Dual One-Way Study of Sepsis Survivability Study in Rats Exposed to Cecal Ligation and Puncture with Propofol or Isoflurane

BACKGROUNDSeveral studies have also shown that short-term exposure to volatile anesthetic agents (VAA) affects proinflammatory pathways such as the cytokine response and provides a protective effect that improves the outcome of sepsis. In contrast, Propofol has been shown to have no protective effect on sepsis in murine and rat models and may increase morbidity and mortality. This study aimed to investigate the efficacy of longer-term exposure to anesthetics, isoflurane, and Propofol (72 hours).METHODSAnimals were randomized into four groups: Isoflurane during surgery followed by three days of 0.8% isoflurane (and Intralipid IV), Propofol during surgery and 314 ug/kg/hr Propofol for three days, isoflurane during surgery and Intralipid for three days, and Propofol during surgery and Intralipid for three days.After induction via Propofol or isoflurane, animals spontaneously ventilated via nose cone with 100% oxygen. Propofol or Intralipid was administered through a 22 gauge intravenous catheter inserted into the jugular vein. Sepsis was induced in the rats by performing cecal ligation and puncture (CLP) through a paramedian incision into the abdominal cavity. The surgical concentration of isoflurane was kept at 2%, Propofol was maintained at 800 ug/kg/hr maintenance. After the recovery and three days of exposure to Intralipid or anesthetic agents, the rats were allowed to roam free in an adequately vented, temperature and humidity-controlled cage with food and water ad libitum. Survival data were summarized using the Kaplan-Meier curve with Log-Rank test to determine significance.RESULTSLog-Rank test for postoperative anesthetic agent groups showed that rats that received isoflurane for three days survived longer than the 72-hour postoperative Propofol group (P = 0.0002). Within the postoperative, no anesthetic agent (control) group, the group that received isoflurane during surgery survived longer than the Propofol during surgery group (P = 0.0081). Within the postoperative Intralipid groups, the male rats did not perform well with Propofol against isoflurane (P = 0.2599).CONCLUSIONSExposure of rats to isoflurane may prolong survival in CLP as compared to exposure to Propofol. This was true for rats with limited exposure during surgery with no postoperative anesthetics and those receiving intraoperative isoflurane with postoperative isoflurane.

Laparoscopic Cholecystectomy under Segmental Thoracic Spinal Anesthesia

Introduction: Cholelithiasis or gallstones are hardened deposits of digestive fluid that can form in gallbladder. The treatment of gallstones depends upon the stage of disease. Once gallstones become symptomatic, definitive surgical intervention with cholecystectomy is usually indicated (typically, laparoscopic cholecystectomy is the first-line therapy). Laparoscopic cholecystectomy removes the gallbladder and gallstones through several small incisions in the abdomen. This case report aims to discuss the managent of segmental thoracic spinal anesthesia in laparoscopic cholecystectomy. Case: We report on the cases of 2 patients who undego elective laparoscopic cholecystectomy. Female, 53 years old, will undergo laparoscopic cholecystectomy, performed anesthesia with segmental thoracic spinal anesthesiatechnique using the anesthetic agent 3 ml of Levobupivacaine 0,5% + 25 mcg of Fentanyl, requiring a sensory block to at least T10-T11 dermatom. Patients received a 1,2 mcg target control infusion (TCI) propofol intravenous is administered as intermittent boluses to achieve deep sedation. The operation lasts 1 hour, with a bleeding 15 cc and urine output 100 cc, hemodynamically stable. Female, 42 years old, will undergo laparoscopic cholecystectomy, performed anesthesia with segmental thoracic spinal anesthesia technique using the anesthetic agent 3 ml of Levobupivacaine 0,5% + 25 mcg of Fentanyl, requiring a sensory block to at least T10-T11 dermatom. Patients received a 3 mg of midazolam intravenous is administered as intermittent boluses to achieve deep sedation. The operation lasts 1 hour, with a bleeding 15 cc and urine output 150 cc, hemodynamically stable. The level and duration of sensory block, intensity and duration of motor block were recorded. A 20 % or more decrease in MAP compared to baseline was considered as hypotension, iv ephedrine 5 mgr bolus administreted. Conclusion: Laparoscopy is a surgical procedure that uses minimally invasive surgical techniques (minimally invasive surgery) where the doctor uses a small telescope / camera that is inserted into the stomach and surgical instruments in mini form. This procedure has many advantages because it is not invasive, the amount of bleeding can be reduced, postoperative pain can be minimized. Regional anesthesia procedure in laparoscopic cholecystectomy based on several studies and case reports can be performed and is a safe procedure.

Effects of general anesthetics on synaptic transmission and plasticity

: General anesthetics depress excitatory and/or enhance inhibitory synaptic transmission principally by modulating the function of glutamatergic or GABAergic synapses, respectively, with relative anesthetic agent-specific mechanisms. Synaptic signaling proteins, including ligand- and voltage-gated ion channels, are targeted by general anesthetics to modulate various synaptic mechanisms including presynaptic neurotransmitter release, postsynaptic receptor signaling, and dendritic spine dynamics to produce their characteristic acute neurophysiological effects. As synaptic structure and plasticity mediate higher-order functions such as learning and memory, long-term synaptic dysfunction following anesthesia may lead to undesirable neurocognitive consequences depending on specific anesthetic agent and the vulnerability of population. Here we review the cellular and molecular mechanisms of transient and persistent general anesthetic alterations of synaptic transmission and plasticity.

Persistent pain relief following a single injection of a local anesthetic for neuropathic abdominal wall and groin pain

Objectives It is our experience that a small portion of patients with neuropathic abdominal wall pain syndromes such as the anterior cutaneous nerve entrapment syndrome (ACNES) have a long term beneficial response following just one single tender point injection (TPI) with a local anesthetic agent. This report focuses on the phenomenon of ongoing pain relief following a single local anesthetic injection in neuropathic abdominal wall and groin pain syndromes. Methods This report is an overview based on earlier studies from a center of expertise for neuropathic abdominal wall and groin pain syndromes. All studies on neuropathic abdominal wall and groin pain syndromes reporting on efficacy of a diagnostic TPI using a local anesthetic agent were included. Results A total of 10 studies including 834 patients fulfilled study criteria. Each of these 10 studies found that approximately 10% (range, 4–25%) of the cases experienced persistent pain relief after a single TPI with lidocaine 1%. Conclusions Persistent pain relief after a single TPI using a local anesthetic agent may be observed in approximately one of 10 patients suffering from neuropathic abdominal wall or groin pain syndromes. When a patient is suspected of having a neuropathic abdominal wall or groin pain syndrome, a single TPI using a local anesthetic agent should be administered as long term pain relief may occasionally occur.

TEKNIK IMOTILISASI IKAN KERAPU CANTANG (Epinephelus sp.) MENGGUNAKAN EKSTRAK DAUN KECUBUNG (Datura metel L.)

The immotilization technique of cantang grouper (Epinephelus sp.) Using Datura metel L. leaf extract. The purpose of this study was to find the best concentration at onset time of Datura metel L. leaves as anesthetic agent for grouper (Epinephelus sp.) And its survival rate. The results of the study, using extracts of natural anesthetic ingredients of amethyst leaves with concentrations of 20%, 25%, and 30% had different effects (P <0.05) on the onset time and recovery of grouper fish. In this study, it provides a life passing rate of 100% at concentrate 20%, and 25%, while concentrate 30% has a 66.67% survival rate. The best concentration in this study was concentrate 30%, with an onset time of 32.07 minutes with a recovery time of 9.07 minutes. This study used a non-factorial completely randomized design (CRD).