Deep Anesthesia Research Articles

Electroencephalographic and Cardiovascular Assessments of Isoflurane-Anesthetized Dogs.

This study investigated the use of frontal electroencephalography (EEG) to monitor varying levels of isoflurane anesthesia in dogs. The patient state index (PSI), burst suppression ratio (SR), and waveforms, were continuously recorded while mean arterial blood pressure (MBP), heart rate, responses to electric stimuli, and subjective anesthetic "depth" were assessed every 3 min. At deep anesthesia (2.5× MAC - 3.2%), the PSI (6.5 ± 10.8) and MBP (45.6 ± 16.4 mmHg) were the lowest, and SR was the highest (78.3 ± 24.0%). At 1× MAC (1.3%), the PSI and MBP increased significantly to 47.8 ± 12.6 and 99.8 ± 13.2, respectively, and SR decreased to 0.5 ± 2.5%. The EEG was predominantly isoelectric at 2×-2.5× MAC, indicating unconsciousness and unresponsiveness. As anesthesia lightened, waveforms transitioned to flatter and faster activity patterns with a response to noxious stimuli, suggesting regained consciousness. The PSI and MBP exhibited a stronger correlation (ρ = 0.8098, p = 0.001) than the relationship of PSI with heart rate (ρ = -0.2089, p = 0.249). Five of the six dogs experienced rough recovery, possibly due to high SR and low MBP. These findings suggest that EEG monitoring in dogs can be a valuable tool for the real-time tracking of brain states and can be used to guide the management of isoflurane anesthesia.

The temporal asymmetry of cortical dynamics as a signature of brain states

The brain is a complex non-equilibrium system capable of expressing many different dynamics as well as the transitions between them. We hypothesized that the level of non-equilibrium can serve as a signature of a given brain state, which was quantified using the arrow of time (the level of irreversibility). Using this thermodynamic framework, the irreversibility of emergent cortical activity was quantified from local field potential recordings in male Lister-hooded rats at different anesthesia levels and during the sleep-wake cycle. This measure was carried out on five distinct brain states: slow-wave sleep, awake, deep anesthesia–slow waves, light anesthesia–slow waves, and microarousals. Low levels of irreversibility were associated with synchronous activity found both in deep anesthesia and slow-wave sleep states, suggesting that slow waves were the state closest to the thermodynamic equilibrium (maximum symmetry), thus requiring minimum energy. Higher levels of irreversibility were found when brain dynamics became more asynchronous, for example, in wakefulness. These changes were also reflected in the hierarchy of cortical dynamics across different cortical areas. The neural dynamics associated with different brain states were characterized by different degrees of irreversibility and hierarchy, also acting as markers of brain state transitions. This could open new routes to monitoring, controlling, and even changing brain states in health and disease.

Down regulation of the c-Fos/MAP kinase signaling pathway during learning memory processes coincides with low GnRH levels in aluminum chloride-induced Alzheimer's male rats.

Aluminum chloride (Al) is associated with Alzheimer's disease (AD) and reproductive disorders. But the relationship between gonadotropin-releasing hormone (GnRH) and c-Fos levels, the end product of MAP-kinase signaling, in AD is unknown, so we aimed to investigate this relationship. We exposed rats to Al dissolved in drinking water (10 and 50mg/kg) for two and four weeks. The control group received only drinking water. At the end, the blood sample was collected under deep anesthesia and the brain was dissected on ice, and the testicular tissue was fixed in formalin. Amyloid beta (βA) plaques in brain regions and the number of CA1 neurons were evaluated by Congo red staining and cresyl violet staining. Activation of neuronal nitric oxide synthase (nNOS) was studied using NADPH-diaphorase. The levels of c-Fos and testosterone receptors in the target area were examined immunohistochemically. Brain GnRH levels were determined by blotting, and serum levels of gonadotropins and steroids were measured by enzyme-linked immunosorbent assay (ELISA). All data were analyzed using analysis of variance (ANOVA) at α = 0.05 level. The accumulation of βA plaque was observed along with a decrease in the number of CA1 pyramidal neurons and a significant decrease in the levels of c-Fos and GnRH in the brains of rats receiving Al, which was aligned with a significant decrease in serum levels of testosterone and LH. This study, for the first time, showed a link between dementia and a concomitant decrease in brain GnRH and c-Fos levels.

Spinal anesthesia for endoscopic submucosal dissection of large recto-sigmoid lesions: a feasibility study

Background and study aims: Colorectal endoscopic submucosal dissection (ESD) is often challenging and time-consuming. Prolonged sedation and general anesthesia are associated with a relevant risk of anesthesia-related adverse events (ARAEs), especially in elderly and difficult airway patients. Spinal anesthesia (SA), a simple technique providing analgesia and motor block without systemic drug administration, has never been described in gastrointestinal endoscopy. We assessed the feasibility of SA in colorectal lesion ESD. Patients and methods: We retrospectively collected data on all consecutive patients who underwent ESD for colorectal laterally spreading tumors (LSTs) under SA in our Center during the last three years. We evaluated the rates of technical success, i.e. ESD completion under SA without need of conversion to deep sedation or general anesthesia, and ARAEs after SA. Results: ESD under SA was performed on 20 recto-sigmoid LSTs ≥35 mm. Technical success was achieved in 95.0% (19/20) of cases, while one patient (5.0%) required conversion to deep sedation. Two patients (10.0%) experienced acute urinary retention that was successfully treated with temporary catheterization. Conclusions: Our initial experience suggests that SA for ESD of large recto-sigmoid LSTs is feasible, and it may prove to be a valuable option especially for elderly and frail patients.

A new herbal anesthetic agent for common carp (Cyprinus carpio) sedation and anesthesia: nutmeg (Myristica fragrans) essential oil.

In aquaculture, interest in natural essential oils is increasing alongside synthetic anesthetic agents. In this context, the anesthetic efficacy of nutmeg essential oil, which had not been previously tested, was investigated in common carp (Cyprinus carpio). The study, conducted using three different concentrations (800 μL/L "LC", 1,200 μL/L "MC", and 1,400 μL/L "HC"), found that induction times were <3 min for MC and HC, while LC had a longer induction time, exceeding acceptable levels. Within the first 4 h, white blood cells, red blood cells, hemoglobin, and hematocrit levels increased to >5 103/μL, >1 106/μL, >6 g/dL, and >12%, respectively. However, they returned to control levels after 8 h. Histological signs were more severe with higher concentrations, and necrosis was only observed in the HC group. Alkaline comet assay results showed DNA migration only in the HC group. According to the PROMETHEE multi-criteria decision-making model, the LC concentration is suitable for sedation, while the MC concentration should be used for deep anesthesia. The current study demonstrates that nutmeg essential oil can be used as an alternative to commercial synthetic anesthetic agents.

Metabolic Rate of Goldfish (Carassius auratus) in the Face of Common Aquaculture Challenges.

This study examined the metabolic rate (MO2, oxygen consumption) of goldfish (Carassius auratus) under normal management conditions in aquaculture. Using an intermittent respirometry system, we assessed daily variations and the effects of feeding, handling, temperature increase, and anesthetics. MO2 exhibited a daily rhythm, with higher values during day. Feeding to satiety produced a 35% increase in MO2 compared to fasted animals, with a maximum peak after 3 h and returning to baseline after 7 h. Handling stress (5 min) produced a 140% MO2 peak (from 180 to 252 mg O2 kg-1 h-1), returning to the routine MO2 after 2.5 h. An increase in water temperature (+0.1 °C min-1) up to 30 °C caused MO2 to peak at 200% after 2.5 h from the start of the temperature increase. The use of common anesthetics in aquaculture (MS-222, 2-phenoxyethanol and clove oil in deep anesthesia concentration) affects MO2 during the first few minutes after anesthetic recovery, but also during the following 4 h. It can be concluded that the metabolic rate is a good indicator of the goldfish's response to aquaculture practices involving energy expenditure and stress. Thus, intermittent respirometry is a valuable non-invasive tool for understanding and improving fish welfare in aquaculture.

Use of dexmedetomidine during light versus deep anaesthesia on postoperative delirium among elderly patients undergoing major non-cardiac surgery: protocol for a multicentre randomised factorial trial.

Elderly patients are at a high risk of postoperative delirium (POD), leading to increased postoperative morbidity and mortality. The use of dexmedetomidine and depth of anaesthesia may influence POD. This study aims to determine the effects of dexmedetomidine infusion versus normal saline placebo during light versus deep anaesthesia on POD among elderly patients undergoing major non-cardiac surgery. This prospective, multicentre, randomised, controlled, factorial trial will be conducted at three tertiary hospitals in Jiangsu, China. We will recruit a total of 420 patients who are at least 60 years old and undergoing major non-cardiac surgery (thoracic, abdominal, urology, orthopaedic and spine surgery) under general anaesthesia. Patients will be randomised (1:1:1:1) to receive one of four anaesthesia regimens: (1) dexmedetomidine and light anaesthesia, (2) dexmedetomidine and deep anaesthesia, (3) placebo and light anaesthesia or (4) placebo and deep anaesthesia. Dexmedetomidine will be infused at 0.5 µg/kg/h throughout surgery, and intraoperative bispectral index target will be 55 for light anaesthesia and 40 for deep anaesthesia. The primary outcome is the occurrence of POD during the first 7 days postoperatively or until hospital discharge, assessed using the 3-min Confusion Assessment Method two times per day. The secondary outcomes include days with POD, type of POD, pain scores at rest and on movement at 24 and 48 hours postoperatively, patient-controlled intravenous fentanyl consumption during 0-24 and 24-48 hours postoperatively, hypotension, bradycardia, postoperative nausea and vomiting, non-delirium complications, length of postoperative hospital stay, 30-day cognitive function and 30-day mortality. Data will be analysed on a modified intention-to-treat basis. This trial was approved by the Ethics Committee of the First Affiliated Hospital of Soochow University and each participating centre. The trial results will be published in a peer-reviewed journal. Chinese Clinical Trial Registry (ChiCTR2300073271).

Integrative approach for supernumerary teeth: a single-center retrospective analysis.

This study aimed to provide a comprehensive case analysis from a single center, with the objective of clarifying the optimal timing and recommendations for a preferred treatment strategy customized to the specific presentation of each type of supernumerary tooth identified in the research. A retrospective study was conducted on patients who presented with a supernumerary tooth and were treated interdisciplinarily at the clinic. In total, 55 patients with 81 supernumerary teeth of the permanent dentition were analyzed, 30 males and 25 females. The dentition status of the patients was as follows: 31 patients with mixed dentition, no patients with primary dentition, and 24 patients with permanent dentition. The diagnosis of supernumerary tooth was primarily made by general or pediatric dental practitioners and/or orthodontists. Patients were then referred to maxillofacial surgeons for treatment decision. The timing of treatment was mainly determined by the oral surgeon, based on the recommendations of the other specialists involved. Cases involving maleruption or malalignment of permanent teeth required both surgical and orthodontic treatment. Patients over 9 years old were treated either under local anesthesia or sedation, whereas those under 9 years old were treated under deep sedation or general anesthesia. A comprehensive investigation of cases involved the utilization of CBCT at the supernumerary tooth site to facilitate treatment planning. There was a significant correlation between younger age and the preference for treatment under sedation or general anesthesia (P &#61; .01, t test). Similarly, a strong association was found between younger age and the need for additional orthodontic treatment (P &#61; .016, t test). Cases of surgical removal of a supernumerary tooth at a young age typically did not require orthodontic traction of the permanent tooth, in contrast to cases of late surgical intervention (patients over 11 years old), which often did necessitate such traction. There was a strong tendency for treating supernumerary teeth in the maxilla. The proximity of supernumerary teeth to vital anatomical landmarks significantly influenced treatment decisions. Patients with supernumerary teeth near the mental foramen or the inferior dental canal in the premolar area were exclusively placed under follow-up care (P &#61; .002, Pearson chi-square test). However, in the maxilla, the proximity of supernumerary teeth to vital structures such as the floor of the nose and the incisive nerve did not affect the treatment approach, and those supernumerary teeth were mostly removed. A team approach for managing supernumerary teeth is recommended. The timing of treatment should carefully consider the advantages and disadvantages of early versus late intervention. Early surgical treatment in cases where eruption is disturbed might result in spontaneous eruption, eliminating the need for orthodontic traction of the permanent teeth.

The evaluation of anaesthetic efficacy of Coriandrum sativum essential oils in three-spotted tilapia (Oreochromis andersonii): a study of fish size and water temperature

The present study aimed to determine the anaesthetic effectiveness, safety, and applicable concentrations of coriander (Coriandrum sativum) essential oils (CEO) for three-spotted tilapia (Oreochromis andersonii). For this purpose, CEO concentrations of 400, 500, and 600 µL/L were tested at two temperatures, 20.90 ± 1.19 °C and 30.60 ± 0.92 °C, on three different sizes (small, medium, and large) of the fish in duplicate glass aquaria with 200 mg/L of tricaine methanesulfonate (MS-222) served as the control. The sedative efficacy during simulated transportation experiments was also carried out. The results demonstrated that the induction and recovery time in O. andersonii anaesthetised with CEO were significantly influenced by concentration, water temperature, and fish size (P < 0.05). A concentration of 600 µL/L of CEO was found to be highly effective in inducing deep anesthesia and promoting rapid recovery in small and medium-sized fish at both water temperatures (20 and 30 °C). Based on this study, 100 µL/L of CEO is recommended for short-term transportation lasting up to 4 h, while 50 µL/L is advised for longer-distance transport. Although coriander essential oil shows anaesthetic effectiveness in three-spotted tilapia, further research is needed to fully understand the efficacy and safety of CEO across different fish species.

Local wakefulness-like activity of layer 5 cortex under general anaesthesia.

Consciousness, defined as being aware of and responsive to one's surroundings, is characteristic of normal waking life and typically is lost during sleep and general anaesthesia. The traditional view of consciousness as a global brain state has evolved toward a more sophisticated interplay between global and local states, with the presence of local sleep in the awake brain and local wakefulness in the sleeping brain. However, this interplay is not clear for general anaesthesia, where loss of consciousness was recently suggested to be associated with a global state of brain-widesynchrony that selectively involves layer 5 cortical pyramidal neurons across sensory, motor and associative areas. According to this global view, local wakefulness of layer 5 cortex should be incompatible with deep anaesthesia, a hypothesis that deserves to be scrutinised with causal manipulations. Here, we show that unilateral chemogenetic activation of layer 5 pyramidal neurons in the sensorimotor cortex of isoflurane-anaesthetised mice induces a local state transition from slow-wave activity to tonic firing in the transfected hemisphere. This wakefulness-like activity dramatically disrupts layer 5 interhemispheric synchrony with mirror-image locations in the contralateral hemisphere, but does not reduce the level of unconsciousness under deep anaesthesia, nor in the transitions to/from anaesthesia. Global layer 5synchrony may thus be a sufficient condition for anaesthesia-induced unconsciousness, but is not a necessary one, at least under isoflurane anaesthesia. Local wakefulness-like activity of layer 5 cortex can be induced and maintained under deep anaesthesia, encouraging further investigation into the local vs. global aspects of anaesthesia-induced unconsciousness. KEY POINTS: The neural correlates of consciousness have evolved from global brain states to a nuanced interplay between global and local states, evident in terms of local sleep in awake brains and local wakefulness in sleeping brains. The concept of local wakefulness remains unclear for general anaesthesia, where the loss of consciousness has been recently suggested to involve brain-wide synchrony of layer 5 cortical neurons. We found that local wakefulness-like activity of layer 5 cortical can be chemogenetically induced in anaesthetised mice without affecting the depth of anaesthesia or the transitions to and from unconsciousness. Global layer 5synchrony may thus be a sufficient but not necessary feature for the unconsciousness induced by general anaesthesia. Local wakefulness-like activity of layer 5 neurons is compatible with general anaesthesia, thus promoting further investigation into the local vs. global aspects of anaesthesia-induced unconsciousness.

Assessment of the effect of tricaine (MS-222)-induced anesthesia on brain-wide neuronal activity of zebrafish (Danio rerio) larvae.

Fast and effective anesthesia is the key for refining many invasive procedures in fish and gaining reliable data. For fish as for all vertebrates, it is also required by European law to reduce pain, suffering, and distress to the unavoidable minimum in husbandry and experiments. The most often used substance to induce anesthesia in zebrafish is tricaine (MS-222). When properly prepared and dosed, tricaine causes rapid loss of mobility, balance and reaction to touch. These signs are interpreted as a stage of deep anesthesia although its effects on the central nervous system have not convincingly been shown. Therefore, it might be possible that tricaine first acts only on the periphery, resulting in a paralyzed instead of an anesthetized fish. This has severe implications for animals undergoing procedures. To investigate the effects of tricaine on the central nervous system, we used zebrafish larvae [Tg(elavl3:H2B-GCaMP6s)] at 4 days post fertilization (dpf), expressing a calcium indicator (GCaMP6s) in all neurons, that allows monitoring and quantifying the neuronal activity. After treating larvae with 168 mg/L tricaine, a rapid loss of neuronal activity in the forebrain was observed in confocal microscopy. In contrast, only mild effects were seen in the midbrain and hindbrain. In conclusion, the different larval brain areas showed differences in the sensitivity to tricaine treatment. The effects on the central nervous system are indicative of tricaine's anesthetic function and are consistent with behavioral observations of inactivity and unresponsiveness to touch.

Evaluation of Neuroprotective Effects of Local Hypothermia in a Porcine Spinal Cord Injury Model

Abstract The goal of this study was to assess the therapeutic potential of a 5-hour local spinal cord (SC) hypothermia by 4 °C saline on preservation of SC tissue at the injury epicentre and 3 cranial and caudal 10 mm long SC segments in a porcine experimental model of spinal cord injury (SCI). The SCI was inflicted through L3 laminectomy by a metallic rod moved by a velocity of 30 mm.sec−1, and operated by a computer-controlled apparatus. A group of 15 female minipigs 5‒8-month-old weighing 28‒35 kg was randomly divided into 5 subgroups (each composed of 3 animals): 1) sham controls; 2) SCI by force 8N; 3) SCI by force 8N, 5-hour hypothermia; 4) SCI by force 15N; 5) SCI by force 15N, 5-hour hypothermia. After a 9-week survival period, the minipigs were in deep general anaesthesia transcardially perfused by 5000 ml of saline and fixed by 5000 ml 4 % neutral paraformaldehyde. White and grey SC matter damage was evaluated in specimens cut from the epicentre of injury as well as 3 cranial and 3 caudal 10 mm long SC blocks dyed according to Luxol fast blue (LFB) with cresyl violet (CV) protocol for light microscopic observations. The percentage of preserved SC white and grey matter was assessed in microphotographs and compared with data from sham controls (considered 100 %). The data were statistically evaluated by ANOVA test, the difference P ˂ 0.05 was considered significant. Results of the study suggest that 5-hour local cooling of the epicentre of SCI is well tolerated and facilitates the preservation of SC tissue integrity. Additional experimental and preclinical studies are necessary before introducing the method in practice.

Clinical evaluation of bispectral index‐guided closed‐loop infusion of propofol for preschool children: A multi‐center randomized controlled study

ABSTRACTImportanceThe closed‐loop infusion system can automatically adjust and maintain the depth of anesthesia by using the propofol target‐controlled infusion (TCI) model under the feedback guidance of the bispectral index (BIS).ObjectiveTo evaluate the safety and superiority of closed‐loop TCI of propofol guided by BIS during maintenance of generalized intravenous anesthesia for preschool children.MethodsA total of 120 children aged 1–6 years were enrolled and were divided into a closed‐loop feedback group (Group C) and an open‐loop manual control group (Group O), with 60 participants in each group. For anesthesia maintenance, the propofol infusion rate was adjusted by the injection system under the guidance of BIS in Group C and was manually adjusted by anesthesiologists according to the BIS and clinical experience in Group O, to maintain a BIS level of 50. The time ratio of adequate anesthesia (40 ≤ BIS ≤ 60), light anesthesia (BIS &gt; 60), and deep anesthesia (BIS &lt; 40) were recorded.ResultsA total of 119 patients (59 in Group C and 60 in Group O) were enrolled in the study. Group C demonstrated a higher time ratio of adequate anesthesia (P = 0.014) compared to Group O. The time ratio of light anesthesia and the global score was lower in Group C than in Group O (P = 0.010, P = 0.015, respectively). The frequency of adjustment per unit of time was higher in Group C for propofol (P &lt; 0.001), while it was lower for remifentanil (P = 0.010).InterpretationBIS‐guided closed‐loop infusion of propofol is safe and effective for preschool children. The depth of anesthesia is controlled more accurately and smoothly.

Comparison of societal guidance on perioperative management of glucagon-like peptide-1 receptor agonists: implications for clinical practice and future investigations.

The use of glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) by patients undergoing surgery and procedures requiring anesthesia has become a topic of significant concern for perioperative providers because of the potential increased risk of aspiration resulting from the medication's effect of delaying gastric emptying. There is currently a lack of high-quality data regarding the safety of GLP-1 RAs in patients undergoing surgery, which has led to variations in practice. We performed an internet search of society-endorsed statements and guidelines related to perioperative management of GLP-1 RAs, focusing on the top 20 countries with the largest anesthesiology societies determined by membership data from the World Federation of Societies of Anesthesiologists. We excluded articles and websites that were not in English. Our search revealed endorsed statements from fourteen major anesthesiology, endocrinology, and gastroenterology societies. There was considerable variation between societies in the recommendations and guidance for withholding these medications before surgery, the duration of withholding, assessment of the need for avoiding deep sedation or general anesthesia, use of rapid sequence intubation, need for prolonged fasting periods and clear fluid before a nil per os period, recognition of signs and symptoms for aspiration risk, the management of glucose in the perioperative period, and the use of point-of-care ultrasound for risk assessment. Society-endorsed statements and guidelines provide varying recommendations on the perioperative management of GLP-1 RAs. The insights gained from this comparative analysis may help guide clinical practice, develop institutional practice guidelines, and direct future research efforts.

Chaotic nature of the electroencephalogram during shallow and deep anesthesia: From analysis of the Lyapunov exponent

In conscious states, the electrodynamics of the cortex are reported to work near a critical point or phase transition of chaotic dynamics, known as the edge-of-chaos, representing a boundary between stability and chaos. Transitions away from this boundary disrupt cortical information processing and induce a loss of consciousness. The entropy of the electroencephalogram (EEG) is known to decrease as the level of anesthesia deepens. However, whether the chaotic dynamics of electroencephalographic activity shift from this boundary to the side of stability or the side of chaotic enhancement during anesthesia-induced loss of consciousness remains poorly understood. We investigated the chaotic properties of EEGs at two different depths of clinical anesthesia using the maximum Lyapunov exponent, which is mathematically regarded as a formal measure of chaotic nature, using the Rosenstein algorithm. In 14 adult patients, 12 s of electroencephalographic signals were selected during two depths of clinical anesthesia (sevoflurane concentration 2% as relatively deep anesthesia, sevoflurane concentration 0.6% as relatively shallow anesthesia). Lyapunov exponents, correlation dimensions and approximate entropy were calculated from these electroencephalographic signals. As a result, maximum Lyapunov exponent was generally positive during sevoflurane anesthesia, and both maximum Lyapunov exponents and correlation dimensions were significantly greater during deep anesthesia than during shallow anesthesia despite reductions in approximate entropy. The chaotic nature of the EEG might be increased at clinically deeper inhalational anesthesia, despite the decrease in randomness as reflected in the decreased entropy, suggesting a shift to the side of chaotic enhancement under anesthesia.

Phytochemical Analysis and in vivo Toxicity Study of Extracted Walnut oil in Sprague Dawley Rats

Background: Medicinal plants have been the focus of scientific research for many decades worldwide, especially those used in traditional medicine. Objective: To perform the phytochemical analysis of extracted walnut oil (EWO) and its subchronic toxicity profile in Sprague Dawley rats. Methods: In this experimental study, the collected Kurdish walnut was authenticated by an authorized taxonomist and the core was obtained. Then, the walnut oil was extracted using the cold press method and sent for phytochemical analysis using GC-MS. Accordingly, the male Sprague Dawley rats were treated with varying doses of the EWO for four consecutive weeks, and animals were checked daily for abnormality and toxicity behaviours while they were weighed each week. At the end of the study, animals were sacrificed under deep anaesthesia, blood samples and organs were collected, and various hematological and biochemical tests were performed together with histopathological analysis. Results: GC-MS analysis showed that EWO contained 49 compounds, some critical in biomedical fields. The body weight of all treated animals was increased significantly. No significant changes were seen for hematological tests except platelets, which decreased in all treated groups (p = 0.015) compared to the control group. At the same time, AST and chloride levels were decreased (p = 0.002 and p = 0.012, respectively), while total protein and calcium were increased (p = 0.004 and p = 0.033, respectively). Simultaneously, histopathological analysis showed no severe lesions in the brain, moderate lesions in the liver and mild, moderate and severe lesions in the kidneys. Conclusions: EWO is rich in various compounds that contain active medicinal components. The EWO can be used at low doses as it does not affect most hematological and biochemical tests and has no significant toxicity in the vital organs of experimental rats.

The role of depth of general anesthesia in serum CGRP and SP level in diabetes patients.

Diabetes, which is associated with cardiovascular disease and related microvascular complications, affects life expectancy and decrease quality of life. A trial reports that the risk of patients with diabetes having cardiovascular disease is 2-4 times compared with that in patients without diabetes. This study aims to investigate the relationship between depth of general anesthesia in patients with diabetes mellitus. This clinical study totally includes 40 patients with diabetes mellitus, and these patients are divided into following two groups: diabetes mellitus deep anesthesia group and diabetes mellitus light anesthesia group, and then these patients receive general anesthesia combined with laparoscopic surgery. Preoperative patient general data and intraoperative patient general data are collected and analyzed. Calcitonin gene-related peptide (CGRP) and substance P (SP) level are determined by Enzyme-linked immunosorbent assay (ELISA). This study included a total of 40 patients. There were no significant differences in demographic and preoperative patient general data between the two groups. Measurements were taken for operative time, anesthesia time, recovery time after drug withdrawal, dwell time in the recovery room, intraoperative fluid volume, intraoperative blood loss, and intraoperative urine output between the two groups. Significant differences were observed in the recovery time after drug withdrawal between the two groups. CGRP and SP level in diabetes mellitus deep anesthesia group are evidently more than those in diabetes mellitus light anesthesia group. CGRP and SP level are involved in the diabetes mellitus and up-regulated CGRP and SP can prevent the development of diabetes mellitus. Our study extends the existing literature by addressing a gap in knowledge regarding the impact of anesthesia depth on neuropeptide levels in diabetes mellitus patients. By delineating this relationship, we aim to contribute to the advancement of perioperative care practices and ultimately improve outcomes for individuals with diabetes undergoing surgical procedures. Our study's findings provide valuable insights into the complex interactions between anesthesia, neuropeptides, and diabetes mellitus, offering the potential for personalized perioperative care, enhanced pain management, and improved surgical outcomes. These implications highlight the clinical relevance of our research and its potential to inform future advancements in perioperative care for diabetic patients undergoing surgery.

Characterization of a novel Ca2+-Activated potassium channel in rat brain rough endoplasmic reticulum

ObjectivesPotassium channels in the endoplasmic reticulum (ER) are crucial for maintaining calcium balance during calcium fluxes. Disruption in ER calcium balance leads to ER stress, implicated in diseases like diabetes and Alzheimer's disease (AD). However, limited data exists on ER potassium channels in excitable tissues such as the brain. To fill this gap, we aimed to evaluate potassium currents in rat brain rough endoplasmic reticulum (RER). MethodsRats were euthanized under deep anesthesia and their brains were immediately removed. The brains were then homogenized in ice-cold sucrose buffer, followed by the extraction of RER microsomes through a series of centrifugation processes. Purity of sample was evaluated using western blotting technique. Single channel recordings were done in voltage steps from +50 to −60 mV following incorporation of rat brain RER vesicles into planar bilayers. ResultsWe observed a voltage-dependent potassium channel with an approximate conductance of 188 pS. Channel open probability was low at negative voltages, increasing at positive voltages. The channel was blocked by Charybdotoxin but not by Iberiotoxin. Additionally, TRAM-34, a specific KCa3.1 channel blocker, suppressed channel current amplitude and open probability. Western blot analysis revealed specific bands for anti-KCa3.1 antibody, approximately 50 kDa in brain homogenate and RER fraction. ConclusionOur study provides strong evidence for the presence of an KCa3.1 channel on the RER membrane in rat brain, exhibiting distinct electro-pharmacological profile compared to plasma membrane and other organelles.

Protium heptaphyllum essential oil from the fruit as a sedative and anesthetic in Rhamdia quelen: influence in cardiac frequency, biochemical, and oxidative parameters.

This study aimed to evaluate the effects of Protium heptaphyllum fruit essential oil (PHEO) on the physiology of silver catfish (Rhamdia quelen) during anesthesia and recovery, through studying echocardiograms, oxidative status, and metabolic parameters. Three experiments were performed: (1) 50 silver catfish juveniles were submitted to anesthesia and recovery tests with 300, 400, 500, 600, and 700mg L-1 of PHEO. (2) Echocardiogram analysis was performed in anesthetized and non-anesthetized fish. (3) Biochemical parameters were evaluated at 0, 30, 60, and 120min of recovery after being anesthetized for 3min with 600mg L-1 PHEO. Times to sedation and deep anesthesia were reduced with PHEO increasing concentrations. The echocardiogram showed a higher cardiac rate in anesthetized fish. Plasma glucose levels increased in control fish through recovery time, but anesthetized fish showed lower levels than controls at 120min of recovery. Metabolic parameters such as plasma and hepatic glucose did not show changes considering the recovery time of up to 120min. Hepatic glycogen, lactate, and triglycerides reduced their levels over recovery times. Fish anesthetized enhanced superoxide dismutase activity and thiobarbituric acid reactive substances levels but decreased reduced glutathione (GSH) levels at 30min compared to controls. After 60min, GSH values were significantly higher in anesthetized fish than in controls. These results suggest that PHEO at 600mg L-1 is an effective anesthetic for the rapid handling of silver catfish, providing stable metabolic parameters and enhanced antioxidant responses during recovery. Echocardiogram analysis confirms the anesthetic effect, supporting PHEO as a viable and efficient option for fish anesthesia in aquaculture. The use of PHEO in aquaculture can enhance fish welfare by reducing stress during handling and transportation, potentially leading to improved growth, health, and survival rates.

Effect of dexamethasone pretreatment using deep learning on the surgical effect of patients with gastrointestinal tumors.

To explore the application efficacy and significance of deep learning in anesthesia management for gastrointestinal tumors (GITs) surgery, 80 elderly patients with GITs who underwent surgical intervention at our institution between January and September 2021 were enrolled. According to the preoperative anesthesia management methodology, patients were rolled into a control (Ctrl) group (using 10 mg dexamethasone 1-2 hours before surgery) and an experimental (Exp) group (using a deep learning-based anesthesia monitoring system on the basis of the Ctrl group), with 40 cases in each group. A comprehensive comparative analysis was performed between the two cohorts, encompassing postoperative cognitive evaluations, Montreal Cognitive Assessment (MoCA) scores, gastrointestinal functionality, serum biomarkers (including interleukin (IL)-6, C-reactive protein (CRP), and cortisol levels), length of hospitalization, incidence of complications, and other pertinent metrics. The findings demonstrated that anesthesia monitoring facilitated by deep learning algorithms effectively assessed the anesthesia state of patients. Compared to the Ctrl group, patients in the Exp group showed significant differences in cognitive assessments (word recall, number connection, number coding) (P<0.05). Additionally, the Exp group exhibited a notably increased MoCA score (25.3±2.4), significantly shorter time to first flatus postoperatively (35.8±13.7 hours), markedly reduced postoperative pain scores, significantly shortened time to tolerate a liquid diet postoperatively (19.6±5.2 hours), accelerated recovery of serum-related indicators, and a significantly decreased mean length of hospital stay (11.4±3.2 days) compared to the Ctrl group. In summary, administering dexamethasone under the anesthesia management of GITs surgery based on gradient boosting decision tree (GBDT) and pharmacokinetics pharmacodynamics (PKPD) models can promote patient recovery, reduce the incidence of postoperative cognitive impairment (POCD), and improve patient prognosis.