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Cai Y, Wu Y, Huang X, Yang J. Progress in the use of anticholinergic drugs during perioperative period. Asian J Surg 2024; 47:2359-2360. [PMID: 38267272 DOI: 10.1016/j.asjsur.2024.01.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/11/2024] [Indexed: 01/26/2024] Open
Affiliation(s)
- Yu Cai
- Department of Anesthesiology, West China Hospital of Sichuan University, Sichuan Province, Chengdu, 610041, China.
| | - Yali Wu
- Department of Anesthesiology, West China Hospital of Sichuan University, Sichuan Province, Chengdu, 610041, China.
| | - Xin Huang
- Department of Anesthesiology, West China Hospital of Sichuan University, Sichuan Province, Chengdu, 610041, China.
| | - Jing Yang
- Department of Anesthesiology, West China Hospital of Sichuan University, Sichuan Province, Chengdu, 610041, China.
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Zhao K, Gao Y, Zhang J, Wang S, Chen J, Guo F, Wang S. Penehyclidine for Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Gynecological Laparoscopic Surgery Under Combined Intravenous and Inhalation Anesthesia: A Randomized, Double-Blind, Placebo-Controlled Trial. Drug Des Devel Ther 2024; 18:685-697. [PMID: 38445065 PMCID: PMC10913797 DOI: 10.2147/dddt.s453327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/13/2024] [Indexed: 03/07/2024] Open
Abstract
Purpose We designed this study to investigate the effect of intravenous use of penehyclidine on postoperative nausea and vomiting (PONV) after gynecological laparoscopic surgery. Patients and Methods Ninety-two Women Patients (Aged ≥ 18) Scheduled for Elective Gynecologic Laparoscopy Were Enrolled in the Current Study. Patients Were Equally Randomized Assigned Into Penehyclidine group (PHC group: received a bolus of penehyclidine 10 μg/kg during the induction of anesthesia, then followed by a continuous infusion of 10 μg/kg penehyclidine at a fixed rate of 2.0 mL/h in postoperative intravenous analgesia pump over 48h, 0.5 mg upper limit respectively) or Control group (received 0.9% saline in replace of penehyclidine at the same time points). The primary outcome measure was the incidence of postoperative nausea and vomiting in the postanesthesia care unit and ward area. Quality of Recovery-15 (QoR-15) scores and general comfort questionnaire (GCQ) scores were assessed on postoperative day (POD) 1, 2. Results Patients between two groups had comparable baseline characteristics. Compared with the Control group, the incidence and severity of PONV, postoperative nausea (PON), and postoperative vomiting (POV) were significantly lower in the PHC group at 2h (PONV: P = 0.002, P = 0.004, respectively; PON: P = 0.018, P = 0.038, respectively; POV: P = 0.011, P = 0.072, respectively), 24h (PONV: P = 0.003, P = 0.001, respectively; PON: P = 0.010, P = 0.032, respectively; POV: P = 0.006, P = 0.044, respectively), and 48h (PONV: P = 0.003, P = 0.002, respectively; PON: P = 0.007, P = 0.019, respectively; POV: P = 0.002, P = 0.013, respectively) after surgery. The QoR-15 and GCQ scores of the PHC group were significantly higher than those of the Control group at POD 1, 2 (P < 0.001; P < 0.001, respectively). Conclusion Our findings suggest that perioperative intravenous application of penehyclidine can effectively prevent postoperative nausea and vomiting in gynecological laparoscopic surgery patients and improve postoperative recovery.
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Affiliation(s)
- Kai Zhao
- Department of Anesthesiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, Anhui, People’s Republic of China
- Department of Anesthesiology, Anhui Provincial Hospital, Hefei, Anhui, People’s Republic of China
| | - Yali Gao
- Department of Anesthesiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, Anhui, People’s Republic of China
- Department of Anesthesiology, Anhui Provincial Hospital, Hefei, Anhui, People’s Republic of China
| | - Jianping Zhang
- Department of Anesthesiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, Anhui, People’s Republic of China
- Department of Anesthesiology, Anhui Provincial Hospital, Hefei, Anhui, People’s Republic of China
| | - Shan Wang
- Department of Anesthesiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, Anhui, People’s Republic of China
- Department of Anesthesiology, Anhui Provincial Hospital, Hefei, Anhui, People’s Republic of China
| | - Jiaqi Chen
- Department of Anesthesiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, Anhui, People’s Republic of China
- Department of Anesthesiology, Anhui Provincial Hospital, Hefei, Anhui, People’s Republic of China
| | - Fenglin Guo
- Department of Anesthesiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, Anhui, People’s Republic of China
- Department of Anesthesiology, Anhui Provincial Hospital, Hefei, Anhui, People’s Republic of China
| | - Sheng Wang
- Department of Anesthesiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, Anhui, People’s Republic of China
- Department of Anesthesiology, Anhui Provincial Hospital, Hefei, Anhui, People’s Republic of China
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An MZ, Xu CY, Hou YR, Li ZP, Gao TS, Zhou QH. Effect of intravenous vs. inhaled penehyclidine on respiratory mechanics in patients during one-lung ventilation for thoracoscopic surgery: a prospective, double-blind, randomised controlled trial. BMC Pulm Med 2023; 23:353. [PMID: 37726724 PMCID: PMC10508004 DOI: 10.1186/s12890-023-02653-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 09/12/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Minimising postoperative pulmonary complications (PPCs) after thoracic surgery is of utmost importance. A major factor contributing to PPCs is the driving pressure, which is determined by the ratio of tidal volume to lung compliance. Inhalation and intravenous administration of penehyclidine can improve lung compliance during intraoperative mechanical ventilation. Therefore, our study aimed to compare the efficacy of inhaled vs. intravenous penehyclidine during one-lung ventilation (OLV) in mitigating driving pressure and mechanical power among patients undergoing thoracic surgery. METHODS A double-blind, prospective, randomised study involving 176 patients scheduled for elective thoracic surgery was conducted. These patients were randomly divided into two groups, namely the penehyclidine inhalation group and the intravenous group before their surgery. Driving pressure was assessed at T1 (5 min after OLV), T2 (15 min after OLV), T3 (30 min after OLV), and T4 (45 min after OLV) in both groups. The primary outcome of this study was the composite measure of driving pressure during OLV. The area under the curve (AUC) of driving pressure from T1 to T4 was computed. Additionally, the secondary outcomes included mechanical power, lung compliance and the incidence of PPCs. RESULTS All 167 participants, 83 from the intravenous group and 84 from the inhalation group, completed the trial. The AUC of driving pressure for the intravenous group was 39.50 ± 9.42, while the inhalation group showed a value of 41.50 ± 8.03 (P = 0.138). The incidence of PPCs within 7 days after surgery was 27.7% in the intravenous group and 23.8% in the inhalation group (P = 0.564). No significant differences were observed in any of the other secondary outcomes between the two groups (all P > 0.05). CONCLUSIONS Our study found that among patients undergoing thoracoscopic surgery, no significant differences were observed in the driving pressure and mechanical power during OLV between those who received an intravenous injection of penehyclidine and those who inhaled it. Moreover, no significant difference was observed in the incidence of PPCs between the two groups.
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Affiliation(s)
- Ming-Zi An
- Anesthesia Medicine, Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
- Department of anaesthesiology, Jiaxing Chinese Medical Hospital, No. 1501, Zhongshan East Road, Jiaxing, Zhejiang Province, China
| | - Cheng-Yun Xu
- Anesthesia Medicine, Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
- Department of anaesthesiology and pain medicine, affiliated hospital of Jiaxing University, No.1882, South Central Road, Jiaxing, Zhejiang Province, China
| | - Yue-Ru Hou
- Anesthesia Medicine, Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
- Department of anaesthesiology and pain medicine, affiliated hospital of Jiaxing University, No.1882, South Central Road, Jiaxing, Zhejiang Province, China
| | - Zhen-Ping Li
- Department of anaesthesiology and pain medicine, affiliated hospital of Jiaxing University, No.1882, South Central Road, Jiaxing, Zhejiang Province, China
| | - Te-Sheng Gao
- Department of anaesthesiology, Jiaxing Chinese Medical Hospital, No. 1501, Zhongshan East Road, Jiaxing, Zhejiang Province, China.
| | - Qing-He Zhou
- Department of anaesthesiology and pain medicine, affiliated hospital of Jiaxing University, No.1882, South Central Road, Jiaxing, Zhejiang Province, China.
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Yang T, Mudabbar MS, Liu B, Xu M, Fu Q. Intraoperative Esketamine Is Effective at Reducing Acute Postoperative Pain in Bariatric Surgery Patients: a Randomized Control Trial. Obes Surg 2023; 33:2368-2374. [PMID: 37344640 DOI: 10.1007/s11695-023-06676-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/25/2023] [Accepted: 06/07/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND The analgesic effect and postoperative effects of esketamine are not yet clear in bariatric surgeries. Many bariatric surgery patients suffer from acute abdominal pain after surgery which leads to increased opioid use. This study aimed to determine whether intraoperative use of esketamine could reduce acute postoperative pain in bariatric surgery patients. METHODS We designed a randomized double-blinded controlled trial. Included patients between the ages of 18 and 50 years with a body mass index ≥27 kg/m2 and American Society of Anesthesiologists Physical Status of I-III, scheduled to undergo sleeve gastrectomy. We divided them into two groups, the control group which received a placebo, and the esketamine group which received a loading dose of esketamine 0.2 mg/kg and a maintenance dose of 0.2 mg/(kg·h) along with other anesthetic drugs during the surgery. After the surgery, they were assessed for Numerical Rating Scale (NRS) pain scores and Post Operative Nausea and Vomiting (PONV) scores, while other surgical data were recorded during the surgery. RESULTS We enrolled 68 patients, 52 females, and 16 males. The 0.5 h, 1 h, 2 h, 6 h, and 12 h NRS scores were significantly lower in the esketamine group compared to the control group, and the extra painkillers administered were significantly lower in the esketamine group (p<0.05). CONCLUSION Intraoperative use of esketamine can reduce acute postoperative pain in bariatric surgery patients. Further studies should explore whether the reduced pain is due to the anti-depressive effect of esketamine or purely the analgesic effect. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR2100054038, https://www.chictr.org.cn/com/25/showproj.aspx?proj=142806 ).
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Affiliation(s)
- Ting Yang
- Department of Anesthesiology, Chengdu Third People's Hospital Affiliated to Southwest Jiaotong University, Chengdu, 610000, Sichuan, China
| | - Muhammad Saqib Mudabbar
- Department of Cardiovascular Medicine, West China Hospital, Sichuan University, #37 Guoxue Alley, Wuhou District, Chengdu, 610000, Sichuan Province, China
| | - Bin Liu
- Department of Anesthesiology, West China Hospital, Sichuan University, #37 Guoxue Alley, Wuhou District, Chengdu, 610000, Sichuan Province, China
| | - Mingxing Xu
- Department of Anesthesiology, Chengdu Third People's Hospital Affiliated to Southwest Jiaotong University, Chengdu, 610000, Sichuan, China
| | - Qiang Fu
- Department of Anesthesiology, Chengdu Third People's Hospital Affiliated to Southwest Jiaotong University, Chengdu, 610000, Sichuan, China.
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He F, Lu Y, Mao Q, Zhou L, Chen Y, Xie Y. Effects of penehyclidine hydrochloride combined with dexmedetomidine on pulmonary function in patients undergoing heart valve surgery: a double-blind, randomized trial. BMC Anesthesiol 2023; 23:237. [PMID: 37442959 PMCID: PMC10339561 DOI: 10.1186/s12871-023-02176-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
AIM To investigate the effects of penehyclidine hydrochloride combined with dexmedetomidine on pulmonary function in patients undergoing heart valve surgery with cardiopulmonary bypass (CPB). METHODS A total of 180 patients undergoing elective heart valve surgery with CPB were randomly divided into four groups: 45 in group P (intravenous penehyclidine hydrochloride 0.02 mg/kg 10 min before anesthesia induction and at the beginning of CPB, total 0.04 mg/kg); 43 in group D (dexmedetomidine 0.5 μg/kg/h after induction of anesthesia until the end of anesthesia); 44 in group PD ( penehyclidine hydrochloride 0.04 mg/kg combined with dexmedetomidine 0.5 μg/kg/h intravenously during anesthesia); and 43 in group C (same amount of normal saline 10 min before and after anesthesia induction, to the end of anesthesia, and at the beginning of CPB). The main outcomes were the incidence and severity of postoperative pulmonary complications (PPCs). The secondary outcomes were: (1) extubation time, length of stay in intensive care, and postoperative hospital stay, and adverse events; and (2) pulmonary function evaluation indices (oxygenation index and respiratory index) and plasma inflammatory factor concentrations (tumor necrosis factor-α, interleukin-6, C-reactive protein and procalcitonin) during the perioperative period. RESULTS The incidence of PPCs in groups P, D and PD after CPB was lower than that in group C (P < 0.05), and the incidence in group PD was significantly lower than that in groups P and D (P < 0.05). The scores for PPCs in groups P, D and PD were lower than those in group C (P < 0.05). CONCLUSION Combined use of penehyclidine hydrochloride and dexmedetomidine during anesthesia reduced the occurrence of postoperative pulmonary dysfunction, and improved the prognosis of patients undergoing heart valve surgery with CPB. TRIAL REGISTRATION The trial was registered in the Chinese Clinical Trial Registry on 3/11/2020 (Registration No.: ChiCTR2000039610).
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Affiliation(s)
- Fang He
- Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yizhi Lu
- Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qi Mao
- Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lifang Zhou
- Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yanhua Chen
- Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
| | - Yubo Xie
- Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
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Zeng S, Ma L, Yang L, Hu X, Wang C, Guo X, Li Y, Gou Y, Zhang Y, Li S, Zhang S, Wu X, Li M, Lei J, Li B, Bi C, Ma L, Luo Q. The advantages of penehyclidine hydrochloride over atropine in acute organophosphorus pesticide poisoning: A meta-analysis. JOURNAL OF INTENSIVE MEDICINE 2023; 3:171-184. [PMID: 37188113 PMCID: PMC10175710 DOI: 10.1016/j.jointm.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/02/2022] [Accepted: 07/14/2022] [Indexed: 05/17/2023]
Abstract
Background Penehyclidine hydrochloride (PHC) has been used for many years as an anticholinergic drug for the treatment of acute organophosphorus pesticide poisoning (AOPP). The purpose of this meta-analysis was to explore whether PHC has advantages over atropine in the use of anticholinergic drugs in AOPP. Methods We searched Scopus, Embase, Cochrane, PubMed, ProQuest, Ovid, Web of Science, China Science and Technology Journal Database (VIP), Duxiu, Chinese Biomedical literature (CBM), WanFang, and Chinese National Knowledge Infrastructure (CNKI), from inception to March 2022. After all qualified randomized controlled trials (RCTs) were included, we conducted quality evaluation, data extraction, and statistical analysis. Statistics using risk ratios (RR), weighted mean difference (WMD), and standard mean difference (SMD). Results Our meta-analysis included 20,797 subjects from 240 studies across 242 different hospitals in China. Compared with the atropine group, the PHC group showed decreased mortality rate (RR=0.20, 95% confidence intervals [CI]: 0.16-0.25, P <0.001), hospitalization time (WMD=-3.89, 95% CI: -4.37 to -3.41, P <0.001), overall incidence rate of complications (RR=0.35, 95% CI: 0.28-0.43, P <0.001), overall incidence of adverse reactions (RR=0.19, 95% CI: 0.17-0.22, P <0.001), total symptom disappearance time (SMD=-2.13, 95% CI: -2.35 to -1.90, P <0.001), time for cholinesterase activity to return to normal value 50-60% (SMD=-1.87, 95% CI: -2.03 to -1.70, P <0.001), coma time (WMD=-5.57, 95% CI: -7.20 to -3.95, P <0.001), and mechanical ventilation time (WMD=-2.16, 95% CI: -2.79 to -1.53, P <0.001). Conclusion PHC has several advantages over atropine as an anticholinergic drug in AOPP.
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Affiliation(s)
- Siyao Zeng
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
- Corresponding author: Siyao Zeng, School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China. Lei Ma, Department of Emergency Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China.
| | - Lei Ma
- Department of Emergency Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
- Corresponding author: Siyao Zeng, School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China. Lei Ma, Department of Emergency Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China.
| | - Lishan Yang
- Department of Emergency Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Xiaodong Hu
- Department of Emergency Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Cheng Wang
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Xinxin Guo
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Yi Li
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Yi Gou
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Yao Zhang
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Shengming Li
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Shaotong Zhang
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Xiaoxuan Wu
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Meihong Li
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Jing Lei
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Bingqian Li
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Chengfei Bi
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Like Ma
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Qingpeng Luo
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
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Ding X, Chen D, Che J, Xu S, Liang H, Gui B. Penehyclidine hydrochloride for treating postoperative nausea and vomiting after laparoscopic bariatric surgery: a double-blinded randomized controlled trial. BMC Anesthesiol 2023; 23:135. [PMID: 37095439 PMCID: PMC10124062 DOI: 10.1186/s12871-023-02078-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/04/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Postoperative nausea and vomiting (PONV) is a common and distressing complication of laparoscopic bariatric surgery (LBS). Penehyclidine hydrochloride has been reported to be effective in preventing PONV. Considering the potential preventive effects of penehyclidine against PONV, we hypothesized that intravenous infusion of penehyclidine may alleviate PONV within the first 48 h in patients scheduled for LBS. METHODS Patients who underwent LBS were randomly assigned (1:2) to receive saline (Control group, n = 113) or a single intravenous dose of penehyclidine 0.5 mg (PHC group, n = 221). The primary outcome was incidence of PONV within the first 48 h postoperatively. Secondary endpoints included severity of PONV, need for rescue antiemetic therapy, volume of water intake, and time to first flatus. RESULTS PONV occurred in 159 (48%) patients within the first 48 h postoperatively, including 51% in the Control group and 46% in the PHC group. There was no significant difference in the incidence or severity of PONV between the two groups (P > 0.05). Within the first 24 h and 24-48 h, no significant difference was found in incidence or severity of PONV, postoperative nausea, postoperative vomiting, need for rescue antiemetic therapy, or volume of water intake (P > 0.05). Kaplan-Meier curves showed that penehyclidine was significantly associated with a prolonged time to first flatus (median onset time: 22 h vs. 21 h, P = 0.036). CONCLUSIONS Penehyclidine did not decrease incidence and severity of PONV in patients undergoing LBS. However, a single intravenous dose of penehyclidine (0.5 mg) was associated with a slightly prolonged time to first flatus. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR2100052418, http://www.chictr.org.cn/showprojen.aspx?proj=134893 , date of registration: 25/10/2021).
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Affiliation(s)
- Xiahao Ding
- Department of Anesthesiology and Perioperative Medicine, 1st Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| | - Dapeng Chen
- Department of Anesthesiology and Perioperative Medicine, 1st Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| | - Jinxing Che
- Department of Anesthesiology and Perioperative Medicine, 1st Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
- Department of Anesthesiology, The Huai'an Maternity and Child Healthcare Hospital, Huai'an, 223002, China
| | - Siyang Xu
- Department of Anesthesiology and Perioperative Medicine, 1st Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
- Department of Anesthesiology, Jiangsu Province Official Hospital, Nanjing, 210009, China
| | - Hui Liang
- Department of General Surgery, 1st Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| | - Bo Gui
- Department of Anesthesiology and Perioperative Medicine, 1st Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China.
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Zhang Y, Lv X, Sun P, Yin D. Sufentanil, dexmedetomidine combined with surface anesthesia for awake fiberoptic nasotracheal intubation in the patient with severe mouth opening difficulty undergoing wedge resection of the right upper lung: A case report and literature review. Medicine (Baltimore) 2023; 102:e33584. [PMID: 37083762 PMCID: PMC10118371 DOI: 10.1097/md.0000000000033584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/31/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Severe mouth opening difficulty may increase the risk of airway management during anesthesia induction, and awake fiberoptic nasotracheal intubation (AFNI) is the first option for patients with orofacial anatomical changes. CASE SUMMARY A 54-year-old man was scheduled to undergo wedge resection of the right upper lung in August 2021. The patient had a history of enlarged right maxillary lesion resection and partial right maxillary resection surgery in April 2020, which led to orofacial anatomical changes and severe mouth opening difficulty. To avoid difficult airway-related emergency scenarios, the AFNI was successfully performed through intravenous injection of sufentanil and dexmedetomidine combined with lidocaine topical anesthesia under a conscious state without any uncomfortable feeling or complications. CONCLUSIONS Intravenous injection of sufentanil and dexmedetomidine combined with lidocaine topical anesthesia can be used as an alternative medication scheme to relieve uncomfortable suffering for AFNI in patients with severe mouth opening difficulty.
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Affiliation(s)
- Yanwei Zhang
- 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
| | - Pingping Sun
- Department of Anesthesiology and Intensive Care Units, Funing People’s Hospital of Jiangsu, Yancheng, Jiangsu province, China
| | - Dekun Yin
- Department of Anesthesiology and Intensive Care Units, Funing People’s Hospital of Jiangsu, Yancheng, Jiangsu province, China
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Effects of Anticholinergic Drugs on Visual Acuity of Patients with Tracheal Intubation under General Anesthesia. DISEASE MARKERS 2022; 2022:4559547. [PMID: 35769814 PMCID: PMC9236765 DOI: 10.1155/2022/4559547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/16/2022] [Accepted: 05/21/2022] [Indexed: 11/17/2022]
Abstract
Background. General anesthesia (GA) is the core means of surgical intervention, mainly used for analgesia and anxiety relief. Therefore, it is necessary to understand the laboratory and clinical research results during induction of GA. Penehyclidine hydrochloride (PHCD) combined with atropine sulfate (Atr) has the potential to induce GA. However, the role of PHCD combined with Atr during tracheal intubation under GA remains unclear. Objective. The research is aimed at exploring the effects of preoperative PHCD or Atr on adverse reactions (ARs) in patients during tracheal intubation under general anesthesia (GA). Methods. This study retrospectively enrolled 473 patients who underwent surgery under GA induction and divided them into a research group (
) and a control group (
) according to preoperative use of PHCD (with or without). Both groups of patients were given Atr postoperatively and nursing intervention. Anesthesia-related indexes, ARs, and hemodynamics were observed and compared between the two groups. Results. There were no significant differences in anesthesia-related indexes and hemodynamics between the research group and the control group. The incidence of blurred vision and diplopia in the research group was higher than that in the control group. Conclusion. Preoperative PHCD combined with postoperative Atr should be avoided in clinical practice, or Atr rather than PHCD should be used preoperatively, so as to reduce the occurrence of blurred vision, diplopia, and other ARs.
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Wang LK, Cheng T, Yang XD, Xiong GL, Li N, Wang DX. Penehyclidine for prevention of postoperative nausea and vomiting following bimaxillary orthognathic surgery: a randomized, double-blind, controlled trial. J Anesth 2021; 36:122-136. [PMID: 34738161 PMCID: PMC8807454 DOI: 10.1007/s00540-021-03017-4] [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: 08/16/2021] [Accepted: 10/23/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE To investigate the efficacy and safety of low-dose bolus plus continuous infusion of penehyclidine in preventing postoperative nausea and vomiting (PONV) following bimaxillary surgery. METHODS Three hundred fifty-four patients were randomly allocated into three groups. In the Control group, placebo (normal saline) was injected before anesthesia and infused over 48 h after surgery; in the Bolus group, 0.5 mg penehyclidine was injected before anesthesia, whereas placebo was infused after surgery; in the Infusion group, 0.25 mg penehyclidine were injected before anesthesia, another 0.25 mg penehyclidine was infused after surgery. The primary endpoint was the incidence of PONV within 72 h. RESULTS A total of 353 patients were included in intention-to-treat analysis. The PONV incidence was 61.0% (72/118) in the Control group, 40.2% (47/117) in the Bolus group, and 28.0% (33/118) in the Infusion group. The incidence was significantly lower in the Bolus group than in the Control group (RR 0.66; 95% CI 0.51-0.86; adjusted P = 0.003) and in the Infusion group than in the Control group (RR 0.46; 95% CI 0.33-0.63; adjusted P < 0.001); the difference between the Infusion and Bolus groups was not statistically significant (RR 0.70; 95% CI 0.48-1.00; adjusted P = 0.144). Emergence agitation occurred more frequently in the Bolus group than in the Control group (36.8% [43/117] vs. 21.2% [25/118], adjusted P = 0.027), but did not differ significantly between the Infusion and Control groups. CONCLUSIONS A low-dose bolus plus continuous infusion of penehyclidine was effective in preventing PONV without increasing emergence agitation. TRIAL REGISTRATION Clinicaltrials.gov. Identifier: NCT04454866.
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Affiliation(s)
- Li-Kuan Wang
- Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No.8 Xishiku street, Beijing, 100034, China.,Department of Anesthesiology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Tong Cheng
- Department of Anesthesiology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xu-Dong Yang
- Department of Anesthesiology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Guo-Li Xiong
- Department of Anesthesiology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Nan Li
- Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No.8 Xishiku street, Beijing, 100034, China
| | - Dong-Xin Wang
- Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No.8 Xishiku street, Beijing, 100034, China. .,Outcomes Research Consortium, Cleveland, OH, USA.
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11
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Yuan M, Jing G, Kong Q, Ming T, Song X, Wu X. Tumor necrosis factor α‑induced protein 8‑like 2 contributes to penehyclidine hydrochloride pretreatment against lipopolysaccharide‑induced acute lung injury in a mouse model. Mol Med Rep 2021; 24:750. [PMID: 34468006 DOI: 10.3892/mmr.2021.12390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/12/2021] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to investigate the effect of penehyclidine hydrochloride (PHC) pretreatment on mice with lipopolysaccharide (LPS)‑induced acute lung injury (ALI) and its possible underlying mechanisms. Mice were randomly separated into six groups: i) Sham group; ii) LPS group; iii) LPS + PHC group; iv) tumor necrosis factor a‑induced protein 8‑like protein 2 (TIPE2) group; v) LPS + TIPE2 group; and vi) LPS + TIPE2 + PHC group. The ALI model was induced using LPS through intratracheal injection. The mice received adenovirus gene to induce the overexpression of TIPE2. After mice were sacrificed, lung injury indices were assessed, and arterial blood, bronchoalveolar lavage fluid and lung tissues were collected for subsequent assays. Expression levels of related proteins were detected by using western blotting. It was found that compared with the sham group, the mice treated with LPS showed increased lung injury and dysfunctions of gas exchange. However, these trends were significantly ameliorated in the LPS + PHC group. Evaluation of protein expression in lung tissues showed that the increased expression of nuclear NF‑κB p65 and p‑c‑Jun N‑terminal kinase (JNK) induced by LPS were suppressed in the LPS + PHC group and the expression of TIPE2 was increased. The mice that received adenovirus gene to induce TIPE2 overexpression could also showed protective effects compared with the mice in the LPS group. However, the expression of TIPE2 decreased rather than increased in LPS group. In the mice pretreated with PHC, the expression of TIPE2 increased in mice with LPS‑induced ALI. To conclude, PHC pretreatment could inhibit the occurrence of inflammation and apoptosis in LPS‑induced ALI. This process may be related to the activation of TIPE2 and the inhibition of NF‑κB and JNK signaling pathway in the lungs of mice.
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Affiliation(s)
- Min Yuan
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Guoqing Jing
- Department of Anesthesiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Qian Kong
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Tingqian Ming
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Xuemin Song
- Department of Anesthesiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Xiaojing Wu
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
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12
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Sun J, Cao X, Lu T, Li N, Min X, Ding Z. Penehyclidine mitigates postoperative nausea and vomiting and intraoperative oculocardiac reflex in patients undergoing strabismus surgery: a prospective, randomized, double-blind comparison. BMC Anesthesiol 2021; 21:49. [PMID: 33581727 PMCID: PMC7881589 DOI: 10.1186/s12871-021-01266-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 02/04/2021] [Indexed: 12/25/2022] Open
Abstract
Background Postoperative nausea and vomiting (PONV) is one of the most frequent complications following strabismus surgery. Penehyclidine, an anticholinergic agent, is widely used as premedication. This study investigated the effect of preoperative penehyclidine on PONV in patients undergoing strabismus surgery. Methods In this prospective, randomized, double-blind study, patients scheduled for strabismus surgery under general anesthesia were randomly assigned to either penehyclidine (n = 114) or normal saline (n = 104) group. Penehyclidine was administrated immediately after anesthesia induction, and normal saline was substituted as control. PONV was investigated from 0 to 48 h after surgery. Intraoperative oculocardiac reflex (OCR) was also recorded. Results Compared with normal saline, penehyclidine significantly reduced PONV incidence (30.7% vs. 54.8%, P < 0.01) and mitigated PONV severity as indicated by severity scoring (P < 0.01). Compared with normal saline, penehyclidine also significantly reduced OCR incidence (57.9% vs. 77.9%, P < 0.01) and mitigated OCR severity, as indicated by the requirement for atropine rescue (77.3% vs. 90.1%, P < 0.05) and the maximum decrease of heart rate during OCR (23.1 ± 9.4 bpm vs. 27.3 ± 12.4 bpm, P < 0.05). The recovery course did not differ between groups. Conclusions Penehyclidine administrated after anesthesia induction significantly reduced the incidence of PONV and alleviated intraoperative OCR in patients undergoing strabismus surgery. Trial registration ClinicalTrials.gov (NCT04054479). Retrospectively registered August 13, 2019.
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Affiliation(s)
- Jiacheng Sun
- Department of Anesthesiology and Perioperative Medicine, First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| | - Xiaofei Cao
- Department of Anesthesiology and Perioperative Medicine, First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| | - Ting Lu
- Department of Anesthesiology and Perioperative Medicine, First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| | - Nan Li
- Department of Anesthesiology and Perioperative Medicine, First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| | - Xinxu Min
- Department of Anesthesiology and Perioperative Medicine, First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| | - Zhengnian Ding
- Department of Anesthesiology and Perioperative Medicine, First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China.
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13
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Wang X, Liu F, Xu M, Wu L. Penehyclidine hydrochloride alleviates lipopolysaccharide‑induced acute respiratory distress syndrome in cells via regulating autophagy‑related pathway. Mol Med Rep 2020; 23:100. [PMID: 33300058 PMCID: PMC7723159 DOI: 10.3892/mmr.2020.11739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 04/30/2020] [Indexed: 12/13/2022] Open
Abstract
Acute progressive hypoxic respiratory failure caused by various predisposing factors is known as acute respiratory distress syndrome (ARDS). Although penehyclidine hydrochloride (PHC), an anticholinergic drug, is widely applied in clinical practice, the specific mechanisms underlying PHC in the treatment of ARDS are not completely understood. In the present study, BEAS-2B cells were treated with 10 ng/ml lipopolysaccharide (LPS) to establish an ARDS cell model and a rat model of acute lung injury (ALI). The influences of PHC and/or autophagy inhibitor (3-methyladenine (3-MA)) on the morphology, autophagy, proliferation and apoptosis of cells and tissues were evaluated using hematoxylin and eosin staining, Cell Counting Kit-8 assays, Hoechst staining, TUNEL staining, flow cytometry, immunofluorescence assays, ELISAs and scanning electron microscopy. The expression levels of apoptosis- and autophagy-related proteins were measured via western blotting. The results indicated that PHC enhanced proliferation and autophagy, and decreased apoptosis and the inflammatory response in LPS-induced BEAS-2B cells and ALI model rats. In addition, 3-MA reversed the effects of PHC on proliferation, inflammation, apoptosis and autophagy in LPS-induced BEAS-2B cells. Therefore, the present study suggested that PHC demonstrated a protective effect in LPS-induced ARDS by regulating an autophagy-related pathway.
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Affiliation(s)
- Xiaopeng Wang
- Department of Pediatrics, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, P.R. China
| | - Fen Liu
- Department of Pediatrics, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, P.R. China
| | - Min Xu
- Department of Pediatrics, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, P.R. China
| | - Liangxia Wu
- Department of Pediatrics, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, P.R. China
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Zheng SH, Yan CY, Duan N, Wang W, Mei XP. Penehyclidine hydrochloride suppressed peripheral nerve injury-induced neuropathic pain by inhibiting microglial MAPK/p-p38/IL-1 β pathway activation. Mol Pain 2020; 15:1744806919858260. [PMID: 31149893 PMCID: PMC6589961 DOI: 10.1177/1744806919858260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Millions of people suffered from neuropathic pain, which is related to neuroinflammation in the central nervous system. Penehyclidine hydrochloride is a premedication of general anesthesia, which has been confirmed possessing neuroprotective effects against various neurodegenerative or neuroinflammatory diseases. However, it is not clear that whether penehyclidine hydrochloride could suppress neuropathic pain through its anti-neuroinflammatory effects. Methods This study investigated the effects of penehyclidine hydrochloride on rat spinal nerve ligation injury-induced neuropathic pain with behavioral, morphological, and molecular biological methods in animals. Results The results indicated that penehyclidine hydrochloride could attenuate spinal nerve ligation-induced neuropathic pain without any motor impairment and had no effect on sham-operated animals after repeated intraperitoneal administration. Intraperitoneal penehyclidine hydrochloride could suppress spinal nerve ligation-induced ipsilateral spinal dorsal horn microglial activation with downregulation of OX42 expression. Moreover, intraperitoneal penehyclidine hydrochloride inhibited spinal nerve ligation-induced spinal p-p38 mitogen-activated protein kinase expression, which was specially colocalized with the spinal dorsal horn microglia. Furthermore, intraperitoneal penehyclidine hydrochloride could depress spinal neuroinflammation by suppressing spinal nerve ligation-induced interleukin (IL)-1β over-expression. Conclusion These results indicated that the anti-allodynic effects of penehyclidine hydrochloride on spinal nerve ligation-induced neuropathic pain did not rely on motor impairment. Inhibiting spinal microglial p-p38/IL-1β pathway activation might contribute to the anti-allodynic effect of penehyclidine hydrochloride on nerve injury-induced neuropathic pain.
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Affiliation(s)
- Shao-Hua Zheng
- 1 Department of Anesthesiology, First Affiliated Hospital of Xi'an JiaoTong University, Xi'an, Shaanxi, China
| | - Chao-Ying Yan
- 1 Department of Anesthesiology, First Affiliated Hospital of Xi'an JiaoTong University, Xi'an, Shaanxi, China
| | - Na Duan
- 1 Department of Anesthesiology, First Affiliated Hospital of Xi'an JiaoTong University, Xi'an, Shaanxi, China
| | - Wei Wang
- 2 State Key Laboratory of Military Stomatology, Department of Anesthesiology, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Xiao-Peng Mei
- 1 Department of Anesthesiology, First Affiliated Hospital of Xi'an JiaoTong University, Xi'an, Shaanxi, China
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Ren JY, Lin DM, Wang CB, Yang YL, Wang ZQ, Cui BQ, Ma J. Postconditioning Protection Against Myocardiocyte Anoxia/Reoxygenation Injury From Penehyclidine Hydrochloride. Drug Des Devel Ther 2019; 13:3977-3988. [PMID: 32063699 PMCID: PMC6884978 DOI: 10.2147/dddt.s224282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 10/19/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND/AIMS To investigate the postconditioning protective effect of penehyclidine hydrochloride (PHC) against anoxia/reoxygenation (A/R) injury in H9c2 cells along with the involved mechanism and timing effect. METHODS We divided H9c2 cells into 7 groups: control group, A/R group and PHC+A/R groups at 0 min, 5 mins, 10 mins, 20 mins, 30 mins, respectively (treated with 0.1 μm/L PHC at 0 min, 5 mins, 10 mins, 20 mins, 30 mins after the reoxygenation procedure began). Cell apoptosis, oxidative stress, intracellular Ca2+ concentration, mitochondrial membrane potential and mitochondrial permeability transition pore (MPTP) opening were explored. Bcl-2, Bax, Cyt C, caspase-3 and caspase-9 levels were measured. RESULTS A/R significantly increased both cell injury and cell apoptosis. PHC showed postconditioning protective effect by attenuating superoxide production, decreasing Ca2+ overload, restraining MPTP activities, restoring mitochondrial membrane potential, regulating cell apoptosis proteins and modulation of mitochondrial pathway. Earlier administration of PHC offered greater postconditioning protective effect. CONCLUSION H9c2 cells were protected by PHC from A/R injury regardless of timing of PHC administration (0 min, 5 mins, 10 mins, 20 mins, 30 mins). However, earlier administration of PHC resulted in better PHC postconditioning protection.
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Affiliation(s)
- JY Ren
- Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, People’s Republic of China
| | - DM Lin
- Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, People’s Republic of China
| | - CB Wang
- Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, People’s Republic of China
| | - YL Yang
- Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, People’s Republic of China
| | - ZQ Wang
- Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, People’s Republic of China
| | - BQ Cui
- Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, People’s Republic of China
| | - J Ma
- Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, People’s Republic of China
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A Selective M1 and M3 Receptor Antagonist, Penehyclidine Hydrochloride, Exerts Antidepressant-Like Effect in Mice. Neurochem Res 2019; 44:2723-2732. [DOI: 10.1007/s11064-019-02891-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/25/2019] [Accepted: 10/10/2019] [Indexed: 12/18/2022]
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Ye S, Yang X, Wang Q, Chen Q, Ma Y. Penehyclidine Hydrochloride Alleviates Lipopolysaccharide-Induced Acute Lung Injury by Ameliorating Apoptosis and Endoplasmic Reticulum Stress. J Surg Res 2019; 245:344-353. [PMID: 31425874 DOI: 10.1016/j.jss.2019.07.080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/16/2019] [Accepted: 07/19/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Penehyclidine hydrochloride (PHC), a novel anticholinergic reagent, has been shown to exert anti-endoplasmic reticulum stress (ERS), antioxidant, and antiinflammation functions in various rat models. However, the definite pathogenesis of lung defensive roles of PHC remains unclear. This study measured the functions of PHC on lipopolysaccharide (LPS)-induced acute lung injury (ALI) in rats. METHODS In this research, the LPS-induced ALI model was assessed through the branchial injection of LPS for 24 h. Male Sprague-Dawley rats were randomly allocated into 5 groups: sham, LPS, LPS + PHC (0.5 mg/kg), LPS + PHC (1 mg/kg), and LPS + PHC (2.5 mg/kg). The concentrations of superoxide dismutase, malondialdehyde, myeloperoxidase, and glutathione peroxidase were measured by enzyme-linked immunosorbent assay and immunohistochemistry analysis. Western blotting, real-time PCR, and immunofluorescence analysis were used to determine the ERS-associated protein levels and mRNA expression. The protein levels of Bax, Bcl-2, caspase-3, and caspase-9 were used to measure lung tissue apoptosis. RESULTS The results revealed that PHC administration inhibited LPS-induced ALI as indicated by the loss in the ratio of injury production evaluated through hematoxylin-eosin staining, in particular the lung sample sections, compared with the LPS group. PHC administration inhibited LPS-induced lung myeloperoxidase and serum concentrations of malondialdehyde, superoxide dismutase, and glutathione peroxidase in rats. PHC administration repressed the LPS-activated ERS-correlated pathway and apoptosis-associated protein levels in rats. CONCLUSIONS In summary, our findings indicated that PHC has a defensive effect on LPS-induced ALI by inhibiting oxidative stress, attenuating PERK and ATF6 signals, and suppressing ERS-mediated apoptosis.
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Affiliation(s)
- Shaobing Ye
- Department of Anesthesiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xue Yang
- Department of Anesthesiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiansong Wang
- Department of Anesthesiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiang Chen
- Department of Anesthesiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yongda Ma
- Department of Anesthesiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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