Opioids for Anesthesia and Postoperative Pain Control

2019 ◽  
Author(s):  
Bryan Cook ◽  
Krystina Geiger ◽  
Megan Barra
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Pain Management ◽  
Respiratory Depression ◽  
Acute Pain ◽  
Patient Controlled Analgesia ◽  
Opioid Agonist ◽  
Duration Of Action ◽  
Central Nervous System Depression ◽  
Organ Systems

Opioid agonists are frequently used to provide anesthesia in combination with sedatives and hypnotic agents and manage postoperative acute pain. There are many different opioid agents available that differ in their potency, onset and duration of action, metabolism, drug interactions, and side-effect profile. All opioids have distinct effects upon various organ systems, including central nervous system depression, respiratory depression, and decreased gastrointestinal motility. Fentanyl and fentanyl-derived agents (alfentanil, sufentanil, remifentanil) are most frequently used in the intraoperative period due to their quick onset and duration of action, allowing them to be easily titrated and discontinued at the completion of a procedure. Oral opioids with moderate durations of action, such as oxycodone, hydrocodone, and morphine, are commonly used for acute pain management in the postoperative setting. When oral analgesics cannot be used, intravenous patient-controlled analgesia is another option for pain management. This review contains 5 figures, 11 tables, and 59 references. Key Words: analgesia, anesthesia, central nervous system depression, fentanyl, morphine, opioid agonist, pain management, patient-controlled analgesia, perioperative, respiratory depression

Amitraz poisoning in children: Clinical and laboratory findings of eight cases

1997 ◽  
Vol 16 (11) ◽  
pp. 680-682 ◽  
Author(s):  
Kürsad Aydin ◽  
Selim Kurtoglu ◽  
M. Hakan Poyrazoglu ◽  
Kazim Üzüm ◽  
H. Basri Üstünbas ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Respiratory Depression ◽  
Pediatric Patients ◽  
Clinical Manifestations ◽  
Limited Information ◽  
Laboratory Findings ◽  
Central Nervous System Depression ◽  
Important Sign ◽  
Poisoning In Children

Amitraz poisoning is a rare disorder characterised by central nervous system and respiratory depression, bradycardia, hypotension, hypothermia, hyperglycemia, vomiting, convulsion and glycosuria. In this study, eight pediatric patients with amitraz poisoning were presented. This study revealed that clinical manifestations of poisoning by oral and dermal route emerged within 30- 120 min and that central nervous system depression which is the most important sign resolved with 8-18 h and others 36-48 h. All cases were discharged as recovered after 48 h. To our knowledge only six cases have been reported in the literature. Because of the limited information in the literature, the cases were reported.

Letter to the Editor

PEDIATRICS ◽  
1974 ◽  
Vol 54 (3) ◽  
pp. 383-384
Author(s):  
Barry H. Rumack ◽  
Phillip Walravens
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Respiratory Depression ◽  
Abstinence Syndrome ◽  
Letter To The Editor ◽  
Central Nervous System Depression ◽  
Chronic Ingestion ◽  
Cns Depression

We must reject Dr. Phillip Nieburg's conjectures as invalid. Central nervous system depression and jitteriness do not correspond well to the ethchlorvynol intoxication syndrome. Patients treated for acute overdosage here, as elsewhere,1-3 demonstrate marked CNS depression, hypothermia, hypertension, hyporeflexia and respiratory depression. This classic syndrome of ethchlorvynol intoxication is not to be confused with the withdrawal syndrome4 of tremors, hallucinations and convulsions. Chronic ingestion of large quantities of ethchlorvynol does not produce toxic features but rather the abstinence syndrome upon termination of the drug.

scholarly journals Tuberin levels during cellular differentiation in brain development

2021 ◽  
Author(s):  
Bashaer Abu Khatir ◽  
Gordon Omar Davis ◽  
Mariam Sameem ◽  
Rutu Patel ◽  
Jackie Fong ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Brain Development ◽  
Cell Lines ◽  
Neural Development ◽  
Time Course ◽  
Embryonic Mouse ◽  
Organ Systems ◽  
The Central Nervous System

Tuberin is a member of a large protein complex, Tuberous Sclerosis Complex, and acts as a sensor for nutrient status regulating protein synthesis and cell cycle progression. Mutations in the Tuberin gene, TSC2, lead to the formation of tumors and developmental defects in many organ systems, including the central nervous system. Tuberin is expressed in the brain throughout development and levels of Tuberin have been found to decrease during neuronal differentiation in cell lines in vitro. Our current work investigates the levels of Tuberin at two stages of embryonic development in vivo, and we study the mRNA and protein levels during a time course using immortalized cell lines in vitro. Our results show that Tuberin levels remain stable in the olfactory bulb but decrease in the Purkinje cell layer during embryonic mouse brain development. We show here that Tuberin levels are higher when cells are cultured as neurospheres, and knockdown of Tuberin results in a reduction in the number of neurospheres. These data provide support for the hypothesis that Tuberin is an important regulator of stemness and the reduction of Tuberin levels might support functional differentiation in the central nervous system. Understanding how Tuberin expression is regulated throughout neural development is essential to fully comprehend the role of this protein in several developmental and neural pathologies.

Desmoplastic Medulloblastoma Metastatic to the Pancreas: Case Report

Neurosurgery ◽  
1991 ◽  
Vol 29 (4) ◽  
pp. 612-616 ◽  
Author(s):  
Hendrikus G.J. Krouwer ◽  
John Vollmerhausen ◽  
Joel White ◽  
Michael D. Prados
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Soft Tissues ◽  
Extraneural Metastases ◽  
Organ Systems ◽  
Multidrug Chemotherapy ◽  
The Central Nervous System ◽  
Desmoplastic Medulloblastoma ◽  
Local Radiation ◽  
Weiss Criteria

Abstract A case is reported in which a desmoplastic medulloblastoma metastasized to the pancreas and to the surrounding soft tissues but did not recur locally or disseminate within the central nervous system. Multidrug chemotherapy and local radiation therapy resulted in a complete remission. In all four previously reported cases of medulloblastoma metastasizing to the pancreas, the diagnosis was not made until the postmortem examination, and all of these patients also had extensive metastases in other organ systems. Modification of the Weiss criteria defining extraneural metastases from tumors of the central nervous system is suggested.

scholarly journals Central Nervous System Infection with Histoplasma capsulatum

2019 ◽  
Vol 5 (3) ◽  
pp. 70 ◽  
Author(s):  
James Riddell ◽  
L. Joseph Wheat
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Histoplasma Capsulatum ◽  
Central Nervous System Infection ◽  
Treatment Strategies ◽  
Multiple Organ ◽  
Filamentous Form ◽  
Disseminated Infection ◽  
Organ Systems ◽  
The Central Nervous System

Histoplasmosis is an endemic fungal infection that may affect both immune compromised and non-immune compromised individuals. It is now recognized that the geographic range of this organism is larger than previously understood, placing more people at risk. Infection with Histoplasma capsulatum may occur after inhalation of conidia that are aerosolized from the filamentous form of the organism in the environment. Clinical syndromes typically associated with histoplasmosis include acute or chronic pneumonia, chronic cavitary pulmonary infection, or mediastinal fibrosis or lymphadenitis. Disseminated infection can also occur, in which multiple organ systems are affected. In up to 10% of cases, infection of the central nervous system (CNS) with histoplasmosis may occur with or without disseminated infection. In this review, we discuss challenges related to the diagnosis of CNS histoplasmosis and appropriate treatment strategies that can lead to successful outcomes.

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