Consciousness In Anesthesia Research Articles

Impact of wrist-ankle acupuncture on propofol dosage under the dual monitoring of density spectrum array and anesthesia consciousness index in elderly patients undergoing urologic surgery: a sham-controlled randomized clinical trial.

Propofol is a widely used intravenous anesthetic in clinic. However, it is easy to cause serious circulatory fluctuation in elderly patients, so the dose should be reduced as appropriate. Studies have shown that wrist-ankle acupuncture (WAA) can reduce the dosage of propofol in patients undergoing painless endoscopy. Unfortunately, there is no report on whether WAA will reduce the dosage of propofol when used for anesthesia in elderly patients. The purpose of this study is to observe the effect of WAA on propofol dosage in elderly patients, and to provide a new method for maintaining circulatory stability in elderly patients under general anesthesia. From October 2022 to December 2022, Hebei Provincial Hospital of Traditional Chinese Medicine was selected. Forty-four elderly patients undergoing general anesthesia in urology department were randomly divided into two groups according to the complete random method with WAA group, consisting of 22 individuals, and non-WAA (NWAA) group, also consisting of 22 individuals. Both groups were treated with WAA or false needle acupuncture at the same site before anesthesia, respectively, and the needle was kept until the operation was finished. During the operation, the dosage of propofol was adjusted according to the depth of field monitoring density spectrum array (DSA) and anesthesia consciousness index (Ai) with anesthesia monitor. A total of 44 patients participated in this study, and all of them completed the experiment. There were no significant difference in sex, age, height, weight, duration of anesthesia, liver and kidney function, score of Fried frailty scale, activity of daily living (ADL), age-adjusted Charlson comorbidity index (aCCI) and mini-cognitive test (Mini-Cog) between the two groups (P>0.05), but the total dose of propofol (WAA =121.5, NWAA =170.5) mg and maintenance dose (WAA =1.02±0.55, NWAA =1.76±0.67) mg/kg/h, utilization rate of vasoactive drugs during operation, recovery time after anesthesia (WAA =2, NWAA =3) min and surgeon satisfaction (WAA =9, NWAA =8.5) had significant differences (P<0.05). Compared with NWAA group, WAA group could reduce the dosage of propofol in anesthesia for elderly patients with exocrine secretion and was beneficial to circulatory stability. Chinese Clinical Trial Registry (ID: ChiCTR2100054132).

Consistency of the anesthesia consciousness index versus the bispectral index during laparoscopic gastrointestinal surgery with sevoflurane anesthesia: A prospective multi-center randomized controlled clinical study.

This study aimed to compare the consistency of anesthesia consciousness index (Ai) with that of bispectral index (BIS) in monitoring the depth of anesthesia (DOA) during sevoflurane anesthesia, to reveal the optimal cutoff values in different states of consciousness, and explore the stability of DOA monitoring during intraoperative injurious stimulation. We enrolled 145 patients (97 men and 48 women) from 10 medical centers. General anesthesia was induced using intravenous anesthetics and maintained with sevoflurane. Ai and BIS values were recorded. The mean difference between the Ai and BIS was-0.1747 (95% confidence interval, -0.6660 to 0.3166; p = 0.4857). The regression equation of Ai and BIS from the Deming regression analysis was y = 5.6387 + 0.9067x (y is BIS, x is Ai), and the slope and intercept were statistically significant. Meanwhile, the receiver operating characteristic curve analysis of anesthesia-induced unconsciousness, loss of consciousness, and recovery of consciousness revealed that the accuracy of Ai and BIS were similar. In addition, the optimal cutoff values of the different states of consciousness were not sensitive to age, and both Ai and BIS had no correlation with hemodynamics. We conclude that Ai and BIS show no systematic deviation in readings with high consistency, similar accuracy, and good stability; these insights provide more data for clinical application.

GABAergic neurons in the dorsomedial hypothalamus regulate states of consciousness in sevoflurane anesthesia

The neural inhibitory gamma-aminobutyric acid (GABA) system in the regulation of anesthetic consciousness is heterogeneous, and the medial hypothalamus (MH), consisting of ventromedial hypothalamus (VMH) and dorsomedial hypothalamus (DMH), plays an important role in sleep and circadian rhythm. However, the role of MH GABAergic neurons (MHGABA) in anesthesia remains unclear. In this study, we used righting reflex, electroencephalogram (EEG), and arousal behavioral score to evaluate the sevoflurane anesthesia. Activation of MHGABA or DMHGABA neurons prolonged the anesthesia induction time, shortened the anesthesia emergence time, and induced EEG arousal and body movement during anesthesia; meanwhile, VMHGABA neurons activated only induced EEG changes during 1.5% sevoflurane anesthesia. Furthermore, inhibition of DMHGABA neurons significantly deepened sevoflurane anesthesia. Therefore, DMHGABA neurons exert a strong emergence-promoting effect on induction, maintenance, and arousal during sevoflurane general anesthesia, which helps to reveal the mechanism of anesthesia.

Study of functional connectivity during anesthesia based on sparse partial least squares

Anesthesia consciousness monitoring is an important issue in basic neuroscience and clinical applications, which has received extensive attention. In this study, in order to find the indicators for monitoring the state of clinical anesthesia, a total of 14 patients undergoing general anesthesia were collected for 5 minutes resting electroencephalogram data under three states of consciousness (awake, moderate and deep anesthesia). Sparse partial least squares (SPLS) and traditional synchronized likelihood (SL) are used to calculate brain functional connectivity, and the three conscious states before and after anesthesia were distinguished by the connection features. The results show that through the whole brain network analysis, SPLS and traditional SL method have the same trend of network parameters in different states of consciousness, and the results obtained by SPLS method are statistically significant ( P<0.05). The connection features obtained by the SPLS method are classified by the support vector machine, and the classification accuracy is 87.93%, which is 7.69% higher than that of the connection feature classification obtained by SL method. The results of this study show that the functional connectivity based on the SPLS method has better performance in distinguishing three kinds of consciousness states, and may provides a new idea for clinical anesthesia monitoring.

A Therapy for Anesthetic Consciousness

A Therapy for Anesthetic Consciousness

Breakdown of local information processing may underlie isoflurane anesthesia effects.

The disruption of coupling between brain areas has been suggested as the mechanism underlying loss of consciousness in anesthesia. This hypothesis has been tested previously by measuring the information transfer between brain areas, and by taking reduced information transfer as a proxy for decoupling. Yet, information transfer is a function of the amount of information available in the information source—such that transfer decreases even for unchanged coupling when less source information is available. Therefore, we reconsidered past interpretations of reduced information transfer as a sign of decoupling, and asked whether impaired local information processing leads to a loss of information transfer. An important prediction of this alternative hypothesis is that changes in locally available information (signal entropy) should be at least as pronounced as changes in information transfer. We tested this prediction by recording local field potentials in two ferrets after administration of isoflurane in concentrations of 0.0%, 0.5%, and 1.0%. We found strong decreases in the source entropy under isoflurane in area V1 and the prefrontal cortex (PFC)—as predicted by our alternative hypothesis. The decrease in source entropy was stronger in PFC compared to V1. Information transfer between V1 and PFC was reduced bidirectionally, but with a stronger decrease from PFC to V1. This links the stronger decrease in information transfer to the stronger decrease in source entropy—suggesting reduced source entropy reduces information transfer. This conclusion fits the observation that the synaptic targets of isoflurane are located in local cortical circuits rather than on the synapses formed by interareal axonal projections. Thus, changes in information transfer under isoflurane seem to be a consequence of changes in local processing more than of decoupling between brain areas. We suggest that source entropy changes must be considered whenever interpreting changes in information transfer as decoupling.

Raising Cost Consciousness in Anesthesia

Raising Cost Consciousness in Anesthesia

Brain Control: A Critical Examination of Brain Stimulation and Psychosurgery By Elliot S. Valenstein (review)

noist, Livingstone, Roberts, and Spuhler are notable exceptions. However, the total of the areas of human genetic interest blanketed provides a useful survey of recent and current research activities in human genetics and displays many of the weaknesses and strengths of existing knowledge. The volume includes papers on gene-frequency differences in human populations ; the use of the omnipresent blood gene markers; studies on isolate and hybrid populations and inbreeding; and demographic methods. The measurement of population distances and computer simulations are discussed in a number of papers. A number of geographic populations are assayed and compared , and the studies on population structures in Micronesia by Morton and his colleagues are models of excellence that budding anthropologists in this field may attempt to emulate. In general, this compendium is a useful source book for graduate students embarking on genetic research in physical anthropology. It is not as comprehensive and encompassing as The Genetics ofHuman Populations by Cavalli-Sforza and Bodmer, and it overlaps considerably with both The Assessment of Population Affinities in Man edited by Weiner and Huizinga and TL· Structure of Human Populations edited by Harrison and Boyce. In the latter two volumes, papers similar to a few in the book under review appear, written by the same authors. Ronald Singer University of Chicago Brain Control: A Critical Examination of Brain Stimulation and Psychosurgery. By Elliot S. Valenstein. New York: Wiley-Interscience, 1973. Pp. 407. $10.95. There is a great deal of antagonism to science and scientists in our society based on unintelligibility. Science is indeed complicated, and intelligibility is a problem even for scientists working within one particular field. But laymen and scientists working in other fields all too often hear from the "bad" scientists, those trying to get publicity among laymen because they failed among their own colleagues. This book convincingly reveals Valenstein as one of the "good" scientists. It is not only an admirable primer for neurologists, neurosurgeons, physiologists, psychologists, and interested laymen, but for anyone who reads, because we have all been brainwashed by grossly inaccurate information. Thus, the stage hypnotist merely cons his subjects into a pseudo performance that appears as hypnotism—to get laughs and entertain his audience. More seriously, psychosurgery has given rise to preposterous allegations with all the popular appeal of crime and science fiction. This book beautifully shows that—apart from clinical anesthesia—consciousness cannot be controlled; it can only control itself. Jacobus W. Mostert, M.D. University of Chicago Perspectives in Biology and Medicine · Autumn 1974 | 145 THE NEED TO COMMUNICATE Communication That's our station And please be clear Stating what we want to hear. Communicate That's our fate. I and thou Will work somehow. This verbal art of mine Serves as a glimmering paradigm. Why is the burden to communicate Placed upon those who innovate? Draft a white paper And feel much safer One sided, but you see, Perhaps you must communicate with me. In the end We should amend. Our reluctance to innovate Parallels our willingness to communicate. The administrator's ploy To make an alloy Of reason Is always in season. There's comfort in our differences That we conjure up by inferences. So you pause and let us ruminate And devise our plan to castigate. On the vine you'll wither While we talk about the weather. But if you too hesitate Yours shall be the similar fate. So this admonition may I share To assure you that I do care, For your own welfare 'Tis essential that you beware of the need to communicate. R. Hullinger 146 I Verse ...