia compared with awake recordings (P = 0.002). Compared with 0.3 MAC isoflurane anesthesia, ECoG interictal spike frequency was higher in all patients during 1.5 MAC sevoflurane anesthesia (P = 0.004) and in 8 of 10 patients during 1.5 MAC isoflurane anesthesia (P = 0.016). Under sufficiently rigorous conditions, both sevoflurane and isoflurane can provoke interictal spike activity at near burst-suppression doses. This property is more prominent with sevoflurane than isoflurane. The results of this study suggest that the capacity to modulate neuroexcitability is a dose-dependent feature of volatile anesthetics that is manifested most prominently at near burst-suppression doses (i.e., 1.5 times the minimum alveolar anesthetic concentration) and is minimal or absent at low doses.

  16. [Low flow anaesthesia with isoflurane and sevoflurane in the dog].

    Science.gov (United States)

    Kramer, Sabine; Alyakine, Hassan; Nolte, Ingo

    2008-01-01

    The aim of the present study was to compare the safety and efficacy of sevoflurane and isoflurane during low flow anaesthesia (fresh gas flow (FGF) 14 ml/kg/min) as well as to compare the consumption of both anaesthetics. Data were gathered from 60 dogs assigned for surgery under general anaesthesia with an expected duration of 75 minutes or longer. All dogs were induced with 0.6 mg/kg (maximum 25 mg) l-methadone and 1 mg/kg (maximum 25 mg) diazepam i.v.. Anaesthesia was maintained with isoflurane (group 1) or sevoflurane (group 2) in a mixture with 50% O2 and 50% N2O as carrier gases, under controlled ventilation. Monitoring included electrocardiogram, body temperature, the temperature of in- and exspired gases, arterial oxygen saturation, arterial blood pressure as well as a continuous monitoring of inhaled and exhaled gas concentrations (O2, N2O, CO2, isoflurane, sevoflurane). The consumption of isoflurane and sevoflurane as well as the dogs' recovery times were evaluated for both groups. In all groups the inspired oxygen concentrations ranged above the minimum value of 30 Vol% during low flow anaesthesia, with an arterial oxygen saturation above 97%. End tidal concentration of CO2, heart rate and arterial blood pressure were within the physiological ranges and showed no differences between the two groups. Recovery time was significantly shorter after sevoflurane compared to isoflurane anaesthesia, whilst the consumption of sevoflurane was higher than that of isoflurane. Sevoflurane appears to be as clinically safe as isoflurane in low flow anaesthesia. Even considering that sevoflurane is more expensive than isoflurane, the use of the low flow technique decreases the cost of anaesthesia due to the reduced volatile anaesthetic consumption.

  17. Anesthetics impact the resolution of inflammation.

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    Nan Chiang

    Full Text Available BACKGROUND: Local and volatile anesthetics are widely used for surgery. It is not known whether anesthetics impinge on the orchestrated events in spontaneous resolution of acute inflammation. Here we investigated whether a commonly used local anesthetic (lidocaine and a widely used inhaled anesthetic (isoflurane impact the active process of resolution of inflammation. METHODS AND FINDINGS: Using murine peritonitis induced by zymosan and a systems approach, we report that lidocaine delayed and blocked key events in resolution of inflammation. Lidocaine inhibited both PMN apoptosis and macrophage uptake of apoptotic PMN, events that contributed to impaired PMN removal from exudates and thereby delayed the onset of resolution of acute inflammation and return to homeostasis. Lidocaine did not alter the levels of specific lipid mediators, including pro-inflammatory leukotriene B(4, prostaglandin E(2 and anti-inflammatory lipoxin A(4, in the cell-free peritoneal lavages. Addition of a lipoxin A(4 stable analog, partially rescued lidocaine-delayed resolution of inflammation. To identify protein components underlying lidocaine's actions in resolution, systematic proteomics was carried out using nanospray-liquid chromatography-tandem mass spectrometry. Lidocaine selectively up-regulated pro-inflammatory proteins including S100A8/9 and CRAMP/LL-37, and down-regulated anti-inflammatory and some pro-resolution peptides and proteins including IL-4, IL-13, TGF-â and Galectin-1. In contrast, the volatile anesthetic isoflurane promoted resolution in this system, diminishing the amplitude of PMN infiltration and shortening the resolution interval (Ri approximately 50%. In addition, isoflurane down-regulated a panel of pro-inflammatory chemokines and cytokines, as well as proteins known to be active in cell migration and chemotaxis (i.e., CRAMP and cofilin-1. The distinct impact of lidocaine and isoflurane on selective molecules may underlie their opposite

  18. Vitamin C Attenuates Isoflurane-Induced Caspase-3 Activation and Cognitive Impairment.

    Science.gov (United States)

    Cheng, Baiqi; Zhang, Yiying; Wang, Arthur; Dong, Yuanlin; Xie, Zhongcong

    2015-12-01

    Anesthetic isoflurane has been reported to induce caspase-3 activation. The underlying mechanism(s) and targeted intervention(s), however, remain largely to be determined. Vitamin C (VitC) inhibits oxidative stress and apoptosis. We therefore employed VitC to further determine the up-stream mechanisms and the down-stream consequences of the isoflurane-induced caspase-3 activation. H4 human neuroglioma cells overexpressed human amyloid precursor protein (H4-APP cells) and rat neuroblastoma cells were treated either with (1) 2% isoflurane or (2) with the control condition, plus saline or 400 μM VitC for 3 or 6 h. Western blot analysis and fluorescence assay were utilized at the end of the experiments to determine caspase-3 activation, levels of reactive oxygen species and ATP, and mitochondrial function. The interaction of isoflurane (1.4% for 2 h) and VitC (100 mg/kg) on cognitive function in mice was also assessed in the fear conditioning system. Here, we show for the first time that the VitC treatment attenuated the isoflurane-induced caspase-3 activation. Moreover, VitC mitigated the isoflurane-induced increases in the levels of reactive oxygen species, opening of mitochondrial permeability transition pore, reduction in mitochondrial membrane potential, and the reduction in ATP levels in the cells. Finally, VitC ameliorated the isoflurane-induced cognitive impairment in the mice. Pending confirmation from future studies, these results suggested that VitC attenuated the isoflurane-induced caspase-3 activation and cognitive impairment by inhibiting the isoflurane-induced oxidative stress, mitochondrial dysfunction, and reduction in ATP levels. These findings would promote further research into the underlying mechanisms and targeted interventions of anesthesia neurotoxicity.

  19. High Glucose Enhances Isoflurane-Induced Neurotoxicity by Regulating TRPC-Dependent Calcium Influx.

    Science.gov (United States)

    Liu, ZhongJie; Ma, ChangQing; Zhao, Wei; Zhang, QingGuo; Xu, Rui; Zhang, HongFei; Lei, HongYi; Xu, ShiYuan

    2017-01-06

    Isoflurane is a commonly used inhalational anesthetic that can induce neurotoxicity via elevating cytosolic calcium (Ca(2+)). High glucose regulates the expression of a family of non-selective cation channels termed transient receptor potential canonical (TRPC) channels that may contribute to Ca(2+) influx. In the present study, we investigated whether high glucose enhances isoflurane-induced neurotoxicity by regulating TRPC-dependent Ca(2+) influx. First, we evaluated toxic damage in mice primary cultured hippocampal neurons and human neuroblastoma cells (SH-SY5Y cells) after hyperglycemia and isoflurane exposure. Next, we investigated cytosolic Ca(2+) concentrations, TRPC mRNA expression levels and tested the effect of the TRPC channel blocker SKF96365 on cytosolic Ca(2+) levels in cells treated with high glucose or/and isoflurane. Finally, we employed knocked down TRPC6 to demonstrate the role of TRPC in high glucose-mediated enhancement of isoflurane-induced neurotoxicity. The results showed that high glucose could enhance isoflurane-induecd toxic damage in primary hippocampal neurons and SH-SY5Y cells. High glucose enhanced the isoflurane-induced increase of cytosolic Ca(2+) in SH-SY5Y cells. High glucose elevated TRPC mRNA expression, especially that of TRPC6. SKF96365 and knock down of TRPC6 were able to inhibit the high glucose-induced increase of cytosolic Ca(2+) and decrease isoflurane-induced neurotoxicity in SH-SY5Y cells cultured with high glucose. Our findings indicate that high glucose could elevate TRPC expression, thus increasing Ca(2+) influx and enhancing isoflurane-induced neurotoxicity.

  20. 速眠新和异氟烷对蟒蛇的全麻效果研究%Research on Sumianxin and Isoflurane Anesthesia for Burmese Python

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    刘建才; 曹婷; 于萍; 张建省; 刘雅芳; 张立岭

    2012-01-01

    本试验通过使用速眠新和异氟烷两种常用全身麻醉剂对缅甸蟒的麻醉效果进行了研究.对15条蟒蛇肌肉注射和腹腔注射(0.1、0.2、0.4 mL/kg)速眠新麻醉剂和对6条蟒蛇使用异氟烷吸人性麻醉后,进行麻醉效果的评估.试验结果表明,常规动物2~4倍的速眠新Ⅱ注射剂对蟒蛇的麻醉效果不明显;4%的异氟烷吸人性麻醉剂可用于蟒蛇的诱导麻醉,2.5%的异氟烷可用于蟒蛇的维持麻醉,其麻醉效果显著,具有诱导麻醉迅速、维持麻醉稳定、肌松作用好、安全性高、可控性强、苏醒快、副作用小等优点.结果显示,异氟烷吸人性麻醉剂可运用于蟒蛇的临床麻醉保定中.%To evaluate the efficacy and safety of general anesthesia with Sumianxin vs isoflurane in Burmese python (Python molurus bivittatus). 15 pythons were anesthetized with Sumianxin- TJ (0. 1, 0. 2, 0. 4 mL/kg) I. M. And I. P. , 6 pythons were anesthetized with isoflurane inhalation. Analgesic effecti righting reflex, breathing, muscle relaxation, time of anesthesia induction, time of recovery from anesthesia, side effects were recorded. High doses of Sumianxin-U which is 2-4 times higher than that used in conventional animals did not show good anesthetic efficacy. In contrast, isoflurane when used 4% for anesthesia induction and 2. 5% for maintenance showed satisfactory efficacy with notable advantages of induction rapidly, good anesthetic efficacy, muscle relaxation, high safety, recovery quickly and less side effects etc. Isoflurane inhalation anesthesia can be used clinically in pythons safely and effectively.

  1. Inhaled anesthetics have hyperalgesic effects at 0.1 minimum alveolar anesthetic concentration.

    Science.gov (United States)

    Zhang, Y; Eger, E I; Dutton, R C; Sonner, J M

    2000-08-01

    We investigated the hyperalgesic (antianalgesic) effect of the inhaled anesthetics isoflurane, halothane, nitrous oxide, and diethyl ether, or the nonimmobilizer 1, 2-dichlorohexafluorocyclobutane at subanesthetic partial pressures (or, for the nonimmobilizer, subanesthetic partial pressures predicted from lipid solubility) in rats. Hyperalgesia was assessed as a decrease in the time to withdrawal of a rat hind paw exposed to heat. All four anesthetics, including nitrous oxide and diethyl ether, produced hyperalgesia at low partial pressures, with a maximal effect at 0.1 minimum alveolar anesthetic concentration (MAC) required to prevent response to movement in 50% of animals, and analgesia (an increased time to withdrawal of the hind paw) at 0. 4 to 0.8 MAC. The nonimmobilizer had neither analgesic nor hyperalgesia effects. We propose that inhaled anesthetics with a higher MAC-Awake (the MAC-fraction that suppresses appropriate responsiveness to command), such as nitrous oxide and diethyl ether, can be used as analgesics because patients are conscious at higher anesthetic partial pressures, including those which have analgesic effects, whereas anesthetics with a lower MAC-Awake do not produce analgesic effects at concentrations that permit consciousness. The inhaled anesthetics isoflurane, halothane, nitrous oxide, and diethyl ether produce antianalgesia at subanesthetic concentrations, with a maximal effect at approximately one-tenth the concentration required for anesthesia. This effect may enhance perception of pain when such small concentrations are reached during recovery from anesthesia.

  2. Cardiac Dysrhythmias with General Anesthesia during Dental Surgery

    OpenAIRE

    Rodrigo, Chandra R.

    1988-01-01

    Dysrhythmias with general anesthesia during dental surgery have been frequently reported. The incidence appears higher in spontaneously breathing patients lightly anesthetized with halothane. Anxiety, sitting posture, hypoxia, Chinese race, and heart disease appear to aggravate the condition. Use of beta blockers or lidocaine prior to anesthesia, intravenous induction, controlled ventilation with muscle relaxants, and use of isoflurane or enflurane in spontaneously breathing patients appear t...

  3. COMPARISON OF ISOFLURANE AND SEVOFLURANE ANESTHESIA IN HOLSTEIN CALVES FOR PLACEMENT OF PORTAL AND JUGULAR VEIN CANNULAS

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    Glen Sellers

    2013-01-01

    Full Text Available Isoflurane and sevoflurane are the two most commonly used inhalation anesthetics in veterinary medicine today. This study compared the anesthetic effects between isoflurane and sevoflurane in 17 calves undergoing surgery for placement of portal and jugular vein cannulas. Using a randomized control trial, calves were assigned to receive sevoflurane or isoflurane. Anesthesia was induced with xylazine and ketamine then maintained with the assigned inhalation anesthetic. Parameters for heart rate, respiratory rate, indirect blood pressures, oxygen hemoglobin saturation and end-tidal carbon dioxide were monitored and recorded during surgery. The anesthetic concentrations of the vaporizers were adjusted according to the calves’ responses, e.g., blood pressure, eye position, respiratory and heart rate, to surgical stimulation. Upon discontinuation of the inhalation anesthetic, calves were placed in sternal recumbency and recovery variables including time to extubation, time to first movement, attempts to stand and time to standing were observed and recorded. Statistical analysis was performed using a two-sample t-test on the recorded variables. There were no statistical differences between isoflurane and sevoflurane for any of the parameters recorded during anesthetic maintenance or recovery. The results of this study showed a faster time to first movement and extubation, 3.38±1.85 min and 11.75±3.73 min for sevoflurane compared to 7.56±5.34 min and 15.56±8.69 min for isoflurane, respectively. Attempts to stand were 3.00±2.14 for sevoflurane and 3.22±1.79 for isoflurane. Though the time to standing during recovery was not statistically different between anesthetics, the values did indicate a quicker trend of recovery from sevoflurane. Both inhalation anesthetics produced comparable anesthetic qualities and there were no statistical differences between the parameters recorded during maintenance of anesthesia. On the basis of the

  4. Disparity of isoflurane effects on left and right ventricular afterload and hydraulic power generation in swine.

    Science.gov (United States)

    Heerdt, P M; Gandhi, C D; Dickstein, M L

    1998-09-01

    The interaction between myocardial and vascular effects of anesthetics has a potential impact on how these drugs influence performance of the heart. Most studies have focused on volatile anesthetic effects on the left ventricle (LV) and systemic circulation. Whether the right ventricle (RV) and pulmonary circulation respond in a similar fashion, however, is unclear. In the present study, we therefore examined the dose-related effects of isoflurane on LV and RV contractility and total afterload and related changes to simultaneous effects on the hydraulic power generated by each chamber. Two groups of swine were studied: one received no additional treatment before isoflurane (ISO, n = 6), and the other received hexamethonium, atropine, and propranolol to produce autonomic blockade before isoflurane administration (ISO+AB, n = 4). For each experiment, measurements were made of RV and LV regional segment lengths and pressures, along with proximal aortic and pulmonary arterial (PA) blood flow and pressure during the administration of 0, 0.5, 1.0, and 1.5 minimum alveolar anesthetic concentration (MAC) isoflurane. Contractility was assessed by calculating the regional preload recruitable stroke work slope (PRSW). Afterload was characterized in both nonpulsatile and pulsatile terms by calculating aortic input impedance magnitude (Z). From these data, total arterial resistance (R), characteristic impedance (ZC), and vascular compliance (C) were determined with reference to a three-element Windkessel model of the circulation. Additionally, steady-state (WSS), oscillatory (WOS), and total (WT) hydraulic power output of each ventricle was calculated. In the ISO group, isoflurane produced a nearly threefold greater decrease of peak systolic pressure in the LV than in the RV, yet the dose-related decrease of regional PRSW was virtually the same in both chambers. In the aorta, isoflurane produced a maximal 25% reduction in R at 1.0 MAC and doubled C without a significant change

  5. Cerebral awakening concentration of sevoflurane and isoflurane predicted during slow and fast alveolar washout.

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    Katoh, T; Suguro, Y; Kimura, T; Ikeda, K

    1993-11-01

    We studied 49 patients of ASA physical status I to determine cerebral anesthetic concentration on awakening calculated with end-tidal anesthetic concentration, when the end-tidal concentration decreased spontaneously. We also attempted to explain the difference in the average of the bracketing alveolar anesthetic concentration that allows and prevents the response to verbal command during recovery from anesthesia (MAC-Awake) between slow and fast alveolar washout by comparing the cerebral anesthetic concentrations with MAC-Awake determined by fast and slow washout. Slow washout was obtained by decreasing anesthetic concentrations in predetermined steps of 15 min, assuming equilibration between brain and alveolar partial pressures. Fast alveolar washout was obtained by discontinuation of the inhaled anesthetic, which had been maintained at 0.5 minimum alveolar anesthetic concentration (MAC) for at least 15 min. MAC-Awake values for sevoflurane and isoflurane obtained by slow washout were 0.34 +/- 0.05 and 0.31 +/- 0.05 (mean +/- SD), respectively, when MAC-Awake was expressed as a ratio to age-adjusted MAC. MAC-Awake values obtained by fast washout (0.22 +/- 0.07 MAC for sevoflurane, 0.22 +/- 0.05 MAC for isoflurane) were significantly smaller than those obtained by slow washout. Anesthetic concentrations in the brain at first eye opening calculated with end-tidal concentrations during fast alveolar washout (0.34 +/- 0.08 MAC for sevoflurane, 0.30 +/- 0.08 MAC for isoflurane) were nearly equal to MAC-Awake obtained by slow alveolar washout. The difference in MAC-Awake between fast and slow alveolar washout could be explained by arterial-to-cerebral and end-tidal-to-arterial anesthetic differences.

  6. Physiological alteration, quality of anesthesia and economy of isoflurane in domestic chickens (Gallus domesticus).

    Science.gov (United States)

    Deori, Parag; Sarma, Kushal Konwar; Nath, Parsha Jyoti; Singh, Chandan Kumar; Nath, Rita

    2017-05-01

    Aim of the study was to evaluate the effect of isoflurane anesthesia on physiological parameters, assessment of anesthetic qualities, and economy of use of isoflurane in domestic chickens (Gallus domesticus). In this study, 18 apparently healthy adult domestic chickens were selected randomly and divided into three groups. The birds were anesthetized by masked induction with isoflurane at a dose rate of 3.5%, 4%, and 5% and were maintained with 1.5%, 2%, and 2.5% isoflurane with oxygen by endotracheal intubation in Groups I, II, and III, respectively. Physiological parameters, viz., cloacal temperature, heart rate, and respiration rate were recorded at 0, 5, 10, 20, 30, 40, 50, and 60 min. The quality of anesthesia was assessed on the basis of induction time, induction behavior, quality of sedation, production of analgesia, degree of muscle relaxation, palpebral reflex, recovery time, and recovery behavior. The economy of anesthesia was calculated in terms of quantity of isoflurane utilized during 60 min of study. Statistical analysis was performed by analysis of variance, Duncan's multiple range tests. There was significant decrease (peconomy without causing any deleterious effect on the birds. The physiological parameters observed in this study can serve as reference values for the wild and endangered birds.

  7. Precautionary practices for administering anesthetic gases: A survey of physician anesthesiologists, nurse anesthetists and anesthesiologist assistants.

    Science.gov (United States)

    Boiano, James M; Steege, Andrea L

    2016-10-02

    Scavenging systems and administrative and work practice controls for minimizing occupational exposure to waste anesthetic gases have been recommended for many years. Anesthetic gases and vapors that are released or leak out during medical procedures are considered waste anesthetic gases. To better understand the extent recommended practices are used, the NIOSH Health and Safety Practices Survey of Healthcare Workers was conducted in 2011 among members of professional practice organizations representing anesthesia care providers including physician anesthesiologists, nurse anesthetists, and anesthesiologist assistants. This national survey is the first to examine self-reported use of controls to minimize exposure to waste anesthetic gases among anesthesia care providers. The survey was completed by 1,783 nurse anesthetists, 1,104 physician anesthesiologists, and 100 anesthesiologist assistants who administered inhaled anesthetics in the seven days prior to the survey. Working in hospitals and outpatient surgical centers, respondents most often administered sevoflurane and, to a lesser extent desflurane and isoflurane, in combination with nitrous oxide. Use of scavenging systems was nearly universal, reported by 97% of respondents. However, adherence to other recommended practices was lacking to varying degrees and differed among those administering anesthetics to pediatric (P) or adult (A) patients. Examples of practices which increase exposure risk, expressed as percent of respondents, included: using high (fresh gas) flow anesthesia only (17% P, 6% A), starting anesthetic gas flow before delivery mask or airway mask was applied to patient (35% P; 14% A); not routinely checking anesthesia equipment for leaks (4% P, 5% A), and using a funnel-fill system to fill vaporizers (16%). Respondents also reported that facilities lacked safe handling procedures (19%) and hazard awareness training (18%). Adherence to precautionary work practices was generally highest among

  8. Is general anesthesia a risk for myocardium? Effect of anesthesia on myocardial function as assessed by cardiac troponin-i in two different groups (isofluran+N2O inhalation and propofol+fentanyl iv anesthesia

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    Demet Dogan Erol

    2007-11-01

    Full Text Available Demet Dogan Erol1, Ibrahim Ozen21Department of Anaesthesiology and Reanimation, School of Medicine, Kocatepe University, Afyonkarahisar, Turkey; 2Department of Anaesthesiology and Reanimation, Karadeniz Technical University Faculty of Medicine, Trabzon, TurkeyBackground and objectives: Peroperative myocardial infarction (MI is the most common cause of morbidity and mortality. What is the role of general anesthesia in this process? Is general anesthesia a risk for myocardial infarction? The present study was designed to determine whether the measurement of serum levels of cardiac troponin I (cTnI, a highly sensitive and specific marker for cardiac injury, would help establish the diagnosis of myocardial infarction in two different types of anesthesia.Method: Elective abdominal hysterectomy was planned with the permission of the ethic committee in 40 patients who were 20–45 years range, in ASA-I group, and have a Goldman Cardiac Risk Index-0. The patients were divided into two groups. Isoflurane + N2O was administrated to first group, and Propofol + Fentanyl to second group. cTnI levels were determined before anesthesia, after induction before surgery and 9 hours after the second period respectively.Results: There was no significant difference between the groups by the means of demographic properties, hemodynamic parameters and cTnI levels, and the cTnI levels were determined under the basal levels in all samples.Conclusion: General anesthesia is not a risk for myocardial infarction to state eliminating risk factors and protection hemodynamia cardiac.Keywords: cardiac troponin-I, myocardial infarction, isofluran + N2O inhalation anesthesia, propofol + fentanyl intravenous anesthesia.

  9. The minimum alveolar concentration (MAC) and hemodynamic effects of halothane, isoflurane, and sevoflurane in newborn swine.

    Science.gov (United States)

    Lerman, J; Oyston, J P; Gallagher, T M; Miyasaka, K; Volgyesi, G A; Burrows, F A

    1990-10-01

    To determine the minimum alveolar concentration (MAC) and hemodynamic responses to halothane, isoflurane, and sevoflurane in newborn swine, 36 fasting swine 4-10 days of age were anesthetized with one of the three volatile anesthetics in 100% oxygen. MAC was determined for each swine. Carotid artery and internal jugular catheters were inserted and each swine was allowed to recover for 48 h. After recovery, heart rate (HR), systemic systolic arterial pressure (SAP), and cardiac index (CI) were measured awake and then at 0.5, 1.0, and 1.5 MAC of the designated anesthetic in random sequence. The (mean +/- SD) MAC for halothane was 0.90 +/- 0.12%; the MAC for isoflurane was 1.48 +/- 0.21%; and the MAC for sevoflurane was 2.12 +/- 0.39%. Awake (mean +/- SD) measurements of HR, SAP, and CI did not differ significantly among the three groups. Compared to the awake HR, the mean HR decreased 35% at 1.5 MAC halothane (P less than 0.001), 19% at 1.5 MAC isoflurane (P less than 0.005), and 31% at 1.5 MAC sevoflurane (P less than 0.005). Compared to awake SAP, mean SAP measurements decreased 46% at 1.5 MAC halothane (P less than 0.001), 43% at 1.5 MAC isoflurane (P less than 0.001), and 36% at 1.5 MAC sevoflurane (P less than 0.005). Mean SAP at 1.0 and 1.5 MAC halothane and isoflurane were significantly less than those measured at equipotent concentrations of sevoflurane (P less than 0.005). Compared to awake CI, mean CI measurements decreased 53% at 1.5 MAC halothane (P less than 0.001) and 43% at 1.5 MAC isoflurane (P less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Isoflurane compared with fentanyl-midazolam-based anesthesia in patients undergoing heart transplantation

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    Hsu, Che-Hao; Hsu, Yung-Chi; Huang, Go-Shine; Lu, Chih-Cherng; Ho, Shung-Tai; Liaw, Wen-Jinn; Tsai, Yi-Ting; Lin, Chih-Yuan; Tsai, Chien-Sung; Lin, Tso-Chou

    2016-01-01

    Abstract Inhalation anesthetics provide myocardial protection for cardiac surgery. This study was undertaken to compare the perioperative effects between isoflurane and fentanyl-midazolam-based anesthesia for heart transplantation. A retrospective cohort study was conducted by reviewing the medical records of heart transplantation in a single medical center from 1990 to 2013. Patients receiving isoflurane or fentanyl-midazolam-based anesthesia were included. Those with preoperative severe pulmonary, hepatic, or renal comorbidities were excluded. The perioperative variables and postoperative short-term outcomes were analyzed, including blood glucose levels, urine output, inotropic use, time to extubation, and length of stay in the intensive care units. After reviewing 112 heart transplantations, 18 recipients with fentanyl-midazolam-based anesthesia, and 29 receiving isoflurane anesthesia with minimal low-flow technique were analyzed. After cessation of cardiopulmonary bypass, recipients with isoflurane anesthesia had a significantly lower mean level and a less increase of blood glucose, as compared with those receiving fentanyl-based anesthesia. In addition, there was less use of dobutamine upon arriving the intensive care unit and a shorter time to extubation after isoflurane anesthesia. Compared with fentanyl-midazolam-based anesthesia, isoflurane minimal low-flow anesthesia maintained better perioperative homeostasis of blood glucose levels, less postoperative use of inotropics, and early extubation time among heart-transplant recipients without severe comorbidities. PMID:27583900

  11. EEG entropy values during isoflurane, sevoflurane and halothane anesthesia with and without nitrous oxide.

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    Prabhakar, Hemanshu; Ali, Zulfiqar; Bithal, Parmod K; Singh, Gyaninder P; Laithangbam, Pradip K; Dash, Hari H

    2009-04-01

    We hypothesized that like bispectral index, entropy may be anesthetic agent specific. We carried out a study to assess the entropy values of different anesthetics at equi-minimal alveolar concentrations (MACs) with air and nitrous oxide as carrier gases. Thirty adult patients undergoing spine surgery were randomized to receive halothane, isoflurane, or sevoflurane, in 2 stages, (a) with air/oxygen mixture (2:1) and (b) in nitrous oxide/oxygen (2:1). Heart rate, mean arterial blood pressure, response entropy (RE), and state entropy (SE) were noted at 1.0 and 1.5 MACs for each agent. Statistical analysis was done using the 2-way analysis of variance followed by Bonferroni correction and Student t test for paired data. P value of less than 0.05 were considered significant. The demographics and baseline values of heart rate, mean arterial blood pressure, RE, and SE were comparable. Changing from air/oxygen as carrier gas to 66% nitrous oxide in oxygen resulted in significant increase in both RE and SE at 1.0 MAC for all the agents (Psevoflurane and isoflurane (P0.05). Again the values of RE and SE remained high for halothane as compared with isoflurane and sevoflurane. In conclusion, our data suggest a possibility of misinterpretation of anesthetic hypnosis when entropy values increase with addition of nitrous oxide to 1 MAC isoflurane and sevoflurane.

  12. COMPARISON OF ONDANSETRON IN TWO DIFFERENT DOSES IN THE REDUCTION OF POST ANESTHETIC SHIVERING AFTER GENERAL ANESTHESIA

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    Umar Qadir

    2015-03-01

    Full Text Available GOALS OF STUDY: Ondansetron, a specific 5 - HT 3 antagonist, conventionally used as an antiemetic may also affect perioperative thermoregulation and Post Anesthetic Shivering (PAS. Therefore, we decided to compare the effect of Ondansetron in 2 different doses (4mg and 8 mg given just before the induction of general anesthesia on the incidence of PAS. METHODS: A double blind, placebo - controlled study was adopted to study 90 patients divided into 3 equal groups receiving general anesthesia for elective general surgeries. Groups – A, B and C received Ondansetron 4 mg, 8mg and Normal Saline 4 ml I/V respectively immediately before anesthetic induction. Core and peripheral temperatures were documented every 10 minutes from baseline to recovery from anaesthesia. After recovery from anaesthesia the occurrence of shivering was documented. Data was entered in excel and statistically important tests were done. P <0.05 was considered as significant. RESULTS: The incidence of PAS was 60% in the Group - C compared with 16.7% in Group - B , and 36.7% in Group - A. PAS was significantly low in the group receiving 8 mg ondansetron. CONCLUSIONS: Ondansetron 8 mg when compared with Ondansetron 4 mg given before the induction of anesthesia, reduces the incidence of PAS in adults significantly, without affecting the core – to - peripheral redistribution of temperature. The incidence of shivering was highest in the control group (60% with an intermediate incidence in the group receiving 4mg Ondansetron (36.7% and a lowest incidence in the group receiving 8mg Ondansetron (16.7%. CONTEXT: Different observations suggest that the serotonergic system has a role in the control of postanesthetic shivering. Ondansetron is a specific 5 - HT 3 antagonist that may affect perioperative thermoregulation and PAS. Therefore, we decided to compare the effect of Ondansetron, in 2 different doses (4mg and 8 mg given just before the induction of general anesthesia, on the

  13. Physiological disturbance may contribute to neurodegeneration induced by isoflurane or sevoflurane in 14 day old rats.

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    Binbin Wu

    Full Text Available BACKGROUND: Volatile anesthetics are widely used in pediatric anesthesia but their potential neurotoxicity raise significant concerns regarding sequelae after anesthesia. However, whether physiological disturbance during anesthetic exposure contributes to such side effects remains unknown. The aim of the current study is to compare the neurotoxic effects of isoflurane and sevoflurane in 14 day old rat pups under spontaneous breathing or ventilated conditions. METHODS: Postnatal 14 day rats were assigned to one of five groups: 1 spontaneous breathing (SB + room air (control, n = 17; 2 SB + isoflurane (n = 35; 3 SB + sevoflurane (n = 37; 4 mechanical ventilation (MV + isoflurane (n = 29; 5 MV + sevoflurane (n = 32. Anesthetized animal received either 1.7% isoflurane or 2.4% seveoflurane for 4 hours. Arterial blood gases and blood pressure were monitored in the anesthetized groups. Neurodegeneration in the CA3 region of hippocampus was assessed with terminal deoxynucleotidyl transferase-mediated DNA nick-end labeling immediately after exposure. Spatial learning and memory were evaluated with the Morris water maze in other cohorts 14 days after experiments. RESULTS: Most rats in the SB groups developed physiological disturbance whereas ventilated rats did not but become hyperglycemic. Mortality from anesthesia in the SB groups was significantly higher than that in the MV groups. Cell death in the SB but not MV groups was significantly higher than controls. SB + anesthesia groups performed worse on the Morris water maze behavioral test, but no deficits were found in the MV group compared with the controls. CONCLUSIONS: These findings could suggest that physiological disturbance induced by isoflurane or sevoflurane anesthesia may also contribute to their neurotoxicity.

  14. Dental treatment need and dental general anesthetics among preschool-age children with cleft lip and palate in northern Finland.

    Science.gov (United States)

    Lehtonen, Ville; Sándor, George K; Ylikontiola, Leena P; Koskinen, Sari; Pesonen, Paula; Harila, Virpi; Anttonen, Vuokko

    2015-08-01

    Cleft lip and palate incidence is high in northern Finland. This study aimed to investigate the proportion of children in need of restorative dental treatment among cleft lip and palate patients in northern Finland, as well as their need for dental treatment under general anesthesia. The records of 183 cleft lip and palate patients, treated in Oulu University Hospital from 1997 to 2013, were reviewed. Data on dental caries were analyzed in association with cleft type, considering also the presence of syndromes. The frequency of dental general anesthetic (DGA) use, and of treatments, were also analyzed. Dental treatment need was most frequently observed, in this rather limited study population, in patients with the most severe deformities, namely bilateral cleft lip and palate, of whom 60% had caries. Among the study population, 11.5% (n = 21) had a syndrome. Of those, 57.1% had dental caries at the age of 3 or 6 yr, and only four could be treated without a DGA. Dental treatment under general anesthesia was performed in 14.8% of cleft patients without a syndrome, but in 38.1% of those with a syndrome. General anaesthesia is required for the provision of dental care more often in cleft (17.5%) than in non-cleft (0.2%) patients, and especially for those with a syndrome. © 2015 Eur J Oral Sci.

  15. Anti-RAGE antibody attenuates isoflurane-induced cognitive dysfunction in aged rats.

    Science.gov (United States)

    Shi, Chengmei; Yi, Duan; Li, Zhengqian; Zhou, Yongde; Cao, Yiyun; Sun, Yan; Chui, Dehua; Guo, Xiangyang

    2017-03-30

    Several animal studies demonstrated that the volatile anesthetic isoflurane could influence the blood-brain barrier (BBB) integrity, which involved the cognitive impairment. Increasing evidence has also shown that the receptor for advanced glycation end-products (RAGE) played a major role in maintaining the integrity of BBB. The present study aimed to determine whether the RAGE-specific antibody protects against BBB disruption and cognitive impairment induced by isoflurane exposure in aged rats. 108 aged rats were randomly divided into four groups: (1) control group (Control); (2) 4h of 2% isoflurane exposure group (ISO); (3) RAGE antibody (20μL, 2.5μg/μL) treated+4h of 2% isoflurane exposure group (anti-RAGE+ISO); (4) RAGE antibody (20μL, 2.5μg/μL) treated group (anti-RAGE). The isoflurane anesthesia resulted in the upregulation of hippocampal RAGE expression, disruption of BBB integrity, neuroinflammation, and beta-amyloid (Aβ) accumulation in aged rats. In addition, significant cognitive deficits in the Morris water maze test was also observed. The antibody pretreatment resulted in significant improvements in BBB integrity. Furthermore, the expression of RAGE and proinflammatory mediators, as well as, Aβ accumulation were attenuated. Moreover, the antibody administration attenuated the isoflurane-induced cognitive impairment in aged rats. These results demonstrate that RAGE signaling is involved in BBB damage after isoflurane exposure. Thus, the RAGE antibody represents a novel therapeutic intervention to prevent isoflurane-induced cognitive impairment. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Electrocardiographic study on geriatric dogs undergoing general anesthesia with isoflurane Estudo eletrocardiográfico em cães geriátricos submetidos à anestesia geral com isofluorano

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    Andreza Conti-Patara

    2009-04-01

    Full Text Available The purpose of this study was to clarify the degree of influence of anesthetic agents commonly used during anesthesia on the heart conduction systems of geriatric dogs, with or without the presence of electrocardiographic changes in the pre-anesthetic electrocardiogram and also to determine the possible causes of ST-segment and T-wave changes during anesthesia, by monitoring ventilation and oxygenation. 36 geriatric dogs were evaluated. In addition to electrocardiographic evaluation, the pre-anesthetic study included serum levels of urea, creatinine, total protein, albumin and electrolytes. The pre-anesthetic medication consisted of acepromazine (0.05mg kg-1 in association with meperidine (3.0mg kg-1 by IM injection. Anesthesia was induced with propofol (3.0 to 5.0mg kg-1 by IV injection and maintained with isoflurane in 100% oxygen. During the anesthesia, the animals were monitored by continued computerized electrocardiogram. Systemic blood pressure, heart rate, respiratory rate, end-tidal carbon dioxide, partial pressure of carbon dioxide in arterial blood, arterial oxygen saturation, partial pressure of arterial oxygen and oxygen saturation of hemoglobin were closely monitored. During maintenance anesthesia, normal sinus rhythm was more common (78%. ST-segment and T-wave changes during the anesthetic procedure were quite common and were related to hypoventilation. The use of isoflurane did not result in arrhythmia, being therefore a good choice for this type of animal; Electrocardiographic findings of ST-segment and T-wave changes during the maintenance anesthesia were evident in animals with hypercapnia, a disorder that should be promptly corrected with assisted or controlled ventilation to prevent complicated arrhythmias.Os objetivos deste estudo foram esclarecer a influência dos agentes anestésicos comumente utilizados durante a anestesia no sistema de condução cardíaco em cães idosos, com ou sem alterações eletrocardiográficas pr

  17. 21 CFR 529.1186 - Isoflurane.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Isoflurane. 529.1186 Section 529.1186 Food and..., FEEDS, AND RELATED PRODUCTS CERTAIN OTHER DOSAGE FORM NEW ANIMAL DRUGS § 529.1186 Isoflurane. (a... inhalation: (1) Amount—(i) Horses: For induction of surgical anesthesia: 3 to 5 percent isoflurane...

  18. Isoflurane depresses hippocampal CA1 glutamate nerve terminals without inhibiting fiber volleys

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    MacIver M Bruce

    2006-01-01

    Full Text Available Abstract Background Anesthetic-induced CNS depression is thought to involve reduction of glutamate release from nerve terminals. Recent studies suggest that isoflurane reduces glutamate release by block of Na channels. To further investigate this question we examined the actions of isoflurane, TTX, extracellular Ca2+, CNQX and stimulus voltage (stim on glutamate-mediated transmission at hippocampal excitatory synapses. EPSPs were recorded from CA1 neurons in rat hippocampal brain slices in response to Schaffer-collateral fiber stimulation. Results Isoflurane (350 μM; 1 MAC reversibly depressed EPSP amplitudes by ~60% while facilitation increased ~20%. Consistent with previous studies, these results indicate a presynaptic site of action that involves reduced excitation-release coupling. EPSPs were depressed to comparable levels by TTX (60 nM or lowered stim, but facilitation was not changed, indicating a simple failure of axonal conduction. Similarly, partial antagonism of postsynaptic glutamate receptors with CNQX (10 μM depressed EPSP amplitudes with no change in facilitation. However, EPSP depression by low external Ca2+ (0.8 mM was accompanied by an increase in facilitation comparable to isoflurane. Isoflurane depression of EPSP amplitudes could also be partly reversed by high external Ca2+ (4 mM that also decreased facilitation. Isoflurane or low Ca2+ markedly reduced the slopes of fiber volley (FV-EPSP input-output curves, consistent with little or no effect on FVs. By contrast, TTX didn't alter the FV-EPSP curve slope, indicating that EPSP depression resulted from FV depression. FVs were remarkably resistant to isoflurane. Somatic spike currents were unaffected by 350 μM (1 MAC isoflurane as well. The EC50 for isoflurane depression of FVs was ~2.8 mM (12 vol. %; 8 MAC. Conclusion Isoflurane appears to depress CA1 synapses at presynaptic sites downstream from Na channels, as evident by the increased facilitation that accompanies EPSP

  19. Impact of Anesthetics on Immune Functions in a Rat Model of Vagus Nerve Stimulation.

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    Chloé A Picq

    Full Text Available Vagus nerve stimulation (VNS has been successfully performed in animals for the treatment of different experimental models of inflammation. The anti-inflammatory effect of VNS involves the release of acetylcholine by vagus nerve efferent fibers inhibiting pro-inflammatory cytokines (e.g. TNF-α produced by macrophages. Moreover, it has recently been demonstrated that splenic lymphocytic populations may also be involved. As anesthetics can modulate the inflammatory response, the current study evaluated the effect of two different anesthetics, isoflurane and pentobarbital, on splenic cellular and molecular parameters in a VNS rat model. Spleens were collected for the characterization of lymphocytes sub-populations by flow cytometry and quantification of cytokines secretion after in vitro activation. Different results were observed depending on the anesthetic used. The use of isoflurane displayed a non-specific effect of VNS characterized by a decrease of most splenic lymphocytes sub-populations studied, and also led to a significantly lower TNF-α secretion by splenocytes. However, the use of pentobarbital brought to light immune modifications in non-stimulated animals that were not observed with isoflurane, and also revealed a specific effect of VNS, notably at the level of T lymphocytes' activation. These differences between the two anesthetics could be related to the anti-inflammatory properties of isoflurane. In conclusion, pentobarbital is more adapted than isoflurane in the study of the anti-inflammatory effect of VNS on an anesthetized rat model in that it allows more accurate monitoring of subtle immunomodulatory processes.

  20. The effects of sevoflurane and isoflurane on intracranial pressure and cerebral perfusion pressure after diffuse brain injury in rats.

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    Goren, S; Kahveci, N; Alkan, T; Goren, B; Korfali, E

    2001-04-01

    Twenty-four adult male Wistar rats, weighing 220 to 290 g, were anesthetized with 30 mg/kg intraperitoneal sodium thiopental, then underwent a tracheostomy. After diffuse impact-acceleration brain injury (BI) was induced, each rat was paralyzed and mechanically ventilated with 30% O2 in nitrous oxide (N2O). The rats were assigned randomly to two groups, each of which received one of the two volatile anesthetic agents, sevoflurane or isoflurane. The anesthetics were administered at 0.5, 0.75, 1.0, and 1.25 minimal alveolar concentration (MAC) for 30 minutes each, respectively, and anesthesia was maintained at 0.75 MAC during the last hour of the study period. Intracranial pressure (ICP), mean arterial pressure (MAP), rectal and intrahemispheric temperatures, and end-tidal volatile anesthetic concentrations were monitored continuously throughout the 3 hours, with measurements recorded every 15 minutes. At baseline, there were no significant differences between the two groups regarding the monitored physiologic values. In the sevoflurane group, MAP fell significantly after 45 minutes, and a similar change was observed in the isoflurane group after 30 minutes (P pressure increased significantly at 45 minutes in the sevoflurane group (P isoflurane group, the change was not significant. Cerebral perfusion pressure (CPP) decreased in parallel with MAP, with the reduction in the sevoflurane group being more pronounced than that in the isoflurane group. The results demonstrated that, under the conditions of diffuse BI, animals that were anesthetized with sevoflurane had higher ICP and lower CPP levels than those anesthetized with isoflurane.

  1. Systemic distribution of blood flow in swine while awake and during 1.0 and 1.5 MAC isoflurane anesthesia with or without 50% nitrous oxide.

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    Lundeen, G; Manohar, M; Parks, C

    1983-05-01

    To examine the effects of isoflurane on systemic distribution of cardiac output, organ/tissue blood flow was measured in 11 isocapnic pigs using 15-micrometer diameter radionuclide-labeled microspheres injected into the left atrium. Measurements were made on each pig during five of the following six conditions; awake (control); 1.0 MAC (1.45% end-tidal)isoflurane anesthesia; 1.5 MAC (2.18% end-tidal) isoflurane anesthesia; 0.95% end-tidal isoflurane and 50% N2O anesthesia equivalent to 1.0 MAC; 1.68% end-tidal isoflurane and 50% N2O anesthesia equivalent to 1.5 MAC; and 50% N2O administration. The order of anesthetized steps was randomized. A period of 60 min was interposed between anesthetized steps to allow pigs to recover towards control values. Mean aortic pressure decreased in a dose-related manner during isoflurane anesthesia, whereas cardiac output decreased only during 1.5 MAC isoflurane anesthesia and heart rate remained unchanged. The addition of N2O attenuated the hypotensive effects of isoflurane and cardiac output was maintained near control values because of increased heart rate. Brain blood flow increased in a dose-dependent manner with isoflurane anesthesia, but myocardial blood flow exhibited a dose-related decrease. The addition of 50% N2O to maintain the same total MAC anesthesia resulted in a larger increase in brain blood flow especially at 1.5 MAC, while myocardial blood flow was maintained near control value. Rate-pressure product and myocardial blood flow at 1.5 MAC anesthesia were higher when N2O was used with isoflurane. While blood flow and fraction of cardiac output going to the adrenal glands were unaltered during isoflurane-N2O anesthesia, blood flow increased at 1.5 MAC isoflurane anesthesia. Splenic blood flow and splenic fraction of cardiac output were increased at both MAC levels of isoflurane as well as isoflurane-N2O anesthesia whereas blood flow to the stomach, small intestine, diaphragm, skeletal muscle, and adipose tissue

  2. Hemodynamic Parameters of Low-Flow Isoflurane and Low-Flow Sevoflurane Anesthesia During Controlled Ventilation With Laryngeal Mask Airway

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    Negargar, Sohrab; Peirovifar, Ali; Mahmoodpoor, Ata; Parish, Masoud; Golzari, Samad EJ; Molseqi, Haniye; Negargar, Soheil

    2014-01-01

    Background: Nowadays laryngeal mask airway (LMA) is popular as one of the best choices for airway management. Low-flow anesthesia has some advantages like lower pollution, hemodynamic stability and cost effectiveness. Volatile anesthetics are widely used for anesthesia maintenance during operations. Sevoflurane has more hemodynamic stability compared to isoflurane, but there are few studies comparing the hemodynamic stabilities of these two anesthetics during controlled low flow anesthesia wi...

  3. Blood -brain barrier disruption was less under isoflurane than pentobarbital anesthesia via a PI3K/Akt pathway in early cerebral ischemia.

    Science.gov (United States)

    Chi, Oak Z; Mellender, Scott J; Kiss, Geza K; Liu, Xia; Weiss, Harvey R

    2017-02-24

    One of the important factors altering the degree of blood-brain barrier (BBB) disruption in cerebral ischemia is the anesthetic used. The phosphoinositide 3-kinase (PI3K)/Akt signaling pathway has been reported to be involved in modulating BBB permeability and in isoflurane induced neuroprotection. This study was performed to compare the degree of BBB disruption in focal cerebral ischemia under isoflurane vs pentobarbital anesthesia and to determine whether inhibition of PI3K/Akt would affect the disruption in the early stage of focal cerebral ischemia. Permanent middle cerebral artery (MCA) occlusion was performed in rats under 1.4% isoflurane or pentobarbital (50mg/kg i.p.) anesthesia with controlled ventilation. In half of each group LY294002, which is a PI3K/Akt inhibitor, was applied on the ischemic cortex immediately after MCA occlusion. After one hour of MCA occlusion, the transfer coefficient (Ki) of (14)C-α-aminoisobutyric acid ((14)C-AIB) was determined to quantify the degree of BBB disruption. MCA occlusion increased the Ki both in the isoflurane and pentobarbital anesthetized rats. However, the value of Ki was lower under isoflurane (11.5±6.0μL/g/min) than under pentobarbital (18.3±7.1μL/g/min) anesthesia. The Ki of the contralateral cortex of the pentobarbital group was higher (+74%) than that of the isoflurane group. Application of LY294002 on the ischemic cortex increased the Ki (+99%) only in the isoflurane group. The degree of BBB disruption by MCA occlusion was significantly lower under isoflurane than pentobarbital anesthesia in the early stage of cerebral ischemia. Our data demonstrated the importance of choice of anesthetics and suggest that PI3K/Akt signaling pathway plays a significant role in altering BBB disruption in cerebral ischemia during isoflurane but not during pentobarbital anesthesia.

  4. Evidence for the Use of Isoflurane as a Replacement for Chloral Hydrate Anesthesia in Experimental Stroke: An Ethical Issue

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    Pétrault Maud

    2014-01-01

    Full Text Available Since an ethical issue has been raised regarding the use of the well-known anesthetic agent chloral hydrate, owing to its mutagenic and carcinogenic effects in animals, attention of neuroscientists has turned to finding out an alternative agent able to meet not only potency, safety, and analgesic efficacy, but also reduced neuroprotective effect for stroke research. The aim of this study was to compare the potential of chloral hydrate and isoflurane for both modulating the action of the experimental neuroprotectant MK801 and exerting analgesia. After middle cerebral artery occlusion in rats, no difference was observed in 24 h survival rate, success of ischemia, or infarct volume reduction between both anesthetics. However, isoflurane exerted a more pronounced analgesic effect than chloral hydrate as evidenced by formalin test 3 hours after anesthesia onset, thus encouraging the use of isoflurane in experimental stroke models.

  5. Anesthetic and airway management of general anesthesia in a patient with Meckel-Gruber syndrome.

    Science.gov (United States)

    Miyazu, Mitsunori; Sobue, Kazuya; Ito, Hiroaki; Azami, Takafumi; Ito, Shoji; Takeuchi, Akinori; Sasano, Hiroshi; Tsuda, Takako; Katsuya, Hirotada

    2005-01-01

    Meckel-Gruber syndrome, characterized by occipital encephalocele, microcephaly, polydactyly, cleft lip or palate, mandibular micrognathism, and anatomical abnormality of the larynx and tongue, along with other associated malformations, is in the list of diseases associated with difficult airway. However, there has been no report on the management of general anesthesia and airway management for such patients. A 2-year-old girl with Meckel-Gruber syndrome was scheduled for cardioplasty and gastrostomy for gastroesophageal reflux under general anesthesia. Preoperative examination revealed obesity, microgenia, dysspondylism, proteinuria, hypoplastic kidneys, and stenosis of the anal canal. Although we anticipated some difficulty with the intubation and prepared several alternative methods for intubation, such as a bronchofiberscope and a laryngeal mask airway, tracheal intubation was completed without difficulty using conventional laryngoscopy after inhalational induction with sevoflurane. Because most patients with this syndrome die before and shortly after delivery, those who survive to some age might have less severe deformities.

  6. General Anesthetic Versus Light Sedation: Effect on Pediatric Endoscopy Wait Times

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    Christine Edwards

    2013-01-01

    Full Text Available BACKGROUND: Wait times are an important measure of health care system effectiveness. There are no studies describing wait times in pediatric gastroenterology for either outpatient visits or endoscopy. Pediatric endoscopy is performed under light sedation or general anesthesia. The latter is hypothesized to be associated with a longer wait time due to practical limits on access to anesthesia in the Canadian health care system.

  7. Taurine Pretreatment Prevents Isoflurane-Induced Cognitive Impairment by Inhibiting ER Stress-Mediated Activation of Apoptosis Pathways in the Hippocampus in Aged Rats.

    Science.gov (United States)

    Zhang, Yanan; Li, Dongliang; Li, Haiou; Hou, Dailiang; Hou, Jingdong

    2016-10-01

    Isoflurane, a commonly used inhalation anesthetic, may induce neurocognitive deficits, especially in elderly patients after surgery. Recent study demonstrated that isoflurane caused endoplasmic reticulum (ER) stress and subsequent neuronal apoptosis in the brain, contributing to cognitive deficits. Taurine, a major intracellular free amino acid, has been shown to inhibit ER stress and neuronal apoptosis in several neurological disorders. Here, we examined whether taurine can prevent isoflurane-induced ER stress and cognitive impairment in aged rats. Thirty minutes prior to a 4-h 1.3 % isoflurane exposure, aged rats were treated with vehicle or taurine at low, middle and high doses. Aged rats without any treatment served as control. The brains were harvested 6 h after isoflurane exposure for molecular measurements, and behavioral study was performed 2 weeks later. Compared with control, isoflurane increased expression of hippocampal ER stress biomarkers including glucose-regulated protein 78, phosphorylated (P-) inositol-requiring enzyme 1, P-eukaryotic initiation factor 2-α (EIF2α), activating transcription factor 4 (ATF-4), cleaved ATF-6 and C/EBP homologous protein, along with activation of apoptosis pathways as indicated by decreased B cell lymphoma 2 (BCL-2)/BCL2-associated X protein, increased expressions of cytochrome-c and cleaved caspase-3. Taurine pretreatment dose-dependently inhibited isoflurane-induced increase in expression of ER stress biomarkers except for P-EIF2α and ATF-4, and reversed isoflurane-induced changes in apoptosis-related proteins. Moreover, isoflurane caused spatial working memory deficits in aged rats, which were prevented by taurine pretreatment. The results indicate that taurine pretreatment prevents anesthetic isoflurane-induced cognitive impairment by inhibiting ER stress-mediated activation of apoptosis pathways in the hippocampus in aged rats.

  8. Effects of isoflurane on echocardiographic parameters in healthy dogs.

    Science.gov (United States)

    Sousa, Marlos G; Carareto, Roberta; De-Nardi, Andrigo B; Brito, Fábio L C; Nunes, Newton; Camacho, Aparecido A

    2008-05-01

    To study the echocardiographic effects of isoflurane at an end-tidal concentration approximating 1.0 times the minimum alveolar concentration (MAC) in healthy unpremedicated dogs. Prospective experimental trial. Sixteen mature mongrel dogs of either sex weighing 11.06 +/- 2.72 kg. After performing a baseline echocardiogram in the awake animal, anesthesia was induced with increasing inspired concentrations of isoflurane via a face mask until tracheal intubation was possible. Following intubation, the end-tidal concentration was decreased to 1.4% for the rest of the anesthetic period. Serial echocardiograms were recorded at 25, 40, and 55 minutes after the end-tidal concentration was reached. No changes were observed in heart rate. However, significant decreases were seen in left ventricular end-diastolic diameter (Mean maximal change: 13.8%), interventricular septal thickness during systole (15.2%), interventricular septal thickening fraction (72.2%), left ventricular free wall thickening fraction (63.5%), ejection fraction (39.9%), and fractional shortening (46.7%). In addition, peak flow velocities across mitral, pulmonic, and aortic valves were significantly lower than baseline values. Decreases were also observed in end-diastolic left ventricular volume index (approximately 32.1% from the awake value), stroke index (58.2%), and cardiac index (55.3%) when compared with awake measurements. and clinical relevance Our results indicate that 1 x MAC isoflurane caused significant myocardial depression in healthy dogs. These changes in myocardial function need to be considered carefully when isoflurane is to be used in dogs with poor cardiovascular reserve.

  9. Cardiopulmonary effects of administration of a combination solution of xylazine, guaifenesin, and ketamine or inhaled isoflurane in mechanically ventilated calves.

    Science.gov (United States)

    Kerr, Carolyn L; Windeyer, Claire; Bouré, Ludovic P; Mirakhur, Kuldip K; McDonell, Wayne

    2007-12-01

    To compare the cardiopulmonary effects of administration of a solution of xylazine, guaifenesin, and ketamine (XGK) or inhaled isoflurane in mechanically ventilated calves undergoing surgery. 13 male calves 2 to 26 days of age. Procedures-In calves in the XGK group, anesthesia was induced (0.5 mL/kg) and maintained (2.5 mL/kg/h) with a combination solution of xylazine (0.1 mg/mL), guaifenesin (50 mg/mL), and ketamine (1.0 mg/mL). For calves in the isoflurane group, anesthesia was induced and maintained with isoflurane in oxygen. The rates of XGK infusion and isoflurane administration were adjusted to achieve suitable anesthetic depth. All calves received 100% oxygen and were mechanically ventilated to maintain end-tidal carbon dioxide concentrations from 35 to 40 mm Hg and underwent laparoscopic bladder surgery through an abdominal approach. Cardiopulmonary variables were measured before induction and at intervals up to 90 minutes after anesthetic induction. The quality of induction was excellent in all calves. The XGK requirements were 0.57 +/- 0.18 mL/kg and 2.70 +/- 0.40 mL/kg/h to induce and maintain anesthesia, respectively. Heart rate was significantly lower than baseline throughout the anesthetic period in the XGK group. Systolic arterial blood pressure was significantly higher in the XGK group, compared with the isoflurane group, from 5 to 90 minutes. Cardiac index was lower than baseline in both groups. Differences between groups in cardiac index and arterial blood gas values were not significant. Administration of XGK resulted in excellent anesthetic induction and maintenance with cardiopulmonary alterations similar to those associated with isoflurane in mechanically ventilated calves.

  10. Minimum alveolar concentration-awake of Xenon alone and in combination with isoflurane or sevoflurane.

    Science.gov (United States)

    Goto, T; Nakata, Y; Ishiguro, Y; Niimi, Y; Suwa, K; Morita, S

    2000-11-01

    The minimum alveolar concentration (MAC)-awake is a traditional index of hypnotic potency of an inhalational anesthetic. The MAC-awake of xenon, an inert gas with anesthetic properties (MAC = 71%), has not been determined. It is also unknown how xenon interacts with isoflurane or sevoflurane on the MAC-awake. In the first part of the study, 90 female patients received xenon, nitrous oxide (N2O), isoflurane, or sevoflurane supplemented with epidural anesthesia (n = 36 for xenon and n = 18 per group for other anesthetics). In the second part, 72 additional patients received either xenon or N2O combined with the 0.5 times MAC-awake concentration of isoflurane or sevoflurane (0.2% and 0.3%, respectively, based on the results of the first part; n = 18 per group). During emergence, the concentration of an assigned anesthetic (xenon or N2O only in the second part) was decreased in 0. 1 MAC decrements every 15 min from 0.8 MAC or from 70% in the case of N2O until the patient followed the command to either open her eyes or to squeeze and release the investigator's hand. The concentration midway between the value permitting the first response to command and that just preventing it was defined as the MAC-awake. The MAC-awake were as follows: xenon, 32.6 +/- 6.1% (mean +/- SD) or 0.46 +/- 0.09 MAC; N2O, 63.3 +/- 7.1% (0.61 +/- 0.07 MAC); isoflurane, 0.40 +/- 0.07% (0.35 +/- 0.06 MAC); and sevoflurane, 0.59 +/- 0.10% (0.35 +/- 0.06 MAC). Addition of the 0.5 MAC-awake concentrations of isoflurane and sevoflurane reduced the MAC-awake of xenon to 0.50 +/- 0.15 and 0.51 +/- 0.16 times its MAC-awake as a sole agent, but that of N2O to the values significantly greater than 0.5 times its MAC-awake as a sole agent (0.68 +/- 0.12 and 0.66 +/- 0.14 times MAC-awake; P MAC-awake of xenon is 33% or 0.46 times its MAC. In terms of the MAC-fraction, this is smaller than that for N2O but greater than those for isoflurane and sevoflurane. Unlike N2O, xenon interacts additively with isoflurane

  11. [Evoked potentials and inhalation anesthetics].

    Science.gov (United States)

    Thiel, A; Russ, W; Hempelmann, G

    1988-01-01

    Intraoperative monitoring of evoked potentials can be affected by various factors including volatile anaesthetics. These effects have to be considered in order to give correct interpretations of the obtained data. Visual evoked potentials (VEP) and auditory evoked potentials (AEP) will show strong alterations under general anaesthesia whereas brainstem auditory evoked potentials (BAEP) are slightly affected. The effects of nitrous oxide, halothane, enflurane, and isoflurane on somatosensory evoked potentials (SEP) after median nerve stimulation were studied in 35 healthy adult patients. pCO2 and tympanic membrane temperature were held constant. Simultaneous cervical and cortical SEP recording was performed using surface electrodes. After induction of anaesthesia SEP were recorded during normoventilation with 100% oxygen and after inhalation of 66.6% nitrous oxide. 10 patients received halothane at inspired concentrations of 0.5, 1.0, 1.5, and 2.0%. After nitrous oxide had been replaced by oxygen, halothane was reduced in steps of 0.5%. SEP were recorded at the end of each period (15 min). Equipotent doses of enflurane or isoflurane were administered to 15 and 10 patients, respectively. Nitrous oxide depressed early cortical SEP amplitude. Halothane, enflurane, and isoflurane caused dose dependent increases of latencies. Reduction of amplitude was most pronounced with isoflurane. Using high doses of enflurane in oxygen cortical SEP showed unusual high amplitudes associated with marked increases of latencies. Even under high concentrations of volatile anaesthetics cervical SEP were minimally affected. The effects of anaesthetic gases have to be considered when SEP are recorded intraoperatively.

  12. 脑电监测SD大鼠异氟醚全身麻醉模型的建立及脑电分析%The Establishment of SD Rats with Dynamic EEG Monitoring Model Under General Anesthesia with Isoflurane

    Institute of Scientific and Technical Information of China (English)

    杨海帆; 董海龙; 张昊鹏; 徐晨; 郭超

    2011-01-01

    目的:建立脑电监测SD大鼠异氟醚全身麻醉模型并分析脑电监测结果.方法:随机选取SD大鼠20只,先行脑电电极置入术,术后使用密闭吸入麻醉动物行为学观察圆筒,观察异氟醚引起的麻醉诱导、维持、觉醒状态并记录诱导、觉醒时间.将记录的行为学结果对照典型脑电图波形改变判断麻醉深度.结果:实验SD大鼠均检测出脑电图,通过对照行为学观察发现动态脑电监测结果同异氟醚麻醉过程进展一致.在麻醉过程中SD大鼠出现典型的全身麻醉脑电循环.结论:动态脑电监测和SD大鼠行为学观察可以准确反应全身麻醉深度.%Objective: To creative a dynamic EEG monitoring SD rats under isoflurane-induced general anesthesia of making animal models and analysis the result of EEG was monitoring. Methods: EEG electrodes were implanted in 20 SD randomly selected rats, and then observed their behavior from the sealed animal observation cylinder. The subtle presentations and precise time of ioflurane-in-duced anesthesia, maintenance, and wakefulness in general anesthesia were respectively recorded. The degree of anesthesia can be judged by comparing the record with the typical EEG waveforms. Results: The EEG waveforms could be detected form SD rats in the experiment. By using the comparison behavior method, the results of dynamic EEG monitoring were observed the same result of the process of isoflurane anesthesia. SD rats showed the typical anesthesia EEG cycle during the anesthesia. Conclusion: Through the comparison of the animal behavior observation of SD rats with dynamic EEG monitoring results, the dynamic EEG monitoring could accurately reflect the general anesthesia degree.

  13. Ginsenoside Rg1 Attenuates Isoflurane-induced Caspase-3 Activation via Inhibiting Mitochondrial Dysfunction

    Institute of Scientific and Technical Information of China (English)

    MIAO Hui Hui; ZHEN Yu; DING Guan Nan; HONG Fang Xiao; XIE Zhong Cong; TIAN Ming

    2015-01-01

    Objective The inhalation anesthetic isoflurane has been shown to induce mitochondrial dysfunction and caspase activation, which may lead to learning and memory impairment. Ginsenoside Rg1 is reported to be neuroprotective. We therefore set out to determine whether ginsenoside Rg1 can attenuate isoflurane-induced caspase activation via inhibiting mitochondrial dysfunction. Methods We investigated the effects of ginsenoside Rg1 at concentrations of 12.5, 25, and 50 µmol/L and pretreatment times of 12 h and 24 h on isoflurane-induced caspase-3 activation in H4 naïve and stably transfected H4 human neuroglioma cells that express full-length human amyloid precursor protein (APP) (H4-APP cells). For mitochondrial dysfunction, we assessed mitochondrial permeability transition pore (mPTP) and adenosine-5’-triphosphate (ATP) levels. We employed Western blot analysis, chemiluminescence, and flowcytometry. Results Here we show that pretreatment with 50 µmol/L ginsenoside Rg1 for 12 h attenuated isoflurane-induced caspase-3 activation and mitochondrial dysfunction in H4-APP cells, while pretreatment with 25 and 50 µmol/L ginsenoside Rg1 for 24 h attenuated isoflurane-induced caspase-3 activation and mitochondrial dysfunction in both H4 naïve and H4-APP cells. Conclusion These data suggest that ginsenoside Rg1 may ameliorate isoflurane-induced caspase-3 activation by inhibiting mitochondrial dysfunction. Pending further studies, these findings might recommend the use of ginsenoside Rg1 in preventing and treating isoflurane-induced neurotoxicity.

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

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    Vivek Rayadurg

    2016-01-01

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

  15. Effects of Isoflurane on the Actions of Neuromuscular Blockers on the Muscle Nicotine Acetylcholine Receptors

    Institute of Scientific and Technical Information of China (English)

    李传翔; 姚尚龙; 聂辉; 吕斌

    2004-01-01

    In this study, we tested the hypothesis that volatile anesthetic enhancement of muscle relaxation is the result of combined drug effects on the nicotinic acetylcholine receptors. The poly A m RNA from muscle by isolation were microinjected into Xenopus oocytes for receptor expression.Concentration-effect curves for the inhibition of Ach-induced currents were established for vecuronium, rocuranium, and isoflurane. Subsequently, inhibitory effects of NDMRs were studied in the presence of the isoflurane at a concentration equivalent to half the concentration producing a 50 %inhibition alone. All tested drugs produced rapid and readily reversible concentration-dependent inhibition. The 50 % inhibitory concentration values were 889 μmol/L (95 % CI: 711-1214μmol),33.4 μmol (95 % CI: 27.1-41.7 nmol) and 9.2 nmol (95 % CI: 7.9-12.3 nmol) for isoflurane,rocuranium and vecuronium, respectively. Coapplication of isoflurane significantly enhanced the inhibitory effects of rocuranium and vecuronium, and it was especially so at low concentration of NMDRs. Isoflurane increases the potency of NDMRs, possibly by enhancing antagonist affinity at the receptor site.

  16. Sulfato de atropina nos parâmetros hemodinâmicos e hemogasométricos de cães anestesiados com clorpromazina, dexmedetomidina e isoflurano Hemodynamic and hemogasometric in the atropine administration in dogs anesthetized with chlorpromazine and dexmedetomidine and isoflurane

    Directory of Open Access Journals (Sweden)

    Fabíola Niederauer Flôres

    2008-08-01

    Full Text Available Seis cães, pesando 17,9kg (±3,9, foram anestesiados em duas ocasiões, com intervalo de sete dias, obedecendo estudo cego. A indução e a manutenção anestésica foram realizadas com isoflurano em ventilação mecânica. Depois da instrumentação, a concentração final de isoflurano foi fixada em 1,3V% durante o estudo. Após período de estabilização de 30 minutos, foram mensurados os parâmetros hemodinâmicos e hemogasométricos (M-15; na seqüência, administrou-se atropina (grupo atropina ou cloreto de sódio 0,9% (grupo salina. Passados 15 minutos, os parâmetros foram avaliados novamente (M0 e aplicou-se clorpromazina e dexmedetomidina (Clor-Dex. As variáveis foram mensuradas por mais 65 minutos depois da Clor-Dex. Empregou-se ANOVA de uma via e teste Student Newman Keuls para valores entre tempos dentro de cada grupo e teste t pareado para avaliação das médias entre grupos (P£0,05. A freqüência cardíaca foi maior no grupo atropina depois da administração de Clor-Dex, e houve redução nos valores de Índice Cardíaco (IC em ambos os grupos. Embora os valores médios de IC tenham sido maiores no grupo atropina, não houve diferença significativa entre grupos administração de Clor-Dex promoveu aumento da pressão arterial em cães tratados com atropina. A pressão arterial média (PAM foi significativamente maior no grupo atropina dos 5 aos 65 minutos após administração de Clor-Dex, assim como o Índice de Resistência Periférica Total (IRPT aumentou em ambos os grupos depois da Clor-Dex.. Os parâmetros hemogasométricos não apresentaram diferenças significativas. A administração de atropina antes da clorpromazina e da dexmedetomidina resultou em aumento da pressão arterial. A bradicardia induzida pela administração da associação de fármacos foi prevenida pelo anticolinérgico, porém a redução do débito cardíaco não foi prevenida.Six dogs weighing 17.9 ±3.9 kg were anesthetized on two occasions

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

    Science.gov (United States)

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

    2016-01-01

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

  18. Up-regulation of heme oxygenase-1 by isoflurane preconditioning during tolerance against neuronal injury induced by oxygen glucose deprivation

    Institute of Scientific and Technical Information of China (English)

    Qifang Li; Yesen Zhu; Hong Jiang; Hui Xu; Heping Liu

    2008-01-01

    Heme oxygenase (HO) is the rate-limiting enzyme in the degradation of heme to produce bile pigments and carbon monoxide. The HO-1 isozyme is induced by a variety of factors such as heat, heme, ischemia, and hydrogen peroxide. In recent years, mounting findings have suggested that HO-1 has a neuroprotective activity against ischemic injury. The neuroprotective role of isoflurane, a commonly used anesthetic, has been well documented, but little is known about the underlying mechanisms involved. Recently, isoflurane has been shown to up-regulate HO-1 in the liver. In this study,we show that isoflurane preconditioning promotes the survival of cultured ischemic hippocampal neurons by increasing the number of surviving neurons and their viability. Further study by reverse transcription-polymerase chain reaction and Western blot analysis showed that isoflurane preconditioning significantly increases HO-1 expression in oxygen glucose deprivation (OGD)-induced neuronal injury. Furthermore,inhibition of HO activity by tin protoporphyrin partially abolishes isoflurane preconditioning's protective effect as measured by lactate dehydrogenase release in OGD neurons.These findings indicated that the neuroprotective role of isoflurane preconditioning against OGD-induced injury might be associated with its role in up-regulating HO-1 in ischemic neurons.

  19. Up-regulation of heme oxygenase-1 by isoflurane preconditioning during tolerance against neuronal injury induced by oxygen glucose deprivation.

    Science.gov (United States)

    Li, Qifang; Zhu, Yesen; Jiang, Hong; Xu, Hui; Liu, Heping

    2008-09-01

    Heme oxygenase (HO) is the rate-limiting enzyme in the degradation of heme to produce bile pigments and carbon monoxide. The HO-1 isozyme is induced by a variety of factors such as heat, heme, ischemia, and hydrogen peroxide. In recent years, mounting findings have suggested that HO-1 has a neuroprotective activity against ischemic injury. The neuroprotective role of isoflurane, a commonly used anesthetic, has been well documented, but little is known about the underlying mechanisms involved. Recently, isoflurane has been shown to up-regulate HO-1 in the liver. In this study, we show that isoflurane preconditioning promotes the survival of cultured ischemic hippocampal neurons by increasing the number of surviving neurons and their viability. Further study by reverse transcription-polymerase chain reaction and Western blot analysis showed that isoflurane preconditioning significantly increases HO-1 expression in oxygen glucose deprivation (OGD)-induced neuronal injury. Furthermore, inhibition of HO activity by tin protoporphyrin partially abolishes isoflurane preconditioning's protective effect as measured by lactate dehydrogenase release in OGD neurons. These findings indicated that the neuroprotective role of isoflurane preconditioning against OGD-induced injury might be associated with its role in up-regulating HO-1 in ischemic neurons.

  20. Effects of anesthetic agents on brain blood oxygenation level revealed with ultra-high field MRI.

    Directory of Open Access Journals (Sweden)

    Luisa Ciobanu

    Full Text Available During general anesthesia it is crucial to control systemic hemodynamics and oxygenation levels. However, anesthetic agents can affect cerebral hemodynamics and metabolism in a drug-dependent manner, while systemic hemodynamics is stable. Brain-wide monitoring of this effect remains highly challenging. Because T(2*-weighted imaging at ultra-high magnetic field strengths benefits from a dramatic increase in contrast to noise ratio, we hypothesized that it could monitor anesthesia effects on brain blood oxygenation. We scanned rat brains at 7T and 17.2T under general anesthesia using different anesthetics (isoflurane, ketamine-xylazine, medetomidine. We showed that the brain/vessels contrast in T(2*-weighted images at 17.2T varied directly according to the applied pharmacological anesthetic agent, a phenomenon that was visible, but to a much smaller extent at 7T. This variation is in agreement with the mechanism of action of these agents. These data demonstrate that preclinical ultra-high field MRI can monitor the effects of a given drug on brain blood oxygenation level in the absence of systemic blood oxygenation changes and of any neural stimulation.

  1. 全麻药物对脑神经毒作用的研究进展%Recend development on toxic effects of general anesthetics on cerebral neurons

    Institute of Scientific and Technical Information of China (English)

    罗铁山; 陶国才

    2010-01-01

    A growing body of evidence from cells culture, rodents and sub-human primates's experimental study suggest that clinical commonly used general anesthetics not only can cause neurotoxicity to neuronal cells of different periods with subsequent central nervous system injury, especially during the brain growth spurt period, but also affect learning and memory function. We review the evidence of neurotoxic effects of anesthetic agents and hypothesis of mechanism, in order to allow people to understand the latest research progress of general anesthetics on toxic effects and change some concept of clinical anesthesia.%从细胞培养、啮齿类动物和非人类灵长类动物的实验研究中得到越来越多的证据:临床常用全麻药物对各期脑神经细胞产生毒性作用,损伤中枢神经系统,特别对处于发育高峰期的大脑影响更大,并影响以后的学习记忆功能.现综述这些事实及目前全麻药物神经毒性作用的机制假设,目的 是让人们对全麻药物毒性作用的最新研究进展有一了解,转变临床麻醉的一些观念.

  2. Effects of desflurane and isoflurane on hepatic and renal functions and coagulation profile during donor hepatectomy.

    Science.gov (United States)

    Toprak, H I; Şahin, T; Aslan, S; Karahan, K; Şanli, M; Ersoy, M Ö

    2012-01-01

    We compared the effect of two inhalation anesthetics desflurane and isoflurane on postoperative hepatic and renal functions as well as coagulation profiles in living donors undergoing right hepatectomy. This study was performed on 80 patients who were randomly allocated to group D (desflurane, n = 40) or group I (isoflurane, n = 40) after Faculty Ethics Committee approval. After induction, isoflurane or desflurane was used with air/oxygen for anesthetic maintenance. The isoflurane or desflurane concentration was set at one minimum alveolar concentration (MAC). Remifentanil was infused for analgesia as well as cisatracurium. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), international normalized ratio (INR), albumin, total bilirubin, blood urea nitrogen, creatinine, platelet count, and hemoglobin levels were analyzed preoperatively at end of the operation, and on postoperative days (PODs) 1, 2, 3, 5, 7, and 30. Both AST and ALT differed significantly and continually except on POD 30. AST showed significant elevations from the end of the operation to POD 2 and ALT, from the end of the operation to POD 5 in group I compared with group D. INR was significantly higher from the end of the operation to POD 3 in group I and to POD 2 in group D. At the end of the operation as well as on POD 1 and POD 2, INR was significantly increased in group I compared with group D. Albumin level was significantly lower at the end of the operation in both groups, but it was not different. No patient developed hepatic or renal failure. Our study showed better postoperative hepatic tests and INR using desflurane than isoflurane at equivalent doses of 1 MAC in living donors undergoing right hepatectomy.

  3. Preferential effect of isoflurane on top-down versus bottom-up pathways in sensory cortex

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    Aeyal eRaz

    2014-10-01

    Full Text Available The mechanism of loss of consciousness (LOC under anesthesia is unknown. Because consciousness depends on activity in the cortico-thalamic network, anesthetic actions on this network are likely critical for LOC. Competing theories stress the importance of anesthetic actions on bottom-up ‘core’ thalamo-cortical (TC versus top-down cortico-cortical (CC and matrix TC connections. We tested these models using laminar recordings in rat auditory cortex in-vivo and murine brain slices. We selectively activated bottom-up vs. top-down afferent pathways using sensory stimuli in vivo and electrical stimulation in brain slices, and compared effects of isoflurane on responses evoked via the two pathways. Auditory stimuli in vivo and core TC afferent stimulation in brain slices evoked short latency current sinks in middle layers, consistent with activation of core TC afferents. By contrast, visual stimuli in vivo and stimulation of CC and matrix TC afferents in brain slices evoked responses mainly in superficial and deep layers, consistent with projection patterns of top-down afferents that carry visual information to auditory cortex. Responses to auditory stimuli in vivo and core TC afferents in brain slices were significantly less affected by isoflurane compared to responses triggered by visual stimuli in vivo and CC/matrix TC afferents in slices. At a just-hypnotic dose in vivo, auditory responses were enhanced by isoflurane, whereas visual responses were dramatically reduced. At a comparable concentration in slices, isoflurane suppressed both core TC and CC/matrix TC responses, but the effect on the latter responses was far greater than on core TC responses, indicating that at least part of the differential effects observed in vivo were due to local actions of isoflurane in auditory cortex. These data support a model in which disruption of top-down connectivity contributes to anesthesia-induced LOC, and have implications for understanding the neural

  4. Comparison of isoflurane and sevoflurane anesthesia after premedication with butorphanol in the green iguana (Iguana iguana).

    Science.gov (United States)

    Hernandez-Divers, Sonia M; Schumacher, Juergen; Stahl, Scott; Hernandez-Divers, Stephen J

    2005-06-01

    The anesthetic and cardiopulmonary effects of butorphanol followed by sevoflurane or isoflurane were compared in 23 male green iguanas (Iguana iguana). Heart and respiratory rates were recorded before administration of butorphanol (2 mg/kg i.m.) and at 30 min after premedication. Anesthesia was induced in 12 iguanas (group 1) with isoflurane (5%) and in 11 iguanas (group 2) with sevoflurane (7%). Heart rate, relative arterial oxygen hemoglobin saturation (SpO2), and end-tidal CO2 concentrations (EtCO2) were measured every minute for the first 5 min and every 5 min thereafter. Arterial blood gas parameters were determined at 10 and 40 min after induction. Thirty minutes after butorphanol administration, no significant changes in heart and respiratory rate were seen as compared with baseline values. Quality and time to induction were superior with butorphanol-sevoflurane (6 +/- 3 min) than with butorphanol-isoflurane (9 +/- 4 min). Vaporizer settings during maintenance ranged between 1-3% and 2-4%, respectively. No significant differences in heart rate were noted between groups. In the sevoflurane group, SpO2 values were > 90% throughout. Although SpO2, values were isoflurane group, no significant differences in SpO2 values were seen over time and between groups. A significant decrease in EtCO2 with time was present in both groups, with no significant differences between the groups. At 10 and 40 min, arterial blood oxygen saturation values were > 90% in both groups and no significant differences were noted with time and between groups. Recovery time was significantly longer in the butorphanol-isoflurane group (35 +/- 27 min) than in the butorphanol-sevoflurane group (7 +/- 4 min). The cardiopulmonary effects of butorphanol-isoflurane and butorphanol-sevoflurane assessed in this study are similar, and both inhalants appear to be safe and effective for induction and maintenance in the green iguana.

  5. Use of brachial plexus blockade and medetomidine-ketamine-isoflurane anaesthesia for repair of radio-ulna fracture in an adult cheetah (Acinonyx jubatus).

    Science.gov (United States)

    Kimeli, Peter; Mogoa, Eddy M; Mwangi, Willy E; Kipyegon, Ambrose N; Kirui, Gilbert; Muasya, Daniel W; Mande, John D; Kariuki, Edward; Mijele, Dominic

    2014-10-10

    Regional anaesthetic techniques have been used in combination with systemic analgesics during small animal surgery to provide multimodal analgesia. Brachial plexus nerves block using local anaesthetics provides analgesia of the thoracic limb through desensitization of the nerves that provide sensory and motor innervation. This has been shown to reduce intra-operative anesthetic requirements and provide postoperative pain relief. Decreasing the doses of general anaesthetics allows more stable cardiopulmonary function during anaesthesia and the development of less side effects. The present case reports a successful use of brachial plexus blockade to supplement medetomidine-ketamine-isoflurane anaesthesia for repair of radio-ulna fracture in an adult cheetah (acinonyx jubatus). An adult male Cheetah weighing about 65 kg was presented with a history of leg carrying lameness of the left forelimb sustained following a car accident a week earlier. Clinical examination under general anaesthesia revealed slight dehydration and a swelling with a wound on the caudo-medial aspect of the left radio-ulna region. Crepitation was present on manipulation and radiography confirmed a complete transverse radio-ulna fracture of the left forelimb, which required open reduction and internal fixation. Brachial plexus blockade using lignocaine hydrochloride was used to supplement medetomidine-ketamine-isoflurane anaesthesia for the surgical procedure. Isoflurane anaesthesia was maintained at 0.5 - 2.0% throughout the surgical procedure, which was uneventful. Temperature and cardio-pulmonary parameters remained stable intra-operatively. Limb paralysis extended for 5 hours post-operatively, suggesting prolonged anaesthesia. To the researchers' knowledge, this is the first reported case of the use of brachial plexus blockade to supplement general anaesthesia to facilitate forelimb surgery in an adult cheetah. The use of brachial plexus block with a light plane of general anaesthesia proved to

  6. Photoacoustic microscopy of cerebral hemodynamic and oxygen-metabolic responses to anesthetics

    Science.gov (United States)

    Cao, Rui; Li, Jun; Ning, Bo; Sun, Naidi; Wang, Tianxiong; Zuo, Zhiyi; Hu, Song

    2017-02-01

    General anesthetics are known to have profound effects on cerebral hemodynamics and neuronal activities. However, it remains a challenge to directly assess anesthetics-induced hemodynamic and oxygen-metabolic changes from the true baseline under wakefulness at the microscopic level, due to the lack of an enabling technology for high-resolution functional imaging of the awake mouse brain. To address this challenge, we have developed head-restrained photoacoustic microscopy (PAM), which enables simultaneous imaging of the cerebrovascular anatomy, total concentration and oxygen saturation of hemoglobin (CHb and sO2), and blood flow in awake mice. From these hemodynamic measurements, two important metabolic parameters, oxygen extraction fraction (OEF) and the cerebral metabolic rate of oxygen (CMRO2), can be derived. Side-by-side comparison of the mouse brain under wakefulness and anesthesia revealed multifaceted cerebral responses to isoflurane, a volatile anesthetic widely used in preclinical research and clinical practice. Key observations include elevated cerebral blood flow (CBF) and reduced oxygen extraction and metabolism.

  7. 全麻药物机制研究的几点新进展%The research progress of general anesthetics on the brain function

    Institute of Scientific and Technical Information of China (English)

    李肇端; 刘兴奎; 喻田

    2013-01-01

    背景 全身麻醉应用于临床已有160多年的历史,但麻醉药导致相应的行为改变如意识丧失、遗忘和镇痛的神经生理机制是什么,至今仍不清楚,尤其对于其中最具特征性的全麻意识消失,人们对其了解最为肤浅. 目的 综述全身麻醉药对离子通道和受体、各脑电活动的影响和脑功能的变化. 内容 全麻机制的研究可以分6个层次,分别是:分子水平、突触水平、细胞水平、神经微环路水平、系统水平(脑区)以及行为水平.总结近年来全身麻醉药(以下简称全麻药)在不同结构水平研究的最新进展,并从宏观上探讨全麻药对脑功能的影响. 趋向 多种实验技术相结合将为全麻机制的研究提供新的方法.%Background The clinical application of general anesthesia has been used for more than 160 years,however,neurophysiological mechanism of corresponding behavioral changes caused by anesthetic such as loss of consciousness,amnesia and analgesic are still unclear,especially for the unconsciousness which we hardly understood.Objective We reviewed the impacts of general anesthetics on ion channels and corresonding receptors,as well as brain electrical activity and changes in brain functions.Content The research of general anesthesia mechanisms can be divided into six levels:the molecular,synaptic,cellular,neural micro-circuit,system (brain areas) and behavioral level.This review summarized the progress about general anesthetics on different levels and explored the change of brain functions by general anesthetics on macro level.Trend The combination of different kinds of experimental techniques could provide new approaches for general anesthesia mechanism.

  8. Evaluation of administration of isoflurane at approximately the minimum alveolar concentration on depression of a nociceptive withdrawal reflex evoked by transcutaneous electrical stimulation in ponies.

    Science.gov (United States)

    Spadavecchia, Claudia; Levionnois, Olivier; Kronen, Peter W; Leandri, Massimo; Spadavecchia, Luciano; Schatzmann, Urs

    2006-05-01

    To investigate effects of isoflurane at approximately the minimum alveolar concentration (MAC) on the nociceptive withdrawal reflex (NWR) of the forelimb of ponies as a method for quantifying anesthetic potency. 7 healthy adult Shetland ponies. Individual MAC (iMAC) for isoflurane was determined for each pony. Then, effects of isoflurane administered at 0.85, 0.95, and 1.05 iMAC on the NWR were assessed. At each concentration, the NWR threshold was defined electromyographically for the common digital extensor and deltoid muscles by stimulating the digital nerve; additional electrical stimulations (3, 5, 10, 20, 30, and 40 mA) were delivered, and the evoked activity was recorded and analyzed. After the end of anesthesia, the NWR threshold was assessed in standing ponies. Mean +/- SD MAC of isoflurane was 1.0 +/- 0.2%. The NWR thresholds for both muscles increased significantly in a concentration-dependent manner during anesthesia, whereas they decreased in awake ponies. Significantly higher thresholds were found for the deltoid muscle, compared with thresholds for the common digital extensor muscle, in anesthetized ponies. At each iMAC tested, amplitudes of the reflex responses from both muscles increased as stimulus intensities increased from 3 to 40 mA. A concentration-dependent depression of evoked reflexes with reduction in slopes of the stimulus-response functions was detected. Anesthetic-induced changes in sensory-motor processing in ponies anesthetized with isoflurane at concentrations of approximately 1.0 MAC can be detected by assessment of NWR. This method will permit comparison of effects of inhaled anesthetics or anesthetic combinations on spinal processing in equids.

  9. Activation of the canonical nuclear factor-κB pathway is involved in isoflurane-induced hippocampal interleukin-1β elevation and the resultant cognitive deficits in aged rats

    Energy Technology Data Exchange (ETDEWEB)

    Li, Zheng-Qian; Rong, Xiao-Ying; Liu, Ya-Jie; Ni, Cheng [Department of Anesthesiology, Peking University Third Hospital, Beijing 100191 (China); Tian, Xiao-Sheng [Neuroscience Research Institute and Department of Neurobiology, Key Laboratory for Neuroscience, Ministry of Education and Ministry of Public Health, Peking University Health Science Center, Beijing 100191 (China); Mo, Na [Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing 100021 (China); Chui, De-Hua, E-mail: dchui@bjmu.edu.cn [Neuroscience Research Institute and Department of Neurobiology, Key Laboratory for Neuroscience, Ministry of Education and Ministry of Public Health, Peking University Health Science Center, Beijing 100191 (China); Guo, Xiang-Yang, E-mail: puthmzk@163.com [Department of Anesthesiology, Peking University Third Hospital, Beijing 100191 (China)

    2013-09-06

    Highlights: •Isoflurane induces hippocampal IL-1β elevation and cognitive deficits in aged rats. •Isoflurane transiently activates the canonical NF-κB pathway in aged rat hippocampus. •NF-κB inhibitor mitigates isoflurane-induced IL-1β elevation and cognitive deficits. •We report a linkage between NF-κB signaling, IL-1β expression, and cognitive changes. -- Abstract: Although much recent evidence has demonstrated that neuroinflammation contributes to volatile anesthetic-induced cognitive deficits, there are few existing mechanistic explanations for this inflammatory process. This study was conducted to investigate the effects of the volatile anesthetic isoflurane on canonical nuclear factor (NF)-κB signaling, and to explore its association with hippocampal interleukin (IL)-1β levels and anesthetic-related cognitive changes in aged rats. After a 4-h exposure to 1.5% isoflurane in 20-month-old rats, increases in IκB kinase and IκB phosphorylation, as well as a reduction in the NF-κB inhibitory protein (IκBα), were observed in the hippocampi of isoflurane-exposed rats compared with control rats. These events were accompanied by an increase in NF-κB p65 nuclear translocation at 6 h after isoflurane exposure and hippocampal IL-1β elevation from 1 to 6 h after isoflurane exposure. Nevertheless, no significant neuroglia activation was observed. Pharmacological inhibition of NF-κB activation by pyrrolidine dithiocarbamate markedly suppressed the IL-1β increase and NF-κB signaling, and also mitigated the severity of cognitive deficits in the Morris water maze task. Overall, our results demonstrate that isoflurane-induced cognitive deficits may stem from upregulation of hippocampal IL-1β, partially via activation of the canonical NF-κB pathway, in aged rats.

  10. 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.

  11. Bispectoral index scores of pediatric patients under dental treatment and recovery conditions: Study of children assigned for general anesthesia under propofol and isofloran regimes.

    Science.gov (United States)

    Tahririan, Dana; Kaviani, Naser; Nourbakhsh, Nosrat

    2016-01-01

    This study was planned to determine the relationship between bispectoral index (BIS) during dental treatment and recovery conditions in children undergoing two regimes of anesthesia of propofol and isoflurane. In this single-blind clinical trial study, 57 4-7-year-old healthy children who had been referred for dental treatment under general anesthesia between 60 and 90 min were selected by convenience sampling and assigned to two groups, after obtaining their parents' written consent. The anesthesia was induced by inhalation. For the first group, the anesthesia was preserved by a mixture of oxygen (50%), nitrous oxide (50%), and isoflurane (1%). For the second group, the anesthesia was preserved by a mixture of oxygen (50%), nitrous oxide (50%), and propofol was administered intravenously at a dose of 100 Ng/kg/min. The patients' vital signs, BIS, and agitation scores were recorded every 10 min. The data were analyzed by repeated measure ANOVA and t-tests at a significance level of α = 0.05 using SPSS version 20. The results of independent t-test for anesthesia time showed no statistically significant difference between isoflurane and propofol (P = 0.87). Controlling age, the BIS difference between the two anesthetic agents was not significant (P > 0.05); however, it was negatively correlated with the duration of anesthesia and the discharge time (P = 0.001, r = -0.308) and (P anesthesia is produced by propofol and isoflurane, but lower recovery complications from anesthesia are observed with isoflurane.

  12. Minimum Alveolar Concentration and Cardiopulmonary Effects of Isoflurane in Ring-tailed Lemurs (Lemur catta).

    Science.gov (United States)

    Chinnadurai, Sathya K; Balko, Julie A; Williams, Cathy V

    2017-07-01

    The goal of this study was to determine the minimum alveolar concentration (MAC) and cardiopulmonary effects of isoflurane in ring-tailed lemurs (Lemur catta). The MAC of isoflurane was determined by using a tail-clamp stimulus in adult ring-tailed lemurs (6 male, 4 female). Once MAC was determined, another group of 10 adult ring-tailed lemurs (5 male, 5 female) were anesthetized and instrumented similarly as the previous group and maintained at 0.5, 1, 1.5, and 2 times MAC for 15 min each with no external stimulation. Five lemurs were exposed to increasing concentrations (that is, 0.5 times MAC increasing to 2 times MAC), and the other 5 animals were exposed to decreasing concentrations. MAC of isoflurane for ringtailed lemurs was 1.9%. The animals became hypotensive, but no significant differences were found in heart rate or systolic, mean, and diastolic blood pressures at the different multiples of MAC examined. At 1 MAC, all lemurs developed a moderate respiratory acidosis, which became more severe at 2 MAC. Given these findings, isoflurane at 0.5 to 2 times MAC in ringtailed lemurs does not result in predictable depression of blood pressure, but hypoventilation occurs at 1 MAC or greater.

  13. Anesthetic Management of a Pediatric Patient With Wilsons Disease

    Science.gov (United States)

    Baykal, Mehmet; Karapolat, Sami

    2010-01-01

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

  14. Isoflurane and sevoflurane decrease entropy indices more than halothane at equal MAC values.

    Science.gov (United States)

    Prabhakar, Hemanshu; Ali, Zulfiqar; Bithal, Parmod K; Rath, Girija P; Singh, Deepak; Dash, Hari H

    2009-01-01

    Recently, bispectral index (BIS) values were demonstrated to be different for various anesthetics as a result of differential effects on electroencephalographic (EEG) signals. Entropy is similar to the BIS monitor, as both process raw EEG to derive a number. We hypothesized that entropy may also be anesthetic agent-specific. Thirty adult patients undergoing spinal surgery were randomized to receive halothane, isoflurane, or sevoflurane. Entropy indices were recorded at various minimum alveolar concentration (MAC) values-0.5, 0.75, 1.0 and 1.5-both during wash-in and wash-out of the agent. Heart rate (HR), mean arterial blood pressure (MAP), response entropy (RE), and state entropy (SE) were noted. Statistical analysis was done using a one-way analysis-ofvariance test. P values less than 0.05 were considered significant. Ten patients in each group completed the study. The demographics and baseline values of HR, MAP, RE, and SE were comparable in all three groups. During the study period, for a given MAC value, both RE and SE remained low in the isoflurane and sevoflurane groups compared to the halothane group. For a given MAC, the RE and SE were comparable during wash-in and wash-out phases. Halothane produced higher entropy values as compared to isoflurane and sevoflurane at equivalent MAC levels.

  15. 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

  16. [Comparison of waste anesthetic gases in operating rooms with or without an scavenging system in a Brazilian University Hospital].

    Science.gov (United States)

    Braz, Leandro Gobbo; Braz, José Reinaldo Cerqueira; Cavalcante, Guilherme Aparecido Silva; Souza, Kátina Meneghetti; Lucio, Lorena Mendes de Carvalho; Braz, Mariana Gobbo

    Occupational exposure to waste anesthetic gases in operating room (OR) without active scavenging system has been associated with adverse health effects. Thus, this study aimed to compare the trace concentrations of the inhaled anesthetics isoflurane and sevoflurane in OR with and without central scavenging system. Waste concentrations of isoflurane and sevoflurane were measured by infrared analyzer at different locations (near the respiratory area of the assistant nurse and anesthesiologist and near the anesthesia station) and at two times (30 and 120minutes after the start of surgery) in both OR types. All isoflurane and sevoflurane concentrations in unscavenged OR were higher than the US recommended limit (2 parts per million), regardless of the location and time evaluated. In scavenged OR, the average concentrations of isoflurane were within the limit of exposure, except for the measurements near the anesthesia station, regardless of the measurement times. For sevoflurane, concentrations exceeded the limit value at all measurement locations and at both times. The exposure to both anesthetics exceeded the international limit in unscavenged OR. In scavenged OR, the concentrations of sevoflurane, and to a lesser extent those of isoflurane, exceeded the recommended limit value. Thus, the OR scavenging system analyzed in the present study decreased the anesthetic concentrations, although not to the internationally recommended values. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  17. 硬膜外辅助全麻与静吸全麻下100例消化道肿瘤患者的麻醉可行性对比%A comparative study of the feasibility of epidural assisted anesthesia and isoflurane anesthesia in 100 patients with gastrointestinal cancer

    Institute of Scientific and Technical Information of China (English)

    鲁竞; 熊桂林

    2012-01-01

    Objective To compare the clinical efficacy and adverse effects of epidural assisted anesthesia with isoflurane surgery under general anesthesia in patients with gastrointestinal tumors, and provide better anesthesia for future surgery. Methods A total of 100 gastrointestinal cancer patients of our hospital who underwent surgery were selected, and they were randomly divided into isoflurane anesthesia group and epidural - assisted group. Patients received endotracheal intubation under general anesthesia. On the basis of general anesthesia, the epidural - assisted group received lidocaine for epidural anesthesia. The extubation time after surgery, postoperative nausea and vomiting, arrhythmias and blood pressure were compared in the two groups. The efficacy of two kinds of anesthetic methods was assessed. Results Extubanon time after anesthesia in the epidural - assisted group was shorter than that in the isoflurane anesthesia group. There were leas postoperative complications in the epidural - assisted group than in the isoflurane anesthesia group. Conclusion Isoflurane general anesthesia combined with lidocaine and epidural anesthesia can obtain a satisfactory anesthetic effect on gastrointestinal cancer patients.%目的 比较硬膜外辅助全麻与静吸全麻下消化道肿瘤患者手术的临床疗效和不良反应,为今后手术患者提供更好的麻醉方法.方法 选取本院就诊行手术治疗的消化道肿瘤患者100例,按照随机原则分为静吸全麻组和硬膜外辅助组.2组均使用气管内插管进行全麻,硬膜外辅助组在全麻的基础上使用利多卡因进行硬膜外阻滞,比较2组在手术完毕后拔管时间,以及术后的恶心呕吐、心律失常、血压升高的不良反应情况,综合评定2种麻醉方法的疗效.结果 硬膜外辅助组麻醉后的拔管时间明显比静吸全麻组短,术后发生并发症的情况少于静吸全麻组.结论 对消化道肿瘤患者采用静吸全麻复合利多卡因

  18. Halothane, isoflurane, xenon, and nitrous oxide inhibit calcium ATPase pump activity in rat brain synaptic plasma membranes.

    Science.gov (United States)

    Franks, J J; Horn, J L; Janicki, P K; Singh, G

    1995-01-01

    Perturbation of neuronal calcium homeostasis may alter neurotransmission in the brain, a phenomenon postulated to characterize the anesthetic state. Because of the central role of plasma membrane Ca(2+)-ATPase (PMCA) in maintaining Ca2+ homeostasis, the authors examined the effect of several inhalational anesthetics on PMCA function in synaptic plasma membranes (SPM) prepared from rat brain. Ca(2+)-ATPase pumping activity was assessed by measurement of ATP-dependent uptake of Ca2+ by SPM vesicles. ATPase hydrolytic activity was assessed by spectrophotometric measurement of inorganic phosphate (Pi) released from ATP. For studies of anesthetic effects on PMCA activity, Ca2+ uptake or Pi release was measured in SPM exposed to halothane, isoflurane, xenon, and nitrous oxide at partial pressures ranging from 0 to 1.6 MAC equivalents. Halothane and isoflurane exposures were carried out under a gassing hood. For xenon and nitrous oxide exposures, samples were incubated in a pressure chamber at total pressures sufficient to provide anesthetizing partial pressures for each agent. Dose-related inhibition of Ca(2+)-ATPase pumping activity was observed in SPM exposed to increasing concentrations of halothane and isoflurane, confirmed by ANOVA and multiple comparison testing (P Xenon and nitrous oxide also inhibited Ca2+ uptake by SPM vesicles. At partial pressures of these two gases equivalent to 1.3 MAC, PMCA was inhibited approximately 20%. Hydrolysis of ATP by SPM fractions was also inhibited in a dose-related fashion. An additive effect occurred when 1 vol% of halothane was added to xenon or nitrous oxide at partial pressures equivalent to 0-1.6 MAC for the latter two agents. Plasma membranes Ca(2+)-ATPase is significantly inhibited, in a dose-related manner, by clinically relevant partial pressures of halothane, isoflurane, xenon, and nitrous oxide. Furthermore, these anesthetics inhibit PMCA activity in accordance with their known potencies, and an additive effect was

  19. Cerebral blood flow at 0.5 and 1.0 minimal alveolar concentrations of desflurane or sevoflurane compared with isoflurane in normoventilated pigs.

    Science.gov (United States)

    Holmström, A; Akeson, J

    2003-04-01

    Whether desflurane and sevoflurane have clinical advantages over isoflurane in neuroanesthesia is much debated. A porcine model was used for comparison of desflurane and sevoflurane with isoflurane with respect to their cerebrovascular effects. The minimal alveolar concentration (MAC) of each of the three agents was first determined in a standardized manner in six domestic juvenile pigs to enhance comparison reliability. Six other pigs were then anesthetized with isoflurane, desflurane, and sevoflurane, given in sequence to each pig in an even crosswise order with the first agent also used to maintain anesthesia during surgical preparation. Cerebral blood flow (CBF) was calculated from the clearance curve of intraarterially injected 133Xe. The mean arterial pressure (MAP) was invasively monitored. The estimated cerebrovascular resistance (CVRe) was calculated by dividing MAP with CBF, thereby approximating the cerebral perfusion pressure with MAP. For both MAC levels, the trend for CBF was desflurane > isoflurane > sevoflurane, and the trend for MAP and CVRe was sevoflurane > isoflurane > desflurane. Statistical comparison of desflurane and sevoflurane with isoflurane with respect to CBF and MAP revealed two statistically significant differences-namely, that CBF at 1.0 MAC desflurane was 17% higher than CBF at 1.0 MAC isoflurane (P =.0025) and that MAP at 1.0 MAC sevoflurane was 16% higher than MAP at 1.0 MAC isoflurane (P =.011). Consequently, in this study at normocapnia, these agents did not seem to differ much in their cerebral vasodilating effects at lower doses. At higher doses, however, desflurane, in contrast to sevoflurane, was found to induce more cerebral vasodilation than isoflurane.

  20. Orexin-A facilitates emergence of the rat from isoflurane anesthesia via mediation of the basal forebrain.

    Science.gov (United States)

    Zhang, Li-Na; Yang, Cen; Ouyang, Peng-Rong; Zhang, Zhi-Chao; Ran, Ming-Zi; Tong, Li; Dong, Hai-Long; Liu, Yong

    2016-08-01

    Previous studies have demonstrated that orexinergic neurons involve in promoting emergence from anesthesia of propofol, an intravenous anesthetics, while whether both of orexin-A and orexin-B have promotive action on emergence via mediation of basal forebrain (BF) in isoflurane anesthesia has not been elucidated. In this study, we observed c-Fos expressions in orexinergic neurons following isoflurane inhalation (for 0, 30, 60, and 120min) and at the time when the righting reflex returned after the cessation of anesthesia. The plasma concentrations of orexin-A and -B in anesthesia-arousal process were measured by radioimmunoassay. Orexin-A and -B (30 or 100pmol) or the orexin receptor-1 and -2 antagonist SB-334867A and TCS-OX2-29 (5 or 20μg) were microinjected into the basal forebrain respectively. The effects of them on the induction (loss of the righting reflex) and the emergence time (return of the righting reflex) under isoflurane anesthesia were observed. The results showed that the numbers of c-Fos-immunoreactive orexinergic neurons in the hypothalamus decreased over time with continued isoflurane inhalation, but restored at emergence. Similar alterations were observed in changes of plasma orexin-A concentrations but not in orexin-B during emergence. Administration of orexins had no effect on the induction time, but orexin-A facilitated the emergence of rats from isoflurane anesthesia while orexin-B didn't. Conversely, microinjection of the orexin receptor-1 antagonist SB-334867A delayed emergence from isoflurane anesthesia. The results indicate that orexin-A plays a promotive role in the emergence of isoflurane anesthesia and this effect is mediated by the basal forebrain.

  1. Old method, new drugs: comparison of the efficacy of sevoflurane, isoflurane, and desflurane in achieving controlled hypotension in spinal surgery.

    Science.gov (United States)

    Kurt, Filiz; Derbent, Abdurrahim; Demirag, Kubilay; Eris, Oguz; Uyar, Mehmet; Islekel, Sertac

    2005-01-01

    This study compared the efficacy of isoflurane, sevoflurane, and desflurane in achieving hemodynamic stability in spinal procedures using moderate levels of controlled hypotension. After obtaining ethics committee approval and written informed consent, 32 American Surgical Association I-II patients were randomly allocated to receive isoflurane (n=12), sevoflurane (n=10), or desflurane (n=10) in O2-N2O (1:1) for maintenance of anesthesia. The induction of anesthesia, fentanyl dosage, and initial and maintenance volume replacements were standardized. Blood pressure was invasively monitored and maintained within a target systolic blood pressure (SBP) range of 80 to 90 mm Hg during the study. SBP outside this range was recorded. Volatile anesthetic concentration was adjusted according to the same protocol for all 3 agents. SPB control was maintained better with sevoflurane and isoflurane than desflurane; median SBP was outside the target range during 32% (range, 15%-55%) of study time with isoflurane, 26% (12%-42%) with sevoflurane, and 44% (20%-80%) with desflurane. Total blood loss did not differ among the groups. Sevoflurane and isoflurane administered in 2 L/min fresh gas flow were more effective than desflurane in achieving controlled hypotension in spinal surgery.

  2. The effect of preoperative suggestions on perioperative dreams and dream recalls after administration of different general anesthetic combinations: a randomized trial in maxillofacial surgery.

    Science.gov (United States)

    Gyulaházi, Judit; Varga, Katalin; Iglói, Endre; Redl, Pál; Kormos, János; Fülesdi, Béla

    2015-01-01

    Images evoked immediately before the induction of anesthesia with the help of suggestions may influence dreaming during anesthesia.The aim of the study was to assess the incidence of evoked dreams and dream recalls by employing suggestions before induction of anesthesia while administering different general anesthetic combinations. This is a single center, prospective randomized including 270 adult patients scheduled for maxillofacial surgical interventions. Patients were assigned to control, suggestion and dreamfilm groups according to the psychological method used. According to the anesthetic protocol there were also three subgroups: etomidate & sevoflurane, propofol & sevoflurane, propofol & propofol groups. Primary outcome measure was the incidence of postoperative dreams in the non-intervention group and in the three groups receiving different psychological interventions. Secondary endpoint was to test the effect of perioperative suggestions and dreamfilm-formation training on the occurrance of dreams and recallable dreams in different general anesthesiological techniques. Dream incidence rates measured in the control group did not differ significantly (etomidate & sevoflurane: 40%, propofol & sevoflurane: 26%, propofol & propofol: 39%). A significant increase could be observed in the incidence rate of dreams between the control and suggestion groups in the propofol & sevoflurane (26%-52%) group (p = 0.023). There was a significant difference in the incidence of dreams between the control and dreamfilm subgroup in the propofol & sevoflurane (26% vs. 57%), and in the propofol & propofol group (39% vs.70%) (p = 0.010, and p = 0.009, respectively). Similar to this, there was a significant difference in dream incidence between the dreamfilm and the suggestion subgroups (44% vs. 70%) in the propofol & propofol group (p = 0.019). Propofol as an induction agent contributed most to dream formation and recalls (χ2-test p value: 0.005). The content of images and dreams

  3. Severe autonomic dysreflexia induced cardiac arrest under isoflurane anesthesia in a patient with lower thoracic spine injury

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    Amit Jain

    2013-01-01

    Full Text Available We present a case of severe autonomic dysreflexia (AD progressing to cardiac arrest and death under isoflurane anesthesia. Though AD in chronic cervical spine injury is a common entity, occurrence of such an event in the stage of flaccid paralysis in lower dorsal spinal cord injury is rare, especially under general anesthesia. Manipulation of urinary bladder catheter under light plane of isoflurane anesthesia might be the precipitating factor. Increasing concentration of isoflurane failed to abort the episode or might have aggravated it. High level of suspicion and vigilance is necessary to prevent, diagnose and treat such a condition.

  4. Evaluation of the Adequacy of General Anesthesia in Cesarean Section by Bispectral Index

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    Sayed Mohammad Reza Hadavi

    2013-09-01

    Full Text Available Background: Awareness and recall, though not common, are the major hazards of general anesthesia, especially in Cesarean section (C/S because of the absence of benzodiazepine and opioids for a significant time during anesthesia. In this study, the Bispectral Index (BIS, end-tidal isoflurane, and hemodynamic parameters were examined to evaluate the depth of the routine general anesthetic technique in C/S. Methods: This study was carried out on 60 parturient patients undergoing elective C/S. A standardized anesthetic technique was applied: induction with Thiopental (4-5 mg/kg and Succinylcholine (1.5-2 mg/kg as well as maintenance with O2, N2O, and isoflurane. Electrocardiogram, heart rate, blood pressure, Spo2, end-tidal isoflurane concentration, BIS, and any clinical signs of inadequate depth of anesthesia such as movement, sweating, lacrimation, coughing, and jerking were continuously monitored and recorded at 16 fixed time points during anesthesia. Results: A median BIS of less than 70 (range: 42-68 was obtained on all occasions during surgery; however, at each milestone, at least 20% of the patients had BIS values above 60. Hemodynamic parameters increased significantly in some patients, especially during laryngoscopy and intubation. No patient experienced recall or awareness. Conclusion: The currently used general anesthetic technique in our center appears inadequate in some milestones to reliably produce BIS values less than 60, which are associated with lower risk of awareness. Therefore, with respect to such desirable outcomes as good Apgar and clinical status in neonates, we would recommend the application of this method (if confirmed by further studies through larger dosages of anesthetic agents.

  5. Protective effects of emulsified isoflurane after myocardial ischemia-reperfusion injury and its mechanism in rabbits

    Institute of Scientific and Technical Information of China (English)

    RAO Yan; WANG Yan-lin; CHEN Yong-quan; ZHANG Wen-sheng; LIU Jin

    2009-01-01

    Objective: To evaluate the protective effects of 8% emulsified isoflurane after myocardial ischemia-reperfusion injury and its mechanism in rabbits.Methods: Twenty-four male adult New Zealand white rabbits were anesthetized with intravenous injection of 30 mg/kg pentobarbital followed by 5 mg·kg-1·h-1 infusion. All rabbits were subjected to 30 minutes of left anterior de-scending coronary artery (LAD) occlusion and 3 hours of subsequent reperfusion. Before LAD occlusion, the rabbits were randomly allocated into three groups for precondi-tioning treatment (eight for each group). The control group (C group) received intravenously 0.9% NaCl for 30 minutes. The emulsified isoflurane group (EI group) received 8% emulsified isoflurane intravenously till 0.64% end-tidal con-centration for 30 minutes that was followed by a 15-minute washout period. The Intralipid group (IN group) received 30% Intralipid for 30 minutes. The infarcted area, plasma malondialdehyde (MDA) content, superoxide dismutase activity (SOD) and nitrite concentration after 3-hour myo-cardial perfusion were recorded simultaneously.Results: For the myocardial ischemia-reperfusion in-jury animals, the infarcted size in the EI group was signifi-cantly reduced (91.9%±8%) as compared with control group (39%±6%,t=5.19, P<0.01). The plasma SOD activity and nitrite concentration in EI group were significantly higher than those in control group (t=2.82, t=8.46, P<0.05), but MDA content was lower in EI group than that in control group (t=2.56, P<0.05).Conclusions: The results indicate that emulsified isoflurane has a cardioprotection effect against ischemia-reperfusion injury. This beneficial effect of emulsified isoflurane is probably through NO release and consequently by increase in autioxidation of myocardium.

  6. Hypoxia-inducible factor-1α is involved in isoflurane-induced blood-brain barrier disruption in aged rats model of POCD.

    Science.gov (United States)

    Cao, Yiyun; Li, Zhengqian; Li, Hongping; Ni, Cheng; Li, Lunxu; Yang, Ning; Shi, Chengmei; Zhong, Yanfeng; Cui, Dehua; Guo, Xiangyang

    2017-09-05

    Prolonged exposure to inhaled anesthetics may lead to postoperative cognitive dysfunction (POCD). Nevertheless, the underlying mechanisms are not known. Hypoxia-inducible factor-1α (HIF-1α) and its target gene vascular endothelial growth factor (VEGF) were shown to be activated by inhaled anesthetics. The aim of the present study was to determine the role of HIF-1α in isoflurane-induced blood-brain barrier (BBB) disruption and resultant cognitive impairment. After a 4-h exposure to 1.5% isoflurane in 20-month-old rats, increases in vascular permeability, and disrupted BBB ultrastructure were accompanied by the degradation of tight junction proteins occludin and collagen type IV in brain blood vessels. Increases in HIF-1α and VEGF proteins and activation of MMP-2 in the hippocampus were also observed in the hippocamp of isoflurane-exposed rats compared with control rats. Pharmacological inhibition of HIF-1α activation by 3-(5'-hydroxymethyl-2'-furyl)-1-benzylindazole (YC-1) markedly suppressed the expression of HIF-1α, VEGF and MMP-2, and mitigated the severity of BBB disruption.YC-1 pretreatment also significantly attenuated isoflurane-induced cognitive deficits in the Morris water maze task. Overall, our results demonstrate that hippocampal HIF-1α/VEGF signaling seems to be the upstream mechanism of isoflurane-induced cognitive impairment, and provides apotential preventive and therapeutic target for POCD. Copyright © 2017. Published by Elsevier B.V.

  7. A COMPARATIVE EVALUATION OF ISOFLURANE VS HALOTHANE TO ATTENUATE HAEMODYNAMIC RESPONSE DUE TO CO 2 PNEUMOPERI- TONEUM DURING LAPAROSCOPIC CHOLECYSTECTOMY

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    Chavi

    2013-03-01

    Full Text Available ABSTRACT: BACKGROUND: Laparoscopic cholecystectomy is a relatively new sur gical procedure which is enjoying ever increasing popularit y and presenting new anesthetic challenges. Volatile anesthetics play an important ro le in the management of haemodynamic changes due to CO2 pneumoperitoneum during laparoscopi c surgeries. The aim of the study is to evaluate Isoflurane Vs Halothane as an adjunct t o obtund haemodynamic response due to CO2 pneumoperitoneum. MATERIALS & METHODS: 50 patients aged 20-60 yrs of either sex belonging to ASA grade I & II scheduled for electiv e laparoscopic cholecystectomy admitted in MLB Medical College, Jhansi were randomly divided i nto two group. Group I – O 2 : N 2 O + Inhalational agent (Isoflurane 1.5-2% Group II – O 2 : N 2 O + Inhalational agent (Halothane 1.5-2% RESULTS : Hypertensive response due to CO 2 pneumoperitoneum was well suppressed by Isoflurane (1.5-2% {Group-I} which maintained pulse rate at a relatively higher side than halothane, (1.5-2%{Group II} decreased mean arteria l pressure more significantly than halothane without any difference in arterial oxygen saturation (SPO 2 and end tidal CO 2 concentration (E T CO 2 . CONCLUSION : This can be concluded from the study that Isoflur ane (Group-I more effectively attenuated the haemodyna mic response due to CO 2 pneumoperitoneum during laparoscopic cholecystectomy as compared to Halothane (Group-II under balanced anesthetic technique.

  8. Effects of isoflurane on ICAM-1 expression and neutrophils infiltration in rats with liver ischemia and reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Xu Guangmin; Tao Guocai

    2009-01-01

    Objective: To establish a rat model of warm partial hepatic ischemia-reperfusion (IR), and investigate the protective and anti-inflammatory effects of isoflurane on warm hepatic ischemia-reperfusion injury (IRI) in rats. Methods: Thirty-two female Sprague-Dawley rots were divided equally into 4 groups (n=8): PB-Sham group in which the rats were anesthetized by intraperitoneal injection of pentobarbital sodium (1.0%, 40 mg/kg, PB) and received a sham operation without occlusion of liver blood flow; PB-IR group whose rats underwent partial hepatic IR after anesthesia; Iso-Sham group in which inhalation of 1.0 MAC isoflurane and sham operation was performed; Iso-IR group in which 1.0 MAC isoflurane was inhaled for 4 h and IR was performed. Rat model of warm partial hepatic IR was established by clamping the hepatic arteries and hilar vessels distributing to the left and median lobes to induce partial hepatic ischemia (70%) for 60 min followed by reperfusion for 3 h. The rats were killed 3 h after declamping, and specimens of liver tissue and blood were obtained. The serum ALT and AST were detected as liver damage markers. Viability of myeloperoxidase (MPO) in liver was measured. The protein level of ICAM-1 in the liver was detected by immunohistochemistry and Western blotting. Results: Rats treated with 1.0 MAC isoflurane during warm partial (70%) hepatic ischemia 60 min and 3 h reperfusion had significantly lower serum ALT and AST compared with rats anesthetized with pentobarbital sodium subjected to hepatic IRI. The expression of ICAM-1 in hepatic tissue was significantly increased by hepatic IRI after pentobarbital sodium anesthesia. Isoflurane significantly inhibited protein expression of ICAM-1 in hepatic IR injury compared with pentobarbital sodium anesthesia. Viability of liver MPO was significantly increased by hepatic IRI after pentobarbital sodium anesthesia; Isoflurane can significantly inhibit MPO alteration in rat liver ischemia-reperfusion injury

  9. [The effect of sevoflurane and isoflurane on striatal dopamine of awake freely moving rats observed in an in vivo microdialysis study].

    Science.gov (United States)

    Adachi, Y; Taoda, M; Uchihashi, Y; Watanabe, K; Satoh, T

    1999-09-01

    We investigated the effect of sevoflurane and isoflurane on the level of interstitial dopamine of in vivo awake, free moving rats brain striatum using microdialysis techniques. Rats were implanted with a microdialysis probe to the right striatum of the brain and administered with 1.2 MAC of each volatile anesthetics for 1 hour, and dialysates from the probe were determined every 20 minutes. Both anesthetics reduced the amount of dopamine derived from dialysate, and increased the efflux of dopamine with pretreatment of nomifensine 10mg. kg-1 i.p. The change of metabolites of dopamine during anesthesia was increased. No significant difference was found between sevoflurane and isoflurane. We hypothesized that these anesthetics might have special actions on interactions between metabolism and re-uptake of dopamine in rats striatum during anesthesia.

  10. Effects of Moderate Hyperventilation on Jugular Bulb Gases under Propofol or Isoflurane Anesthesia during Supratentorial Craniotomy

    Institute of Scientific and Technical Information of China (English)

    Lan Meng; Shu-Qin Li; Nan Ji; Fang Luo

    2015-01-01

    Background:The optimal ventilated status under total intravenous or inhalation anesthesia in neurosurgical patients with a supratentorial tumor has not been ascertained.The purpose of this study was to intraoperatively compare the effects of moderate hyperventilation on the jugular bulb oxygen saturation (SjO2),cerebral oxygen extraction ratio (O2ER),mean arterial blood pressure (MAP),and heart rate (HR) in patients with a supratentorial tumor under different anesthetic regimens.Methods:Twenty adult patients suffered from supratentorial tumors were randomly assigned to receive a propofol infusion followed by isoflurane anesthesia after a 30-min stabilization period or isoflurane followed by propofol.The patients were randomized to one of the following two treatment sequences:hyperventilation followed by normoventilation or normoventilation followed by hyperventilation during isoflurane or propofol anesthesia,respectively.The ventilation and end-tidal CO2 tension were maintained at a constant level for 20 min.Radial arterial and jugular bulb catheters were inserted for the blood gas sampling.At the end of each study period,we measured the change in the arterial and jugular bulb blood gases.Results:The mean value of the jugular bulb oxygen saturation (SjO2) significantly decreased,and the oxygen extraction ratio (O2ER) significantly increased under isoflurane or propofol anesthesia during hyperventilation compared with those during normoventilation (SjO2:t =-2.728,P =0.011 or t =-3.504,P =0.001;O2ER:t =2.484,P =0.020 or t =2.892,P =0.009).The SjO2 significantly decreased,and the O2ER significantly increased under propofol anesthesia compared with those values under isoflurane anesthesia during moderate hyperventilation (SjO2:t =-2.769,P =0.012;O2ER:t =2.719,P =0.013).In the study,no significant changes in the SjO2 and the O2ER were observed under propofol compared with those values under isoflurane during normoventilation.Conclusions:Our results suggest that the

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

    Science.gov (United States)

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

    2012-11-01

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

  12. Early exposure to volatile anesthetics impairs long-term associative learning and recognition memory.

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    Bradley H Lee

    Full Text Available BACKGROUND: Anesthetic exposure early in life affects neural development and long-term cognitive function, but our understanding of the types of memory that are altered is incomplete. Specific cognitive tests in rodents that isolate different memory processes provide a useful approach for gaining insight into this issue. METHODS: Postnatal day 7 (P7 rats were exposed to either desflurane or isoflurane at 1 Minimum Alveolar Concentration for 4 h. Acute neuronal death was assessed 12 h later in the thalamus, CA1-3 regions of hippocampus, and dentate gyrus. In separate behavioral experiments, beginning at P48, subjects were evaluated in a series of object recognition tests relying on associative learning, as well as social recognition. RESULTS: Exposure to either anesthetic led to a significant increase in neuroapoptosis in each brain region. The extent of neuronal death did not differ between groups. Subjects were unaffected in simple tasks of novel object and object-location recognition. However, anesthetized animals from both groups were impaired in allocentric object-location memory and a more complex task requiring subjects to associate an object with its location and contextual setting. Isoflurane exposure led to additional impairment in object-context association and social memory. CONCLUSION: Isoflurane and desflurane exposure during development result in deficits in tasks relying on associative learning and recognition memory. Isoflurane may potentially cause worse impairment than desflurane.

  13. The neurochemical profile of the hippocampus in isoflurane-treated and unanesthetized rat pups

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    Menshanov Petr N.

    2015-09-01

    Full Text Available In vivo study of cerebral metabolism in neonatal animals by high-resolution magnetic resonance spectroscopy (MRS is an important tool for deciphering the developmental origins of adult diseases. Up to date, all in vivo spectrum acquisition procedures have been performed in neonatal rodents under anesthesia. However, it is still unknown if the inhaled anesthetic isoflurane, which is commonly used in magnetic resonance imaging studies, could affect metabolite levels in the brain of neonatal rats. Moreover, the unanesthetized MRS preparation that uses neonatal rodent pups is still lacking.

  14. Effect of Inhalational Anesthetics on Cytotoxicity and Intracellular Calcium Differently in Rat Pheochromocytoma Cells (PC12)

    Institute of Scientific and Technical Information of China (English)

    Qiujun WANG; Kezhong LI; Shanglong YAO

    2008-01-01

    Isoflurane, a commonly used inhaled anesthetic, induces apoptosis in rat pheochromo-cytoma cells (PC12) in a concentration- and time-dependent manner with unknown mechanism. We hypothesized that isoflurane induced apoptosis by causing abnormal calcium release from the endo-plasmic reticulum (ER) via activation of inositol 1,4,5-trisphosphate (IP3) receptors. Alzheimer's pre-senilin-1 (PS1) mutation increased activity of IP3 receptors and therefore rendered cells vulnerable to isoflurane-induced cytotoxicity. Sevoflurane and desflurane had less ability to disrupt intraceUular calcium homeostasis and thus being less potent to cause cytotoxicity. This study examined and com- pared the cytotoxic effects of various inhaled anesthetics on PC12 cells transfected with the Alz- heimer's mutated Psi (L286V) and the disruption of intracellular calcium homeostasis. PC12 cells transfected with wild type (WT) and mutated PS1 (L286V) were treated with equivalent of 1 MAC of isoflurane, sevoflurane and desflurane for 12 h. MTT reduction and LDH release assays were per- formed to evaluate cell viability. Changes of calcium concentration in cytosolic space ([Ca2+]c) were determined after exposing different types of cells to various inhalational anesthetics. The effects of IP3 receptor antagonist xestospongin C on isoflurane-induced cytotoxicity and calcium release from the ER in L286V PC12 cells were also determined. The results showed that isoflurane at 1 MAC for 12 h induced cytoxicity in L286V but not WT PC12 cells, which was also associated with greater and faster elevation of peak [Ca2+]c in L286V than in the WT cells. Xestospongin C significantly amelio- rated isoflurane cytotoxicity in L286V cells, as well as inhibited the calcium release from the ER in L286V cells. Sevoflurane and desflurane at equivalent exposure to isoflurane did not induce similar cytotoxicity or elevation of peak [Ca2+]c in L286V PC12 cells. These results suggested that isoflurane induced cytoxicity by

  15. Influence of isoflurane, fentanyl, thiopental, and alpha-chloralose on formation of brain edema resulting from a focal cryogenic lesion.

    Science.gov (United States)

    Murr, R; Berger, S; Schürer, L; Peter, K; Baethmann, A

    1995-06-01

    The objective of this study was to analyze the effects of various anesthetics on the formation of brain edema resulting from a focal cryogenic lesion. Thirty rabbits (six per group) were anesthetized with isoflurane (1 minimum alveolar anesthetic concentration [MAC] 2.1 vol%), fentanyl (bolus 5 micrograms/kg; infusion rate 1.0-0.5 micrograms.kg-1.min-1), thiopental (32.5 mg.kg-1.h-1), or alpha-chloralose (50 mg/kg). Control animals (sham operation, no lesion) received alpha-chloralose (50 mg/kg). Regional cerebral blood flow (rCBF) in perifocal brain tissue was measured by H2-clearance. Animals anesthetized with isoflurane required support of arterial pressure by angiotensin II (0.15 micrograms.kg-1.min-1). Six hours after trauma the animals were killed. Formation of brain edema was studied by specific gravity of cortical gray matter, white matter, hippocampus, caudate nucleus, putamen, and thalamus. Brain tissue samples were collected at multiple sites close to and distant from the lesion. Mean arterial pressure, arterial PCO2 and PO2, hematocrit, body temperature, and blood glucose were not different between groups during the posttraumatic course (except for an increased arterial pressure with alpha-chloralose compared to thiopental 4-6 h after trauma). The specific gravity of cortical gray matter was significantly reduced up to a distance of 6 mm from the center of the lesion in animals anesthetized with isoflurane, thiopental, or alpha-chloralose and up to 9 mm in animals given fentanyl.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Effect of propofol, sevoflurane, and isoflurane on postoperative cognitive dysfunction following laparoscopic cholecystectomy in elderly patients: A randomized controlled trial.

    Science.gov (United States)

    Geng, Ying-Jie; Wu, Qing-Hua; Zhang, Rui-Qin

    2017-05-01

    To compare the incidence of postoperative cognitive dysfunction (POCD) in elderly surgical patients (>60years) receiving different anesthetics (propofol, sevoflurane, or isoflurane) and to identify potential biomarkers of POCD in this patient population. Prospective, randomized, double-blind clinical trial. University-affiliated teaching hospital. One hundred and fifty elderly patients scheduled for laparoscopic cholecystectomy. Elderly patients undergoing laparoscopic cholecystectomy were randomly assigned to receive propofol, sevoflurane, or isoflurane anesthesia. Cognitive function was assessed using neuropsychological tests at baseline (1day before surgery [D0]), and on postoperative day 1 (D1) and day 3 (D3). Plasma S-100β and Aβ1-40 protein, IL-1β, IL-6 and TNF-α concentrations were assessed before induction of anesthesia (T0), after extubation (T1), and 1h (T2) and 24h (T3) postoperatively. The incidence of POCD was significantly lower in the propofol group compared to the isoflurane group and the sevoflurane group at D1 and D3 (propofol vs. isoflurane: D1 and D3, Ppropofol vs. sevoflurane: D1, P=0.012; D3, P=0.013). The incidence of POCD was significantly lower in the sevoflurane group compared to the isoflurane group at D1 (P=0.041), but not at D3. Postoperatively, plasma S-100β and Aβ1-40 protein, IL-1β, IL-6, and TNF-α concentrations were significantly decreased in the propofol group compared to the isoflurane group. Propofol anesthesia may be an option for elderly surgical patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Effect of hypercarbia and isoflurane on brain cell death and neurocognitive dysfunction in 7-day-old rats.

    Science.gov (United States)

    Stratmann, Greg; May, Laura D V; Sall, Jeffrey W; Alvi, Rehan S; Bell, Joseph S; Ormerod, Brandi K; Rau, Vinuta; Hilton, Joan F; Dai, Ran; Lee, Michael T; Visrodia, Kavel H; Ku, Ban; Zusmer, Emanuel J; Guggenheim, Jeremy; Firouzian, Atoosa

    2009-04-01

    Millions of neonates undergo anesthesia each year. Certain anesthetic agents cause brain cell death and long-term neurocognitive dysfunction in postnatal day (P)7 rats. Despite its intuitive appeal, a causal link between cell death and neurocognitive decline after anesthesia has not been established. If one existed, the degree of cell death would be expected to correlate with the degree of neurocognitive dysfunction caused by anesthesia. The authors therefore tested if cell death caused by various durations of isoflurane at 1 minimum alveolar concentration causes duration-dependent long-term neurocognitive dysfunction. Isoflurane was administered to P7 rats at 1 minimum alveolar concentration for 0, 1, 2, or 4 h. To control for the respiratory depressant effects of anesthesia, a group of rats was treated with 4 h of carbon dioxide. Cell death was assessed by FluoroJade staining 12 h after the end of each intervention, and neurocognitive outcome was assessed 8 weeks later by using fear conditioning, spatial reference memory, and spatial working memory tasks. Widespread brain cell death was caused by 2 h and 4 h of isoflurane and by 4 h of carbon dioxide. The degree and distribution of thalamic cell death was similar in 4 h isoflurane-treated and 4-h carbon dioxide-treated rats. Only 4 h of isoflurane caused a long-term neurocognitive deficit affecting both spatial reference memory and spatial working memory. Working memory was improved in carbon dioxide-treated rats. Isoflurane-induced brain cell death may be partly caused by hypercarbia. The inconsistencies between cell death and neurocognitive outcome suggest that additional or alternative mechanisms may mediate anesthesia-induced long-term neurocognitive dysfunction.

  18. 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.

  19. Influence of halothane, isoflurane, and sevoflurane on gastroesophageal reflux during anesthesia in dogs.

    Science.gov (United States)

    Wilson, Deborah V; Boruta, Daniel T; Evans, A Tom

    2006-11-01

    To determine whether maintenance of anesthesia with halothane or sevoflurane is associated with a lower incidence of gastroesophageal reflux (GER) than the use of isoflurane in dogs undergoing orthopedic surgery. 90 dogs. Dogs were evaluated during elective orthopedic surgery. Dogs with a history of vomiting or that had received any drugs that would alter gastrointestinal tract function were excluded from the study. The anesthetic protocol used was standardized to include administration of acepromazine maleate and morphine prior to induction of anesthesia with thiopental. Dogs were allocated to receive halothane, isoflurane, or sevoflurane to maintain anesthesia. A sensor-tipped catheter was placed to measure esophageal pH during anesthesia. Gastroesophageal reflux was defined as an esophageal pH 7.5. 51 dogs had 1 or more episodes of acidic GER during anesthesia. Reflux was detected in 14 dogs receiving isoflurane, 19 dogs receiving halothane, and 18 dogs receiving sevoflurane. In dogs with GER, mean +/- SD time from probe placement to onset of GER was 36 +/- 65 minutes and esophageal pH remained surgery or moving a dog on or off the surgery table. Dogs that developed GER soon after induction of anesthesia were more likely to regurgitate. Maintenance of anesthesia with any of the 3 commonly used inhalant agents is associated with a similar risk for development of GER in dogs.

  20. Evaluation of transpulmonary thermodilution as a method to measure cardiac output in anesthetized cats.

    Science.gov (United States)

    Beaulieu, Kim E; Kerr, Carolyn L; McDonell, Wayne N

    2009-01-01

    The objectives of this study were to evaluate the use of a transpulmonary thermodilution (Trans) technique for the measurement of cardiac output, and to determine the agreement between Trans and conventional thermodilution (TD) in anesthetized cats. Using each technique, cardiac output was measured in 5 mature cats (weights 2.4 to 5.6 kg) anesthetized with isoflurane. To induce different levels of cardiac output in each cat, anesthesia was maintained at > 1.5x end-tidal minimum alveolar concentration (MAC) of isoflurane, and at 1.3x end-tidal isoflurane MAC with and without administration of dobutamine. At least 2 comparisons between TD and Trans values were made at each cardiac output rate. Thirty-two of the 42 recorded comparisons were analyzed. Linear regression analysis (TD vs Trans) yielded an r(2) value of 0.83. The mean bias (TD-Trans) was -3.7 mL/kg/min with limits of agreement of -35.9 to 28.5 mL/kg/min. The concordance coefficient was 0.91. The Trans method showed good relationship and good agreement with TD in anesthetized cats. The Trans method is a relatively noninvasive, practical, and safe method to measure cardiac output in anesthetized cats.

  1. Anesthetics interacting with lipid rafts.

    Science.gov (United States)

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

    2013-01-23

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

  2. Effects of remifentanil on measures of anesthetic immobility and analgesia in cats.

    Science.gov (United States)

    Brosnan, Robert J; Pypendop, Bruno H; Siao, Kristine T; Stanley, Scott D

    2009-09-01

    To evaluate effects of various doses of remifentanil on measures of analgesia in anesthetized cats. 6 healthy adult cats. Minimum alveolar concentration (MAC) for isoflurane and thermal threshold responses were evaluated in anesthetized cats. Remifentanil infusions of 0 (baseline), 0.0625, 0.125, 0.25, 0.5, 1, 2, 4, 8, and 16 microg/kg/min were administered; after a 45-minute equilibration period, isoflurane MAC and responses were determined. Isoflurane MAC was determined in anesthetized cats once for each remifentanil infusion rate by use of a standard tail clamp technique. Thermal threshold was measured in awake cats by use of a commercially available analgesiometric probe placed on the lateral portion of the thorax; remifentanil infusions were administered in randomized order to anesthetized cats, and thermal threshold determinations were made by an investigator who was unaware of the infusion rate. Mean +/- SEM median effective concentration (EC(50)) for remifentanil and its active metabolite, GR90291, for the thermal threshold test was 1.00 +/- 0.35 ng/mL and 307 +/- 28 ng/mL of blood, respectively. Dysphoria was detected in all awake cats at the 2 highest remifentanil infusion rates. However, isoflurane MAC during remifentanil infusions was unchanged from baseline values, even at blood opioid concentrations approximately 75 times the analgesic EC(50). Immobility and analgesia as reflected by thermal threshold testing were independent anesthetic end points in the cats. Results of MAC-sparing evaluations should not be used to infer analgesic potency without prior validation of an MAC-analgesia relationship for specific drugs and species.

  3. Effects of the morphine-lidocaine-ketamine combination on cardiopulmonary function and isoflurane sparing in sheep

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    Suzane Lilian Beier

    2014-10-01

    Full Text Available The aims of this study were to evaluate the isoflurane sparing and clinical effects of a constant rate infusion of morphine – lidocaine – ketamine (MLK in healthy sheep undergoing experimental gastrointestinal surgery. Twelve adult female sheep (Texel breed were used, weighing 36.5 ± 8.1 kg. The sheep were anesthetized for the implantation of duodenal cannulas. The sheep were premedicated with 0.3 mg kg-1 intramuscular (IM morphine and 20 ?g kg-1 intravenous (IV detomidine. After premedication, anesthesia was induced using 5 mg kg-1 ketamine and 0.5 mg kg-1 diazepam IV and maintained using isoflurane in 100% oxygen. After the induction of anesthesia, the animals were allocated into two groups (each n=6; the GMLK (MLK group – 10 mg morphine, 150 mg lidocaine, 30 mg de ketamine were added in 500 mL saline received a 10 mL kg-1h-1 MLK infusion during the maintenance of anesthesia, and GCON (control group received 10 mL kg-1h-1 of 0.9% sodium chloride. The animals were mechanically ventilated. Cardiopulmonary variables and end-tidal isoflurane concentration (FE´Iso were measured at baseline (immediately before the surgery and 15, 30 and 45 minutes after initiation of surgery. In GMLK, there was a decrease in the FE´Iso at 15, 30 and 45 minutes, a reduction of up to 75.6% during the surgery. The HR was lower in GMLK compared with GCON at 30 minutes, and the MAP was at during baseline in GCON compared with GMLK. The standing time was less in GMLK than in GCON. The use of intravenous MLK was demonstrated to offer great efficiency as part of a balanced anesthesia protocol in sheep, with a 75.6% reduction in the need for isoflurane, providing stability of the cardiovascular parameters and blood gases with a shortened recovery period.

  4. Protective Effect of Isoflurane and Sevoflurane on Ischemic Neurons and Expression of Bcl-2 and ICE Genes in Rat Brain

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    To study the protective effect of volatile anesthetics, isoflurane and sevoflurane, on ischemic neurons after cerebral ischemia-reperfusion in rats and its possible molecular mechanism. Methods Rat cerebral ischemia-reperfusion model was developed by occlusion of the middle cerebral artery (MCA) and bilateral common carotid arteries (CCAs) 1 h after reperfusion. Using flow cytometry (FCM) and Northern blot hybridization, we calculated the number of apoptotic bodies and detected the expression of bcl-2 mRNA and interleukin-1 β converting enzyme (ICE) mRNA. Results The apoptotic bodies in hippocampus analyzed by FCM peaked at appeared 24 h after reperfusion, and decreased about 54% and 40%, respectively,after treatment with isoflurane and sevoflurane, as compared with ischemic group. There was no significant difference in the expression of bcl-2 mRNA and ICE mRNA between the inhaled anesthetic groups and ischemic group in hippocampus 24 hafter MCA/CCAs occlusion. Conclusion Isoflurane and sevoflurane partially inhibit apoptosis but have no significant effect on the expression of bcl-2 and ICE genes.

  5. Caveolin-3 expression and caveolae are required for isoflurane-induced cardiac protection from hypoxia and ischemia/reperfusion injury.

    Science.gov (United States)

    Horikawa, Yousuke T; Patel, Hemal H; Tsutsumi, Yasuo M; Jennings, Michelle M; Kidd, Michael W; Hagiwara, Yasuko; Ishikawa, Yoshihiro; Insel, Paul A; Roth, David M

    2008-01-01

    Volatile anesthetics protect the heart from ischemia/reperfusion injury but the mechanisms for this protection are poorly understood. Caveolae, sarcolemmal invaginations, and caveolins, scaffolding proteins in caveolae, localize molecules involved in cardiac protection. We tested the hypothesis that caveolae and caveolins are essential for volatile anesthetic-induced cardiac protection using cardiac myocytes (CMs) from adult rats and in vivo studies in caveolin-3 knockout mice (Cav-3(-/-)). We incubated CM with methyl-beta-cyclodextrin (MbetaCD) or colchicine to disrupt caveolae formation, and then exposed the myocytes to the volatile anesthetic isoflurane (30 min, 1.4%), followed by simulated ischemia/reperfusion (SI/R). Isoflurane protected CM from SI/R [23.2+/-1.6% vs. 71.0+/-5.8% cell death (assessed by trypan blue exclusion), Pprotection was abolished by MbetaCD or colchicine (84.9+/-5.5% and 64.5+/-6.1% cell death, Pprotection in vivo was assessed by measurement of infarct size relative to the area at risk and cardiac troponin levels. Isoflurane-induced a reduction in infarct size and cardiac troponin relative to control (infarct size: 26.5%+/-2.6% vs. 45.3%+/-5.4%, Pprotection was abolished in Cav-3(-/-) mice (infarct size: 53.4%+/-6.1% vs. 53.2%+/-3.5%, Pprotection is thus dependent on the presence of caveolae and the expression of caveolin-3. We conclude that caveolae and caveolin-3 are critical for volatile anesthetic-induced protection of the heart from ischemia/reperfusion injury.

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

    Science.gov (United States)

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

    2016-08-22

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

  7. Study on the anesthetic effect of combined intravenous-inhalation general anesthesia under nasopharyngeal airway-mask spontaneous breathing for laparoscopic inguinal hernia surgery in children

    Institute of Scientific and Technical Information of China (English)

    Jing Liu

    2016-01-01

    Objective:To analyze the anesthetic effect of combined intravenous-inhalation general anesthesia under nasopharyngeal airway-mask spontaneous breathing for laparoscopic inguinal hernia surgery in children.Methods:A total of118 cases of children with inguinal hernia who received laparoscopic surgery in our hospital from August 2012 to August 2014 were enrolled as research subjects and randomly divided into observation group 59 cases and control group 59 cases. Control group received conventional tracheal intubation intravenous general anesthesia, observation group received combined intravenous-inhalation general anesthesia under nasopharyngeal airway-mask spontaneous breathing, and then differences in respiratory and circulatory indicators, awareness-related indicators, G-6PD, PFK and inflammatory factor levels and oxidative stress levels between two groups were compared.Results:HR and MAP values of observation group at T1 and T2 were lower than those of control group, and SpO2 value was higher than that of control group; intraoperative Ppeak, Pplat, Raw, D(A-a)O2 and RI levels of observation group were lower than those of control group, and levels of Cdyn and OI were higher than those of control group; intraoperative G-6PD, PFK, CRP and IL-6 levels of observation group were lower than those of control group, and IL-10 level was higher than that of control group; intraoperative NO, SOD and GSH levels of observation group were higher than those of control group, and levels of ET-1, CAT and blood glucose were lower than those of control group.Conclusion:Combined intravenous-inhalation general anesthesia under nasopharyngeal airway-mask spontaneous breathing for laparoscopic inguinal hernia surgery in children can effectively stabilize respiratory and circulatory level, reduce intraoperative systemic inflammation and oxidative stress state and contribute to early postoperative rehabilitation.

  8. Neuroprotective effect of paeonol against isoflurane- induced ...

    African Journals Online (AJOL)

    Results: Isoflurane exposure caused (p < 0.05) severe neuronal apoptosis in the hippocampal region ... The expression levels of ERK were not significantly (p < 0.05) changed, but there was ... developing animal brains and primary neuronal cells [3]. Neuroinflammation has been reported to .... Equal amounts (60 µg) of.

  9. Intravenous Infusion of Dexmedetomidine Combined Isoflurane Inhalation Reduces Oxidative Stress and Potentiates Hypoxia Pulmonary Vasoconstriction during One-Lung Ventilation in Patients

    Directory of Open Access Journals (Sweden)

    Rui Xia

    2015-01-01

    Full Text Available Inhalation anesthetic isoflurane inhibits hypoxia pulmonary vasoconstriction (HPV, while dexmedetomidine (Dex could reduce the dose of isoflurane inhalation and potentiate HPV, but the mechanism is unclear. Inhibition of reactive oxygen species (ROS production can favor HPV during one-lung ventilation (OLV. Similarly, nitric oxide (NO, an important endothelium-derived vasodilator in lung circulation, can decrease the regional pulmonary vascular resistance of ventilated lung and reduce intrapulmonary shunting. We hypothesized that Dex may augment HPV and improve oxygenation during OLV through inhibiting oxidative stress and increasing NO release. Patients undergoing OLV during elective thoracic surgery were randomly allocated to either isoflurane + saline (NISO, n=24 or isoflurane + dexmedetomidine (DISO, n=25 group. Anesthesia was maintained with intravenous remifentanil and inhalational isoflurane (1.0–2.0%, with concomitant infusion of dexmedetomidine 0.7 μgkg−1h−1 in DISO and saline 0.25 mL kg−1h−1 in NISO group. Hemodynamic variables or depth of anesthesia did not significantly differ between groups. Administration of Dex significantly reduced Qs/Qt and increased PaO2 after OLV, accompanied with reduced lipid peroxidation product malondialdehyde and higher levels of SOD activity as well as serum NO (all P<0.05 DISO versus NISO. In conclusion, reducing oxidative stress and increasing NO release during OLV may represent a mechanism whereby Dex potentiates HPV.

  10. Volatile anesthetics influence blood-brain barrier integrity by modulation of tight junction protein expression in traumatic brain injury.

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    Serge C Thal

    Full Text Available Disruption of the blood-brain barrier (BBB results in cerebral edema formation, which is a major cause for high mortality after traumatic brain injury (TBI. As anesthetic care is mandatory in patients suffering from severe TBI it may be important to elucidate the effect of different anesthetics on cerebral edema formation. Tight junction proteins (TJ such as zonula occludens-1 (ZO-1 and claudin-5 (cl5 play a central role for BBB stability. First, the influence of the volatile anesthetics sevoflurane and isoflurane on in-vitro BBB integrity was investigated by quantification of the electrical resistance (TEER in murine brain endothelial monolayers and neurovascular co-cultures of the BBB. Secondly brain edema and TJ expression of ZO-1 and cl5 were measured in-vivo after exposure towards volatile anesthetics in native mice and after controlled cortical impact (CCI. In in-vitro endothelial monocultures, both anesthetics significantly reduced TEER within 24 hours after exposure. In BBB co-cultures mimicking the neurovascular unit (NVU volatile anesthetics had no impact on TEER. In healthy mice, anesthesia did not influence brain water content and TJ expression, while 24 hours after CCI brain water content increased significantly stronger with isoflurane compared to sevoflurane. In line with the brain edema data, ZO-1 expression was significantly higher in sevoflurane compared to isoflurane exposed CCI animals. Immunohistochemical analyses revealed disruption of ZO-1 at the cerebrovascular level, while cl5 was less affected in the pericontusional area. The study demonstrates that anesthetics influence brain edema formation after experimental TBI. This effect may be attributed to modulation of BBB permeability by differential TJ protein expression. Therefore, selection of anesthetics may influence the barrier function and introduce a strong bias in experimental research on pathophysiology of BBB dysfunction. Future research is required to investigate

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

    Science.gov (United States)

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

    1994-05-01

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

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

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    Eckmann David M

    2006-11-01

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

  13. Anesthetics drug pharmacodynamics.

    Science.gov (United States)

    Bischoff, P; Schneider, G; Kochs, E

    2008-01-01

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

  14. Strychnine-sensitive glycine receptors mediate the analgesic but not hypnotic effects of emulsified volatile anesthetics.

    Science.gov (United States)

    Chen, Yan; Dai, Ti-Jun; Zeng, Yin-Ming

    2007-01-01

    The present study was designed to investigate the role of strychnine-sensitive glycine receptors in hypnosis and analgesia induced by emulsified volatile anesthetics. After having established the mice model of hypnosis and analgesia by intraperitoneally injecting (i.p.) appropriate doses of ether, enflurane, isoflurane or sevoflurane, we intracerebroventricularly (i.c.v.) or intrathecally (i.t.) injected different doses of strychnine and then observed the effects on the sleeping time using the awaken test and the pain index in hot-plate test (HPPI) using the hot-plate test. In the awaken test, strychnine 1, 2, 4 microg (i.c.v.) had no distinctive effect on the sleeping time of the mice treated with the four emulsified inhalation anesthetics mentioned above (p > 0.05); in the hot-plate test, strychnine 0.1, 0.2, 0.4 microg (i.t.) can significantly and dose-dependently decrease the HPPI of the mice treated with emulsified ether, enflurane and sevoflurane (p strychnine 0.1 microg (i.t.) did not affect the HPPI of the mice treated with emulsified isoflurane (p > 0.05), but 0.2 and 0.4 microg (i.t.) can significantly decrease the HPPI of the mice treatedwith emulsified isoflurane (p strychnine-sensitive glycine receptors may contribute to the analgesic but not to the hypnotic effects induced by ether, enflurane, isoflurane and sevoflurane. Copyright (c) 2007 S. Karger AG, Basel.

  15. General anesthetic action at an internal protein site involving the S4-S5 cytoplasmic loop of a neuronal K(+) channel.

    Science.gov (United States)

    Harris, T; Shahidullah, M; Ellingson, J S; Covarrubias, M

    2000-02-18

    The structural bases of general anesthetic action on a neuronal K(+) channel were investigated using the series of homologous 1-alkanols, electrophysiology, and mutational analysis. Domain swapping between dShaw2 (alkanol-sensitive) and hKv3.4 (alkanol-resistant) and site-directed mutagenesis demonstrated that a 13-amino acid cytoplasmic loop (S4-S5) determines the selective inhibition of native dShaw2 channels by 1-alkanols. The S4-S5 loop may contribute to a receptor for both 1-alkanols and the inactivation particle, because the enhanced 1-alkanol sensitivity of hKv3.4 channels hosting S4-S5 mutations correlates directly with disrupted channel inactivation. Evidence of a discrete protein site was also obtained from the analysis of the relationship between potency and alkyl chain length, which begins to level off after 1-hexanol. Rapid application to the cytoplasmic side of inside-out membrane patches shows that the interaction between dShaw2 channels and 1-alkanols equilibrates in 1000-fold slower when the drug is applied externally to outside-out membrane patches. The data strongly favor a mechanism of inhibition involving a discrete internal site for 1-alkanols in dShaw2 K(+) channels. A new working hypothesis proposes that 1-alkanols lock dShaw2 channels in their closed conformation by a direct interaction at a crevice formed by the S4-S5 loop.

  16. Differential effects of hyperventilation on cerebral blood flow velocity after tourniquet deflation during sevoflurane, isoflurane, or propofol anesthesia.

    Science.gov (United States)

    Hinohara, Hiroshi; Kadoi, Yuji; Ide, Masanobu; Kuroda, Masataka; Saito, Shigeru; Mizutani, Akio

    2010-08-01

    The purpose of this study was to compare the degree of increase in middle cerebral artery (MCA) blood flow velocity after tourniquet deflation when modulating hyperventilation during orthopedic surgery under sevoflurane, isoflurane, or propofol anesthesia. Twenty-four patients undergoing elective orthopedic surgery were randomly divided into sevoflurane, isoflurane, and propofol groups. Anesthesia was maintained with sevoflurane, isoflurane, or propofol administration with 33% oxygen and 67% nitrous oxide at anesthetic drug concentrations adequate to maintain bispectral values between 45 and 50. A 2.0-MHz transcranial Doppler probe was attached to the patient's head at the temporal window, and mean blood flow velocity in the MCA (V (mca)) was continuously measured. The extremity was exsanguinated with an Esmarch bandage, and the pneumatic tourniquet was inflated to a pressure of 450 mmHg. Arterial blood pressure, heart rate, V (mca) and arterial blood gases were measured every minute for 10 min after release of the tourniquet in all three groups. Immediately after tourniquet release, the patients' respiratory rates were increased to tightly maintain end-tidal carbon dioxide (PetCO(2)) at 35 mmHg. No change in partial pressure of carbon dioxide in arterial blood (PaCO(2)) was observed pre- and posttourniquet deflation in any of the three groups. Increase in V (mca) in the isoflurane group was greater than that in the other two groups after tourniquet deflation. In addition, during the study period, no difference in V (mca) after tourniquet deflation was observed between the propofol and sevoflurane groups. Hyperventilation could prevent an increase in V (mca) in the propofol and sevoflurane groups after tourniquet deflation. However, hyperventilation could not prevent an increase in V (mca) in the isoflurane group.

  17. The effects of anesthetics on cortical spreading depression elicitation and c-fos expression in rats.

    Science.gov (United States)

    Kitahara, Y; Taga, K; Abe, H; Shimoji, K

    2001-01-01

    The effects of anesthetics on the generation of cortical spreading depression (CSD) were investigated. Volatile anesthetics halothane, isoflurane, sevoflurane (0.5, 1.0, and 2.0 MAC), and the intravenous anesthetic pentobarbital were studied. Cortical spreading depression was induced by 3M-KCl applied to a surface of brain cortex for 30 minutes. Direct current (DC) potential was recorded, and the number, amplitude, and duration of CSDs were observed. With increasing concentrations of each volatile anesthetic, there was a dose-related reduction in CSD frequency but not in CSD amplitude. At 2.0 MAC of sevoflurane the suppression of CSD was less than with the other volatile anesthetics. In addition, the influence of anesthetics on expression of c-fos mRNA was investigated. Additional animals anesthetized by isoflurane or sevoflurane were studied. Five CSDs were elicited by electric stimulation (0.5 mV, 1 second) in each animal. In situ hybridization with 35S-labeled oligonucleotides was used to evaluate the level of c-fos mRNA. The expression of c-fos was observed in the hemisphere in which CSD was elicited, but there was no difference in expression of c-fos among the groups. We conclude that volatile anesthetics can induce suppression of CSD elicitation in a dose dependent manner, but that at high concentrations sevoflurane is significantly less effective than other volatile agents. Pentobarbital has the least effect on KCl-induced CSD. These data suggest that the choice of anesthetics can impact the results of studies examining membrane depolarization and the ionic changes initiated by CSD.

  18. Influence of Ringer’s lactated solution in continuous infusion and general anesthesia on hematocrit in dogs

    Directory of Open Access Journals (Sweden)

    Rogério Luizari Guedes

    2015-08-01

    Full Text Available The measurement of serum parameters during general anesthesia procedures are subject to variations due to differences in protocol, splenic storage, and by the instituted fluid therapy. The aim of this study was to assess the hematocrit changes promoted by controlled fluid therapy and general anesthesia. Six mongrel female dogs underwent an anesthetic protocol with acepromazine (0.03 mg kg-1 and tramadol (5 mg kg-1 for premedication, induction with propofol (3 mg kg-1, and maintained with isoflurane and mechanical ventilation for 120 minutes. After induction, they were infused with 10 ml kg hr-1 of Ringer’s lactate solution. Hematocrit measurements were performed from the start until 72 hours from anesthesia and evaluated statistically to check if there were significant changes over time. The fluid therapy, the acepromazine and propofol in the anesthetic protocol promotes a significant reduction of hematocrit up to four hours after general anesthesia.

  19. Carbon monoxide production from degradation of desflurane, enflurane, isoflurane, halothane, and sevoflurane by soda lime and Baralyme.

    Science.gov (United States)

    Fang, Z X; Eger, E I; Laster, M J; Chortkoff, B S; Kandel, L; Ionescu, P

    1995-06-01

    Anecdotal reports suggest that soda lime and Baralyme brand absorbent can degrade inhaled anesthetics to carbon monoxide (CO). We examined the factors that govern CO production and found that these include: 1) The anesthetic used: for a given minimum alveolar anesthetic concentration (MAC)-multiple, the magnitude of CO production (greatest to least) is desflurane > or = enflurane > isoflurane > halothane = sevoflurane. 2) The absorbent dryness: completely dry soda lime produces much more CO than absorbent with just 1.4% water content, and soda lime containing 4.8% or more water (standard soda lime contains 15% water) generates no CO. In contrast, both completely dry Baralyme and Baralyme with 1.6% water produce high concentrations of CO, and Baralyme containing 4.7% water produces concentrations equaling those produced by soda lime containing 1.4% water. Baralyme containing 9.7% or more water and standard Baralyme (13% water) do not generate CO.3) The type of absorbent: at a given water content, Baralyme produces more CO than does soda lime. 4) The temperature: an increased temperature increases CO production. 5) The anesthetic concentration: more CO is produced from higher anesthetic concentrations. These results suggest that CO generation can be avoided for all anesthetics by using soda lime with 4.8% (or more) water or Baralyme with 9.7% (or more) water, and by using inflow rates of less than 2-3 L/min. Such inflow rates are low enough to ensure that the absorbent does not dry out.

  20. Sensitivity to isoflurane anesthesia increases in autism spectrum disorder Shank3(+/∆c) mutant mouse model.

    Science.gov (United States)

    Li, Changsheng; Schaefer, Michele; Gray, Christy; Yang, Ya; Furmanski, Orion; Liu, Sufang; Worley, Paul; Mintz, C David; Tao, Feng; Johns, Roger A

    Autism is a heterogeneous developmental disorder characterized by impaired social interaction, impaired communication skills, and restricted and repetitive behavior. The abnormal behaviors of these patients can make their anesthetic and perioperative management difficult. Evidence in the literature suggests that some patients with autism or specific autism spectrum disorders (ASD) exhibit altered responses to pain and to anesthesia or sedation. A genetic mouse model of one particular ASD, Phelan McDermid Syndrome, has been developed that has a Shank3 haplotype truncation (Shank3(+/Δc)). These mice exhibit important characteristics of autism that mimic human autistic behavior. Our study demonstrates that a Shank3(+/ΔC) mutation in mice is associated with a reduction in both the MAC and RREC50 of isoflurane and down regulation of NR1 in vestibular nuclei and PSD95 in spinal cord. Decreased expression of NR1 and PSD95 in the central nervous system of Shank3(+/ΔC) mice could help reduce the MAC and RREC50 of isoflurane, which would warrant confirmation in a clinical study. If Shank3 mutations are found to affect anesthetic sensitivity in patients with ASD, better communication and stricter monitoring of anesthetic depth may be necessary.

  1. Treating myocardial stunning randomly, with either propofol or isoflurane following transient coronary occlusion and reperfusion in pigs

    Directory of Open Access Journals (Sweden)

    Urdaneta Felipe

    2009-01-01

    Full Text Available Propofol and isoflurane may be used during fast track anesthesia for off-pump bypass, where transient ischemia is common. The purpose of this study was to compare the effects of propofol vs isoflurane in a porcine model of acute coronary occlusion. Twenty five pigs were randomized to receive general anesthesia with either isoflurane, 1 MAC (n = 13, or propofol, 3 mg/kg bolus followed by 200 μg/ kg/min infusion (n = 12. Pressure-tipped catheters were placed in the left ventricle (LV and carotid artery; cardiac output was measured by ultrasound; two pairs of ultrasonic dimension catheters were placed in the subendocardium of LV. The slope of LV end-systolic pressure-volume relationship (E max was calculated. Reversible ischemia for 15 mins was accomplished with an occluder around the left anterior descending artery followed by reperfusion period. Measurements were done at baseline, end ischemia, early (5 min and late (30 min reperfusion. The data collected included systemic hemodynamics, LV end-diastolic pressure (LVEDP, dP/dt, E max , and the presence of ventricular arrhythmias. The number of animals studied to completion was 19 (n = 11 in the isoflurane group; n = 8 in propofol group. There was a significant difference in E max between isoflurane and propofol during early and late reperfusion [3.4 (0.5 and 4.0 (0.3 vs 2.6 (0.4 and 3.2 (0.5 mmHg/sec, respectively; P < 0.05]. Postreperfusion ventricular fibrillation occurred in 54% animals in the propofol group vs none in the isoflurane group ( P < 0.05. Isoflurane administration was found to be cardioprotective against ventricular depression and arrhythmias compared to propofol.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Science.gov (United States)

    Kurdi, Madhuri S; Ramaswamy, Ashwini H

    2015-01-01

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

  4. Discrimination of auditory stimuli during isoflurane anesthesia.

    Science.gov (United States)

    Rojas, Manuel J; Navas, Jinna A; Greene, Stephen A; Rector, David M

    2008-10-01

    Deep isoflurane anesthesia initiates a burst suppression pattern in which high-amplitude bursts are preceded by periods of nearly silent electroencephalogram. The burst suppression ratio (BSR) is the percentage of suppression (silent electroencephalogram) during the burst suppression pattern and is one parameter used to assess anesthesia depth. We investigated cortical burst activity in rats in response to different auditory stimuli presented during the burst suppression state. We noted a rapid appearance of bursts and a significant decrease in the BSR during stimulation. The BSR changes were distinctive for the different stimuli applied, and the BSR decreased significantly more when stimulated with a voice familiar to the rat as compared with an unfamiliar voice. These results show that the cortex can show differential sensory responses during deep isoflurane anesthesia.

  5. Effects of intravenous administration of perzinfotel, fentanyl, and a combination of both drugs on the minimum alveolar concentration of isoflurane in dogs.

    Science.gov (United States)

    Ueyama, Yukie; Lerche, Phillip; Eppler, C Mark; Muir, William W

    2009-12-01

    OBJECTIVE-To determine the effects of IV administration of perzinfotel and a perzinfotel-fentanyl combination on the minimum alveolar concentration (MAC) of isoflurane in dogs. ANIMALS-6 healthy sexually intact Beagles (3 males and 3 females). PROCEDURES-All dogs were instrumented with a telemetry device for continuous monitoring of heart rate, arterial blood pressure, and core body temperature (at a femoral artery). Dogs were anesthetized with propofol (6 mg/kg, IV) and isoflurane. Isoflurane MAC values were determined in 3 experiments in each dog, separated by at least 7 days, before (baseline) and after the following treatments: no treatment (anesthetic only), perzinfotel (20 mg/kg, IV), fentanyl (5 microg/kg bolus, IV, followed by a continuous IV infusion at 0.15 microg/kg/min), and a fentanyl-perzinfotel combination (20 mg of perzinfotel/kg, IV, plus the fentanyl infusion). Bispectral index and oxygen saturation as measured by pulse oximetry were also monitored throughout anesthesia. RESULTS-Without treatment, the mean +/- SD isoflurane MAC for all 6 dogs was 1.41 +/- 0.10%. Baseline MAC was 1.42 +/- 0.08%. Intravenous administration of perzinfotel, fentanyl, and the perzinfotel-fentanyl combination significantly decreased the MAC by 39%, 35%, and 66%, respectively. Perzinfotel and perzinfotel-fentanyl administration yielded significant increases in the bispectral index. Mean, systolic, and diastolic arterial blood pressures significantly increased from baseline values when perzinfotel was administered. Systolic arterial blood pressure significantly increased from the baseline value when perzinfotel-fentanyl was administered. No adverse effects were detected. CONCLUSIONS AND CLINICAL RELEVANCE-IV administration of perzinfotel, fentanyl, or a perzinfotel-fentanyl combination reduced isoflurane MAC in dogs and increased arterial blood pressure.

  6. Comparison of use of an infrared anesthetic gas monitor and refractometry for measurement of anesthetic agent concentrations.

    Science.gov (United States)

    Ambrisko, Tamas D; Klide, Alan M

    2011-10-01

    To assess agreement between anesthetic agent concentrations measured by use of an infrared anesthetic gas monitor (IAGM) and refractometry. SAMPLE-4 IAGMs of the same type and 1 refractometer. Mixtures of oxygen and isoflurane, sevoflurane, desflurane, or N(2)O were used. Agent volume percent was measured simultaneously with 4 IAGMs and a refractometer at the common gas outlet. Measurements obtained with each of the 4 IAGMs were compared with the corresponding refractometer measurements via the Bland-Altman method. Similarly, Bland-Altman plots were also created with either IAGM or refractometer measurements and desflurane vaporizer dial settings. Bias ± 2 SD for comparisons of IAGM and refractometer measurements was as follows: isoflurane, -0.03 ± 0.18 volume percent; sevoflurane, -0.19 ± 0.23 volume percent; desflurane, 0.43 ± 1.22 volume percent; and N(2)O, -0.21 ± 1.88 volume percent. Bland-Altman plots comparing IAGM and refractometer measurements revealed nonlinear relationships for sevoflurane, desflurane, and N(2)O. Desflurane measurements were notably affected; bias ± limits of agreement (2 SD) were small (0.1 ± 0.22 volume percent) at < 12 volume percent, but both bias and limits of agreement increased at higher concentrations. Because IAGM measurements did not but refractometer measurements did agree with the desflurane vaporizer dial settings, infrared measurement technology was a suspected cause of the nonlinear relationships. Given that the assumption of linearity is a cornerstone of anesthetic monitor calibration, this assumption should be confirmed before anesthetic monitors are used in experiments.

  7. Awareness with recall during general anesthesia: incidence and risk factors.

    Science.gov (United States)

    Ranta, S O; Laurila, R; Saario, J; Ali-Melkkilä, T; Hynynen, M

    1998-05-01

    We studied the associated factors and incidence of awareness during general anesthesia and the nature of subsequent psychiatric disorders. Patients older than 12 yr undergoing surgery under general anesthesia in a secondary care hospital during 1 yr were included in the study. The doses of anesthetics were calculated for the patients with and without awareness. There were 4818 operations under general anesthesia; 2612 (54%) patients were interviewed. Ten (0.4% of those interviewed) patients were found to have undisputed awareness, and there were nine (0.3%) patients with possible awareness. The doses of isoflurane (P awareness. Five patients with awareness underwent a psychiatric evaluation. One patient experienced sleep disturbances afterward, but the other four patients did not have any after effects. In conclusion, awareness is a rare complication of general anesthesia associated with small doses of anesthetics. In an interview of 2612 patients after general anesthesia, 10 (0.4%) patients with awareness and 9 (0.3%) patients with possible awareness were found. A predisposing factor was small doses of the principal anesthetic. In a psychiatric interview, a large proportion of the patients with awareness were found to have suffered from depression in the past.

  8. Selected clinical, biochemical, and electrolyte alterations in anesthetized captive tigers (Panthera tigris) and lions (Panthera leo).

    Science.gov (United States)

    Reilly, Sabrina; Seddighi, M Reza; Steeil, James C; Sura, Patricia; Whittemore, Jacqueline C; Gompf, Rebecca E; Elliott, Sarah B; Ramsay, Edward C

    2014-06-01

    A prospective study to assess changes in selected plasma biochemistry and electrolyte values, plasma insulin and aldosterone concentrations, and electrocardiography (ECG) was performed on eight female captive tigers (Panthera tigris) and three lions (Panthera leo) undergoing general anesthesia for elective laparoscopic ovariectomy. Each animal was sedated with medetomidine (18-25 microg/kg) and midazolam (0.06-0.1 mg/kg) intramuscularly, and anesthesia was induced with ketamine (1.9-3.5 mg/kg) intramuscularly and maintained with isoflurane. Venous blood samples were collected and analyzed for plasma biochemistry parameters and insulin and aldosterone concentrations. An ECG was recorded at the time of each blood sample collection. Mean plasma potassium, glucose, phosphorus, and aldosterone concentrations increased during anesthesia (P < or = 0.05). One tiger developed hyperkalemia (6.5 mmol/L) 2.5 hr after anesthetic induction. Plasma insulin concentrations were initially below the low end of the domestic cat reference interval (72-583 pmol/L), but mean insulin concentration increased (P < or = 0.05) over time compared with the baseline values. Three tigers and two lions had ECG changes that were representative of myocardial hypoxemia. Based on these results, continuous monitoring of clinical and biochemical alterations during general anesthesia in large nondomestic felids is warranted, and consideration should be given to reversal of medetomidine in these animals should significant changes in electrolytes or ECG occur.

  9. Bispectoral index scores of pediatric patients under dental treatment and recovery conditions: Study of children assigned for general anesthesia under propofol and isofloran regimes

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    Dana Tahririan

    2016-01-01

    Full Text Available Background: This study was planned to determine the relationship between bispectoral index (BIS during dental treatment and recovery conditions in children undergoing two regimes of anesthesia of propofol and isoflurane. Materials and Methods: In this single-blind clinical trial study, 57 4-7-year-old healthy children who had been referred for dental treatment under general anesthesia between 60 and 90 min were selected by convenience sampling and assigned to two groups, after obtaining their parents′ written consent. The anesthesia was induced by inhalation. For the first group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and isoflurane (1%. For the second group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and propofol was administered intravenously at a dose of 100 Ng/kg/min. The patients′ vital signs, BIS, and agitation scores were recorded every 10 min. The data were analyzed by repeated measure ANOVA and t-tests at a significance level of α = 0.05 using SPSS version 20. Results: The results of independent t-test for anesthesia time showed no statistically significant difference between isoflurane and propofol (P = 0.87. Controlling age, the BIS difference between the two anesthetic agents was not significant (P > 0.05; however, it was negatively correlated with the duration of anesthesia and the discharge time (P = 0.001, r = -0.308 and (P < 0.001, r = -0.55. Conclusion: The same depth of anesthesia is produced by propofol and isoflurane, but lower recovery complications from anesthesia are observed with isoflurane.

  10. Effects of isoflurane, fentanyl, or thiopental anesthesia on regional cerebral blood flow and brain surface PO2 in the presence of a focal lesion in rabbits.

    Science.gov (United States)

    Murr, R; Schürer, L; Berger, S; Enzenbach, R; Peter, K; Baethmann, A

    1993-11-01

    These studies were conducted to determine the effect of anesthetic drugs on tissue perfusion and O2 supply in the brain with focal cerebral edema. Using an open cranium preparation, we studied the effects of isoflurane (I; 1 minimum alveolar anesthetic concentration), of fentanyl (F; 0.5-1 microgram.kg-1 x min-1), or of thiopental (T; 32.5 mg.kg-1 x h-1) on regional cerebral blood flow (rCBF) and regional brain tissue PO2 in albino rabbits (n = 6 per group) with a focal brain lesion (cold injury). The doses of anesthetics were sufficient to suppress nociception. rCBF (H2 clearance) and tissue PO2 (multiwire surface electrode) were studied adjacent to and distant from the lesion. Cerebral hyperemia developed immediately after trauma in all groups, although the flow increase did not attain statistical significance. rCBF was subsequently reduced by about 25% in the vicinity of the lesion. Distant from the trauma, a continuing hyperemia (+30%) was later observed in animals with isoflurane, whereas rCBF was decreased then by 10%-20% in animals with fentanyl, or was unchanged with thiopental. Brain tissue PO2 was increased with isoflurane in areas distant from the lesion, but decreased with fentanyl. However, with thiopental, the PO2 level had already been lowered before trauma with a subsequent tendency toward normalization. The heterogeneity of the tissue PO2 in fentanyl anesthesia, as well as the increased frequency of hypoxic PO2 values with thiopental, might have resulted from microcirculatory disturbances. Thus, although isoflurane seemed to facilitate hyperemia with an increased O2 supply to the brain, fentanyl tended to induce the opposite response. Although these properties suggest the potential to manipulate perfusion and O2 supply in cerebral ischemia or hyperemia after head injury, the effects of such measures on intracranial pressure, neurologic status, and outcome have yet to be proven.

  11. Child with aplastic anemia: Anesthetic management

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    Manpreet Kaur

    2012-01-01

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

  12. Identification of causal relations between haemodynamic variables, auditory evoked potentials and isoflurane by means of fuzzy logic

    DEFF Research Database (Denmark)

    Jensen, E W; Nebot, A; Caminal, P;

    1999-01-01

    The aim of this study was to identify a possible relationship between haemodynamic variables, auditory evoked potentials (AEP) and inspired fraction of isoflurane (ISOFl). Two different models (isoflurane and mean arterial pressure) were identified using the fuzzy inductive reasoning (FIR......) methodology. A fuzzy model is able to identify non-linear and linear components of a causal relationship by means of optimization of information content of available data. Nine young female patients undergoing hysterectomy under general anaesthesia were included. Mean arterial pressure (MAP), heart rate (HR...

  13. Captopril Pretreatment Produces an Additive Cardioprotection to Isoflurane Preconditioning in Attenuating Myocardial Ischemia Reperfusion Injury in Rabbits and in Humans.

    Science.gov (United States)

    Tian, Yi; Li, Haobo; Liu, Peiyu; Xu, Jun-mei; Irwin, Michael G; Xia, Zhengyuan; Tian, Guogang

    2015-01-01

    Pretreatment with the angiotensin-converting inhibitor captopril or volatile anesthetic isoflurane has, respectively, been shown to attenuate myocardial ischemia reperfusion (MI/R) injury in rodents and in patients. It is unknown whether or not captopril pretreatment and isoflurane preconditioning (Iso) may additively or synergistically attenuate MI/R injury. Patients selected for heart valve replacement surgery were randomly assigned to five groups: untreated control (Control), captopril pretreatment for 3 days (Cap3d), or single dose captopril (Cap1hr, 1 hour) before surgery with or without Iso (Cap3d+Iso and Cap1hr+Iso). Rabbit MI/R model was induced by occluding coronary artery for 30 min followed by 2-hour reperfusion. Rabbits were randomized to receive sham operation (Sham), MI/R (I/R), captopril (Cap, 24 hours before MI/R), Iso, or the combination of captopril and Iso (Iso+Cap). In patients, Cap3d+Iso but not Cap1hr+Iso additively reduced postischemic myocardial injury and attenuated postischemic myocardial inflammation. In rabbits, Cap or Iso significantly reduced postischemic myocardial infarction. Iso+Cap additively reduced cellular injury that was associated with improved postischemic myocardial functional recovery and reduced myocardial apoptosis and attenuated oxidative stress. A joint use of 3-day captopril treatment and isoflurane preconditioning additively attenuated MI/R by reducing oxidative stress and inflammation.

  14. 麻醉常用药物对异氟醚作用的影响%Interaction between isoflurane and other drugs in anesthesia

    Institute of Scientific and Technical Information of China (English)

    杨经文; 刘进

    2009-01-01

    异氟醚是全世界使用最多的吸入麻醉药,其作用机制有许多学说,但具体的作用机制还是不明确.传统的MAC主要作用在脊髓;而其镇静、催眠等作用主要在大脑.异氟醚常与许多其他药物联合应用.阿片类药物、局麻药、苯二氮革类药物、a2受体激动剂以及其他吸入麻醉药等都能影响其催眠,麻醉和镇痛作用和其抑制记忆、反应和学习的能力.%Isoflurane is the most widely used inilaled anesthetic in the wodd and its definite anesthesia mechanism is unidentified.Isoflurane produces sedation and hypnosis effect by acting on brain,while traditional anesthetic effect(MAC)comes from its action on spinal cord.Combinated with other drugs such as opioids,local anesthetics,benzodiazepines,alpha 2-adrenergic agonists,other inhaled anesthetics may affect its effects of sedation.hypnosis,analgesia and anesthesia,and sup-press memory.response and learning ability.

  15. Volatile anesthetic action in a computational model of the thalamic reticular nucleus.

    Science.gov (United States)

    Gottschalk, Allan; Miotke, Sam A

    2009-05-01

    Although volatile anesthetics (VAs) modulate the activity of multiple ion channels, the process whereby one or more of these effects are integrated to produce components of the general anesthetic state remains enigmatic. Computer models offer the opportunity to examine systems level effects of VA action at one or more sites. Motivated by the role of the thalamus in consciousness and sensory processing, a computational model of the thalamic reticular nucleus was used to determine the collective impact on model behavior of VA action at multiple sites. A computational model of the thalamic reticular nucleus was modified to permit VA modulation of its ion channels. Isobolographic analysis was used to determine how multiple sites interact. VA modulation of either T-type Ca(2+) channels or gamma-aminobutyric acid type A receptors led to increased network synchrony. VA modulation of both further increased network synchronization. VA-induced decrements in Ca(2+) current permitted greater impact of inhibitory currents on membrane potential, but at higher VA concentrations the decrease in Ca(2+) current led to a decreased number of spikes in the burst generating the inhibitory signal. MAC-awake (the minimum alveolar concentration at which 50% of subjects will recover consciousness) concentrations of both isoflurane and halothane led to similar levels of network synchrony in the model. Relatively modest VA effects at both T-type Ca(2+) channels and gamma-aminobutyric acid type A receptors can substantially alter network behavior in a computational model of a thalamic nucleus. The similarity of network behavior at MAC-awake concentrations of different VAs is consistent with a contribution of the thalamus to VA-induced unconsciousness through action at these channels.

  16. Lactato sanguíneo na avaliação dos efeitos da peridural torácica em cães anestesiados pelo isoflurano Blood lactate in the evaluation of the thoracic epidural effects in isoflurane anesthetized dogs

    Directory of Open Access Journals (Sweden)

    Beatriz Perez Floriano

    2010-03-01

    evaluate the tissue perfusion through blood lactate in dogs submitted to thoracic peridural anesthesia. For such, eight dogs with MAC previously determined for isoflurano, were divided into two experimental groups and were induced and maintained with isofluorane. The dogs had their spinal low lumbar space reached with an epidural catheter, inserted to the T1-T2 interval, with later application of ropivacaine in two different volumes, one for each group: 0.25ml kg-1 (GR1 and 0.33ml kg-1 (GR2. The animals were monitored at nine total moments of anesthesia and electrostimulation in the radio-ulnar region was made to detect the presence of the local block, with evaluation of the following parameters: lactate levels, mean arterial pressure, hemogasometric variables, heart rate and respiratory rate. Respiratory depression was observed, caused by the block, as well as an increase on the pH and slight reduction of HR and MAP. There was a significant decrease in lactate levels after anesthetic induction and a return to its basal levels after recovery, on both groups. There was no correlation between lactate and other evaluated parameters. The changes in lactate levels are probably related to the inhalant anesthesia, assuming an influence of isofluorane on this parameter. There was no influence of the local block on tissue perfusion, analized through blood lactate measures.

  17. Induction of ischemic stroke in awake freely moving mice reveals that isoflurane anesthesia can mask the benefits of a neuroprotection therapy

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    Angela eSeto

    2014-04-01

    Full Text Available Anesthetics such as isoflurane are commonly used to sedate experimental animals during the induction of stroke. Since these agents are known to modulate synaptic excitability, inflammation and blood flow, they could hinder the development and discovery of new neuroprotection therapies. To address this issue, we developed a protocol for inducing photothrombotic occlusion of cerebral vessels in fully conscious mice and tested two potential neuroprotectant drugs (a GluN2B or α4β2 nicotinic receptor antagonist. Our data show in vehicle treated mice that just 20 minutes of exposure to isoflurane during stroke induction can significantly reduce ischemic cortical damage relative to mice that were awake during stroke. When comparing potential stroke therapies, none provided any level of neuroprotection if the stroke was induced with anesthesia. However, if mice were fully conscious during stroke, the α4β2 nicotinic receptor antagonist reduced ischemic damage by 23% relative to vehicle treated controls, whereas the GluN2B antagonist had no significant effect. These results suggest that isoflurane anesthesia can occlude the benefits of certain stroke treatments and warrant caution when using anesthetics for pre-clinical testing of neuroprotective agents.

  18. Subanesthetic concentration of sevoflurane increases regional cerebral blood flow more, but regional cerebral blood volume less, than subanesthetic concentration of isoflurane in human volunteers.

    Science.gov (United States)

    Lorenz, I H; Kolbitsch, C; Hörmann, C; Schocke, M; Felber, S; Zschiegner, F; Hinteregger, M; Kremser, C; Pfeiffer, K P; Benzer, A

    2001-10-01

    Both sevoflurane and isoflurane are used in moderate concentrations in neuroanesthesia practice. The limiting factors for using higher concentrations of inhalational anesthetics in patients undergoing neurosurgery are the agents' effects on cerebral blood flow (CBF) and cerebral blood volume (CBV). In particular, an increase in CBV, which is a key determinant of intracranial pressure, may add to the neurosurgical patient's perioperative risk. To compare the effects of a subanesthetic concentration (0.4 minimum alveolar concentration) of sevoflurane or isoflurane on regional CBF (rCBF), regional CBV (rCBV) and regional mean transit time (rMTT), contrast-enhanced magnetic resonance imaging perfusion measurements were made in spontaneously breathing human volunteers. Absolute changes in rCBF, regional CBV, and rMTT during administration of either drug in regions of interest outlined bilaterally in white and grey matter were nonparametrically (Mann-Whitney test) analyzed. Sevoflurane increased rCBF in practically all regions (absolute change, 4.44 +/- 2.87 to 61.54 +/- 2.39 mL/100g per minute) more than isoflurane did (absolute change, 12.91 +/- 2.52 to 52.67 +/- 3.32 mL/100g per minute), which decreased frontal, parietal, and white matter rCBF (absolute change, -1.12 +/- 0.59 to -14.69 +/- 3.03 mL/100g per minute). Regional CBV was higher in most regions during isoflurane administration (absolute change, 0.75 +/- 0.03 to 4.92 +/- 0.16 mL/100g) than during sevoflurane administration (absolute change, 0.05 +/- 0.14 to 3.57 +/- 0.14 mL/100g). Regional mean transit time was decreased by sevoflurane (absolute change, -0.18 +/- 0.05 to -0.60 +/- 0.04 s) but increased by isoflurane (absolute change, 0.19 +/- 0.03 to 0.69 +/- 0.04 s). In summary, regional CBV was significantly lower during sevoflurane than during isoflurane administration, although sevoflurane increased rCBF more than isoflurane, which even decreased rCBF in some regions. For sevoflurane and, even more

  19. Brief anesthesia by isoflurane alters plasma corticosterone levels distinctly in male and female rats: implications for tissue collection methods

    Science.gov (United States)

    Bekhbat, Mandakh; Merrill, Liana; Kelly, Sean D.; Lee, Vanessa K.; Neigh, Gretchen N.

    2016-01-01

    Euthanasia by anesthetic agents is commonly performed prior to tissue collection in order to minimize pain and distress to the animal. However, depending on their mechanism of action as well as administration regimen, different methods of anesthesia may trigger an acute stress response through engaging the hypothalamic-pituitary-adrenal (HPA) axis, which can impact numerous other physiological processes that the researcher may wish to examine as endpoints. We investigated the effects of the commonly used anesthetic agent isoflurane on two different endpoints related to the stress response: plasma corticosterone levels and gene expression of the glucocorticoid receptor (GR) as well as several of its regulators including FK506-binding protein 51 (Fkbp5) in the hippocampus of male and female rats. Our results indicate that brief exposure to anesthesia by isoflurane prior to decapitation can alter plasma corticosterone levels differentially in male and female rats within minutes without impacting gene expression in the hippocampus. We conclude that collection methods can influence stress-related physiological endpoints in female rats and the potential influence of even brief anesthesia as well as sex differences in response to anesthesia should be evaluated during the experimental design process and data interpretation. This finding is particularly important in light of new NIH standards regarding sex and reproducibility, and care should be taken to be certain that sex differences in endpoints of interest are not an artifact of sex differences in response to collection paradigms. PMID:26946276

  20. A Comparative Study of Cardioprotective Effect of Three Anesthetic Agents by Measuring Serum Level of Troponin-T after Coronary Artery Bypass Grafting

    Directory of Open Access Journals (Sweden)

    Vali Imantalab

    2012-09-01

    Full Text Available Background: Cardiac surgery is associated with some degree of myocardial injury. Preconditioning first described in 1986 was pharmacologic and non- pharmacologic. Among the long list of anesthetic drugs, isoflurane as an inhaling agent along with midazolam and propofol as injectable substances have been documented to confer some preconditioning effects on myocardium. Objectives: In this study cardiac Troponin T (cTnT ,as a reliable marker, was used for evaluating myocardial injury. Methods: This prospective double blind study was comprised of 60 patients scheduled for CABG and were randomly assigned into three groups who received infusion of propofol or midazolam or isoflorane. Surgical procedures and anesthetics were similar for 3 groups. cTnT measured preoperatively and at 12, 24 and 36hr after arrival in ICU. Results: There were no statistically significant differences in mean cTnT levels between three groups in the preoperative period and 12-24 hours after arrival in ICU. However, mean cTnT in 3 groups at 36 hours after arrival in ICU were different (P< 0.013 and cTnT level was significantly higher in midazolam group (P<0.001 and lowest in isoflurane group (P=0.002. Conclusion: There were significant differences on cTnT levels between anesthetic groups of isofluran, midazolam and propofol at 36 hr after surgery. Preconditioning effect of isoflurane was higher than the other two groups.

  1. LOCAL ANESTHETICS IN PATIENTS WITH CARDIOVASCULAR DISEASES.

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    risto Daskalov

    2015-03-01

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

  2. Treatment of status migrainosus by general anesthesia: a case report.

    Science.gov (United States)

    Udelsmann, Artur; Saccomani, Priscila; Dreyer, Elisabeth; da Costa, Alberto Luiz Cunha

    2015-01-01

    The status migrainosus is a complication of migraine characterized by severe headache for more than 72h that did not respond to treatment, with risk of stroke and suicide. Researches on treatment are directed to drugs that stimulate GABA receptors; propofol and isoflurane act on sub-GABAa receptors and theoretically could be interesting. The first has been the subject of research in severe migraine. Opioids are employed in pain, and its use in chronic headache is debatable, but these agents are employed in acute cases. The goal is to present a case of refractory status migrainosus in that we decided to break the pain cycle by general anesthesia. Female patient, aged 50 years, with status migrainosus, in the last five days with visits to the emergency department, medicated parenterally with various agents without result. Without comorbidities, dehydrated, described her pain as "well over 10" in Visual Numeric Scale (VNS). After consulting the literature, and given the apparent severity of the condition, we opted for a general anesthesia: induction with fentanyl, propofol, and vecuronium and maintenance with isoflurane and propofol for two hours. Following the treatment, in the postanesthetic recuperation (PAR), the patient related her pain as VNS 3, and was released after five hours with VNS 2. Subsequently, her preventive treatment was resumed. Status migrainosus is a rare disabling complication and anesthetics have been the subject of research in its treatment; the option for general anesthesia with agents that stimulate GABA receptors, propofol and isoflurane, in association with fentanyl, proved effective and should encourage new research. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  3. [Treatment of status migrainosus by general anesthesia: a case report].

    Science.gov (United States)

    Udelsmann, Artur; Saccomani, Priscila; Dreyer, Elisabeth; Costa, Alberto Luiz Cunha da

    2015-01-01

    The status migrainosus is a complication of migraine characterizedby severe headache for more than 72 h that did not respond to treatment, with risk of strokeand suicide. Researches on treatment are directed to drugs that stimulate GABA receptors; propofol and isoflurane act on sub-GABAa receptors and theoretically could be interesting. The first has been the subject of research in severe migraine. Opioids are employed in pain, and its use in chronic headache is debatable, but these agents are employed in acute cases. The goalis to present a case of refractory status migrainosus in that we decided to break the pain cycle by general anesthesia. Female patient, aged 50 years, with status migrainosus, in the last five days withvisits to the emergency department, medicated parenterally with various agents without result. Without comorbidities, dehydrated, described her pain as "well over 10" in Visual NumericScale (VNS). After consulting the literature, and given the apparent severity of the condition, we opted for a general anesthesia: induction with fentanyl, propofol, and vecuroniumand maintenance with isoflurane and propofol for two hours. Following the treatment, in the postanesthetic recuperation (PAR), the patient related her pain as VNS 3, and was released after five hours with VNS 2. Subsequently, her preventive treatment was resumed. Status migrainosus is a rare disabling complication and anesthetics have been the subject of research in its treatment; the option for general anesthesia with agents that stimulate GABA receptors, propofol and isoflurane, in association with fentanyl, proved effective and should encourage new research. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  4. Anesthetizing the obese child

    DEFF Research Database (Denmark)

    Mortensen, Anette; Lenz, Katja; Abildstrøm, Hanne

    2011-01-01

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

  5. Time-Dependent Decline in Multifocal Electroretinogram Requires Faster Recording Procedures in Anesthetized Pigs

    DEFF Research Database (Denmark)

    Sørensen, Nina Buus; Christiansen, Anders Tolstrup; Kjær, Troels Wesenberg

    2017-01-01

    PURPOSE: The time-dependent effect of anesthetics on the retinal function is debated. We hypothesize that in anesthetized animals there is a time-dependent decline that requires optimized multifocal electroretinogram (mfERG) recording procedures. METHODS: Conventional and four-frame global-flash mf...... injection of tetrodotoxin (TTX) was given and the mfERG was rerecorded as described above. Data were analyzed using mixed models in SAS statistical software. RESULTS: Propofol significantly decreases the conventional and global-flash amplitudes over time. The only significant effect of isoflurane...... is sufficient in anesthetized pigs. Recordings should be obtained immediately after the induction of anesthesia. The effect of TTX is significant 15 minutes after injection, but is contaminated by the effect of anesthesia 90 minutes after injection. Therefore, the quality of mfERG recordings can be further...

  6. Impact of Anesthetics on 3′-[18F]Fluoro-3′-Deoxythymidine ([18F]FLT Uptake in Animal Models of Cancer and Inflammation

    Directory of Open Access Journals (Sweden)

    Kerstin Fuchs

    2013-07-01

    Full Text Available The aim of this study was to evaluate the impact of different anesthetics on 3′-[18F]fluoro-3′-deoxythymidine ([18F]FLT uptake in carcinomas and arthritic ankles. To determine the amount of [18F]FLT uptake in subcutaneous CT26 colon carcinomas or arthritic ankles, spontaneously room air/medical air–breathing mice were anesthetized with isoflurane, a combination of medetomidine/midazolam, or ketamine/xylazine. Mice were kept conscious or anesthetized during [18F]FLT uptake before the 10-minute static positron emission tomographic (PET investigations. [18F]FLT uptake in CT26 colon carcinomas and arthritic ankles was calculated by drawing regions of interest. We detected a significantly reduced (4.4 ± 0.9 %ID/cm3 [18F]FLT uptake in the carcinomas of ketamine/xylazine-anesthetized mice compared to the [18F]FLT-uptake in carcinomas of medetomidine/midazolam- (7.0 ± 1.5 %ID/cm3 or isoflurane-anesthetized mice (6.4 ± 1.5 %ID/cm3, whereas no significant differences were observed in arthritic ankles regardless of whether mice were anesthetized or conscious during tracer uptake. The time-activity curves of carcinomas and arthritic ankles yielded diverse [18F]FLT accumulation related to the used anesthetics. [18F]FLT uptake dynamics are different in arthritic ankles and carcinoma, and the magnitude and pharmacokinetics of [18F]FLT uptake are sensitive to anesthetics. Thus, for preclinical in vivo [18F]FLT PET studies in experimental tumor or inflammation models, we recommend the use of isoflurane anesthesia as it yields a stable tracer uptake and is easy to handle.

  7. Application of anesthetic drugs in the therapy of status epilepticus%麻醉药在癫痫持续状态治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    陈一萌; 韩冲芳

    2014-01-01

    Status epilepticus is a common neurological emergency and associated with high morbidity and mortality.Refractory status epilepticus describes continuing seizures despite adequate initial pharmacologic treatment and requiring general anaesthesia .The anesthetic drugs include midazolam ,propofol , ketamine,pentobarbital, thiopental, lidocaire, isoflurane and desflurance.It is necessary to know the pharmacological function ,usage and adverse reactions of the anesthetic drugs .%癫痫持续状态是神经系统的急症,有较高的发病率与致死率。难治性癫痫持续状态是指尽管用了足够剂量的初始药物仍然不能控制发作的情况,需要应用麻醉方法。这些麻醉药包括咪达唑仑、丙泊酚、氯胺酮、戊巴比妥钠、硫喷妥钠、利多卡因、异氟醚与地氟醚。了解这些麻醉药治疗难治性癫痫持续状态的药理作用、用法与不良反应是非常必要的。

  8. Drastic decrease in isoflurane minimum alveolar concentration and limb movement forces after thoracic spinal cooling and chronic spinal transection in rats.

    Science.gov (United States)

    Jinks, Steven L; Dominguez, Carmen L; Antognini, Joseph F

    2005-03-01

    Individuals with spinal cord injury may undergo multiple surgical procedures; however, it is not clear how spinal cord injury affects anesthetic requirements and movement force under anesthesia during both acute and chronic stages of the injury. The authors determined the isoflurane minimum alveolar concentration (MAC) necessary to block movement in response to supramaximal noxious stimulation, as well as tail-flick and hind paw withdrawal latencies, before and up to 28 days after thoracic spinal transection. Tail-flick and hind paw withdrawal latencies were measured in the awake state to test for the presence of spinal shock or hyperreflexia. The authors measured limb forces elicited by noxious mechanical stimulation of a paw or the tail at 28 days after transection. Limb force experiments were also conducted in other animals that received a reversible spinal conduction block by cooling the spinal cord at the level of the eighth thoracic vertebra. A large decrease in MAC (to Awake tail-flick and hind paw withdrawal latencies were facilitated or unchanged, whereas reflex latencies under isoflurane were depressed or absent. However, at 80-90% of MAC, noxious stimulation of the hind paw elicited ipsilateral limb withdrawals in all animals. Hind limb forces were reduced (by >/= 90%) in both chronic and acute cold-block spinal animals. The immobilizing potency of isoflurane increases substantially after spinal transection, despite the absence of a baseline motor depression, or "spinal shock." Therefore, isoflurane MAC is determined by a spinal depressant action, possibly counteracted by a supraspinal facilitatory action. The partial recovery in MAC at later time points suggests that neuronal plasticity after spinal cord injury influences anesthetic requirements.

  9. Recovery index, attentiveness and state of memory after xenon or isoflurane anaesthesia: a randomized controlled trial

    Science.gov (United States)

    2010-01-01

    Background Performance of patients immediately after anaesthesia is an area of special interest and so a clinical trial was conducted to compare Xenon with Isoflurane anaesthesia. In order to assess the early cognitive recovery the syndrome short test (SST) according to Erzigkeit (Geromed GmbH) was applied. Methods ASA I and II patients undergoing long and short surgical interventions were randomised to receive either general anaesthesia with Xenon or Isoflurane. The primary endpoint was the validated SST which covering memory disturbances and attentiveness. The test was used on the day prior to intervention, one and three hours post extubation. The secondary endpoint was the recovery index (RI) measured after the end of the inhalation of Xenon or Isoflurane. In addition the Aldrete score was evaluated up to 180 min. On the first post-operative day the patients rated the quality of the anaesthetic using a scoring system from 1-6. Results The demographics of the groups were similar. The sum score of the SST delivered a clear trend one hour post extubation and a statistically significant superiority for Xenon three hours post extubation (p Aldrete score was significantly higher for 45 min. The scoring system results were also better after Xenon anaesthesia (p < 0.001). Conclusions The results show that recovery from anaesthesia and the early return of post-operative cognitive functions are significantly better after Xenon anaesthesia compared to Isoflurane. The results of the RI for Xenon are similar with the previously published results. Trial Registration The trial was registered with the number ISRCTN01110844 http://www.controlled-trials.com/isrctn/pf/01110844. PMID:20459661

  10. Effect of anthracyclines and isoflurane on QTc interval

    Directory of Open Access Journals (Sweden)

    A. Venugopal

    2014-01-01

    Conclusions: Anthracycline chemotherapy can produce significant prolongation of QTc interval. In addition, use of 0.5% end tidal concentration of isoflurane can further augment the QTc interval significantly.

  11. Manipulations of extracellular Loop 2 in α1 GlyR ultra-sensitive ethanol receptors (USERs) enhance receptor sensitivity to isoflurane, ethanol, and lidocaine, but not propofol.

    Science.gov (United States)

    Naito, A; Muchhala, K H; Trang, J; Asatryan, L; Trudell, J R; Homanics, G E; Alkana, R L; Davies, D L

    2015-06-25

    We recently developed ultra-sensitive ethanol receptors (USERs) as a novel tool for investigation of single receptor subunit populations sensitized to extremely low ethanol concentrations that do not affect other receptors in the nervous system. To this end, we found that mutations within the extracellular Loop 2 region of glycine receptors (GlyRs) and γ-aminobutyric acid type A receptors (GABAARs) can significantly increase receptor sensitivity to micro-molar concentrations of ethanol resulting in up to a 100-fold increase in ethanol sensitivity relative to wild-type (WT) receptors. The current study investigated: (1) Whether structural manipulations of Loop 2 in α1 GlyRs could similarly increase receptor sensitivity to other anesthetics; and (2) If mutations exclusive to the C-terminal end of Loop 2 are sufficient to impart these changes. We expressed α1 GlyR USERs in Xenopus oocytes and tested the effects of three classes of anesthetics, isoflurane (volatile), propofol (intravenous), and lidocaine (local), known to enhance glycine-induced chloride currents using two-electrode voltage clamp electrophysiology. Loop 2 mutations produced a significant 10-fold increase in isoflurane and lidocaine sensitivity, but no increase in propofol sensitivity compared to WT α1 GlyRs. Interestingly, we also found that structural manipulations in the C-terminal end of Loop 2 were sufficient and selective for α1 GlyR modulation by ethanol, isoflurane, and lidocaine. These studies are the first to report the extracellular region of α1 GlyRs as a site of lidocaine action. Overall, the findings suggest that Loop 2 of α1 GlyRs is a key region that mediates isoflurane and lidocaine modulation. Moreover, the results identify important amino acids in Loop 2 that regulate isoflurane, lidocaine, and ethanol action. Collectively, these data indicate the commonality of the sites for isoflurane, lidocaine, and ethanol action, and the structural requirements for allosteric modulation on

  12. Isoflurane-induced neuronal apoptosis in developing hippocampal neurons

    Institute of Scientific and Technical Information of China (English)

    Hongliang Liu; Tijun Dai; Weitao Guo

    2013-01-01

    We hypothesized that the P2X7 receptor may be the target of isoflurane, so we investigated the roles of the P2X7 receptor and inositol triphosphate receptor in calcium overload and neuronal apoptosis induced by isoflurane in cultured embryonic rat hippocampal neurons. Results showed that isoflurane induced widespread neuronal apoptosis and significantly increased cytoplasmic Ca2+. Blockade of P2X7 receptors or removal of extracellular Ca2+ combined with blockade of inositol triphosphate receptors completely inhibited apoptosis or increase in cytoplasmic Ca2+. Removal of extracellular Ca2+ or blockade of inositol triphosphate receptor alone could partly inhibit these effects of isoflurane. Isoflurane could directly activate P2X7-gated channels and induce inward currents, but did not affect the expression of P2X7 receptor protein in neurons. These findings indicate that the mechanism by which isoflurane induced neuronal apoptosis in rat developing brain was mediated by intracellular calcium overload, which was caused by P2X7 receptor mediated calcium influx and inositol triphosphate receptor mediated calcium release.

  13. Goalpha regulates volatile anesthetic action in Caenorhabditis elegans.

    Science.gov (United States)

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

    2001-06-01

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

  14. Isoflurane versus sevoflurane with interscalene block for shoulder arthroscopic procedures: Value of process capability indices as an additional tool for data analysis

    Directory of Open Access Journals (Sweden)

    Thrivikrama Padur Tantry

    2016-01-01

    Full Text Available Background and Aims : Hypotensive anaesthesia reduces intra-articular bleed and promotes visualisation during arthroscopy. The haemodynamic effects of inhalational agents isoflurane and sevoflurane were studied extensively, and both were found to reduce mean arterial pressures (MBP to an equivalent magnitude. We investigated the relative ability of isoflurane vis-a-vis sevoflurane to maintain the target systolic blood pressure (SBP in patients undergoing shoulder arthroscopic procedures. Methods: In a prospective randomised study, 59 patients in two groups of 30 and 29 patients each received concomitant general anaesthesia (1.2-1.5 MAC of isoflurane and sevoflurane and interscalene brachial plexus block. Nitrous oxide was used in both groups. Intraoperatively, serial blood pressure recordings of SBP, diastolic blood pressure (DBP, MBP and heart rates were done at every 3 rd min intervals. The manipulations needed to achieve target SBP (T = 90 mmHg for optimal arthroscopic visualisation and treat unacceptable hypotensive episodes were noted. Conventional statistical tests and process capability index (PCI evaluation were both deployed for data analysis. Results: Lower mean SBP and DBPs were recorded for isoflurane patients as compared to sevoflurane (P < 0.05, for mean, maximum and minimum recordings. Higher mean heart rates were recorded for isoflurane (P < 0.05. PCIs indicated that isoflurane was superior to sevoflurane in the ease of achieving target SBP of 90 mmHg as well as maintaining blood pressures in the range of 80-100 mmHg. Conclusion: Isoflurane provides better intraoperative haemodynamic status vis-a-vis sevoflurane in patients undergoing shoulder arthroscopic surgery with preliminary interscalene blockade. The PCI can be a useful additional medical data analysis tool.

  15. Oseltamivir reduces hippocampal abnormal EEG activities after a virus infection (influenza) in isoflurane-anesthetized rats

    OpenAIRE

    Inoue,, S.; Kido, Hiroshi

    2012-01-01

    Youssouf Cissé,1 Isao Inoue,2 Hiroshi Kido11Division of Enzyme Chemistry, 2Division of Molecular Neurobiology, Institute for Enzyme Research, University of Tokushima, Tokushima, JapanBackground: Oseltamivir phosphate (OP, Tamiflu®) is a widely used drug in the treatment of influenza with fever. However, case reports have associated OP intake with sudden abnormal behaviors. In rats infected by the influenza A virus (IAV), the electroencephalogram (EEG) displayed abnormal hig...

  16. Does chronic occupational exposure to volatile anesthetic agents influence the rate of neutrophil apoptosis?

    LENUS (Irish Health Repository)

    Goto, Y

    2012-02-03

    PURPOSE: The purpose of this preliminary investigation was to determine whether the rate of neutrophil apoptosis in health care workers is influenced by exposure to volatile anesthetic agents. METHODS: Percentage neutrophil apoptosis (Annexin-V FITC assay) was measured in health care workers (n = 20) and unexposed volunteers (n = 10). For the health care workers, time weighted personal exposure monitoring to N2O, sevoflurane and isoflurane was carried out. RESULTS: The sevoflurane and isoflurane concentrations to which health care workers were exposed were less than recommended levels in all 20 cases. Percent apoptosis was less at 24 (but not at one and 12) hr culture in health care workers [50.5 (9.7)%; P = 0.008] than in unexposed volunteers [57.3 (5.1)%]. CONCLUSION: Inhibition of neutrophil apoptosis at 24 hr culture was demonstrated in health care workers chronically exposed to volatile anesthetic agents. Exposure was well below recommended levels in the both scavenged and unscavenged work areas in which the study was carried out. Further study is required to assess the effect of greater degrees of chronic exposure to volatile anesthetic agents on neutrophil apoptosis.

  17. Volatile anesthetics inhibit the activity of calmodulin by interacting with its hydrophobic site

    Institute of Scientific and Technical Information of China (English)

    ZHOU Miao-miao; XIA Hui-min; LIU Jiao; XU You-nian; XIN Nai-xin; ZHANG Shi-hai

    2012-01-01

    Background Volatile anesthetics (VAs) may affect varied and complex physiology processes by manipulating Ca2+-calmodulin (CaM).However,the detailed mechanism about the action of VAs on CaM has not been elucidated.This study was undertaken to examine the effects of VAs on the conformational change,hydrophobic site,and downstream signaling pathway of CaM,to explore the possible mechanism of anesthetic action of VAs.Methods Real-time second-harmonic generation (SHG) was performed to monitor the conformational change of CaM in the presence of VAs, each plus 100 μmol/L Ca2+. A hydrophobic fluorescence indicator,8-anilinonaphthalene-1-sulfonate (ANS),was utilized to define whether the VAs would interact with CaM at the hydrophobic site or not.High-performance liquid chromatography (HPLC) was carried out to analyze the activity of CaM-dependent phosphodiesterase (PDE1) in the presence of VAs.The VAs studied were ether,enflurane,isoflurane,and sevoflurane,with their aqueous concentrations 7.6,9.5,11.4 mmol/L; 0.42,0.52,0.62 mmol/L; 0.25,0.31,0.37 mmol/L and 0.47,0.59,0.71 mmol/L respectively,each were equivalent to their 0.8,1.0 and 1.2 concentration for 50% of maximal effect (EC50) for general anesthesia.Results The second-harmonic radiation of CaM in the presence of Ca2+ was largely inhibited by the VAs.The fluorescence intensity of ANS,generated by binding of Ca2+ to CaM,was reversed by the VAs.HPLC results also showed that AMP,the product of the hydrolysis of cAMP by CaM-dependent PDE1,was reduced by the VAs.Conclusions Our findings demonstrate that the above VAs interact with the hydrophobic core of Ca2+-CaM and the interaction results in the inhibition of the conformational change and activity of CaM.This in vitro study may provide us insight into the possible mechanism of anesthetic action of VAs in vivo.

  18. A Unitary Anesthetic Binding Site at High Resolution

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-10-21

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

  19. A Unitary Anesthetic Binding Site at High Resolution

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-12-31

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

  20. A Unitary Anesthetic-Binding Site at High Resolution

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-01-01

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

  1. Is general anesthesia a risk for myocardium? Effect of anesthesia on myocardial function as assessed by cardiac troponin-i in two different groups (isofluran+N2O inhalation and propofol+fentanyl iv anesthesia)

    OpenAIRE

    Demet Dogan Erol; Ibrahim Ozen

    2007-01-01

    Demet Dogan Erol1, Ibrahim Ozen21Department of Anaesthesiology and Reanimation, School of Medicine, Kocatepe University, Afyonkarahisar, Turkey; 2Department of Anaesthesiology and Reanimation, Karadeniz Technical University Faculty of Medicine, Trabzon, TurkeyBackground and objectives: Peroperative myocardial infarction (MI) is the most common cause of morbidity and mortality. What is the role of general anesthesia in this process? Is general anesthesia a risk for myocardial infarction? The p...

  2. The effects of N-acetylcysteine on hepatic function during isoflurane anaesthesia for laparoscopic surgery patients

    Directory of Open Access Journals (Sweden)

    Serbülent Gökhan Beyaz

    2011-01-01

    Full Text Available Introduction: Although most general anaesthesia procedures are performed without any complications, volatile agents may have adverse effects on various living systems. This study aims to compare the antioxidant effects of isoflurane and N-acetylcysteine (NAC on liver function. Methods: Forty-one patients in the ASA I-II risk groups, who were scheduled to undergo gynaecologic laparoscopy, were randomly divided into two groups: The placebo (group P, n=21 and the NAC group (group N, n=20. In both groups, anaesthesia was maintained with 1-2% isoflurane in 50% Oxygen-50% N 2 O at 6 l/min, also administered by inhalation. Venous blood samples were obtained before anaesthesia induction, and then in the postoperative 1 st hour and at the 24 th hour. The samples were centrifuged and serum levels of glutathione S-transferase (GST, malondialdehyde (MDA, aspartate amino transferase (AST, alanine amino transferase (ALT, lactate dehydrogenase (LDH, gamma glutamyltranspeptidase (GGT, prothrombin time (PT, activated partial thromboplastin time (aPTT and international normalised ratio were determined. Results: GST levels were significantly higher in group N than in group P in the postoperative 1 st hour. Postoperative values of GST in the two groups were higher when compared to preoperative values (P<0.05. When postoperative levels were compared with preoperative levels, the postoperative MDA levels of group N were significantly higher (P<0.05. Levels of AST, ALT, GGT and LDH in both groups revealed significant decreases at the postoperative 1 st hour and postoperative 24 th hour compared to preoperative values (P<0.05, P<0.001. PT values were significantly higher in both groups in the postoperative 1 st hour and 24 th hour (P<0.05, P<0.001, although there were no differences in aPTT levels. Conclusion: Our results showed that liver functions were well preserved with administration of NAC during anaesthesia with isoflurane. Isoflurane with NAC has lesser

  3. Hipotermia dan Waktu Pemulihannya dalam Anestesi Gas Isofluran dengan Induksi Ketamin-Xylazin pada Anjing (HYPOTHERMIA AND ITS RECOVERY IN GAS ISOFLURANE ANESTHESIA WITH KETAMINE-XYLAZINE INDUCTION ON DOGS

    Directory of Open Access Journals (Sweden)

    Gagak Donny Satria

    2016-03-01

    Full Text Available The most common effect occurred during anaesthesia is the decrease of body temperature. Technologicaldevelopment has enabled the used the latest innovations in order to to increase the efficacy and the safetyof anaesthesia. The purpose of this study was to determine the effect of ketamine-xylazine injection onhypothermia and its recovery at dog which anesthetized with isoflurane. Ten healthy dogs were dividedinto two groups with each group consisted offive dogs. In Group A, dogs were given premedication (atropinesulfate 0.04 mg/kg and then anaesthetized with isoflurane gas (4% for induction dose and 1% for themaintenance dose. In Group B dogs were given premedication atropine sulfate (0.04 mg/kg and ketamineHCl induction solution (10 mg/kg mixed with xylazine HCl (2 mg/kg, and anaesthetized with isofluranegas (maintenance dose of 1%. Adaptation period was conducted in one week. Body temperature wasmeasured before, during, and after the duration of anaesthesia. The data was analyzed statistically by arepeated Anova test. This study found that the mean body temperature of dogs in Group A decreased from37,88±0,51 oC to 34,64±0,95 oC over a period of anaesthesia, and the recovery time was over 40 minutespost-anaesthesia. In Group B, body temperature decreased from 38.06±0.42 oC to 34.96±1.23 oC, and therecovery time was 90 minutes. In conclusion, the use of ketamine-xylazine in isoflurane anaesthesiaprocedures on dogs, would need post-anaesthesia preparation procedure regarding with hypothermia andits recovery.

  4. 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

  5. Anesthetic Techniques and Cancer Recurrence after Surgery

    Directory of Open Access Journals (Sweden)

    Vincenzo Fodale

    2014-01-01

    Full Text Available Many of the most common anesthetics are used in surgical oncology, yet effects on cancer cells are still not known. Anesthesia technique could differentially affect cancer recurrence in oncologic patients undergoing surgery, due to immunosuppression, stimulation of angiogenesis, and dissemination of residual cancer cells. Data support the use of intravenous anesthetics, such as propofol anesthesia, thanks to antitumoral protective effects inhibiting cyclooxygenase 2 and prostaglandins E2 in cancer cells, and stimulation of immunity response; a restriction in the use of volatile anesthetics; restriction in the use of opioids as they suppress humoral and cellular immunity, and their chronic use favors angiogenesis and development of metastases; use of locoregional anesthesia compared with general anesthesia, as locoregional appears to reduce cancer recurrence after surgery. However, these findings must be interpreted cautiously as there is no evidence that simple changes in the practice of anesthesia can have a positive impact on postsurgical survival of cancer patients.

  6. The Effect of Nitrous Oxide and Isoflurane on the Total RNA Yield from the Cochlea of the Rats

    Institute of Scientific and Technical Information of China (English)

    LI Yuantao; KE Changbin; YANG Jingli; XIONG Liangzhi; YAO Shanglong

    2007-01-01

    The possible mechanism of inhalation anesthetics on the internal auditory impairment of the rat was investigated by determining the effect of nitrous oxide (N20) and isoflurane on the total RNA yield from the cochlea of the rats. Thirty healthy Wistar rats were randomly divided into 3 groups: group C (control group, n=10) with a 3-h unremitting inhalation of 50% O2 group N (ex-periment group, n= 10) with a continuous inhalation of 50% N2O+50% O2for 3 h, and group I (ex-periment group, n=10) with a 3-h sustained inhalation of 2.5% isoflurane. The TRIzol in combination with RNeasy was used to respectively extract the total RNA from cochlea of rats in the 3 groups. Spectrophotometry was used to detect total RNA yield and electrophoresis to detect the quality. The total RNA extracted from the cochlea of the rats in the groups C and N was 7.69 and 6.51 μg, respec- tively. There was a 15% decrease in the N group as compared with group C. The total RNA from the rats in the group I was 7.32 μg, and there was hardly any change in the group as compared with the group C. The value of A260/A280 in groups C, N and I was 2.07, 2.04 and 2.04, respectively, showing a very high RNA purity. The result of gel electrophoresis suggested that there was no degradation in the total RNA. It was suggested that the interference of N2O on the cochlear RNA yield might be one of the reasons which cause an injury of the ear. The isoflurane shows no harm on the heating.

  7. Pulse pressure variation and stroke volume variation under different inhaled concentrations of isoflurane, sevoflurane and desflurane in pigs undergoing hemorrhage

    Directory of Open Access Journals (Sweden)

    Alexandre Hideaki Oshiro

    2015-12-01

    Full Text Available OBJECTIVES: Inhalant anesthesia induces dose-dependent cardiovascular depression, but whether fluid responsiveness is differentially influenced by the inhalant agent and plasma volemia remains unknown. The aim of this study was to compare the effects of isoflurane, sevoflurane and desflurane on pulse pressure variation and stroke volume variation in pigs undergoing hemorrhage. METHODS: Twenty-five pigs were randomly anesthetized with isoflurane, sevoflurane or desflurane. Hemodynamic and echocardiographic data were registered sequentially at minimum alveolar concentrations of 1.00 (M1, 1.25 (M2, and 1.00 (M3. Then, following withdrawal of 30% of the estimated blood volume, these data were registered at a minimum alveolar concentrations of 1.00 (M4 and 1.25 (M5. RESULTS: The minimum alveolar concentration increase from 1.00 to 1.25 (M2 decreased the cardiac index and increased the central venous pressure, but only modest changes in mean arterial pressure, pulse pressure variation and stroke volume variation were observed in all groups from M1 to M2. A significant decrease in mean arterial pressure was only observed with desflurane. Following blood loss (M4, pulse pressure variation, stroke volume variation and central venous pressure increased (p <0.001 and mean arterial pressure decreased in all groups. Under hypovolemia, the cardiac index decreased with the increase of anesthesia depth in a similar manner in all groups. CONCLUSION: The effects of desflurane, sevoflurane and isoflurane on pulse pressure variation and stroke volume variation were not different during normovolemia or hypovolemia.

  8. Prophylactic Antiarrhythmic Effect of Anesthetics at Subanesthetic Concentration on Epinephrine-Induced Arrhythmias in Rats after Brain Death

    Directory of Open Access Journals (Sweden)

    Yuka Miyata

    2015-01-01

    Full Text Available The present study using brain death model of rats was designed to examine whether prophylactic administration of volatile anesthetics and propofol prevent the epinephrine-induced arrhythmias. A Fogarty catheter was placed intracranially for induction of brain death. After brain death, the rats were randomly assigned to five groups: the control group (no anesthetics, the sevoflurane group (0.8%, the isoflurane group (0.5%, the halothane group (0.3%, and the propofol group (195 μg·kg−1·min−1. These anesthetics were about 30% of ED50 of each anesthetic. The arrhythmogenic dose of epinephrine was determined in each anesthetic group. In addition, we examined left ventricular levels of connexin 43 phosphorylation 30 min after administration of each anesthetic with Western blot analysis. The arrhythmogenic dose of epinephrine in the sevoflurane group was significantly higher than that in the control group, while the arrhythmogenic dose of epinephrine in any other anesthetic group was not different. On the other hand, the ratio of phosphorylated-connexin 43/total connexin 43 was also similar among the study groups. Thus, prophylactic administration of subanesthetic dose of sevoflurane is effective in preventing epinephrine-induced arrhythmias after brain death, but phosphorylation of connexin is not involved in the antiarrhythmic property of sevoflurane.

  9. Prophylactic antiarrhythmic effect of anesthetics at subanesthetic concentration on epinephrine-induced arrhythmias in rats after brain death.

    Science.gov (United States)

    Miyata, Yuka; Iwasaki, Mitsuo; Yamanaka, Hiroo; Sato, Masanori; Kamibayashi, Takahiko; Fujino, Yuji; Hayashi, Yukio

    2015-01-01

    The present study using brain death model of rats was designed to examine whether prophylactic administration of volatile anesthetics and propofol prevent the epinephrine-induced arrhythmias. A Fogarty catheter was placed intracranially for induction of brain death. After brain death, the rats were randomly assigned to five groups: the control group (no anesthetics), the sevoflurane group (0.8%), the isoflurane group (0.5%), the halothane group (0.3%), and the propofol group (195 μg·kg(-1) ·min(-1)). These anesthetics were about 30% of ED50 of each anesthetic. The arrhythmogenic dose of epinephrine was determined in each anesthetic group. In addition, we examined left ventricular levels of connexin 43 phosphorylation 30 min after administration of each anesthetic with Western blot analysis. The arrhythmogenic dose of epinephrine in the sevoflurane group was significantly higher than that in the control group, while the arrhythmogenic dose of epinephrine in any other anesthetic group was not different. On the other hand, the ratio of phosphorylated-connexin 43/total connexin 43 was also similar among the study groups. Thus, prophylactic administration of subanesthetic dose of sevoflurane is effective in preventing epinephrine-induced arrhythmias after brain death, but phosphorylation of connexin is not involved in the antiarrhythmic property of sevoflurane.

  10. Anesthetic management of a patient undergoing liver transplantation who had previous coronary artery bypass grafting using an in situ right gastroepiploic artery.

    OpenAIRE

    Murata, Hiroaki; Inoue, Haruka; Sumikawa, Koji

    2010-01-01

    We describe successful anesthetic management during living-donor liver transplantation in a 63-year-old man with previous coronary artery bypass grafting (CABG) that employed an in situ right gastroepiploic artery (RGEA). Anesthesia was maintained with 1.5% isoflurane in air/oxygen and fentanyl. A five-lead electrocardiogram, transesophageal echocardiogram, and pacing pulmonary artery catheter evaluated cardiac function. A pacing wire was inserted through the catheter to prepare for intraoper...

  11. Clinical Study on Effect of Electro-acupuncture Combined with Different Anesthetics on Auditory-evoked Potential Index

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To observe the effect of electro-acupuncture (EA) on auto regressive with exogenous input model (ARX-model) auditory evoked index (AAI) in patients anesthetized with different anesthetics. Methods: Forty-eight adult patients undergoing scheduled surgical operation were enrolled and divided into two groups (24 in each group) according to the anesthetics applied, Group A was anesthetized with propofol sedation and Group B with Isoflurane-epidural anesthesia. Group A was subdivided into three groups of low, middle and high concentration of target effect-site of 1.0 μg/ml, 1.5 μg/ml and 2.0 μg/ml through target controlled infusion (TCI) and Group B into 3 subgroups of minimum alveolar effective concentration of isoflurane (0.4 MAC, 0.6 MAC and 0.8 MAC for B1, B2 and B3 subgroups) respectively, with 8 patients in every subgroup. EA on acupoints of Hegu (LI4) and Neiguan (P6) was applied on all the patients during anesthesia, and the change of AAI at various time points was recorded. Results: In the three subgroups of Group A, levels of AAI were significantly elevated in the first few minutes after EA, and significantly lowered 20 min after EA in subgroup A2. While in the subgroups of Group B, except the elevating in Group B1 1 -2 min after EA, levels of AAI remained unchanged at other time points. Conclusion: Pain response could be reflected by AAI during EA. EA could enhance the sedative effect of propofol in middle concentration, but its effect on isoflurane epidural anesthesia is insignificant.

  12. Cardiopulmonary effects of dobutamine and norepinephrine infusion in healthy anesthetized alpacas.

    Science.gov (United States)

    Vincent, Caitlin J; Hawley, Alexander T; Rozanski, Elizabeth A; Lascola, Kara M; Bedenice, Daniela

    2009-10-01

    To characterize the cardiopulmonary effects of dobutamine and norepinephrine infusion in isoflurane-anesthetized healthy alpacas. 8 adult alpacas. Initial baseline cardiovascular, respiratory, and metabolic variables were obtained 30 minutes after induction of isoflurane anesthesia in 8 alpacas (3 females and 5 sexually intact males). Four treatments (dobutamine at 4 and 8 microg/kg/min and norepinephrine at 0.3 and 1 microg/kg/min) were administered in random order via constant rate infusion over 15 minutes, followed by repeat measurements of cardiopulmonary values and a 20-minute washout period. Subsequent baseline and posttreatment measurements were similarly repeated until both drugs and dosages were administered to each animal. Baseline data in awake alpacas were obtained 18 to 24 hours following recovery from anesthesia. Both dobutamine and norepinephrine significantly increased cardiac index and arterial blood pressure from baseline values. Similar increases in hemoglobin concentration, oxygen content, and oxygen delivery were observed following administration of each drug at either dosage. Only dobutamine, however, reduced relative oxygen consumption while improving overall tissue oxygenation. Furthermore, heart rate was selectively enhanced by dobutamine and systemic vascular resistance by norepinephrine. Norepinephrine infusion resulted in dose-dependent changes in cardiopulmonary variables. Results indicated that both dobutamine and norepinephrine were appropriate choices to improve cardiac index, mean arterial pressure, and overall oxygen delivery in alpacas with isoflurane-induced hypotension. Careful titration by use of low infusion rates of dobutamine and norepinephrine is recommended to avoid potential arrhythmogenic effects and excessive vasoconstriction, respectively.

  13. Optimization of anesthesia protocol for resting-state fMRI in mice based on differential effects of anesthetics on functional connectivity patterns.

    Science.gov (United States)

    Grandjean, Joanes; Schroeter, Aileen; Batata, Imene; Rudin, Markus

    2014-11-15

    Resting state-fMRI (rs-fMRI) in mice allows studying mechanisms underlying functional connectivity (FC) as well as alterations of FC occurring in murine models of neurological diseases. Mouse fMRI experiments are typically carried out under anesthesia to minimize animal movement and potential distress during examination. Yet, anesthesia inevitably affects FC patterns. Such effects have to be understood for proper interpretation of data. We have compared the influence of four commonly used anesthetics on rs-fMRI. Rs-fMRI data acquired under isoflurane, propofol, and urethane presented similar patterns when accounting for anesthesia depth. FC maps displayed bilateral correlation with respect to cortical seeds, but no significant inter-hemispheric striatal connectivity. In contrast, for medetomidine, we detected bilateral striatal but compromised inter-hemispheric cortical connectivity. The spatiotemporal patterns of the rs-fMRI signal have been rationalized considering anesthesia depth and pharmacodynamic properties of the anesthetics. Our results bridge the results from different studies from the burgeoning field of mouse rs-fMRI and offer a framework for understanding the influences of anesthetics on FC patterns. Utilizing this information, we suggest the combined use of medetomidine and isoflurane representing the two proposed classes of anesthetics; the combination of low doses of the two anesthetics retained strong correlations both within cortical and subcortical structures, without the potential seizure-inducing effects of medetomidine, rendering this regimen an attractive anesthesia for rs-fMRI in mice.

  14. Estudo comparativo entre sevofluorano, halotano e isofluorano em Gallus domesticus Comparite evaluation with sevoflurane, halothane and isoflurane in Gallus domesticus

    Directory of Open Access Journals (Sweden)

    Luciana Dambrosio Guimarães

    2000-12-01

    Full Text Available Foram utilizados 30 frangos com 20 semanas de idade, pesando em média 2,90 ± 0,65kg divididos aleatoriamente em três grupos. A indução da anestesia foi realizada com máscara facial artesanal conectada ao sistema de Maggil Modificado, utilizando entre 3,0 e 3,5 vezes a dose anestésica mínima (DAM de cada agente e fluxo diluente de O2 de 2l/min, sendo que posteriormente os animais foram intubados e mantidos com valores de aproximadamente 1,7DAM durante 65 minutos. O isofluorano causou maior depressão respiratória e hipotensão; o halotano proporcionou maiores valores de pressão arterial e temperatura corporal e o sevofluorano, menor depressão respiratória e hipotensão em relação ao grupo do isofluorano, sendo considerado o agente mais indicado para a utilização em aves. A indução e recuperação foram mais rápidas com o sevofluorano, embora sem diferença significativa estatisticamente.For the comparison 30 twenty-week-old chicken were used. They weigh na averdage of 2.90 ± 0.65kg aleatorily divided into 3 groups. The anesthetic induction was accomplished with a home-made facial mask connected with the modified circuit of Maggil using values between 3.0 e 3.5 a minimal anesthetic dose (MAD for each agent. Posteriorly, the animals were intubated and anesthesia was maintained with values approximately 1.7DAM during 65 minutes. Isoflurane caused further respiratory depression and hypotension when it is compared to the other two anesthetic agents. The group of halothane presented higher values of blood pressure and body temperature and the group of sevoflurane, lower respiratory depression and hypotension in relation to the group of isoflurane. The induction and recuperation were faster with the sevoflurane, although without expressive diference statistically. The sevoflurane is the most indicated anesthetic agent.

  15. Gambaran Fungsi Jantung Kelinci Domestik Secara Ekhokardiogram pada Anestesi Propofol dan Isoflurane Jangka Panjang (ECHOCARDIOGRAM PROFILE OF CARDIAC FUNCTION IN DOMESTIC RABBITS DURING LONG-TERM ANESTHESIA PROPOFOL AND ISOFLURANE

    Directory of Open Access Journals (Sweden)

    Sitaria Siallagan

    2014-08-01

    Full Text Available Several major surgeries may require long time use of anesthetics and therefore increase the heartfunction suppression. The purpose of this study was to determine long term effects of anesthetic propofoland isoflurane on heart structure and function of domestic rabbits through observation of the blood flowvolume and contraction capabilities by M-mode echocardiography examination. This study used thecombination of propofol 12.5 mg/kg IV as an induction and isoflurane inhalation as the maintenanceanesthetic for a 12-hour observation. Parameters observed in this study were heart rate, wall thickness,internal chamber dimension, blood flow volume, fractional shortening, and ejection fraction. Results showedthat the left ventricle heart chamber dimensions during diastole (LVIDd and systole (LVIDs were between1.21±0.08 to 1.33±0.1 cm, and 0.87±0.08 to 0.98±0.08 cm respectively. Left ventricular wall thickness atdiastole (LVWd and systole (LVWs ranged from 0.24±0.04 to 0.28±0.04 cm, and 0.23±0.03 to 0.28±0.05cm respectively, while the thickness of the interventricular septa at diastole (IVSd and systole (IVSsranged from 0.23±0.02 to 0.27±0.04 cm, and 0.28±0.06 to 0.30±0.05 cm. Heart rate ranged from 244.6±18.46to 266.4±24.55 beat/min. Heart flow volumes which included stroke volume (SV and cardiac output (COranged from 1.07±0.29 to 1.57±0.53 mL/beat and 0.27±0.07 to 0.39±0.14 L/min respectively. Fractionalshortening and ejection fraction ranged from 26±3 to 31±5% and 60±2 to 67±8% respectively. In conclusion,long term anesthesic of propofol and isoflurane combination induced minimum cardiac suppression indomestic rabbits.

  16. Effects of isoflurane and sevoflurane postconditioning and changes in JNK1/2 pathway activity on rat brain slices subjected to oxygen and glucose deprivation in vitro

    Institute of Scientific and Technical Information of China (English)

    Sheng Wang; Zhigang Dai; Xiwei Dong; Suxiang Guo; Yang Liu; Shan Jiang; Zhiping Wang

    2011-01-01

    Recent research shows that the JNK1/2 signaling pathway plays a neuroprotective role against ischemia-reperfusion injury by cross-talk with other pathways. The present study investigated the effects of isoflurane and sevoflurane postconditioning on JNK1/2 pathway activity and neuronal cell viability after oxygen and glucose deprivation injury in hippocampal slices in vitro. Techniques used included population spike analysis, propidium iodide fluorescent staining, western blot assay, and the use of JNK1/2-specific pharmacological tools such as anisomycin (agonist) and SP600125 (inhibitor). We found that both isoflurane and sevoflurane inhibited JNK pathway activity and had neuroprotective effects against oxygen and glucose deprivation injury in slices of rat hippocampus in vitro. Postconditioning with volatile anesthetics exerted neuroprotective effects on nerve cells and preserved the function of the CA1 region by inhibiting JNK1/2 phosphorylation. This suppression of JNK1/2 activity could underlie the observed synergistic neuroprotective effect produced by volatile anesthetic postconditioning.

  17. Assessment of occupational exposure of medical personnel to inhalatory anesthetics in Poland

    Directory of Open Access Journals (Sweden)

    Małgorzata Kucharska

    2014-02-01

    Full Text Available Objectives: Despite common use of inhalatory anesthetics, such as nitrous oxide (N2O, halothane, sevoflurane, and the like, occupational exposure to these substances in operating theatres was not monitored in Poland until 2006. The situation changed when maximum admissible concentration (MAC values for anesthetics used in Poland were established in 2005 for N2O, and in 2007 for sevoflurane, desflurane and isoflurane. The aim of this work was to assess occupational exposure in operating rooms on the basis of reliable and uniform analytical procedures. Material and Methods: The method for the determination of all anesthetics used in Poland, i.e. nitrous oxide, sevoflurane, isoflurane, desflurane, and halothane, was developed and validated. The measurements were performed in 2006-2010 in 31 hospitals countrywide. The study covered 117 operating rooms; air samples were collected from the breathing zone of 146 anesthesiologists, and 154 nurses, mostly anaesthetic. The measurements were carried out during various surgical operations, mostly on adult patients but also in hospitals for children. Results: Time weighted average concentrations of the anesthetics varied considerably, and the greatest differences were noted for N2O (0.1-1438.5 mg/m3; 40% of the results exceeded the MAC value. Only 3% of halothane, and 2% of sevoflurane concentrations exceeded the respective MAC values. Conclusions: Working in operating theatres is dangerous to the health of the operating staff. The coefficient of combined exposure to anesthesiologists under study exceeded the admissible value in 130 cases, which makes over 40% of the whole study population. Most of the excessive exposure values were noted for nitrous oxide. Med Pr 2014;65(1:43–54

  18. Comparison of pneumotachography and anemometery for flow measurement during mechanical ventilation with volatile anesthetics.

    Science.gov (United States)

    Mondoñedo, Jarred R; Herrmann, Jacob; McNeil, John S; Kaczka, David W

    2016-11-14

    Volatile anesthetics alter the physical properties of inhaled gases, such as density and viscosity. We hypothesized that the use of these agents during mechanical ventilation would yield systematic biases in estimates of flow ([Formula: see text]) and tidal volume (V T) for two commonly used flowmeters: the pneumotachograph (PNT), which measures a differential pressure across a calibrated resistive element, and the hot-wire anemometer (HWA), which operates based on convective heat transfer from a current-carrying wire to a flowing gas. We measured [Formula: see text] during ventilation of a spring-loaded mechanical test lung, using both the PNT and HWA placed in series at the airway opening. Delivered V T was estimated from the numerically-integrated [Formula: see text]. Measurements were acquired under baseline conditions with room air, and during ventilation with increasing concentrations of isoflurane, sevoflurane, and desflurane. We also evaluated a simple compensation technique for HWA flow, which accounted for changes in gas mixture density. We found that discrepancies in estimated V T between the PNT and HWA occurred during ventilation with isoflurane (6.3 ± 3.0%), sevoflurane (10.0 ± 7.3%), and desflurane (25.8 ± 17.2%) compared to baseline conditions. The magnitude of these discrepancies increased with anesthetic concentration. A simple compensation factor based on density reduced observed differences between the flowmeters, regardless of the anesthetic or concentration. These data indicate that the choice and concentration of anesthetic agents are primary factors for differences in estimated V T between the PNT and HWA. Such discrepancies may be compensated by accounting for alterations in gas density.

  19. Identification of causal relations between haemodynamic variables, auditory evoked potentials and isoflurane by means of fuzzy logic

    DEFF Research Database (Denmark)

    Jensen, E W; Nebot, A; Caminal, P;

    1999-01-01

    ) methodology. A fuzzy model is able to identify non-linear and linear components of a causal relationship by means of optimization of information content of available data. Nine young female patients undergoing hysterectomy under general anaesthesia were included. Mean arterial pressure (MAP), heart rate (HR......The aim of this study was to identify a possible relationship between haemodynamic variables, auditory evoked potentials (AEP) and inspired fraction of isoflurane (ISOFl). Two different models (isoflurane and mean arterial pressure) were identified using the fuzzy inductive reasoning (FIR...... the depth of anaesthesia index (DAI) normalized to 100 when the patient was awake and descending to an average of 25 during loss of consciousness. The FIR methodology identified those variables among the input variables (MAP, HR, CO2ET, DAI or ISOFl) that had the highest causal relation with the output...

  20. Llama anesthetic programs.

    Science.gov (United States)

    Heath, R B

    1989-03-01

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

  1. Anesthetic-Induced Developmental Neurotoxicity

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  2. Stable inhibition of brain synaptic plasma membrane calcium ATPase in rats anesthetized with halothane.

    Science.gov (United States)

    Franks, J J; Horn, J L; Janicki, P K; Singh, G

    1995-01-01

    The authors recently showed that plasma membrane Ca(2+)-ATPase (PMCA) activity in cerebral synaptic plasma membrane (SPM) is diminished in a dose-related fashion during exposure in vitro to halothane, isoflurane, xenon, and nitrous oxide at clinically relevant partial pressures. They have now extended their work to in vivo studies, examining PMCA pumping in SPM obtained from control rats decapitated without anesthetic exposure, from rats decapitated during halothane anesthesia, and from rats decapitated after recovery from halothane anesthesia. Three treatment groups were studied: 1) C, control rats that were decapitated without anesthetic exposure, 2) A, anesthetized rats exposed to 1 minimum effective dose (MED) for 20 min and then decapitated, and 3) R, rats exposed to 1 MED for 20 min and then decapitated after recovery from anesthesia, defined as beginning to groom. Plasma membrane Ca(2+)-ATPase pumping and Ca(2+)-dependent ATPase hydrolytic activity, as well as sodium-calcium exchanger activity and Na+-K+-ATPase hydrolytic activity, were assessed in cerebral SPM. In addition, halothane effect on smooth endoplasmic reticulum Ca(2+)-ATPase (SERCA) was examined. Plasma membrane Ca(2+)-ATPase transport of Ca2+ into SPM vesicles from anesthetized rats was reduced to 71% of control (P SPM from rats killed while anesthetized with halothane, compared with rats killed without anesthesia or after recovery from anesthesia. The studies described in this report, in conjunction with previously reported inhibition of PMCA activity in vitro by a wide range of anesthetic agents, indicate a relationship between inhibition of PMCA and action of inhalational anesthetics.

  3. Hepatic effects of halothane, isoflurane or sevoflurane anaesthesia in dogs.

    Science.gov (United States)

    Topal, A; Gül, N; Ilçöl, Y; Görgül, O S

    2003-12-01

    The effects of halothane, isoflurane and sevoflurane anaesthesia on hepatic function and hepatocellular damage were investigated in dogs, comparing the activity of hepatic enzymes and bilirubin concentration in serum. An experimental study was designed. Twenty-one clinically normal mongrel dogs were divided into three groups and accordingly anaesthetized with halothane (n = 7), isoflurane (n = 7) and sevoflurane (n = 7). The dogs were 1-4 years old, and weighed between 13.5 and 27 kg (18.4 +/- 3.9). Xylazine HCI (1-2 mg/kg) i.m. was used as pre-anaesthetic medication. Anaesthesia was induced with propofol 2 mg/kg i.v. The trachea was intubated and anaesthesia maintained with halothane, isoflurane or sevoflurane in oxygen at concentrations of 1.35, 2 and 3%, respectively. Intermittent positive pressure ventilation (tidal volume, 15 ml/kg; respiration rate, 12-14/min) was started immediately after intubation and the anaesthesia lasted for 60 min. Venous blood samples were collected before pre-medication, 24 and 48 h, and 7 and 14 days after anaesthesia. Serum level of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma-glutamyltransferase (GGT), lactate dehydrogenase (LDH GGT) activities and bilirubin concentration were measured. Serum AST, ALT and GGT activities increased after anaesthesia in all groups. In the halothane group, serum AST and ALT activities significantly increased all the time after anaesthesia compared with baseline activities. But in the isoflurane group AST and ALT activities increased only between 2 and 7 days, and in the sevoflurane group 7 days after anaesthesia. GGT activity was increased in the halothane group between 2 and 7 days, and in the isoflurane and sevoflurane groups 7 days after anaesthesia. All dogs recovered from anaesthesia without complications and none developed clinical signs of hepatic damage within 14 days. The results suggest that the use of halothane anaesthesia induces an

  4. Neurotoxicity versus Neuroprotection of Anesthetics: Young Children on the Ropes?

    Science.gov (United States)

    Eizaga Rebollar, Ramón; García Palacios, María V; Morales Guerrero, Javier; Torres Morera, Luis M

    2017-08-01

    Normal brain development in young children depends on a balance between excitation and inhibition of neurons, and alterations to this balance may cause apoptosis. During the perioperative period, both surgical stimuli and anesthetics can induce neurotoxicity. This article attempts to expand the perspective of a topical issue-anesthetic-induced neurotoxicity-by also considering the protective effect of general anesthetics against surgery-induced neurotoxicity, all of which may generate some controversy in the current literature. The "new" major factor influencing neurotoxicity-nociceptive stimulus-is discussed together with other factors to develop clinical and research strategies to obtain a balance between neurotoxicity and neuroprotection.

  5. Child with aplastic anemia: Anesthetic management

    OpenAIRE

    Manpreet Kaur; Babita Gupta; Aanchal Sharma; Sanjeev Sharma

    2012-01-01

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

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

    Science.gov (United States)

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

    2010-12-01

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

  7. Evaluation of the aesthetics of physical methods of euthanasia of anesthetized rats.

    Science.gov (United States)

    Hickman, Debra L; Johnson, Steven W

    2011-09-01

    Dissection of living brain tissue for in vitro experiments requires the use of a rapid euthanasia method. However, the method must not subject animals to unnecessary pain and must be aesthetically acceptable to experimenters. The purposes of the current study were to assess the aesthetics of 6 euthanasia methods, measure the procedure duration, and evaluate brain for pathology after each procedure. We digitally recorded euthanasia of isoflurane-anesthetized rats by 6 physical methods: anesthetic overdose, cardiac exsanguination, decapitation, closed intrathoracic transection of the great vessels and heart, thoracic percussion, and thoracotomy with rupture of great vessels. Volunteer researchers and animal caretakers watched the video and completed an associated questionnaire. Anesthetic overdose and cardiac exsanguinations were rated most aesthetically pleasing, although these procedures took the longest to complete. In contrast, decapitation and thoracic percussion were the least aesthetically pleasing, but these methods were the quickest. No demographic factor was identified that could predict whether a given euthanasia procedure would be favored for aesthetic reasons, and participants provided a wide variety of rationales for the aesthetic ratings they assigned. Although all of these euthanasia methods meet the criteria of approved methods of euthanasia of anesthetized rats as defined by the AVMA, aesthetic features and the scientific need for rapid euthanasia are both considerations in selecting a method.

  8. Evaluation of the Aesthetics of Physical Methods of Euthanasia of Anesthetized Rats

    Science.gov (United States)

    Hickman, Debra L; Johnson, Steven W

    2011-01-01

    Dissection of living brain tissue for in vitro experiments requires the use of a rapid euthanasia method. However, the method must not subject animals to unnecessary pain and must be aesthetically acceptable to experimenters. The purposes of the current study were to assess the aesthetics of 6 euthanasia methods, measure the procedure duration, and evaluate brain for pathology after each procedure. We digitally recorded euthanasia of isoflurane-anesthetized rats by 6 physical methods: anesthetic overdose, cardiac exsanguination, decapitation, closed intrathoracic transection of the great vessels and heart, thoracic percussion, and thoracotomy with rupture of great vessels. Volunteer researchers and animal caretakers watched the video and completed an associated questionnaire. Anesthetic overdose and cardiac exsanguinations were rated most aesthetically pleasing, although these procedures took the longest to complete. In contrast, decapitation and thoracic percussion were the least aesthetically pleasing, but these methods were the quickest. No demographic factor was identified that could predict whether a given euthanasia procedure would be favored for aesthetic reasons, and participants provided a wide variety of rationales for the aesthetic ratings they assigned. Although all of these euthanasia methods meet the criteria of approved methods of euthanasia of anesthetized rats as defined by the AVMA, aesthetic features and the scientific need for rapid euthanasia are both considerations in selecting a method. PMID:22330717

  9. 抗NMDA受体脑炎患者卵巢囊肿剔除术的麻醉处理%Anesthetic management for ovarian cystectomy in patients with anti-N-methyl-D-aspartate receptor encephalitis undergoing general anesthesia

    Institute of Scientific and Technical Information of China (English)

    陈雯; 桑诺尔; 罗爱伦; 黄宇光

    2014-01-01

    Objective Anti-N-methyl-D-Aspartate (NMDA) receptor encephalitis is a rare disease,recently described as autoimmune disorder of paraneoplastic limbic encephalitis,which is related to the NMDA receptor antibodies and frequently develops in young women with ovarian teratoma.The disease is usually accompanied by symptoms of psychosis and abnormal behaviors,autonomic nervous system dysfunction,central hypoventilation,and hyperthermia.During induction and maintenance of general anesthesia,we should be aware of adverse reactions such as cardiovascular events,hyperthermia and respiratory insufficiency.In order to maintain vital signs stable,pharmacological agents including vasopressors,β-blockers,antihypertensives,and anticholinergics should be prepared before the surgery.Invasive monitoring for blood pressure can be set if necessary.This study described the method for anesthetic management of 3 patients with anti-NMDA receptor encephalitis undergoing resection of ovarian teratoma under general anesthesia.Preoperative treatment included antipsychotic,anti-infective and immune therapy.General anesthesia was induced with propofol,rocuronium,fentanyl and midazolam to facilitate tracheal intubation and was maintained with inhalation of sevoflurane (mixed with oxygen and air) and intermittent iv boluses of fentanyl and rocuronium during the surgery.All the drugs mentioned above had no interaction or had slight indirect action on anti-NMDA receptors to avoid NMDA-related adverse reactions.In conclusion,the adequate preparation for the surgery should be done in this kind of patients,we should avoid using anesthetics having NMDA receptor antagonism (such as ketamine,N2O,methadone,dextromethorphan,phencyclidine) or other anesthetics acting indirectly (such as pentobarbital) on the NMDA receptors during anesthetic management in the patients with anti-NMDA receptor encephalitis.%目的 抗NMDA受体脑炎是一种与抗NMDA受体抗体相关的、自身免疫性副肿瘤边缘叶

  10. Effects of isoflurane anesthesia and pilocarpine on rat parotid saliva flow

    DEFF Research Database (Denmark)

    Knudsen, Jacob Dronninglund; Nauntofte, Birgitte; Josipovic, M

    2011-01-01

    The purpose of this study was to investigate the effects of isoflurane on unstimulated and pilocarpine-stimulated parotid saliva secretion. Ten male Sprague-Dawley rats weighing 350-400 g were randomized into two groups, and the saliva flow rate and lag phase were measured at two doses...... of isoflurane in a crossover study design. Increasing the isoflurane concentration from 1% to 2% was associated with a 19% decrease in saliva secretion rate, and the lag to saliva secretion was increased by 155%. To clarify whether the effect of isoflurane (1.5%) on the parotid flow varied with stimulus...... rats was 50% slower than that of the sham-irradiated rats. In conclusion, 1.5% isoflurane was found to be a good compromise between proper anesthesia and isoflurane-induced inhibition of saliva secretion. Pilocarpine induces saliva secretion in a dose-dependent matter, with supra-maximal stimulation...

  11. Anesthetic management of patients with ornithine transcarbamylase deficiency.

    Science.gov (United States)

    Schmidt, Joachim; Kroeber, Stefanie; Irouschek, Andrea; Birkholz, Torsten; Schroth, Michael; Albrecht, Sven

    2006-03-01

    Ornithine transcarbamylase deficiency (OTCD) is the most common inborn error of the urea cycle. Several specific factors require care during anesthesia in patients with this condition to avoid metabolic decompensation with acute hyperammonemia and encephalopathy. We report monozygous twins with severe neonatal-onset OTCD undergoing general anesthesia twice each, with midazolam, s-ketamine, fentanyl and isoflurane in combination with surgical field infiltration with ropivacaine. Alternative pathway medication and high-caloric diet with 10% glucose solutions were continuously administered during the perioperative course. Both children were extubated within 10 min of the final suture, and their neurological state remained unchanged. Perioperatively, blood ammonia levels remained within the normal range.

  12. Immunomodulatory Effects of Anesthetics during Thoracic Surgery

    Directory of Open Access Journals (Sweden)

    Khaled Mahmoud

    2011-01-01

    (=25 anesthesia. The primary outcome measures included alveolar and plasma concentrations of interleukin-8(IL-8 and tumour necrosis factor-α (TNF-α, whereas secondary outcome measures were alveolar and plasma concentrations of malondialdehyde (MDA, superoxide dismutase (SOD, and changes in alveolar albumin concentrations and cell numbers. Results. Alveolar and plasma concentrations of IL-8 and TNF-α were significantly lower in the isoflurane group, whereas alveolar and plasma concentrations of MDA were significantly lower in the propofol group. Alveolar and plasma SOD levels increased significantly in the propofol group whereas they showed no significant change in the isoflurane group. Furthermore, the isoflurane group patients developed significantly lower alveolar albumin concentrations and cell numbers. Conclusion. Isoflurane decreased the inflammatory response associated with OLV during thoracic surgery and may be preferable over propofol in patients with expected high levels of proinflammatory cytokines like cancer patients.

  13. Glottic closing force in an anesthetized, awake pig model: biomechanical effects on the laryngeal closure reflex resulting from altered central facilitation.

    Science.gov (United States)

    Kim, Y H; Sasaki, C T

    2001-01-01

    Reflex sphincteric closure of the larynx, essential to lower airway protection, is most efficiently achieved through strong reflex adduction by both vocal cords. Because the conversion of a bilaterally evoked response to a unilaterally evoked one appears anesthesia-dependent, we hypothesized that central facilitation is an essential component of a bilateral adductor reflex and that its disturbance could result in weakened sphincteric closure. Six adult 50 kg pigs were used in this study. During electrical stimulation of the internal branch of the superior laryngeal nerve (iSLN) using bipolar platinum-iridium electrodes, the force of the evoked glottic closure response was measured using a pressure transducer positioned between both vocal cords, while electromyographic evoked response was recorded from both thyroarytenoid muscles under varying levels [0.5-1.0 minimal alveolar concentration (MAC)] of isoflurane anesthesia. The force of glottic closure appeared less under deep anesthesia, even with bilateral stimulation of the iSLN, than under light anesthesia with unilateral stimulation. As anesthetic levels approached 1.0 MAC, the glottic closing force decreased to 52-72% of the force measured under 0.5 MAC light anesthesia. Although it is generally understood that alteration of central facilitation by deepening anesthesia abolishes the crossed adductor reflex, the biomechanical effects of altered central facilitation on force differentials have never been previously demonstrated. Precise understanding of this effect may improve the prevention of aspiration in patients emerging from heavy sedation or under prolonged psychotropic control.

  14. Development of three Drosophila melanogaster strains with different sensitivity to volatile anesthetics

    Institute of Scientific and Technical Information of China (English)

    LIU Jin; HU Zhao-yang; YE Qi-quan; DAI Shuo-hua

    2009-01-01

    Background The mechanisms of action for volatile anesthetics remain unknown for centuries partly owing to the insufficient or ineffective research models. We designed this study to develop three strains derived from a wild-type Drosophila melanogaster with different sensitivities to volatile anesthetics, which may ultimately facilitate molecular and genetic studies of the mechanism involved.Methods Median effective doses (ED50) of sevoflurane in seven-day-old virgin female and male wild-type Drosophila melanogaster were determined. The sensitive males and females of percentile 6-10 were cultured for breeding sensitive offspring (S1). So did median ones of percentile 48-52 for breeding median offspring (M1), resistant ones of percentile 91-95 for breeding resistant offspring (R1). Process was repeated through 31 generations, in the 37th generation, S37,M37 and R37 were used to determine ED50 for enflurane, isoflurane, sevoflurane, desflurane, halothane, methoxyflurane,chloroform and trichloroethylene, then ED50 values were correlated with minimum alveolar concentration (MAC) values in human.Results From a wild-type Drosophila melanogaster we were able to breed three strains with high, median and low sevoflurane requirements. The ratio of sevoflurane requirements of three strains were 1.20:1.00:0.53 for females and 1.22:1.00:0.72 for males. Strains sensitive, median and resistant to sevoflurane were also sensitive, median and resistant to other volatile anesthetics. For eight anesthetics, ED50 values in three strains correlated directly with MAC values in human.Conclusions Three Drosophila me/anogaster strains with high, median and low sensitivity to volatile anesthetics, but with same hereditary background were developed. The ED50 are directly correlated with MAC in human for eight volatile anesthetics.

  15. Schirmer tear tests and intraocular pressures in conscious and anesthetized koalas (Phascolarctus cinereus).

    Science.gov (United States)

    Grundon, Rachael A; Anderson, Gary A; Lynch, Michael; Hardman, Chlöe; O'Reilly, Anu; Stanley, Robin G

    2011-09-01

    To estimate mean Schirmer tear test (STT) and intraocular pressure (IOP) values in healthy koalas both conscious and anesthetized. Data were gathered from koalas in Victoria, Australia. Conscious examinations were performed on captive koalas. Free-ranging (wild) koalas were examined under anesthesia. Anesthesia was induced using alfaxalone, and animals were maintained on oxygen and isoflurane if required. All animals were healthy and had no surface ocular pathology detectable during slit lamp biomicroscopy. STT I tests were performed using commercial STT test strips placed in the lower fornix for 1 min. IOP was measured using an applanation tonometer after topical anesthesia. The higher value of the two eyes for both STT and IOP was analyzed. STT was measured in 53 koalas (34 conscious, 19 anesthetized) and IOP was measured in 43 koalas (30 conscious, 13 anesthetized). A two-sample t-test was used to compare means. A P-value koalas was 10.3 ± 3.6 mm wetting/min and in anesthetized koalas it decreased to 3.8 ± 4.0 mm wetting/min (P koalas was 15.3 ± 5.1 mmHg, and in anesthetized koalas it was 13.8 ± 3.4 mmHg (P = 0.32). There was no effect of sex on either STT or IOP. The mean and SD of STT and IOP values for koalas both conscious and anesthetized were reported. The mean STT was significantly reduced by alfaxalone anesthesia. © 2011 American College of Veterinary Ophthalmologists.

  16. Isoflurane anesthesia initiated at the onset of reperfusion attenuates oxidative and hypoxic-ischemic brain injury.

    Directory of Open Access Journals (Sweden)

    Sergey A Sosunov

    Full Text Available This study demonstrates that in mice subjected to hypoxia-ischemia (HI brain injury isoflurane anesthesia initiated upon reperfusion limits a release of mitochondrial oxidative radicals by inhibiting a recovery of complex-I dependent mitochondrial respiration. This significantly attenuates an oxidative stress and reduces the extent of HI brain injury. Neonatal mice were subjected to HI, and at the initiation of reperfusion were exposed to isoflurane with or without mechanical ventilation. At the end of HI and isoflurane exposure cerebral mitochondrial respiration, H2O2 emission rates were measured followed by an assessment of cerebral oxidative damage and infarct volumes. At 8 weeks after HI navigational memory and brain atrophy were assessed. In vitro, direct effect of isoflurane on mitochondrial H2O2 emission was compared to that of complex-I inhibitor, rotenone. Compared to controls, 15 minutes of isoflurane anesthesia inhibited recovery of the compex I-dependent mitochondrial respiration and decreased H2O2 production in mitochondria supported with succinate. This was associated with reduced oxidative brain injury, superior navigational memory and decreased cerebral atrophy compared to the vehicle-treated HI-mice. Extended isoflurane anesthesia was associated with sluggish recovery of cerebral blood flow (CBF and the neuroprotection was lost. However, when isoflurane anesthesia was supported with mechanical ventilation the CBF recovery improved, the event associated with further reduction of infarct volume compared to HI-mice exposed to isoflurane without respiratory support. Thus, in neonatal mice brief isoflurane anesthesia initiated at the onset of reperfusion limits mitochondrial release of oxidative radicals and attenuates an oxidative stress. This novel mechanism contributes to neuroprotective action of isoflurane. The use of mechanical ventilation during isoflurane anesthesia counterbalances negative effect of isoflurane anesthesia on

  17. Comparison of sevoflurane and isoflurane in OPCAB surgery.

    Science.gov (United States)

    Venkatesh, B G; Mehta, Yatin; Kumar, Anand; Trehan, Naresh

    2007-01-01

    Maintenance of anaesthesia with volatile anaesthetic agents affects the perioperative course of patients undergoing off-pump coronary artery bypass (OPCAB) surgery. This facilitates adequate depth of anaesthesia, reduction in need of analgesic dosage, early extubation and transfer from Intensive Care Unit. We compared two volatile anaesthetic agents sevoflurane and isoflurane in terms of haemodynamic effects, amount of analgesic needed during surgery, quantity of agent needed for maintenance of anaesthesia and postoperative recovery in 40 patients undergoing OPCAB surgery. Anaesthesia was induced with fentanyl, midazolam and thiopentone, and vecuronium was used for muscle relaxation. An Octopus stabiliser was used and coronary anastomosis was performed using internal mammary artery and saphenous vein grafts. Routine monitoring was performed. The depth of anaesthesia was monitored using Bispectral index monitor. The inspired/expired concentration of anaesthetic agents to maintain the desired BIS and the amount of volatile anaesthetic agent needed was also noted. The amount of analgesic used intraoperatively was noted in both the groups. The 'time of awakening' defined as eye opening on verbal commands, and time of extubation were noted. There were no differences in haemodynamic parameters, depth of anaesthesia, and quantity of agent needed, but patients in isoflurane group required more intraoperative analgesics than sevoflurane group. Time of awakening (48+/-13 vs 114 +/- 21 mins; P sevoflurane group than isoflurane group. There was no evidence of perioperative myocardial infarction in both the groups. We conclude that sevoflurane and isoflurane can both be safely used in OPCAB surgery, but the awakening and extubation times are significantly less with sevoflurane.

  18. Water solvent and local anesthetics: A computational study

    Science.gov (United States)

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

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

  19. Combined spinal and general anesthesia is better than general anesthesia alone for laparoscopic hysterectomy

    Directory of Open Access Journals (Sweden)

    Poonam S Ghodki

    2014-01-01

    Full Text Available Context: Spinal anesthesia (SA was combined with general anesthesia (GA for achieving hemodynamic stability in laparoscopic hysterectomy. Aims: The aim of our study was to evaluate the impact of SA combined with GA in maintaining hemodynamic stability in laparoscopic hysterectomy. The secondary outcomes studied were requirement of inhaled anesthetics, vasodilators, and recovery profile. Settings and Design: We conducted a prospective, randomized study in ASAI/II patients posted for laparoscopic hysterectomy, who were willing to participate in the study. Materials and Methods: Patients were randomly assigned to receive SA with GA (group SGA or plain GA (group GA. Group SGA received 10 mg bupivacaine (heavy for SA. GA was administered using conventional balanced technique. Maintenance was carried out with nitrous oxide, oxygen, and isoflurane. Comparison of hemodynamic parameters was carried out during creation of pneumoperitoneum and thereafter. Total isoflurane requirement, need of vasodilators, recovery profile, and regression of SA were studied. Statistical analysis used: Descriptive statistics in the form of mean, standard deviation, frequency, and percentages were calculated for interval and categorical variables, respectively. One-way analysis of variance (ANOVA was applied for noting significant difference between the two groups, with chi-square tests for categorical variables and post-hoc Bonferroni test for interval variables. Comparison of heart rate (HR, mean arterial pressure (MAP, SPO2, and etCO2 was done with Student′s t-test or Mann-Whitney test, wherever applicable. Results: Patients in group SGA maintained stable and acceptable MAP values throughout pneumoperitoneum. The difference as compared to group GA was statistically significant (P < 0.01. Group GA showed additional requirement of metoprolol (53.33% and higher concentration of isoflurane (P < 0.001 to combat the increased MAP. Recovery was early and quick in group SGA as

  20. Isoflurane Damages the Developing Brain of Mice and Induces Subsequent Learning and Memory Deficits through FASL-FAS Signaling

    Directory of Open Access Journals (Sweden)

    Xiuwen Yi

    2015-01-01

    Full Text Available Background. Isoflurane disrupts brain development of neonatal mice, but its mechanism is unclear. We explored whether isoflurane damaged developing hippocampi through FASL-FAS signaling pathway, which is a well-known pathway of apoptosis. Method. Wild type and FAS- or FASL-gene-knockout mice aged 7 days were exposed to either isoflurane or pure oxygen. We used western blotting to study expressions of caspase-3, FAS (CD95, and FAS ligand (FASL or CD95L proteins, TUNEL staining to count apoptotic cells in hippocampus, and Morris water maze (MWM to evaluate learning and memory. Result. Isoflurane increased expression of FAS and FASL proteins in wild type mice. Compared to isoflurane-treated FAS- and FASL-knockout mice, isoflurane-treated wild type mice had higher expression of caspase-3 and more TUNEL-positive hippocampal cells. Expression of caspase-3 in wild isoflurane group, wild control group, FAS/FASL-gene-knockout control group, and FAS/FASL-gene-knockout isoflurane group showed FAS or FASL gene knockout might attenuate increase of caspase-3 caused by isoflurane. MWM showed isoflurane treatment of wild type mice significantly prolonged escape latency and reduced platform crossing times compared with gene-knockout isoflurane-treated groups. Conclusion. Isoflurane induces apoptosis in developing hippocampi of wild type mice but not in FAS- and FASL-knockout mice and damages brain development through FASL-FAS signaling.

  1. Effects of isoflurane anesthesia and pilocarpine on rat parotid saliva flow

    DEFF Research Database (Denmark)

    Knudsen, Jacob Dronninglund; Nauntofte, Birgitte; Josipovic, M

    2011-01-01

    rats was 50% slower than that of the sham-irradiated rats. In conclusion, 1.5% isoflurane was found to be a good compromise between proper anesthesia and isoflurane-induced inhibition of saliva secretion. Pilocarpine induces saliva secretion in a dose-dependent matter, with supra-maximal stimulation...

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

    Science.gov (United States)

    Iizuka, Makito

    2009-05-01

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

  3. Quantifying the effect of isoflurane and nitrous oxide on somatosensory-evoked potentials

    Directory of Open Access Journals (Sweden)

    Usha Devadoss

    2010-01-01

    Full Text Available Anaesthetic techniques may have a significant effect on intraoperative-evoked potentials (EP. The present study is designed to compare Propofol anaesthesia with Isoflurane (with or without nitrous oxide during intraoperative somatosensory-evoked potential (SSEP monitoring in 15 ASA Grade I and II patients undergoing surgery for intracranial tumours. SSEPs in response to median and posterior tibial nerve stimulation were recorded under four different anaesthetic conditions: 1 Propofol infusion and ventilation with air-oxygen, 2 Isoflurane, 1.0 MAC and ventilation with air-oxygen, 3 Isoflurane 1.0 MAC and ventilation with nitrous oxide-oxygen, and 4 Return to Isoflurane, 1.0 MAC and ventilation with air-oxygen. Intraoperative monitoring of somatosensory evoked potentials is best recordable using Propofol. The morphology of the EP is reproducible with Isoflurane. This effect is exaggerated when it is advisable to avoid nitrous oxide.

  4. Reduced anesthetic requirements, diminished brain plasma membrane Ca(2+)-ATPase pumping, and enhanced brain synaptic plasma membrane phospholipid methylation in diabetic rats: effects of insulin.

    Science.gov (United States)

    Janicki, P K; Horn, J L; Singh, G; Janson, V E; Franks, W T; Franks, J J

    1995-01-01

    We have recently reported that streptozocin (STZ)-induced diabetes in rats was associated with i) reduced Ca2+ pumping by rat brain synaptic plasma membrane Ca(2+)-ATPase (PMCA) and ii) a substantial reduction in the partial pressures of halothane and xenon required to prevent movement in response to stimulation (minimum effective dose or MED). MED for both agents correlated well with the degree of hemoglobin glycation and with PMCA activity. We now report that MEDs for isoflurane, enflurane, and desflurane were also substantially reduced in STZ-diabetic rats, compared with placebo-injected controls. In addition, we examined the effect of insulin treatment, begun 2 weeks after induction of diabetes and continued for 3 more weeks, on isoflurane MED and on brain synaptic PMCA and phospholipid-N-methyltransferase I (PLMT I), another enzyme altered by inhalation anesthetics (IA). Partial treatment of diabetes, as indicated by decreased glycated hemoglobin (GHb) compared to untreated diabetic rats, was associated with an isoflurane MED of 1.05 vol%, intermediate between a control mean of 1.57 vol% and an untreated diabetic mean of 0.82 vol% (p SPM from diabetic rats did not differ from control values, but PMCA pumping in SPM from the D-M was reduced to about 85% of control levels. Good correlation (r = 0.89, p < 0.01) was found between isoflurane MED and GHb in all treatment groups. These findings provide further evidence for an important role for PMCA in IA action. They also suggest that anesthetic effects on the calcium pump at specific anatomic sites may be of major importance in producing anesthesia.

  5. Clinical Study of Sevoflurane and Isoflurane in Low Flow Anesthesia%七氟醚和异氟醚低流量吸入麻醉的临床应用

    Institute of Scientific and Technical Information of China (English)

    陈龙谦; 黄慧瑜; 黄丽

    2014-01-01

    Objective To investigate the clinical effect of sevoflurane and isoflurane on patients with low flow anesthesia. Meth-ods Among the patients needing operation treatment with endotracheal intubation and general anesthesia in our hospital, 90 patients were selected and randomly divided into the experimental group and the control group, 45 patients in each group. The two groups a-dopted the same anesthesia technology-low flow anesthesia. Based on this, the test group received Sevoflurane anesthesia, while the control group received Isoflurane anesthesia. The two anesthetics' clinical effects were compared based on the observation of the awak-ening time, extubation time, aldrete grade time and the satisfaction degree of patients between the two groups. Results There was no statistical difference in gender, age, weight, height, operation time and other basic information between the two groups. Through the observation and statistics, the recovery time, extubation time and Aldrete score time in experimental group were shorter than those in the control group. There was statistically significant difference between the two groups (P< 0.05). In the postoperative satisfaction survey, the experimental group (43 cases, accounting for 95.6% of the total) was significantly higher than the control group (30 ca-ses, accounting for 66.7% of the total). The difference was obvious with statistical significance (P< 0.05). Conclusion Low flow anesthesia with Sevoflurane has good security, effects and high satisfaction degree compared with Isoflurane, which can be widely used in clinical practice.%目的探讨临床上采用七氟醚和异氟醚低流量麻醉时对患者疗效的对比。方法在我院收治的手术治疗时需要气管插管和全身麻醉的患者中,抽取90例随机分成试验组和对照组,试验组和对照组各45名患者。在接收相同的低流量麻醉技术麻醉前提下,试验组接收七氟醚麻醉,对照组接受异氟醚麻醉。通过观

  6. 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

  7. 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.

  8. Anesthetic Maintenance of Thyroid Surgery

    Directory of Open Access Journals (Sweden)

    A. A. Negovsky

    2008-01-01

    Full Text Available Thyroid diseases are most common in endocrinology. Thyrotoxicosis induces dysfunction of virtually all organs and systems, the blood circulatory system being subjected to considerable changes. Cardiovascular diseases affect not only the quality of life in a patient, but significantly increase a risk from surgery that is the only radical treatment. For this reason, most authors consider thyrotoxicosis to be a contraindication to elective surgical intervention. At the same time it is known that drug compensation of thyrotoxicosis may be attained in not all patients. In this case, the results of treatment and a patient’s safety during surgery depend on the type and quality of anesthetic protection. The capabilities of anesthetic maintenance of thyroid surgery have recently expanded substantially. The paper deals with the preparation of patients with thyrotoxicosis for surgical intervention and the perioperative management of these patients. Key words: thyroid, toxic goiter, thyrotoxicosis, premedication, anesthetic mode, sevoflurane, xenon.

  9. Effects of repetitive exposure to anesthetics and analgesics in the Tg2576 mouse Alzheimer's model.

    Science.gov (United States)

    Quiroga, Carolina; Chaparro, Rafael E; Karlnoski, Rachel; Erasso, Diana; Gordon, Marcia; Morgan, David; Bosco, Gerardo; Rubini, Alessandro; Parmagnani, Andrea; Paoli, Antonio; Mangar, Devanand; Camporesi, Enrico M

    2014-11-01

    The use of anesthetics and sedatives has been suggested to be a contributor to Alzheimer's disease neuropathogenesis. We wanted to address the in vivo relevance of those substances in the Tg2576 Alzheimer's mouse model. Tg7526 mice were anesthesia-sedated for 90 min once a week for 4 weeks. Y maze, Congo Red, and amyloid beta (Aβ) immunochemistry were performed. We did not find any significant change in the navigation behavior of the exposed mice compared to the controls. Significantly less deposition of Aβ in the CA1 area of the hippocampus and frontal cortex of mice exposed to isoflurane, propofol, diazepam, ketamine, and pentobarbital was observed. In the dentate gyrus, Aβ deposition was significantly greater in the group treated with pentobarbital. Congo Red staining evidenced significantly fewer fibrils in the cortex of mice exposed to diazepam, ketamine, or pentobarbital. The adopted repetitive exposure did not cause a significant detriment in Tg7526 mouse.

  10. 异氟醚对成年大鼠行为学的影响%Effect of domestic isoflurane induced cognitive dysfunction on adult rats

    Institute of Scientific and Technical Information of China (English)

    郑雪; 朱昭琼; 张超; 张帆

    2012-01-01

    Objective To explore the effect of domestic isoflurane (Ningfen) induced learning and memory dysfunction on adult rats. Methods 36(n =6 ?)adult male Sprague Dawley rats were randomly divided into 6 groups,control group(group air) ,positive control group (group O2) ,anesthesia group (4 subgroups were divided as inhalation of domestic isoflurane). SD rats in anesthesia groups were given 2% isoflurane, recorded breath rate of the preanesthesia, anesthetized for 30min, then repeat the test again after 2 h, 1 d ,7 d, 14 d recover time respectively. Results Compared with group 1 d after anesthesia, the escape latency and path length of group 2 d,3 d,4 d and 5 d after anesthesia have shown significantly statistical differences ( P < 0. 01) , shortened as time passing on. Conclusion The inhalation of domestic isoflurane (Ningfen) after 1 d might affect the special memorizing ability of SD rats,however,after 1d of post anesthesia recovery,such ability can be restored completely to the original level.%目的 探讨国产异氟醚(宁芬)对成年大鼠学习记忆功能的影响.方法 成年雄性SD大鼠36只(n=6 x6组),将其随机分为空白对照组(A组)、阳性对照组(O2组)、麻醉组.三组大鼠进行Morris水迷宫定位航行适应性训练5d,记录逃避潜伏期和总路程.麻醉组吸入2.0%浓度国产异氟醚30 min,苏醒后2h、1d、7d、14 d再次行水迷宫实验,观察指标与适应性训练相同.结果 麻醉30 min呼吸次数明显减少;与第1天比较,第2、3、4、5天逃避潜伏期、总路程差异显著(P<0.01),且随着天数的增加逐渐缩短.结论 大鼠吸入宁芬30 min后,1d内对学习记忆有一定程度影响,1d后学习记忆逐渐改善,自行恢复到麻醉前水平.

  11. A critical test of Drosophila anaesthetics: Isoflurane and sevoflurane are benign alternatives to cold and CO2.

    Science.gov (United States)

    MacMillan, Heath A; Nørgård, Mikkel; MacLean, Heidi J; Overgaard, Johannes; Williams, Catherine J A

    2017-08-01

    Anaesthesia is often a necessary step when studying insects like the model organism Drosophila melanogaster. Most studies of Drosophila and other insects that require anaesthesia use either cold exposure or carbon dioxide exposure to induce a narcotic state. These anaesthetic methods are known to disrupt physiology and behavior with increasing exposure, and thus ample recovery time is required prior to experimentation. Here, we examine whether two halogenated ethers commonly used in vertebrate anaesthesia, isoflurane and sevoflurane, may serve as alternative means of insect anaesthesia. Using D. melanogaster, we generated dose-response curves to identify exposure times for each anaesthetic (cold, CO2, isoflurane and sevoflurane) that allow for five-minutes of experimental manipulation of the animals after the anaesthetic was removed (i.e. 5min recovery doses). We then compared the effects of this practical dose on high temperature, low temperature, starvation, and desiccation tolerance, as well as locomotor activity and fecundity of female flies following recovery from anaesthesia. Cold, CO2 and isoflurane each had significant or near significant effects on the traits measured, but the specific effects of each anaesthetic differed, and effects on stress tolerance generally did not persist if the flies were given 48h to recover from anaesthesia. Sevoflurane had no measureable effect on any of the traits examined. Care must be taken when choosing an anaesthetic in Drosophila research, as the impacts of specific anaesthetics on stress tolerance, behavior and reproduction can widely differ. Sevoflurane may be a practical alternative to cold and CO2 anaesthesia in insects - particularly if flies are to be used for experiments shortly after anesthesia. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. The thermodynamics of general and local anesthesia

    CERN Document Server

    Graesboll, Kaare; Heimburg, Thomas

    2014-01-01

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

  13. Caffeine accelerates recovery from general anesthesia via multiple pathways.

    Science.gov (United States)

    Fong, Robert; Khokhar, Suhail; Chowdhury, Atif N; Xie, Kelvin G; Wong, Josiah Hiu-Yuen; Fox, Aaron P; Xie, Zheng

    2017-09-01

    Various studies have explored different ways to speed emergence from anesthesia. Previously, we have shown that three drugs that elevate intracellular cAMP (forskolin, theophylline, and caffeine) accelerate emergence from anesthesia in rats. However, our earlier studies left two main questions unanswered. First, were cAMP-elevating drugs effective at all anesthetic concentrations? Second, given that caffeine was the most effective of the drugs tested, why was caffeine more effective than forskolin since both drugs elevate cAMP? In our current study, emergence time from anesthesia was measured in adult rats exposed to 3% isoflurane for 60 min. Caffeine dramatically accelerated emergence from anesthesia, even at the high level of anesthetic employed. Caffeine has multiple actions including blockade of adenosine receptors. We show that the selective A2a adenosine receptor antagonist preladenant or the intracellular cAMP ([cAMP]i)-elevating drug forskolin, accelerated recovery from anesthesia. When preladenant and forskolin were tested together, the effect on anesthesia recovery time was additive indicating that these drugs operate via different pathways. Furthermore, the combination of preladenant and forskolin was about as effective as caffeine suggesting that both A2A receptor blockade and [cAMP]i elevation play a role in caffeine's ability to accelerate emergence from anesthesia. Because anesthesia in rodents is thought to be similar to that in humans, these results suggest that caffeine might allow for rapid and uniform emergence from general anesthesia in humans at all anesthetic concentrations and that both the elevation of [cAMP]i and adenosine receptor blockade play a role in this response.NEW & NOTEWORTHY Currently, there is no method to accelerate emergence from anesthesia. Patients "wake" when they clear the anesthetic from their systems. Previously, we have shown that caffeine can accelerate emergence from anesthesia. In this study, we show that caffeine

  14. Effects of halothane, isoflurane and enflurane on isolated rat heart muscle.

    Science.gov (United States)

    Miralles, F S; Carceles, M D; Laorden, M L; Hernandez, J

    1989-05-01

    Since the effects in the intact organism are complicated by central as well as peripheral effects, we compared the direct cardiac effects of three commonly used inhalational anaesthetics--halothane, isoflurane and enflurane--on isolated heart muscle. Concentration-response curves for inotropic, chronotropic and ventricular automaticity effects of halothane, isoflurane and enflurane (0.1-2% v/v) on electrically stimulated left atria, right atria and right ventricles of the rat were obtained. All three inhalational anaesthetics significantly decreased contractile force; the inhibitory concentration 50 (IC50) of enflurane was 0.55 +/- 0.06% v/v, significantly lower than halothane (0.96 +/- 0.08% v/v) and isoflurane (0.67 +/- 0.05% v/v). Similar results were obtained on atrial nomotopic rate. Halothane, isoflurane and enflurane produced negative chronotropic effects in this preparation. On the other hand, halothane and isoflurane significantly reduced the ventricular ectopic automaticity. However enflurane (0.3, 0.5, 1% v/v) increased ventricular rate. There were statistically significant differences between the IC50 values of atrial and ventricular rate for halothane and isoflurane. These results indicate: (a) direct negative inotropic and chronotropic effects for the three inhalational anaesthetics tested; (b) anti-dysrhythmic actions for halothane and isoflurane; and (c) dysrhythmogenic effects of enflurane.

  15. Protective effects of salidroside against isoflurane-induced cognitive impairment in rats.

    Science.gov (United States)

    Liang, L; Ma, Z; Dong, M; Ma, J; Jiang, A; Sun, X

    2017-01-01

    Postoperative cognitive dysfunction, which is associated with a wide range of cognitive functions including working memory, long-term memory, information processing, attention, and cognitive flexibility, is a major clinical issue in geriatric surgical patients. The aim of the current study was to determine the protective role and possible mechanisms of salidroside against isoflurane-induced cognitive impairment. Sprague Dawley rats were randomly assigned to five groups and were treated with or without salidroside before isoflurane exposure. Open-field and fear conditioning tests were conducted to evaluate the cognitive function of the rats. Moreover, the hippocampus tissues were obtained for biochemical analysis. The results showed that the isoflurane anesthesia decreased the freezing time to context significantly at 48 h after the isoflurane exposure in the fear conditioning test. Salidroside could ameliorate isoflurane-induced cognitive dysfunction. Further analysis demonstrated salidroside markedly suppressed the release of tumor necrosis factor-α and interleukin-1β. Moreover, salidroside reversed the decreased activity of choline acetyltransferase, superoxide dismutase, glutathione peroxidase, and content of acetylcholine, as well as the increased activity of acetylcholine esterase and content of malondialdehyde in hippocampal tissue of isoflurane-exposed rats. According to the results, we concluded that that salidroside has a protective effect against isoflurane-induced cognitive dysfunction by inhibiting excessive inflammatory responses, decreasing oxidative stress, and regulating the cholinergic system.

  16. [MAC-awake and wake-up time of isoflurane and sevoflurane with reference to the concentration of gas, duration of inhalation and patient's age and obesity].

    Science.gov (United States)

    Tabo, E; Ohkuma, Y; Sakuragi, Y; Arai, T

    1995-02-01

    We evaluated the influence of the concentration of volatile anesthetics, the duration of inhalation time, the patient's age and degree of obesity on MAC-awake (the end-tidal concentration of volatile anesthetics on awakening) and Wake-up time (the period from stopping inhalation to eye-opening in response to verbal command) following isoflurane (Iso) or sevoflurane (Sev) anesthesia in 240 patients (ASA I or II, age 17-84 yr). The patients were anesthetized with 50% oxygen, 50% nitrous oxide and various concentrations of Iso or Sev. They were divided into 6 groups in respect to the end-tidal concentration of Iso or Sev: Iso 0.7% (1 MAC), Iso 1.0% (1.5 MAC), Iso 1.4% (2 MAC), Sev 0.9% (1 MAC), Sev 1.3% (1.5 MAC) and Sev 1.8% (2 MAC). After operation all anesthetics were discontinued and MAC-awake and Wake-up time were measured under 100% oxygen inhalation. MAC-awake value of Iso was 0.14 +/- 0.05% (SD)% in all groups and that of Sev was 0.17 +/- 0.05% in Sev 0.9% group, 0.16 +/- 0.05% in Sev 1.3%, 0.17 +/- 0.06% in Sev 1.8%, respectively. All of them became smaller in aged groups than in younger groups but they were not influenced by the concentration of gas, the duration of inhalation nor the degree of obesity.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Effect of some anesthetics on memory and exploration.

    Science.gov (United States)

    Valzelli, L; Kozak, W; Skorupska, M

    1988-04-01

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

  18. Anesthetic management of a horse with traumatic pneumothorax

    OpenAIRE

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

    2012-01-01

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

  19. Genotoxicity of Anesthetics Evaluated In Vivo (Animals)

    Science.gov (United States)

    Braz, Mariana G.; Karahalil, Bensu

    2015-01-01

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

  20. 全麻中不同插管方式对麻醉并发症的影响%Effects of Different Endotracheal Intubation on General Anesthesia on Anesthetic Complications

    Institute of Scientific and Technical Information of China (English)

    马先春; 厉宝书; 刘静

    2012-01-01

      目的探讨喉罩(LM)及气管插管(EI)在全麻(GA)中对血流动力学及麻醉并发症的影响.方法选取我院近2年来腹腔镜胆囊切除术(LC)患者68例,随机分为 A、B 两组,各组34例,A 组采用 LMA,B 组采用 EIA,比较两组麻醉对血流动力学及术后并发症的影响.结果 A 组置管时、拔管时血流动力学较 B 组稳定,A 组术后麻醉并发症少于 B 组,差异有统计学意义(P<0.05).结论 LC 中采用LMA 安全性高,不增加不良反应.%  Objective To study the effects of GA using the LM and EI on hemodynamic stability and anesthetic complications. Method Select the past two years in our hospital,68 cases of LC patients, were randomly divided into A and B groups, each 34, A group using the LMA, B group using EIA. The two groups were compared anesthetic effect. Results A group LMA insertion,5min after LMA insertion, removal of LMA, A group of blood flow dynamics than in group B stable, Anesthetic complications after surgery, group A than group B decreased,the difference was statistically significant (P<0.05). Conclusion LC using the LMA safe, without increasing adverse events.

  1. Comparing anesthesia with isoflurane and fentanyl/fluanisone/midazolam in a rat model of cardiac arrest

    DEFF Research Database (Denmark)

    Secher, Niels; Malte, Christian Lind; Tønnesen, Else

    2016-01-01

    CA model. We hypothesize that isoflurane anesthesia improves short-term outcome following resuscitation from CA compared with a subcutaneous fentanyl/fluanisone/midazolam anesthesia. METHODS: Male Sprague Dawley rats were randomized to anesthesia with isoflurane (n=11) or fentanyl...... samples for Endothelin-1 and cathecolamines were drawn before and after CA. KEY FINDINGS: Compared with fentanyl/fluanisone/midazolam anesthesia, isoflurane resulted in a shorter time to return of spontaneous circulation (ROSC), less use of epinephrine, increased coronary perfusion pressure during CPR......, higher mean arterial pressure post ROSC, increased plasma levels of Endothelin-1 and decreased levels of epinephrine. The choice of anesthesia did not affect ROSC rate or systemic O2 consumption. CONCLUSION: Isoflurane reduces time to ROSC, increases coronary perfusion pressure, and improves hemodynamic...

  2. Anesthetic Related Advances with Cyclodextrins

    OpenAIRE

    Mark Welliver; John P. McDonough

    2007-01-01

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

  3. Potent Inhalational Anesthetics for Dentistry.

    Science.gov (United States)

    Satuito, Mary; Tom, James

    2016-01-01

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

  4. Excitatory and inhibitory actions of isoflurane on the cholinergic ascending arousal system of the rat.

    Science.gov (United States)

    Dong, Hai-Long; Fukuda, Satoru; Murata, Eri; Higuchi, Takashi

    2006-01-01

    The cholinergic arousal systems are known to critically regulate the state of consciousness. The aim of this study was to determine the effect of isoflurane on the inhibitory or excitatory neurotransmitters efflux in important nuclei within the cholinergic arousal system using in vivo intracerebral microdialysis. The efflux of glutamate, gamma-aminobutyric acid (GABA), or acetylcholine in the posterior hypothalamus (PH), the basal forebrain (BF), and the somatosensory cortex (S1BF) of rats was detected using intracerebral microdialysis under an awake condition and at 0.5-2.0 minimum alveolar concentration (MAC) isoflurane anesthesia. The intrabasalis perfusion of alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) and N-methyl-D-aspartate on the cortical acetylcholine effluxes was also examined under both conditions. Isoflurane had no influence on the glutamate and GABA efflux in the PH, whereas in the BF, it dose-dependently increased glutamate efflux and decreased GABA efflux. A transient increase in glutamate efflux at 1.0 MAC and a decrease in GABA at 0.5-1.5 MAC were observed in the S1BF. Isoflurane dose-dependently decreased acetylcholine efflux in the S1BF. Perfusion of the BF with AMPA increased acetylcholine efflux in the S1BF with electroencephalographic activation during 0.75 MAC isoflurane anesthesia, suggesting an inhibitory action of isoflurane on AMPA receptors in the BF. However, N-methyl-D-aspartate had no effect on these parameters. Isoflurane induces both excitatory and inhibitory actions in the cholinergic arousal system. The predominant inhibitory action of isoflurane over its excitatory action at the BF would result in the decrease in the acetylcholine efflux in the S1BF.

  5. Insight into the modulation of Shaw2 Kv channels by general anesthetics: structural and functional studies of S4-S5 linker and S6 C-terminal peptides in micelles by NMR.

    Science.gov (United States)

    Zhang, Jin; Qu, Xiaoguang; Covarrubias, Manuel; Germann, Markus W

    2013-02-01

    The modulation of the Drosophila Shaw2 Kv channel by 1-alkanols and inhaled anesthetics is correlated with the involvement of the S4-S5 linker and C-terminus of S6, and consistent with stabilization of the channel's closed state. Structural analysis of peptides from S4-S5 (L45) and S6 (S6c), by nuclear magnetic resonance and circular dichroism spectroscopy supports that an α-helical conformation was adopted by L45, while S6c was only in an unstable/dynamic partially folded α-helix in dodecylphosphocholine micelles. Solvent accessibility and paramagnetic probing of L45 revealed that L45 lies parallel to the surface of micelles with charged and polar residues pointing towards the solution while hydrophobic residues are buried inside the micelles. Chemical shift perturbation introduced by 1-butanol on residues Gln320, Thr321, Phe322 and Arg323 of L45, as well as Thr423 and Gln424 of S6c indicates possible anesthetic binding sites on these two important components in the channel activation apparatus. Diffusion measurements confirmed the association of L45, S6c and 1-butanol with micelles which suggests the capability of 1-butanol to influence a possible interaction of L45 and S6c in the micelle environment.

  6. Effects of isoflurane anesthesia on F-waves in the sciatic nerve of the adult rat.

    Science.gov (United States)

    Nowicki, Marcin; Baum, Petra; Kosacka, Joanna; Stockinger, Maximilian; Klöting, Nora; Blüher, Matthias; Bechmann, Ingo; Toyka, Klaus V

    2014-08-01

    Nerve conduction studies provide insights into the functional consequences of axonal and myelin pathology in peripheral neuropathies. We investigated whether isoflurane inhalation anesthesia alters F-wave latencies and F-persistence in the sciatic nerve of adult rats. Ten rats were investigated at 3 different isoflurane concentrations followed by ketamine-xylazine injection anesthesia. To assess F-wave latencies, a stimulation paradigm was chosen to minimize H-reflex masking of F-waves. F-wave persistence rates were reduced with 3.5% isoflurane concentration at 4 and 10 Hz supramaximal stimulation and marginally reduced with 2.5% isoflurane when compared with ketamine-xylazine. F-wave amplitudes decreased progressively with rising stimulus frequency in all types of anesthesia and most at 3.5% isoflurane concentration. The type of anesthesia and the stimulus repetition rate have an impact on some F-wave parameters. Higher isoflurane concentrations and repetition rates are not recommended in experimental studies using rat neuropathy models where F-waves are of interest. Copyright © 2013 Wiley Periodicals, Inc.

  7. Costs of anesthetics and other drugs in anesthesia

    Directory of Open Access Journals (Sweden)

    Majstorović Branislava M.

    2012-01-01

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

  8. Exposure of isoflurane-treated cells to hyperoxia decreases cell viability and activates the mitochondrial apoptotic pathway.

    Science.gov (United States)

    Kim, Gunn Hee; Lee, Jeong Jin; Lee, Sang Hyun; Chung, Yang Hoon; Cho, Hyun Sung; Kim, Jie Ae; Kim, Min Kyung

    2016-04-01

    Isoflurane has either neuroprotective or neurotoxic effects. High-dose oxygen is frequently used throughout the perioperative period. We hypothesized that hyperoxia will affect cell viability of rat pheochromocytoma (PC12) cells that were exposed to isoflurane and reactive oxygen species (ROS) may be involved. PC12 cells were exposed to 1.2% or 2.4% isoflurane for 6 or 24h respectively, and cell viability was evaluated. To investigate the effects of hyperoxia, PC12 cells were treated with 21%, 50%, or 95% oxygen and 2.4% isoflurane for 6h, and cell viability, TUNEL staining, ROS production, and expression of B-cell lymphoma 2 (BCL-2), BCL2-associated X protein (BAX), caspase-3 and beta-site APP cleaving enzyme (BACE) were measured. ROS involvement was evaluated using the ROS scavenger 2-mercaptopropiopylglycine (MPG). The viability of cells exposed to 2.4% isoflurane was lower than that of cells exposed to 1.2% isoflurane. Prolonged exposure (6h vs. 24h) to 2.4% isoflurane resulted in a profound reduction in cell viability. Treatment with 95% (but not 50%) oxygen enhanced the decrease in cell viability induced by 2.4% isoflurane alone. Levels of ROS, Bax, caspase-3 and BACE were increased, whereas expression of Bcl-2 was decreased, in cells treated with 95% oxygen plus 2.4% isoflurane compared with the control and 2.4% isoflurane plus air groups. MPG attenuated the effects of oxygen and isoflurane. In conclusion, isoflurane affects cell viability in a dose- and time-dependent manner. This effect is augmented by hyperoxia and may involve ROS, the mitochondrial apoptotic signaling pathway, and β-amyloid protein.

  9. The Role of Dendritic Signaling in the Anesthetic Suppression of Consciousness

    National Research Council Canada - National Science Library

    Meyer, Kaspar

    2015-01-01

    Despite considerable progress in the identification of the molecular targets of general anesthetics, it remains unclear how these drugs affect the brain at the systems level to suppress consciousness...

  10. Reduced anesthetic requirements in aged rats: association with altered brain synaptic plasma membrane Ca(2+)-ATPase pump and phospholipid methyltransferase I activities.

    Science.gov (United States)

    Horn, J L; Janicki, P K; Singh, G; Wamil, A W; Franks, J J

    1996-01-01

    Aging is associated with a decrease in anesthetic requirements. Animal models of aging manifest alteration of brain Ca2+ homeostasis and increased methyltransferase I (PLMTI) activity. In this study we evaluated concurrently anesthetic requirements and brain plasma membrane Ca(2+)-ATPase (PMCA) and PLMTI activities in young and aged rats. Halothane, desflurane, isoflurane and xenon MEDs (lowest partial pressures that suppress a pain response) were measured in 2 and 25 month old, male Fisher-344 rats. Halothane MED was also measured in 2 and 30 month old F344/BNF1 rats, a strain that undergoes aging with less debilitation. PMCA pumping and PLMTI activities were measured in synaptic plasma membranes (SPM) prepared from the cortex and diencephalon-mesencephalon (DM). For aged Fisher-344 rats, MEDs for halothane, desflurane, isoflurane and xenon were reduced to 81%, 82%, 67% and 86%, respectively, of young controls; PMCA activity was diminished to 91% in cortical SPM and 82% in DM SPM; and cortical and DM PLMTI activities were increased to 131% and 114% of young control. For F344/BNF1 rats, MED for halothane was reduced to 87%, PMCA activity was diminished to 90% in cortical SPM and 72% DM SPM, and PLMTI activity was increased to 133% in cortical SPM and 112% in DM SPM. The strong association between age and reduced anesthetic requirements for inhalational agents on the one hand and altered PMCA and PLMTI activity on the other lends support to the underlying hypothesis that PMCA and PLMTI may be involved in the production of the anesthetic state.

  11. Anesthetic management of transcatheter aortic valve implantation

    Directory of Open Access Journals (Sweden)

    Annalisa Franco

    2012-01-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

  13. Anesthetic related advances with cyclodextrins.

    Science.gov (United States)

    Welliver, Mark; McDonough, John

    2007-03-02

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

  14. Anesthetic Related Advances with Cyclodextrins

    Directory of Open Access Journals (Sweden)

    Mark Welliver

    2007-01-01

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

  15. Strabismus complications from local anesthetics.

    Science.gov (United States)

    Guyton, David L

    2008-01-01

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

  16. Diluted isoflurane as a suitable alternative for diethyl ether for rat anaesthesia in regular toxicology studies.

    Science.gov (United States)

    Nagate, Toshiaki; Chino, Tomonobu; Nishiyama, Chizuru; Okuhara, Daisuke; Tahara, Toru; Maruyama, Yoshimasa; Kasahara, Hiroko; Takashima, Kayoko; Kobayashi, Sayaka; Motokawa, Yoshiyuki; Muto, Shin-ichi; Kuroda, Junji

    2007-11-01

    Despite its explosive properties and toxicity to both animals and humans, diethyl ether is an agent long used in Japan in the anaesthesia jar method of rat anaesthetises. However, in response to a recent report from the Science Council of Japan condemning diethyl ether as acceptable practice, we searched for an alternative rat anaesthesia method that provided data continuous with pre-existing regular toxicology studies already conducted under diethyl ether anaesthesia. For this, we examined two candidates; 30% isoflurane diluted with propylene glycol and pentobarbitone. Whereas isoflurane is considered to be one of the representatives of modern volatile anaesthetics, the method of propylene glycol-diluted 30% isoflurane used in this study was our modification of a recently reported method revealed to have several advantages as an inhalation anaesthesia. Intraperitoneal pentobarbitone has long been accepted as a humane method in laboratory animal anaesthesiology. These 2 modalities were scrutinized in terms of consistency of haematology and blood chemistry with previous results using ether. We found that pentobarbitone required a much longer induction time than diethyl ether, which is suspected to be the cause of fluctuations in several haematological and blood chemical results. Conversely, only calcium ion concentration showed a slight difference from traditional results in the case of 30% isoflurane. Additionally, serum prolactin and corticosterone levels indicated that 30% isoflurane induced less stress than ether, confirming that 30% isoflurane can both provide results consistent with diethyl ether, while at the same time remove its disadvantages. As such 30% isoflurane appears to be a strong alternative anaesthetic agent for future regular toxicology studies in Japan.

  17. Cardiorespiratory parameters in the awake pigeon and during anaesthesia with isoflurane.

    Science.gov (United States)

    Botman, Julie; Dugdale, Alex; Gabriel, Fabien; Vandeweerd, Jean-Michel

    2016-01-01

    To determine baseline cardiovascular and respiratory variables in the awake pigeon, and to assess those variables during anaesthesia at the individual minimal anaesthetic concentration (MAC) of isoflurane during spontaneous breathing. Prospective, experimental trial. Seven healthy adult pigeons weighing a mean ± standard deviation (SD) of 438 ± 38 g. Heart rate (HR), heart rhythm, respiratory rate (fR), end-expired carbon dioxide tension (Pe'CO2), indirect systolic arterial pressure (SAP) and cloacal temperature (T) were measured in birds in the awake state (after acclimatization to handling). Two weeks later, the pigeons were anaesthetized with isoflurane in order to determine their MAC and evaluate the same cardiovascular and respiratory variables during a further 40 minutes of isoflurane anaesthesia. In the awake pigeon, mean ± SD HR, SAP, fR, Pe'CO2 and T were, respectively, 155 ± 28 beats minute(-1), 155 ± 21 mmHg, 34 ± 6 breaths minute(-1), 38 ± 8 mmHg (5.1 ± 1.1 kPa) and 41.8 ± 0.5 °C. Mean isoflurane MAC was 1.8 ± 0.4%. During maintenance of anaesthesia at MAC, although no significant decreases between values obtained in the awake and anaesthetized states emerged in HR or respiratory rate, significant decreases in SAP and cloacal temperature and an increase in Pe'CO2 were observed. No arrhythmia was identified in awake pigeons, whereas second- and third-degree atrioventricular blocks occurred under isoflurane. Isoflurane MAC in pigeons appeared to be higher than in other avian species. Isoflurane anaesthesia in pigeons resulted in hypercapnia, hypotension, mild hypothermia and second- and third-degree atrioventricular blocks. © 2015 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  18. Bispectral index as a predictor of sedation depth during isoflurane or midazolam sedation in ICU patients.

    Science.gov (United States)

    Sackey, P V; Radell, P J; Granath, F; Martling, C R

    2007-06-01

    Bispectral index (BIS) is used for monitoring anaesthetic depth with inhaled anaesthetic agents in the operating room but has not been evaluated as a monitor of sedation depth in the intensive care unit (ICU) setting with these agents. If BIS could predict sedation depth in ICU patients, patient disturbances could be reduced and oversedation avoided. Twenty ventilator-dependent ICU patients aged 27 to 80 years were randomised to sedation with isoflurane via the AnaConDa or intravenous midazolam. BIS (A-2000 XP, version 3.12), electromyogram activity (EMG) and Signal Quality Index were measured continuously. Hourly clinical evaluation of sedation depth according to Bloomsbury Sedation Score (Bloomsbury) was performed. The median BIS value during a 10-minute interval prior to the clinical evaluation at the bedside was compared with Bloomsbury. Nurses performing the clinical sedation scoring were blinded to the BIS values. End-tidal isoflurane concentration was measured and compared with Bloomsbury. Correlation was poor between BIS and Bloomsbury in both groups (Spearman's rho 0.012 in the isoflurane group and -0.057 in the midazolam group). Strong correlation was found between BIS and EMG (Spearman's rho 0.74). Significant correlation was found between end-tidal isoflurane concentration and Bloomsbury (Spearman's rho 0.47). In conclusion, BIS XP does not reliably predict sedation depth as measured by clinical evaluation in non-paralysed ICU patients sedated with isoflurane or midazolam. EMG contributes significantly to BIS values in isoflurane or midazolam sedated, non-paralysed ICU patients. End-tidal isoflurane concentration appeared to be a better indicator of clinical sedation depth than BIS.

  19. Anxiety in preoperative anesthetic procedures.

    Science.gov (United States)

    Valenzuela Millán, Jaquelyn; Barrera Serrano, José René; Ornelas Aguirre, José Manuel

    2010-01-01

    Preoperative anxiety is a common and poorly evaluated condition in patients who will undergo an anesthetic and surgical intervention. The objective of this study was to determine the prevalence of anxiety in a group of patients undergoing elective surgery, as assessed by the Amsterdam Anxiety Preoperative and Information (AAPI) scale. We studied 135 patients scheduled for elective surgery applying the AAPI scale 24 h before the surgical procedure to evaluate the presence of anxiety and patient characteristics. A descriptive analysis with mean +/- standard deviation for categorical variables was done. For intragroup differences, chi(2) test was used. Pearson correlation for the association between anxiety and postoperative complications was carried out. A value of p =0.05 was considered significant. One hundred six patients were surgically treated, 88% were female (average age 44 +/- 12 years). Some degree of preoperative anxiety was present in 72 patients (76%; p = 0.001) with a grade point average on the AAPI scale equal to 17 +/- 7 points, of which 95 (70%, OR = 5.08; p = 0.002) were females. Results of this study suggest the presence of high levels of preoperative anxiety in patients scheduled for elective surgery. The origin of the anxiety appears to be related to many factors that can be evaluated in pre-anesthetic consultation. Further study is needed to prevent the presence of this disorder.

  20. Drug: D00545 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D00545 Drug Isoflurane (JP16/USP/INN); Forane (TN) C3H2ClF5O 183.9714 184.4924 D00545.gif Anesthetic...l nervous system 111 General anesthetics 1114 Ethers D00545 Isoflurane (JP16/USP/INN) 1119 Others D00545 Iso

  1. Effects of various anesthetic techniques and PaCO2 levels on cerebral oxygen balance in neurosurgical patients

    Institute of Scientific and Technical Information of China (English)

    陈绍洋; 王强; 熊利泽; 胡胜; 曾祥龙

    2003-01-01

    Objective: To assess the effects of various anesthetic techniques and PaCO2 levels on cerebral oxygen supply/consumption balance during craniotomy for removal of tumors, and to explore an anesthetic technique for neurosurgery and an appropriate degree of PaCO2 during neuroanesthesia. Methods: One hundred and fourteen patients with supratentorial tumors for elective craniotomy, ASA grade Ⅰ-Ⅱ, were randomly allocated to six groups. Patients were anesthetized with continuous intravenous infusion of 2% procaine 1.0 mg*kg-1*min-1 in Group Ⅰ, inhalation of 1.0%-1.5% isoflurane in Group Ⅱ, and infusion of 2% procaine 0.5 mg*kg-1*min-1 combined with inhalation of 0.5%-0.7% isoflurane in Group Ⅲ during the period of study. The end-tidal pressure of CO2 (PET CO2 )was maintained at 4.0 kPa in these 3 groups. In Group Ⅳ, Ⅴ and Ⅵ, the anesthetic technique was the same as that in Group Ⅰ but the PETCO2 was adjusted to 3.5, 4.0 and 4.5 kPa respectively for 60 min during which the study was performed. The radial arterial and retrograde jugular venous blood samples were obtained at the onset and the end of this study for determining jugular venous bulb oxygen saturation (SjvO2), arteriovenous oxygen content difference (AVDO2) and cerebral extraction of oxygen (CEO2). Results: In Group Ⅰ and Ⅲ SjvO2, AVDO2 and CEO2 remained stable. Although SjvO2 kept constant, AVDO2 and CEO2 decreased significantly (P<0.05) in Group Ⅱ. Moreover, AVDO2 and CEO2 in Group Ⅱ were significantly lower than those of Group Ⅲ (P<0.05). In Group Ⅳ, 60 min after hyperventilation, SjvO2 and jugular venous oxygen content(CjvO2) decreased markedly (P<0.01) while CEO2 increased significantly (P<0.01). In addition, SjvO2, CjvO2 and CEO2 in Group Ⅳ were significantly different from the corresponding parameters in Group Ⅴ and Group Ⅵ (P<0.05). In view of sustained excessive hyperventilation, SjvO2 was less than 50% in 37.5% patients of Group Ⅳ. Conclusion: Anesthesia with

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

    Directory of Open Access Journals (Sweden)

    Suman Rajagopalan

    2016-04-01

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

  3. Measurement of motor evoked potentials following repetitive magnetic motor cortex stimulation during isoflurane or propofol anaesthesia.

    Science.gov (United States)

    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.

  4. Effects of isoflurane and sevoflurane on the neutrophil myeloperoxidase system of horses.

    Science.gov (United States)

    Minguet, Grégory; Franck, Thierry; Joris, Jean; Ceusters, Justine; Mouithys-Mickalad, Ange; Serteyn, Didier; Sandersen, Charlotte

    2015-05-15

    Volatile anaesthestics have shown to modulate the oxidative response of polymorphonuclear neutrophils (PMNs). We investigated the effects of isoflurane and sevoflurane on the degranulation of total and active myeloperoxidase (MPO) from horse PMNs and their direct interaction with MPO activity. Whole blood from horse was incubated in 1 and 2 minimal alveolar concentrations (MAC) of isoflurane or sevoflurane for 1h and PMNs were stimulated with cytochalasin B (CB) plus N-formyl-méthionyl-leucyl-phenylalanine (fMLP). After stimulation, the plasma was collected to measure total and active MPO by enzyme-linked immunosorbent assay (ELISA) and specific immunological extraction followed by enzymatic detection (SIEFED) respectively. The effects of 1 and 2 MAC of isoflurane and sevoflurane on the peroxidase and chlorination activity of pure MPO were assessed by fluorescence using Amplex red and 3'-(p-aminophenyl) fluorescein (APF) respectively and in parallel with a SIEFED assay to estimate the potential interaction of the anaesthetics with the enzyme. Although isoflurane and sevoflurane had inconsistent effects on total MPO release, both volatile agents reduced active MPO release and showed a direct inhibition on the peroxidase and the chlorination activity of the enzyme. A persistent interaction between MPO and anaesthetics was evidenced with isoflurane but not with sevoflurane.

  5. Carbon dioxide, but not isoflurane, elicits ultrasonic vocalizations in female rats.

    Science.gov (United States)

    Chisholm, J; De Rantere, D; Fernandez, N J; Krajacic, A; Pang, D S J

    2013-10-01

    Gradual filling of a chamber with carbon dioxide is currently listed by the Canadian Council on Animal Care guidelines as a conditionally acceptable method of euthanasia for rats. Behavioural evidence suggests, however, that exposure to carbon dioxide gas is aversive. Isoflurane is less aversive than carbon dioxide and may be a viable alternative, though objective data are lacking for the period leading up to loss of consciousness. It has been shown that during negative states, such as pain and distress, rats produce ultrasonic vocalizations. The objective of this study was to detect ultrasonic vocalizations during exposure to carbon dioxide gas or isoflurane as an indicator of a negative state. Specialized recording equipment, with a frequency detection range of 10 to 200 kHz, was used to register these calls during administration of each agent. Nine female Sprague-Dawley rats were exposed to either carbon dioxide or isoflurane on two different occasions. All rats vocalized in the ultrasonic range (30 to 70 kHz) during exposure to carbon dioxide. When exposed to isoflurane, no calls were detected from any of the animals. The frequent occurrence of ultrasonic vocalizations during carbon dioxide exposure suggests that the common practice of carbon dioxide euthanasia is aversive to rats and that isoflurane may be a preferable alternative.

  6. [Anesthetic management of a patient with acromegaly complicated with hyperthyroidism].

    Science.gov (United States)

    Kawakubo, A; Ariyoshi, S; Fukui, S; Shimada, M; Haseba, S; Gotoh, Y

    1989-05-01

    A rare anesthetic experience of a 30-year-old woman with acromegaly complicated with Basedow's disease is reported. After the thyroid function was successfully controlled by drug therapy, resection of pituitary adenoma was performed under general anesthesia. Anesthesia was induced and maintained with NLA. No problem was observed during the operation and postoperative period. Careful attention should be paid to the management of circulation, respiration, metabolism and endocrinium through the perioperative period.

  7. Concentration-dependent isoflurane effects on withdrawal reflexes in pigs and the role of the stimulation paradigm.

    Science.gov (United States)

    Spadavecchia, C; Haga, H A; Ranheim, B

    2012-12-01

    In this prospective two-phase experimental trial, 10 pigs were anaesthetized twice with isoflurane only. In the first phase, the individual minimum alveolar concentration (MAC) was determined and in the second phase the effects on withdrawal reflexes of increasing end-tidal isoflurane concentrations (from 1.6% to 2.8%) were assessed. Single, 10 and 60 repeated electrical stimulations were used to evoke withdrawal reflexes which were recorded and quantified by electromyography. Recruitment curves for reflex amplitude for increasing stimulation intensities and isoflurane concentrations were constructed. Isoflurane MAC was 1.9 ± 0.3%. Reflexes evoked by repeated stimulation were suppressed at isoflurane concentrations significantly higher than those which suppressed complex movements during MAC determination (P=0.014 and P=0.006 for 10 and 60 repeated stimuli respectively). Isoflurane up to 2.8% was still not able to abolish reflex activity evoked by repeated stimulations in all pigs. Single stimulation reflexes were suppressed at significantly lower concentrations than repeated stimulation reflexes (P=0.008 and P=0.004 for 10 and 60 repeated stimuli, respectively). Reflex amplitude was significantly correlated with isoflurane concentration (Preflexes is dependent on the stimulation paradigm (single vs. repeated electrical stimulation), and there is limited value in expressing reflex withdrawal suppression in terms of MAC as purposeful and reflex movements are independently affected by isoflurane in individual animals. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Kendig, J J

    1984-01-01

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

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

    Science.gov (United States)

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

    1980-07-01

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

  10. Isoflurane exposure during mid-adulthood attenuates age-related spatial memory impairment in APP/PS1 transgenic mice.

    Directory of Open Access Journals (Sweden)

    Diansan Su

    Full Text Available Many in vitro findings suggest that isoflurane exposure might accelerate the process of Alzheimer Disease (AD; however, no behavioral evidence exists to support this theory. In the present study, we hypothesized that exposure of APP/PS1 transgenic mice to isoflurane during mid-adulthood, which is the pre-symptomatic phase of amyloid beta (Abeta deposition, would alter the progression of AD. Seven-month-old Tg(APPswe,PSEN1dE985Dbo/J transgenic mice and their wild-type littermates were exposed to 1.1% isoflurane for 2 hours per day for 5 days. Learning and memory ability was tested 48 hours and 5 months following isoflurane exposure using the Morris Water Maze and Y maze, respectively. Abeta deposition and oligomers in the hippocampus were measured by immunohistochemistry or Elisa 5 months following isoflurane exposure. We found that the performance of both the transgenic and wild-type mice in the Morris Water Maze significantly improved 48 hours following isoflurane exposure. The transgenic mice made significantly fewer discrimination errors in the Y maze following isoflurane exposure, and no differences were found between wild-type littermates 5 months following isoflurane exposure. For the transgenic mice, the Abeta plaque and oligomers in the hippocampus was significantly decreased in the 5 months following isoflurane exposure. In summary, repeated isoflurane exposure during the pre-symptomatic phase not only improved spatial memory in both the APP/PS1 transgenic and wild-type mice shortly after the exposure but also prevented age-related decline in learning and memory and attenuated the Abeta plaque and oligomers in the hippocampus of transgenic mice.

  11. Neonatal isoflurane exposure induces neurocognitive impairment and abnormal hippocampal histone acetylation in mice.

    Directory of Open Access Journals (Sweden)

    Tao Zhong

    Full Text Available Neonatal exposure to isoflurane may induce long-term memory impairment in mice. Histone acetylation is an important form of chromatin modification that regulates the transcription of genes required for memory formation. This study investigated whether neonatal isoflurane exposure-induced neurocognitive impairment is related to dysregulated histone acetylation in the hippocampus and whether it can be attenuated by the histone deacetylase (HDAC inhibitor trichostatin A (TSA.C57BL/6 mice were exposed to 0.75% isoflurane three times (each for 4 h at postnatal days 7, 8, and 9. Contextual fear conditioning (CFC was tested at 3 months after anesthesia administration. TSA was intraperitoneally injected 2 h before CFC training. Hippocampal histone acetylation levels were analyzed following CFC training. Levels of the neuronal activation and synaptic plasticity marker c-Fos were investigated at the same time point.Mice that were neonatally exposed to isoflurane showed significant memory impairment on CFC testing. These mice also exhibited dysregulated hippocampal H4K12 acetylation and decreased c-Fos expression following CFC training. TSA attenuated isoflurane-induced memory impairment and simultaneously increased histone acetylation and c-Fos levels in the hippocampal cornu ammonis (CA1 area 1 h after CFC training.Memory impairment induced by repeated neonatal exposure to isoflurane is associated with dysregulated histone H4K12 acetylation in the hippocampus, which probably affects downstream c-Fos gene expression following CFC training. The HDAC inhibitor TSA successfully rescued impaired contextual fear memory, presumably by promoting histone acetylation and histone acetylation-mediated gene expression.

  12. Different effects of propofol and isoflurane on cochlear blood flow and hearing function in Guinea pigs.

    Directory of Open Access Journals (Sweden)

    Ying Xiao

    Full Text Available OBJECTIVES: To investigate the effects of isoflurane and propofol on mean arterial pressure (MAP, cochlear blood flow (CoBF, distortion-product otoacoustic emission (DPOAE, and the ultrastructure of outer hair cells (OHCs in guinea pig cochleae. METHODS: Forty-eight male guinea pigs were randomly assigned to one of six treatment groups. Groups 1 to 3 were infused (i.v. with a loading dose of propofol (5 mg/kg for 5 min and three maintenance doses (10, 20, or 40 mg kg-1·h-1, respectively for 115 min. Groups 4 to 6 were inhaled with isoflurane at concentrations of 1.15 vol%, 2.30 vol% or 3.45 vol% respectively for 120 min. CoBF and MAP were recorded prior to and at 5 min intervals during drug administration. DPOAE was measured before, immediately after, and 1 h after administration. Following the final DPOAE test, cochleae were examined using scanning electron microscopy. RESULTS: Propofol treatment reduced MAP in a dose-dependent manner. CoBF and DPOAE showed increases at propofol maintenance doses of 10 and 20 mg kg-1·h-1. Inhalation of isoflurane at concentrations of 2.30 vol% and 3.45 vol% reduced MAP and CoBF. DPOAE amplitude increased following inhalation of 1.15 vol% isoflurane, but decreased following inhalations of 2.30 vol% and 3.45 vol%. Cochlear structure was changed following inhalation of either 2.30 vol% or 3.45 vol% isoflurane. CONCLUSIONS: Propofol could decrease MAP and increase both CoBF and DPOAE without affecting OHC structure. Inhalation of isoflurane at concentrations >2.30 vol% decreased CoBF and DPOAE, and produced injury to OHCs.

  13. 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

  14. Comparison of sevoflurane and isoflurane effects on cardiovascular andrespiratory system during spontaneous ventilation in Angora goats

    OpenAIRE

    KUMANDAŞ, ALİ; ELMA, ERTUĞRUL

    2015-01-01

    Seven healthy Angora goats were used to compare the effects of isoflurane and sevoflurane on the cardiovascular and respiratory systems during anesthesia periods. Once anesthesia was induced with propofol at 5.1 ± 0.9 mg/kg, it was maintained with isoflurane at 1%-3% in the first treatment period and sevoflurane at 2%-4% in the second treatment period after a 15-day interval. Heart rates measured immediately after anesthesia induction and 5 min later were found to be statistically significant...

  15. Factors associated with anesthetic-related death in dogs and cats in primary care veterinary hospitals.

    Science.gov (United States)

    Matthews, Nora S; Mohn, Thomas J; Yang, Mingyin; Spofford, Nathaniel; Marsh, Alison; Faunt, Karen; Lund, Elizabeth M; Lefebvre, Sandra L

    2017-03-15

    OBJECTIVE To identify risk factors for anesthetic-related death in pet dogs and cats. DESIGN Matched case-control study. ANIMALS 237 dogs and 181 cats. PROCEDURES Electronic medical records from 822 hospitals were examined to identify dogs and cats that underwent general anesthesia (including sedation) or sedation alone and had death attributable to the anesthetic episode ≤ 7 days later (case animals; 115 dogs and 89 cats) or survived > 7 days afterward (control animals [matched by species and hospital]; 122 dogs and 92 cats). Information on patient characteristics and data related to the anesthesia session were extracted. Conditional multivariable logistic regression was performed to identify factors associated with anesthetic-related death for each species. RESULTS The anesthetic-related death rate was higher for cats (11/10,000 anesthetic episodes [0.11%]) than for dogs (5/10,000 anesthetic episodes [0.05%]). Increasing age was associated with increased odds of death for both species, as was undergoing nonelective (vs elective) procedures. Odds of death for dogs were significantly greater when preanesthetic physical examination results were not recorded (vs recorded) or when preanesthetic Hct was outside (vs within) the reference range. Odds of death for cats were greater when intra-anesthesia records for oxygen saturation as measured by pulse oximetry were absent. Underweight dogs had almost 15 times the odds of death as nonunderweight dogs; for cats, odds of death increased with increasing body weight (but not with overweight body condition). CONCLUSIONS AND CLINICAL RELEVANCE Several factors were associated with anesthetic-related death in cats and dogs. This information may be useful for development of strategies to reduce anesthetic-related risks when possible and for education of pet owners about anesthetic risks.

  16. Pharmacodynamic evaluation of augmentation effect of isoflurane on mivacurium.

    Science.gov (United States)

    Tripathi, Mukesh; Pandey, Mamta

    2009-06-01

    This study evaluated the augmentation effect of isoflurane (ISO) given before or after the mivacurium (MIV) injection. Consented 33 adults (18-58 years), ASA I patients of both sexes were randomly assigned into three groups. In group 1 (no ISO) patients--IV propofol (0.5-1 mg/kg) for induction and (25-50 mg) aliquots every 2-5 minutes, N2O (60%) in O2 by mask, was followed by IV MIV (0.04 mg/kg). In group 2 (ISO before MIV) patients-IV propofol as in group 1 and ISO in N2O (60%) and O2 to achiever end tidal level 1% for 10 minutes was followed by same dose of IV MIV. In group 3 (ISO after MIV) patients-after propofol and IV MIV as above, ISO in N2O (60%) and O2 was given to get end tidal level 1% for 10 minutes. All patients were breathing spontaneously using tight fitting facemask and respiration was assisted to keep ETCO2 (35-40 mmHg), SaO2 100%. To monitor MIV effect, ulnar nerve was stimulated at wrist using supramaximal double burst stimuli (DBS). Adductor pollicis response was recorded on myograph-2000 (Biometer, Denmark). Twitch amplitude (D1) and tetanic fade DBSr (D2/D1) were calculated for each stimulus and recorded. Peak MIV effect (D1 suppression by approximately equal to 90% and abolished D2) was significantly (p < 0.05) more in group 2 patients (ISO before MIV) than in group 1 (control) or group 3 (ISO after MIV) patients. ISO given prior of MIV administration significantly augmented the effect of MIV. When ISO was started after MIV injection probably the quick hydrolysis of MIV limited the augmentation effect to tetanic fade only as compared to the patients, who did not get ISO at any point of study. Prior administration of ISO causes intense MIV block at adductor pollicis.

  17. How we recall (or don't): the hippocampal memory machine and anesthetic amnesia.

    Science.gov (United States)

    Perouansky, Misha; Pearce, Robert A

    2011-02-01

    The hippocampal formation occupies a central position for the processing of sensory input into learned, remembered, and consciously retrievable information. The mechanisms by which anesthetic drugs interfere with these processes are now emerging. We review the current understanding of the role of the hippocampal formation in the generation of memory traces and how anesthetics might interfere with its function. Intraoperative amnesia is a desired endpoint of general anesthesia from the perspective of both the patient and the practitioner. "Intraoperative awareness with recall" can result when learning and memory do occur. In addition, anesthetics are capable of inducing a state of "conscious amnesia" that can provide insight into the workings of the brain and might be useful clinically. Anesthesiologists routinely induce the most fascinating pharmacologic effects in existence, the reversible interference of anesthetics with higher cognitive functions. Understanding how the drugs in our custody exert their effects should be our contribution to mankind's universal knowledge base.

  18. 经皮穴位电刺激配合全麻行异氟醚控制性降压对组织氧代谢的影响%Effects of Combined Transdermal Acupoint Electric Stimulation and Isoflurane Anesthesia on Isoflurane-Induced Hypotension and Tissue Oxygen Metabolism in Patients Undergoing Craniotomy

    Institute of Scientific and Technical Information of China (English)

    王均炉; 谢文霞; 张琦

    2001-01-01

    Objective: To observe the effects of combined transdermalacupoint electric stimulation and isoflurane anesthesia on isoflurane-induced hypotension and tissue oxygen metabolism in patients undergoing craniotomy. Methods: Forty-two patients with brain tumor of ASA physical status Ⅰ or Ⅱ and scheduled for elective surgery were randomly divided into two groups. The craniotomy was undergoing in Group A with isoflurane anesthesia, while in Group B, with combined transdermal acupoint electric stimulation (TAES) and isoflurane anesthesia. Isoflurane induced hypotension was performed in both groups by augmenting the concentration of isoflurane to lower the mean arterial pressure than before anesthesia for 30%-40% and maintain for 30-45 mins. The tissue oxygen metabolism, blood gas and arterial lactic acid level before, during and after hypotension were monitored by Swan-Ganz floating catheterization. Results: As compared with before hypotension, the pulmonary arterial and mixed with venous blood oxygen saturation lowered and oxygen supply lowered, and oxygen uptake increased significantly in both groups (P<0.05), but the extent of changes in oxygen metabolic criteria in Group B were all lesser than those in Group A (P<0.05). Conclusion: Combined acupoint electric stimulation and general anesthesia could maintain the tissue oxygen supply and demand balance better in the isoflurane-induced hypotension process.%目的:观察经皮穴位电刺激配合全麻在脑瘤术中行异氟醚控制性降压对患者组织氧代谢的影响。方法:选取ASA分级为Ⅰ~Ⅱ级的脑瘤择期手术患者42例,随机均分为两组。A组为常规全麻行异氟醚控制性降压;B组为经皮穴位电刺激配合全麻行异氟醚控制性降压。两组术中通过加大异氟醚浓度使平均动脉压较麻醉前下降30%~40%,维持30~45min。采用Swan-Ganz漂浮导管技术,对比监测降压前、中、后组织氧代谢及相应血气和动脉乳

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

    Science.gov (United States)

    Malamed, S F

    1994-12-01

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

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

    Science.gov (United States)

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

    2009-12-01

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

  1. SYSTEMIC TOXIC REACTIONS TO LOCAL ANESTHETICS

    Science.gov (United States)

    Moore, Daniel C.; Green, John

    1956-01-01

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

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

    OpenAIRE

    Madhuri S Kurdi; Ramaswamy, Ashwini H

    2015-01-01

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

  3. Recovery of older patients undergoing ambulatory anaesthesia with isoflurane or sevoflurane.

    LENUS (Irish Health Repository)

    Mahajan, V A

    2007-06-01

    Delayed recovery of cognitive function is a well-recognized phenomenon in older patients. The potential for the volatile anaesthetic used to contribute to alterations in postoperative cognitive function in older patients following minor surgical procedures has not been determined. We compared emergence from isoflurane and sevoflurane anaesthesia in older surgical patients undergoing urological procedures of short duration.

  4. The effect of the anaesthetic agent isoflurane on the rate of neutrophil apoptosis in vitro.

    LENUS (Irish Health Repository)

    Tyther, R

    2012-02-03

    BACKGROUND: Volatile anaesthetic agents influence neutrophil function, and potentially, the inflammatory response to surgery. AIM: The objective of this study was to determine the effect of isoflurane (1-4%) on human polymorphonuclear neutrophil apoptosis in vitro. METHODS: Venous blood from 12 healthy volunteers was exposed to 0, 1, and 4% isoflurane delivered via a 14G Wallace flexihub internal jugular cannula, at a fresh gas flow of 0.51\\/min for 5 minutes. Isolated neutrophils were assessed for apoptosis at 1, 12, and 24 hours in culture using dual staining with annexin V-FITC and propidium iodide (Annexin-V FITC assay). Data were analysed using paired, one-tailed Student\\'s t-tests. p<0.05 was considered significant. RESULTS: At 1 hour apoptosis was inhibited in the 1% (5.1 [6.8]%; p=0.017) and 4% (4.8 [4.5]%; p=0.008) isoflurane groups compared to control (11.3 [6.9]%). At 12 and 24 hours, a dose-dependent inhibition of apoptosis was demonstrated, i.e. 4% > 1% > 0%. CONCLUSION: Human neutrophil apoptosis is inhibited in a concentration-dependent manner in vitro by isoflurane in clinical concentrations.

  5. The effect of xenon on isoflurane protection against experimental myocardial infarction.

    NARCIS (Netherlands)

    Baumert, J.H.; Hein, M.; Gerets, C.; Baltus, T.; Hecker, K.E.; Rossaint, R.

    2009-01-01

    OBJECTIVES: To investigate if the protective effects of xenon and isoflurane against myocardial ischemia-reperfusion damage would be additive. DESIGN: A prospective, randomized laboratory investigation. SETTING: An animal laboratory of a university hospital. PARTICIPANTS: Thirty-six pigs (female Ger

  6. Preliminary investigation into the ventilatory effects of midazolam in isoflurane-anaesthetised goats

    Directory of Open Access Journals (Sweden)

    George F. Stegmann

    2012-04-01

    Full Text Available The ventilatory effects of intravenous midazolam (MDZ were evaluated in isoflurane- anaesthetised goats. Eight female goats aged 2–3 years were fasted from food and water for 12 h. Anaesthesia was then induced using a face mask with isoflurane in oxygen, whilst the trachea was intubated with a cuffed tracheal tube and anaesthesia maintained with isoflurane at 1.5% end-tidal concentration. Ventilation was spontaneous. The goats were treated with either a saline placebo (PLC or MDZ intravenously at 0.2 mg/kg. Analysis of variance for repeated measures was used for the analysis of data. Significance was taken at the 0.05 level. Differences between treatments were not statistically significant (p > 0.05 for tidal volume, ventilation rate, tidal volume/kg (VT/kg and end-tidal carbon dioxide partial pressure. Within treatments, VT and VT/kg differed 5 min after MDZ administration; this was statistically significant (p < 0.05. The occurrence of apnoea in the MDZ-treated goats was statistically significant (p = 0.04 compared with the PLC treated goats. Intravenous MDZ at 0.2 mg/kg administered to isoflurane-anaesthetised goats may result in transient apnoea and a mild decrease in VT and VT/kg.

  7. Effect of morphine and flunixin meglumine on isoflurane minimum alveolar concentration in goats.

    Science.gov (United States)

    Doherty, Tom J; Will, Whitney A; Rohrbach, Barton W; Geiser, Dennis R

    2004-04-01

    To determine the effect of morphine and flunixin meglumine on isoflurane (ISO) minimum alveolar concentration (MAC) in goats. Prospective, randomized experimental study. Five adult, wether goats from 1 to 3 years in age, and weighing 24-65 kg. Anesthesia was induced using ISO, which was delivered via a mask. Goats were intubated and ventilated to maintain an end-tidal carbon dioxide concentration between 25 and 30 mm Hg (3.3-4 kPa). End-tidal ISO concentration was measured using an infrared analyzer. The baseline ISO MAC that prevented purposeful movement in response to clamping a claw was determined. Following baseline MAC determination, each goat received one of the following four treatments intravenously (IV): morphine (2 mg kg(-1)), flunixin (1.5 mg kg(-1)), flunixin (1.5 mg kg(-1)) plus morphine (2 mg kg(-1)) or saline, and the MAC was re-determined. Goats were studied at weekly intervals, and each goat received each treatment in a randomized fashion. The baseline ISO MAC for the control treatment was 1.43%. Morphine reduced the MAC by 29.7%. Flunixin did not significantly decrease the MAC nor did it potentiate the effect of morphine on MAC. The quality of recovery was good in all cases. Morphine (2 mg kg(-1), IV) significantly reduced the ISO MAC in goats and did not adversely affect the quality of recovery. The use of morphine, at the dose studied, in association with ISO anesthesia, will allow a clinically significant reduction in the concentration of ISO required to maintain general anesthesia in goats.

  8. Propofol increased the interleukin-6 to interleukin-10 ratio more than isoflurane after surgery in long-term alcoholic patients

    DEFF Research Database (Denmark)

    Von Dossow, V; Baur, S; Sander, M;

    2007-01-01

    times and rates of post-operative infections were documented. The IL-6/IL-10 ratio significantly increased with propofol compared with isoflurane on day 1 after surgery and the IL-10 level significantly increased with isoflurane on day 1 after surgery. The overall post-operative infection rate......This study investigated the effect of an anaesthetic regimen on the immune response in 40 long-term alcoholic patients undergoing surgery. Patients were randomly allocated to receive either propofol or isoflurane during surgery. Plasma cytokines interleukin (IL)-6 and IL-10 were measured at defined...

  9. Propofol increased the interleukin-6 to interleukin-10 ratio more than isoflurane after surgery in long-term alcoholic patients

    DEFF Research Database (Denmark)

    Von Dossow, V; Baur, S; Sander, M;

    2011-01-01

    times and rates of post-operative infections were documented. The IL-6/IL-10 ratio significantly increased with propofol compared with isoflurane on day 1 after surgery and the IL-10 level significantly increased with isoflurane on day 1 after surgery. The overall post-operative infection rate......This study investigated the effect of an anaesthetic regimen on the immune response in 40 long-term alcoholic patients undergoing surgery. Patients were randomly allocated to receive either propofol or isoflurane during surgery. Plasma cytokines interleukin (IL)-6 and IL-10 were measured at defined...

  10. Assessment of patient satisfaction with the preoperative anesthetic evaluation

    Directory of Open Access Journals (Sweden)

    Gebremedhn EG

    2014-09-01

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

  11. MAC-awake of isoflurane, enflurane and halothane evaluated by slow and fast alveolar washout.

    Science.gov (United States)

    Gaumann, D M; Mustaki, J P; Tassonyi, E

    1992-01-01

    End-tidal anaesthetic concentrations at first eye opening in response to a verbal command during recovery from anaesthesia (MAC-awake), were measured for isoflurane (n = 16), enflurane (n = 16) and halothane (n = 14). MAC-awake was measured during either slow or fast alveolar washout. Slow washout was obtained by decreasing anaesthetic concentrations in predetermined steps of 15 min, assuming equilibration between brain and alveolar partial pressures. Fast alveolar washout was obtained by discontinuation of the inhalation anaesthetic, which had been maintained at 1 MAC for at least 15 min. Mean MAC-awake obtained with slow alveolar washout was similar for isoflurane (0.25 (SD 0.03) MAC), and enflurane (0.27 (0.04) MAC) and significantly greater than values obtained by fast alveolar washout (isoflurane: 0.19 (0.03) MAC; enflurane: 0.20 (0.03) MAC). The MAC-awake of isoflurane and enflurane was significantly less than that of halothane, which was 0.59 (0.10) MAC as evaluated by the slow and 0.50 (0.05) MAC as evaluated by the fast alveolar washout method. Recovery time from anaesthesia with fast alveolar washout was 8.8 (4.0) min for halothane, which was not different from isoflurane (15 (2.5) min), but significantly shorter than for enflurane (22 (10) min), reflecting differences in the anaesthetic concentration gradient between MAC and MAC-awake values. These data do not support the hypothesis of a uniform ratio between MAC and MAC-awake values.

  12. Comparison of sevoflurane with isoflurane for rapid mask induction in midazolam and butorphanol-sedated dogs.

    Science.gov (United States)

    Mutoh, T; Kojima, K; Takao, K; Nishimura, R; Sasaki, N

    2001-05-01

    Rapid mask induction can be a useful induction technique for veterinary patients, although it is often accompanied by exaggerated excitement responses in unpremedicated animals (Mutoh et al.: Jpn. J. Vet. Anesth. Surg. 26, 109-116; J. Vet. Med. Sci. 57, 1007-1013; J. Vet. Med. Sci. 57, 1121-1124; 1995). The aim of this study was to compare sevoflurane with isoflurane for rapid mask induction in six dogs sedated by a combination of midazolam (0.1 mg/kg) and butorphanol (0.2 mg/kg). Induction with sevoflurane (5%, 2.4 minimum alveolar concentration [MAC]) in O2 resulted in shorter time to loss of the palpebral reflex, negative tail clamp response, and successful intubation than with isoflurane (3%, 2.4 MAC) in O2. There were no changes in heart rate or mean arterial blood pressure during induction with sevoflurane, whereas an increase in heart rate was observed in dogs induced with isoflurane. A decrease in respiratory rate compared with the pre-induction rate was observed during induction, and associated mild respiratory acidosis, characterized by an increase in arterial PCO2, was measured at the end of the induction period in both induction groups. None of the animals had episodes of induction-related complications. These results suggest that both sevoflurane and isoflurane produce a smooth onset of induction in midazolam and butorphanol-sedated dogs. Sevoflurane is a more suitable for rapid mask induction than isoflurane since it provides faster induction associated with a lower blood/gas partition coefficient.

  13. Desflurane increases intracranial pressure more and sevoflurane less than isoflurane in pigs subjected to intracranial hypertension.

    Science.gov (United States)

    Holmström, Anders; Akeson, J

    2004-04-01

    Desflurane and sevoflurane may have advantages over isoflurane in neuroanesthesia, but this is still under debate. A porcine model with experimental intracranial hypertension was used for paired comparison of desflurane, sevoflurane, and isoflurane with respect to the effects on cerebral blood flow (CBF), cerebrovascular resistance (CVR), and intracranial pressure (ICP). The agents, given in sequence to each of six pigs, were compared at 0.5 and 1.0 minimal alveolar concentrations (MAC) and three mean arterial blood pressure (MAP) levels (50, 70, and 90 mm Hg) at normocapnia and one MAP level (70 mm Hg) at hypocapnia. MAC for each agent had been previously determined in a standardized manner for comparison reliability. CBF was measured with Xe. MAP was lowered by inflation of a balloon catheter in the inferior caval vein and raised by inflation of a balloon catheter in the descending aorta. ICP was measured intraparenchymally. Two Fogarty catheters positioned extradurally were inflated to a baseline ICP of 20 to 22 mm Hg at 0.2 MAC of each agent. CBF and ICP with the three agents at normocapnia and MAP 70 and 90 mm Hg at both 0.5 and 1.0 MAC were as follows (P isoflurane > sevoflurane. None of the agents abolished CO2 reactivity. High-dose desflurane resulted in a higher CBF at hypocapnia than corresponding doses of sevoflurane or isoflurane, but there were no significant differences between the agents in ICP at hypocapnia. The present study showed that desflurane increased ICP more and sevoflurane less than isoflurane during normoventilation, but the differences disappeared with hyperventilation.

  14. Developmental Neurotoxicity of Alcohol and Anesthetic Drugs Is Augmented by Co-Exposure to Caffeine

    Directory of Open Access Journals (Sweden)

    Catherine E. Creeley

    2013-07-01

    Full Text Available Anesthetic and anti-epileptic drugs used in pediatric and obstetric medicine and several drugs, including alcohol, that are abused by pregnant women, trigger widespread neuroapoptosis in the developing brain of several animal species, including non-human primates. Caffeine (CAF is often administered to premature infants to stimulate respiration, and these infants are also exposed simultaneously to anesthetic drugs for procedural sedation and/or surgical procedures. Pregnant women who abuse alcohol or other apoptogenic drugs also may heavily consume CAF. We administered CAF to infant mice alone or in combination with alcohol, phencyclidine, diazepam, midazolam, ketamine, or isoflurane, which are drugs of abuse and/or drugs frequently used in pediatric medicine, and found that CAF weakly triggers neuroapoptosis by itself and markedly potentiates the neuroapoptogenic action of each of these other drugs. Exposure of infant mice to CAF + phencyclidine resulted in long-term impairment in behavioral domains relevant to attention deficit/hyperactivity disorder, whereas exposure to CAF + diazepam resulted in long-term learning/memory impairment. At doses used in these experiments, these behavioral impairments either did not occur or were substantially less pronounced in mice exposed to CAF alone or to phencyclidine or diazepam alone. CAF currently enjoys the reputation of being highly beneficial and safe for use in neonatal medicine. Our data suggest the need to consider whether CAF may have harmful as well as beneficial effects on the developing brain, and the need for research aimed at understanding the full advantage of its beneficial effects while avoiding its potentially harmful effects.

  15. Clinical features of pheochromocytoma and perioperative anesthetic management

    Institute of Scientific and Technical Information of China (English)

    罗爱伦; 郭向阳; 易杰; 任洪智; 黄宇光; 叶铁虎

    2003-01-01

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

  16. Effects of Injectable Anesthetic Combinations on Left Ventricular Function and Cardiac Morphology in Sprague–Dawley Rats

    OpenAIRE

    Sabatini, Carla F; O'Sullivan, M. Lynne; Valcour, James E.; Sears, William; Johnson, Ron J

    2013-01-01

    Novel anesthetic agents or combinations may provide superior general anesthesia for echocardiography in rodents with the potential for reduced adverse effects. This study sought to characterize the effects of 3 injectable anesthetics on left ventricular (LV) systolic function and cardiac morphology in healthy male and female rats. Rats underwent echocardiographic assessment after general anesthesia via pentobarbital or combinations of ketamine and medetomidine (KME) and ketamine and midazolam...

  17. Is conformation a fundamental descriptor in QSAR? A case for halogenated anesthetics

    Science.gov (United States)

    Guimarães, Maria C; Duarte, Mariene H; Silla, Josué M

    2016-01-01

    Summary An intriguing question in 3D-QSAR lies on which conformation(s) to use when generating molecular descriptors (MD) for correlation with bioactivity values. This is not a simple task because the bioactive conformation in molecule data sets is usually unknown and, therefore, optimized structures in a receptor-free environment are often used to generate the MD´s. In this case, a wrong conformational choice can cause misinterpretation of the QSAR model. The present computational work reports the conformational analysis of the volatile anesthetic isoflurane (2-chloro-2-(difluoromethoxy)-1,1,1-trifluoroethane) in the gas phase and also in polar and nonpolar implicit and explicit solvents to show that stable minima (ruled by intramolecular interactions) do not necessarily coincide with the bioconformation (ruled by enzyme induced fit). Consequently, a QSAR model based on two-dimensional chemical structures was built and exhibited satisfactory modeling/prediction capability and interpretability, then suggesting that these 2D MD´s can be advantageous over some three-dimensional descriptors. PMID:27340468

  18. Effects of bispectral index monitoring on isoflurane consumption and recovery profiles for anesthesia in an elderly asian population

    Directory of Open Access Journals (Sweden)

    Faraz Shafiq

    2012-01-01

    Conclusion: The use of BIS in an elderly Asian population resulted in 40% reduction of isoflurane usage. The patients having BIS monitoring awoke earlier and had better recovery profiles at the end of anesthesia.

  19. A Study to Compare the Quality of Surgical Field Using Total Intravenous Anesthesia (with Propofol) versus Inhalational Anesthesia (with Isoflurane) for Functional Endoscopic Sinus Surgeries

    Science.gov (United States)

    Aujla, K. S.; Kaur, Manbir; Gupta, Ruchi; Singh, Sukhjinder; Bhanupreet; Tavleen

    2017-01-01

    Background and Objectives: Functional endoscopic sinus surgery (FESS) being a delicate technique, intraoperative bleeding is one of the major challenges. Even a little bleeding can adversely affect the surgeon's ability to visualize the region to be operated. General anesthesia is preferred over topical anesthesia in FESS. This study was conducted to compare the surgical field using total intravenous anesthesia (TIVA) with propofol and inhalational anesthesia with isoflurane for FESS. Secondary outcomes such as intraoperative blood loss and the incidence of perioperative complications were also recorded. Subjects and Methods: A total of sixty patients in the age group of 16–60 years with physical status American Society of Anesthesiologists Classes I and II, undergoing FESS were randomly divided into two groups of thirty each after taking informed consent and approval from the Hospital Ethics Committee. Thirty patients in Group I: received isoflurane-based inhalational anesthesia and other Thirty patients in Group II: were administered TIVA with propofol. Various parameters were recorded and statistically analyzed. Results: There was improved quality of surgical field at the end of surgery in the Group II as compared to Group I. Total blood loss during surgery and incidence of intraoperative complications were less in Group II as compared to Group I. Conclusion: This study concludes that in FESS, using TIVA with propofol decreases blood loss and the incidence of complications during surgery in addition to providing good quality of surgical field.

  20. 部分全麻药对突触发生期中枢神经系统发育的影响及机制%Effects of some general anesthetics on the development of the central nervous system and their mechanisms

    Institute of Scientific and Technical Information of China (English)

    燕琳

    2012-01-01

    近年的研究表明,在未成熟哺乳动物突触发生期,短暂性拮抗N-甲基-D-天(门)冬氨酸(N-methyl-D-asparate,NMDA)受体或过度激动γ-氨基丁酸A(gamma-amino butyric acid,GABAA)受体可诱发大脑神经细胞的大量凋亡、脊髓凋亡性退变.这些药物主要有全身麻醉药、抗惊厥药及乙醇等.人类突触发生高峰期为妊娠后3个月到出生后3年.妊娠晚期、新生儿及婴幼儿刚好处在这个时间窗,因此该类药物对脑发育的影响成为人们研究的热点,其机制的阐明可能对新生儿、婴幼儿以及孕产妇临床合理用药及新药的开发有指导意义.文中就部分全麻药对突触发生期中枢神经系统发育的影响及机制作一综述.%Recent researches have found that the exposure of the developing mammalians during the period of synaptogenesis to drugs that transiently block N-methyl-D-asparate glutamate receptors or that transiently potentiate gamma-amino butyric acid receptors can trigger widespread apoptotic neurodegeneration in the brains, even in the spinal cords. These drugs include general anesthetics, anticonvulsants, alcohol, etc. The brain growth spurt period, also called synaptogenesis occurs in humans from the third trimester of pregnancy to three years after birth. The time windows include late pregnancy, neonate period and infancy. Therefore, people pay much more attention to the question how these drugs impact the development of the human central nervous system. Elucidation of the mechanisms of some general anesthetics may help the development of new drugs and rational clinical use of the drugs in neonates, in-fants, and pregnant and parturient women.

  1. Recognition of anesthetic barbiturates by a protein binding site: a high resolution structural analysis.

    Directory of Open Access Journals (Sweden)

    Simon Oakley

    Full Text Available Barbiturates potentiate GABA actions at the GABA(A receptor and act as central nervous system depressants that can induce effects ranging from sedation to general anesthesia. No structural information has been available about how barbiturates are recognized by their protein targets. For this reason, we tested whether these drugs were able to bind specifically to horse spleen apoferritin, a model protein that has previously been shown to bind many anesthetic agents with affinities that are closely correlated with anesthetic potency. Thiopental, pentobarbital, and phenobarbital were all found to bind to apoferritin with affinities ranging from 10-500 µM, approximately matching the concentrations required to produce anesthetic and GABAergic responses. X-ray crystal structures were determined for the complexes of apoferritin with thiopental and pentobarbital at resolutions of 1.9 and 2.0 Å, respectively. These structures reveal that the barbiturates bind to a cavity in the apoferritin shell that also binds haloalkanes, halogenated ethers, and propofol. Unlike these other general anesthetics, however, which rely entirely upon van der Waals interactions and the hydrophobic effect for recognition, the barbiturates are recognized in the apoferritin site using a mixture of both polar and nonpolar interactions. These results suggest that any protein binding site that is able to recognize and respond to the chemically and structurally diverse set of compounds used as general anesthetics is likely to include a versatile mixture of both polar and hydrophobic elements.

  2. Sevoflurane: a new inhalational anesthetic agent.

    Science.gov (United States)

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

    1975-01-01

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

  3. Effects of dose-dependent levels of isoflurane on cerebral blood flow in healthy subjects studied using positron emission tomography.

    Science.gov (United States)

    Schlünzen, L; Cold, G E; Rasmussen, M; Vafaee, M S

    2006-03-01

    In this study, we tested the hypothesis that escalating drug concentrations of isoflurane are associated with a significant decline in cerebral blood flow (CBF) in regions sub-serving conscious brain activity, including specifically the thalamus. Nine human volunteers received three escalating drug concentrations: 0.2, 0.4 and 1.0 MAC end-tidal inhalation. During waking, baseline and the three levels of sedation, aO PET scan was performed. Isoflurane decreased the bispectral index (BIS) values dose-dependently. Cardiovascular and respiratory parameters were maintained constant over time. No significant change in global CBF was observed. Throughout all three MAC levels of sedation, isoflurane caused an increased regional cerebral blood flow (rCBF) in the anterior cingulate and decreased rCBF in the cerebellum. Initially, isoflurane (0 vs. 0.2 MAC) significantly increased relative rCBF in the medial frontal gyrus and in the nucleus accumbens. At the next level (0.2 vs. 0.4 MAC), relative rCBF was significantly increased in the caudate nucleus and decreased in the lingual gyrus and cuneus. At the last level (0.4 vs. 1 MAC), relative rCBF was significantly increased in the insula and decreased in the thalamus, the cuneus and lingual gyrus. Compared with flow distribution in awake volunteers, 1 MAC of isoflurane significantly raised relative activity in the anterior cingulate and insula regions. In contrast, a significant relative flow reduction was identified in the thalamus, the cerebellum and lingual gyrus. Isoflurane, like sevoflurane, induced characteristic flow redistribution at doses of 0.2-1.0 MAC. At 1 MAC of isoflurane, rCBF decreased in the thalamus. Specific areas affected by both isoflurane and sevoflurane included the anterior cingulate, insula regions, cerebellum, lingual gyrus and thalamus.

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

    Science.gov (United States)

    Cassavaugh, Jessica M; Oravitz, Todd M

    2016-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Upma B Batra

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Abdullah Sulieman Terkawi

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    İsmail Aydın Erden

    2013-03-01

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

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

    Science.gov (United States)

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

    2011-04-01

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

  9. Intraoperative end-tidal concentration of isoflurane in cats undergoing ovariectomy that received tramadol, buprenorphine or a combination of both.

    Science.gov (United States)

    Bellini, Luca; Mollo, Antonio; Contiero, Barbara; Busetto, Roberto

    2017-02-01

    Objectives The aim of the study was to evaluate the end-tidal concentration of isoflurane required to maintain heart and respiratory rate within ± 20% of basal measurement in cats undergoing ovariectomy that received buprenorphine, tramadol or a combination of both. Methods Thirty cats, divided into three groups, were enrolled in a simple operator-blinded, randomised study. Cats received acepromazine (0.03 mg/kg) and one of the following treatments: buprenorphine (0.02 mg/kg), tramadol (2 mg/kg) or a combination of both. Anaesthesia was induced with propofol and maintained with isoflurane titrated in order to maintain heart and respiratory rate within the target values recorded before premedication. Results Groups were similar for age, weight, dose of propofol administered, sedation and recovery scores. Cats receiving tramadol with buprenorphine were extubated earlier after isoflurane discontinuation. No statistical differences were detected in end-tidal fraction of isoflurane between buprenorphine alone or with tramadol. In cats that received tramadol or buprenorphine alone, ovarian pedicle traction caused a statistical increase in end-tidal isoflurane concentration compared with that measured during incision and suture of the skin. In cats that received the combination of tramadol plus buprenorphine no differences among surgical time points were observed. Conclusions and relevance Tramadol added to buprenorphine did not provide any advantage in decreasing the end-tidal fraction of isoflurane compared with buprenorphine alone, although it is speculated there may be an infra-additive interaction between tramadol and buprenorphine in cats.

  10. Knowledge about local anesthetics in odontology students.

    Science.gov (United States)

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

    2009-01-01

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

  11. The Effect of Inspired Oxygen Concentration and Transportation Time on Arterial Hemoglobin Oxygen Saturation During Transport from the Operating Room to the Postanesthesia Care UnitCare Unit

    Science.gov (United States)

    1996-08-14

    oxygen to all ambulatory patients recovering from general anesthesia. The second study involved 71 healthy pediatric patients undergoing general...Male/Female 7. ASA Status (I, II, III) _ 8. Anesthetic Agent Enflurane Halothane Desflurane Isoflurane Nitrous oxide Propofol 9. Narcotic

  12. Anesthetic Management of a Patient With Charcot-Marie-Tooth Disease.

    Science.gov (United States)

    Ohshita, Naohiro; Oka, Saeko; Tsuji, Kaname; Yoshida, Hiroaki; Morita, Shosuke; Momota, Yoshihiro; Tsutsumi, Yasuo M

    2016-01-01

    Charcot-Marie-Tooth disease (CMTD) is a hereditary peripheral neuropathy and is characterized by progressive muscle atrophy and motor-sensory disorders in all 4 limbs. Most reports have indicated that major challenges with general anesthetic administration in CMTD patients are the appropriate use of nondepolarizing muscle relaxants and preparation for malignant hyperthermia in neuromuscular disease. Moderate sedation may be associated with the same complications as those of general anesthesia, as well as dysfunction of the autonomic nervous system, reduced perioperative respiratory function, difficulty in positioning, and sensitivity to intravenous anesthetic agents. We decided to use intravenous sedation in a CMTD patient and administered midazolam initially and propofol continuously, with total doses of 1.5 mg and 300 mg, respectively. Anesthesia was completed in 3 hours and 30 minutes without adverse events. We suggest that dental anesthetic treatment with propofol and midazolam may be effective for patients with CMTD.

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

    DEFF Research Database (Denmark)

    Kehlet, H

    1988-01-01

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

  14. Poikilocapnic hypoxic ventilatory response in humans during 0.85 MAC isoflurane anesthesia.

    Science.gov (United States)

    Sjögren, D; Sollevi, A; Ebberyd, A; Lindahl, S G

    1994-02-01

    Ventilatory responses to hypoxia (HVR) were investigated using poikilocapnic conditions (i.e. end-tidal CO2's allowed to seek it's own level) in 15 cardio-pulmonary healthy patients who were first studied awake and then at 0.85 MAC isoflurane. The influence of hypercapnia (HyperCapnic Ventilatory Response, HCVR) was also elucidated. Pneumotachography, capnography and airway occlusion pressures at 0.1 s (P degree 0.1) were used before and during both mild hypoxia (end-tidal O2 tension 8.7 kPa) and hypercapnia achieved by an inspired CO2 concentration of 5%. HCVR was attenuated by 60% during anesthesia (P awake state, five of the 15 patients decreased HVR during hypoxia as compared with during normoxia. This resulted in a VE that on average increased by 0.6 l.min-1 (P MAC isoflurane.

  15. 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

  16. Postconditioning with isoflurane reduces acute lung injury induced by cecal ligation and perforation in rats%异氟烷后处理减轻大鼠盲肠结扎穿孔所致急性肺损伤

    Institute of Scientific and Technical Information of China (English)

    吕翔; 董翔; 李启芳; 姜虹; 朱也森

    2012-01-01

    Objective To study the protective effects of isoflurane postcondition on acute lung injury (ALI) induced by cecal ligation and perforation (CLP) in rats. Methods A total of 48 male Sprague-Dawley rats were randomly divided into 4 groups (n = 12): normal group, without any treatment; sham operation group, with incision and closure of abdomen; CLP group, the CLP model was used to induce ALI; and isoflurane group, rats were anesthetized with 1.4% isoflurane at 4 h after CLP modeling for 2 h. Then 6 rats in each group were randomly killed by decapitation 6 h and 24 h after pretreatment. Blood samples of abdominal aorta were taken for arterial blood gas analysis. The tissues of left lung were taken for the determination of lung wet/dry (W/D) ratio. Tumor necrosis factor-a (TNF-α) and interleukin-6 (IL-6) levels were measured with blood sample of heart. Histopathological changes of the right lung and the expression of nuclear factor (NF)-KB were observed by H-E staining and immunohistochemical staining, respectively. Results There were no significant differences in arterial oxygen partial pressure (paO2), the ratio of W/D or serum concentrations of TNF-α and IL-6 between sham operation group and normal group (P>0.05). The paO2 in CLP group and isoflurane group was significantly lower than that in the normal group, while the ratio of W/D and serum concentrations of TNF-a and IL-6 in CLP group and isoflurane group were significantly higher than those in the normal group (P<0. 05). There were significant differences in above mentioned parameters between isoflurane group and CLP group (P<0. 05). There was no obvious lung injury in normal group or sham operation group. The rats in CLP group suffered more serious lung injury as compared with isoflurane group, and the lung injury at 24 h after precondition was much severe than that at 6 h after precondition. The cells with NF-KB expression were occasionally seen in normal group and sham operation group, while a large number

  17. Utility of Bispectral Index (BIS) monotoring during general anesthesia

    OpenAIRE

    Lindholm, Maj-Lis

    2009-01-01

    p>The possibility to objectively measure effects from anesthetics on the level of consciousness has since long been desired. General anesthetics cause changes in brain electrical activity, seen as changes in the electroencephalogram (EEG). Devices utilizing processed EEG for pseudo-quantification of anesthetic depth have been available for more than ten years. These monitors display the anesthetic, or rather, hypnotic depth as an index number. In this thesis, some aspects ...

  18. 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.

  19. Isoflurane anaesthesia in an African wild dog, Lycaon pictus : short communication

    Directory of Open Access Journals (Sweden)

    G.F. Stegmann

    2000-07-01

    Full Text Available Anaesthesia was required in a captive female African wild dog (Lycaon pictus for surgical wound treatment. After it was immobilised with a medetomidine-ketamine combination, bradycardia, hypothermia, systolic hypertension and metabolic acidosis were observed. Surgical anaesthesia was maintained with a 1 %end-tidal isoflurane concentration. A decrease in the arterial blood pressure, rectal temperature and pHoccurred during maintenance of anaesthesia.

  20. Administration and monitoring of intravenous anesthetics

    NARCIS (Netherlands)

    Sahinovic, Marko M.; Absalom, Anthony R.; Struys, Michel M. R. F.

    2010-01-01

    Purpose of review The importance of accuracy in controlling the dose-response relation for intravenous anesthetics is directly related to the importance of optimizing the efficacy and quality of anesthesia while minimizing adverse drug effects. Therefore, it is important to measure and control all

  1. Astaxanthin reduces isoflurane-induced neuroapoptosis via the PI3K/Akt pathway.

    Science.gov (United States)

    Wang, Chun-Mei; Cai, Xiao-Lan; Wen, Qing-Ping

    2016-05-01

    Astaxanthin is an oxygen-containing derivative of carotenoids that effectively suppresses reactive oxygen and has nutritional and medicinal value. The mechanisms underlying the effects of astaxanthin on isoflurane‑induced neuroapoptosis remain to be fully understood. The present study was conducted to evaluate the protective effect of astaxanthin to reduce isoflurane‑induced neuroapoptosis and to investigate the underlying mechanisms. The results demonstrated that isoflurane induced brain damage, increased caspase‑3 activity and suppressed the phosphatidylinositol 3‑kinase (PI3K)/protein kinase B (Akt) signaling pathway in an in vivo model. However, treatment with astaxanthin significantly inhibited brain damage, suppressed caspase‑3 activity and upregulated the PI3K/Akt pathway in the isoflurane‑induced rats. Furthermore, isoflurane suppressed cell growth, induced cell apoptosis, enhanced caspase‑3 activity and downregulated the PI3K/Akt pathway in organotypic hippocampal slice culture. Administration of astaxanthin significantly promoted cell growth, reduced cell apoptosis and caspase‑3 activity, and upregulated the PI3K/Akt pathway and isoflurane‑induced neuroapoptosis. The present study demonstrated that downregulation of the PI3K/Akt pathway reduced the effect of astaxanthin to protect against isoflurane‑induced neuroapoptosis in the in vitro model. The results of the current study suggested that the protective effect of astaxanthin reduces the isoflurane-induced neuroapoptosis via activation of the PI3K/Akt signaling pathway.

  2. Effects of nitrous oxide on cerebral haemodynamics and metabolism during isoflurane anaesthesia in man

    Energy Technology Data Exchange (ETDEWEB)

    Algotsson, L.; Messeter, K. (Department of Anaesthesiology, University Hospital, Lund (Sweden)); Rosen, I. (Department of Clinical Neurophysiology, University Hospital, Lund (Sweden)); Holmin, T. (Department of Surgery, University Hospital, Lund (Sweden))

    1992-01-01

    Seven normoventilated and five hyperventilated healthy adults undergoing cholecystectomy and anaesthetized with methohexitone, fentanyl and pancuronium were studied with measurement of cerebral blood flow (CBF), cereal metabolic rate of oxygen (CMRo[sub 2]), and quantified electroencephalography (EEG) under two sets of conditions: (1) 1.7% end-tidal concentration of isoflurane in air/oxygen: (2) 0.85% end-tidal concentration of isoflurane in nitrous oxide (N[sub 2]O)/oxygen. The object was to study the effects of N[sub 2]O during isoflurane anaesthesia on cerebral circulation, metabolism and neuroelectric activity. N[sub 2]O in the anaesthetic gas mixture caused a 43% (P<0.05) increase in CBF during normocarbic conditions but no significant change during hypocapnia. CMRo[sub 2] was not significantly altered by N[sub 2]O. EEG demonstrated an activated pattern with decreased low frequency activity and increased high frequency activity. The results confirm that N[sub 2]O is a potent cerebral vasodilator in man, although the mechanisms underlying the effects on CBF are still unclear. (au).

  3. Comparison of Isoflurane and Sevoflurane for Controlled Hypotension in Endoscopic Sinus Surgeries and Tympanomastoidectomy

    Directory of Open Access Journals (Sweden)

    B. Yazdi

    2014-07-01

    Full Text Available Introduction & Objective: Even a little bleeding can adversely affect the surgeon's ability to visualize the region to be operated in ENT operations. The aim of this study is to compare the effects of isoflurane and sevoflurane on hemodynamics and bleeding in controlled hypoten-sion. Materials & Methods: This study was a double-blind clinical trial. Ninety patients who were candidates for endoscopic sinus surgery and tympanomastoidectomy in Amirkabir hospital of Arak were randomly assigned into two groups of isoflurane and sevoflurane. Remifentanil was infused at 0.1 µg/kg/min for both groups during surgery and the amount of bleeding and hemodynamic parameter were recorded. The data was analyzed by SPSS-20 and ANOVA statistical test. Results: Underlying and hemodynamic variables were similar between the two groups preop-eratively. The amount of blood loss during surgery showed that there were no significant dif-ferences between the two groups (P=0.802 and no significant differences in hemodynamic variables (heart rate, systolic/diastolic blood pressure and arterial oxygen saturation were observed between the two groups during the surgery. Conclusion: It is concluded that there is no difference between sevoflurane and isoflurane in controlled hypotension. Thus, using these drugs in operations with excessive bleeding is rec-ommended. (Sci J Hamadan Univ Med Sci 2014; 21(2:85-91

  4. Determination of the minimum alveolar concentration for halothane, isoflurane and sevoflurane in the gerbil.

    Science.gov (United States)

    de Segura, I A Gómez; de la Víbora, J Benito; Criado, A

    2009-07-01

    The present work determined the minimum alveolar concentrations (MAC) of halothane, isoflurane and sevoflurane in adult female gerbils (n=24). Animals were placed in a chamber for anaesthetic induction before performing tracheal intubation. The tracheal tube was connected to a non-rebreathing circuit with minimal dead space. Body temperature, blood pressure, heart and respiratory rates and end-tidal volatile anaesthetic levels were measured continuously. MAC was determined using a standard noxious stimulus (tail-clamp). All experiments were performed at the same time of the day, body temperature was maintained constant and blood-gas analysis was performed to confirm that values were within normal limits. The mean+/-SD MAC values were 1.06+/-0.11% halothane (n=8), 1.55+/-0.08% isoflurane (n=8) and 2.90+/-0.12% sevoflurane (n=7). Cardiovascular parameters at 1xMAC did not differ significantly among anaesthetics but the respiratory rate was significantly higher in the halothane group than in the isoflurane and sevoflurane groups. The SpO2 values recorded throughout anaesthesia and the pH and partial oxygen pressure values determined at the end of the study did not differ among the studied anaesthetics at 1xMAC. These data suggest that the MAC for halogenated inhalant anaesthetics in gerbils is lower than the average MAC values obtained in rats and mice.

  5. The acute hypoxic ventilatory response under halothane, isoflurane, and sevoflurane anaesthesia in rats.

    Science.gov (United States)

    Karanovic, N; Pecotic, R; Valic, M; Jeroncic, A; Carev, M; Karanovic, S; Ujevic, A; Dogas, Z

    2010-03-01

    The relative order of potency of anaesthetic agents on the hypoxic ventilatory response has been tested in humans, but animal data are sparse. We examined the effects of 1.4, 1.6, 1.8, and 2.0 MAC halothane, isoflurane, and sevoflurane on phrenic nerve activity in euoxia (baseline) and during acute normocapnic hypoxia (inspired oxygen fraction 0.09) in adult male Sprague-Dawley rats. With halothane, all animals became apnoeic even in euoxia, and the hypoxic response was completely abolished at all anaesthetic levels. With isoflurane, 5 of 14 animals exhibited phrenic nerve activity in euoxia at 1.4 MAC and demonstrated a hypoxic response (302% of baseline activity), but all became apnoeic and lost the hypoxic response at higher doses. With sevoflurane, phrenic nerve activity and a hypoxic response was preserved in at least some animals at all doses (i.e. even the highest dose of 2.0 MAC). Similar to the rank order of potency previously observed in humans, the relative order of potency of depression of the hypoxic ventilatory response in rats was halothane (most depressive) > isoflurane > sevoflurane (p = 0.01 for differences between agents).

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

    OpenAIRE

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

    2011-01-01

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

  7. Anesthetic management for cesarean delivery in a pregnant woman with polymyositis: A case report and review of literature

    OpenAIRE

    Gunusen, Ilkben; Karaman, Semra; Nemli, Seymen; FIRAT, Vicdan

    2009-01-01

    Introduction Polymyositis which is a rare disease both in general population and in pregnancy is systemic connective tissue disorder characterized by inflammation and degeneration of muscles. There is only a little information relating to the anesthetic management of a pregnant woman with polymyositis. Case presentation In this article, we present anesthetic management of urgent cesarean delivery of a 28-year-old parturient with polymyositis under epidural anesthesia who was diagnosed with po...

  8. Trigeminal nerve injury associated with injection of local anesthetics

    DEFF Research Database (Denmark)

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

    2011-01-01

    anesthetics (from 1995 through 2007), 292 reports to the Danish Medicines Agency, Copenhagen, Denmark, of adverse reactions to local anesthetic drugs, and a clinical sample of 115 patients with NSD associated with local anesthetics. The authors assessed lidocaine 2 percent, mepivacaine 2 percent and 3 percent...

  9. 麻醉药的心脑保护作用:最新临床研究证据及展望%Cardio-neuroprotection of anesthetic agents: recent clinical evidence and perspectives

    Institute of Scientific and Technical Information of China (English)

    李新; 熊利泽

    2015-01-01

    Background The cardio-neuroprotective effect of anesthetics has been widely concerned but still controversial.Although strong preclinical data support that anesthetics could attenuate ischemic/hypoxic myocardial and cerebral injury,confirmative conclusions have not been demonstrated from clinical studies.We reviewed clinical trials in recent years(especially randomized controlled trials) on cardio-neuroprotection of commonly used anesthetic agents (volatile anesthetics:isoflurane,sevoflurane,intravenous anesthetics:propofol,dexmedetomidine).Among the mostly studied anesthetics that reveal the property of cardio-neuroprotection,ether-derived volatile anesthetics have shown more promising potentials than intravenous anesthetics,especially in cardiac surgeries.The cardio-neuroprotection of intravenous anesthetic dexmedetomidine was validated in heart surgery by randomized controlled trial with large sample.However,the neuroprotection of anesthetic agents is controversial,and there's lack of simple and objective evaluation indicators for it.Thus,large-scale,multicenter clinical trials are necessary in the future.%麻醉药的心脑保护作用一直广受关注,但仍存在一些争议.尽管多数临床前研究发现常用麻醉药能减轻缺血/缺氧性心脑损伤,但临床研究却未得到确定性结论.综述近年来关于麻醉药心脑保护作用的临床研究,尤其是随机对照研究,结果表明,多数常用的麻醉药(吸入性麻醉药异氟醚、七氟醚,静脉麻醉药丙泊酚、右美托咪定等)均表现出一定的心脏保护作用,其中氟烷类吸入性麻醉药较静脉麻醉药效果更明显,可显著减轻心脏手术患者的心肌损伤.静脉麻醉药中,右美托咪定对心脏手术患者的心肌保护作用在大样本临床研究中得到验证.麻醉药的脑保护作用存在较大争议,也缺少简单、客观的疗效评价指标,还应开展大规模、多中心的临床研究.

  10. Anesthetic management of a neonate with arthrogryposis multiplex congenita for emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Rajat Chowdhuri

    2011-01-01

    Full Text Available Arthrogryposis multiplex congenita is a rare disease, characterized by non-progressive, multiple joint contractures since birth. Anesthetic issues include difficult intravenous access, difficult airway management and regional anesthesia. We report the anesthetic management of a six-day-old neonate presenting to the emergency with features of intestinal obstruction, who was detected for the first time to have arthrogryposis multiplex congenita. General anesthesia along with caudal analgesia for peroperative and postoperative pain relief was used. There was an episode of intraoperative hyperthermia, which was tackled successfully. The child had an uneventful post-anesthesia recovery.

  11. Child with Saethre-Chotzen syndrome: anesthetic management and literature review.

    Science.gov (United States)

    Sharma, A; Patel, N; Arora, S; Ramachandran, R

    2014-01-01

    Saethre-Chotzen syndrome (SCS) is a type of acro-cephalo-syndactyly (ACS) syndrome, characterized by premature fusion of the coronal sutures, facial dysmorphism, syndactyly, skeletal deformity, and congenital heart malformations. We here describe a child with diagnosed SCS, who underwent squint surgery under general anesthesia, and review the anesthetic concerns thereof.

  12. Combined mucopolysaccharidosis type VI and congenital adrenal hyperplasia in a child: Anesthetic considerations

    Directory of Open Access Journals (Sweden)

    Abhishek Bansal

    2012-01-01

    Full Text Available We present a child posted for magnetic resonance imaging of brain under general anesthesia with the rare combination of mucopolysachharidosis type VI and congenital adrenal hyperplasia. The presence of both these disorders has important anesthetic implications. The pathophysiology of this rare combination of disease is reviewed with emphasis on the anesthesia management.

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

    Science.gov (United States)

    Tobe, Masaru; Saito, Shigeru

    2015-10-01

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

  14. Pacemakers and implantable cardioverter defibrillators - general and anesthetic considerations

    Directory of Open Access Journals (Sweden)

    Amy G. Rapsang

    2014-06-01

    Full Text Available A pacemaking system consists of an impulse generator and lead or leads to carry the electrical impulse to the patient's heart. Pacemaker and implantable cardioverter defibrillator codes were made to describe the type of pacemaker or implantable cardioverter defibrillator implanted. Indications for pacing and implantable cardioverter defibrillator implantation were given by the American College of Cardiologists. Certain pacemakers have magnet-operated reed switches incorporated; however, magnet application can have serious adverse effects; hence, devices should be considered programmable unless known otherwise. When a device patient undergoes any procedure (with or without anesthesia, special precautions have to be observed including a focused history/physical examination, interrogation of pacemaker before and after the procedure, emergency drugs/temporary pacing and defibrillation, reprogramming of pacemaker and disabling certain pacemaker functions if required, monitoring of electrolyte and metabolic disturbance and avoiding certain drugs and equipments that can interfere with pacemaker function. If unanticipated device interactions are found, consider discontinuation of the procedure until the source of interference can be eliminated or managed and all corrective measures should be taken to ensure proper pacemaker function should be done. Post procedure, the cardiac rate and rhythm should be monitored continuously and emergency drugs and equipments should be kept ready and consultation with a cardiologist or a pacemaker-implantable cardioverter defibrillator service may be necessary.

  15. A simple method for evaluation of the uptake of isoflurane and its comparison with the square root of time model

    Directory of Open Access Journals (Sweden)

    Ashish Bangaari

    2013-01-01

    Full Text Available Background: The square root of time (SqRT model had been used to predict the uptake of volatile agents. Methods: We studied the rate of uptake of isoflurane in 10 patients using liquid isoflurane infusion through syringe pump into the closed circuit. The infusion rates were titrated to maintain a constant end tidal concentration of isoflurane of 1.5%. The predicted uptake values were also calculated from the square root principle and compared with the derived uptake. Results: The observed rate of uptake was higher than predicted from the Lowe and Ernst equation (P<0.001. There exists considerable inter-individual variability in uptake pharmacokinetics and it showed statistically significant correlation with ideal body weight, body weight (P<0.01, body surface area, and body weight 3/4 from 30 min of start of isoflurane infusion (P<0.05. Conclusion: SqRT model is inaccurate in predicting isoflurane uptake and underestimates it during closed circuit anaesthesia.

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

    Directory of Open Access Journals (Sweden)

    Sara Socorro Faria

    2015-04-01

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

  17. Influence of prior determination of baseline minimum alveolar concentration (MAC) of isoflurane on the effect of ketamine on MAC in dogs.

    Science.gov (United States)

    Gianotti, Giacomo; Valverde, Alexander; Johnson, Ron; Sinclair, Melissa; Gibson, Thomas; Dyson, Doris H

    2014-07-01

    The objective of this study was to determine if prior measurement of the minimum alveolar concentration (MAC) of isoflurane influences the effect of ketamine on the MAC of isoflurane in dogs. Eight mixed-breed dogs were studied on 2 occasions. Anesthesia was induced and maintained using isoflurane. In group 1 the effect of ketamine on isoflurane MAC was determined after initially finding the baseline isoflurane MAC. In group 2, the effect of ketamine on isoflurane MAC was determined without previous measure of the baseline isoflurane MAC. In both groups, MAC was determined again 30 min after stopping the CRI of ketamine. Plasma ketamine concentrations were measured during MAC determinations. In group 1, baseline MAC (mean ± SD: 1.18 ± 0.14%) was decreased by ketamine (0.88 ± 0.14%; P MAC after stopping ketamine was similar (1.09 ± 0.16%) to baseline MAC and higher than with ketamine (P MAC with ketamine (0.79 ± 0.11%) was also increased after stopping ketamine (1.10 ± 0.17%; P MAC values with ketamine were different between groups (P MAC determination. The MAC of isoflurane during the CRI of ketamine yielded different results when methods of same day (group-1) versus separate days (group-2) are used, despite similar plasma ketamine concentrations with both methods. However, because the magnitude of this difference was less than 10%, either method of determining MAC is deemed acceptable for research purposes.

  18. Opioid induced hyperalgesia in anesthetic settings.

    Science.gov (United States)

    Lee, Hyeon Jeong; Yeomans, David C

    2014-11-01

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

  19. Hypoxic pulmonary vasoconstriction: physiology and anesthetic implications.

    Science.gov (United States)

    Lumb, Andrew B; Slinger, Peter

    2015-04-01

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

  20. [Rectal administration of anesthetic agents].

    Science.gov (United States)

    Ceriana, P; Maurelli, M

    1995-05-01

    To collect data in the current literature dealing with the diffusion, the reliability and the effectiveness of the rectal administration of anaesthetic drugs. To evaluate differences with parenteral administration. Pharmacokinetics and clinical studies published in recent years in indexed journals. Based on the study methodology, drugs employed and pharmacokinetic parameters evaluated. Factors involved in absorption of drugs from the rectal mucosa, clinical effect and pharmacokinetic data of the following drugs: diazepam, flunitrazepam, midazolam, ketamin and methohexital, then a brief evaluation of other drugs: thiopental, etomidate, morphine and chloral hydrate. The most widely used drugs are benzodiazepines: they are safe, easy to manage and highly effective; among them midazolam has the best kinetic and dynamic pattern. Ketamin is useful during painful diagnostic procedures; with the use of barbiturates there is a greater risk of respiratory depression and more caution must be employed. Wide intervariability of rate of absorption, achievement of plasma levels and clinical effect is a relevant drawback of this technique, such to make it not preferable to the parenteral route, when both are feasible. It deserves, anyway, more consideration, and maintains its validity for the preparation of the paediatric patient to general anaesthesia.

  1. [Tropical Spastic paraparesis - anesthetic approach].

    Science.gov (United States)

    Rodrigues, Margarida; Cabral, Francisco; Pina, Fátima

    2015-11-25

    HTLV-1 infection is endemic in Japan, Caribbean, Africa, and South America. It is transmitted from mother to child, sexual contact, blood transfusions, or sharing needles. Tropical Spastic paraparesis (TSP) is a chronic degenerative neurological disease associated with this infection. It results from a spinal cord symmetrical degeneration at the thoracic level and is characterized by progressive motor weakness in the lower limbs, hyperreflexia, sensitivity changes, urinary incontinence, and bladder dysfunction. Female, 53 years old, HTLV-1 infection and TSP. She had decreased strength in the lower limbs and hyperreflexia, paretic gait, spasticity, and neurogenic bladder symptoms, with recurrent urinary infections. She was scheduled for cystectomy. The patient was monitored according to standard ASA. Due to severe coagulopathy and the possibility of neurological worsening, epidural catheter was not placed. The induction of general anesthesia was performed with midazolam and fentanyl, followed by etomidate and cisatracurium. She was intubated with a tube size seven and maintained with desflurane and oxygen. Anesthesia was uneventful; the surgery lasted 1 hour and 50minutes. There were no complications in the immediate postoperative period, during hospitalization, nor deterioration of the neurological examination. The patient was discharged 20 days later. There are reports of decreased electromyographic response and neurological deterioration associated with propofol in these patients, etomidate was used. The hepatic metabolism of rocuronium posed a risk, we chose to use cistracurium. It was concluded that the anesthesia chosen did not affect the course of the disease. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  2. Long-Term Isoflurane Therapy for Refractory Bronchospasm Associated with Herpes Simplex Pneumonia in a Heart Transplant Patient

    Directory of Open Access Journals (Sweden)

    C. Hornuss

    2010-01-01

    Full Text Available A 47-year-old man with a history of heart transplant was admitted after severe traumatic brain injury and seizures. During mechanical ventilation, the patient developed bronchospasm that severely compromised respiratory function that led to cardiac arrest. After resuscitation, application of isoflurane through the Anaesthetic Conserving Device (AnaConDa in the ICU successfully treated bronchospasm, provided adequate sedation, and enabled appropriate ventilation and diagnostic bronchoscopy. A subsequent bronchoalveolar lavage revealed a high amount of Herpes simplex DNA. Herpes simplex pneumonia was diagnosed and treated with acyclovir. Isoflurane treatment was applied for twelve days total without side effects on renal and cerebral function. The patient recovered quickly after the termination of sedation. At discharge, he was fully awake without focal neurological deficiency and his long-term outcome was excellent. This case demonstrates that isoflurane is a treatment option in life-threatening cases of bronchospasm and a safe option for long-term sedation.

  3. Cerebral blood flow and metabolism during isoflurane-induced hypotension in patients subjected to surgery for cerebral aneurysms

    DEFF Research Database (Denmark)

    Madsen, J B; Cold, G E; Hansen, E S;

    1987-01-01

    Cerebral blood flow and cerebral metabolic rate for oxygen were measured during isoflurane-induced hypotension in 10 patients subjected to craniotomy for clipping of a cerebral aneurysm. Flow and metabolism were measured 5-13 days after the subarachnoid haemorrhage by a modification of the classi......Cerebral blood flow and cerebral metabolic rate for oxygen were measured during isoflurane-induced hypotension in 10 patients subjected to craniotomy for clipping of a cerebral aneurysm. Flow and metabolism were measured 5-13 days after the subarachnoid haemorrhage by a modification......). Controlled hypotension to an average MAP of 50-55 mm Hg was induced by increasing the dose of isoflurane, and maintained at an inspired concentration of 2.2 +/- 0.2%. This resulted in a significant decrease in CMRO2 (to 1.73 +/- 0.16 ml/100 g min-1), while CBF was unchanged. After the clipping...

  4. Osteocalcin, but not deoxypyridinoline, increases in response to isoflurane-induced anaesthesia in young female guinea pigs.

    Science.gov (United States)

    Tabatabaei, Negar; Rodd, Celia J; Kremer, Richard; Weiler, Hope A

    2015-05-01

    The effect of the inhaled anaesthetic isoflurane was investigated on bone biomarkers, both during maturation and on minerals and glucose postpartum. Female guinea pigs (n = 10) were anaesthetized during maturation (5 and 9 weeks) and postpartum (26 weeks of age) with isoflurane during dual-energy X-ray absorptiometry scanning. Blood collection was performed at all ages before and after anaesthesia for measurement of plasma osteocalcin (OC), total deoxypyridinoline (tDPD), and cortisol. Postpartum measurements also included: blood ions, acid-base parameters and glucose, plasma minerals, total alkaline phosphatase (tALP), and albumin. Plasma OC concentration almost doubled after exposure to isoflurane at 5 weeks (30.1 ± 5.0-57.9 ± 11.2 nmol/L, p  0.05). Blood ionized Ca(2+), Na(+) and plasma total Ca did not change, whereas plasma albumin decreased, and inorganic phosphate (PO4) and Cl(-) increased upon exposure to isoflurane. Isoflurane decreased tALP (43.2 ± 6.6-40.2 ± 5.9 IU/L, p = 0.01) and increased glucose (7.5 ± 0.6-10.9 ± 1.7 mmol/L, p < 0.0001) postpartum. Isoflurane inflates the assessment of a bone-derived biomarker, OC, during rapid growth, but not following pregnancy when formation is very low. Measurements prior to anaesthesia are recommended to reflect normal metabolism.

  5. Labour time required for piglet castration with isoflurane-anaesthesia using shared and stationary inhaler devices.

    Science.gov (United States)

    Weber, Sabrina; Das, Gürbüz; Waldmann, Karl-Heinz; Gauly, Matthias

    2014-01-01

    Isoflurane-anaesthesia combined with an analgesic represents a welfare-friendly method of pain mitigation for castration of piglets. However, it requires an inhaler device, which is uneconomic for small farms. Sharing a device among farms may be an economical option if the shared use does not increase labour time and the resulting costs. This study aimed to investigate the amount and components of labour time required for piglet castration with isoflurane anaesthesia performed with stationary and shared devices. Piglets (N = 1579) were anaesthetised with isoflurane (using either stationary or shared devices) and castrated.The stationary devices were used in a group (n = 5) of larger farms (84 sows/farm on an average), whereas smaller farms (n = 7; 32 sows/farm on an average) shared one device. Each farm was visited four times and labour time for each process-step was recorded. The complete process included machine set-up, anaesthesia and castration by a practitioner, and preparation, collection and transport of piglets by a farmer. Labour time of the complete process was increased (P = 0.012) on farms sharing a device (266 s/piglet) compared to farms using stationary devices (177 s/ piglet), due to increased time for preparation (P = 0.055), castration (P = 0.026) and packing (P = 0.010) when sharing a device. However, components of the time budget of farms using stationary or shared devices did not differ significantly (P > 0.05). Cost arising from time spent by farmers did not differ considerably between the use of stationary (0.28 Euro per piglet) and shared (0.26 Euro) devices. It is concluded that costs arising from the increased labour time due to sharing a device can be considered marginal, since the high expenses originating from purchasing an inhaler device are shared among several farms.

  6. [Infusion of propofol or closed-circuit isoflurane. A study of cost].

    Science.gov (United States)

    Nathan, N; Rezzoug, A; Dolan, P; Bonada, G; Feiss, P

    1993-01-01

    The choice of an anaesthetic agent is influenced by its cost. The use of a circle absorber system decreases the cost of the maintenance of anaesthesia with halogenated agents. Fast recovery and low incidence of postoperative nausea and vomiting are the main advantages of propofol. The cost of propofol can limit its use for the maintenance of anaesthesia except for short procedures. This prospective study compared in 50 ASA 1 and 2 patients the cost of anaesthesia with either propofol (group P, n = 25) or the association thiopentone-isoflurane administered with a rebreathing circuit (group I, n = 25). Patients were premedicated the evening before surgery with 2.5 mg lorazepam. Anaesthesia was induced with either propofol (2-3 mg.kg-1) or thiopentone (4-6 mg.kg-1) and maintained with either propofol (6-10 mg.kg-1.h-1) in group P or isoflurane continuously injected as liquid in the expiratory limb of the circuit in group I. The side effects of anaesthesia and the delay of recovery and discharge from the recovery room were assessed. Peroperative cost of anaesthesia included nitrous oxide, isoflurane and i.v. agents, fluids volumes and disposable devices. The total cost of anaesthesia included also the recovery room stay. The mean duration of anaesthesia was not significantly different between the two groups (109.4 +/- 7.1 min vs 107.3 +/- 7.3 min group P vs group I). The delay lf recovery (eyes opening) was shorter in the propofol group (14.4 +/- 1.3 min vs 19.4 +/- 1.4 min) as well as the delay of discharge from the recovery room (70 +/- 4 min, vs 82.4 +/- 4.6 min).(ABSTRACT TRUNCATED AT 250 WORDS)

  7. [Anesthesia with flunitrazepam/fentanyl and isoflurane/fentanyl. Unconscious perception and mid-latency auditory evoked potentials].

    Science.gov (United States)

    Schwender, D; Kaiser, A; Klasing, S; Faber-Züllig, E; Golling, W; Pöppel, E; Peter, K

    1994-05-01

    There is a high incidence of intraoperative awareness during cardiac surgery. Mid-latency auditory evoked potentials (MLAEP) reflect the primary cortical processing of auditory stimuli. In the present study, we investigated MLAEP and explicit and implicit memory for information presented during cardiac anaesthesia. PATIENTS AND METHODS. Institutional approval and informed consent was obtained in 30 patients scheduled for elective cardiac surgery. Anaesthesia was induced in group I (n = 10) with flunitrazepam/fentanyl (0.01 mg/kg) and maintained with flunitrazepam/fentanyl (1.2 mg/h). The patients in group II (n = 10) received etomidate (0.25 mg/kg) and fentanyl (0.005 mg/kg) for induction and isoflurane (0.6-1.2 vol%)/fentanyl (1.2 mg/h) for maintenance of general anaesthesia. Group III (n = 10) served as a control and patients were anaesthetized as in I or II. After sternotomy an audiotape that included an implicit memory task was presented to the patients in groups I and II. The story of Robinson Crusoe was told, and it was suggested to the patients that they remember Robinson Crusoe when asked what they associated with the word Friday 3-5 days postoperatively. Auditory evoked potentials were recorded awake and during general anaesthesia before and after the audiotape presentation on vertex (positive) and mastoids on both sides (negative). Auditory clicks were presented binaurally at 70 dBnHL at a rate of 9.3 Hz. Using the electrodiagnostic system Pathfinder I (Nicolet), 1000 successive stimulus responses were averaged over a 100 ms poststimulus interval and analyzed off-line. Latencies of the peak V, Na, Pa were measured. V belongs to the brainstem-generated potentials, which demonstrates that auditory stimuli were correctly transduced. Na, Pa are generated in the primary auditory cortex of the temporal lobe and are the electrophysiological correlate of the primary cortical processing of the auditory stimuli. RESULTS. None of the patients had an explicit memory

  8. Adjunct Nitrous Oxide Normalizes Vascular Reactivity Changes after Hemorrhagic Shock in Mice under Isoflurane Anesthesia

    NARCIS (Netherlands)

    Samarska, Iryna V.; van Meurs, Matijs; Buikema, Hendrik; Houwertjes, Martin C.; Wulfert, Francis M.; Molema, Grietje; Epema, Anne H.; Henning, Robert H.

    2009-01-01

    Background: Hemorrhagic shock is associated with changes in vascular responsiveness that may lead to organ dysfunction and, ultimately, multiple organ dysfunction syndrome. Volatile anesthetics interfere with vasoresponsiveness, which may contribute to organ hypoperfusion. in this study, the authors

  9. Xenon and isoflurane improved biventricular function during right ventricular ischemia and reperfusion.

    NARCIS (Netherlands)

    Hein, M.; Roehl, A.B.; Baumert, J.H.; Bleilevens, C.; Fischer, S.; Steendijk, P.; Rossaint, R.

    2010-01-01

    BACKGROUND: Although anesthetics have some cardioprotective properties, these benefits are often counterbalanced by their negative inotropic effects. Xenon, on the other hand, does not influence myocardial contractility. Thus, xenon may be a superior treatment for the maintenance of global hemodynam

  10. Arterial blood gas parameters in pet rabbits anaesthetized using a combination of fentanyl-fluanisone-midazolam-isoflurane.

    Science.gov (United States)

    Benato, L; Chesnel, M; Eatwell, K; Meredith, A

    2013-07-01

    Blood gas analysis is a well-recognized method to monitor pulmonary function, blood oxygenation, ventilation and acid-base status during general anaesthesia. The aim of this study was to report blood gas analysis results in pet rabbits (Oryctolagus cuniculus) obtained during general anaesthesia using a portable clinical analyser. Thirty-two rabbits were premedicated with 0·2 mL/kg fentanyl and fluanisone. Anaesthesia was induced with 0·2 mg/kg midazolam and maintained with 2% isoflurane in oxygen via endotracheal tube. Arterial blood samples were taken from the central ear artery 10 minutes after induction of anaesthesia. Respiratory acidaemia was observed during anaesthesia. Mean ±sd (range) arterial blood pH was 7·33 ±0·08 (7·15 to 7·48). PaCO2 and PaO2 were, respectively, 55·02 ±10·5 (37·7 to 92·1) mmHg and 370·0 ±120·5 (67 to 561) mmHg. Base excess was 2·8 ±3·6 (-3 to 11) mmol/L, HCO3 was 28·73 ±3·07 (23·7 to 35·4) mmol/L and TCO2 was 30·4 ±3·2 (25 to 37) mmol/L. None of the rabbits developed haematoma during arterial blood collection or ischaemia of the pinna during the hospitalization period. Arterial blood gas analysis is a safe and easy to perform diagnostic technique that can contribute to improved safety of rabbit anaesthesia, by providing information on the respiratory and metabolic status of the patient. © 2013 British Small Animal Veterinary Association.

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

    Directory of Open Access Journals (Sweden)

    Katayoun Esfahanizadeh

    2014-09-01

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

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

    Science.gov (United States)

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

    2014-09-01

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

  13. Use of pethidine as an intravenous regional anesthetic.

    Science.gov (United States)

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

    1989-06-01

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

  14. Upper airway collapsibility in anesthetized children.

    Science.gov (United States)

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

    2006-03-01

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

  15. Local anesthetics as pain therapy in horses.

    Science.gov (United States)

    Doherty, Thomas J; Seddighi, M Reza

    2010-12-01

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

  16. Gestational trophoblastic disease with hyperthyroidism: Anesthetic management

    Directory of Open Access Journals (Sweden)

    Puneet Khanna

    2012-01-01

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

  17. Anesthetic considerations in Sheldon-Hall syndrome.

    Science.gov (United States)

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

    2014-05-01

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

  18. Mimosa pudica, Dionaea muscipula and anesthetics.

    Science.gov (United States)

    De Luccia, Thiago Paes de Barros

    2012-09-01

    Some studies showed that anesthetics reduce the response of physical stimuli in Mimosa pudica and in Venus Flytrap (Dionaea muscipula), peculiar plants that have the ability to respond to touch stimuli. In this research we tested the effects of ketamine, lidocaine, diethyl ether, and amlodipine on the movements of Mimosa pudica and Venus Flytrap. With a literature review, we tried to bring elements to theorize about the interaction of these substances with these plants. The angular displacement in Mimosa´s petiole and in Dionaea leaves is what was measured to compare the drugs group with control groups.

  19. Age, minimum alveolar anesthetic concentration, and minimum alveolar anesthetic concentration-awake.

    Science.gov (United States)

    Eger, E I

    2001-10-01

    Two defining effects of inhaled anesthetics (immobility in the face of noxious stimulation, and absence of memory) correlate with the end-tidal concentrations of the anesthetics. Such defining effects are characterized as MAC (the concentration producing immobility in 50% of patients subjected to a noxious stimulus) and MAC-Awake (the concentration suppressing appropriate response to command in 50% of patients; memory is usually lost at MAC-Awake). If the concentrations are monitored and corrected for the effects of age and temperature, the concentrations may be displayed as multiples of MAC for a standard age, usually 40 yr. This article provides an algorithm that might be used to produce such a display, including provision of an estimate of the effect of nitrous oxide. Two defining effects of inhaled anesthetics (immobility in the face of noxious stimulation, and absence of memory) correlate with the end-tidal concentrations of the anesthetics. Thus, these defining effects may be monitored and the results displayed if the concentrations are known and corrected for the effects of age and temperature.

  20. Anesthetic Management of a Child with Mitochondrial Neurogastrointestinal Encephalopathy

    Science.gov (United States)

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

    2015-01-01

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

  1. Anesthetic Management of a Child with Mitochondrial Neurogastrointestinal Encephalopathy

    Directory of Open Access Journals (Sweden)

    Vianey Q. Casarez

    2015-01-01

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

  2. Lidocaine, dexmedetomidine and their combination reduce isoflurane minimum alveolar concentration in dogs.

    Directory of Open Access Journals (Sweden)

    Carlos M Acevedo-Arcique

    Full Text Available The effects of intravenous (i.v. lidocaine, dexmedetomidine and their combination delivered as a bolus followed by a constant rate infusion (CRI on the minimum alveolar concentration of isoflurane (MACISO in dogs were evaluated. Seven healthy adult dogs were included. Anaesthesia was induced with propofol and maintained with isoflurane. For each dog, baseline MAC (MACISO/BASAL was determined after a 90-minute equilibration period. Thereafter, each dog received one of the following treatments (loading dose, CRI: lidocaine 2 mg kg(-1, 100 µg kg(-1 minute(-1; dexmedetomidine 2 µg kg(-1, 2 µg kg(-1 hour(-1; or their combination. MAC was then determined again after 45- minutes of treatment by CRI. At the doses administered, lidocaine, dexmedetomidine and their combination significantly reduced MACISO by 27.3% (range: 12.5-39.2%, 43.4% (33.3-53.3% and 60.9% (46.1-78.1%, respectively, when compared to MACISO/BASAL. The combination resulted in a greater MACISO reduction than the two drugs alone. Their use, at the doses studied, provides a clinically important reduction in the concentration of ISO during anaesthesia in dogs.

  3. Anesthetic management of dental procedures in patients with special needs: A retrospective analysis of 519 patients in North of Turkey

    OpenAIRE

    YILMAZ, Mehmet; ÇAĞLAR TORUN, Aysun; Baş, Burcu; DURAN, Hatice; KÖSE, İlyas; FURUNCUOĞLU, Halit

    2015-01-01

    Special need patients have increased risk for oral diseases throughout their life. Sedation and general anesthesia is generally the preferred treatment for special needs patients though it provides optimal conditions for dental treatment. This study was aimed to describe our anesthetic experience in dental treatments of 519 special needs patients at a dental faculty in the north side of Turkey during a three-year period. The data referring to patient’s demographic information, anesthetic tech...

  4. Prior determination of baseline minimum alveolar concentration (MAC) of isoflurane does not influence the effect of ketamine on MAC in rabbits.

    Science.gov (United States)

    Gianotti, Giacomo; Valverde, Alexander; Sinclair, Melissa; Dyson, Doris H; Gibson, Thomas; Johnson, Ron

    2012-10-01

    The objective of this study was to compare the effect on the minimum alveolar concentration (MAC) of isoflurane when ketamine was administered either after or without prior determination of the baseline MAC of isoflurane in rabbits. Using a prospective randomized crossover study, 8 adult, female New Zealand rabbits were allocated to 2 treatment groups. Anesthesia was induced and maintained with isoflurane. Group 1 (same-day determination) had the MAC-sparing effect of ketamine [1 mg/kg bodyweight (BW) bolus followed by a constant rate infusion (CRI) of 40 μg/kg BW per min, given by intravenous (IV)], which was determined after the baseline MAC of isoflurane was determined beforehand. A third MAC determination was started 30 min after stopping the CRI. Group 2 (separate-day determination) had the MAC-sparing effect of ketamine determined without previous determination of the baseline MAC of isoflurane. A second MAC determination was started 30 min after stopping the CRI. In group 1, the MAC of isoflurane (2.15 ± 0.09%) was significantly decreased by ketamine (1.63 ± 0.07%). After stopping the CRI, the MAC was significantly less (2.04 ± 0.11%) than the baseline MAC of isoflurane and significantly greater than the MAC during the CRI. In group 2, ketamine decreased isoflurane MAC (1.53 ± 0.22%) and the MAC increased significantly (1.94 ± 0.25%) after stopping the CRI. Minimum alveolar concentration (MAC) values did not differ significantly between the groups either during ketamine administration or after stopping ketamine. Under the study conditions, prior determination of the baseline isoflurane MAC did not alter the effect of ketamine on MAC. Both methods of determining MAC seemed to be valid for research purposes.

  5. The effects of anesthetic technique and ambient temperature on thermoregulation in lower extremity surgery.

    Science.gov (United States)

    Ozer, Ayse B; Tosun, Fadime; Demirel, Ismail; Unlu, Serap; Bayar, Mustafa K; Erhan, Omer L

    2013-08-01

    The purpose of our study was to determine the effects of anesthetic technique and ambient temperature on thermoregulation for patients undergoing lower extremity surgery. Our study included 90 male patients aged 18-60 years in American Society of Anesthesiologists Physical Status groups I or II who were scheduled for lower extremity surgery. Patients were randomly divided into three groups according to anesthetic technique: general anesthesia (GA), epidural anesthesia (EA), and femoral-sciatic block (FS). These groups were divided into subgroups according to room temperature: the temperature for group I was 20-22 °C and that for group II was 23-25 °C. Therefore, we labeled the groups as follows: GA I, GA II, EA I, EA II, FS I, and FS II. Probes for measuring tympanic membrane and peripheral temperature were placed in and on the patients, and mean skin temperature (MST) and mean body temperature (MBT) were assessed. Postoperative shivering scores were recorded. During anesthesia, tympanic temperature and MBT decreased whereas MST increased for all patients. There was no significant difference between tympanic temperatures in either the room temperature or anesthetic method groups. MST was lower in group GA I than in group GA II after 5, 10, 15, 20, 60 and 90 min whereas MBT was significantly lower at the basal level (p thermoregulation among anesthetic techniques. Room temperature affected thermoregulation in Group GA.

  6. Risk of acquired methemoglobinemia with different topical anesthetics during endoscopic procedures

    Directory of Open Access Journals (Sweden)

    Vallurupalli S

    2011-07-01

    Full Text Available Srikanth Vallurupalli1, Shalini Manchanda21Division of General Internal Medicine, Department of Medicine, Southern Illinois University School of Medicine, Springfield, IL, USA; 2Division of Pulmonary, Allergy, Critical Care, and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USAIntroduction: Methemoglobinemia is a recognized complication of the use of topical anesthetic sprays. The true scope of the problem or the risk with different topical anesthetic sprays and endoscopic procedures is unknown.Methods: We retrospectively identified all cases of methemoglobinemia that occurred in a university affiliated community hospital from 2001 to 2007.Results: Eleven cases of methemoglobinemia were identified over the 6-year period. Nine (82% occurred with use of benzocaine spray during transesophageal echocardiography (TEE. Patients who developed methemoglobinemia secondary to the topical anesthetic spray compared to other causes were more likely to be older, have lower mean hemoglobin levels (10.5 ± 0.5 g/dL vs 11.3 ± 0.0 g/dL, and a higher mean methemoglobin concentration at diagnosis (40.8% ± 5.2% vs 24% ± 10%. However, only age reached statistical significance (P = 0.004.Conclusion: In a university-affiliated community hospital, topical anesthetic sprays account for most of the burden of methemoglobinemia. Benzocaine use in the context of TEE caused more methemoglobinemia compared to lidocaine and other endoscopic procedures. This observation supports previous data and findings deserve further study.Keywords: methemoglobinemia, benzocaine, lidocaine, transesophageal echocardiography, endoscopy

  7. Effects of a constant rate infusion of detomidine on cardiovascular function, isoflurane requirements and recovery quality in horses.

    Science.gov (United States)

    Schauvliege, Stijn; Marcilla, Miguel Gozalo; Verryken, Kirsten; Duchateau, Luc; Devisscher, Lindsey; Gasthuys, Frank

    2011-11-01

    To examine the influence of a detomidine constant rate infusion (CRI) on cardiovascular function, isoflurane requirements and recovery quality in horses undergoing elective surgery. Prospective, randomized, blinded, clinical trial. Twenty adult healthy horses. After sedation (detomidine, 10 μg kg(-1) intravenously [IV]) and induction of anaesthesia (midazolam 0.06 mg kg(-1) , ketamine 2.2 mg kg(-1) IV), anaesthesia was maintained with isoflurane in oxygen/air (inspiratory oxygen fraction 55%). When indicated, the lungs were mechanically ventilated. Dobutamine was administered when MAPquality and duration were recorded in each horse. For statistical analysis, anova, Pearson chi-square and Wilcoxon rank sum tests were used as relevant. Heart rate (p=0.0176) and ḊO(2) I (p= 0.0084) were lower and SVR higher (p=0.0126) in group D, compared to group S. Heart rate (p=0.0011) and pH (p=0.0187) increased over time. Significant differences in isoflurane requirements were not detected. Recovery quality and duration were comparable between treatments. A detomidine CRI produced cardiovascular effects typical for α(2) -agonists, without affecting isoflurane requirements, recovery duration or recovery quality. © 2011 The Authors. Veterinary Anaesthesia and Analgesia. © 2011 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

  8. Time Course of Isoflurane-Induced Vasodilation: A Doppler Ultrasound Study of the Left Coronary Artery in Mice.

    Science.gov (United States)

    Lenzarini, Francesca; Di Lascio, Nicole; Stea, Francesco; Kusmic, Claudia; Faita, Francesco

    2016-04-01

    Isoflurane is widely used as vasodilator in studies of coronary flow reserve (CFR) in small animals, but the protocols have not been standardized. This study assessed the time course of the increase in isoflurane-induced flow in the mouse coronary artery by pulsed-wave Doppler measurements at 1% isoflurane concentration maintained for 6 min and then increased to 2.5% for 30 min. Velocity-time integral and velocity peak values were best fitted by the sigmoid model, which allowed derivation of the mean time (Tt90 = 14 min) of high-isoflurane needed to reach 90% of the hyperemic plateau value. In subsequent experiments, CFR was measured at 4 min (mean time of literature data) and 14 min of hyperemic response. The 4-min CFR was significantly lower than the 14 -min CFR, and the Bland-Altman plot revealed significant bias of the 4-min CFR against the 14-min CFR. This result suggests that measurements of flow velocity at times shorter than 14 min may be inappropriate for expressing the effective value of CFR.

  9. Effect of isoflurane and sevoflurane on the magnitude and time course of neuromuscular block produced by vecuronium, pancuronium and atracurium.

    Science.gov (United States)

    Vanlinthout, L E; Booij, L H; van Egmond, J; Robertson, E N

    1996-03-01

    We have compared the ability of equipotent concentrations of isoflurane and sevoflurane to enhance the effect of non-depolarizing neuromuscular blocking drugs. Ninety ASA I and II patients of both sexes, aged 18-50 yr, were stratified into three blocker groups (Vec, Pan and Atr), to undergo neuromuscular block with vecuronium (n = 30), pancuronium (n = 30) or atracurium (n = 30), respectively. Within each group, patients were allocated randomly to one of three anaesthetic subgroups to undergo maintenance of anaesthesia with: (1) alfentanil-nitrous oxide-oxygen (n = 10); (2) alfentanil-nitrous oxide-oxygen-isoflurane (n = 10); or (3) alfentanil-nitrous oxide-oxygen-sevoflurane (n = 10) anaesthesia. During maintenance of anaesthesia, end-tidal concentrations of isoflurane, sevoflurane and nitrous oxide were 0.95, 1.70 and 70%, respectively. Both the evoked integrated electromyogram and mechanomyogram of the adductor pollicis brevis muscle were measured simultaneously. In the Vec and Pan groups, a total dose of 40 micrograms kg-1 of vecuronium or pancuronium, respectively, was given, and in the Atr group a total dose of atracurium 100 micrograms kg-1. Each blocker was given in four equal doses and administered cumulatively. We showed that 0.95% isoflurane and 1.70% sevoflurane (corresponding to 0.8 MAC of each inhalation anaesthetic, omitting the MAC contribution of nitrous oxide) augmented and prolonged the neuromuscular block produced by vecuronium, pancuronium and atracurium to a similar degree.

  10. Effects of dose-dependent levels of isoflurane on cerebral blood flow in healthy subjects studied using positron emission tomography

    DEFF Research Database (Denmark)

    Schlünzen, L; Cold, G E; Rasmussen, Mads

    2006-01-01

    BACKGROUND: In this study, we tested the hypothesis that escalating drug concentrations of isoflurane are associated with a significant decline in cerebral blood flow (CBF) in regions sub-serving conscious brain activity, including specifically the thalamus. METHODS: Nine human volunteers receive...

  11. Dose-response and concentration-response relation of rocuronium infusion during propofol nitrous oxide and isoflurane nitrous oxide anaesthesia

    NARCIS (Netherlands)

    Kansanaho, M; Olkkola, KT; Wierda, JMKH

    1997-01-01

    The dose-response and concentration-response relation of rocuronium infusion was studied in 20 adult surgical patients during proporfol-nitrous oxide and isoflurane (1 MAC) -nitrous oxide anaesthesia. Neuromuscular block was kept constant, initially at 90% and then at 50% with a closed-loop feedback

  12. Instabilidade hemodinâmica grave durante o uso de isoflurano em paciente portador de escoliose idiopática: relato de caso Severe hemodynamic instability during the use of isoflurane in a patient with idiopathic scoliosis: case report

    Directory of Open Access Journals (Sweden)

    Adriano Bechara de Souza Hobaika

    2007-04-01

    ámica grave causada por isoflurano en pacientes previamente saludables. Anafilaxia, taquicardia supraventricular con repercusión hemodinámica y sensibilidad cardiaca aumentada al isoflurano son discutidas como posibles causas de la inestabilidad hemodinámica. Actualmente, existen evidencias de que el isoflurano pude interferir en el sistema de acoplamiento y desacoplamiento de la contratilidad miocárdica a través de la reducción del Ca2+ citosólico y/o deprimiendo la función de las proteínas contráctiles. Los mecanismos moleculares fundamentales de este proceso deben ser elucidados todavía. El relato sugiere que la administración del isoflurano fue la causa de las alteraciones hemodinámicas presentadas por el paciente y que este, probablemente, presentó una sensibilidad cardiovascular no común al fármaco.BACKGROUND AND OBJECTIVES: Isoflurane is considered a safe inhalational anesthetic. It has a low level of biotransformation, and low hepatic and renal toxicity. In clinical concentrations, it has minimal negative inotropic effect, causes a small reduction in systemic vascular resistance, and, rarely, can cause cardiac arrhythmias. The objective of this report was to present a case of severe hemodynamic instability in a patient with idiopathic scoliosis. CASE REPORT: Male patient, 13 years old, ASA physical status I, with no prior history of allergy to medications, scheduled for surgical repair of idiopathic scoliosis. After anesthetic induction with fentanyl, midazolam, propofol, and atracurium, 1% isoflurane with 100% oxygen was initiated for anesthesia maintenance. After five minutes, the patient presented severe hypotension (MAP = 26 mmHg associated with sinus tachycardia (HR = 166 bpm that did not respond to the administration of vasopressors and fluids. Lung and heart auscultation, pulse oxymetry, capnography, nasopharyngeal temperature, and arterial blood gases did not change. The patient was treated for anaphylaxis and the surgery was cancelled. The

  13. 复方利多卡因乳膏对喉罩插入不良反应的抑制作用%Surface anesthetic effect of compound lidocaine cream-coated laryngeal mask airway in patients undergoing modified radical mastectomy under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    张锦英; 沈途

    2011-01-01

    目的 观察复方利多卡因乳膏乳癌改良根治术中喉罩插入时不良反应的抑制作用.方法 择期行全麻乳癌改良根治术的患者80例,ASA Ⅰ~Ⅲ级,随机均分为复方利多卡因乳膏喉罩组(A组)和石蜡油喉罩组(B组),将复方利多卡因乳膏和石蜡油涂抹于喉罩表面.麻醉诱导后插入喉罩,记录麻醉诱导前、喉罩插入前、喉罩插入即刻及喉罩插人后3 min患者SBP、DBP、HR,以及术后咽痛或咽部不适的发生率.结果 与喉罩插入前和A组比较,B组喉罩插入即刻和喉罩插入后3min时SBP、DBP明显升高,HR明显增快(P<0.01).A组患者术中呛咳和术后咽痛、咽部不适感发生率明显低于B组(P<0.05).结论 复方利多卡因乳膏能有效抑制全麻乳癌改良根治术中喉罩插人所引起的咽反射和术后咽痛.%Objective To evaluate the surface anesthetic effect of compound lidocaine crearcoated laryngeal mask airway (LMA) in patients undergoing modified radical mastectomy under general anesthesia. Methods Eighty ASA Ⅰ-Ⅲ patients undergoing modified radical mastectomy under general anesthesia received insertion of LMA coated with either compound lidocaine cream (group A, n = 40) or paraffin oil (group B, n = 40). Systolic blood pressure(SBP), diastolic blood pressure(DBP) and heart rate(HR)were measured during LMA insertion. Incidence of irritating cough and sore throat was recorded after operation. Results Compared with group B, not only SBP, DBP or HR at 0 min, 3 min after LMA insertion were lower, but the incidence of irritating cough and sore throat was significantly also lower in group A (P<0. 01). SBP, DBP and HR at 0 min, 3 min after LMA insertion was higher than that before LMA insertion in B group ( P< 0. 01 ). Conclusion Compound lidocaine cream-coated LMA can inhibit the pharyngeal reaction and reduce the incidence of sore throat in patients undergoing modified radical mastectomy under general anesthesia.

  14. 复方利多卡因乳膏在喉罩全麻腹腔镜胆囊切除术中的应用%Surface anesthetic effect of compound lidocaine cream-coated laryngeal mask airway in patients undergoing laparoscopic cholecystectomy and general anesthesia