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Effect of hydromorphone combined with ropivacaine caudal block on immune function after hypospadias surgery in children.

BACKGROUND: This study aimed to evaluate the effects of caudal block anesthesia with hydromorphone-ropivacaine compared to ropivacaine alone … ntravenous administration of pentobarbital (0.01 mg/kg) and dexamethasone (0.15 mg/kg), followed by sevoflurane inhalation. All patients underwent ultrasound-guided caudal block anesthesia administered by the same anesthetist. Primary outcomes included the distribution of T lymphocyte subsets (CD3+, CD4+, CD8+, and CD4+/CD8 + ratios) measured at five time poi …

The Glycocalyx and Its Role in Vascular Physiology and Vascular Related Diseases.

PurposeIn 2007 the two senior authors wrote a review on the structure and function of the endothelial glycocalyx layer (Weinbaum in Annu Rev Biomed Eng 9:121-167, 2007). Since then there has been an explosion of interest in this hydrated gel-like structure that coats the luminal surface of endothelial cells that line our vasculature due to its important functions in (A) basic vascular physiology and (B) vascular related diseases. This review will highlight the major advances that have occurred since our 2007 paper.MethodsA literature search mainly focusing on the role of the glycocalyx in the

[Perioperative acquired long QT syndrome: a case report].

Acquired long QT syndrome is a rare condition whose diagnosis is of vital importance given the risk of torsade de pointes and sudden death. This syndrome may be triggered by various events in patients with a genetic predisposition. Patients usually have a normal baseline QT interval. Some of the factors that may prolong the interval are exposure to common drugs such as antibiotics or agents used for general anesthesia. Diagnosis of the condition is essential, as is knowledge of how to manage anesthesia and prevent ventricular fibrillation, which is the most feared complication. We report the c

[Perioperative treatment of a pregnant woman with recent cerebral infarction secondary to noncompaction cardiomyopathy].

Recent-onset noncompaction of the myocardium is a rare but serious entity with uncertain prognosis. Cerebral infarction is among the forms of presentation, and pregnancy and hypercoagulability increase risk. We report the case of a pregnant woman brought to the emergency department with ischemic cerebral infarction. Investigation demonstrated the cause to be cardiac embolism, and noncompaction of the myocardium was diagnosed. She was stabilized and a few days later underwent elective cesarean section under general anesthesia. Surgery and postoperative recovery were uneventful, and she was tran

Perioperative anesthetic management of children with congenital central hypoventilation syndrome and rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation undergoing thoracoscopic phrenic nerve-diaphragm pacemaker implantation.

BACKGROUND: Congenital Central Hypoventilation Syndrome and Rapid-Onset Obesity with Hypothalamic dysfunction, Hypoventilation, and Autonomi … s (7%) for lung isolation. Anesthesia was maintained using a balanced technique of volatile agents (sevoflurane/isoflurane) and opioids (fentanyl). Bradyarrhythmias developed in six patients (43%) during surgery, 5 (36%) responded to anticholinergics and one patient (7%) required backup cardiac pacing using a previously implanted bipolar cardiac pacemaker. In …

Postoperative Natural Killer Cell Dysfunction: The Prime Suspect in the Case of Metastasis Following Curative Cancer Surgery.

Surgical resection is the foundation for the curative treatment of solid tumors. However, metastatic recurrence due to the difficulty in eradicating micrometastases remain a feared outcome. Paradoxically, despite the beneficial effects of surgical removal of the primary tumor, the physiological stress resulting from surgical trauma serves to promote cancer recurrence and metastasis. The postoperative environment suppresses critical anti-tumor immune effector cells, including Natural Killer (NK) cells. The literature suggests that NK cells are critical mediators in the formation of metastases i

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… Lim et al., assessed the effects of propofol versus sevoflurane on NK cells isolated from patients who underwent breast cancer surgery. … However, Tazawa and colleagues assessed NK92-MI cytotoxicity, proliferation, conjugation, lytic granule polarization, and degranulation in a co-culture system with K562 cells and found that isoflurane and sevoflurane attenuated cytotoxicity, conjugation, and polarization of NK cells via LFA-1 inhibition …

Novel technique for placement of laryngeal mask airway in difficult pediatric airways.

BACKGROUND: The main responsibility of an anesthesiologist is to safely maintain an open airway and preserve sufficient gas exchange in the … r the legal guardians of those who met the inclusion criteria. Inhalation anesthesia was induced by sevoflurane. The patients had assisted spontaneous respiration. No muscle relaxant was administered. LMA was inserted using the classic method in the anesthesia depth of BIS = 35-40. After 2 unsuccessful attempts according to the criteria for adequate function …

Effects of dexmedetomidine at different dosages on perioperative haemodynamics and postoperative recovery quality in elderly patients undergoing hip replacement surgery under general anaesthesia: a randomized controlled trial.

BACKGROUND: Dexmedetomidine could provide some advantages to prevent postoperative complications in elderly patients undergoing under genera … rly patients undergoing hip replacement after intravenous general anaesthesia combined with inhaled sevoflurane without delayed recovery. However, it is necessary to be vigilant about the haemodynamic inhibition of the drug at high dosages throughout the perioperative period. Dexmedetomidine 0.25-0.5 μg/kg as the initial loading dose followed by 0.5 μg/kg/h c …

[Clinical use of the ProSeal™ laryngeal mask in infants, children and adolescents : prospective observational survey].

BACKGROUND: In contrast to the adult population scientific data on ProSeal™-LMA (PLMA) usage in infants, children, and adolescents are rathe … as by total intravenous anesthesia (propofol) in 184 patients (36.5%) and by an inhalational agent (sevoflurane or desflurane) in 320 patients (63.7%). Neuromuscular blocking agents were used in 7 patients (1.4%). The patients were anesthetized for an average of 80 min (range 15-270 min) and insertion success rate was 99% with a maximum of 3 attempts. The ave …

Новый тип нарушения почечной функции после радикальной нефрэктомии при почечной карциноме: ретроспективное исследование клинических, интраоперационных и постоперационных факторов риска.

ОБЗОР: Радикальная нефрэктомия является рекомендованным методом лечения локализованного нефрогенного карциномы, когда частичная нефрэктомия не возможна. Этот подход обычно применяется у пациентов с нормальной контрлатеральной нефридой и отсутствием предшествующего хронического почечного заболевания (ХПО). Основная проблема с операцией заключается в потенциальном долгосрочном влиянии на почечную функцию. ЦЕЛИ: Оценить риск развития хронического почечного заболевания после радикальной нефрэктомии. МЕТОДЫ И ПРОЕКТ: Это ретроспективное когортное исследование пациентов с нормальной предоперационн

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… Induction was carried out using propofol 1–2 mg/kg with opioids, while sevoflurane (2–4 vol %) was used for maintenance. Patients were mechanically ventilated with a volume-controlled mode with a tidal volume of 6–8 mL/kg and a FiO2 of 0.4 to 0.5. … Studies have shown that propofol anesthesia was associated with a lower risk of AKI and CKD than volatile anesthesia, with no significant differences between sevoflurane and desflurane on renal function. 10 , 31 In this study, all but three patients received maintenance sevoflurane volatile anesthesia …

Anesthetic management of a parturient with neuromyelitis optica.

Women with neuromyelitis optica, an acute inflammatory demyelinating condition of the central nervous system, have an unpredictable clinical course in pregnancy. Providing neuraxial anesthesia for these patients is controversial, although relapses may occur after exposure to either general or neuraxial anesthesia and are common. We report the successful obstetric anesthesia management of a parturient with neuromyelitis optica, review the medical literature, and discuss specific considerations for obstetric anesthesia in patients with underlying demyelinating disease.

[Esketamine Alleviates Postoperative Depressive Symptoms in Frail Elderly Patients Undergoing Thoracoscopic Radical Resection of Lung Cancer: A Randomized Double-Blind Controlled Trial].

OBJECTIVE: To investigate the effect of esketamine on postoperative depression in frail elderly patients undergoing thoracoscopic radical re … ificantly lower at T1 and T2 (P < 0.01); the consumption of propofol, sufentanil, remifentanil, and sevoflurane during surgery in the Esk group was significantly reduced (P < 0.05 or 0.01); the incidence of postoperative nausea/vomiting and hyperalgesia was significantly lower (P < 0.01); the duration of postoperative mechanical ventilation, length-of-stay in …

Psoas compartment block efficacy and safety for perioperative analgesia in the elderly with proximal femur fractures: a randomized controlled study.

BACKGROUND: Proximal femur fractures are most common fractures in the elderly and associated with significant mortality and morbidity, with … h. In group 2 intraoperative spinal anaesthesia were performed. Group 3 patients underwent general sevoflurane inhalation anaesthesia with fentanyl infusion for analgesia. All patients received paracetamol 3 g/day and dexketoprofen 75 mg/day during hospitalization. On-demand, nalbuphine 5 mg SC was used for analgesia. Efficacy outcomes were the ICU length of …

[Common variable immunodeficiency associated with autoimmune thrombocytopenia: anesthetic management].

A 44-year-old man diagnosed of common variable immunodeficiency associated with thrombopenia due to autoimmunity required anesthesia for anal fissure repair and hemorrhoidectomy. Hemostatic complications developed after surgery, with extreme thrombopenia (1,000 platelets/pl) and analytical changes that necessitated administration of six units of platelets from apheresis, as well as immunoglobulins, antifibrinolytic agents (e-aminocaproic acid) and granulocytic colony stimulating factors. Anesthesia for such patients is reviewed, with emphasis on careful management of the airways, preparation o

Upper-limb somatosensory evoked potential monitoring in lumbosacral spine surgery: a prognostic marker for position-related ulnar nerve injury.

BACKGROUND CONTEXT: Somatosensory evoked potential (SSEP) is used to monitor integrity of the brain, spinal cord, and nerve roots during spi … rone on Jackson or Andrews spinal table. Anesthesia was maintained with inhalant gas (desflurane or sevoflurane) and propofol infusion with and without minimal infusion of narcotics (fentanyl, sufentanyl, or remifentanil). Intraoperative neurophysiologic monitoring of upper-limb or ulnar SSEP was achieved by continuously recording cortical and subcortical res …

Antiallodynic Effect of Thalidomide and Morphine on Rat Spinal Nerve Ligation-induced Neuropathic Pain.

BackgroundTumor necrosis factor-alpha and other proinflammatory cytokines are becoming well recognized as key mediators in the pathogenesis of many types of neuropathic pain. Thalidomide has profound immunomodulatory actions in addition to their originally intended pharmacological actions. There has been debate on the analgesic efficacy of opioids in neuropathic pain. The aim of this study was to investigate the effect of thalidomide and morphine on a spinal nerve ligation model in rats.MethodsMale Sprague-Dawley rats weighing 100-120 g were used. Lumbar (L) 5 and 6 spinal nerve ligations were

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… Briefly, the left L5 and L6 spinal nerves of rats were isolated adjacent to the vertebral column during sevoflurane anesthesia and tightly ligated with a 6-0 silk suture distal to the dorsal root ganglia. Care was taken to avoid injury of the L4 spinal nerve. … Rats showing motor impairment after surgery were killed immediately using overdose of sevoflurane. 3. Drugs The following drugs were used in this study: thalidomide (Sigma Chemical Co., St. Louis, MO, USA) and morphine sulfate (Sigma Aldrich Co., St. Louis, MO, USA). …

Effect of remifentanil on the hemodynamic responses and recovery profile of patients undergoing single jaw orthognathic surgery.

The aim of this study was to compare fentanyl-based versus remifentanil-based anesthesia with regards to the intraoperative hemodynamic stress response and recovery profiles in patients undergoing Le Fort I osteotomy. Seventeen patients were randomly divided into two groups: patients in the F-group received 2 μg/kg fentanyl intravenously followed by an infusion of 0.03-0.06 μg/kg/min, while patients in the R-group received a 0.5 μg/kg bolus of remifentanil followed by an infusion of 0.0625-0.250 μg/kg/min. Mean arterial pressure and heart rate were recorded at the following points: before anes

Mechanisms and effects of metformin on skeletal muscle disorders.

Skeletal muscle disorders are mostly genetic and include several rare diseases. With disease progression, muscle fibrosis and adiposis occur, resulting in limited mobility. The long course of these diseases combined with limited treatment options affect patients both psychologically and economically, hence the development of novel treatments for neuromuscular diseases is crucial to obtain a better quality of life. As a widely used hypoglycemic drug in clinical practice, metformin not only has anti-inflammatory, autophagy-regulating, and mitochondrial biogenesis-regulating effects, but it has a

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… Interestingly, another study found that metformin increased phosphorylation of AMPK (Thr172), which in turn caused increased phosphorylation of ULK1 (Ser317 and Ser777) and upregulated autophagic activity to protect against sevoflurane-induced synaptic decline and neurocognitive deficits, suggesting … Metformin attenuates sevoflurane-induced neurocognitive impairment through Ampk-Ulk1-dependent autophagy in aged mice. Brain Res Bull. (2020) 157:18–25. doi: 10.1016/j.brainresbull.2020.01.018 57. Wang C, Yao Z, Zhang Y, Yang Y, Liu J, Shi Y, et al. …