scholarly journals Active Emergence from Propofol General Anesthesia Is Induced by Methylphenidate

2012 ◽  
Vol 116 (5) ◽  
pp. 998-1005 ◽  
Author(s):  
Jessica J. Chemali ◽  
Christa J. Van Dort ◽  
Emery N. Brown ◽  
Ken Solt
Keyword(s):  
Spectral Analysis ◽  
Single Dose ◽  
General Anesthesia ◽  
Median Time ◽  
Molecular Mechanisms ◽  
General Anesthetics ◽  
Adult Rats ◽  
Before And After ◽  
Target Plasma Concentration ◽  
The Difference

Background A recent study showed that methylphenidate induces emergence from isoflurane general anesthesia. Isoflurane and propofol are general anesthetics that may have distinct molecular mechanisms of action. The objective of this study was to test the hypothesis that methylphenidate actively induces emergence from propofol general anesthesia. Methods Using adult rats, the effect of methylphenidate on time to emergence after a single bolus of propofol was determined. The ability of methylphenidate to restore righting during a continuous target-controlled infusion (TCI) of propofol was also tested. In a separate group of rats, a TCI of propofol was established and spectral analysis was performed on electroencephalogram recordings taken before and after methylphenidate administration. Results Methylphenidate decreased median time to emergence after a single dose of propofol from 735 s (95% CI: 598-897 s, n = 6) to 448 s (95% CI: 371-495 s, n = 6). The difference was statistically significant (P = 0.0051). During continuous propofol anesthesia with a median final target plasma concentration of 4.0 μg/ml (95% CI: 3.2-4.6, n = 6), none of the rats exhibited purposeful movements after injection of normal saline. After methylphenidate, however, all six rats promptly exhibited arousal and had restoration of righting with a median time of 82 s (95% CI: 30-166 s). Spectral analysis of electroencephalogram data demonstrated a shift in peak power from δ (less than 4 Hz) to θ (4-8 Hz) and β (12-30 Hz) after administration of methylphenidate, indicating arousal in 4/4 rats. Conclusions Methylphenidate decreases time to emergence after a single dose of propofol, and induces emergence during continuous propofol anesthesia in rats. Further study is warranted to test the hypothesis that methylphenidate induces emergence from propofol general anesthesia in humans.

scholarly journals PENGARUH PEMBERIAN TERAPI MUSIK TERHADAP KECEMASAN PASIEN PRE GENERAL ANESTESI DI RS PKU MUHAMMADIYAH YOGYAKARTA

2018 ◽  
Vol 7 (2) ◽  
pp. 60-65
Author(s):  
Ichtiarfi Waryanuarita ◽  
Induniasih Induniasih ◽  
Yustiana Olfah
Keyword(s):  
Music Therapy ◽  
General Anesthesia ◽  
Elective Surgery ◽  
Intervention Group ◽  
Wilcoxon Test ◽  
Control Group ◽  
Dopamine Level ◽  
Before And After ◽  
Post Test ◽  
The Difference

Pre operative anxiety occur in patients that undergoing anesthesia procedure and elective surgery. Music therapy is one of distraction technique , because music can reduce physiological pain, stress, and anxiety. Music therapy pushed down sympathy nerve system that reduce body stress respons. Music cause the brain release endorphine, increase dopamine level, and help rise up safety feeling. Find out the effect of music therapy to anxiety in pre general anesthesia patients in PKU Muhammadiyah Yogyakarta Hospital. This study uses a quasy experimental which aims to see the difference in pre anesthesia anxiety before and after given music therapy in intervention and control group. This study uses quasy experimental design here takes group pre test and post test with control sort design. Patients is given pre test and post test with APAIS scale, in intervention group with treatment. Samples in this study amounted to 20 respondents of control group and 20 respondents of intervension group. Data collection is done on May to June 2017. The result of collected data were processed using Wilcoxon test with significant α = 0,05. There is a difference of anxiety before and after in the intervention group using music therapy. Wilcoxon test results obtained Sig. 0,000 (<0.05) so that H1 is accepted or rejected H0. There is a significant effect of music therapy to anxiety on pre general anesthesia patients in PKU Muhammadiyah Yogyakarta Hospital.

scholarly journals A Potential Mechanism of Sodium Channel Mediating the General Anesthesia Induced by Propofol

2020 ◽  
Vol 14 ◽  
Author(s):  
Jinglei Xiao ◽  
Zhengguo Chen ◽  
Buwei Yu
Keyword(s):  
Sodium Channel ◽  
General Anesthesia ◽  
Channel Blockers ◽  
General Anesthetics ◽  
Maximal Conductance ◽  
Left Shift ◽  
Voltage Gated Sodium Channels ◽  
State Dependent ◽  
Before And After ◽  
Electrophysiological Measurements

General anesthesia has revolutionized healthcare over the past 200 years and continues to show advancements. However, many phenomena induced by general anesthetics including paradoxical excitation are still poorly understood. Voltage-gated sodium channels (NaV) were believed to be one of the proteins targeted during general anesthesia. Based on electrophysiological measurements before and after propofol treatments of different concentrations, we mathematically modified the Hodgkin–Huxley sodium channel formulations and constructed a thalamocortical model to investigate the potential roles of NaV. The ion channels of individual neurons were modeled using the Hodgkin–Huxley type equations. The enhancement of propofol-induced GABAa current was simulated by increasing the maximal conductance and the time-constant of decay. Electroencephalogram (EEG) was evaluated as the post-synaptic potential from pyramidal (PY) cells. We found that a left shift in activation of NaV was induced primarily by a low concentration of propofol (0.3–10 μM), while a left shift in inactivation of NaV was induced by an increasing concentration (0.3–30 μM). Mathematical simulation indicated that a left shift of NaV activation produced a Hopf bifurcation, leading to cell oscillations. Left shift of NaV activation around a value of 5.5 mV in the thalamocortical models suppressed normal bursting of thalamocortical (TC) cells by triggering its chaotic oscillations. This led to irregular spiking of PY cells and an increased frequency in EEG readings. This observation suggests a mechanism leading to paradoxical excitation during general anesthesia. While a left shift in inactivation led to light hyperpolarization in individual cells, it inhibited the activity of the thalamocortical model after a certain depth of anesthesia. This finding implies that high doses of propofol inhibit the network partly by accelerating NaV toward inactivation. Additionally, this result explains why the application of sodium channel blockers decreases the requirement for general anesthetics. Our study provides an insight into the roles that NaV plays in the mechanism of general anesthesia. Since the activation and inactivation of NaV are structurally independent, it should be possible to avoid side effects by state-dependent binding to the NaV to achieve precision medicine in the future.

scholarly journals Role of Network Science in the Study of Anesthetic State Transitions

2018 ◽  
Vol 129 (5) ◽  
pp. 1029-1044 ◽  
Author(s):  
UnCheol Lee ◽  
George A. Mashour
Keyword(s):  
General Anesthesia ◽  
Molecular Mechanisms ◽  
Network Science ◽  
State Transitions ◽  
General Anesthetics ◽  
Network Efficiency ◽  
Cortical Dynamics ◽  
Brain Functions ◽  
Complex Interactions

Abstract The heterogeneity of molecular mechanisms, target neural circuits, and neurophysiologic effects of general anesthetics makes it difficult to develop a reliable and drug-invariant index of general anesthesia. No single brain region or mechanism has been identified as the neural correlate of consciousness, suggesting that consciousness might emerge through complex interactions of spatially and temporally distributed brain functions. The goal of this review article is to introduce the basic concepts of networks and explain why the application of network science to general anesthesia could be a pathway to discover a fundamental mechanism of anesthetic-induced unconsciousness. This article reviews data suggesting that reduced network efficiency, constrained network repertoires, and changes in cortical dynamics create inhospitable conditions for information processing and transfer, which lead to unconsciousness. This review proposes that network science is not just a useful tool but a necessary theoretical framework and method to uncover common principles of anesthetic-induced unconsciousness.

P6315Effects of chronic heart failure unconventional therapies on endothelial function

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Maloberti ◽  
E Piccinelli ◽  
J Zannoni ◽  
S Castelnuovo ◽  
P Vallerio ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Endothelial Function ◽  
Median Time ◽  
Drug Effects ◽  
Left Ventricular ◽  
Ventricular Assist ◽  
Before And After ◽  
The Difference ◽  
Value Flow

Abstract Introduction Endothelial Dysfunction (ED) of peripheral arteries in Chronic Heart Failure (CHF) subjects has been demonstrated. Purpose We assessed endothelial function in subjects undergoing unconventional treatments for CHF, namely Heart Transplantation (HTX), continuous-flow Left Ventricular Assist Device implantation (LVAD), and repeated levosimendan infusions (r-LEVO). Methods Twenty HTX recipients (median time from HTX 21 months), 20 patients supported with LVAD (median time from implant 39 months), and 20 patients receiving monthly Levosimendan infusions (median time on treatment 28 months) were enrolled and compared to a group of 20 healthy subjects. ED was evaluated with ultrasound assessment of the diameter before and after ischemic stress at the brachial artery level. The difference between the two diameters normalized for the baseline value (Flow Mediated Dilation – FMD) has been used for the analysis. All the patients were stable at the time of FMD assessment, with those on r-LEVO being evaluated prior to infusion. Results FMD was significantly lower in HTX and LVAD groups with respect to controls (9.8±7.4, 9.3±5.7, and 15.6±6.4% respectively, p=0.01), but not in r-LEVO group (12.5±6.9%). When patients were analyzed according to time from the operation or on treatment, (< versus > of the median value), no differences were seen in HTX and r-LEVO group, while in LVAD group FMD was borderline significantly higher in patients with longer follow-up (8.4±6.4% versus 10.2±5.2%, p=0.05). Conclusions Based on this preliminary data we can inference the following: 1- FMD is abnormal in HTX recipients, despite their good functional status, probably due to factors unrelated to CHF (e.g. hypertension, renal insufficiency, denervation, and drug effects); 2- LVAD patients also show ED, with possible better adaptation in very long-term survivors; 3- Near-normal FMD values in CHF patients who remain stable with r-LEVO suggest that pulsed treatment may obtain favorable effects at peripheral level, persisting after clearance of the drug and its metabolites. Acknowledgement/Funding None

scholarly journals Preoperative Patient Anxiety Level Before And After Informed Consent For General Anesthesia

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Ardi Pramono ◽  
Bagus Putra Raharjo
Keyword(s):  
Informed Consent ◽  
General Anesthesia ◽  
Anxiety Level ◽  
Patient Anxiety ◽  
Test Study ◽  
Before And After ◽  
Post Test ◽  
Quasi Experimental ◽  
The Difference ◽  
Preoperative Patient

Background — Informed consent anesthesia should be administered even in pediatric patients through their parents, thereby reducing anxiety. Objective — This study aimed to determine the difference in anxiety level of the preoperative patient before and after given informed consent about general anesthesia. Settings and Design — This was a quasi-experimental study with one group pre-test and post-test study design. Material and Methods - Patients who were to undergo surgery with general anesthesia in PKU Muhammadiyah Gamping Hospital were the subjects in this study. There were 41 subjects selected as study samples using consecutive sampling. Anxiety level was assessed by the HRS-A scale (0.91 and 0.97). Statistical analysis used: All data were analyzed by the marginal homogeneity comparative test. Results — A significant decrease in preoperative patient anxiety levels was observed after the patient was given general anesthesia informed consent (p<0.05), compared to levels before informed consent. Thus, giving informed consent before general anesthesia could decrease the subject’s anxiety level in preoperative patients. Conclusion — Thus, giving informed consent prior to general anesthesia could decrease the subject’s anxiety level in preoperative patients.

scholarly journals Changes in bowel sounds of inpatients undergo general anesthesia

2020 ◽  
Author(s):  
Guojing Wang ◽  
Mingjun Wang ◽  
Hongyun Liu ◽  
Suping Zhao ◽  
Lu Liu ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Intestinal Function ◽  
Bowel Sounds ◽  
Significant Difference ◽  
Before And After ◽  
Degree Of Stability ◽  
Characteristic Values ◽  
The Difference ◽  
The Stability ◽  
Postoperative Feeding

Abstract Background: General anesthesia can affect intestinal function, but there is no objective and effective indicator to evaluate the inhibition and recovery of intestinal function. The main objective of this study is to assess whether bowel sounds (BSs) change before and after general anesthesia, then it can be explained that the BS can be an effective indicator of intestinal function. Methods: We randomly selected 26 inpatients and collected three sets of 5-minute continuous BSs before operation (Pre-op), after operation (Pro-op) and three hours after operation(3h-Pro-op) separately for each patient. The data were de-noised with adaptive filtering and wavelet threshold denoising, and processed with fractal dimension to identify the effective bowel sounds (EBSs). Then the linear and nonlinear characteristic values (CVs) of each EBS were extracted and paired t -test and rank-sum test were used to evaluate the changes of the BSs after general anesthesia. Results: For the difference between Pre-op and Pro-op, as well as between Pro-op and 3h-Pro-op, there are statistical differences ( p <0.05). Specifically, the linear CVs that can reflect the occurrence frequency, overall energy and overall duration of EBSs and the nonlinear CVs that can reflect the dispersion degree of stability and complexity of EBSs were statistically significant. However, there is no statistical difference in the CVs reflecting the energy and duration, as well as the stability and complexity of locally EBSs ( p >0.05). Also, there is no statistically significant difference between all the characteristic values between Pre-op and 3h-Pro-op ( p >0.05). Conclusion: The BSs change after general anesthesia. Furthermore, the BSs are weakened after general anesthesia and recovered to the state before general anesthesia three hours later. Therefore, the BS can be an indicator of intestinal function under general anesthesia, so as to provide guidance for postoperative feeding , which is of great clinical significance.

Tem analysis of multiple-energy arsenic implanted and Rta'd silicon

1987 ◽  
Vol 45 ◽  
pp. 246-247
Author(s):  
R.A. Herring
Keyword(s):  
Device Fabrication ◽  
High Concentration ◽  
Tem Analysis ◽  
Defect Clusters ◽  
High Fluences ◽  
Small Defect ◽  
Before And After ◽  
The Matrix ◽  
The Difference ◽  
Factor Type

Rapid thermal annealing (RTA) of ion-implanted Si is important for device fabrication. The defect structures of 2.5, 4.0, and 6.0 MeV As-implanted silicon irradiated to fluences of 2E14, 4E14, and 6E14, respectively, have been analyzed by electron diffraction both before and after RTA at 1100°C for 10 seconds. At such high fluences and energies the implanted As ions change the Si from crystalline to amorphous. Three distinct amorphous regions emerge due to the three implantation energies used (Fig. 1). The amorphous regions are separated from each other by crystalline Si (marked L1, L2, and L3 in Fig. 1) which contains a high concentration of small defect clusters. The small defect clusters were similar to what had been determined earlier as being amorphous zones since their contrast was principally of the structure-factor type that arises due to the difference in extinction distance between the matrix and damage regions.

Changes in Platelet Aggregability after Ovariectomy

1979 ◽  
Vol 42 (04) ◽  
pp. 1332-1339 ◽  
Author(s):  
Hiroh Yamazaki ◽  
Takeshi Motomiya ◽  
Minoru Sonoda ◽  
Noboru Miyagawa
Keyword(s):  
Platelet Count ◽  
Platelet Activation ◽  
Ovarian Hormones ◽  
Control Group ◽  
Platelet Aggregability ◽  
Appearance Rate ◽  
Before And After ◽  
The Difference ◽  
Induced Aggregation ◽  
Observation Period

SummaryChanges in platelets in 48 patients with uterine myoma before and after hysterectomy with and without ovariectomy were examined. Bilateral ovariectomy in 25 cases (ovariec-tomized group) and unilateral or non-ovariectomy in 23 cases (control group) were performed at the hysterectomy. Platelet count and an appearance rate of secondary aggregation decreased at one day after and increased at one week after the operation, similarly in both the ovariectomized and the control group. The appearance rate of secondary aggregation was reflected in an intensity of aggregation at 5 min after the addition of reagent to PRP. At one month after the operation, the appearance rate of secondary aggregation induced by 3 μM ADP showed a statistically significant decrease in comparison with the preoperation value (P <0.05) and the enhancement of 5-min aggregation was still observed in the control group, while ceased in the ovariectomized group. The difference between the two groups was significant (P < 0.05). There was almost no change in the speed and intensity of primary and secondary aggregation during the observation period. No significant differences in collagen-induced aggregation were noted between the two groups. The results suggest that ovarian hormones, mainly estrogen, facilitate platelet activation which is mediated by the so-called secondary aggregation.

PENGARUH TERAPI TERTAWA TERHADAP PENURUNAN TEKANAN DARAH LANSIA DI UPT PANTI WREDHA BUDHI DHARMA YOGYAKARTA

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Niken Setyaningrum ◽  
Andri Setyorini ◽  
Fachruddin Tri Fitrianta
Keyword(s):  
Blood Pressure ◽  
Data Analysis ◽  
The Elderly ◽  
Control Group ◽  
Group Comparison ◽  
Control Blood Pressure ◽  
Men And Women ◽  
Treatment Of Hypertension ◽  
Before And After ◽  
The Difference

ABSTRACTBackground: Hypertension is one of the most common diseases, because this disease is suffered byboth men and women, as well as adults and young people. Treatment of hypertension does not onlyrely on medications from the doctor or regulate diet alone, but it is also important to make our bodyalways relaxed. Laughter can help to control blood pressure by reducing endocrine stress andcreating a relaxed condition to deal with relaxation.Objective: The general objective of the study was to determine the effect of laughter therapy ondecreasing elderly blood pressure in UPT Panti Wredha Budhi Dharma Yogyakarta.Methods: The design used in this study is a pre-experimental design study with one group pre-posttestresearch design where there is no control group (comparison). The population in this study wereelderly aged over> 60 years at 55 UPT Panti Wredha Budhi Dharma Yogyakarta. The method oftaking in this study uses total sampling. The sample in this study were 55 elderly. Data analysis wasused to determine the difference in blood pressure before and after laughing therapy with a ratio datascale that was using Pairs T-TestResult: There is an effect of laughing therapy on blood pressure in the elderly at UPT Panti WredhaBudhi Dharma Yogyakarta marked with a significant value of 0.000 (P <0.05)

Klein with Lacan: A Study on the Reception of Lacanian Ideas in Uruguay and Its Effects on Clinical Practices (1955–82)

2020 ◽  
Vol 22 (3) ◽  
pp. 341-361
Author(s):  
Gonzalo Grau-Pérez ◽  
J. Guillermo Milán
Keyword(s):  
Clinical Practice ◽  
Clinical Material ◽  
Clinical Practices ◽  
Before And After ◽  
The Difference ◽  
The 1960S ◽  
The Relationship ◽  
Discursive Approach ◽  
The Way ◽  
Clinical Cases

In Uruguay, Lacanian ideas arrived in the 1960s, into a context of Kleinian hegemony. Adopting a discursive approach, this study researched the initial reception of these ideas and its effects on clinical practices. We gathered a corpus of discursive data from clinical cases and theoretical-doctrinal articles (from the 1960s, 1970s and 1980s). In order to examine the effects of Lacanian ideas, we analysed the difference in the way of interpreting the clinical material before and after Lacan's reception. The results of this research illuminate some epistemological problems of psychoanalysis, especially the relationship between theory and clinical practice.

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