Isoflurane Inhalation Anesthesia Research Articles

A randomised controlled trial comparing quality of recovery between desflurane and isoflurane inhalation anaesthesia in patients undergoing ophthalmological surgery at a tertiary hospital in South Africa (DIQoR trial)

BackgroundThe patient's experience of their postoperative recovery is an important perioperative outcome, with the 15-item quality of recovery scale (QoR-15) recommended as a standardised outcomes measure. Desflurane has a faster emergence from anaesthesia compared with other volatile anaesthetics, but it is uncertain whether this translates to better subjective quality of recovery. The hypothesis for this study is that patients receiving desflurane for maintenance of anaesthesia would have better postoperative quality of recovery than patients receiving isoflurane. MethodsMale and female adult patients undergoing ophthalmological surgery under general anaesthesia were randomly allocated to receive desflurane or isoflurane for maintenance of anaesthesia. The primary outcome was to compare postoperative QoR-15 scores. Secondary outcomes included comparing preoperative QoR-15 scores, volatile agent consumption, and time spent in the recovery room. ResultsData from 164 patients were analysed (80 desflurane, 84 isoflurane). Median (Q1, Q3) postoperative QoR-15 scores were not significantly different (desflurane: 145 [141, 148], isoflurane: 144 [139, 147], 95% confidence interval 0–3, P=0.176, minimal clinically important difference=8). Median (Q1, Q3) volatile agent consumption was 15.4 (12.5, 19.3) ml hr−1 in the desflurane group, and 7.4 (5.9, 9.7) ml hr−1 in the isoflurane group. Median (Q1, Q3) time spent in the recovery room was significantly shorter in the desflurane group (desflurane: 18 [13, 23]; isoflurane: 25 [19, 32], 95% confidence interval −10 to 5, P<0.001). ConclusionsThis study found no difference in quality of recovery between patients who received desflurane or isoflurane for maintenance of general anaesthesia during ophthalmological surgery. A shorter time in the recovery room was not associated with improved QoR-15 scores. Clinical trial registrationNCT04188314.

Plasma neurofilament light chain as a potential biomarker of neurodegeneration in murine brain.

Reliable fluid biomarkers for evaluating neurotoxicity have yet to be established. However, recent studies have reported neurofilament light chain as a fluid biomarker of several neurodegenerative disorders. In this study, we investigated changes in the cerebrospinal fluid and plasma levels of neurofilament light chain in mice treated with trimethyltin as a neurotoxicant. Trimethyltin diluted with saline was administered by intraperitoneal injection to mice at dose levels of 0 (vehicle control), 1.0, and 2.6mg/kg body weight (dosage volume: 10mL/kg). At 3 or 7days after administration, animals were euthanized by exsanguination under 2-3% isoflurane inhalation anesthesia. Increased neurofilament light chain levels in both the cerebrospinal fluid and plasma were observed in animals from the trimethyltin 2.6mg/kg body weight group, which indicated the brain lesions including neuronal cell death. Animals from the trimethyltin 1.0mg/kg body weight group exhibited changes neither in neurofilament light chain levels in the cerebrospinal fluid and plasma nor in the histopathology of the brain at any time point. These data indicate that plasma neurofilament light chain can serve as a useful peripheral biomarker for detecting brain lesions such as neuronal necrosis in mice.

Use of midazolam and butorphanol to sedate harbor seal pups (Phoca vitulina) undergoing rehabilitation

AbstractBetween 2012 and 2022, the Vancouver Aquarium Marine Mammal Rescue Centre sedated 110 harbor seal pups for physical examinations, diagnostic procedures, or treatment. A sedation protocol of butorphanol and midazolam (0.1–0.2 mg/kg each) was administered via a single i.v. injection in 171 procedures. Of these, 21 pups were anesthetized only with the injectables, while supplemental isoflurane inhalation anesthesia by mask was provided during 58 procedures; 92 other animals required intubation for respiratory support due to apnea or to achieve a deeper plane of anesthesia to facilitate more invasive procedures. Of the 171 sedations, five were euthanized due to poor prognosis and six failed to recover. Maximum sedation, sufficient for intended procedure or anesthesia induction, was achieved within a mean of 8.5 ± 5.8 min for i.v. injection (n = 133). Sedation duration (drug administration to full recovery) without supplemental inhalation anesthesia had a mean of 30.2 min and ranged from 14 to 52 min (n = 13). When used in stabilized young harbor seals, administration of injectable butorphanol and midazolam proved to be an effective protocol to obtain safe and reliable sedation for physical examination, minimally invasive diagnostic procedures, or as a premedication for general anesthesia.

Examination of postmortem changes in the lungs, trachea, and bronchi in a rat model imaged with small-animal computed tomography.

As less autopsies are performed, the need for postmortem computed tomography (PMCT) as an alternative is increasing. It is important to know how postmortem changes over time are reflected on CT, in order to improve the diagnostic capability of PMCT and replace forensic pathology evaluations such as time of death estimation. In this study, we examined temporal changes on postmortem chest CT images of a rat model. After acquiring antemortem images under isoflurane inhalation anesthesia, the rats were euthanized with a rapid intravenous injection of anesthetics. From immediately after death to 48 hours postmortem, chest images were acquired using small-animal CT. The 3D images were then evaluated on a workstation to measure the antemortem and postmortem air content in the lungs, trachea, and bronchi over time. The air content in the lungs decreased, but the air content of the trachea and bronchi temporarily increased 1-12 hours postmortem, then decreased at 48 hours postmortem. Therefore, the measurement of trachea and bronchi volumes on PMCT could be an objective way to estimate the time of death. While the air content of the lungs decreased, the volume of the trachea and bronchi temporarily increased after death, indicating the potential to use such measurements to estimate time of death.

Use of an ultrasound‐guided block of the radial, ulnar, median and musculocutaneous nerves in seven calves undergoing tenotomy or carpus arthrodesis surgery

AbstractThis report describes an ultrasound‐guided technique to block the radial, ulnar, median and musculocutaneous nerves in seven calves submitted for tenotomy of flexor tendons or carpus arthrodesis surgery. Surgery was performed under sedation and locoregional anaesthesia (n = 4) or under isoflurane inhalation and locoregional anaesthesia (n = 3). A block of the radial and ulnar, median and musculocutaneous nerves was performed at the lateral and medial aspect of the brachium, respectively, using a linear ultrasound probe positioned transversely to the mid‐humerus. A 19‐gauge spinal needle was introduced in‐plane through the triceps or transverse pectoral muscle until reaching the target nerves, where 5 ml of lidocaine 20 mg/ml or a mixture of lidocaine 20 mg/ml and detomidine 15 μg/ml was injected at each site. The calves’ cardiovascular parameters varied from baseline by less than 15% during surgery. Complications such as prolonged paralysis or haematoma/swelling at the injection site were not observed.

Transcranial Photobiomodulation Therapy Ameliorates Perioperative Neurocognitive Disorder Through Modulation of Mitochondrial Function in Aged Mice

Perioperative neurocognitive disorder (PND) is a serious nervous system complication characterized by progressive cognitive impairment, especially in geriatric population. However, the neuropathogenesis of PND is complex, and there are no approved disease-modifying therapeutic options. Mitochondrial dysfunction has been demonstrated to contribute to the occurrence and development of PND. Transcranial near-infrared (tNIR) light treatment helps to improve mitochondrial dysfunction and enhance cognition, but its effect on PND remains unclear. Here, we evaluated the effect of tNIR light treatment on PND caused by anesthesia and surgery in aged mice. We built the PND models with 18-month C57BL/6 male mice by exploratory laparotomy under isoflurane inhalation anesthesia, and treated by tNIR light with wavelength 810 nm for 2 weeks. The short-term and long-term changes in cognitive function were analyzed by behavioral tests. We further explored the effects of tNIR light on mitochondria, synapses, neurons, and signaling pathways through different experimental methods. The results demonstrated that the cognitive impairment and mitochondrial dysfunction in PND mice were ameliorated after tNIR light treatment. Further experiments demonstrated that photobiomodulation therapy (PBMT) increased synapse-related protein expression, neuronal survival, and protected synapse from depletion. Moreover, downregulated sirtuin 1 (SIRT1) and peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) were increased after tNIR light treatment. Our results suggested that tNIR light was an effective treatment of PND through PBMT effect, accompanied by synaptic and neuronal improvement. The improvement of mitochondrial dysfunction mediated by SIRT1/PGC-1α signaling pathway might participate in this process. Those findings might provide a novel and noninvasive therapeutic target for PND.

Successful Use of Inhalational Anesthesia and Electroconvulsive Therapy in a Child with New Onset Prolonged Super-Refractory Status Epilepticus

AbstractThe treatment of super-refractory status epilepticus (SRSE) and prolonged SRSE rests on urgent seizure control to minimize excitotoxic cerebral damage, other forms of neurologic damage, and multiple medical complications. To date no randomized controlled trials or clear-cut guidelines are available for the management of SRSE. We reported the case of a 10-year-old previously healthy male child patient who presented with a febrile illness and new onset prolonged SRSE that became refractory to multiple antiseizure medications (ASMs). Coma induction with anesthetic agents, 14 ASMs, ketogenic diet, immunotherapy failed to completely control the SRSE in our patient. On day 22, clinical and electroencephalographic seizure control was achieved with isoflurane inhalation anesthesia, which was continued for 3 weeks but was unable to be weaned. From day 57 onwards, electroconvulsive therapy was administered (total 14 sessions that resulted in complete control of seizures). He was discharged on the 80th day.

Successful Treatment of Capture Myopathy and Satellite Transmitter Injury in an Atlantic Yellow-nosed Albatross (Thalassarche chlororhynchos)

An Atlantic yellow-nosed albatross (Thalassarche chlororhynchos) was found on shore 3 days after having been captured at sea by researchers. It presented very lethargic, moderately dehydrated, and in poor body condition. It was mildly hypothermic, with moderate pediculosis, and dark malodorous feces with yellow urates. The bird had a 48-g satellite transmitter attached with a backpack-style chest harness, which caused an ulcerative lesion on the interscapular area. The bird was severely anemic (packed cell volume, 18%), and plasma chemistry results were suggestive of a severe rhabdomyolysis (aspartate transaminase, 3620 U/L; creatine kinase, 100 400 U/L). We hypothesized that capture myopathy occurred because of a combination of capture stress and prolonged physical restraint by researchers, stress associated with repeated attempts by the bird to remove the satellite-transmitter harness, and a lengthy road transport to the rehabilitation center. A treatment protocol, which relied on a combination of aggressive fluid therapy, selenium, vitamins E and B12, and multivitamin supplementation, was administered after the initial physical assessment of the albatross. Isoflurane inhalation anesthesia was used to minimize stress associated with the performed medical procedures (eg, physical examination, removal of the satellite transmitter harness, blood collection, and wound management). Measures were adopted while the bird was hospitalized to reduce stress (eg, quiet and comfortable environment with visual barriers and restricting handling of the patient to experienced staff). Clinical and hematological monitoring was used to assess the patient's condition as the bird gradually recovered while hospitalized. The albatross was successfully released 28 days after the initial presentation, suggesting that the medical protocol employed in this case may be useful for the treatment of capture myopathy in albatrosses and other birds.

Inhalation anesthesia and shielding devices to allow accurate preclinical irradiation of mice with clinical linac-based systems: Design and dosimetric characteristics

This technical note describes two devices to enable accurate irradiation of mice on clinical linac-based systems. To study the effects of radiation in murine, preclinical animal models, controlled and accurate dosing is important. This is not only important when specific volumes need to be irradiated, but also when the whole animal body is irradiated. To enable both purposes, we designed two devices. One device to administer Total Body Irradiation (TBI) simultaneously to six, free walking mice, and a second device, denoted as target box, in which we irradiate specific parts of the mice whilst organs-at-risk (OAR) are protected. In this latter device, we can position the mice in multiple ways. One configuration allows to sedate twelve mice simultaneously by isoflurane inhalation anesthesia and protect the body by lead shielding to allow radiation of the head only. Alternatively, the target box can be used to sedate maximal 4 mice simultaneously to irradiate the flank or paws only. All these setups allow high experimental throughput and thus a minimal occupation of the clinical equipment. As measured, the delivered radiation dosages in the regions of interest were accurate for both devices. In this technical note, we describe the design and build of these devices.

Comparison of the Anesthetic Effects of Isoflurane and Sevoflurane Inhalation on the Cardiovascular System of the Common Buzzard (Buteo buteo).

The aim of this study was to compare the effects of isoflurane (ISO) and sevoflurane (SEVO) inhalation anesthesia on the cardiovascular system of the common buzzard (Buteo buteo). Fourteen common buzzards of unknown sex and age, weighing 700-900 g each, were used for the study. The buzzards were randomly divided into an ISO group and a SEVO group, each comprising 7 buzzards. The buzzards were then anesthetized by masked induction with either ISO or SEVO. After induction, all buzzards were intubated with a 2.5-mm-diameter uncuffed endotracheal tube. Anesthesia was maintained with 3% ISO or 4% SEVO in a 3 L/min flow of 100% oxygen. Before induction, immediately after induction, and at intervals of 5, 10, 15, 20, 25, and 30 min after the patients were induced, the heart rate, respiratory rate, and body temperature of the buzzards were recorded. In addition, before and during anesthesia, serum electrolytes (sodium, ionized calcium, and potassium), blood gas measurements (arterial pH, arterial partial pressure of carbon dioxide, arterial partial pressure of oxygen, bicarbonate concentration, and oxyhemoglobin saturation), and hematocrit values were evaluated in the blood samples taken from both the ISO and SEVO groups. A statistically significant decrease in body temperature was observed in both groups. A significant decrease in heart rate was observed in the ISO group. The increases in partial pressure of carbon dioxide and bicarbonate concentration were statistically significant in both groups. The effects of ISO and SEVO anesthesia on the cardiovascular and respiratory system in the buzzards were similar based on the results of this study.

Histone H3K9 Trimethylation Downregulates the Expression of Brain-Derived Neurotrophic Factor in the Dorsal Hippocampus and Impairs Memory Formation During Anaesthesia and Surgery.

Brain-derived neurotrophic factor (BDNF) is essential for cognitive and memory functions. Abnormal BDNF expression in the central nervous system may impair these functions. Anaesthesia and surgery can induce perioperative neurocognitive disorders (PND). Clinical studies show that BDNF expression is decreased in patients presenting with cognitive impairment after anaesthesia and surgery. However, the molecular mechanism is still unclear. Epigenetic regulation plays an important role in cognition. The hypermethylation of H3K9 is crucial for transcriptional silencing and the onset of cognitive disorders. Here, we hypothesised that H3K9 trimethylation repressed BDNF expression and impaired memory formation or recall during anaesthesia and surgery. Laparotomy under isoflurane inhalation anaesthesia, behavioural tests, Western blotting, quantitative real-time reverse-transcription polymerase chain reaction (qRT-PCR), chromatin immunoprecipitation (ChIP), and immunohistochemistry were used in this study. BDNF expression was decreased in the hippocampus after anaesthesia and surgery. Cognitive impairment affected memory formation but not recall. The trimethylation of H3K9 downregulated BDNF expression. The overexpression of BDNF or use of exogenous BDNF improved the impairment of memory formation caused by anaesthesia and surgery. Therefore, inhibiting H3K9 trimethylation and increasing the expression of BDNF may help prevent PND in the clinical setting.

Effects of intrathecal transient receptor potential vanilloid 1 blocker on cervical distension induced visceral pain response

Objective: With the aid of an acute visceral pain model of uterine cervical distension (UCD), the present study aimed to observe the effects of intrathecal administration of transient receptor potential vanilloid 1 (TRPV1) antagonist SB-366791 on UCD induced-visceral nociception as well as its involved molecular mechanisms. Methods: A total of 30 Sprague-Dawley-derived adult virgin female rats were used. UCD model was established under isoflurane inhalation anesthesia. Briefly, a lower abdominal incision at midline was made to expose the uteral cervix, two metal rods were inserted through both sides of the cervix separately, one rod was fixed and the other one was connected to a pulley system with application of manual weighted traction (0, 25, 50, 75 or 100 g) for simulating 1 h of cervical distension. In addition, 12 Sprague-Dawley-derived adult virgin female rats were subjected to intrathecal catheter implantation, and UCD was established 7 days later. The rats were divided randomly into two groups; one group was administrated with intrathecal SB-366791 while the other was administrated with the same volume of saline as control. The 75 g distension force was then applied for an hour and the electromyographic (EMG) of musculus rectus abdominis, heart rate as well as respiratory frequency were measured continuously during the surgery. The spinal cord (T(12)-L(2)) was collected 30 minutes after UCD for the detection of changes of c-FOS and TRPV1 expression. Results: UCD increased EMG activity (P<0.05) and c-FOS expression (P<0.05) in the deep dorsal horn region and central canal of the spinal cord (T(12)-L(2)) in a stimuli-dependent manner, the expression of TRPV1 in the T(12)-L(2) spinal cord also increased in response to UCD stimulation (P<0.05). Compared with the saline group, intrathecal SB-366791 significantly decreased EMG activity (P<0.05) as well as spinal c-FOS (P<0.05) expression induced by UCD. Conclusions: UCD in rats increases EMG activity of musculus rectus abdominis as well as spinal c-FOS and TRPV1 expression. Intrathecal administration of TRPV1 antagonist SB-366791 significantly decreases the visceral nociception induced by UCD.

Surgical management of uterine torsion through ventral celiotomy in eleven mares

This article describes the surgical management of uterine torsion by midline celiotomy for cesarean section in 11 mares presented with signs of colic at a teaching veterinary hospital. The mares were either in full term of gestation (n = 6) or in advanced stage of pregnancy (n = 5). Majority of the mares (44.5%) were in fourth parity. 78% cases of uterine torsion were post cervical and clockwise and (22%) cases were post cervical and anticlockwise. For surgical intervention, mares were anesthetized using a combination of xylazine (1.1 mg/kg) and ketamine (2.2 mg/kg), intravenously and maintained on isoflurane inhalation anesthesia. Midline celiotomy was performed, and foals were delivered by cesarean section. Before closing the abdominal wound, the uterus was detorted manually and confirmed per-vaginally for its normal position. After long-term follow-up, the study reported 90.0% (10/11) survival rate out of which, seven were bred successfully.

Plasma glutathione peroxidase (GPx3) activity in the freshwater turtle Trachemys scripta elegans after isoflurane inhalation anesthesia

Introduction. Glutathione peroxidases are selenoenzymes which have a crucial role in the protection of animals against oxidative stress. Materials and Methods. From September 2017 to April 2018, a group of eight red-eared sliders were admitted at the Clinic for Small Animals, Faculty of Veterinary Medicine, University of Belgrade for elective diagnostic celioscopy. The turtles were of unknown age, weight from 1.20 kg to 1.86 kg. The anesthesia protocol involved using ketamine and medetomidine, both at a low dosage (10 mg kg-1 and 0.1 mg kg-1, respectively) as induction, after which anesthesia was maintained using isoflurane at 3% (vapor setting) in 100% oxygen (0.5 L min-1). Medetomidine was reversed with atipamezole (0.2 mg kg-1), given intramuscularly. The elective celioscopy was performed according to standard protocols. One day prior to anesthesia, heparinized blood samples were taken using the subcarapacial venous plexus for venipuncture. The second sampling took place three hours after the anesthetics were administered. Results and Conclusions. GPx3 activity in the blood plasmas (n=8) was measured by the coupled test as described by G?nzler et al. (1974). Data were tested for normality by the Shapiro-Wilk normality test and the groups were compared using a paired t-test. Blood plasma GPx3 activity was significantly higher (p=0.009) after a three-hour recovery period from inhalation anesthesia performed for elective diagnostic celioscopy, than before anesthesia. The measured post-anesthesia GPx3 activities were, on average, 80% higher than the measurements prior to anesthesia. It can be concluded that the statistically significant increase in the activity of plasma GPx3 from 91.02?36.05 mKat L-1 prior to anesthesia to 160.21?58.94 mKat L-1 three hours after anesthesia is due to the change in oxygen saturation. This is increased to 100% during the procedure, thus exposing the turtles to conditions of high oxygen saturation.

Na+/K+-ATPase, acetylcholinesterase and glutathione S-transferase activities as new markers of postmortem interval in Swiss mice.

Determining precisely the postmortem interval (PMI) is a key parameter for forensic researches, given that various physical, biochemical and metabolic changes begin to occur in the body after death. In the present study, the Na+/K+-ATPase, glutathione S-transferase (GST) and acetylcholinesterase (AChE) activities were evaluated. For this, male adult Swiss mice were killed by isoflurane inhalation anesthesia and divided into four groups according to time of death (0, 6, 24 and 48 h). The brain, liver, kidney and skeletal muscle tissues were removed. Our results revealed that at the time of 6 h, there was a decrease on Na+/K+-ATPase and GST activities in the brain and liver tissues, respectively. In addition, at this time point, an increase on renal GST activity was verified. At the time of 24 h, an increase on the cerebral AChE and renal GST activities was observed, while the cerebral Na+/K+-ATPase activity was decreased. Forty-eight hours after death, cerebral Na+/K+-ATPase and renal GST activities remained decreased and increased, respectively. In addition, no alteration was observed on the GST activity in the skeletal muscle and brain (in PMIs evaluated). The present study revealed that the brain and kidney (at the times of 24 and 48 h) were the tissues that suffered the most changes in almost all the enzymes evaluated. Our results demonstrated that enzyme activity assessments are reliable, easy-to-perform and low-cost determinations, and could be promising postmortem markers.

713 Isoflurane inhalation anesthesia should be a new requirement in intracavernosal pressure detection—the gold standard of erectile function assessment

713 Isoflurane inhalation anesthesia should be a new requirement in intracavernosal pressure detection—the gold standard of erectile function assessment

Effects of epidural anesthesia combined with inhalation anesthesia or intravenous anesthesia on intrapulmonary shunt and oxygenation in patients undergoing long term single lung ventilation

Objective:To investigate the effect of epidural anesthesia combined with inhalation or intravenous anesthesia on intrapulmonary shunt and oxygenation in patients undergoing long term single lung ventilation.Methods:Eighty patients, aged 35-75, American Society of Anesthesiology (ASA) classification of I-III, undergoing thoracic surgery with one lung ventilation more than three hour, were randomly divided into propofol group (group Pro), propofol combined with epidural anesthesia group (group Pro+Epi), isoflurane group (group Iso) and isoflurane combined with epidural anesthesia group (group Iso+ Epi), 20 patients in each group. Arterial blood and mixed venous blood were taken for blood gas analysis, and hemodynamic data were recorded at following time points: before induction in supine position (T1), 30min after bilateral lung ventilation (T2), 15min after one lung ventilation (T3), 30min after one lung ventilation (T4), 60min after one lung ventilation (T5), 180min after one lung ventilation (T6), intrapulmonary shunt (Qs/Qt) was calculated according to the correlation formula.Results:Qs/Qt values at T2-6 in four groups were significantly higher than that of T1, and Qs/Qt values at T3-6 was significantly higher than that of T2 (P< 0.05); PaO2 at T2-6 were significantly higher than that of T1, with PaO2 at T3-6 were significantly lower than T2 (P< 0.05). Between groups, Qs/Qt values in group Iso were significantly higher than that of group Pro, Pro+Epi and Iso+Epi at T3-5 (P< 0.05). There was no significant difference in PaO2 between groups (P> 0.05). CI at T3-6 in group Iso and Iso+Epi were significantly higher than that of T1 (P<0.05), and were significantly higher than that of propofol group (P<0.05). MAP at T3-6 in group Pro+Epi and Iso+Epi were significantly lower than that at T1 (P <0.05). Heart rate at T4-6 in group Iso were significantly higher than T1, and higher than group Pro and group Iso+Epi (P <0.05).Conclusion:One lung ventilation may predispose to increase of intrapulmonary shunt and decrease in arterial partial pressure of oxygen; isoflurane inhalation anesthesia is more likely to cause intrapulmonary shunt, but no changes in arterial partial pressure of oxygen.

Isoflurane inhalation anesthesia should be a new requirement in intracavernosal pressure detection\u2014the gold standard of erectile function assessment

Intracavernosal pressure (ICP) is gold standard for the detection of erectile function in animals, but no consensus has yet been achieved on what kind of anesthetic protocol should be applied. A total of 16 adult male Sprague-Dawley rats were randomized into two groups. In group A, chloral hydrate was injected intraperitoneally. Rats in group B were induced in 5% isoflurane for 3 min and then maintained in 1.0–1.5% isoflurane. Mean arterial pressure (MAP), respiratory rate (RR) and heart rate were monitored during all experiments. After ICP detection, tail vein and carotid artery blood were collected. The maximum ICP value, MAP and ICP/MAP ratio in group B was significantly higher than in that of group A. The RR in group A was lower than in that of group B, but the heart rate in group A was higher than in group B. There were no significant differences in both pO2 and pCO2 between groups. While the data showed that animals in group A were relatively hypoxemic. Isoflurane inhalation anesthesia in detection of erectile function could offer a relatively more stable physical state than in that under the effect of chloral hydrate intraperitoneal anesthesia. Isoflurane inhalation anesthesia is more suitable for ICP test.

Native Spleen Removal and Modified Multivisceral Transplantation in Rats

[1]Aim: Various techniques and several modifications have been described for experimental intestinal transplantation. Modified multivisceral (MMV) graft offers the advantage of including all abdominal viscera with the corresponding immunologic load without the potential liver inclusion benefits. Our aim was to describe some technical modifications of MMV transplantation in rats with the addition of native splenectomy. Methods: Heterotopic syngeneic (Lewis-Lewis) MMV transplantations were performed in 5 pair of rats. Average weight of donors and recipients was 198± 10g and 250±14g respectively. Animals were operated under isoflurane inhalation anesthesia. Each graft consisted of the distal half of the stomach, duodenum, pancreas, spleen and the small bowel of the donor. The graft spleen was removed in the back table in two of them. Native intestine was preserved, avoiding the need of biliary reconstruction. The native spleen was removed. The vascular pedicle consisted of the celiac trunk and superior mesenteric artery with a cuff of aorta and the portal vein. Cold (4°C) Ringer’s solution with heparin (10 units/ml) was used to perfuse the vessels and irrigate the intestinal lumen. Venous outflow of the graft was reestablished first with end-to-side anastomoses between graft portal vein and recipient vena cava. Arterial revascularization was achieved by end-to-side arterial anastomoses between the cuff of the donor aorta and the recipient infrarenal aorta. Results: 4/5 recipients survived more than 1h after the procedure. One died due to arterial bleeding. All grafts showed adequate initial reperfusion, one showed mild congestion due to portal estenosis. Donor and recipient time were 37±7.7 min and 66.6±3.8 min respectively; venous anastomosis time was 14±3 min and arterial anastomosis time was 12±1 min. Conclusions: MMV offers an excellent experimental model. The lymphoid load can be modified with the inclusion of the graft spleen, and the removal of the native spleen is an original modification that improves the interest of this model for GVHD and other immunological studies. Reference: 1. Galvao F, et al. Transplant. 2013; 96 (2):e4-5.

Effect of intravenous anesthesia with propofol versus isoflurane inhalation anesthesia in postoperative pain of inguinal herniotomy: a randomized clinical trial.

Postoperative pain is a common problem after inguinal herniotomy. We aimed to compare the intravenous anesthesia effects of propofol and isoflurane inhalation anesthesia on postoperative pain after inguinal herniotomy. In a randomized clinical trial, 102 eligible patients were selected based on inclusion and exclusion criteria and were randomly divided in two groups. In the first group, propofol was used for the maintenance of anesthesia, while isoflurane was used in the second group. The patient’s heart rate, systolic and diastolic blood pressure and oxygen saturation before, during and after surgery, recovery time and postoperative pain were measured immediately, 2, 4 and 6 hours after surgery and compared between two groups. T-test, and repeated measurement test were used for statistical analysis. No statistically significant differences were observed in heart rate, blood pressure and oxygen saturation levels between the two groups (P > 0.05). Propofol has higher effect in easing postoperative pain of patients than isoflurane, but no difference in postoperative complications, including chills, nausea and vomiting, occurs in both two groups. Propofol is effective in declining the postoperative pain of patients after anesthesia in comparison with isoflurane. Moreover, due to the antioxidant, anti-inflammatory and analgesic properties of propofol, it is preferred to isoflurane and the authors recommended it to be used.