Effects Of Anesthesia Research Articles

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.

Convergent effects of different anesthetics on changes in phase alignment of cortical oscillations.

Many anesthetics cause loss of responsiveness despite having diverse underlying molecular and circuit actions. To explore the convergent effects of these drugs, we examined how anesthetic doses of ketamine and dexmedetomidine affected oscillations in the prefrontal cortex of nonhuman primates. Both anesthetics caused increases in phase locking in the ventrolateral and dorsolateral prefrontal cortex, within and across hemispheres. However, the nature of the phase locking varied. Activity in different subregions within a hemisphere became more anti-phase with both drugs. Local analyses within a region suggested that this finding could be explained by broad cortical distance-based effects, such as large traveling waves. By contrast, homologous areas across hemispheres became more in-phase. Our results suggest that both anesthetics induce strong patterns of cortical phase alignment that are markedly different from those in the awake state, and that these patterns may be a common feature driving loss of responsiveness from different anesthetic drugs.

Awake thoracoscopic non-anatomic pulmonary resections under thoracic paravertebral block: Results of a tertiary referral centre.

Awake video-assisted thoracoscopic surgery (VATS) helps to avoid the adverse effects of general anaesthesia (GA) with single-lung ventilation. Its usage in anatomic and non-anatomic pulmonary resections has spread worldwide, and it is mostly performed under thoracic epidural analgesia (TEA). We herein report our surgical experience with awake VATS non-anatomical resections under the thoracic paravertebral block (TPB). This retrospective, single-centred study reviewed patients undergoing awake VATS non-anatomical pulmonary resection under TPB, who voluntarily accepted awake VATS despite being suitable for GA and were found unsuitable for GA based on pre-operative assessment results. Demographic, pre-, per- and post-operative data were collected, analysed and compared with the literature data. Twenty-four patients (16 patients with normal pre-operative assessment results and 8 patients having high risk for GA) were selected. Fourteen bullectomies for recurrent spontaneous pneumothorax and 10 wedge resections (nine for metastasectomy and one for lung biopsy) were performed. Global in-operating room time was 77 ± 31 min. The morbidity rate was 20.8% (n = 5), including prolonged air leak in three and pneumonia in two patients. The mean duration of the chest tube was 1.9 ± 1.5 days and mean duration of hospital stay was 3.5 ± 2.1 days. There was no in-hospital mortality. Our results were mostly similar to the literature data. Non-anatomical lung resections by VATS can be performed easily and safely under TPB in awake patients. Although the perioperative and post-operative outcomes are not superior to other anaesthesia approaches, preferring TPB may help to avoid the serious potential complications of TEA.

Implementasi Latihan Batuk Efektif Dalam Upaya Pembersihan Jalan Nafas Pada Pasien Pasca Anestesi Umum Di Ruang Pemulihan

Introduction: Common side effects of general anesthesia, particularly when administered by inhalation, include sore throat, coughing, and hoarseness after surgery. An effective cough is an attempt to alleviate sore throat, cough, and hoarseness in individuals who have had general anesthesia. In order to keep the lungs clean, it is important to cough properly so that secretions may be removed swiftly and efficiently. Objective: At Jatiwinangun Surgical Specialty Hospital, we aim to teach our patients how to cough effectively so that they can reopen their airways following general anesthesia. Method: After one round of general anesthesia, 30 participants will undergo effective coughing activities as part of this activity's methodology. One technique to evaluate a cougher's ability to clear their airways is with the use of a checklist and an observation sheet for airway clearing. This method takes into account the cougher's breathing rate, the noises they make when coughing, the strength of their breathing muscles, and how easily they clear their airways. Result: Ten participants (or 33.3% of the total) fell within the 26–35 age bracket, while nineteen (or 63.3% of the total) were female, fourteen (or 46.7% of the total) had only completed high school, and ten (or 33.3% of the total) were housewives. At least 21 participants (70.0%) had more knowledge regarding how to effectively apply cough training after receiving good-quality education, whereas 6 participants (20.0%) had adequate knowledge and 3 participants (10.0%) had less. After undergoing general anesthesia, 24 subjects (80.0%) had effective coughing abilities, whereas 6 people (20%) shown less competence. When it came time to observe airway clearance, the results showed that 93.3% of participants breathed normally, 83.3% did not make any extra ronchi breath sounds, 90.0% did not use any additional breathing muscles, and 80.0% of participants had no trouble clearing their airways. Conclusion: From the results of PkM it can be concluded that effective cough training can clear the airway in patients after general anesthesia.

Pulse oximetry-based perfusion index as a non-invasive indicator of systemic hemodynamics during spinal anesthesia in cesarean delivery

Background & Objectives: Placental perfusion is not autoregulated and is susceptible to effects of spinal anesthesia (SA) induced hypotension. The perfusion index (PI) is a non-invasive marker of peripheral vascular tone, and a higher PI indicates increased risk of hypotension following SA. This study aims to establish preoperative baseline PI in our local population and its correlation with incidence of intraoperative hypotension. Methods: This prospective observational study recruited 35 parturients who underwent elective lower segment cesarean section (LSCS). Preoperatively, baseline heart rate (HR), systolic blood pressure (SBP), mean arterial pressure (MAP) and PI were documented. SA was performed with 8 to 10 mg of injection bupivacaine 0.5% (hyperbaric) at L3–L4 interspace followed by co-loading with 1 L Hartmann solution. Hypotension was defined as SBP less than 80% of baseline or less than 90 mmHg. A bolus of phenylephrine 50 µg was given as rescue medication to treat the hypotension. Intraoperatively, degree of decrease in SBP, MAP and HR, as well as the amount of phenylephrine required was recorded every minute until delivery of the baby and 3 min thereafter. Results: The correlations between parturients’ baseline PI with the degree of decreases in systolic and mean arterial pressure (r = 0.81, P < 0.001 and r = 0.76, P < 0.001, respectively) and phenylephrine requirement (r = 0.761, p < 0.005) were recorded. This study identified that the patients with cut-off PI value of 3.2 were at higher risk for SA induced hypotension with a sensitivity of 85.9% and a specificity of 87.5% (P = 0.001). Conclusion: The patients with baseline cut-off perfusion index value of more than 3.2 were at higher risk for spinal anesthesia induced hypotension in elective cesarean section. Abbreviations: CO - cardiac output; LSCS - lower segment cesarean section MAP - mean arterial pressure; PI - perfusion index; SA - spinal anesthesia Keywords: Hypotension; Pulse Oximeter; Perfusion Index; Spinal Anesthesia; Cesarean section; Citation: Manap NSA, Zaini RHM, Shukeri WFWM, Omar SC, Abu Bakar MZ, Seevaunnamtum P. Pulse oximetry-based perfusion index as a non-invasive indicator of systemic hemodynamics during spinal anesthesia in cesarean delivery. Anaesth. pain intensive care 2024;28(5):927−932; DOI: 10.35975/apic.v28i5.2570 Received: July 23, 2024; Reviewed: September 02, 2024; Accepted: September 10, 2024

The role of adjuvants in regional anesthesia: the postoperative analgesic effectiveness of dexamethasone vs. tramadol given as adjuvants to bupivacaine for ultrasound-guided supraclavicular block for upper extremity surgery—a prospective cohort study

BackgroundBrachial plexus block is used as a surgical anesthesia and analgesia for postoperative pain. Recently, the use of local anesthetics for regional nerve block has been enhanced by mixing them with a different class of drugs as adjuvants. These adjuvants of local anesthetics improved the quality and duration of nerve block and reduced the dose-dependent side effects of local anesthetics. However, the effectiveness of these adjuvants varies depending on the nature of the nerve block and the type of local anesthetics used. Therefore, we aimed to compare the postoperative analgesic effectiveness of dexamethasone vs. tramadol when used as adjuvants to bupivacaine for ultrasound-guided supraclavicular block in upper extremity surgery.MethodsUtilizing a prospective cohort study design, 126 consecutive patients who were undergoing upper extremity surgery with ultrasound-guided supraclavicular block were included. Patients were divided into three groups based on the preference of the responsible anesthetist to use adjuvants with bupivacaine for the block. The dexamethasone group (n = 42) were given 30 ml of 0.25% bupivacaine with 8 mg dexamethasone, the tramadol group (n = 42) were given 30 ml of 0.25% bupivacaine with 100 mg tramadol, and the non-adjuvant group (n = 42) were given 30 ml of 0.25% bupivacaine alone. The primary outcomes evaluated were postoperative pain severity using the numerical pain rating scale (NRS), the duration of analgesia, and the total postoperative analgesic consumption. Secondary outcomes included the incidence of postoperative complications.ResultA total of 126 patients were recruited and analyzed. There was no statistical difference in the demographic data among the groups. The postoperative NRS score was significantly reduced in the dexamethasone and tramadol group compared with the non-adjuvant group (p < 0.001). The NRS score in the dexamethasone group at 18 and 24 h was statistically much lower than in the tramadol and non-adjuvant group. The postoperative duration of analgesia was significantly prolonged in the dexamethasone (1,069 ± 316.99 min) group compared with the tramadol (617.02 ± 214.05 min) and non-adjuvant (434.17 ± 111.23 min) groups (p < 0.001). Patients in the non-adjuvant group had a significantly higher total analgesic consumption over 24 h. The dexamethasone group experienced significantly fewer incidences of nausea, with no differences in other complications among the groups.ConclusionThe addition of dexamethasone as an adjuvant to bupivacaine for ultrasound-guided supraclavicular block improves postoperative analgesia. We recommend the integration of dexamethasone as an adjuvant to local anesthetics during nerve blocks to enhance postoperative pain management after surgery.

Anesthetic sampling and the tissue regeneration potential of oysters: A study with Crassostrea hongkongensis

The use of an appropriate amount of anesthetic can prevent the sacrifice of oysters during experimental sampling or seedling rearing. In this study, we assessed the effects of air exposure and three concentrations of magnesium chloride (10, 40, and 70 g L–1) on the anesthetic efficiency for Crassostrea hongkongensis. We examined the recuperative capacity of the oysters post-tissue sampling. The results indicated that 36 h of air exposure could significantly enhance the anesthetic efficiency of C. hongkongensis while ensuring the oysters’ survival. A 40 g L–1 solution of magnesium chloride had the optimal anesthetic effect on C. hongkongensis across all oyster sizes. In addition, smaller oysters (119.10 g) had a higher relaxation rate than larger oysters (191.00 g). The oysters anesthetized with 40 g L–1 magnesium chloride also demonstrated the best recovery. No deaths were observed among the non-anesthetized oysters, anesthetized-recovered oysters, or non-recovered oysters during a seven-day post-farming period. In terms of live sampling, the control group (100 %), gonad group (100 %), mantle group (98.67 %), gill group (89.33 %), and adductor muscle group (97.33 %) all showed high survival rates after anesthesia. Observation of tissue growth post-sampling revealed the presence of focal green areas in tissues between days 7 and 14. By day 30, the adductor muscle and mantle tissues had fully healed, and the regrown tissue in the gills had approached its original length. A 40 g L–1 magnesium chloride solution had no significant effects on gametes in terms of fertilization rate, growth rate, and attachment rate. The present findings indicated that C. hongkongensis could be effectively anesthetized using a 40 g L–1 magnesium chloride solution following 36 h of aerial exposure. Post-anesthesia tissue and gamete sampling did not result in significant mortality, and the tissues had fully recovered within 30 days post-sampling. The anesthesia did not have any adverse effects on the progeny.

OXY-SCORE and Volatile Anesthetics: A New Perspective of Oxidative Stress in EndoVascular Aneurysm Repair-A Randomized Clinical Trial.

An aortic aneurysm (AA) is a life-threatening condition. Oxidative stress may be a common pathway linking multiple mechanisms of an AA, including vascular inflammation and metalloproteinase activity. Endovascular aneurysm repair (EVAR) is the preferred surgical approach for AA treatment. During surgery, inflammation and ischemia-reperfusion injury occur, and reactive oxygen species (ROS) play a key role in their modulation. Increased perioperative oxidative stress is associated with higher postoperative complications. The use of volatile anesthetics during surgery has been shown to reduce oxidative stress. Individual biomarkers only partially reflect the oxidative status of the patients. A global indicator of oxidative stress (OXY-SCORE) has been validated in various pathologies. This study aimed to compare the effects of the main volatile anesthetics, sevoflurane and desflurane, on oxidative status during EVAR. Eighty consecutive patients undergoing EVAR were randomized into two groups: sevoflurane and desflurane. Plasma biomarkers of oxidative damage (protein carbonylation and malondialdehyde) and antioxidant defense (total thiols, glutathione, nitrates, superoxide dismutase, and catalase activity) were measured before surgery and 24 h after EVAR. The analysis of individual biomarkers showed no significant differences between the groups. However, the OXY-SCORE was positive in the desflurane group (indicating a shift towards antioxidants) and negative in the sevoflurane group (favoring oxidants) (p < 0.044). Compared to sevoflurane, desflurane had a positive effect on oxidative stress during EVAR. The OXY-SCORE could provide a more comprehensive perspective on oxidative stress in this patient population.

Desflurane Versus Sevoflurane and Postoperative Cardiac Biomarkers in Older Adults Undergoing Low- to Moderate-Risk Noncardiac Surgery-Secondary Analysis of a Prospective, Observer-Blinded, Randomized Clinical Trial.

Background/Objectives: Previous preclinical studies have shown that desflurane might have the most significant cardioprotective effect of all volatile anesthetics. However, data regarding the cardioprotective effects of desflurane versus sevoflurane are lacking. Therefore, we evaluated the effect of the maintenance of anesthesia using desflurane versus sevoflurane on the postoperative maximum concentrations of cardiac biomarkers in older adults undergoing low- to moderate-risk noncardiac surgery. Methods: In this secondary analysis of a prospective randomized trial, we included all 190 older adults undergoing low- to moderate-risk noncardiac surgery. Patients were randomized to receive desflurane or sevoflurane for the maintenance of anesthesia. We administered desflurane or sevoflurane, aiming at a BIS value of 50 ± 5. The cardiac-specific biomarkers included troponin T, NT-proBNP, and copeptin, which were measured preoperatively, within one hour after surgery, and on the second postoperative day. Results: There were no significant differences between the desflurane and sevoflurane groups in the postoperative maximum concentrations of troponin T (11 ng.L-1 [8; 16] versus 13 ng.L-1 [9; 18]; p = 0.595), NT-proBNP (196 pg.mL-1 [90; 686] versus 253 pg.mL-1 [134; 499]; p = 0.288), or copeptin (19 pmol.L-1 [7; 58] versus 12 pmol.L-1 [6; 41]; p = 0.096). We also observed no significant differences in the troponin T, NT-proBNP, or copeptin concentrations between the desflurane and sevoflurane groups at any measured timepoint (all p > 0.05). Conclusions: In contrast to preclinical studies, we did not observe a significant difference in the postoperative maximum concentrations of cardiac biomarkers. It seems likely that desflurane does not exert significant clinical meaningful cardioprotective effects in older adults. Thus, our results do not support the use of desflurane in patients undergoing low- to moderate-risk noncardiac surgery.

The effectiveness of combined anesthesia in comparison with general anesthesia in thyroid and parathyroid surgery: a single-center prospective randomized study

BACKGROUND. Operations on the organs of the anterior surface of the neck (thyroidectomy, carotidectomy, plastic surgery, etc.) are widespread in the Russian Federation. The development of adequate anesthesiological support for these interventions is an urgent task of modern anesthesiology. The introduction of combined regional anesthesia techniques into surgical practice makes it possible to minimize postoperative complications, manifested in the form of severe pain syndrome, postoperative nausea and vomiting. AIM. To conduct a comparative assessment of the effectiveness of combined (general + regional) and only general anesthesia during operations on the thyroid and parathyroid glands. MATERIALS AND METHODS. In a prospective randomized study, 60 patients operated on for thyroid and parathyroid gland diseases were divided into 2 groups: in group 1, general anesthesia was performed in combination with blockade of the internal fascia of the neck and bilateral blockade of the superficial branches of the cervical plexus, as well as the Berry ligament area under ultrasound navigation; patients of group 2 were operated on in conditions of combined general anesthesia. The hemodynamic profile during surgery, plasma cortisol concentration, required doses of fentanyl, intensity of postoperative pain syndrome, need for anesthesia, and recovery time were evaluated. RESULTS. Combined (general + regional) anesthesia was characterized by a decrease in fentanyl consumption compared with the group receiving only general anesthesia (p 0.0001), a decrease in cortisol content in blood plasma 12 hours after extubation (p=0.0439), a reduction in median pain after tracheal extubation 3 and 12 hours after surgery (p=0.0190, p 0.0001), as well as a twofold reduction in the time interval from the end of the operation to the moment of extubation (p=0.0001). The assessment of patients on the Aldreth awakening scale in the group of people who underwent combined anesthesia indicates a higher willingness of patients to be transferred from the operating room to the awakening ward (p=0.0114). CONCLUSION. The study demonstrated the effectiveness and safety of the combined anesthesia technique in thyroid and parathyroid surgery, which provides adequate anesthetic protection for patients.

Effect of General Anesthesia vs Regional Anesthesia on Sleep Disturbance in Elderly Patients After Discharge from the Hospital for 3 Months.

This study aims to investigate the impact of anesthetic methods on the occurrence of postoperative sleep disorders in elderly patients following their discharge from the hospital for 3 months. This retrospective observational cohort study included elderly patients aged >60 years who had undergone general and regional anesthesia from 1 June 2023 to 31 December 2023. These patients were then assessed for sleep by telephone callback using the Athens Insomnia Scale after discharge from the hospital three months later. The duration of pain and sleep disturbance experienced by patients following discharge was also recorded. Following propensity score matching, 308 individuals were included in the study (154 in the GA group and 154 in the RA group). Compared with general anesthesia (11.7%), regional anesthesia (5.2%) reduced the prevalence of sleep disorders in elderly patients after discharge from the hospital. However, the duration of sleep disturbance and pain exhibited no statistically significant difference between the two groups (p=0.818; p=0.211). Regional anesthesia was associated with a reduction in the incidence of sleep disorders in elderly patients after discharge from the hospital for 3 months.

Chitosan, a Natural Polymer, is an Excellent Sustained-Release Carrier for Amide Local Anesthetics.

Local anesthetics, particularly amide types, play a crucial role in perioperative anesthesia to alleviate pain and manage chronic, long-term pain, with their brief effect period remaining a universal challenge that needs resolution. There is a high anticipation for creating materials that maintain prolonged effectiveness of local anesthetics through a straightforward administration technique. Chitosan is the most typical natural amino polymer, which is highly reactive and easy to modify. It has been widely and deeply used in the field of medicine. At present, it is mainly used in tissue regeneration and repair, hemostasis and wound healing, antibacterial and anti-infection, disease diagnosis and treatment detection, and drug delivery. In the field of anesthesia, chitosan is regarded as a potential perfect carrier for the sustained release of amide local anesthetics. This document aims to analyze the current application of chitosan as a prolonged-release substance in amide-type local anesthetics, encapsulate the associated research advancements, and subsequently investigate the practicality and prospects of its medical uses.

Comparison of Peribulbar and Topical Anesthesia in Phacoemulsification Cataract Surgery in Terms of Pain

Purpose: To compare effectiveness of Peribulbar and topical anesthesia in phacoemulsification in terms of severity of pain. Study Design: Quasi experimental study. Place and Duration of Study: This cross sectional study was conducted at Eye Department, Liaquat National Hospital, Karachi, from August 2017 to January 2020. Methods: This study included 1154 patients of 40-75 years of age who underwent phacoemulsification. Complete ocular examination was performed. Patients were allocated into two groups by convenient sampling. Cataract surgery was performed under Peribulbar anesthesia in 577 patients and other 577 patients were operated using topical anesthesia. Pain was assessed by Visual Analogue Scale Score. Frequency and percentage and mean± standard deviation was computed for qualitative and quantitative variables respectively using SPSS version 21. Chi square test was used for stratification of gender, duration of symptom and age, p≤0.05 was considered significant. Results: Average age of the patients was 57.43±6.70 years. There were 576(49.9%) males and 578(50.1%) females. There were 34 (5.9%) patients in Peribulbar group and 382 (66.2%) patients in topical group who had no pain (p=0.0005).Frequency of mild, moderate and sever pain was less in patients given topical anesthesia. The rate of pain was significantly higher in older and female patients with shorter duration of symptoms (p 0.0005). Conclusion: Phacoemulsification can be accomplished efficiently and effectively using topical anesthesia. Compared to retro bulbar and Peribulbar anesthesia, it offers several advantages and a high degree of pain satisfaction for the patient.

Magnesium Sulphate Versus Fentanyl as Adjuncts to Epidural Anaesthesia for Lower Limb Orthopaedic Surgeries: A Comparative Study

Abstract Introduction: Pain relief for lower limb orthopaedic surgeries is achievable with epidural anaesthesia. This study compared the analgesic effects of epidural anaesthesia with magnesium sulphate or fentanyl adjuvant in patients scheduled for elective lower limb orthopaedic surgeries. Patients and Methods: A double-blind randomisation study was carried out on 96 patients categorised into three groups; M, F, and C. All participants received 18 mL of 0.5% bupivacaine plus 1.5 mL of 75 mg magnesium sulphate in Group M or 50 mg of fentanyl in Group F or normal saline in Group C via the lumbar epidural route. Variables including the onset time of sensory and motor blockade, duration of anaesthesia, and time for postoperative Numerical Rating Scale (NRS) score of 3 were summarised using mean, median, standard deviation, and percentages as appropriate. A P value of &lt;0.05 was considered statistically significant. Results: Mean onset time for the sensory blockade at T8 was 23.7 ± 5.3, 20.5 ± 3.4, and 17.9 ± 5.6 min for groups C, F, and M, respectively (P = 0.001). The onset time for the motor blockade (Bromage score 3) was 29.8 ± 4.0, 26.6 ± 3.5, and 24.5 ± 5.3 min in groups C, F, and M, respectively (P = 0.001). The duration of epidural anaesthesia was 121.6 ± 31.5, 145.9 ± 29.6, and 167.0 ± 27.0 min in groups C, F, and M, respectively (P = 0.001). The time to attain an NRS pain score of 3 was 133.2 ± 27.7, 151.8 ± 32.4, and 172.0 ± 30.9 min in groups C, F, and M, respectively (P = 0.001). Conclusion: Magnesium sulphate is better as an epidural adjuvant compared to fentanyl in patients undergoing lower limb orthopaedic surgeries.

Comparison of inhalational and intravenous anesthesia induction on electroencephalogram and cerebral perfusion in children with congenital heart disease: A secondary analysis of a randomized controlled trial

ObjectiveThe effects of anesthetics on electroencephalograms and cerebral perfusion remain understudied in children with congenital heart disease. With regard to this, we compared inhalational anesthesia induction and intravenous anesthesia induction. DesignA randomized controlled trial. SettingOperation room in two tertiary hospitals. ParticipantsA cohort of 116 pediatrics patients undergoing cardiac surgery. Measurements and main resultsThe patients were randomly assigned to either the intravenous group (n=58) or the inhalational group (n=58). The inhalational group received anesthesia induction with 4-6% sevoflurane and a bolus of pipecuronium 0.2 mg/kg, while the intravenous group received anesthesia induction with intravenous midazolam 0.2 mg/kg, pipecuronium 0.2 mg/kg, and sufentanil 1 μg/kg. Ten minutes after tracheal intubation, the following parameters were measured: spectral edge frequency, burst suppression event, patient state index, middle cerebral artery blood flow velocity, cerebral oxygen saturation, and hemodynamic parameters. In comparison to the intravenous group, the inhalational group exhibited significant increases in 95% spectral edge frequency, ratio of burst suppression event, blood flow velocity in the middle cerebral artery, and cerebral oxygen saturation (P<0.05 for all), as well as decreases in systolic pressure, diastolic pressure, cardiac index, and the maximal slope of systolic upstroke (P<0.05 for all). ConclusionThe administration of sevoflurane for anesthesia induction results in more burst suppression, while also demonstrating superior cerebral perfusion when compared to the use of intravenous medications for anesthesia induction.

Changes in masseter muscle structure, membrane lipid peroxidation and Ca-ATPase activity as effects of different local anesthetics.

Local anesthetics (LA) can cause undesired effects such as sustained contraction of skeletal muscles as a result of structural and functional changes. Proper skeletal muscle function is controlled by intracellular Ca2+ concentration and efficient energy (ATP) production, which is closely related to cell ultrastructure. Aim: The aim of this study was to identify the structural and functional changes caused by LAs. Materials and Method: Male Wistar rats weighing 200 to 250g were used (n:49). They were divided into seven groups. One group was not anesthetized or treated (Control). The other six groups underwent intramuscular (IM) anesthesia with xylazine 2% (0.05 ml) and ketamine 50 mg/ml (0.1 ml/100g rat weight), and one of the following was applied to the masseter muscle (MM): no further treatment (Anesthetic Control group, CA); 0.1ml physiological saline solution (group SF); Carrageenin (group Carr) 1% as positive control group; prilocaine (group Pri), mepivacaine (group Mepi); or articaine (group Arti) 0.3M, IM. The animals were euthanized by cervical dislocation one hour after treatment. The effects of the different anesthetics on the MM were evaluated histologically and by electronic microscopy (EM). Ca-ATPase and membrane lipid peroxidation (LPX) were evaluated in muscle homogenates under the same conditions as those used to prepare the histological sections. Results: In general, structural damage and increased muscle contraction were observed in tissues treated with anesthetics. The most extreme values of Ca-ATPase activity and LPX were observed in the positive control group (carrageenin). Results were analyzed by one-way ANOVA for multiple comparisons and Tukey's test (p < 0.05). Conclusions: The results suggest that in the short term, local anesthetics affect the muscle function and are associated to structural changes.

The effects of general anaesthesia on body temperature of dogs subjected to ovariohysterectomy or orchiectomy performed by veterinary students in a teaching hospital

Hypothermia during anaesthesia is a significant concern in veterinary practice, as it can lead to various complications, making it essential to understand the factors that contribute to temperature regulation in animals undergoing surgical procedures. This retrospective study aimed to evaluate the change in body temperature over the course of anaesthesia in dogs undergoing elective ovariohysterectomy and orchiectomy, and determine the effect of gender, dose of premedication, weight, age and duration of anaesthesia of the change of body temperature over time. One-hundred and ten dogs (n=110) that underwent elective ovariohysterectomy (n=75) and orchiectomy (n=35) surgery performed by veterinary students at the University of Adelaide were enrolled in this study. Dogs’ anaesthesia records were evaluated for change in body temperature over the course of anaesthesia, and correlated with gender, two premedication doses of acepromazine (mg/kg), body weight (kg), age (months) and anaesthesia times (minutes). The analyses were performed at TPm (temperature at premedication), T0 (induction), T15, T30, T60, T90, T120 and TRec (recovery) minutes. Statistical analysis was performed using the GenStat software and included repeated measures analysis and ANOVA. Significance was considered when p < 0.05. The data showed a significant time-by-gender interaction with female dogs experienced a greater degree of heat loss than male dogs at T60 (p<0.01), T90 (p<0.01) and T120 (p<0.01). At recovery, female average temperature was higher than in males (p<0.01). There was no significant difference in body temperature when other covariates were used in the analysis. The core body temperature of female dogs decreased significantly over time compared to males, with the most pronounced differenced during the intraoperative period. However, the study’s retrospective nature and limited sample size may influence the generalizability of these findings.

Comparison of nerve block and spinal anesthesia in second toe pulp free flap surgery for fingertip reconstruction.

Toe pulp flap surgery is a viable option for soft tissue defects of the fingertips, effectively addressing patient needs and fingertip characteristics. The preferred anesthesia for lower-extremity surgery includes spinal and regional anesthesia. However, the choice between these methods depends on patient safety and surgical efficacy. In this retrospective study, we aimed to ascertain the optimal anesthetic technique by examining the efficacy, safety, pain control, and potential side effects of spinal and peripheral nerve block anesthetics. We included 40 patients aged 18-60 years who underwent partial second toe pulp free flap surgery for fingertip reconstruction. Twenty patients received spinal anesthesia (SA), while the remaining 20 received peripheral nerve block anesthesia. We conducted a comparative analysis of postoperative pain scores, adverse effects, analgesic usage, and patient satisfaction scores associated with each anesthesia method. Independent t-test, Mann-Whitney U test, and chi-squared test were performed. The SA group exhibited hypotension, bradycardia, urinary retention, and postdural puncture headache rates of 10%, 10%, 5%, and 5%, respectively. A significant difference in the timing of first analgesic use was observed (spinal, 3.7 ± 0.8 vs. peripheral nerve block, 13.2 ± 6.6; P = 0.006). Visual analog scale (VAS) scores of the patients at the 2nd, 4th, and 6th h were significantly lower in the peripheral nerve block group (P < 0.001, P < 0.001, P < 0.001, respectively). VAS scores at 12 and 24 h were similar between the groups (P = 0.07, P = 0.135, respectively). Peripheral nerve block anesthesia is superior to SA for partial second toe pulp free flap surgery, offering lower complication rates, reduced postoperative pain, and improved patient comfort.

Lameness of horses is effectively ameliorated with a low volume of mepivacaine administered as a palmar digital nerve block.

To determine the effect of 1.5 mL 2% mepivacaine, 0.75 mL 2% mepivacaine, and a combination of 0.75 mL 2% mepivacaine with epinephrine (1:200,000 solution) administered over each palmar digital nerve (PDN) to 6 horses with naturally occurring lameness caused by digital pain. In a crossover study design, 6 horses with forefoot-related lameness were randomly assigned to 1 of 3 groups. Each group received, on different study days, a PDN block using 1.5 mL of 2% mepivacaine, 0.75 mL 2% mepivacaine, or 0.75 mL of a combination of 2% mepivacaine and epinephrine (1:200,000 solution) injected over each nerve. The horses' gait while trotting was analyzed with an inertial, sensor-based motion-analysis system immediately before treatment. The assigned treatment was then administered to the lame forelimb, after which the gait was reevaluated at 5-minute intervals for 15 minutes. All 3 treatments significantly reduced lameness scores at all gait evaluations, but the effect of treatment on the lameness score did not differ significantly among treatments. 0.75 mL of mepivacaine hydrochloric acid injected over each PDN was as effective as twice that volume in decreasing the lameness score of horses with digital pain. The 0.75-mL solution of mepivacaine/epinephrine injected over each nerve did not significantly improve the anesthetic effect of mepivacaine. For a palmar digital nerve block, a lower-than-commonly-recommended volume of 2% mepivacaine effectively ameliorates digital pain. This finding invites investigation as to whether administering a low volume of local anesthetic will more precisely localize pain.

Impact of dexmedetomidine-assisted anesthesia in elderly patients undergoing radical resection of colon cancer.

Radical resection of colon cancer under general anesthesia is one of the main treatment methods for this malignancy. However, due to the physiological characteristics of elderly patients, the safety of perioperative anesthesia needs special attention. As an α2-adrenergic receptor agonist, dexmedetomidine (Dex) has attracted much attention from anesthesiologists due to its stabilizing effect on heart rate and blood pressure, inhibitory effect on inflammation, and sedative and analgesic effects. Its application in general anesthesia may have a positive impact on the quality of anesthesia and postoperative recovery in elderly patients undergoing radical resection of colon cancer. To investigate the anesthetic effects of Dex during radical surgery for colon cancer under general anesthesia in elderly patients. A total of 165 colon cancer patients who underwent radical surgery for colon cancer under general anesthesia at Qingdao University Affiliated Haici Hospital, Qingdao, China were recruited and divided into two groups: A and B. In group A, Dex was administered 30 min before surgery, while group B received an equivalent amount of normal saline. The hemodynamic changes, pulmonary compliance, airway pressure, inflammatory factors, confusion assessment method scores, Ramsay Sedation-Agitation Scale scores, and cellular immune function indicators were compared between the two groups. Group A showed less intraoperative hemodynamic fluctuations, better pulmonary compliance, and lower airway resistance compared with group B. Twelve hours after the surgery, the serum levels of TLR-2, TLR-4, IL-6, and TNF-α in group A were significantly lower than those of group B (P < 0.05). After extubation, the Ramsay Sedation-Agitation Scale score of group A patients was significantly higher than that of group B patients, indicating a higher level of sedation. The incidence of delirium was significantly lower in group A than in group B (P < 0.05). The use of Dex as an adjunct to general anesthesia for radical surgery in elderly patients with colon cancer results in better effectiveness of anesthesia.