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Yang Y, Wu J, Feng S, Yu H, Liu C, Wang S. Notoginsenoside R1 attenuates bupivacaine induced neurotoxicity by activating Jak1/Stat3/Mcl1 pathway. Toxicology 2024; 503:153740. [PMID: 38316350 DOI: 10.1016/j.tox.2024.153740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 02/07/2024]
Abstract
Bupivacaine, a common amide local anesthetic, can provide effective analgesia or pain relief but can also cause neurotoxicity, which remains a mounting concern in clinic and animal care. However, the precise underlying mechanisms have not been fully elucidated. A natural compound, notoginsenoside R1 (NG-R1) has been reported to exhibit a neuroprotective role in stress conditions. In this study, we explored the function and mechanism of NG-R1 in alleviating bupivacaine-induced neurotoxicity in mouse hippocampal neuronal (HT-22) and mouse neuroblastoma (Neuro-2a) cell lines. Our results exhibited that NG-R1 treatment can significantly rescue the decline of cell survival induced by bupivacaine. Tunel staining and western blotting showed that NG-R1 could attenuate BPV‑induced cell apoptosis. Besides, we focused on Mcl1 as a potential target as it showed opposite expression tendency in response to NG-R1 and bupivacaine exposure. Mcl1 knockdown blocked the inhibitory effect of NG-R1 on cell apoptosis against bupivacaine treatment. Intriguingly, we found that NG-R1 can upregulate Mcl1 transcription by activating Stat3 and promote its nuclear translocation. In addition, NG-R1 can also promote Jak1 phosphorylation and docking analysis provide a predicted model for interaction between NG-R1 and phosphorylated Jak1. Taken together, our results demonstrated that NG-R1 can attenuate bupivacaine induced neurotoxicity by activating Jak1/Stat3/Mcl1 pathway.
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Affiliation(s)
- Yu Yang
- School of Mental Health, Jining Medical University, Jining 272013, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment and Behavioral Interventions of Mental Disorders, Jining Medical University, Jining, Shandong, China
| | - Jiwen Wu
- School of Mental Health, Jining Medical University, Jining 272013, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment and Behavioral Interventions of Mental Disorders, Jining Medical University, Jining, Shandong, China
| | - Shicheng Feng
- School of Mental Health, Jining Medical University, Jining 272013, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment and Behavioral Interventions of Mental Disorders, Jining Medical University, Jining, Shandong, China
| | - Hao Yu
- School of Mental Health, Jining Medical University, Jining 272013, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment and Behavioral Interventions of Mental Disorders, Jining Medical University, Jining, Shandong, China
| | - Chuanxin Liu
- School of Mental Health, Jining Medical University, Jining 272013, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment and Behavioral Interventions of Mental Disorders, Jining Medical University, Jining, Shandong, China; Department of Psychiatry, Affiliated Hospital of Jining Medical University, Jining, Shandong, China.
| | - Shuai Wang
- School of Mental Health, Jining Medical University, Jining 272013, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment and Behavioral Interventions of Mental Disorders, Jining Medical University, Jining, Shandong, China.
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Wu N, Liu H, Lv X, Sun Y, Jiang H. Neobaicalein prevents isoflurane anesthesia-induced cognitive impairment in neonatal mice via regulating CREB1. Clinics (Sao Paulo) 2023; 78:100201. [PMID: 37120983 PMCID: PMC10173397 DOI: 10.1016/j.clinsp.2023.100201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/24/2023] [Accepted: 04/04/2023] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVES Isoflurane (ISO) is widely used in the clinic and research. The authors aimed to explore whether Neobaicalein (Neob) could protect neonatal mice from ISO-induced cognitive damage. METHOD The open field test, Morris water maze test, and tail suspension test was performed to assess the cognitive function in mice. Enzyme-linked immunosorbent assay was used to evaluate inflammatory-related protein concentrations. Immunohistochemistry was used to assess Ionized calcium-Binding Adapter molecule-1 (IBA-1) expression. Hippocampal neuron viability was detected using the Cell Counting Kit-8 assay. Double immunofluorescence staining was employed to confirm the interaction between proteins. Western blotting was used to assess protein expression levels. RESULTS Neob notably improved cognitive function and exhibited anti-inflammatory effects; moreover, under iso-treatment, it exhibited neuroprotective effects. Furthermore, Neob suppressed interleukin-1β, tumor necrosis factor-α, and interleukin-6 levels and upregulated interleukin-10 levels in ISO-treated mice. Neob significantly mitigated iso-induced increases in IBA-1-positive cell numbers of the hippocampus in neonatal mice. Furthermore, it inhibited ISO-induced neuronal apoptosis. Mechanistically, Neob was observed to upregulate cAMP Response Element Binding protein (CREB1) phosphorylation and protected hippocampal neurons from ISO-mediated apoptosis. Moreover, it rescued ISO-induced abnormalities of synaptic protein. CONCLUSIONS Neob prevented ISO anesthesia-induced cognitive impairment by suppressing apoptosis and inflammation through upregulating CREB1.
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Affiliation(s)
- Niming Wu
- Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hua Liu
- Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiang Lv
- Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Sun
- Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong Jiang
- Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Dexmedetomidine Pre-Treatment of Neonatal Rats Prevents Sevoflurane-Induced Deficits in Learning and Memory in the Adult Animals. Biomedicines 2023; 11:biomedicines11020391. [PMID: 36830927 PMCID: PMC9953733 DOI: 10.3390/biomedicines11020391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 02/01/2023] Open
Abstract
Anesthetics have been shown to cause cytotoxicity, cell death, affect neuronal growth and connectivity in animal models; however, their effects on learning and memory remain to be fully defined. Here, we examined the effects of the inhalation anesthetic sevoflurane (SEV)-both in vivo by examining learning and memory in freely behaving animals, and in vitro using cultured neurons to assess its impact on viability, mitochondrial structure, and function. We demonstrate here that neonatal exposure to sub-clinically used concentrations of SEV results in significant, albeit subtle and previously unreported, learning and memory deficits in adult animals. These deficits involve neuronal cell death, as observed in cell culture, and are likely mediated through perturbed mitochondrial structure and function. Parenthetically, both behavioural deficits and cell death were prevented when the animals and cultured neurons were pre-treated with the anesthetic adjuvant Dexmedetomidine (DEX). Taken together, our data provide direct evidence for sevoflurane-induced cytotoxic effects at the neuronal level while perturbing learning and memory at the behavioural level. In addition, our data underscore the importance of adjuvant agents such as DEX that could potentially counter the harmful effects of commonly used anesthetic agents for better clinical outcomes.
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Sllamniku S, Beqo BP, Krasniqi I, Tërshana A, Murtezani A, Quehenberger F, Haxhija EQ. Splint Duration and Not the Mode of Anesthesia Is the Main Factor Influencing Avascular Necrosis After Closed Reduction for Developmental Dysplasia of the Hip in Kosovo. Front Pediatr 2022; 10:850605. [PMID: 35558375 PMCID: PMC9090470 DOI: 10.3389/fped.2022.850605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/21/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to determine whether the use of analgesia and sedation (AS) as opposed to general anesthesia (GA) for closed reduction and spica casting of children with severe developmental dysplasia of the hip (DDH) influenced the long-term incidence of avascular necrosis (AVN). In a prospective, randomized, single-blinded clinical trial we investigated 100 pediatric patients with DDH type IIIa, IIIb, and IV (according to Graf classification), who were randomly assigned into the group receiving AS, and the group receiving GA. Baseline demographics, splint duration, and type of DDH were carefully assessed. The presence of AVN was assessed at the follow-up visits at 1 and 7 years after the end of treatment. The AS-group consisted of 50 patients (46 girls) with 76 hips affected (n = 11/Type-IIIa, n = 32/Type-IIIb, and n = 33/Type-IV). The GA-group consisted also of 50 patients (44 girls) with 78 hips involved (n = 15/Type-IIIa, n = 34/Type-IIIb, and n = 29/Type-IV). At 7-years follow-up, AVN was diagnosed in 9 of 154 hips (5.8%), 5 hips in the AS-group and 4 hips in the GA group. The logistic regression model showed no significant difference in AVN incidence between the AS and GA groups at 7-years follow-up (p = 0.27). The multivariate regression analysis showed that neither the type of DDH nor the age at diagnosis influenced the incidence of AVN (p = 0.48 and p = 0.28, respectively). Splint duration was identified as the only significant factor for the long-term incidence of AVN in the treatment of severe DDH. For every month of longer splint duration, the odds of AVN at 7-years follow-up increased by a factor of 3.81 (95%CI: 1.35-13.73, p = 0.02). Closed reduction and spica casting of children with severe DDH under AS can be considered a feasible alternative to management under GA. All efforts must be made to diagnose patients with DDH as early as possible and shorten the duration of splint treatment to prevent the development of AVN. Level of Evidence. Level II-1.
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Affiliation(s)
- Sabit Sllamniku
- Orthopedic Department, University Clinical Center of Kosovo, Prishtina, Republic of Kosovo
| | - Besiana P. Beqo
- Department of Postgraduate Medical Education, Global Clinical Scholars Research Program, Harvard Medical School, Boston, MA, United States
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Islam Krasniqi
- Department of Anesthesiology, University Clinical Center of Kosovo, Prishtina, Republic of Kosovo
| | - Azem Tërshana
- Department of Pediatrics, Medical Faculty of Prishtina University, Prishtina, Republic of Kosovo
| | - Ardiana Murtezani
- Physical Medicine and Rehabilitation Department, University Clinical Center of Kosovo, Prishtina, Republic of Kosovo
| | - Franz Quehenberger
- Institute of Medical Informatics, Statistics and Documentation, University of Graz, Graz, Austria
| | - Emir Q. Haxhija
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
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Li C, Li J, Tao H, Shan J, Liu F, Deng X, Lin Y, Lin X, Fu L, Wang B, Bi Y. Differential hippocampal protein expression between normal mice and mice with the perioperative neurocognitive disorder: a proteomic analysis. Eur J Med Res 2021; 26:130. [PMID: 34732255 PMCID: PMC8565051 DOI: 10.1186/s40001-021-00599-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/06/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To compare differential expression protein in hippocampal tissues from mice of perioperative neurocognitive disorder (PND) and normal control mice and to explore the possible mechanism of PND. METHODS Mice were randomly divided into a PND group (n = 9) and a control group (n = 9).The mice in the PND group were treated with open tibial fracture with intramedullary fixation under isoflurane anesthesia, while the mice in the control group received pure oxygen without surgery. The cognitive functions of the two groups were examined using Morris water maze experiment, Open field test and Fear conditioning test. The protein expression of the hippocampus of mice was analyzed by high-performance liquid chromatography-mass spectrometry (HPLC-MS/MS). Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed to explore the principal functions of dysregulated proteins. RESULTS A total of 21 proteins were differentially expressed between PND and control mice on days 1, 3, and 7 after the operation. These proteins were involved in many pathological processes, such as neuroinflammatory responses, mitochondrial oxidative stress, impaired synaptic plasticity, and neuronal cell apoptosis. Also, the dysregulated proteins were involved in MAPK, AMPK, and ErbB signaling pathways. CONCLUSION The occurrence of PND could be attributed to multiple mechanisms.
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Affiliation(s)
- Chuan Li
- Department of Anesthesiology, Qingdao Municipal Hospital Affiliated to Qingdao University, 5 Donghai Middle Road, Qingdao, Shandong, 266071, People's Republic of China
| | - Jingzhu Li
- Department of Anesthesiology, Qingdao Municipal Hospital Affiliated to Qingdao University, 5 Donghai Middle Road, Qingdao, Shandong, 266071, People's Republic of China
| | - He Tao
- Department of Anesthesiology, Dalian Medical University, Dalian, Liaoning, China
| | - Jinghua Shan
- Department of Anesthesiology, Weifang Medical University, Weifang, Shandong, China
| | - Fanghao Liu
- Department of Anesthesiology, Qingdao Municipal Hospital Affiliated to Qingdao University, 5 Donghai Middle Road, Qingdao, Shandong, 266071, People's Republic of China
| | - Xiyuan Deng
- Department of Anesthesiology, Dalian Medical University, Dalian, Liaoning, China
| | - Yanan Lin
- Department of Anesthesiology, Weifang Medical University, Weifang, Shandong, China
| | - Xu Lin
- Department of Anesthesiology, Qingdao Municipal Hospital Affiliated to Qingdao University, 5 Donghai Middle Road, Qingdao, Shandong, 266071, People's Republic of China
| | - Li Fu
- Department of Anesthesiology, Qingdao Municipal Hospital Affiliated to Qingdao University, 5 Donghai Middle Road, Qingdao, Shandong, 266071, People's Republic of China
| | - Bin Wang
- Department of Anesthesiology, Qingdao Municipal Hospital Affiliated to Qingdao University, 5 Donghai Middle Road, Qingdao, Shandong, 266071, People's Republic of China
| | - Yanlin Bi
- Department of Anesthesiology, Qingdao Municipal Hospital Affiliated to Qingdao University, 5 Donghai Middle Road, Qingdao, Shandong, 266071, People's Republic of China.
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Jimenez-Tellez N, Iqbal F, Pehar M, Casas-Ortiz A, Rice T, Syed NI. Dexmedetomidine does not compromise neuronal viability, synaptic connectivity, learning and memory in a rodent model. Sci Rep 2021; 11:16153. [PMID: 34373548 PMCID: PMC8352930 DOI: 10.1038/s41598-021-95635-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/21/2021] [Indexed: 02/08/2023] Open
Abstract
Recent animal studies have drawn concerns regarding most commonly used anesthetics and their long-term cytotoxic effects, specifically on the nervous tissue. It is therefore imperative that the search continues for agents that are non-toxic at both the cellular and behavioural level. One such agent appears to be dexmedetomidine (DEX) which has not only been found to be less neurotoxic but has also been shown to protect neurons from cytotoxicity induced by other anesthetic agents. However, DEX's effects on the growth and synaptic connectivity at the individual neuronal level, and the underlying mechanisms have not yet been fully resolved. Here, we tested DEX for its impact on neuronal growth, synapse formation (in vitro) and learning and memory in a rodent model. Rat cortical neurons were exposed to a range of clinically relevant DEX concentrations (0.05-10 µM) and cellular viability, neurite outgrowth, synaptic assembly and mitochondrial morphology were assessed. We discovered that DEX did not affect neuronal viability when used below 10 µM, whereas significant cell death was noted at higher concentrations. Interestingly, in the presence of DEX, neurons exhibited more neurite branching, albeit with no differences in corresponding synaptic puncta formation. When rat pups were injected subcutaneously with DEX 25 µg/kg on postnatal day 7 and again on postnatal day 8, we discovered that this agent did not affect hippocampal-dependent memory in freely behaving animals. Our data demonstrates, for the first time, the non-neurotoxic nature of DEX both in vitro and in vivo in an animal model providing support for its utility as a safer anesthetic agent. Moreover, this study provides the first direct evidence that although DEX is growth permissive, causes mitochondrial fusion and reduces oxygen reactive species production, it does not affect the total number of synaptic connections between the cortical neurons in vitro.
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Affiliation(s)
- Nerea Jimenez-Tellez
- grid.22072.350000 0004 1936 7697Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Canada ,grid.22072.350000 0004 1936 7697Hotchkiss Brain Institute, Calgary, Canada ,grid.413571.50000 0001 0684 7358Alberta Children’s Hospital Research Institute, Calgary, Canada
| | - Fahad Iqbal
- grid.413571.50000 0001 0684 7358Alberta Children’s Hospital Research Institute, Calgary, Canada
| | - Marcus Pehar
- grid.22072.350000 0004 1936 7697Hotchkiss Brain Institute, Calgary, Canada ,grid.413571.50000 0001 0684 7358Alberta Children’s Hospital Research Institute, Calgary, Canada
| | - Alberto Casas-Ortiz
- grid.22072.350000 0004 1936 7697Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Canada ,grid.413571.50000 0001 0684 7358Alberta Children’s Hospital Research Institute, Calgary, Canada
| | - Tiffany Rice
- grid.413571.50000 0001 0684 7358Alberta Children’s Hospital Research Institute, Calgary, Canada ,grid.22072.350000 0004 1936 7697Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary, Calgary, Canada
| | - Naweed I. Syed
- grid.22072.350000 0004 1936 7697Hotchkiss Brain Institute, Calgary, Canada ,grid.413571.50000 0001 0684 7358Alberta Children’s Hospital Research Institute, Calgary, Canada ,grid.22072.350000 0004 1936 7697Department of Cell Biology and Anatomy, University of Calgary, Calgary, Canada
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Relationship between Artificial Intelligence-Based General Anesthetics and Postoperative Cognitive Dysfunction. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:5553029. [PMID: 33868620 PMCID: PMC8032528 DOI: 10.1155/2021/5553029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/08/2021] [Accepted: 03/20/2021] [Indexed: 11/23/2022]
Abstract
Postoperative cognitive dysfunction (POCD) refers to the complications of the central nervous system before and after surgery in patients without mental disorders. Many studies have shown that surgical anesthesia may cause POCD, especially in elderly patients. This article aims to study the relationship between artificial intelligence-based general anesthetics and postoperative cognitive dysfunction. This article first describes and classifies artificial intelligence, introduces its realization method, machine learning algorithms, and briefly introduces the basic principles of regression and classification methods in machine learning; then, the principles and techniques of general anesthetics are proposed. The pathogenesis of postoperative cognitive dysfunction (POCD) is explained in detail. Finally, the effect of anesthetics on postoperative cognitive dysfunction is obtained from both inhaled anesthetics and intravenous anesthetics. The impact on postoperative cognitive function is explained. The experimental results in this article show that there is no statistically significant difference in the two groups of patients' age, gender ratio, body mass index, education level, preoperative comorbidities, and other general indicators. Through the use of EEG bispectral index monitors to monitor the depth of anesthesia and postoperative cognitive dysfunction, first, there was no obvious relationship between the occurrence of postoperative cognitive dysfunction at 1, 5, 10, and 50 days and discharge time. The comprehensive monitoring group can reduce the clinical dose of preventive medication and cis-atracurium and shorten the patient's recovery time, extubation time, and recovery time. In addition, it can also reduce the increase of serum protein S100β in elderly patients and reduce the incidence of early postoperative cognitive dysfunction.
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Puthoff TD, Veneziano G, Kulaylat AN, Seabrook RB, Diefenbach KA, Ryshen G, Hastie S, Lane A, Renner L, Bapat R. Development of a Structured Regional Analgesia Program for Postoperative Pain Management. Pediatrics 2021; 147:peds.2020-0138. [PMID: 33602800 DOI: 10.1542/peds.2020-0138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We pursued the use of regional analgesia (RA) to minimize the use of postoperative opioids. Our aim was to increase the use of postoperative RA for eligible surgical procedures in the NICU from 0% to 80% by June 30, 2019. METHODS A multidisciplinary team determined the eligibility criteria, developed an extensive process map, implemented comprehensive education, and a structured process for communication of postoperative pain management plans. Daily pain team rounds provided an opportunity for collaborative comanagement. An additional 30 minutes for catheter placement was added in operating room (OR) scheduling so that it would not affect the surgeon OR time. RESULTS There were 21 eligible surgeries in the baseline period and 34 in the intervention period. In total, 30 of 34 infants in eligible surgeries (88%) received RA. The average total opioid exposure in intravenous morphine milligram equivalents decreased from 5.0 to 1.1 mg/kg in the intervention group. The average time to extubation was 45 hours in the baseline period and 19.9 hours in the intervention group. After interventions, 75% of infants were extubated in the OR, as compared with 10.5% in the baseline period. No difference was seen in postoperative pain scores or postoperative hypothermia between the baseline and intervention groups. CONCLUSIONS We used quality improvement methodology to develop a structured RA program. We demonstrated a significant reduction in opioid requirements and need for mechanical ventilation postoperatively for those infants who received RA. Our findings support safe and effective use of RA, and provide a framework for implementation of a similar program.
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Affiliation(s)
| | - Giorgio Veneziano
- Nationwide Children's Hospital, Columbus, Ohio; and.,The Ohio State University, Columbus, Ohio
| | | | - Ruth B Seabrook
- Nationwide Children's Hospital, Columbus, Ohio; and.,The Ohio State University, Columbus, Ohio
| | - Karen A Diefenbach
- Nationwide Children's Hospital, Columbus, Ohio; and.,The Ohio State University, Columbus, Ohio
| | - Greg Ryshen
- Nationwide Children's Hospital, Columbus, Ohio; and
| | - Sarah Hastie
- Nationwide Children's Hospital, Columbus, Ohio; and
| | - Autumn Lane
- Nationwide Children's Hospital, Columbus, Ohio; and
| | | | - Roopali Bapat
- Nationwide Children's Hospital, Columbus, Ohio; and .,The Ohio State University, Columbus, Ohio
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Wang Y, Yin CP, Tai YL, Zhao ZJ, Hou ZY, Wang QJ. Apoptosis inhibition is involved in improvement of sevoflurane-induced cognitive impairment following normobaric hyperoxia preconditioning in aged rats. Exp Ther Med 2021; 21:203. [PMID: 33500697 PMCID: PMC7818554 DOI: 10.3892/etm.2021.9636] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 12/04/2020] [Indexed: 12/13/2022] Open
Abstract
Sevoflurane, a commonly used anesthetic agent has been confirmed to induce cognitive impairment in aged rats. Normobaric hyperoxia preconditioning has been demonstrated to induce neuroprotection in rats. The present study aimed to determine whether normobaric hyperoxia preconditioning could ameliorate cognitive deficit induced by sevoflurane and the possible mechanism by which it may exert its effect. A total of 66, 20-month-old male Sprague-Dawley rats were randomly divided into 3 groups (n=22 each): Rats in the control (C) and sevoflurane anesthesia (S) groups received no normobaric hyperoxia preconditioning before sevoflurane exposure, rats in the normobaric hyperoxia pretreatment (HO) group received normobaric hyperoxia preconditioning before sevoflurane exposure (95% oxygen for 4 continuous h daily for 6 consecutive days). The anesthesia rats (S and HO groups), were exposed to 2.5% sevoflurane for 5 h, while the sham anesthesia rats (C group) were exposed to no sevoflurane. The neurobehavioral assessment was performed using a Morris water maze test, the expressions of the apoptosis proteins were determined using western blot analysis, and the apoptosis rate and cytosolic calcium concentration were measured by flow cytometry. Normobaric hyperoxia preconditioning improved prolonged escape latency and raised the number of platform crossings induced by sevoflurane in the Morris water maze test, increased the level of bcl-2 protein, and decreased the level of bax and active caspase-3 protein, the apoptosis rate and cytosolic calcium concentration in the hippocampus 24 h after sevoflurane exposure. The findings of the present study may imply that normobaric hyperoxia preconditioning attenuates sevoflurane-induced spatial learning and memory impairment, and this effect may be partly related to apoptosis inhibition in the hippocampus. In conclusion, normobaric hyperoxia preconditioning may be a promising strategy against sevoflurane-induced cognitive impairment by inhibiting the hippocampal neuron apoptosis.
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Affiliation(s)
- Ying Wang
- Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China.,Department of Anesthesiology, Tangshan Gongren Hospital, Tangshan, Hebei 063000, P.R. China
| | - Chun-Ping Yin
- Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Yan-Lei Tai
- Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Zi-Jun Zhao
- Department of Anesthesiology, Hebei Chest Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Zhi-Yong Hou
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Qiu-Jun Wang
- Department of Anesthesiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
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Meng T, Ren X, Chen X, Yu J, Agrimi J, Paolocci N, Gao WD. Anesthetic Agents Isoflurane and Propofol Decrease Maximal Ca 2+-Activated Force and Thus Contractility in the Failing Myocardium. J Pharmacol Exp Ther 2019; 371:615-623. [PMID: 31515443 DOI: 10.1124/jpet.119.259556] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 09/11/2019] [Indexed: 01/16/2023] Open
Abstract
In the normal heart, frequently used anesthetics such as isoflurane and propofol can reduce inotropy. However, the impact of these agents on the failing myocardium is unclear. Here, we examined whether and how isoflurane and propofol influence cardiac contractility in intact cardiac muscles from rats treated with monocrotaline to induce heart failure. We measured force and intracellular Ca2+ ([Ca2 +]i) in trabeculae from the right ventricles of the rats in the absence or presence of propofol or isoflurane. At low to moderate concentrations, both propofol and isoflurane dose-dependently depressed cardiac force generation in failing trabeculae without altering [Ca2+]i At high doses, propofol (but not isoflurane) also decreased amplitude of [Ca2+]i transients. During steady-state activation, both propofol and isoflurane impaired maximal Ca2+-activated force (Fmax) while increasing the amount of [Ca2+]i required for 50% of maximal activation (Ca50). These events occurred without apparent change in the Hill coefficient, suggesting no impairment of cooperativity. Exposing these same muscles to the anesthetics after fiber skinning resulted in a similar decrement in Fmax and rise in Ca50 but no change in the myofibrillar ATPase-Ca2+ relationship. Thus, our study demonstrates that challenging the failing myocardium with commonly used anesthetic agents such as propofol and isoflurane leads to reduced force development as a result of lowered myofilament responsiveness to Ca2+ SIGNIFICANCE STATEMENT: Commonly used anesthetics such as isoflurane and propofol can impair myocardial contractility in subjects with heart failure by lowering myofilament responsiveness to Ca2+. High doses of propofol can also reduce the overall amplitude of the intracellular Ca2+ transient. These findings may have important implications for the safety and quality of intra- and perioperative care of patients with heart failure and other cardiac disorders.
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Affiliation(s)
- Tao Meng
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China (T.M., J.Y.); Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China (X.R.); Department of Cardiac Surgery, Tongji University Medical Center, Wuhan, China (X.C.); Division of Cardiology (J.A., N.P.) and Department of Anesthesiology and Critical Care Medicine (W.D.G.), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Department of Biomedical Sciences, University of Padova, Padova, Italy (N.P.)
| | - Xianfeng Ren
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China (T.M., J.Y.); Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China (X.R.); Department of Cardiac Surgery, Tongji University Medical Center, Wuhan, China (X.C.); Division of Cardiology (J.A., N.P.) and Department of Anesthesiology and Critical Care Medicine (W.D.G.), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Department of Biomedical Sciences, University of Padova, Padova, Italy (N.P.)
| | - Xinzhong Chen
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China (T.M., J.Y.); Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China (X.R.); Department of Cardiac Surgery, Tongji University Medical Center, Wuhan, China (X.C.); Division of Cardiology (J.A., N.P.) and Department of Anesthesiology and Critical Care Medicine (W.D.G.), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Department of Biomedical Sciences, University of Padova, Padova, Italy (N.P.)
| | - Jingui Yu
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China (T.M., J.Y.); Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China (X.R.); Department of Cardiac Surgery, Tongji University Medical Center, Wuhan, China (X.C.); Division of Cardiology (J.A., N.P.) and Department of Anesthesiology and Critical Care Medicine (W.D.G.), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Department of Biomedical Sciences, University of Padova, Padova, Italy (N.P.)
| | - Jacopo Agrimi
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China (T.M., J.Y.); Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China (X.R.); Department of Cardiac Surgery, Tongji University Medical Center, Wuhan, China (X.C.); Division of Cardiology (J.A., N.P.) and Department of Anesthesiology and Critical Care Medicine (W.D.G.), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Department of Biomedical Sciences, University of Padova, Padova, Italy (N.P.)
| | - Nazareno Paolocci
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China (T.M., J.Y.); Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China (X.R.); Department of Cardiac Surgery, Tongji University Medical Center, Wuhan, China (X.C.); Division of Cardiology (J.A., N.P.) and Department of Anesthesiology and Critical Care Medicine (W.D.G.), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Department of Biomedical Sciences, University of Padova, Padova, Italy (N.P.)
| | - Wei Dong Gao
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China (T.M., J.Y.); Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China (X.R.); Department of Cardiac Surgery, Tongji University Medical Center, Wuhan, China (X.C.); Division of Cardiology (J.A., N.P.) and Department of Anesthesiology and Critical Care Medicine (W.D.G.), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Department of Biomedical Sciences, University of Padova, Padova, Italy (N.P.)
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Iqbal F, Thompson AJ, Riaz S, Pehar M, Rice T, Syed NI. Anesthetics: from modes of action to unconsciousness and neurotoxicity. J Neurophysiol 2019; 122:760-787. [PMID: 31242059 DOI: 10.1152/jn.00210.2019] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Modern anesthetic compounds and advanced monitoring tools have revolutionized the field of medicine, allowing for complex surgical procedures to occur safely and effectively. Faster induction times and quicker recovery periods of current anesthetic agents have also helped reduce health care costs significantly. Moreover, extensive research has allowed for a better understanding of anesthetic modes of action, thus facilitating the development of more effective and safer compounds. Notwithstanding the realization that anesthetics are a prerequisite to all surgical procedures, evidence is emerging to support the notion that exposure of the developing brain to certain anesthetics may impact future brain development and function. Whereas the data in support of this postulate from human studies is equivocal, the vast majority of animal research strongly suggests that anesthetics are indeed cytotoxic at multiple brain structure and function levels. In this review, we first highlight various modes of anesthetic action and then debate the evidence of harm from both basic science and clinical studies perspectives. We present evidence from animal and human studies vis-à-vis the possible detrimental effects of anesthetic agents on both the young developing and the elderly aging brain while discussing potential ways to mitigate these effects. We hope that this review will, on the one hand, invoke debate vis-à-vis the evidence of anesthetic harm in young children and the elderly, and on the other hand, incentivize the search for better and less toxic anesthetic compounds.
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Affiliation(s)
- Fahad Iqbal
- Vi Riddell Pain Program, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Andrew J Thompson
- Vi Riddell Pain Program, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Neuroscience, Faculty of Science, University of Calgary, Calgary, Alberta, Canada
| | - Saba Riaz
- Vi Riddell Pain Program, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Marcus Pehar
- Vi Riddell Pain Program, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tiffany Rice
- Department of Anesthesiology, Perioperative and Pain Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Naweed I Syed
- Vi Riddell Pain Program, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Song Z, Fan TJ. Tetracaine induces apoptosis through a mitochondrion-dependent pathway in human corneal stromal cells in vitro. Cutan Ocul Toxicol 2018; 37:350-358. [PMID: 29742927 DOI: 10.1080/15569527.2018.1468342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
PURPOSE Tetracaine is a local anesthetic widely used in ocular diagnosis and ophthalmic surgery and may lead to some adverse effects and complications at a clinical dose. To assess the cytotoxicity and molecular toxicity mechanisms of tetracaine, we used human corneal stromal (HCS) cells as an in vitro model to study the effects of tetracaine on HCS cells. MATERIALS AND METHODS The cytotoxicity of tetracaine on HCS cells was investigated by examining the changes of cell growth, morphology, viability and cell cycle progressing when HCS cells were treated with tetracaine at concentrations from 10 g/L to 0.078125 g/L. To prove the hypothesis that the cytotoxicity of tetracaine on HCS cells was related with apoptosis induction, we further detected multiple changes in HCS cells, including plasma membrane (PM) permeability, phosphatidylserine (PS) orientation, genomic DNA integrality, and cell ultrastrcuture after treated with tetracaine. Furthermore, the pro-apoptotic signalling pathway induced by tetracaine was explored through detecting the activation of various caspases, the changes of mitochondrial transmembrane potential (MTP), the expression level of Bcl-2 family proteins and the amount of mitochondria-released apoptosis regulating proteins in cytoplasm. RESULTS Tetracaine at concentrations above 0.15625 g/L had a dose- and time-dependent cytotoxicity to HCS cells, which resulted cell growth inhibition, proliferation retardation, morphological abnormalities and decreased viability. Meanwhile, we found that the HCS cells treated with tetracaine had typical features associated with apoptosis, including an increase in PM permeability, PS externalization, DNA fragmentation and apoptotic body formation. Tetracaine not only resulted in caspase-3, caspase-8 and caspase-9 activation and disruption of MTP but also downregulated Bcl-2 and Bcl-xL and upregulated Bad and Bax, along with the upregulation of cytoplasmic cytochrome c (Cyt. c) and apoptosis-inducing factor (AIF). CONCLUSIONS These results suggested that tetracaine-induced apoptosis might be triggered through Fas death receptors and mediated by Bcl-2 family proteins in the mitochondria-dependent pathway. Our findings identified the cytotoxicity and molecular mechanisms of tetracaine, which could provide a reference value for the safety of this medication and prospective therapeutic interventions in eye clinic.
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Affiliation(s)
- Zhan Song
- a Laboratory for Corneal Tissue Engineering , College of Marine Life Sciences, Ocean University of China , Qingdao , Shandong province , P. R. China
| | - Ting-Jun Fan
- a Laboratory for Corneal Tissue Engineering , College of Marine Life Sciences, Ocean University of China , Qingdao , Shandong province , P. R. China
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Affiliation(s)
- Ferenc Zsila
- Biomolecular Self-Assembly Group; Institute of Materials and Environmental Chemistry; Research Centre for Natural Sciences; Hungarian Academy of Sciences; 1117 Budapest Hungary
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14
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Powell J, Powell S. Obstructive Sleep Apnea in the Very Young. CURRENT OTORHINOLARYNGOLOGY REPORTS 2018. [DOI: 10.1007/s40136-018-0184-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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