Comparison of the Effect of Propofol and Dexmedetomidine on Hemodynamic Parameters and Stress Response Hormones During Laparoscopic Cholecystectomy Surgery

Background: General anesthesia induces endocrine, immunologic, and metabolic responses. Anesthetic drugs affect the endocrine system by changing the level of stress hormones and hemodynamic variables of the patient. Objectives: The purpose of this study was to compare the effects of propofol and dexmedetomidine on hemodynamic parameters and stress-induced hormones in laparoscopic cholecystectomy (LC) surgery. Methods: Seventy patients of elective LC were included in this study. The patients were randomly assigned into two equal groups of propofol (75 µg/kg/min) and dexmedetomidine (0.5 µg/kg/hour) as anesthesia maintenance. Hemodynamic parameters (heart rate and mean atrial pressure), blood sugar, and serum epinephrine level were monitored and recorded from pre-anesthesia period to 10 min after entry to post-anesthesia care unit (PACU) according to a planned method. Results: Heart rate and mean atrial pressure changes were significantly lower in dexmedetomidine group in all stages compared to propofol group (P < 0.001). Also, the rises in blood glucose and serum epinephrine levels in the dexmedetomidine group were significantly higher than in the propofol group (P < 0.001). Conclusions: Anesthesia maintenance by dexmedetomidine showed a significant difference in hemodynamic parameters in comparison with propofol. While dexmedetomidine had better effects on controlling hemodynamic parameters, propofol showed better effects on decreasing stress hormones, and it can be suggested for LC surgery.

A comparative study on anti-inflammatory drug combinations in domestic pigeons with experimentally induced acute arthritis

The study compares the effect of one-time administration of nonsteroidal and/or steroidal anti-inflammatory combinations by topical or intramuscular (IM) routes to pigeons with monosodium urate (MSU)-induced arthritis. Forty-five adult domestic pigeons were assigned into nine equal groups: NC, negative control; PC, positive control with arthritis; sham, sham control; T1, meloxicam + hydrocortisone; T2, dexamethasone + piroxicam; T3, meloxicam + dexamethasone; T4, hydrocortisone + piroxicam; T5, dexamethasone + hydrocortisone; T6, meloxicam + piroxicam. Arthritis was also induced in T1 to T6 birds. Meloxicam and dexamethasone were administered by IM injection and the other drugs topically right after the induction of arthritis. Different drug combinations significantly decreased one-leg standing time. Induction of arthritis significantly increased TNF-α and IL-6 levels in synovial fluid and serum corticosterone and epinephrine in the PC group. Administration of drugs to birds of Groups T1 and T5 did not significantly change corticosterone concentration, while all different drug combinations decreased epinephrine level. Drug combinations that demonstrated better analgesic effect more strongly reduced serum epinephrine concentration. Meloxicam + hydrocortisone was the most effective combination in reducing inflammatory cytokines. In conclusion, one-time combination therapy with anti-inflammatory agents was effective in the acute management of inflammatory pain due to MSU-induced arthritis in pigeons, even by the topical route.

The Effect of Natural Ocean Sound Exposure and Ocean-Side Relaxation on Chronic Tinnitus Patients: A Pilot Study in Korea

Sound therapy is a treatment modality for tinnitus patients by increasing the background neuronal activity in the auditory system and inducing relative alleviation of the tinnitus. This study was performed to evaluate the efficacy of natural ocean sound exposure and ocean-side relaxation in chronic tinnitus patients. We prospectively enrolled all 18 chronic tinnitus patients (≥6 months) from July to November 2018. All patients completed 90 hours of our programs. The improvement in their subjective tinnitus severity, moods, the quality of life, and sleep was serially assessed using several questionnaires at baseline, immediately, and 1 month after the program. Changes in serum stress hormone levels of the patients were also compared between the baseline and immediately after the program. Average total Tinnitus Handicap Questionnaire score and factor 2 (hearing difficulty related to tinnitus) score significantly improved over time ( P = .024 and P = .002). Patient’s serum cortisol and epinephrine level did not show significant decrease, and serum norepinephrine and serotonin level significantly increased immediately after our program ( P < .001 and P < .001). Natural ocean sound exposure and ocean-side relaxation for short-term period has a potential efficacy on chronic tinnitus patients.

Plasma Catecholamine Response in Trained Rats Following Hemorrhage

The purpose of this study was to evaluate the effect of physical training on hemorrhage-induced catecholamine release in rats. The training program consisted of swimming 5 days a week, from 15 min in the first week to 2.5 hours in the 14th week. The rats were divided into four groups. Two groups (one trained and the other untrained) were studied during hemorrhage. The third and fourth groups (one trained and the other untrained) were not subjected to hemorrhage. After 14 weeks, trained rats had a lower heart rate than untrained animals at rest (311.86 ± 8.9 vs. 361.33 ± 12.13 bpm, p <.002) for a similar body weight. The trained and untrained groups had the same blood pressure, hematocrit, and norepinephrine responses following hemorrhage. However, plasma epinephrine concentration was lower in the trained rats 15 and 25 min following hemorrhage. These results suggest a decrease of the hemorrhage-induced epinephrine secretion in trained rats. An alteration of the relationship of arterial baroreflexes and of their hormonal effectors is a potential mechanism for the reduced plasma epinephrine level in trained hemorrhaged rats. Key words: epinephrine, norepinephrine, hypotension, physical training