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1.
Medicine (Baltimore) ; 99(16): e19704, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311952

RESUMO

General anesthesia with double-lumen endobronchial intubation is considered mandatory for thoracoscopic bullectomy. We assessed the safety and feasibility of thoracoscopic bullectomy for treatment of primary spontaneous pneumothorax (PSP) under intubating laryngeal mask airway (ILMA) with spontaneous breathing sevoflurane anesthesia combined with thoracic paravertebral block (TPB).From January 2018 to December 2018, some 34 consecutive patients with PSP were treated by thoracoscopic bullectomy under ILMA with spontaneous breathing sevoflurane anesthesia combined with TPB (study group). To evaluate the safety and feasibility of this new technique, these patients were compared with the control group consisting of 34 consecutive patients with PSP who underwent thoracoscopic bullectomy using tracheal intubation with controlled ventilation from January 2017 to December 2017. The demographic characteristics, intraoperative surgical and anesthetic results, and postoperative results were assessed.The 2 groups had comparable anesthetic time, operation time, chest drainage time, postoperative hospital stays, and hospitalization cost. Visual analogue score (VAS) scores at 3 hours at rest and at coughing were significantly lower in the study group than in the control group (mean, 0.9 vs 2.0 and 1.8 vs 4.0, P = .024 and P = .006, respectively). No differences were seen in PaO2 values between the 2 groups in the intraoperative stage and postoperative stage (P > .05, respectively). The pH value was significantly lower in the intraoperative stage (mean, 7.28 vs 7.40, P = .01) and higher in the postoperative stage (mean, 7.35 vs 7.33, P = .014) in the study group than in the control group. The PaCO2 value was significantly higher in the intraoperative stage in the study group than in the control group (mean, 57.0 mm Hg vs 42.0 mm Hg, P = .015). In the study group, no cough reflex was found, and the level of collapse of the operative lung was excellent in 31 cases and good in 3 cases.Our study demonstrated that thoracoscopic bullectomy for treatment of PSP can be safely and feasibly performed in highly selected patients under ILMA with spontaneous breathing sevoflurane anesthesia combined with TPB.


Assuntos
Intubação Intratraqueal , Pneumotórax/cirurgia , Respiração Artificial , Toracoscopia , Anestésicos Inalatórios/uso terapêutico , Estudos de Viabilidade , Feminino , Humanos , Intubação Intratraqueal/métodos , Pulmão/cirurgia , Masculino , Bloqueio Nervoso , Segurança do Paciente , Respiração Artificial/métodos , Sevoflurano/uso terapêutico , Toracoscopia/métodos , Resultado do Tratamento , Adulto Jovem
2.
Medicine (Baltimore) ; 99(16): e19733, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311965

RESUMO

RATIONALE: Becker muscular dystrophy (BMD) and Duchenne muscular dystrophy (DMD) are progressive neuromuscular disorders caused by mutations in the dystrophin gene. The management of anesthesia in patients with BMD is complicated because they are highly sensitive to the conventional anesthetics such as volatile anesthetics and muscle relaxants. It is reported that anesthesia in patients with DMD is associated with several complications. However, a few case reports have been published on adult patients with BMD undergoing surgery with general anesthesia. Reports indicate that children with BMD may experience some serious complications with flurane-inhaled anesthesia. However, no study has yet shown that the use of flurane-induced anesthesia in adults with DMD carries high risks. PATIENT CONCERNS: We describe a 56-year-old woman with BMD who was scheduled for laparoscopic hysterectomy and bilateral adnexectomy under general anesthesia due to a mass in the uterus. The patient was diagnosed with BMD 20 years back and reported that during this period, she was able to walk slowly with help during her daily life. Additionally, she also had a history of hypertension since 4 years and type 2 diabetes mellitus since 2 years. DIAGNOSIS: The patient was postmenopausal and presented with abnormal uterine bleeding and elevated CA125. Abdominal ultrasonography revealed diffuse enlargement of the uterus and hypoechoic internal echoes. These findings were suggestive of diffuse adenomyosis with multiple uterine leiomyomas, which would have adverse effects later in her life. Therefore, the patient required surgery to address the symptoms and further confirm the diagnosis. The final diagnosis was confirmed by histopathological analysis. INTERVENTIONS: The patient was scheduled for laparoscopic hysterectomy and bilateral adnexectomy. Anesthesia was induced and maintained by a combination of intravenous and inhalation anesthetic agents, particularly cisatracurium besilate and inhaled. sevoflurane. OUTCOMES: The duration of anesthesia and postoperative period were uneventful. At the end of the operation, the patient had normal vital signs and was fully conscious. The patient was followed up for 8 months and no complications were noted during this period. LESSONS: The combination of sevoflurane and cisatracurium besilate is a safe and effective method for the anesthetic management of adult patients with BMD scheduled for laparoscopic gynecological surgery. On the other hand, it is important to be aware of even rare complications of procedures, so that necessary precautions can be undertaken. Further investigations are necessary to determine the safe dosage of volatile anesthetics specifically for this clinical scenario so that anesthesiologists can use this combination method more accurately and precisely.


Assuntos
Anestesia Geral/métodos , Distrofia Muscular de Duchenne , Anestésicos Inalatórios/administração & dosagem , Atracúrio/administração & dosagem , Atracúrio/análogos & derivados , Feminino , Procedimentos Cirúrgicos em Ginecologia , Humanos , Laparoscopia , Pessoa de Meia-Idade , Bloqueadores Neuromusculares/administração & dosagem , Sevoflurano/administração & dosagem
4.
Chem Biol Interact ; 322: 109027, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32147387

RESUMO

OBJECTIVE: Evidence has shown that sevoflurane plays a protective role in acute lung injury (ALI) due to its anti-inflammatory and apoptotic-regulating activity. Nevertheless, the mechanism of sevoflurane is still not completely understood. This study intends to discuss the mechanism of sevoflurane on ALI and the possible mechanisms involved. METHODS: ALI model of rats was established through intravenous injection of endotoxin lipopolysaccharide. microRNA-34a-3p (miR-34a-3p) and signal transducers and activators of transcription 1 (STAT1) expression in lung tissues of ALI rats were detected. The optimal inhaled concentration of sevoflurane was screened, and then the modeled rats were injected with miR-34a-3p inhibitors, overexpressed STAT1 and inhaled 1.0 Minimum Alveolar Concentration (MAC) sevoflurane to determine mean arterial pressure (MAP) of rats, wet weight/dry weight ratio and myeloperoxidase (MPO) activity, oxidative stress- and inflammation-related factors in lung tissues of rats, along with lung cell viability and apoptosis. RESULTS: MiR-34a-3p was downregulated while STAT1 was upregulated in ALI rats. Sevoflurane of 1.0 MAC was selected as the optimal inhalation concentration. Sevoflurane (1.0 MAC) increased MAP at T3 and reduced MPO activity, alleviated pathological damage, suppressed apoptosis, oxidative stress and inflammation, and induced cell viability in lung tissues of ALI rats. Down-regulated miR-34a-3p or up-regulated STAT reversed the functions of sevoflurane (1.0 MAC) on ALI rats. CONCLUSION: Collectively, we demonstrate that sevoflurane reduces inflammatory factor expression, increases lung cell viability and inhibits lung cell apoptosis in ALI through upregulation of miR-34a-3p and downregulation of STAT1, which provides new clues for ALI treatment.


Assuntos
Apoptose , Pulmão/metabolismo , MicroRNAs/metabolismo , Fator de Transcrição STAT1/metabolismo , Sevoflurano/administração & dosagem , Lesão Pulmonar Aguda/etiologia , Lesão Pulmonar Aguda/metabolismo , Lesão Pulmonar Aguda/veterinária , Administração por Inalação , Animais , Antagomirs/metabolismo , Apoptose/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Regulação para Baixo/efeitos dos fármacos , Lipopolissacarídeos/toxicidade , Pulmão/patologia , Masculino , MicroRNAs/antagonistas & inibidores , MicroRNAs/genética , Estresse Oxidativo/efeitos dos fármacos , Peroxidase/metabolismo , Interferência de RNA , RNA Interferente Pequeno/metabolismo , Ratos , Ratos Sprague-Dawley , Fator de Transcrição STAT1/antagonistas & inibidores , Fator de Transcrição STAT1/genética , Sevoflurano/farmacologia , Regulação para Cima/efeitos dos fármacos
5.
Life Sci ; 249: 117472, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32112870

RESUMO

Aim Determine changes in the expressions of the ion channel-TRPV1-and neuropeptides-NKA, NKB, calcitonin gene-related peptide (CGRP), and SP-in 14-, 21-, and 42-day-old rats after inhaling 1.5% and 2.6% sevoflurane. MAIN METHODS: A small in-house inhalation anesthesia chamber was designed to allow 14-, 21-, and 42-day-old rats inhale 1.5% and 2.6% sevoflurane, and rats in the control group inhaled carrier gas(1 L/min air +1 L/min O2). In addition, 14- and 21-day-old rats were pretreated with capsazepine, followed by inhalation of 1.5% and 2.6% sevoflurane or the carrier gas. The expression of TRPV1 in lung tissues was detected by Western blotting, whereas the expressions of NKA, NKB, CGRP, and SP in the trachea were detected by immunohistochemistry. KEY FINDINGS: After inhalation of 1.5% sevoflurane, the expression of TRPV1 in the lung tissues of 14- and 21-day-old rats was significantly increased compared with that in the control group, which was antagonized by capsazepine pretreatment. Moreover, inhalation of 1.5% sevoflurane markedly increased the expressions of NKA, NKB, CGRP, and SP in the trachea of 21-day-old rats and of NKB, CGRP, and SP in the trachea of 14-day-old rats. The expressions of these molecules were antagonized by capsazepine pretreatment. Conversely, inhalation of 2.6% sevoflurane decreased the expressions of NKA and NKB in the trachea of 42-day-old rats. SIGNIFICANCE: Sevoflurane did not upregulate the expression of TRPV1 in the airways of late-developing rats. This anesthetic may have a two-way effect on airways, resulting in considerable effects in pediatric clinical anesthesia management.


Assuntos
Anestésicos Inalatórios/administração & dosagem , Sevoflurano/administração & dosagem , Canais de Cátion TRPV/metabolismo , Traqueia/metabolismo , Administração por Inalação , Fatores Etários , Animais , Gasometria , Peso Corporal/efeitos dos fármacos , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Capsaicina/análogos & derivados , Capsaicina/farmacologia , Relação Dose-Resposta a Droga , Neurocinina A/metabolismo , Neurocinina B/metabolismo , Ratos , Ratos Sprague-Dawley , Respiração/efeitos dos fármacos , Substância P/metabolismo
6.
Bratisl Lek Listy ; 121(2): 117-121, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32115963

RESUMO

AIM: The aim of this study is to demonstrate whether fullerenol C60 protects renal injury in sevoflurane­administered rats. METHOD: Rats (n: 24) were randomly divided into four groups: Control (Group C), Fullerenol C60 (Group F), Sevoflurane (Group S), Fullerenol C60-Sevoflurane (Group FS). Thirty minutes before the procedure, Fullerenol C60, 100 mg/kg, was administered intraperitoneally. Sevoflurane (2.3 %) was applied for 3 hours to rats in S and FS groups. Biochemical and histopathological parameters were analyzed in renal tissue samples. Kruskal-Wallis and Mann-Whitney U tests were used in statistical analyzes. RESULTS: Malondialdehyde (MDA) level and catalase (CAT) enzyme activity in Group S were significantly higher than that in all other groups. Paraoxanase (PON) enzyme activity in Group S was significantly lower than in Groups C and FS. The histopathological examination showed that vascular vacuolization and hypertrophy (VVH) and lymphocyte infiltration (LI) were significantly higher in the Group S compared to the Group C. CONCLUSION: Renal histopathology revealed that the administration of Fullerenol C60 prior to sevoflurane inhalation reduced oxidative stress and partially corrected the damage caused by anesthesia. We concluded that Fullerenol C60 has a renal protective effect in rats when administered before sevoflurane anesthesia (Tab. 2, Fig. 4, Ref. 40).


Assuntos
Fulerenos , Rim , Nanopartículas , Animais , Fulerenos/farmacologia , Rim/efeitos dos fármacos , Malondialdeído , Estresse Oxidativo , Ratos , Sevoflurano
7.
Med Sci Monit ; 26: e919971, 2020 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-32198342

RESUMO

BACKGROUND Intravenous lidocaine administered during surgery improves postoperative outcomes; however, few studies have evaluated the relationship between intravenous lidocaine and volatile anesthetics requirements. This study assessed the effects of lidocaine treatment on sevoflurane consumption and postoperative consciousness disorders in children undergoing major spine surgery. MATERIAL AND METHODS Patients were randomly divided into 2 treatment groups: lidocaine and placebo (control). The lidocaine group received lidocaine as a bolus of 1.5 mg/kg over 30 min, followed by a continuous infusion at 1 mg/kg/h to 6 h after surgery. The following data were assessed: end-tidal sevoflurane concentration required to maintain a bispectral index BIS between 40 and 60, intraoperative blood pressure, heart rate, demand for fentanyl, and consciousness level assessed after surgery using the Richmond Agitation-Sedation Scale. Any treatment-related adverse events were recorded. RESULTS Compared to the control group, lidocaine treatment reduced by 15% the end-tidal sevoflurane concentration required to maintain the intraoperative hemodynamic stability and appropriate level of anesthesia (P=0.0003). There were no intergroup differences in total dose of fentanyl used, average mean arterial pressure, or heart rate measured intraoperatively. The postoperative level of patient consciousness did not differ during the first 6 h between groups. After 9 h, more patients in the control group were still sleepy (P=0.032), and there were fewer perioperative complications in the lidocaine group. CONCLUSIONS Lidocaine treatment decreases sevoflurane consumption and improves recovery profiles in children undergoing major spine surgery.


Assuntos
Período de Recuperação da Anestesia , Lidocaína/administração & dosagem , Sevoflurano/administração & dosagem , Coluna Vertebral/cirurgia , Adolescente , Anestesia Geral , Anestésicos Combinados/administração & dosagem , Criança , Relação Dose-Resposta a Droga , Feminino , Hemodinâmica/efeitos dos fármacos , Humanos , Infusões Intravenosas , Período Intraoperatório , Lidocaína/efeitos adversos , Lidocaína/sangue , Masculino , Monitorização Intraoperatória , Sevoflurano/sangue
8.
PLoS One ; 15(2): e0223700, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32092080

RESUMO

Emulsified volatile anesthetic can be directly injected into the circulation and eliminated from blood through lungs. Taking advantage of the unique pharmacokinetics of the emulsified volatile anesthetics, we aimed to develop a less traumatic method to differentially deliver them to the spinal cord of rabbit. Sixteen New Zealand White rabbits were randomly assigned to the isoflurane or sevoflurane group. A catheter was placed into the descending aorta, and emulsified isoflurane (8mg/kg/h) or sevoflurane (12mg/kg/h) was given respectively. The concentration and partial pressure of the anesthetics in the jugular and femoral vein were measured. Our results showed that the partial pressure for isoflurane was 3.91±1.11 mmHg and 12.61±1.60 mmHg (1.0MAC), and for sevoflurane was 3.89±1.00 mmHg and 19.92±1.84mmHg (1.0MAC), in the jugular vein and femoral vein, respectively. There was significant difference between jugular and femoral vein partial pressure for both isoflurane and sevoflurane groups (both P < 0.001). In conclusion, a simple and minimally invasive method has been successfully developed to selectively deliver isoflurane and sevoflurane to the spinal cord in the rabbit. Before the anesthetics taking action on the brain, 69% of isoflurane and 81% of sevoflurane were removed through lungs. This method can be used to investigate sites and mechanisms of volatile anesthetic action.


Assuntos
Anestésicos Inalatórios/administração & dosagem , Medula Espinal/metabolismo , Anestésicos Inalatórios/farmacocinética , Animais , Encéfalo/efeitos dos fármacos , Emulsões , Veia Femoral , Isoflurano/administração & dosagem , Veias Jugulares , Pulmão/metabolismo , Métodos , Pressão Parcial , Coelhos , Sevoflurano/administração & dosagem , Volatilização
9.
Life Sci ; 248: 117457, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32092334

RESUMO

AIMS: Multiple surgical procedures and anesthesia increase the risk of the development in children. However, the influence of such exposures on the developing childhood immunity organs is rarely reported. MATERIALS AND METHODS: High-throughput sequencing of T-cell receptor (TCR) repertoires (TCRseq) from rhesus monkeys' thymus was performed to investigate whether anesthetics could induce de novo antigen recognition via TCR or TCR development impairments. KEY FINDINGS: No significant difference between sevoflurane and control groups regarding VJ gene combinations and diversity of V and J gene was seen, nor was there an obvious change in similar average number of Complementarity Determining Region 3 (CDR3) aa clonotypes. Our analysis of Rank abundance, Gini coefficient, Simpson index, Normalized Shannon Diversity Entropy (NSDE), Morisita-Horn Similarity Index (MHSI) and Bhattacharyya Distance (BD) indicated there is no difference in TCR diversity and similarity. SIGNIFICANCE: These results suggest early events in thymic T cell development and repertoire generation are not abnormality after multiple sevoflurane exposure during childhood. The stabilization of the immune repertoires suggested the safety of sevoflurane in host immune response in children.


Assuntos
Anestésicos Inalatórios/farmacologia , Regiões Determinantes de Complementaridade/genética , Receptores de Antígenos de Linfócitos T/genética , Sevoflurano/farmacologia , Linfócitos T/efeitos dos fármacos , Timo/efeitos dos fármacos , Animais , Animais Recém-Nascidos , Regiões Determinantes de Complementaridade/classificação , Feminino , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Sequenciamento de Nucleotídeos em Larga Escala , Macaca mulatta , Masculino , Receptores de Antígenos de Linfócitos T/classificação , Receptores de Antígenos de Linfócitos T/imunologia , Linfócitos T/citologia , Linfócitos T/imunologia , Timo/citologia , Timo/imunologia , Recombinação V(D)J/imunologia
10.
Nat Commun ; 11(1): 642, 2020 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-32005799

RESUMO

Metastasis can occur following surgical resection of solid tumors and metastasis is the main cause of cancer death. The role of anesthetics used during surgery in cancer metastasis and the underlying mechanism remains largely unknown. Here we show that surgical dissection of primary tumors in mice under anesthesia with sevoflurane leads to significantly more lung metastasis than with propofol in both syngeneic murine 4T1 and xenograft human MDA-MB-231 breast cancer models. Sevoflurane increases the level of serum IL-6, which activates STAT3 and the infiltration of CD11b+ myeloid cells into the lung. Interruption of IL-6/JAK/STAT3 pathway by a JAK inhibitor AZD1480 reverses the pro-metastatic effect of sevoflurane and the associated increase of both activated STAT3 and infiltrated CD11b+ cells in 4T1 model. Our study provides the preclinical evidence informing the distinct effects of anesthetics on metastasis of breast cancers through change of cytokines and the tumor microenvironment.


Assuntos
Anestésicos Gerais/efeitos adversos , Neoplasias da Mama/cirurgia , Interleucina-6/metabolismo , Janus Quinases/metabolismo , Neoplasias Pulmonares/secundário , Fator de Transcrição STAT3/metabolismo , Anestésicos Gerais/administração & dosagem , Animais , Neoplasias da Mama/patologia , Linhagem Celular Tumoral , Modelos Animais de Doenças , Feminino , Humanos , Interleucina-6/genética , Janus Quinases/genética , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Propofol/administração & dosagem , Propofol/efeitos adversos , Fator de Transcrição STAT3/genética , Sevoflurano/administração & dosagem , Sevoflurano/efeitos adversos
11.
Niger J Clin Pract ; 23(1): 120-122, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31929218

RESUMO

We present a very rare case of Sevoflurane Induced Diffuse Alveolar Haemorrhage in a young male patient with a closed tibial fracture after direct trauma to the right cruris. The patient was operated for tibial fracture, but diffuse alveolar haemorrhage developed after sevoflurane inhalation in the postoperative period following general anesthesia. Diffuse alveolar haemorrhage (DAH) is associated with inhalation injury from halogenated gases and reported as a unique entity in the literature that practicing clinicians should be aware of and consider in post-operative cases of acute respiratory distress. As DAH usually presents with symptoms the presence of hemoptysis, anemia, dyspnoea and radiological alveolar infiltrates, rapid detection of the aetiology and initiation of cause-directed treatment are of great importance on survival.


Assuntos
Anestésicos Inalatórios/efeitos adversos , Hemoptise/induzido quimicamente , Hemorragia/induzido quimicamente , Procedimentos Ortopédicos/efeitos adversos , Complicações Pós-Operatórias/induzido quimicamente , Alvéolos Pulmonares/diagnóstico por imagem , Sevoflurano/farmacologia , Fraturas da Tíbia/cirurgia , Adulto , Anestesia Geral , Broncoscopia , Hemoptise/terapia , Humanos , Masculino , Complicações Pós-Operatórias/terapia , Período Pós-Operatório , Alvéolos Pulmonares/patologia , Tomógrafos Computadorizados , Resultado do Tratamento
14.
Life Sci ; 242: 117151, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31843526

RESUMO

AIMS: Anaesthesia-related neurotoxicity in the developing brain is a controversial issue that has recently attracted much attention. Hemin plays a protective role in hypoxic and ischemic brain damage; however, its effects on sevoflurane-induced neurotoxicity remain unclear. Our aim was to investigate the mechanisms of sevoflurane neurotoxicity and potential neuroprotective roles of hemin upon sevoflurane exposure. MAIN METHODS: Hippocampi were harvested 18 h after sevoflurane exposure. Haem oxygenase 1 (HMOX1), superoxide dismutase 2 (SOD2), discs large MAGUK scaffold protein 4 (DLG4), phosphorylated Akt, Akt, cleaved caspase 3, and neuroglobin were detected by western blotting. A water maze test was used to assess learning and memory ability in P30 rats. KEY FINDINGS: Sevoflurane inhalation increased cleaved caspase 3 levels. Hemin treatment enhanced the antioxidant defence response, protecting rats from oxidative stress injury. Hemin plays its neuroprotective role via phosphoinositide 3-kinase (PI3K)/Akt signalling. A single inhalation of sevoflurane did not affect DLG4 expression, while hemin treatment did. Platform crossing increased in rats treated with hemin as well, which may be related to increased DLG4. Neuroglobin expression was not affected, suggesting that it may act upstream of PI3K/Akt signalling. SIGNIFICANCE: Our study demonstrates that hemin plays a protective role in anaesthesia-induced neurotoxicity by both inhibiting apoptosis via the PI3K/Akt pathway and increasing the expression of antioxidant enzymes, reducing oxidative damage. The results provide mechanistic insight into the effects of sevoflurane anaesthesia on the developing brain and suggest that hemin could help avoid these effects.


Assuntos
Anestésicos Inalatórios/toxicidade , Encéfalo/efeitos dos fármacos , Hemina/farmacologia , Fármacos Neuroprotetores/farmacologia , Fosfatidilinositol 3-Quinase/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Sevoflurano/toxicidade , Transdução de Sinais/efeitos dos fármacos , Administração por Inalação , Animais , Animais Recém-Nascidos , Western Blotting , Caspase 3/metabolismo , Proteína 4 Homóloga a Disks-Large/metabolismo , Heme Oxigenase (Desciclizante)/metabolismo , Hipocampo/química , Hipocampo/efeitos dos fármacos , Hipocampo/enzimologia , Aprendizagem em Labirinto/efeitos dos fármacos , Neuroglobina/metabolismo , Ratos , Ratos Sprague-Dawley , Sevoflurano/antagonistas & inibidores , Superóxido Dismutase/metabolismo
15.
Chemosphere ; 239: 124839, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31726519

RESUMO

The inhalational anaesthetic agent - sevoflurane is widely employed for the induction and maintenance of surgical anaesthesia. Sevoflurane possesses a high global warming potential that imposes negative impact to the environment. The only way to resolve the issue is to remove sevoflurane from the medical waste gas before it reaches the atmosphere. A continuous adsorption study with a fixed-bed column was conducted using two commercial granular activated carbons (E-GAC and H-GAC), to selectively remove sevoflurane. The effect of bed depth (Z, 5-15 cm), gas flow rate (Q, 0.5-6.0 L/min) and inlet sevoflurane concentration (C0, ∼55-700 mg/L) was investigated. E-GAC demonstrated ∼60% higher adsorption capacity than H-GAC under the same operating conditions. Varying the levels of Z, Q and C0 showed significant differences in the adsorption capacities of E-GAC, whereas only changing the C0 level had significant differences for H-GAC. Three breakthrough models (Adams-Bohart, Thomas, and Yoon-Nelson) and Bed-depth/service time (BDST) analysis were applied to predict the breakthrough characteristics of the adsorption tests and determine the characteristic parameters of the column. The Yoon-Nelson and Thomas model-predicted breakthrough curves were in good agreement with the experimental values. In the case of the Adams-Bohart model, a low correlation was observed. The predicted breakthrough time (tb) based on kinetic constant (kBDST) in BDST analysis showed satisfactory agreement with the measured values. The results suggest the possibility of designing, scaling up and optimising an adsorption system for removing sevoflurane with the aid of the models and BDST analysis.


Assuntos
Poluentes Atmosféricos/análise , Anestésicos Inalatórios/análise , Carvão Vegetal/química , Eliminação de Resíduos de Serviços de Saúde/métodos , Resíduos de Serviços de Saúde/análise , Sevoflurano/análise , Adsorção
16.
Anesthesiology ; 132(1): 107-120, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31596735

RESUMO

BACKGROUND: Extracellular vesicles and their microRNA cargo are crucial facilitators of malignant cell communication and could mediate effects of anesthetics on tumor biology during cancer resection. The authors performed a proof-of-concept study to demonstrate that propofol and sevoflurane have differential effects on vesicle-associated microRNAs that influence signaling pathways involved in tumor progression and metastasis. METHODS: Circulating vesicles were investigated in a prospective, matched-case pilot study in two cohorts of colorectal cancer patients receiving either propofol (n = 8) or sevoflurane (n = 9), matched for tumor stage and location. Serum was sampled before anesthesia and after tumor resection. Vesicular microRNA profiles were analyzed by next generation sequencing and confirmed by real-time polymerase chain reaction. Next, we assessed perioperative changes in microRNA expression induced by either anesthetic and compared their biologic effects on tumor-relevant pathways. Additionally, vesicles from pre- and postoperative sera were biologic characterized. RESULTS: Postoperative microRNA profiles were shifted in both groups with overlap in the perioperative response. A total of 64 (48 up, range of log2 fold change 1.07 to 3.76; 16 down, -1.00 to -1.55) and 33 (32 up, 1.02 to 2.98; 1 down, -1.36) microRNAs were significantly regulated (adjusted P value less than 0.05) by propofol and sevoflurane, respectively. Thirty-six (propofol) and five (sevoflurane) microRNAs were specifically responsive to either anesthetic agent. In silico target analyses of microRNA expression patterns indicated an inhibitory effect of propofol on crucial carcinoma-related pathways such as proliferation (z-score, -1.73) and migration (z-score, -1.97), as well as enhanced apoptosis (z-score, 1.19). While size distribution and protein markers of circulating vesicles were not affected by anesthesia, their concentration was reduced after surgery using both anesthetic procedures. CONCLUSIONS: This proof-of-concept study provides preliminary evidence that anesthetic agents have specific effects on microRNA profiles in circulating vesicles. These findings could form the basis for larger and mechanistically oriented outcome studies in cancer patients.


Assuntos
Anestésicos Inalatórios/farmacologia , Anestésicos Intravenosos/farmacologia , Neoplasias Colorretais/cirurgia , MicroRNAs/efeitos dos fármacos , Propofol/farmacologia , Sevoflurano/farmacologia , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos
17.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(6): 852-858, 2019 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-31880117

RESUMO

OBJECTIVE: To investigate the protection effect of dexamethasone (DXMS) on the memory impairment and neuronal damage of neonate rats that caused by sevoflurane (SEVO) exposure. METHODS: 5-days-old newborn SD rats were randomly divided into normal group (NC group) (10 rats), SEVO group (10 rats) and SEVO+DXMS group (10 rats). Rats of SEVO group and SEVO+DXMS group were exposed to 2.5% SEVO 2 h per day for 1 week, meanwhile the rats of SEVO+DXMS group were given 20 mg/kg DXMS treatment before exposure and the normal group was given the same amount of placebo and carrier gas as control. All rats were fed normally till infancy. Then the Morris water maze test was used to assess the learning and memory function of rats of each group. HE and Nissl staining were used to observe the histomorphology and neuronal changes in the hippocampus of rats. ELISA was performed to test the changes in nitric oxide (NO), superoxide dismutase (SOD) and malondialdehyde (MDA) level in brain tissues. The expression of silent information regulator 1 (SIRT1), peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α), fork head protein transcription factor 3α (FOXO3α) mRNA in brain tissue was detected by qRT-PCR. Western blot was used to explore the changes in SIRT1 and caspase-3 protein expression of hippocampus. RESULTS: Compared with the NC group, the pathologic damage of hippocampus tissues was severely in SEVO group, and the number of neuronal cells was decreased as well. After SEVO intervention, the degree of pathologic damage was alleviated, and the number of neuronal cells was significantly increased. The Morris water maze test showed that the escape latency, number of platform crossing and target quadrant retention time between SEVO group and SEVO+DXMS group were significant different. The level of NO and MDA in brain of SEVO+DXMS group was significantly decreased than that of SEVO group, while the level of SOD was increased. qRT-PCR showed that the mRNA levels of SIRT1, PGC-1α and FOXO3α in SEVO+DXMS group were significantly higher those in SEVO group, but mRNA level of SIRT1 was still significantly lower than that of NC group. Western blot showed that the expression of SIRT1 protein in SEVO+DXMS group was significantly higher than that of SEVO group, and the expression of caspase-3 was reduced in SEVO+DXMS compared with SEVO group. CONCLUSION: DXMS could reduce the level of oxidative stress and suppress the apoptosis of neuronal cells, reduce SEVO-induced brain damage in neonatal rats and improve learning and memory ability in infant rats.


Assuntos
Memória/efeitos dos fármacos , Animais , Dexametasona , Hipocampo , Aprendizagem em Labirinto , Ratos , Ratos Sprague-Dawley , Sevoflurano
18.
Bratisl Lek Listy ; 120(12): 887-893, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31855046

RESUMO

OBJECTIVE: We aimed to investigate the effects of recurrent sevoflurane anesthesia on cognitive functions in Alzheimer Disease. MATERIALS AND METHODS: Rats were divided into 4 groups as followed: control (Group C), sevoflurane (Group S), Alzheimer's (Group A) and Alzheimer's + sevoflurane (Group AS)]. Cognitive functions were evaluated with Radial Arm Maze Test (RAMT). Alzheimer model was created by administering 3 mg/kg (10 µl) STZ. Sevoflurane was administered to S and AS groups. Serum samples and hippocampus tissues were analyzed. RESULTS: In RAM test, the entry-exit data were significantly decreased in A and AS groups. After the 2nd and 3rd administration of anesthesia, the numbers were significantly decreased in Group S. Glial-fibrillary-acidic protein levels were significantly higher in AS compared to the C and S groups. The brain tissue caspase 3 activity was less than 1% in all rats in the Group C, 3 % in 2 rats and 1 % in 1 rat in the Group AS. In A and AS group, serum catalase, myeloperoxidase and ferroxidase activities were found to be higher than in the other groups and myeloperoxidase activity was higher in the AS than in the A Group. Serum native thiol, total thiol and disulfide levels were found to be significantly different in the A and AS groups. CONCLUSION: Sevoflurane anesthesia negatively affected the cognitive functions (Tab. 5, Fig. 10, Ref. 51).


Assuntos
Doença de Alzheimer/induzido quimicamente , Anestesia , Anestésicos Inalatórios , Cognição/efeitos dos fármacos , Éteres Metílicos/farmacologia , Sevoflurano/efeitos adversos , Estreptozocina/farmacologia , Animais , Aprendizagem em Labirinto/efeitos dos fármacos , Ratos , Sevoflurano/administração & dosagem
19.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(5): 689-694, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31762239

RESUMO

OBJECTIVE: To assess changes in the cognitive function and hippocampal ultrastructure of elderly rats exposed to sevoflurane. METHODS: Ault male Sprague-Dawley rats were given subcutaneous injection of D-galactose on the neck for 40 d to establish elderly models, after 9-day behavioral training. The model rats were divided into 3 groups randomly: control group with natural air, A/O group with 6 h exposure to carrier gas (2 L/min Air+2 L/min O2), and Sev group with 6 h exposure to 3.2% sevoflurane through carrier gas. Morris Water Maze and balance beam experiment were conducted on 6 rats in each group 2 h, 1 week and 4 weeks after treatments, respectively. The hippocampal tissues of the rats were rapidly dissected and prepared by glutaraldehyde fixation, ethanol dehydration, infiltration, embedding polymerization, semimembrane section localization and staining for examinations under transmission electron microscopy. The hippocampal ultrastructure such as nucleus, cytoplasm, mitochondria, endoplasmic reticulum, medullary nerve fiber, synapse and apoptotic corpuscle were observed. RESULTS: Ethology: compared with the control and A/O groups, significant reductions in the probe trial capability were found in the rats after 2 h exposure to sevoflurane, which recovered at 1 week and 4 weeks. Sevoflurane also increased the working memory escape latency 2 h and 1 week after exposure. The balance beam experiment showed that sevoflurane prolonged the staring time of rats after 2 h exposure, which recovered at 1 week and 4 weeks. Prolonged length for going through the balance beam was found consistently in the rats exposed to sevoflurane. Transmission electron microscopy: rats in the control group were found to have clear hippocampal ultrastructure, intact nuclear membrane, no edema fluid in the cytoplasm, intact mitochondria and endoplasmic reticulum, normal medullary nerve fibers, intact synaptic structure, and no apoptotic bodies in the cells. But a small amount of edema were observed in the cytoplasm of hippocampal cells in the rats exposed to sevoflurane and A/O at 2 h, which increased at 1 week. The cytoplasmic morphology of rats in the A/O group returned to normal at 4 weeks. But further increase of edema was observed in the rats 4 weeks after exposure to sevoflurane. No abnormal morphological structures or apoptotic bodies in other organelles were found. CONCLUSIONS: Sevoflurane can induce early neurocognitive impairments in elderly rats, which may be related with changes in the hippocampus ultrastructure.


Assuntos
Envelhecimento , Cognição , Hipocampo/ultraestrutura , Sevoflurano/farmacologia , Animais , Hipocampo/efeitos dos fármacos , Masculino , Aprendizagem em Labirinto , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley
20.
Medicine (Baltimore) ; 98(47): e18088, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31764844

RESUMO

The objective of this study is to compare the effects of paravertebral nerve block-propofol intravenous general anesthesia (PPA) and sevoflurane inhalation general anesthesia (SGA) on the expression of serum vascular endothelial growth factor (VEGF) and transforming growth factor beta (TGF-ß) in patients undergoing radical resection of lung cancer.Patients undergoing radical resection of lung cancer were divided into PPA group and SGA group. In PPA group, thoracic paraspinal nerve block was performed with 0.5% ropivacaine (2 mg/kg) before general anesthesia. Anesthesia was maintained with 2.5-3.5 µg/mL TCI of propofol. In SGA group, anesthesia was maintained with 1.0-1.5 MAC sevoflurane. The dosage of opioids during and 24 h after operation, the pain score at 2, 8, 24, 48, and 72 h after operation, and the concentrations of serum VEGF and TGF-ß before and 24 h after operation were observed in the two groups.The intraoperative dosage of remifentanil in PPA group was significantly less than that in SGA group (P < 0.05). The dosage of sufentanil in SGA group was significantly less than that in SGA group at 24 h after operation (P < 0.05). The VAS score at 2, 8, and 24 h after operation was significantly lower than that in SGA group (P < 0.05). The serum VEGF and TGF-ß concentration in PPA group was significantly lower than that in SGA group (P < 0.05).Thoracic paravertebral nerve block-propofol intravenous general anesthesia can reduce the dosage of opioids, improve the effect of postoperative analgesia, and reduce the serum concentration of tumor angiogenesis-related factors in patients undergoing radical resection of lung cancer.


Assuntos
Anestesia Geral/métodos , Anestésicos Inalatórios/administração & dosagem , Anestésicos Intravenosos/administração & dosagem , Neoplasias Pulmonares/cirurgia , Pneumonectomia , Propofol/administração & dosagem , Sevoflurano/administração & dosagem , Sevoflurano/farmacologia , Fator de Crescimento Transformador beta/efeitos dos fármacos , Fator A de Crescimento do Endotélio Vascular/efeitos dos fármacos , Anestesia por Inalação , Anestesia Intravenosa , Anestésicos Inalatórios/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculos Paraespinais/inervação , Pneumonectomia/métodos , Propofol/farmacologia , Estudos Prospectivos , Tórax
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