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Curic D, Ashby DM, McGirr A, Davidsen J. Existence of multiple transitions of the critical state due to anesthetics. Nat Commun 2024; 15:7025. [PMID: 39147749 PMCID: PMC11327335 DOI: 10.1038/s41467-024-51399-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 08/05/2024] [Indexed: 08/17/2024] Open
Abstract
Scale-free statistics of coordinated neuronal activity, suggesting a universal operating mechanism across spatio-temporal scales, have been proposed as a necessary condition of healthy resting-state brain activity. Recent studies have focused on anesthetic agents to induce distinct neural states in which consciousness is altered to understand the importance of critical dynamics. However, variation in experimental techniques, species, and anesthetics, have made comparisons across studies difficult. Here we conduct a survey of several common anesthetics (isoflurane, pentobarbital, ketamine) at multiple dosages, using calcium wide-field optical imaging of the mouse cortex. We show that while low-dose anesthesia largely preserves scale-free statistics, surgical plane anesthesia induces multiple dynamical modes, most of which do not maintain critical avalanche dynamics. Our findings indicate multiple pathways away from default critical dynamics associated with quiet wakefulness, not only reflecting differences between these common anesthetics but also showing significant variations in individual responses. This is suggestive of a non-trivial relationship between criticality and the underlying state of the subject.
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Affiliation(s)
- Davor Curic
- Complexity Science Group, Department of Physics and Astronomy, University of Calgary, Calgary, Alberta, T2N 1N4, Canada.
| | - Donovan M Ashby
- Department of Psychiatry, University of Calgary, Calgary, AB, T2N 1N4, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
- Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada
| | - Alexander McGirr
- Department of Psychiatry, University of Calgary, Calgary, AB, T2N 1N4, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
- Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada
| | - Jörn Davidsen
- Complexity Science Group, Department of Physics and Astronomy, University of Calgary, Calgary, Alberta, T2N 1N4, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
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Wang H, Te R, Zhang J, Su Y, Zhou H, Guo N, Chi D, Huang W. Effects of a single subanesthetic dose of esketamine on postoperative subthreshold depressive symptoms in patients undergoing unilateral modified radical mastectomy: a randomised, controlled, double-blind trial. BMC Psychiatry 2024; 24:315. [PMID: 38658886 PMCID: PMC11044398 DOI: 10.1186/s12888-024-05753-9] [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: 10/26/2023] [Accepted: 04/09/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Breast cancer is the most common malignant tumor in females worldwide. During disease development, breast cancer patients suffer anxious and depressed, which may lead to worse quality of life or even higher mortality. Esketamine has been regarded as an antidepressant in breast cancer patients with mild or moderate depression. Here, we wonder whether the administration of esketamine could reduce the postoperative depressive symptom score of breast cancer patients who have no preoperative depression. METHODS A total of 64 patients treated with unilateral modified radical mastectomy were randomly divided into an experimental group (esketamine group, Group E) and a control group (Group C), with 32 cases in each one. After anesthesia induction, Group C received 0.2 ml/kg of normal saline intravenously and Group E was administered 0.2 mg/kg intravenous esketamine. The primary outcome was the Patient Health Questionnaire-9 (PHQ-9) scores. The secondary outcomes included the Visual Analogue Scale (VAS) scores for pain, inflammatory markers, perioperative-related indicators, and the incidence of postoperative delirium, nausea and vomiting. RESULTS The PHQ-9 score on postoperative day (POD) 1 in Group E declined from the preoperative level, while the score in Group C was higher than before, and the former was far lower than the latter (P = 0.047). There is no statistically significant difference in PHQ-9 scores between Group E and Group C on POD 3, 7, and 30. Moreover, the postoperative leukocyte level of Group E was higher than that of Group C, and the difference was statistically significant (P = 0.030). CONCLUSIONS A single subanesthetic dose of esketamine can result in lower postoperative score on subthreshold depressive symptoms compared to the Group C on POD 1, without increasing the occurrence of postoperative adverse reactions. TRIAL REGISTRATION Registration number: Chinese Clinical Trial Registry ChiCTR2200057028. Date of registration: 26/02/2022.
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Affiliation(s)
- Huanwei Wang
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, People's Republic of China
| | - Rigen Te
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, People's Republic of China
| | - Jianxing Zhang
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, People's Republic of China
| | - Yanbing Su
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, People's Republic of China
| | - Hongxia Zhou
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, People's Republic of China
| | - Na Guo
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, People's Republic of China.
| | - Dongmei Chi
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, People's Republic of China.
| | - Wan Huang
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, People's Republic of China.
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Smith JA, Ji Y, Lorsung R, Breault MS, Koenig J, Cramer N, Masri R, Keller A. Parabrachial Nucleus Activity in Nociception and Pain in Awake Mice. J Neurosci 2023; 43:5656-5667. [PMID: 37451980 PMCID: PMC10401640 DOI: 10.1523/jneurosci.0587-23.2023] [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: 03/29/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023] Open
Abstract
The parabrachial nuclear complex (PBN) is a nexus for aversion and for the sensory and affective components of pain perception. We have previously shown that during chronic pain PBN neurons in anesthetized rodents have amplified activity. We report a method to record from PBN neurons of behaving, head-restrained mice while applying reproducible noxious stimuli. We find that both spontaneous and evoked activity are higher in awake animals compared with urethane anesthetized mice. Fiber photometry of calcium responses from calcitonin-gene-related peptide-expressing PBN neurons demonstrates that these neurons respond to noxious stimuli. In both males and females with neuropathic or inflammatory pain, responses of PBN neurons remain amplified for at least 5 weeks, in parallel with increased pain metrics. We also show that PBN neurons can be rapidly conditioned to respond to innocuous stimuli after pairing with noxious stimuli. Finally, we demonstrate that changes in PBN neuronal activity are correlated with changes in arousal, measured as changes in pupil area.SIGNIFICANCE STATEMENT The parabrachial complex is a nexus of aversion, including pain. We report a method to record from parabrachial nucleus neurons of behaving mice while applying reproducible noxious stimuli. This allowed us to track parabrachial activity over time in animals with neuropathic or inflammatory pain. It also allowed us to show that the activity of these neurons correlates with arousal states and that these neurons can be conditioned to respond to innocuous stimuli.
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Affiliation(s)
- Jesse A Smith
- Program in Neuroscience, Department of Neurobiology, School of Medicine, University of Maryland, Baltimore, Maryland 21201
| | - Yadong Ji
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland 21201-1786
| | - Rebecca Lorsung
- Program in Neuroscience, Department of Neurobiology, School of Medicine, University of Maryland, Baltimore, Maryland 21201
| | - Macauley S Breault
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139
| | - Jeffrey Koenig
- Program in Molecular Medicine, Department of Neurobiology, School of Medicine, University of Maryland, Baltimore, Maryland 21201
| | - Nathan Cramer
- Program in Neuroscience, Department of Neurobiology, School of Medicine, University of Maryland, Baltimore, Maryland 21201
| | - Radi Masri
- Program in Neuroscience, Department of Neurobiology, School of Medicine, University of Maryland, Baltimore, Maryland 21201
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland 21201-1786
| | - Asaf Keller
- Program in Neuroscience, Department of Neurobiology, School of Medicine, University of Maryland, Baltimore, Maryland 21201
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Bruno AS, Castor RGM, Berg B, Dos Reis Costa DEF, Monteiro ALL, Scalzo S, Oliveira KCM, Bello FLM, Aguiar GC, Melo MB, Santos RAS, Bonaventura D, Guatimosim S, Castor MGM, Ferreira AJ, Cau SBA. Cardiac disturbances and changes in tissue cytokine levels in mice fed with a high-refined carbohydrate diet. Cytokine 2023; 166:156192. [PMID: 37054665 DOI: 10.1016/j.cyto.2023.156192] [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: 12/21/2022] [Accepted: 03/24/2023] [Indexed: 04/15/2023]
Abstract
AIMS The consumption of highly refined carbohydrates increases systemic inflammatory markers, but its potential to exert direct myocardial inflammation is uncertain. Herein, we addressed the impact of a high-refined carbohydrate (HC) diet on mice heart and local inflammation over time. MAIN METHODS BALB/c mice were fed with a standard chow (control) or an isocaloric HC diet for 2, 4, or 8 weeks (HC groups), in which the morphometry of heart sections and contractile analyses by invasive catheterization and Langendorff-perfused hearts were assessed. Cytokines levels by ELISA, matrix metalloproteinase (MMP) activity by zymography, in situ reactive oxygen species (ROS) staining and lipid peroxidation-induced TBARS levels, were also determined. KEY FINDINGS HC diet fed mice displayed left ventricular hypertrophy and interstitial fibrosis in all times analyzed, which was confirmed by echocardiographic analyses of 8HC group. Impaired contractility indices of HC groups were observed by left ventricular catheterization, whereas ex vivo and in vitro indices of contraction under isoprenaline-stimulation were higher in HC-fed mice compared with controls. Peak levels of TNF-α, TGF-β, ROS, TBARS, and MMP-2 occur independently of HC diet time. However, a long-lasting local reduction of the anti-inflammatory cytokine IL-10 was found, which was linearly correlated to the decline of systolic function in vivo. SIGNIFICANCE Altogether, the results indicate that short-term consumption of HC diet negatively impacts the balance of anti-inflammatory defenses and proinflammatory/profibrotic mediators in the heart, which can contribute to HC diet-induced morphofunctional cardiac alterations.
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Affiliation(s)
- Alexandre Santos Bruno
- Departments of Pharmacology, Institute of Biological Science, Federal University of Minas Gerais, MG, Brazil
| | - Renata Gomes Miranda Castor
- Departments of Pharmacology, Institute of Biological Science, Federal University of Minas Gerais, MG, Brazil
| | - Bárbara Berg
- Departments of Pharmacology, Institute of Biological Science, Federal University of Minas Gerais, MG, Brazil
| | | | - André Luis Lima Monteiro
- Departments of Physiology & Biophysics, Institute of Biological Science, Federal University of Minas Gerais, MG, Brazil
| | - Sérgio Scalzo
- Departments of Physiology & Biophysics, Institute of Biological Science, Federal University of Minas Gerais, MG, Brazil
| | | | | | - Grazielle Cordeiro Aguiar
- Departments of Morphology, Institute of Biological Science, Federal University of Minas Gerais, MG, Brazil
| | - Marcos Barrouin Melo
- Departments of Physiology & Biophysics, Institute of Biological Science, Federal University of Minas Gerais, MG, Brazil
| | - Robson Augusto Souza Santos
- Departments of Physiology & Biophysics, Institute of Biological Science, Federal University of Minas Gerais, MG, Brazil
| | - Daniella Bonaventura
- Departments of Pharmacology, Institute of Biological Science, Federal University of Minas Gerais, MG, Brazil
| | - Silvia Guatimosim
- Departments of Physiology & Biophysics, Institute of Biological Science, Federal University of Minas Gerais, MG, Brazil
| | - Marina Gomes Miranda Castor
- Departments of Pharmacology, Institute of Biological Science, Federal University of Minas Gerais, MG, Brazil
| | - Anderson Jose Ferreira
- Departments of Morphology, Institute of Biological Science, Federal University of Minas Gerais, MG, Brazil
| | - Stefany Bruno Assis Cau
- Departments of Pharmacology, Institute of Biological Science, Federal University of Minas Gerais, MG, Brazil.
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Zhu T, Zhao X, Sun M, An Y, Kong W, Ji F, Wang G. Opioid-reduced anesthesia based on esketamine in gynecological day surgery: a randomized double-blind controlled study. BMC Anesthesiol 2022; 22:354. [PMCID: PMC9667678 DOI: 10.1186/s12871-022-01889-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 10/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background Opioid-reduced anesthesia may accelerate postoperative rehabilitation by reducing opioid-related side effects. The objective was to investigate the feasibility of opioid-reduced general anesthesia based on esketamine and to observe postoperative nausea and vomiting (PONV), postoperative pain, hemodynamics and other adverse reactions in gynecological day surgery compared with the traditional opioid-based anesthesia program. Method This study was conducted as a prospective parallel-group randomized controlled trial. A total of 141 adult women undergoing gynecological day surgery were included. Patients were randomly assigned to receive traditional opioid-based anesthesia (Group C) with alfentanil, or opioid-reduced anesthesia (a moderate-opioid group (Group MO) and low-opioid group (Group LO) with esketamine and alfentanil). For anesthesia induction, the three groups received 20, 20, 10 μg/kg alfentanil respectively and Group LO received an additional 0.2 mg/kg esketamine. For maintenance of anesthesia, the patients in Group C received 40 μg/kg/h alfentanil, and those in Group MO and Group LO received 0.5 mg/kg/h esketamine. Results Patients in the three groups had comparable clinical and surgical data. A total of 33.3% of patients in Group C, 18.4% of patients in Group MO and 43.2% of patients in Group LO met the primary endpoint (p = 0.033), and the incidence of nausea within 24 hours after surgery in Group MO was lower than in Group LO (p < 0.05). The extubation time, median length of stay in the hospital after surgery and visual analog scale (VAS) of postoperative pain were equivalent in the three groups. The frequencies of adverse hemodynamic events in the MO 1(0, 2) and LO 0(0, 1) groups were significantly decreased (p < 0.05). Compared with Group C, the median length of stay in the postanesthesia care unit (PACU) in Group LO was increased, 60.0 (36.25, 88.75) vs. 42.5 (25, 73.75) minutes (p < 0.05). Conclusions Opioid-reduced anesthesia based on esketamine is feasible and provides effective analgesia for patients. Esketamine provided a positive analgesic effect and the opioid-reduced groups showed more stable hemodynamics. However, less or no use of opioids did not result in a more comfortable prognosis. Trial registration This study was registered at Chictr.org.cn (NO. ChiCTR2100053153); November 13, 2021.
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Affiliation(s)
- Teng Zhu
- grid.268079.20000 0004 1790 6079School of Anesthesiology, WeiFang Medical University, WeiFang, 261053 China
| | - Xiaoyong Zhao
- grid.268079.20000 0004 1790 6079School of Anesthesiology, WeiFang Medical University, WeiFang, 261053 China
| | - Meiyan Sun
- grid.268079.20000 0004 1790 6079School of Anesthesiology, WeiFang Medical University, WeiFang, 261053 China
| | - Yan An
- grid.268079.20000 0004 1790 6079School of Anesthesiology, WeiFang Medical University, WeiFang, 261053 China
| | - Wenwen Kong
- grid.268079.20000 0004 1790 6079School of Anesthesiology, WeiFang Medical University, WeiFang, 261053 China
| | - Fanceng Ji
- Department of Anesthesiology, WeiFang, People’ Hospital, WeiFang, 261000 China
| | - Guizhi Wang
- grid.268079.20000 0004 1790 6079School of Anesthesiology, WeiFang Medical University, WeiFang, 261053 China
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Xuan H, Xu K. Warning and Nursing Experience of Anesthesia Depth Monitoring for Patients with General Anesthesia Delayed to Leave Anesthesia Recovery Room and Delirium. Emerg Med Int 2022; 2022:3610838. [PMID: 36406932 PMCID: PMC9671713 DOI: 10.1155/2022/3610838] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2024] Open
Abstract
Affected by the residues of narcotic drugs, patients under general anesthesia are vulnerable to emergence of agitation, delirium, hemodynamic changes, and other adverse events in the recovery period of anesthesia. Therefore, it is necessary to strengthen the observation and care of these patients. Depth of anesthesia monitoring (DAM) has always been a concern for anesthesiologists, but there are few reports related to it. This study compared the early warning value of DAM for patients under general anesthesia with delayed exit from the anesthesia recovery unit (PACU) and delirium and summarized the related nursing experience. The results showed that DAM could reduce the incidence of complications in patients under general anesthesia, reduce the incidence of delirium, shorten the time of postoperative anesthesia recovery and PACU observation time, reduce the workload of nursing staff, and improve nursing satisfaction. DAM plays an important role in improving the quality and efficiency of care in PACU.
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Affiliation(s)
- Hongmei Xuan
- Department of Pain, Zhuji People's Hospital of Zhejiang Province, Zhuji, Shaoxing 311800, Zhejiang, China
| | - Keping Xu
- Department of Anesthesia, Zhuji Traditional Chinese Medicine Hospital of Zhejiang Province, Zhuji, Shaoxing 311800, Zhejiang, China
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O'Reilly JA. Modelling mouse auditory response dynamics along a continuum of consciousness using a deep recurrent neural network. J Neural Eng 2022; 19. [DOI: 10.1088/1741-2552/ac9257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 09/15/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Objective Understanding neurophysiological changes that accompany transitions between anaesthetized and conscious states is a key objective of anesthesiology and consciousness science. This study aimed to characterize the dynamics of auditory-evoked potential morphology in mice along a continuum of consciousness. Approach Epidural field potentials were recorded from above the primary auditory cortices of two groups of laboratory mice: urethane-anaesthetized (A, n = 14) and conscious (C, n = 17). Both groups received auditory stimulation in the form of a repeated pure-tone stimulus, before and after receiving 10 mg/kg i.p. ketamine (AK and CK). Evoked responses were then ordered by ascending sample entropy into AK, A, CK, and C, considered to reflect physiological correlates of awareness. These data were used to train a recurrent neural network (RNN) with an input parameter encoding state. Model outputs were compared with grand-average event-related potential (ERP) waveforms. Subsequently, the state parameter was varied to simulate changes in the ERP that occur during transitions between states, and relationships with dominant peak amplitudes were quantified. Main results The RNN synthesized output waveforms that were in close agreement with grand-average ERPs for each group (r2 > 0.9, p < 0.0001). Varying the input state parameter generated model outputs reflecting changes in ERP morphology predicted to occur between states. Positive peak amplitudes within 25 to 50 ms, and negative peak amplitudes within 50 to 75 ms post-stimulus-onset, were found to display a sigmoidal characteristic during the transition from anaesthetized to conscious states. In contrast, negative peak amplitudes within 0 to 25 ms displayed greater linearity. Significance This study demonstrates a method for modelling changes in ERP morphology that accompany transitions between states of consciousness using a RNN. In future studies, this approach may be applied to human data to support the clinical use of ERPs to predict transition to consciousness.
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Tu W, Yuan H, Zhang S, Lu F, Yin L, Chen C, Li J. Influence of anesthetic induction of propofol combined with esketamine on perioperative stress and inflammatory responses and postoperative cognition of elderly surgical patients. Am J Transl Res 2021; 13:1701-1709. [PMID: 33841692 PMCID: PMC8014402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/11/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To analyze the influence of anesthetic induction of propofol combined with esketamine on perioperative stress and inflammatory responses and postoperative cognition in elderly surgical patients. METHODS A total of 80 elderly surgical patients were randomly divided into a control group (n=40) and a study group (n=40). The control group received anesthetic induction with propofol combined with sufentanil, while the study group received anesthetic induction with propofol combined with esketamine. Hemodynamics, stress and inflammatory responses and changes in cognitive function, perioperative related indexes and adverse responses were compared between the two groups. RESULTS At T1, the levels of adrenaline, norepinephrine, endothelin, C-reactive protein, white blood cell and procalcitonin in the two groups were not markedly changed compared with those at T0. The levels of the indices at T2 and T3 were elevated compared with those at T1. However, the levels of the indices at T4 were almost close to those at T0, and the levels in the study group were higher than those in the control group. There were statistically significant differences in the comparison of the interaction of the levels of the aforementioned indices between groups, between time points, and between groups and time points (P < 0.05). At 24 h after surgery, the Montreal Cognitive Assessment (MoCA) scores were decreased in both groups, and the MoCA scores in the study group were higher than those in the control group (P < 0.05). The anesthesia time and consciousness recovery time in the study group were shorter than those in the control group (P < 0.05). CONCLUSION The anesthetic induction of propofol combined with esketamine, exhibits a good safety profile and reliability, it can improve hemodynamics and surgical stress and inflammatory responses, shorten anesthesia time, promote the recovery of postoperative cognitive function, and cause relatively mild adverse responses.
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Affiliation(s)
- Wencai Tu
- Department of Anesthesiology, Yichun People's Hospital Yichun 336000, Jiangxi Province, China
| | - Haibo Yuan
- Department of Anesthesiology, Yichun People's Hospital Yichun 336000, Jiangxi Province, China
| | - Shaojin Zhang
- Department of Anesthesiology, Yichun People's Hospital Yichun 336000, Jiangxi Province, China
| | - Fang Lu
- Department of Anesthesiology, Yichun People's Hospital Yichun 336000, Jiangxi Province, China
| | - Lin Yin
- Department of Anesthesiology, Yichun People's Hospital Yichun 336000, Jiangxi Province, China
| | - Chuanfeng Chen
- Department of Anesthesiology, Yichun People's Hospital Yichun 336000, Jiangxi Province, China
| | - Jianhua Li
- Department of Anesthesiology, Yichun People's Hospital Yichun 336000, Jiangxi Province, China
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