1
|
Aghababaie Z, Wang THH, Nisbet LA, Matthee A, Dowrick J, Sands GB, Paskaranandavadivel N, Cheng LK, O'Grady G, Angeli-Gordon TR. Anaesthesia by intravenous propofol reduces the incidence of intra-operative gastric electrical slow-wave dysrhythmias compared to isoflurane. Sci Rep 2023; 13:11824. [PMID: 37479717 PMCID: PMC10362009 DOI: 10.1038/s41598-023-38612-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/11/2023] [Indexed: 07/23/2023] Open
Abstract
Gastric motility is coordinated by bioelectrical slow-wave activity, and abnormal electrical dysrhythmias have been associated with nausea and vomiting. Studies have often been conducted under general anaesthesia, while the impact of general anaesthesia on slow-wave activity has not been studied. Clinical studies have shown that propofol anaesthesia reduces postoperative nausea and vomiting (PONV) compared with isoflurane, while the underlying mechanisms remain unclear. In this study, we investigated the effects of two anaesthetic drugs, intravenous (IV) propofol and volatile isoflurane, on slow-wave activity. In vivo experiments were performed in female weaner pigs (n = 24). Zolazepam and tiletamine were used to induce general anaesthesia, which was maintained using either IV propofol (n = 12) or isoflurane (n = 12). High-resolution electrical mapping of slow-wave activity was performed. Slow-wave dysrhythmias occurred less often in the propofol group, both in the duration of the recorded period that was dysrhythmic (propofol 14 ± 26%, isoflurane 43 ± 39%, P = 0.043 (Mann-Whitney U test)), and in a case-by-case basis (propofol 3/12, isoflurane 8/12, P = 0.015 (Chi-squared test)). Slow-wave amplitude was similar, while velocity and frequency were higher in the propofol group than the isoflurane group (P < 0.001 (Student's t-test)). This study presents a potential physiological biomarker linked to recent observations of reduced PONV with IV propofol. The results suggest that propofol is a more suitable anaesthetic for studying slow-wave patterns in vivo.
Collapse
Affiliation(s)
- Zahra Aghababaie
- Auckland Bioengineering Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Tim Hsu-Han Wang
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Linley A Nisbet
- Auckland Bioengineering Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Ashton Matthee
- Auckland Bioengineering Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Jarrah Dowrick
- Auckland Bioengineering Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Gregory B Sands
- Auckland Bioengineering Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | | | - Leo K Cheng
- Auckland Bioengineering Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Gregory O'Grady
- Auckland Bioengineering Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Timothy R Angeli-Gordon
- Auckland Bioengineering Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand.
- Department of Surgery, University of Auckland, Auckland, New Zealand.
| |
Collapse
|
2
|
Wang THH, Tokhi A, Gharibans A, Evennett N, Beban G, Schamberg G, Varghese C, Calder S, Duong C, O'Grady G. Non-invasive thoracoabdominal mapping of postoesophagectomy conduit function. BJS Open 2023; 7:7153161. [PMID: 37146206 PMCID: PMC10162678 DOI: 10.1093/bjsopen/zrad036] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/26/2023] [Indexed: 05/07/2023] Open
Affiliation(s)
- Tim Hsu-Han Wang
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Ashraf Tokhi
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Armen Gharibans
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry Ltd, Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Nicholas Evennett
- Department of Surgery, Auckland City Hospital, Auckland, New Zealand
| | - Grant Beban
- Department of Surgery, Auckland City Hospital, Auckland, New Zealand
| | - Gabriel Schamberg
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry Ltd, Auckland, New Zealand
| | - Chris Varghese
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Stefan Calder
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry Ltd, Auckland, New Zealand
| | - Cuong Duong
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Greg O'Grady
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry Ltd, Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
3
|
Angeli TR, Cheng LK, Du P, Wang THH, Bernard CE, Vannucchi MG, Faussone-Pellegrini MS, Lahr C, Vather R, Windsor JA, Farrugia G, Abell TL, O’Grady G. Loss of Interstitial Cells of Cajal and Patterns of Gastric Dysrhythmia in Patients With Chronic Unexplained Nausea and Vomiting. Gastroenterology 2015; 149:56-66.e5. [PMID: 25863217 PMCID: PMC4617790 DOI: 10.1053/j.gastro.2015.04.003] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 03/24/2015] [Accepted: 04/01/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND & AIMS Chronic unexplained nausea and vomiting (CUNV) is a debilitating disease of unknown cause. Symptoms of CUNV substantially overlap with those of gastroparesis, therefore the diseases may share pathophysiologic features. We investigated this hypothesis by quantifying densities of interstitial cells of Cajal (ICCs) and mapping slow-wave abnormalities in patients with CUNV vs controls. METHODS Clinical data and gastric biopsy specimens were collected from 9 consecutive patients with at least 6 months of continuous symptoms of CUNV but normal gastric emptying who were treated at the University of Mississippi Medical Center, and from 9 controls (individuals free of gastrointestinal disease or diabetes). ICCs were counted and ultrastructural analyses were performed on tissue samples. Slow-wave propagation profiles were defined by high-resolution electrical mapping (256 electrodes; 36 cm(2)). Results from patients with CUNV were compared with those of controls as well as patients with gastroparesis who were studied previously by identical methods. RESULTS Patients with CUNV had fewer ICCs than controls (mean, 3.5 vs 5.6 bodies/field, respectively; P < .05), with mild ultrastructural abnormalities in the remaining ICCs. Slow-wave dysrhythmias were identified in all 9 subjects with CUNV vs only 1 of 9 controls. Dysrhythmias included abnormalities of initiation (stable ectopic pacemakers, unstable focal activities) and conduction (retrograde propagation, wavefront collisions, conduction blocks, and re-entry), operating across bradygastric, normal (range, 2.4-3.7 cycles/min), and tachygastric frequencies; dysrhythmias showed velocity anisotropy (mean, 3.3 mm/s longitudinal vs 7.6 mm/s circumferential; P < .01). ICCs were less depleted in patients with CUNV than in those with gastroparesis (mean, 3.5 vs 2.3 bodies/field, respectively; P < .05), but slow-wave dysrhythmias were similar between groups. CONCLUSIONS This study defined cellular and bioelectrical abnormalities in patients with CUNV, including the identification of slow-wave re-entry. Pathophysiologic features of CUNV were observed to be similar to those of gastroparesis, indicating that they could be spectra of the same disorder. These findings offer new insights into the pathogenesis of CUNV and may help to inform future treatments.
Collapse
Affiliation(s)
- Timothy R. Angeli
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Leo K. Cheng
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand,Department of Surgery, Vanderbilt University, Nashville, Tennessee, USA
| | - Peng Du
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Tim Hsu-Han Wang
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Cheryl E. Bernard
- Division of Gastroenterology and Hepatology, and Enteric Neurosciences Program, Mayo Clinic, Rochester, Minnesota, USA
| | - Maria-Giuliana Vannucchi
- Histology and Embryology Research Unit, Department of Experimental and Clinical Medicine, University of Florence, Italy
| | | | - Christopher Lahr
- Department of Surgery, Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ryash Vather
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - John A. Windsor
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Gianrico Farrugia
- Division of Gastroenterology and Hepatology, and Enteric Neurosciences Program, Mayo Clinic, Rochester, Minnesota, USA
| | - Thomas L. Abell
- Department of Gastroenterology, University of Louisville, Louisville, Kentucky, USA
| | - Gregory O’Grady
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand,Department of Surgery, University of Auckland, Auckland, New Zealand,Corresponding Author: Dr. Gregory O’Grady, Dept. of Surgery, University of Auckland, Private Bag 92019, Auckland, New Zealand, +64 (21) 422 2989 (phone); +64 9 367 7157 (fax),
| |
Collapse
|