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Braz J Anesthesiol 2021 Apr 19. Epub 2021 Apr 19.

Klinikum Dortmund, Department of Anesthesiology and Operative Intensive Care Medicine, Dortmund, Germany; University Hospital Bonn, Department of Anesthesiology and Operative Intensive Care Medicine, Bonn, Germany. Electronic address:

Background: The aim of this prospective multicenter observational study was to measure the incidence of postoperative pediatric emergence delirium and to investigate the occurrence of early postoperative negative behavior within two weeks after outpatient adenoidectomy in preschool children.

Methods: The study comprised 222 patients (1-7 years of age). All children received a multimodal anesthesia based on total intravenous anesthesia with propofol and remifentanil in combination with piritramid (0. Read More

J Pediatr Hematol Oncol 2021 Apr 21. Epub 2021 Apr 21.

Departments of Anesthesiology Pediatrics Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC.

Deep sedation/general anesthesia is commonly used in pediatric oncology patients undergoing lumbar puncture (LP). Propofol is often used for sedation, with or without a narcotic. We hypothesized that eutectic mixture of lidocaine and prilocaine (EMLA) would allow for lower cumulative doses of propofol and less movement. Read More

Ann Card Anaesth 2021 Apr-Jun;24(2):172-177

Department of Cardiothoracic and Vascular Anaesthesia, Sree Chitra Tirunal Institute of Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.

Aim: The objective of the present study was to compare the effect of sevoflurane with the sevoflurane-propofol combination on renal function in patients undergoing valvular heart surgery. The renal protective effect was assessed using a novel marker called neutrophil gelatinase-associated lipocalin (NGAL).

Materials And Methods: This was a prospective randomized controlled pilot study conducted at a tertiary care center in India. Read More

Acta Anaesthesiol Scand 2021 Apr 21. Epub 2021 Apr 21.

Neurology Unit, Neurophysiologic Section. Parc de Salut Mar. Barcelona, Spain.

Background: Dexmedetomidine is used as adjuvant in total intravenous anaesthesia (TIVA), but there have been few studies concerning its effect on intraoperative neurophysiological monitoring (IONM) during cranial surgery. Our aim was to study the effect of dexmedetomidine on IONM in patients undergoing brain stem and supratentorial cranial surgery.

Methods: Two prospective, randomized, double-blind substudies were conducted. Read More

Curr Neuropharmacol 2021 Apr 20. Epub 2021 Apr 20.

Department of Anesthesia, Peking University, Shenzhen, China.

Acetylcholine in the brain serves arousal and cognitive functions. Cholinergic neurons in the mesopontine brainstem and basal forebrain are important for activation of the cerebral cortex, which is characterized by suppression of irregular slow waves and increase in gamma (30-100 Hz) activity in the electroencephalogram, and appearance of a hippocampal theta rhythm. During general anesthesia, decrease in acetylcholine release and cholinergic functions contribute to the desirable outcomes of general anesthesia such as amnesia, loss of awareness and consciousness, and immobility. Read More

World J Surg 2021 Apr 21. Epub 2021 Apr 21.

Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-Gu, Seoul, 03722, Korea.

Background: There has been increasing attention on the subjective recovery of patients undergoing cancer surgery. Total intravenous anesthesia (TIVA) and inhaled anesthesia with volatile anesthetics (INHA) are safe and common anesthetic techniques. Currently, TIVA and INHA have only been compared for less invasive and less complex surgeries. Read More

Sci Prog 2021 Apr-Jun;104(2):368504211010629

Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, South Korea.

The neuromuscular block state may affect the electroencephalogram-derived index representing the anesthetic depth. We applied an Anesthetic Depth Monitoring for Sedation (ADMS) to patients undergoing laparoscopic cholecystectomy under total intravenous anesthesia, and evaluated the requirement of propofol according to the different neuromuscular block state. Adult patients scheduled to undergo laparoscopic cholecystectomy were enrolled and randomly assigned to either the moderate (MB) or deep neuromuscular block (DB) group. Read More

Eur J Anaesthesiol 2021 Apr 14. Epub 2021 Apr 14.

From the Department of Anaesthesiology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands (ES, EO, AD, JV).

Background: It is generally accepted that a neuraxial blockade strengthens the sedative effects of propofol. Deafferentation caused by neuraxial blockade is thought to play a key role.

Objectives: The objective is to determine whether epidural blockade affects the bispectral index (BIS) of propofol and two other pharmacodynamic endpoints, mean arterial pressure (MAP) and cardiac output (CO). Read More

eNeuro 2021 Apr 15. Epub 2021 Apr 15.

Queensland Brain Institute, The University of Queensland, Brisbane, QLD Australia

Super-resolution microscopy provides valuable insight for understanding the nanoscale organization within living tissue, although this method is typically restricted to cultured or dissociated cells. Here, we develop a method to track the mobility of individual proteins in adult brains, focusing on a key component of the presynaptic release machinery, syntaxin1A. We show that individual syntaxin1A dynamics can be reliably tracked within neurons in the whole fly brain, and that the mobility of syntaxin1A molecules increases following conditional neural stimulation. Read More

BMC Anesthesiol 2021 Apr 19;21(1):122. Epub 2021 Apr 19.

Faculty of Medicine, Beni -Suef University, Beni - Suef, Egypt.

Background: This study compared the effects of premedication with different doses of aminophylline on the recovery profile after general anaesthesia.

Methods: Forty-five patients scheduled for pelvic-abdominal surgeries were divided into 3 groups: Group C: the patients received 100 ml of IV normal saline, Group A1: the patients received 2 mg/kg IV aminophylline, and Group A2: the patients received 4 mg/kg IV aminophylline 30 min before induction of general anaesthesia. The following data were recorded: demographic data, ASA physical status, duration of anaesthesia and surgery, heart rate, mean arterial blood pressure, propofol dose, fentanyl dose, times to reach BIS (48 ± 2) after induction of anaesthesia and to reach a value of 80 after discontinuation of sevoflurane anaesthesia, time to recovery of consciousness and to tracheal extubation and to discharge from the post-anaesthesia care unit, and side effects of aminophylline. Read More

J Healthc Eng 2021 1;2021:5529798. Epub 2021 Apr 1.

Department of Hand and Foot Surgery, Affiliated Hospital of Beihua University, Jilin 132012, China.

The rapid development of intelligent computer technology has promoted the improvement of people's living standards and the application of the entire intelligent system. In modern medicine, doctors use their accumulated experience and medical knowledge to diagnose diseases and draw conclusions. In order to effectively inherit the diagnosis experience accumulated by doctors, R&D personnel put forward the idea of using artificial intelligence technology to develop an intelligent auxiliary medical diagnosis system. Read More

Neurohospitalist 2021 Jan 15;11(1):49-53. Epub 2020 Jun 15.

Departement of Intensive Care Medicine, Hôpital du Valais, Sion, Switzerland.

We describe a case of severe neuroexcitatory reaction with hyperthermia after administration of propofol in a 43-year-old patient suspected of a relapse of sarcoidosis who underwent bronchoscopy. This resulted in a lengthy stay in intensive care and long-term neuropsychological impairment. A review of the literature shows that severe neuroexcitatory symptoms (seizure-like phenomena, abnormal hypertonic, and/or jerky movements) occur rarely after propofol administration and may be life-threatening. Read More

JA Clin Rep 2021 Apr 17;7(1):35. Epub 2021 Apr 17.

Department of Anesthesiology and Perioperative Medicine, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai-shi, Miyagi, 980-8575, Japan.

Background: The depth of anesthesia (DOA) is estimated based on the anesthesia-induced electroencephalogram (EEG) changes. However, the surgical environment, as well as the patient him/herself, generates electrical interferences that cause EEG waveform distortion.

Case Presentation: A 52-year-old patient required general anesthesia due to the right femur necrotizing fasciitis. Read More

J Med Case Rep 2021 Apr 17;15(1):201. Epub 2021 Apr 17.

Department of Anesthesia, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.

Background: Malignant hyperthermia (MH) is a rare genetic disease characterized by the development of very serious symptoms, and hence prompt and appropriate treatment is required. However, postoperative MH is very rare, representing only 1.9% of cases as reported in the North American Malignant Hyperthermia Registry (NAMHR). Read More

Oncol Ther 2021 Apr 16. Epub 2021 Apr 16.

Department of Anesthesiology, Louisiana State University Shreveport, Shreveport, LA, USA.

Cancer is now a leading health concern worldwide. In an effort to provide these patients with adequate care, coordination between anesthesiologists and surgeons is crucial. In cancer-related treatment, it is very clear that radio-chemotherapy and medical procedures are important. Read More

Anesth Analg 2021 May;132(5):1254-1264

From the Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.

General anesthesia is characterized by loss of consciousness, amnesia, analgesia, and immobility. Important molecular targets of general anesthetics have been identified, but the neural circuits underlying the discrete end points of general anesthesia remain incompletely understood. General anesthesia and natural sleep share the common feature of reversible unconsciousness, and recent developments in neuroscience have enabled elegant studies that investigate the brain nuclei and neural circuits underlying this important end point. Read More

Anesth Analg 2021 Apr 15. Epub 2021 Apr 15.

From the Department of Anesthesiology and Perioperative Medicine.

Background: Propofol administration in patients with Brugada syndrome (BrS) is still a matter of debate. Despite lacking evidence for its feared arrhythmogenicity, up to date, expert cardiologists recommend avoiding propofol. The main aim of this study is to assess the occurrence of malignant arrhythmias or defibrillations in patients with BrS, during and 30 days after propofol administration. Read More

Epileptic Disord 2021 Apr 14. Epub 2021 Apr 14.

Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.

The aim of this study was to clarify the effect of a stable concentration of propofol on interictal high-frequency oscillations (HFOs), which may contribute to identifying the epileptogenic zone intraoperatively for resection surgery. Nine patients with drug-resistant focal epilepsy who underwent invasive pre-surgical evaluation with chronic subdural electrodes were recruited. Five-minute electrocorticograms during wakefulness, slow-wave sleep, and under a stable brain concentration of propofol were recorded with the same electrodes. Read More

Neurol Res 2021 Apr 15:1-4. Epub 2021 Apr 15.

Department of Neurological Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

: To determine the value of the blink reflex in evaluating trigeminal sensory function during microvascular decompression for trigeminal neuralgia.: The blink reflex (BR) in 103 patients with primary typical trigeminal neuralgia treated by microvascular decompression (MVD) was tested pre- and intraoperatively. The changes in BR were recorded. Read More

Orphanet J Rare Dis 2021 Apr 13;16(1):172. Epub 2021 Apr 13.

Servei Central D'Anestesiología (Anestalia), Centro Médico Teknon, Carrer Vilana 12, 08022, Barcelona, Spain.

Background: Patients with Ehlers-Danlos Syndrome/Hypermobility Type (EDS-HT/JHS) and Craneo-Cervical Instability frequently suffer from severe widespread pain which is difficult to control. Chronic neuroinflammation, opioid-induced hyperalgesia, and central sensitization may explain this painful condition. The aim of this study was to determine if opioid-free anesthesia plus the postoperative administration of lidocaine, ketamine and dexmedetomidine can reduce postoperative pain and the need of methadone rescues in comparison with opioid-based management in these patients undergoing Craneo-Cervical Fixation (CCF). Read More

Neuroimage 2021 Apr 10:118042. Epub 2021 Apr 10.

Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI 48109, USA. Electronic address:

Anesthetics are known to disrupt neural interactions in cortical and subcortical brain circuits. While the effect of anesthetic drugs on consciousness is reversible, the neural mechanism mediating induction and recovery may be different. Insight into these distinct mechanisms can be gained from a systematic comparison of neural dynamics during slow induction of and emergence from anesthesia. Read More

Medicine (Baltimore) 2021 Apr;100(15):e25531

Department of Geriatrics.

Introduction: As the adjunctive anesthesia to propofol, both dezocine and fentanyl showed some potential for gastrointestinal endoscopy. This meta-analysis aimed to compare their efficacy and safety.

Methods: PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Read More

Mol Med Rep 2021 Jun 13;23(6). Epub 2021 Apr 13.

Department of Anesthesiology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610041, P.R. China.

Propofol‑based anesthesia has been reported to reduce the recurrence and metastasis of a number of cancer types following surgical resection. However, the effects of propofol in bladder cancer (BC) are yet to be fully elucidated. The aim of the present study was to investigate the functions of propofol in BC and their underlying mechanisms. Read More

J Int Med Res 2021 Apr;49(4):3000605211001705

Department of Anaesthesiology, Peking University Shenzhen Hospital, Shenzhen, China.

Objective: To compare the accuracy, correlation and agreement between the bispectral index (BIS) and BISpro during propofol anaesthesia.

Methods: The BIS, BISpro, heart rate, target-concentration of propofol and Observer's Assessment of Alertness and Sedation (OAA/S) score were recorded every 30 s in female patients scheduled for hysteroscopic surgery. Propofol anaesthesia was induced by an initial target-controlled concentration (1. Read More

Anesth Pain Med (Seoul) 2021 Apr 12. Epub 2021 Apr 12.

Department of Anesthesiology and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

Background: Joubert syndrome and mitochondrial disease are rare congenital diseases in which a wide range of symptoms affects multiple organs. Patients with these diseases present characteristic symptoms related to the musculoskeletal, respiratory, and neurological systems, which make it difficult for anesthesiologists to manage the patient's airway and choose appropriate anesthetic drugs.

Case: A 13-year-old male patient with Joubert syndrome and mitochondrial disease underwent elective surgery to insert a continuous ambulatory peritoneal dialysis catheter. Read More

Cureus 2021 Mar 6;13(3):e13739. Epub 2021 Mar 6.

Neurology, Saiseikai Matsuyama Hospital, Matsuyama, JPN.

Dyskinesia is among the most problematic issues for local anaesthesia management in Parkinson's disease (PD) patients. We present a case of a patient with PD who underwent spinal anaesthesia while utilizing dexmedetomidine (DEX) to reduce dyskinesia during urological surgery. DEX stimulates α₂-adrenergic receptors, which works to reduce the dyskinesia in PD patients. Read More

Am J Transl Res 2021 15;13(3):1701-1709. Epub 2021 Mar 15.

Department of Anesthesiology, Yichun People's Hospital Yichun 336000, Jiangxi Province, China.

Objective: To analyze the influence of anesthetic induction of propofol combined with esketamine on perioperative stress and inflammatory responses and postoperative cognition in elderly surgical patients.

Methods: A total of 80 elderly surgical patients were randomly divided into a control group (n=40) and a study group (n=40). The control group received anesthetic induction with propofol combined with sufentanil, while the study group received anesthetic induction with propofol combined with esketamine. Read More

Rev Port Cir Cardiotorac Vasc 2021 Apr 8;28(1):31-33. Epub 2021 Apr 8.

Cardiothoracic Surgery, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal.

Introduction/Study Goals: Thoracic sympathectomy is considered to be the most effective treatment for hyperhidrosis, a procedure traditionally performed under general anesthesia. Nowadays it's a minimally invasive procedure, which makes it possible to perform under sedation with local anesthesia. The goal in this study was to assess the efficacy and safety of this anesthetic technique in video-assisted thoracic sympathectomy. Read More

J Pediatr Pharmacol Ther 2021 31;26(3):277-283. Epub 2021 Mar 31.

Objective: Propofol is frequently used for outpatient sedation for pediatric patients, some of whom require multiple rounds of sedation for separate procedures within a short period. Anecdotal experience suggests that frequent use of propofol results in escalating doses; however, clinical evidence is unconvincing. This study was designed to evaluate if tolerance develops with frequent administration of propofol for children requiring multiple successive sedations. Read More

Ann Plast Surg 2021 Mar 18. Epub 2021 Mar 18.

From the Division of Plastic Surgery Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, New York.

Purpose: 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.

Methods: After institutional review board approval, 100 patients undergoing elective ambulatory surgery with general anesthesia were randomized into 2 groups. Read More