Different Doses Of Propofol Research Articles

Comparison of Two Intravenous Propofol Doses after Jugular Administration for Short Non-Surgical Procedures in Red-Eared Sliders (Trachemys scripta elegans).

This study compares the effects of two different doses of propofol administered intravenously (IV), in the jugular vein, to red-eared sliders (Trachemys scripta elegans). In this crossover study, 5 or 10 mg/kg propofol was administered to six Trachemys scripta elegans after cannulation of the jugular vein. Each turtle received each dose, G1 (5 mg/kg IV) and G2 (10 mg/kg IV), after a 7-day washout period. The parameters evaluated were heart rate, palpebral reflex, cloacal reflex, muscle relaxation, ease of handling, sensitivity to anterior and posterior pinch stimuli, and possibility of intubation. Additionally, respiratory rate was measured when possible, and the times from propofol administration to full recovery and from intubation to extubation were recorded. None of the turtles in G1 could be intubated, and this dose provided little relaxation and ease of handling, with a duration of effect until full recovery of 12.16 ± 8.32 (SD) min for this group. In G2, five out of the six turtles could be intubated, and the duration of effect was 32.33 ± 5.85 (SD) min. Heart rates were influenced by manipulation for catheter placement. There were statistically significant differences (p value ≤ 0.05) between the two groups in muscle relaxation degree, handling, cloacal reflex, and possibility of intubation. The 5 mg/kg propofol dose was not sufficient to induce anesthesia, even when administered in the jugular vein, in red-eared sliders. A dose of 10 mg/kg IV or higher should be used.

Retracted: Effect of Different Doses of Propofol on Pulmonary Function and Inflammatory Response in Patients with Lung Ischemia Reperfusion Injury Induced by One-Lung Ventilation Based on Big Data Analysis.

[This retracts the article DOI: 10.1155/2022/7677266.].

Intravenous anesthesia with different doses of propofol combined with etomidate for painless colonoscopy in elderly obese patients: Effectiveness and impact on neurocognitive disorders

Intravenous anesthesia with different doses of propofol combined with etomidate for painless colonoscopy in elderly obese patients: Effectiveness and impact on neurocognitive disorders

Effect of Different Doses of Propofol on Pulmonary Function and Inflammatory Response in Patients with Lung Ischemia Reperfusion Injury Induced by One-Lung Ventilation Based on Big Data Analysis.

Objective To analyze the effect of different doses of propofol on pulmonary function and inflammatory response in patients with lung ischemia reperfusion injury (LIRI) induced by one-lung ventilation (OLV) based on big data analysis. Methods A retrospective study was performed on 105 patients who underwent lobectomy in our hospital (January 2018 to January 2022). According to the doses of propofol, they were split into low-dose group (LDG), middle-dose group (MDG), and high-dose group (HDG), which received the continuous micropump infusion of propofol at the doses of 2 mg/(kg·h), 5 mg/(kg·h), and 10 mg/(kg·h) after induction, respectively, with 35 cases in each group. The indexes, such as the pulmonary function and inflammatory factors of patients, at different times were compared. The logistic regression analysis was performed according to the occurrence of LIRI. Results With no notable difference at T0 among the three groups (P > 0.05), the Cdyn levels significantly decreased at T1 (P < 0.05) and gradually increased at T2. The Cdyn levels at T1 and T2 were remarkably higher in HDG and MDG than in LDG (P < 0.05). With no notable differences at T0 and T1 among the three groups (P > 0.05), the PA-aO2 levels and RI values at T2 in MDG and HDG were lower compared with LDG (P < 0.05). The RI values at T1 and T2 in HDG were higher compared with MDG, with no obvious difference (P > 0.05). The OI levels at T1 and T2 in HDG were lower compared with the other two groups (P < 0.05), and the OI levels at T1, T2, and T3 in LDG were higher compared with MDG, with no obvious difference (P > 0.05). The TNF-α and ICAM-1 levels at T1 and T2 in MDG and HDG were lower compared with LDG, with no obvious difference between MDG and HDG (P > 0.05). Compared with LDG, the MDG and HDG at T1 and T2 had lower MDA levels (P < 0.05) and higher SOD levels (P < 0.05). Logistic regression analysis showed that Cdyn, PA-aO2, and OLV time were independent risk factors for LIRI in patients undergoing lobectomy. Conclusion Propofol has a good protective effect on lung function in patients with OLV-induced LIRI. Appropriately increasing the dose of propofol can effectively improve the local cerebral hypoxia and lung compliance of patients and reduce the inflammatory response and oxidative stress response, with 5 mg/(kg·h) as the clinical reference. Preoperative assessment and preparation should be made for patients, close attention should be paid to risk factors, such as Cdyn and PA-aO2, and OLV time should be controlled.

English

BACKGROUND Stress response to intubation produces marked hemodynamic changes during direct laryngoscopy using muscle relaxants. Since attenuation of hemodynamic response to laryngoscopy and tracheal intubation leads to better outcomes, a method for providing good intubating conditions rapidly without using muscle relaxants is being sought. The objective of the present study was to compare the hemodynamic changes occurring while intubating with 2 different doses of propofol. METHODS We compared heart rate, systolic blood pressure, diastolic pressure and mean arterial pressure changes during tracheal intubation with 2 different propofol doses without using muscle relaxants. Intravenous fentanyl inhibits the sympathetic nervous response to direct laryngoscopy and tracheal intubation in both groups of patients and acts as pre-emptive analgesia. RESULTS Comparison of the hemodynamic parameters revealed no statistically significant differences between the low dose propofol (PL) and high dose propofol (PH) groups with regard to heart rate or blood pressure changes at similar intervals postintubation. Both patient groups showed blood pressure fall along with a reflex increase in heart rate at 1 minute to 5 minutes post-intubation, returning to nearbaseline values 10 minutes post-intubation. None of these changes was either clinically detrimental or produced incidents of desaturation or arrhythmias in any study patient. CONCLUSIONS Low dose propofol may be useful in elderly or mildly hypovolemic patients, intolerant to a higher drug dosage whereas, the higher propofol dose may be particularly useful in the adult with a higher muscle mass in situations where muscle relaxant is to be restricted or avoided. KEY WORDS Tracheal Intubation, Hemodynamic Changes, Different Doses Propofol.

NPAS4 suppresses propofol-induced neurotoxicity by inhibiting autophagy in hippocampal neuronal cells

Propofol, a general intravenous anesthetic, has been demonstrated to cause a profound neuroapoptosis in the developing brain followed by long-term neurocognitive impairment. Our study aimed to examine the neuroprotective effect of neuronal PAS domain protein 4 (NPAS4), an activity-dependent neuron-specific transcription factor, on propofol-induced neurotoxicity in hippocampal neuronal HT22 cells. The differentially expressed genes in HT22 cells after treatment with propofol were screened from Gene Expression Omnibus dataset GSE106799. NPAS4 expression in HT22 cells treated with different doses of propofol was investigated by qRT-PCR and Western blot analysis. Cell viability, lactate dehydrogenase (LDH) release, caspase-3 activity, and apoptosis were evaluated by MTT, a LDH-Cytotoxicity Assay Kit, a Caspase-3 Colorimetric Assay Kit, and TUNEL assay, respectively. The protein levels of LC3-I, LC3-II, Beclin 1, p62 and NPAS4 were detected using Western blot analysis. Propofol treatment concentration-dependently decreased NPAS4 expression in HT22 cells. Propofol treatment inhibited cell viability, increased LDH release and caspase-3 activity, and induced apoptosis and autophagy in HT22 cells. NPAS4 overexpression suppressed propofol-induced cell injury and autophagy in HT22 cells. Mechanistically, autophagy agonist rapamycin attenuated the neuroprotective effect of NPAS4 in propofol-treated HT22 cells. In conclusion, NAPS4 overexpression protected hippocampal neuronal HT22 cells against propofol-induced neurotoxicity by reducing autophagy.

Effect of Different Doses of Propofol and Nerve block Combined with General Anesthesia on The Intraoperative Anesthesia and Postoperative Awakening and Cognitive Function in Elderly Patients with Knee Osteoarthritis

Objective. To explore the effect of different doses of propofol and nerve block combined with general anesthesia on the intraoperative anesthesia and postoperative awakening and cognitive function in elder patients with knee osteoarthritis (OA). Methods. According to the inclusion criteria for research object, we selected 98 elderly patients with knee OA who needed surgery and were admitted to our hospital from January 2019 to January 2021 for the study. Patients were divided into the low dose group (given 2 mg/kg propofol by pumping under constant speed during surgery) and the high dose group (given 4 mg/kg propofol by pumping during surgery) by the number table method to compare their indicators including the intraoperative anesthesia effect, with 49 cases in each group. Results. No between-group difference was shown in the anesthesia time and postoperative VAS scores, but the awakening time of the low dose group was significantly shorter than that of the high dose group (P&lt;0.05); the differences in heart rate (HR) values at various time points between the two groups were not obvious, but the high dose group obtained significantly higher HR values at T4 than the low dose group; the mean arterial pressure (MAP) values of both groups were significantly reduced at Ti and then returned to the level before anesthesia (P&gt;0.05); the bispectral index scores (BIS) of both groups experienced a marked drop at Ti and then recovered gradually, but failed to return to the level at T0 till the end, and a between-group difference in BIS indexes presented at Ti; the plasma corticosterone (CORT) concentration at Ti of both groups were significantly lowered and then returned to the level at T0, with no between-group difference; and compared with the low dose group, the high dose group achieved slightly lower mini-mental state examination (MMSE) scores at 24-72 h after surgery, with no significant difference between them (P&gt;0.05). Conclusion. The therapy of different doses of propofol and nerve block combined with general anesthesia has no significant effect on the cognitive function in elderly knee OA patients after surgery. With the nerve block improving the analgesic effect, a low dose of propofol is good for the postoperative awakening of patients. Different doses of propofol inhibited the stress response to a different degree and produced good anesthesia outcomes in elderly patients, but comparatively speaking, a low-dose propofol ensures more smooth indexes and less effect on the intraoperative hemodynamics.

Hemodynamic impact of increasing time between fentanyl and propofol administration during anesthesia induction: a randomised, clinical trial

Background and objectiveAnesthesia induction can produce severe propofol dose-dependent hypotension. Fentanyl coadministration reduces the catecholaminergic response to orotracheal intubation allowing propofol dose reduction. The aim of this study is to determine whether the hemodynamic response is improved by increasing the time between fentanyl and propofol administration and reducing the dose of the latter without increasing the time to achieve optimal hypnosis. MethodsAfter approval by the Research Ethics Committee, patients undergoing non-cardiac surgery with endotracheal intubation were randomized by a computer-generated table into six time-dose groups (1 or 2...minutes/1, 1.5, or 2...mg.kg-1 of propofol). Patients with high bronchoaspiration risk, a difficult airway, hemodynamic instability, or anesthetic allergies were excluded. After giving intravenous fentanyl (2.....g.kg-1), each group received different doses of propofol after 1 or 2...minutes. Noninvasive blood pressure (BP) and heart rate (HR) were measured at pre-induction, pre-intubation, and post-intubation. Time to hypnosis (bispectral index < 60) was also recorded. ResultsOf the 192 recruited patients, 186 completed the study (1...min group n...=...94; 2...min group n...=...92). It was observed that HR and BP decreased after propofol administration and increased after intubation in all groups (p...<...0.0001). In patients over 55 years, the 2 min ... 2 mg.kg-1 group showed the greatest systolic BP reduction (36........12%) at pre-intubation, while the 1...min.........1.5...mg.kg-1 group showed the least hemodynamic alteration between pre- and post-intubation (-4........13%). No significant differences were found in younger patients or in the time to reach hypnosis between the six groups. While no cases of severe bradycardia were recorded, 5,4% of the sample required vasopressors. ConclusionIncreasing the time between the administration of fentanyl and propofol by up to two minutes results in greater hypotension in patients over 55 years.

Pharmacologic Provocative Testing in Combination With Intraoperative Neurophysiologic Monitoring During Arteriovenous Malformation Embolization

To review our use of pharmacologic provocative testing (PT) and intraoperative neurophysiologic monitoring (IONM) during endovascular embolization for eloquent arteriovenous malformations (AVMs), and better define their clinical utility. This is a prospective study between 1 June 2018 and 1 June 2020. Prior to endovascular embolization, superselective PTs with propofol injection were performed. The PT results were assessed by IONM. The impact of different doses of propofol on PT results was compared. Under general anesthesia, 111 PTs and 48 endovascular embolizations were performed in 22 patients. For the initial 48 PTs before planned embolization, 38 PTs with 5 mg propofol were negative and repeat PTs with 7 mg propofol were also negative. For the remaining 10 positive PTs, the microcatheter tip was adjusted to an alternative site until repeat PTs were negative to ensure a subsequent safe embolization. In comparison, 5-mg-propofol PT results were consistent with 7-mg-propofol PTs in larger-sized feeders, whereas for smaller-sized vessels, 3-mg-propofol PT results were consistent with 5-mg-propofol PTs. The negative predictive value of PTs was 97.9% (47 of 48), as only 1 of the 48 embolizations with negative PTs resulted in postoperative hemorrhage and none of the other 47 embolizations led to a postoperative neurologic deficit. PTs and IONM are valuable techniques to predict neurologic deficits and improve procedure decision-making during AVM embolization under general anesthesia. A 5-mg dose of propofol may be sufficient for PTs in larger-sized feeders and a 3-mg dose may be sufficient in smaller-sized feeding branches.

Effect of Propofol and Fentanyl on Brain Oxidative Stress after Systemic Lipopolysaccharide Injection in Rats

Systemic inflammation causes brain oxidative stress, a prerequisite for neurodegeneration. In this study, we investigated the effect of the anesthetic agents propofol and fentanyl on brain oxidative stress during mild systemic endotoxemia induced by lipopolysaccharide (LPS) endotoxin. For this purpose, rats were administered LPS (400 μg/kg, intraperitoneally; i.p.), treated at the same time with different doses of propofol or fentanyl, i.p., and euthanized 4 h later. Other groups were treated with the saline, only propofol, or only fentanyl. Oxidative stress markers including malondialdehyde (MDA), nitric oxide (NO), and reduced glutathione (GSH) were determined. In addition, nuclear factor kappaB (NF-kB), paraoxonase-1 (PON-1), and butyrylcholinesterase (BChE) activities were measured in the brain tissue. Results showed that compared with the saline group, administration of LPS caused a marked and significant increase in brain MDA and NO combined with depletion of GSH and decreased PON-1 and BChE activities. Additionally, the active form of NF-kB was significantly increased in the brain of LPS only-treated rats. Treatment with propofol or fentanyl led to a marked and significant decrease in the levels of brain MDA and NO together with a significant increase in GSH and restoration of PON-1 and BChE activities. Furthermore, lower levels of active form of NF-kB were found following treatment with propofol or fentanyl compared with those in the LPS only group. Collectively, these results suggest that propofol and fentanyl exhibit an antioxidant action and attenuate the endotoxin-induced brain oxidative stress.

Comparing two different doses of propofol after sevoflurane induction for intubation in paediatric patients without use of neuromuscular blocking agents

In the practice of paediatric anaesthesia, intubation of trachea without using neuromuscular blocking agents is becoming commoner more so in conditions in which muscle relaxants are not preferred. Different combinations of drugs including opioids, intravenous agents and inhalational agents are being used for facilitating endotracheal intubation when muscle relaxants are not used. In this study we compared intubating conditions in paediatric patients after sevoflurane induction and propofol in two different doses.80 children of 2 to 12 years age undergoing elective surgeries were divided into two groups P2 and P3 of 40 each. After sevoflurane induction and fentanyl 2mcg/kg I.V. group P2 received propofol 2mg/kg and group P3 received propofol 3mg/kg I.V. The two groups were compared with respect to intubating conditions and haemodynamic parameters.Clinically acceptable intubating conditions were seen in all patients in both groups. Excellent intubating conditions were more in group P3 (87.5%) than group P2 (80%). Haemodynamic parameters showed no significant difference between the two groups.In paediatric patients, endotracheal intubation can be comfortably performed without muscle relaxantsby using propofol and fentanyl with sevoflurane induction with no respiratory or haemodynamic adverse events. Propofol in a dose of 3mg/kg gives better intubating conditions than 2mg/kg without adverse haemodynamic effects, although 2mg/kg propofol also gives acceptable intubating conditions.

Effects of different doses of propofol on the growth and expression of PCNA, CD34 and pAKT proteins in xenografted tumor of BALB/C mice with liver cancer.

To observe the effects of different doses of propofol on the growth of transplanted liver tumor in BALB/C mice and check the expression of PCNA, CD34 and pAKT proteins to clarify the mechanism on molecule level. Human primary liver cancer cells SMMC-7721 were subcutaneously cultured in BALB/C mice, and the transplanted tumor model of BALB/C mice was constructed. Forty mice successfully modeled were randomly divided into 5 groups (n = 8): the blank control group (group C), low-fat milk group (group I), low-dose (50mg/kg) propofol group (P1), middle-dose (100mg/kg) propofol group (P2) and high dose (150mg/kg) propofol group (P3). Tumor volume changes were observed at 3, 6, 9, 12, 15 and 18days (T1, T2, T3, T4, T5, T6 and T7) before and after administration of the drug, and tumor growth curves were plotted. After 19days of administration, all mice were killed for tumor collection, tumor weight was measured, and the tumor inhibition rate of propofol was calculated. The protein expression of cluster of differentiation 34 (CD34) in transplanted tumor was detected by immunohistochemistry, and the protein expression of proliferating cell nuclear antigen (PCNA) and phospho-Akt (pAKT) was detected by immunofluorescence. Compared with group C, there was no significant difference in tumor volume in group I. At T2 ~ 7, the tumor volume of group P1, P2 and P3 decreased successively (P < 0.05). There was no significant difference in the inhibitory rate of tumor in group I, and the inhibitory rate of tumor in group P1, P2 and P3 increased successively (P < 0.05). There was no significant difference in PCNA, CD34, and pAKT protein expression in group I, while PCNA, CD34, and pAKT protein content in P1, P2, P3 groups were successively decreased (P < 0.05). Propofol had a dose-dependent effect on the growth of liver cancer xenografts in mice, inhibiting the expression of PCNA, CD34 and pAKT proteins, and the effect was most obvious in the 150mg/kg propofol group.

Propofol Reduces Epithelial to Mesenchymal Transition, Invasion and Migration of Gastric Cancer Cells through the MicroRNA-195-5p/Snail Axis.

BackgroundGastric cancer (GC) is a life-threating malignancy worldwide. Accumulating studies suggest propofol has anti-tumor functions in addition to the anesthetic effect. This study aimed to figure out the effects of propofol treatment in GC development.Material/MethodsHuman GC SGC-7901 and NCI-N87 cells were treated with different doses of propofol. Then the invasion and migration of GC cells was measured. SGC-7901 cells following 10 μM propofol treatment were applied in the following experiments. MicroRNAs (miRNAs) with differential expression in cells with or without propofol treatment were analyzed. Expression of miR-195-5p, Snail, vimentin and E-cadherin in SGC-7901 cells was measured, and then loss-of-function of miR-195-5p and gain-of-function of Snail were performed. Target relation between miR-195-5p and Snail was confirmed using luciferase assay. Xenograft tumor was induced in nude mice to identify the effect of propofol on GC in vivo.ResultsPropofol reduced epithelial to mesenchymal transition (EMT), invasion and migration of GC cells in a dose-dependent manner. Propofol elevated miR-195-5p expression but reduced Snail expression, and it reduced vimentin but increased E-cadherin expression in SGC-7901 cells. miR-195-5p directly bound to Snail. miR-195-5p inhibition or Snail promotion reversed propofol-inhibited malignant behaviors of SGC-7901 cells. In vitro results were reproduced in in vivo experiments.ConclusionsOur study found that propofol could inhibit EMT, invasion, and migration of GC cells by promoting miR-195-5p expression and suppressing Snail expression. This study may provide novel insights in GC treatment.

Propofol Inhibits Cell Proliferation, Migration, and Invasion via mir-410-3p/Transforming Growth Factor-β Receptor Type 2 (TGFBR2) Axis in Glioma.

BackgroundPropofol is a common intravenous anesthetic used to induce and maintain anesthesia. Numerous studies have reported that propofol plays an anti-tumor role in diverse human cancers, including glioma. In this research, we explored the roles of propofol and its related molecular mechanisms in glioma.Material/MethodsU251 and A172 cells were exposed to different doses of propofol for 24 h. Cell proliferation, migration, and invasion in glioma were evaluated using MTT assay and Transwell assay, respectively. The levels of microRNA-410-3p (miR-410-3p) and transforming growth factor-β receptor type 2 (TGFBR2) were detected by quantitative real-time polymerase chain reaction (qRT-PCR) assay and Western blot assay, respectively. The association between miR-410-3p and TGFBR2 was predicted by TargetScan and confirmed by dual-luciferase reporter assay.ResultsPropofol inhibited the proliferation, migration, and invasion of glioma cells in a concentration-dependent way. miR-410-3p was induced and TGFBR2 was inhibited by different concentrations of propofol treatment. Moreover, TGFBR2 was confirmed to be a target gene of miR-410-3p and TGFBR2 was inversely modulated by miR-410-3p in glioma cells. Depletion of miR-410-3p reversed the inhibition of propofol treatment on U251 and A172 cell growth and metastasis, but the effects were further abolished by knocking down the expression of TGFBR2.ConclusionsPropofol can suppress cell growth and metastasis by regulating the miR-410-3p/TGFBR2 axis in glioma.

Intubating conditions following four different doses of propofol in children

Background: Day case surgery offers advantages to the patient, the family and the performing institution. Children are excellent candidates since they are generally healthy and often require brief surgical interventions. Day case surgery requires rapid emergence from anaesthesia, minimal delay in recovery and rapid readiness for discharge from the ward. The ideal anaesthetic agents should have rapid onset, short duration, minimal side effects and minimal residual effects. The pharmacodynamics and -kinetics of propofol and alfentanil are well suited for day case surgery and may obviate the need for muscle relaxants. The purpose of our study was to determine the optimal dosing schedules for intubation following propofol combined with alfentanil and sevoflurane anaesthesia while maintaining haemodynamic stability as these dosing schedules still warrant refinement. Methods: We conducted a randomised prospective blinded study in which fifty-nine children (aged 3–10 years) presenting for dental extractions were induced with sevoflurane (in 50% oxygen/nitrous oxide), then received propofol (0.5, 1, 1.5 or 2 mg/kg) and alfentanil (10 μg/kg) to aid intubation. For each dose of propofol, the ease of intubation (assessed by the Helbo-Hansen score) was correlated with blood pressure and pulse rate (prior, during and after intubation) to determine the optimal propofol dosage allowing adequate intubation conditions with the least haemodynamic effects. Results: Overall adequacy of intubating conditions improved significantly (p = 0.0079) as propofol dose increased. Similarly, decrease in vocal cord movement (p = 0.0341), incidence of coughing (p = 0.0379) and limb movement (p = 0.0165) was observed. Ease of laryngoscopy and jaw relaxation did not improve significantly (p = 0.1319 and 0.1971 respectively). Changes in systolic, diastolic and mean arterial pressure as propofol dose increased were not statistically significant. Conclusion: Propofol in a dose of 1.5 to 2 mg/kg (when used in conjunction with alfentanil 10 μg/kg, after sevoflurane induction) allowed adequate intubating conditions whilst maintaining cardiovascular stability. The decrease in blood pressure, although not statistically significant, may become clinically relevant in children with underlying cardiovascular disease. This drug combination seems to be a reasonable means for avoiding the need for muscle relaxation for children who require tracheal intubation for brief surgical procedures.

Effect of propofol on myelin basic protein expression and myelination of oligodendrocytes in neonatal SD rats

To investigate the effects of different doses of propofol on myelin basic protein (MBP) synthesis and myelination of oligodendrocytes in neonatal SD rats. A total of 57 neonatal SD rats (7 days old) were randomly divided into control group (n=13), vehicle (fat emulsion) group (n=5), and 25, 50 and 100 mg/kg propofol groups (n=13 in each group). Eight hours after a single intraperitoneal injection of propofol or the vehicle, the rats were examined for expressions of mbp mRNA, caspase-3 mRNA, cleaved caspase-3 and MBP in the brain tissues using qPCR and Western blotting. Immunofluorescence assay was used to detect the apoptosis of the oligodendrocytes at 8 h after the injection and the myelination of the corpus callosum and internal capsule at 24 h. Compared with the control group, the neonatal rats with propofol injections showed significantly down-regulated expressions of mbp mRNA and MBP protein in the brain tissue (P &lt; 0.05). Propofol dose-dependently increased the transcription level of caspase-3 and the protein levels of cleaved caspase-3 at 8 h after the injection (P &lt; 0.05). Propofol injection significantly increased the apoptosis of the oligodendrocytes, and the effect was significantly stronger in 50 and 100 mg/kg groups than in 25 mg/kg group (P &lt; 0.05). At 24 h after propofol injection, myelin formation was significantly decreased in the corpus callosum of the neonatal rats in 100 mg/kg propofol group and in the internal capsule in 50 and 100 mg/kg groups (P &lt; 0.05). In neonatal SD rats, propofol can dose-dependently promote oligodendrocyte apoptosis, decrease MBP expressions in the brain, and suppress myelin formation in the corpus callosum and the internal capsule.

Propofol and propofol glucuronide concentrations in hair following medical propofol administration and in forensic death cases

Propofol is the most preferred drug for general anesthesia as well as for analgosedation. However, the rate of abuse cases has increased in the past decade. Hair analysis is considered as the method of choice to determine chronic drug use, and propofol and propofol glucuronide have already been used to confirm previous propofol administration. However, given its frequent medical use, it is important that nonmedical propofol abuse can be distinguished from medical propofol application. Nineteen hair samples collected from living subjects who received different doses of propofol in the setting of medical treatment and 31 hair samples from forensic death cases with indications of previous propofol administration were examined using our previously described method enabling the simultaneous extraction of propofol and propofol glucuronide from hair followed by validated liquid chromatography–tandem mass spectrometry analyses. Recent propofol administration was verified for eight of 19 living cases and 29 of 31 deceased cases. Of the living cases, propofol glucuronide could be detected in all eight cases, whereas propofol could only be detected in three of these cases. Propofol glucuronide could be detected more frequently and in higher concentrations than propofol following medical propofol administration and observed concentrations varied more widely. Although further research is still required to clarify the mechanisms involved in propofol incorporation into hair and to establish reliable cutoff concentrations for the differentiation of medical from nonmedical propofol use, it seems likely that relatively high concentrations of propofol found across multiple hair segments strongly suggest a nonmedical propofol abuse.

Propofol for the promotion of sleep in adults in the intensive care unit.

People in the intensive care unit (ICU) experience sleep deprivation caused by environmental disruption, such as high noise levels and 24-hour lighting, as well as increased patient care activities and invasive monitoring as part of their care. Sleep deprivation affects physical and psychological health, and people perceive the quality of their sleep to be poor whilst in the ICU. Propofol is an anaesthetic agent which can be used in the ICU to maintain patient sedation and some studies suggest it may be a suitable agent to replicate normal sleep. To assess whether the quantity and quality of sleep may be improved by administration of propofol to adults in the ICU and to assess whether propofol given for sleep promotion improves both physical and psychological patient outcomes. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 10), MEDLINE (1946 to October 2017), Embase (1974 to October 2017), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1937 to October 2017) and PsycINFO (1806 to October 2017). We searched clinical trials registers for ongoing studies, and conducted backward and forward citation searching of relevant articles. We included randomized and quasi-randomized controlled trials with adults, over the age of 16 years, admitted to the ICU with any diagnoses, given propofol versus a comparator to promote overnight sleep. We included participants who were and were not mechanically ventilated. We included studies that compared the use of propofol, given at an appropriate clinical dose with the intention of promoting night-time sleep, against: no agent; propofol at a different rate or dose; or another agent, administered specifically to promote sleep. We included only studies in which propofol was given during 'normal' sleeping hours (i.e. between 10 pm and 7 am) to promote a sleep-like state with a diurnal rhythm. Two review authors independently assessed studies for inclusion, extracted data, assessed risk of bias and synthesized findings. We included four studies with 149 randomized participants. We identified two studies awaiting classification for which we were unable to assess eligibility and one ongoing study.Participants differed in severity of illness as assessed by APACHE II scores in three studies and further differences existed between comparisons and methods. One study compared propofol versus no agent, one study compared different doses of propofol and two studies compared propofol versus a benzodiazepine (flunitrazepam, one study; midazolam, one study). All studies reported randomization and allocation concealment inadequately. We judged all studies to have high risk of performance bias from personnel who were unblinded. We noted that some study authors had blinded study outcome assessors and participants for relevant outcomes.It was not appropriate to combine data owing to high levels of methodological heterogeneity.One study comparing propofol with no agent (13 participants) measured quantity and quality of sleep using polysomnography; study authors reported no evidence of a difference in duration of sleep or sleep efficiency, and reported disruption to usual REM (rapid eye movement sleep) with propofol.One study comparing different doses of propofol (30 participants) measured quantity and quality of sleep by personnel using the Ramsay Sedation Scale; study authors reported that more participants who were given a higher dose of propofol had a successful diurnal rhythm, and achieved a greater sedation rhythmicity.Two studies comparing propofol with a different agent (106 participants) measured quantity and quality of sleep using the Pittsburgh Sleep Diary and the Hospital Anxiety and Depression Scale; one study reported fewer awakenings of reduced duration with propofol, and similar total sleep time between groups, and one study reported no evidence of a difference in sleep quality. One study comparing propofol with another agent (66 participants) measured quantity and quality of sleep with the Bispectral Index and reported longer time in deep sleep, with fewer arousals. One study comparing propofol with another agent (40 participants) reported higher levels of anxiety and depression in both groups, and no evidence of a difference when participants were given propofol.No studies reported adverse events.We used the GRADE approach to downgrade the certainty of the evidence for each outcome to very low. We identified sparse data with few participants, and methodological differences in study designs and comparative agents introduced inconsistency, and we noted that measurement tools were imprecise or not valid for purpose. We found insufficient evidence to determine whether administration of propofol would improve the quality and quantity of sleep in adults in the ICU. We noted differences in study designs, methodology, comparative agents and illness severity amongst study participants. We did not pool data and we used the GRADE approach to downgrade the certainty of our evidence to very low.

A Study to Assess the Efficacy of Different Doses of Propofol for Tracheal Intubation: A Randomized Clinical Trial.

Background:Tracheal intubation is usually facilitated by using a muscle relaxant to supplement drugs given for the induction of general anesthesia. Nondepolarizing muscle relaxants are also associated with the few disadvantages. Endotracheal intubation under volatile anesthetics without the use of muscle relaxants is possible, but it has disadvantages. Time available for intubation is much less when compared to the use of muscle relaxants. Considering the disadvantages of muscle relaxants and volatile agents in mind, there is a need for endotracheal intubation without muscle relaxants.Objective:The objective of the study is to assess the efficacy of different doses of propofol for tracheal intubation – a randomized clinical trial.Materials and Methods:A randomized study was conducted on 80 patients, comprising of 40 patients each. Patients of either sex were randomly allocated into Group P1 and Group P2 by computer-generated random numbers where Group P1 received 2 mg/kg propofol +3 μg/kg fentanyl and Group P2 received 4 mg/kg propofol +3 μg/kg fentanyl. SpO2, heart rate, blood pressure (BP)- systolic BP, diastolic BP, and mean arterial pressure were recorded at 1 and 3 min after administration of study drugs were recorded. Intubating conditions were assessed modified Helbo–Hansen scoring system.Results:The success rate of endotracheal intubation was 62.5% and 95% in propofol 2 mg/kg + fentanyl 3 μg/kg and propofol 4 mg/kg + Fentanyl 3 μg/kg, respectively. The total incidence of hypotension was 40% and 83% in propofol 2 mg/kg + Fentanyl 3 μg/kg and propofol 4 mg/kg + Fentanyl 3 μg/kg, respectively. The incidence of hypersensitivity was noted only in propofol 4 mg/kg + Fentanyl 3 μg/kg group and was 2.5%.Conclusion:We conclude that endotracheal intubation is possible in premedicated adult American Society of Anesthesiologists by Grade I patients with receiving 3 μg/kg Fentanyl + 2 mg/kg or 4 mg/kg propofol for induction without muscle relaxants, and the intubating conditions are acceptable. We found that propofol 4 mg/kg + Fentanyl 3 μg/kg is the optimal dose required for intubation without the use of muscle relaxants.

Propofol Does Not Reduce Pyroptosis of Enterocytes and Intestinal Epithelial Injury After Lipopolysaccharide Challenge

To date, mechanisms of sepsis-induced intestinal epithelial injury are not well known. P2X7 receptor (P2X7R) regulates pyroptosis of lymphocytes, and propofol is usually used for sedation in septic patients. We aimed to determine the occurrence of enterocyte pyroptosis mediated by P2X7R and to explore the effects of propofol on pyroptosis and intestinal epithelial injury after lipopolysaccharide (LPS) challenge. A novel regimen of LPS challenge was applied in vitro and in vivo. Inhibitors of P2X7R (A438079) and NLRP3 inflammasome (MCC950), and different doses of propofol were administered. The caspase-1 expression, caspase-3 expression, caspase-11 expression, P2X7R expression and NLRP3 expression, extracellular ATP concentration and YO-PRO-1 uptake, and cytotoxicity and HMGB1 concentration were detected to evaluate enterocyte pyroptosis in cultured cells and intestinal epithelial tissues. Chiu's score, diamine oxidase and villus length were used to evaluate intestinal epithelial injury. Moreover, survival analysis was performed. LPS challenge activated caspase-11 expression and P2X7R expression, enhanced ATP concentration and YO-PRO-1 uptake, and led to increased cytotoxicity and HMGB1 concentration. Subsequently, LPS resulted in intestinal epithelial damage, as evidenced by increased levels of Chiu's score and diamine oxidase, and shorter villus length and high mortality of animals. A438079, but not MCC950, significantly relieved LPS-induced enterocyte pyroptosis and intestinal epithelial injury. Importantly, propofol did not confer the protective effects on enterocyte pyroptosis and intestinal epithelia although it markedly decreased P2X7R expression. LPS attack leads to activation of caspase-11/P2X7R and pyroptosis of enterocytes. Propofol does not reduce LPS-induced pyroptosis and intestinal epithelial injury, although it inhibits P2X7R upregulation.