Apamin, an SK2 Inhibitor, Attenuated Neonatal Sevoflurane Exposures Caused Cognitive Deficits in Mice through the Regulation of Hippocampal Neuroinflammation.

Cognitive dysfunction induced by anesthesia in the infant is a crucial clinical issue that is still being debated and the focus of concern for the parents. However, the mechanism of cognitive decline caused by anesthesia and the corresponding treatment methods remain unclear. Postnatal day 7 (PND7) C57BL/6 mice included in the study were randomly divided into a control group (Control), a group with repeated exposure to sevoflurane (Sevo), and an Apamin intervention group (Sevo + Apamin). Apamin (0.5 µL at the concentration of 100 nmol/L) was injected into the bilateral hippocampus of mice. qRT-PCR, enzyme-linked immunosorbent assay (ELISA), and western blotting assay were used to evaluate the protein levels in the hippocampus. Object location memory (OLM) and novel object recognition (NOR) tasks, as well as elevated plus maze and contextual and cued fear conditioning tasks were used to evaluate the cognitive function of mice. Apamin mitigated sevoflurane-induced cognitive impairment of mice, sevoflurane-induced neuronal injury, and sevoflurane-induced activation of microglial in the hippocampus of the mice. Apamin inhibited M1-type polarization but promoted M2-type polarization of microglia after neonatal sevoflurane exposures in the hippocampus. In conclusion, Apamin attenuates neonatal sevoflurane exposures that cause cognitive deficits in mice through regulating hippocampal neuroinflammation.

The Efficacy of Ultrasound-Guided Superior Laryngeal Nerve Block as an Adjuvant to General Anesthesia during Suspension Laryngoscopy Vocal Cord Polypectomy.

Background: In the current study, we assessed the effect of the ultrasound-guided internal branch of the upper laryngeal nerve (USG-guided iSLN) block combined with general anesthesia on perioperative sore throat (POST), cough, hoarseness of voice, intraoperative hemodynamic changes, and the quality of early recovery for the patients undergoing suspension laryngoscopy vocal cord polypectomy (SLVCP). Methods: This was a randomized controlled trail. Eighty patients, aged from 18 to 70 years old, ASA I ∼ II, scheduled for polypectomy of the vocal cord by using a laryngoscope, were randomized into 2 groups (n = 40 each) using a random number table. Patients in group C received general anesthesia (GA), whereas those in group S received USG-guided iSLN block bilaterally (37.5 mg of 0.375% ropivacaine, 5 ml each side) combined with GA. The primary outcome was the quality of patients' recovery using the Quality of Recovery Questionnaire (QoR-9). The secondary outcomes were postoperative cough, sore throat, hoarseness of voice, and hemodynamic changes in both groups at corresponding time points. The adverse reactions such as postoperative chocking, or aspiration, and dyspnea was recorded as well. Results: The QoR-9 scores of patients in group C were lower than those of group S at time points of D1∼D2 (P < 0.05). Patients in group S had a significantly lower incidence of perioperative cough than those in group C in the early postoperative period (1 hour after extubation) (P < 0.05), the scores of sore throat were lower in group S than those in group C (P < 0.05), the incidence of postoperative hoarseness was increased in group S than that in group C at the time points of 30 min, 2 h, and 4 h after extubation (P < 0.05); however, the incidence of postoperative hoarseness was decreased in group S than that in group C at the time point of 24 h after extubation (P < 0.05). MAP and HR of group S was lower than those of group C at time points of T1∼T4 (P < 0.05). No serious adverse events were observed in both groups. Conclusion: The study found that the application of ultrasound guided superior laryngeal nerve block combined with general anesthesia for the patients undergoing SLVCP could effectively promote the quality of early recovery. Clinical trial registration: This trial is registered with NCT05309174. The date of registration: March 12th 2021.Trial registry name: The Study of Bilateral Upper Laryngeal Nerve Block for Supporting the Removal of Vocal Cord Polyps Under Laryngoscopy.