Intravenous Injection Of Propofol Research Articles

Avoiding pain during propofol injection in pediatric anesthesia: Hypnoanalgesia of the hand versus intravenous lidocaine.

Pain related to injection of propofol during induction of anesthesia decreases from 66.8% without prevention, to 22-31% of cases when lidocaine is associated. Hypnoanalgesia of the hand is currently used for painful procedures in children but has never been evaluated in this indication. The primary aim of this prospective randomized single-blind study was to evaluate the efficacy of hypnoanalgesia of the hand for the prevention of moderate to severe pain during intravenous injection of propofol alone in comparison to lidocaine admixture. The secondary aim was to compare the global satisfaction of children in both methods. One hundred patients aged 7-14 years, ASA 1-2, admitted for scheduled surgery under general anesthesia were randomized into two groups. Group L received a mixture of 1% propofol (3 mg/kg) and 1% Lidocaine (0.3 mg/kg). Group H received 1% propofol (3 mg/kg) after hypnoanalgesia of the hand realized by a single experimented operator. A video was made in order to evaluate the pain related to propofol injection by a blinded observer using the 4-point score of Cameron (painful ≥ 2). The global satisfaction of children was evaluated in postanesthesia care unit and documented if visual analog score was <7/10. Ninety-six patients were analyzed. The rate of painful patients did not differ significantly between groups (8.5% in group H [n = 47] vs 6.1% in group L [n = 49], OR= 0.70; 95% CI [0.13-3.35], p = 0.65), nor did the rate of nonsatisfied patients (10.6 in group H vs. 12.2% in group L, OR = 0.85; 95% CI [0.19-3.65], p = 1). Our results suggest that hypnoanalgesia of the hand alone is effective to prevent the pain related to propofol injection in children. No significant difference was found in comparison with lidocaine admixture nor for pain or satisfaction.

Dose-response study of propofol combined with two different doses of esketamine for laryngeal mask airway insertion in women undergoing hysteroscopy

ObjectiveTo prospectively determine the median effective dose (ED50) of propofol for inhibiting a response to laryngeal mask airway (LMA) insertion when combined with different doses of esketamine in female patients. MethodsA total of 58 female patients (aged 20–60 years, ASAⅠ–Ⅱ) scheduled for elective hysteroscopy were enrolled and randomly divided into 2 groups, one of which was administered 0.2 mg/kg of esketamine (K1 group, n = 28) and the other 0.3 mg/kg of esketamine (K2 group, n = 30). The 2 groups received the corresponding doses of esketamine intravenously, followed by an intravenous injection of propofol (injection time was 30 s). The initial dose of propofol was 2 mg/kg, and the dose ratio of propofol in the adjacent patients was 0.9. If a positive reaction occurred due to LMA insertion, the dose ratio in the next patient was increased by 1 gradient; if not, the dose ratio was decreased by 1 gradient. The ED50, 95 % effective dose (ED95) and 95 % confidence interval (CI) of propofol for inhibiting a response to LMA insertion in the 2 esketamine groups were calculated using probit analysis. ResultsThe ED50 of propofol for inhibiting a response to LMA insertion in female patients was 1.95 mg/kg (95 % CI, 1.82–2.08 mg/kg) in the K1 group and 1.60 mg/kg (95 % CI, 1.18–1.83 mg/kg) in the K2 group. The ED95 of propofol for inhibiting a response to LMA insertion in female patients was 2.22 mg/kg (95 % CI, 2.09–2.86 mg/kg) in the K1 group and 2.15 mg/kg (95 % CI, 1.88–3.09 mg/kg) in the K2 group. ConclusionPropofol combined with 0.3 mg/kg of esketamine has low ED50 and ED95 effective doses for inhibiting an LMA insertion response in female patients undergoing hysteroscopy and surgery. There were no significant adverse effects, but the additional dose of propofol and airway pressure were significantly higher than those in the group administered 0.2 mg/kg of esketamine. Based on the results, we recommend the combination of propofol with 0.2 mg/kg esketamine for optimal conditions during LMA insertion in women undergoing hysteroscopy.

Efficacy of different techniques in attenuation of the pain caused by intravenous propofol injection

Efficacy of different techniques in attenuation of the pain caused by intravenous propofol injection

The Effect of Premedication with Oral Acetaminophen on the Prevention of Localized Pain Resulting from Intravenous Propofol Injection: A Randomized Double Blind Placebo Clinical Trial

Background: Propofol is one of the most widely used medications in anesthesia and intensive care. Propofol Intravenous injection is painful for patients at the injection site. The aim of this study was to determine the effect of premedication with oral acetaminophen in prevention of local pain caused by intravenous injection of propofol.&#x0D; Methods: This study was a double-blind randomized controlled trial. Data were collected from July 2020 to July 2021 in Shariati Hospital. All stages of premedication and induction of anesthesia were the same in all three groups of patients. Pb, P500 and P1000 groups (patients with oral placebo, 500 or 1000 mg of oral paracetamol, respectively) received the medication 1 hour before transfer to the operating room.&#x0D; Results: In this study, 150 patients were included. 44.7% were men, 55.3% women, and mean age of patients was 36.82 ± 10.24. The highest severity of reported pain was in the group of patients receiving placebo. Patients receiving 1 gram of acetaminophen had the lowest reported pain. Patients receiving 500 mg of acetaminophen reported significantly less pain than patients receiving placebo and more pain than patients in the group receiving 1 g of acetaminophen. Age, gender and weight did not have any significant effect on the pain severity.&#x0D; Conclusion: When compared to placebo, the use of oral acetaminophen as a premedication considerably lowers discomfort induced by intravenous propofol infusion. A dosage of 1 g of oral acetaminophen is more effective than 500 mg in decreasing pain. The level of pain and acetaminophen's pain-relieving effects were not affected by age, gender or weight.

Comparative study between lidocaine, magnesium sulfate and dexmedetomidine in alleviation of pain induced by intravenous injection of propofol

Background Propofol is the most widely used intravenous anaesthetic agent for induction and maintenance of anaesthesia. Pain on injection of propofol is a common problem. Propofol injection pain, despite various interventions, still occurs during the anaesthesia induction and causes intense discomfort and anxiety in patients. Objective Compare the efficacy of lidocaine, magnesium sulfate and dexmedetomidine drugs in reduction of pain of propofol. Also, study the effects of these drugs on cardiovascular system. Subjective This prospective controlled randomized double-blind study was carried out on 90 adult patients ASA status I or II, haemodynemically stable and Scheduled for elective surgery under general anaesthesia by propofol intravenous induction. Results The pain level during administration showed a significant decrease in group D (dexmedetomidine) less than both group L and M and there was no significant effect of the three drugs on haemodynamic parameters. Conclusions Dexmedetomidine is an effective and safe way to reduce the intensity and incidence of propofol injection pain. Magnesium and lidocaine pretreatment are equally effective in attenuating propofol-induced pain with some priority of magnesium sulphate more than lidocaine. There were no significant effects of the drugs on haemodynamics parameters

Comparing the Pretreatment with Lignocaine 40 mg and Fentanyl 100 ug as an Adjuvant for Preclusion of Pain Associated with Intravenous Propofol Injection

Abstract&#x0D; Background: Propofol (2,6-di-isopropylphenol) is one of the most favored drugs used for induction of anesthesia. Pain on injection is a common problem. Various methods have been tried to alleviate this pain but with conflicting results.&#x0D; Objective: To compare effectiveness of lignocaine versus fentanyl in patients receiving propofol for general anesthesia in population of Pakistan who come to PIMS hospital in Islamabad.&#x0D; Materials and Methods: 120 participants of either sex, between 18 and 40 years of age, belonging to ASA physical status I and II, undergoing elective surgery under general anesthesia, were randomized into two equal groups of 60 participants. They received, intravenously, either lignocaine 2 ml (20 mg/ml )or fentanyl 2 ml (50 mcg/mL) as a pretreatment before propofol injection.&#x0D; Results: The efficacy of lignocaine as a pretreatment drug injection was higher (96.7%) compared to fentanyl (85.0%). In the lignocaine group, 2.3% of the participants experienced pain as compared with 15% in the fentanyl group (P&lt;0.05).&#x0D; Conclusion: Compared with fentanyl, lignocaine pretreatment was more effective in preventing pain on propofol injection.&#x0D; KEY WORDS: Comparison, Fentanyl, LIgnocaine, Propofol, Pain.

Combined sevoflurane/sufentanil anesthesia for removal of tracheal foreign bodies in pediatric surgery, and its effect on hemodynamics

Purpose: To determine the efficacy of sevoflurane + sufentanil combination anesthesia in pediatric surgery for removal of tracheal foreign bodies, and its effect on hemodynamics.Methods: A total of 128 children with airway foreign bodies were assigned to control and study groups, each with 64 children. The control patients received slow intravenous injection of propofol (3 mg/kg). The study group was given 5 % sevoflurane and a slow intravenous injection of sufentanil (0.3 μg/kg). Hemodynamic parameters (diastolic blood pressure, systolic blood pressure and heart rate) were recorded before induction of anesthesia, at the time of intubation, during placement of a rigid bronchoscope (when the lens was placed), during removal of foreign bodies, and when extubating. Complications in children in the two groups after the removal of airway foreign body were recorded.Results: At the times of intubation and extubation, blood pressure and heart rate were significantly increased in both groups, but appreciably lower values were seen in study group. The major complications in pediatric airway foreign body removal in two groups were vomiting, bronchospasm and holding of breath.Conclusion: In children with airway extraction, sevoflurane, in combination with sufentanil produced better anesthetic effect and less impact on hemodynamics than propofol. Moreover, the children woke up faster and had fewer complications. The combined anesthesia is safe and reliable. However, the clinical application of this combined anesthesia requires larger-sample clinical studies.

Does Lidocaine Shorten Seizure Duration in Electroconvulsive Therapy?

Electroconvulsive therapy (ECT) is an effective short-term treatment for schizophrenia and depression, amongst other disorders. Lidocaine is typically added to reduce pain from intravenous propofol injection. However, depending on the dose used in the ECT setting, it can shorten seizure duration. The aim of this study was to investigate the effect of lidocaine dose on seizure duration. This retrospective, naturalistic cohort study included 169 patients treated with ECT. We examined 4714 ECT sessions with propofol or propofol plus lidocaine. Ictal quality was manually rated by visual inspection. The main outcome of this study was the relation of lidocaine with seizure duration after controlling for socio-demographic, ECT, and other anesthetic variables. There was a significant negative association between lidocaine usage and seizure duration. Multivariate analyses showed that seizure duration was shortened by an average of 3.21 s in sessions with lidocaine. Moreover, in this subgroup, there was a significant negative dose-dependent association between lidocaine dose and seizure length. Complementarily, a significant positive association between preictal BIS and seizure length was found in the subgroup of sessions where preictal was used. We provide additional evidence highlighting the importance of caution regarding lidocaine dosing due to the effect on seizure length in the ECT setting. It is advisable for clinicians to exercise caution when administering lidocaine regarding its dosing and seizure length in ECT settings. Future investigation is needed to assess causal relationships by studying certain vulnerable groups or employing other charge calculation techniques, such as the titration method.

Comparative Evaluation of the Efficacy of Treatment with Intravenous Lignocaine and Intravenous Granisetron in Prevention of Pain Due to Intravenous Injection of Propofol

Abstract Background Propofol is today considered the most common intravenous drug for the induction of general anesthesia. It is a drug with Phenol structure whose common complication is pain at the injection site as well as low blood pressure. Objective Comparison of treatment with granisetron versus lignocaine with respect to improvement of pain induced by injection of propofol, in patient admitted for elective surgery under general anesthesia. Materials and Methods This study was carried-out for Comparison of treatment with granisetron versus lignocaine with respect to improvement of pain induced by injection of propofol, in patient admitted for elective surgery under general anesthesia. This study was carried-out on 284 patients belonging to American Society of Anesthesiologists (ASA) physical status (PS) 1 and 2, of either sex, aged 18–60 years, scheduled for various elective surgical procedures under general anesthesia. The patients divided into 2 groups; Group 1 that consist of 142 patients which received injection of intravenous propofol (1-2 mg/kg) after injection with 1 ml of 2% lignocaine. Group 2 consist of another 142 which received injection of intravenous propofol (1-2 mg/kg) after injection with 1 ml of 1 ml of granisetron (1 mg/ml). Results The demographic data (age, body weight, sex ratio), physical status and type of surgery are not differ significantly (P &amp;gt; 0.05) among the two groups of this study. Our results on the heart rate, Systolic arterial blood pressure and diastolic arterial blood pressure showed no statistical significance after injection of lignocaine, granisetron and propofol at different points of time. The moderate and severe pain observed after different points of time from the injection of propofol can be reduced by injection of granisetron or lignocaine before propofol administration. Conclusion Our results concluded that, propofol commonly used as injection for induction of general anesthesia but it causes severe pain at the site of injection. For obtaining the best results and avoid the pain the patients must be received intravenous injection of granisetron or lignocaine. They can effectively reduce the severity of the pain resulted from propofol injection, granisetron is more effective for pain reduction than lignocaine.

Effects of Propofol Combined with Sufentanil Target-Controlled Intravenous Anesthesia on Expression of Bax, Bcl-2, and Caspase-3 Genes in Spontaneous Hypertensive Rats with Cerebral Hemorrhage: a Prospective Case-Controlled Study.

It is a well-known fact that general anesthesia leads to cerebral hemorrhage in patients with spontaneous hypertension apart of the fact that the hypertension is under control. The literature is already flooded with this debate, and still, there appears a lag regarding the effects of high blood pressure on pathological changes in the brain after cerebral hemorrhage. They are still not well recognized. Furthermore, it is the stage of anesthesia resuscitation which is known to have adverse effects on the body during cerebral hemorrhage. Owing to the lag of knowledge in the above said facts, the objectives of this study were to evaluate the effects of propofol combined with sufentanil on the expression of Bax, BCL-2, and caspase-3 genes in spontaneously hypertensive rats suffering with cerebral hemorrhage. The initial sample consisted of 54 male Wrister rats. All were of the age of 7 to 8months with a weight of 500 ± 100 gm. All the rats were evaluated by the investigators before enrolment. A total of 0.5mg/kg ketamine followed by a 10mg/kg intravenous injection of propofol was introduced to each included rat. It was followed by a total of 1 μG/kg/h of sufentanil which was administered to rats who had cerebral hemorrhage (n = 27). The rest 27 normal rats were not administered with sufentanil. Hemodynamic parameters, biochemistry, western blot assay, and immunohistochemical staining were performed. The results were statistically analyzed. Heart rate (p < 0.0001) was higher for rats who had a cerebral hemorrhage. The cytokine levels of rats who had cerebral hemorrhage were higher than those of normal rats (p < 0.01 for all). Bacl-2 (p < 0.01), bax (p < 0.01), and caspase-3 (p < 0.01) expressions were reported to be disturbed in rats who had cerebral hemorrhage. Urine volume was reduced in rats who had cerebral hemorrhage (p < 0.01). It was concluded that in spontaneously hypertensive rats with cerebral hemorrhage, propofol combined with sufentanil target-controlled intravenous anesthesia increased hemodynamic parameters and cytokine levels. Furthermore, cerebral hemorrhage disturbs the expression of bacl-2, Bax, and caspase-3 expressions.

Cerebrospinal fluid contacting nucleus and its 5-HT: A new insight into the regulation mechanism of general intravenous anesthesia

General anesthesia is one of the most common clinical anesthesia methods. Many studies have suggested that 5-HT plays an important role in the mechanism of general anesthesia, but its basic principle is still unclear. The cerebrospinal fluid (CSF)-contacting nucleus, which we identified 30 years ago, contains a large number of 5-HT neurons. In the brain, many of the nuclei involved in regulating the effects of general anesthesia send projections to the CSF-contacting nucleus.Does the CSF-contacting nucleus and its 5-HT neurons participate in regulating the effect of general anesthesia? This is a new and interesting scientific question.To answer this question, rats underwent general anesthesia by intravenous injection of propofol. During the maintenance of and recovery from general anesthesia, the protein expression of c-Fos in the CSF-contacting nucleus was significantly increased. “Knockout” of this nucleus significantly increased the of number of low-frequency δ waves, which are indicative of deep anesthesia, during general anesthesia maintenance; however, the number of high-frequency β waves, which indicate consciousness, was significantly decreased. During recovery from general anesthesia, the recovery of the righting reflex (RORR) time of rats with CSF-contacting nucleus ablation was significantly prolonged; activation of 5-HT neurons in the CSF-contacting nucleus promoted recovery from general anesthesia, while inhibition of 5-HT neurons in the CSF-contacting nucleus delayed recovery from general anesthesia.The above results suggest that the CSF-contacting nucleus and its 5-HT neurons play a key role in regulating the effect of intravenous anesthesia, especially during recovery from general anesthesia.

PRETREATMENT WITH ONDANSETRON IN PREVENTION OF PAIN ON PROPOFOL INJECTION

Background: Pain on intravenous injection of propofol is seen in almost 70% of patients without any pretreatments. This study was conducted to evaluate the effect of ondanse­tron in reducing the occurrence of pain on intravenous injection of propofol. Methods: Two hundred and thirty-two patients aged between 18- 60 years of either sex belong­ing to ASA status I and II, scheduled for laparoscopic cholecystectomy under general anesthesia at Chitwan Medical College, Bharatpur, Nepal, from from September 1, 2020 to March 31, 2021 were recruited in this study. They were assigned randomly into two groups with 116 participants in each, where Group 1 received 2 ml (4 mg) of ondansetron and Group 2 received 2 ml of 0.9% saline (placebo) intravenously as the pretreatment solution prior to injection of propofol for induction of general anesthesia. The overall incidence of pain in the saline group was 84.5% compared to 48.3% in the ondansetron group (P &lt; 0.001). Result: Pain was of mild intensity in most patients who belonged to the ondansetron group (33.6%) whereas it was of moderate intensity in most participants of the saline group (54.3%). Few patients in the study group experienced severe pain (0.9%) as compared to the placebo group (9.5%) with P &lt; 0.001. Conclusion: Therefore, it was concluded that pretreatment with ondansetron may be a useful intervention in reducing the incidence of pain on intravenous propofol administration without any adverse effects in significant number of patients.

The effectiveness of esketamine and propofol versus dezocine and propofol sedation during gastroscopy: A randomized controlled study.

Propofol is widely used in painless gastroscopy. However, sedation with propofol alone might increase the risk of respiratory and circulatory complications. This randomized clinical study compares the efficacy and safety of esketamine or dezocine combined with intravenous (IV) propofol in patients undergoing gastroscopy. A total of 102 patients were enrolled in this study and randomized into two groups. All patients were adults aged 18-64 years who underwent upper gastrointestinal gastroscopy. Patients were randomly assigned to two groups to receive esketamine (0.3mg/kg) combined with propofol (group E) or dezocine (0.05 mg/kg) combined with propofol (group D). In both groups, the drugs were administered intravenously. The primary outcome was the dose of propofol which provided a satisfactory sedative effect, both to the endoscopist and the patients. Secondary outcomes included recovery time, side effects (such as hypotension, nausea and vomiting and agitation), and the number of adverse circulatory and respiratory events. Data of 83 patients were analysed in the present study. Dosage of propofol required in group E (1.44 mg/kg ± 0.67 mg/kg) was significantly lower compared with that in group D (2.12 mg/kg ± 0.37 mg/kg) (p < 0.0001). There was no statistically significant difference in recovery time, side effects, and the frequency of sedation-related adverse events between the two groups. The study indicates that intravenous injection of propofol and esmketamine is more effective for gastroscopy. Use of esketamine reduces the total amount of propofol required in ASA I-II patients undergoing gastroscopy compared with single use of dezocine. It also provides more stable hemodynamics, without affecting the recovery time and side effects such as respiratory and circulatory adverse events. The study was registered at the Chinese Clinical Trial Registry (www.chictr.org.cn; registration number: ChiCTR2100051814) on 05/10/2021.

Comparative study on propofol and ketamine total intravenous anaesthesia in midazolam-butorphanol premedicated goats

A study was conducted during January to July 2020 to compare the clinical, physiological and haemodynamic effects of propofol and ketamine total intravenous anaesthesia in midazolam-butorphanol premedicated goats. Twelve goats presented for various surgical procedures were divided randomly into propofol (PRO) and ketamine (KET) group having six animals each. Goats were premedicated with intravenous midazolam (@ 0.3 mg/kg) and butorphanol (@ 0.2 mg/kg) combination. Anaesthesia was inducted with intravenous propofol (PRO group) and ketamine (KET group) administration (@ 2 mg/kg body weight). Anaesthesia was maintained with intermittent intravenous injections of propofol and ketamine in respective groups. Efficacy of anaesthesia was assessed on the basis of clinico-physiological and haemodynamic parameters. Induction time, induction dose, propofol maintenance dose, recovery quality, mean recovery time, time to recovery of swallowing reflex, sternal recumbency time and standing time were significantly (p<0.05) lower in PRO group compared to KET group. Heart rate and mean arterial pressure was significantly (p<0.05) higher in KET group. Respiration rate and SpO2were significantly (p<0.05) lower in PRO group. No significant difference in scores of salivation, pedal reflex, induction quality, time to first head movement and rectal temperature was observed between the two groups. To conclude, total intravenous anaesthesia with propofol under midazolam-butorphanol premedication is a better anaesthetic choice compared to ketamine in goats as it provides smooth, rapid induction, excellent muscle relaxation, better recovery quality, and shorter recovery and standing times.

COMPARISON OF INDUCTION WITH PROPOFOLAND SEVOFLURANE FOR LARYNGEAL MASK AIRWAY INSERTION DURING ELECTIVE SURGERIES

Background And Aims: Laryngeal mask airways are gaining popularity these days in airway management and can be used for various types of surgeries and also during resuscitation. The aim of the study is to compare the induction characteristics and hemodynamic changes associated with intravenous injection of Propofol or inhalational Sevourane induction for LMAinsertion during elective surgeries. Materials And Methods: It is a prospective, single blind, randomized controlled study that is conducted at Maharajah's Institute of Medical Sciences, Nellimarla,Vizianagaram from January 2019 to July 2019. The study consists of sixty patients belonging to ASA grade I &amp; II, aged between 20-60 years of both sexes, undergoing elective surgical procedures, which were randomly divided into 2 groups of 30 each. Patients in Group-A were induced with intravenous injection of Propofol 2mg/kg and inhalation of 100% Oxygen whereas in Group-B were induced with inhalation of 8% Sevourane in 100% Oxygen. The data regarding time for induction, LMAinsertion and hemodynamic parameters were recorded and compared in both the study groups. Results: The mean time taken for induction and insertion of LMAwas less in Group A(100±13.6sec) compared to Group B(120±14.2sec) and this difference is statistically signicant. The fall in MAPand HR in group - Ais also signicant. Conclusion: The quality of anaesthesia provided by propofol is better when compared to Sevourane for LMAinsertion, even though Sevourane is associated with better haemodynamic stability.

The Effect of Vibration on Pain During Intravenous Injection of Propofol: A Randomized Controlled Trial.

Pain is a common side effect of intravenous injection of propofol. We conducted a randomized, prospective, single-blinded controlled trial to assess the efficacy of vibration analgesia on pain during propofol infusion in ambulatory surgery. After institutional review board approval, 100 patients undergoing elective ambulatory surgery with general anesthesia were randomized into 2 groups. A control group (n = 50) consisted of patients who received infusion of propofol without vibration analgesia. A treatment group (n = 50) consisted of patients who received infusion of propofol with vibration analgesia using the Buzzy device. Pain was assessed using a 4-point pain manifestation scale scored by 2 independent, blinded observers. Participants in the treatment group with vibration analgesia were 0.47 times less likely (95% confidence interval, 0.24-0.94; P = 0.03) to experience any pain than the control group. The median summative pain score in the treatment group was significantly less than that of the control group [1 (interquartile range, 1-2) vs 2 (interquartile range, 2-4); P < 0.01] among participants who experienced any pain. Agreement between the 2 blinded observers regarding pain scores was excellent with κw = 0.82 (P < 0.001). Age, sex, body mass index, needle location or size, and medication doses did not differ significantly between the 2 groups. Vibration analgesia is an effective, low-risk modality that reduces the pain of intravenous propofol injection in general anesthesia.

Effect of basal forebrain somatostatin and parvalbumin neurons in propofol and isoflurane anesthesia.

AimsThe basal forebrain (BF) plays an essential role in wakefulness and cognition. Two subtypes of BF gamma‐aminobutyric acid (GABA) neurons, including somatostatin‐expressing (GABASOM) and parvalbumin‐positive (GABAParv) neurons, function differently in mediating the natural sleep–wake cycle. Since the loss of consciousness induced by general anesthesia and the natural sleep–wake cycle probably share similar mechanisms, it is important to clarify the accurate roles of these neurons in general anesthesia procedure.MethodsBased on two transgenic mouse lines expressing SOM‐IRES‐Cre and PV‐IRES‐Cre, we used a combination of genetic activation, inactivation, and chronic ablation approaches to further explore the behavioral and electroencephalography (EEG) roles of BFSOM and BFParv neurons in general anesthesia. After a single intravenous injection of propofol and the induction and recovery times of isoflurane anesthesia, the anesthesia time was compared. The changes in cortical EEG under different conditions were also compared.ResultsActivation of BF GABASOM neurons facilitates both the propofol and isoflurane anesthesia, manifesting as a longer anesthesia duration time with propofol anesthesia and a fast induction time and longer recovery time with isoflurane anesthesia. Moreover, BF GABASOM‐activated mice displayed a greater suppression of cortical electrical activity during anesthesia, showing an increase in δ power bands or a simultaneous decrease in high‐frequency power bands. However, only a limited and nuanced effect on propofol and isoflurane anesthesia was observed with the manipulated BF GABAParv neurons.ConclusionsOur results suggested that BF GABASOM neurons play a critical role in propofol and isoflurane general anesthesia, while BF GABAParv neurons appeared to have little effect.

Diagnosis and surgical management of acanthomatous ameloblastoma in a 5-month-old female Boerboel puppy

A five-month-old female Boerboel puppy presented with a rapidly expanding fibrous growth around the canine tooth of the right maxilla was diagnosed as having acanthomatous ameloblastoma based on findings from skull radiography, cytology of fine needle aspiration, biopsy and histopathology of resected growth. Lateral radiograph of the skull revealed moderate osteolysis of the maxilla with presence ofun-erupted maxillary canine teeth. Cytology of fine needle aspirate from the growth showed clusters of epithelial cells that were hyperchromatic and showing palisade arrangement. The mass was surgically resected using diathermy instrument following general anaesthesia using combination of intramuscular injection of xylazine (0.5mg/kg), and intravenous injection of propofol (4mg/kg). Post-operative management included Ibuprofen suspension (100mg) administered for 3-days, intravenous vincristine (0.5mg/m2 ) once weekly and oral cyclophosphamide (50mg) was administered twice weekly for six weeks. Histopathology of the growth showed odontogenic epithelium embedded in pulp ectomesenchyme. Features of odontogenic epithelium include palisading epithelium with anti-basilar nuclei and centrally located cells having features of stellate reticulum. This is probably the first reported case of acanthomatous ameloblastoma in a Boerboel puppy that was successfully managed.&#x0D; Keywords: Acanthomatous, Ameloblastoma, Boerboel-puppy, Chemotherapy, Odontoid

Effects of propofol on inflammatory response and activation of p38 MAPK signaling pathway in rats with ventilator-induced lung injury.

ABSTRACTPurpose:To investigate the effects of propofol on inflammatory response and activation of p38 mitogen-activated protein kinase (MAPK) signaling pathway in rats with ventilator-associated lung injury (VALI).Methods:Thirty-six Sprague Dawley (SD) rats were divided into control, VALI and VALI+propofol groups. The VALI group received the mechanical ventilation for 2 h. The VALI+propofol group received the mechanical ventilation for 2 h, which was accompanied by intravenous injection of propofol with dose of 8 mg·kg-1·h-1. At the end, the mean arterial pressure (MAP) and blood gas indexes were measured, and the lung wet/dry mass ratio (W/D) and biochemical indexes of lung tissue and bronchoalveolar lavage fluid (BALF) were determined.Results:Compared with VALI group, in VALI+propofol group the blood pH, partial pressure of oxygen, partial pressure of carbon dioxide and MAP were increased, the lung W/D, lung tissue myeloperoxidase activity and total protein concentration, white blood cell count, and tumor necrosis factor α, interleukin 1β and interleukin 6 levels in BALF were decreased, and the p-p38 MAPK protein expression level and phosphorylated p38 MAPK (p-p38 MAPK)/p38 MAPK ratio were decreased.Conclusions:Propofol treatment may alleviate the VALI in rats by reducing the inflammatory response and inhibiting the activation of p38 MAPK signaling pathway.

A small dose of dezocine suppresses remifentanil-induced cough in general anesthesia induction: a prospective, randomized, controlled study

BackgroundThe aim of this prospective randomized controlled study was to evaluate whether pretreatment with a small dose of dezocine could prevent remifentanil-induced cough in general anesthesia induction.Trial designa prospective, randomized, controlled study.MethodsA total of 210 patients receiving elective operative hysteroscopy from December 2018 to April 2019 were enrolled in the present study. They were randomly equally separated into dezocine group (n = 105) and control group (n = 105). Patients were intravenously pre-administrated with dezocine 0.03 mg/kg (diluted to 5 mL) or the same volume of normal saline 1 min prior to remifentanil infusion. One minute later, intravenous injection of propofol 1.5 mg/kg and cisatracurium 0.1 mg/kg were given to all patients for induction of general anesthesia. The counts of coughs occurred during the anesthesia induction period were recorded and the severity of cough was scaled.ResultsThere were 7 cases of mild cough in dezocine group and 18 cases of mild cough, 12 cases of moderate cough and 4 cases of severe cough in control group. The incidence rate of cough was significantly lower and the severity of cough was obviously relieved in dezocine group compared to control group (6.67% vs. 32.38%, P < 0.001). The two groups were not significantly different in heart rate and mean arterial pressure before the induction, before and after the intubation, and in operating time and postoperative visual analog scale pain scores.ConclusionThis study recommends the efficacy and safety of a pretreatment with a small dose of dezocine in reducing remifentanil-induced cough during general anesthesia.Trial RegistrationChiCTR2000032035.Date of registration: Retrospectively registered on 2020/04/18.