Neonatal administration of a subanaesthetic dose of JM-1232(−) in mice results in no behavioural deficits in adulthood

In animal models, neonatal exposure of general anaesthetics significantly increases apoptosis in the brain, resulting in persistent behavioural deficits later in adulthood. Consequently, there is growing concern about the use of general anaesthetics in obstetric and paediatric practice. JM-1232(−) has been developed as a novel intravenous anaesthetic, but the effects of JM-1232(−) on the developing brain are not understood. Here we show that neonatal administration of JM-1232(−) does not lead to detectable behavioural deficits in adulthood, contrarily to other widely-used intravenous anaesthetics. At postnatal day 6 (P6), mice were injected intraperitoneally with a sedative-equivalent dose of JM-1232(−), propofol, or midazolam. Western blot analysis of forebrain extracts using cleaved poly-(adenosine diphosphate-ribose) polymerase antibody showed that JM-1232(−) is accompanied by slight but measurable apoptosis 6 h after administration, but it was relatively small compared to those of propofol and midazolam. Behavioural studies were performed in adulthood, long after the neonatal anaesthesia, to evaluate the long-term effects on cognitive, social, and affective functions. P6 administration to JM-1232(−) was not accompanied by detectable long-term behavioural deficits in adulthood. However, animals receiving propofol or midazolam had impaired social and/or cognitive functions. These data suggest that JM-1232(−) has prospects for use in obstetric and paediatric practice.

Fast-track cardiac anaesthesia and early extubation

‘Fast-track’ cardiac anaesthesia and recovery is the term given to a multicomponent intervention during cardiac surgery and postoperatively, with the ultimate goal of early extubation (within 1–6 hours) in order to reduce duration of mechanical ventilation, length of stay in the intensive care unit, and overall resource utilization. Key components of fast-track cardiac care include balanced anaesthesia (low-dose opioids together with inhaled or intravenous anaesthetics) and a time-directed extubation protocol. Fast-track cardiac care requires an interdisciplinary approach to anaesthesia during surgery, as well as a coordinated approach after surgery, in order to achieve early extubation and an overall streamlined approach to recovery and hospital discharge.