Journal of anesthesia
-
Journal of anesthesia · Oct 2018
Remifentanil suppresses increase in interleukin-6 mRNA in the brain by inhibiting cyclic AMP synthesis.
Neuronal inflammation is caused by systemic inflammation and induces cognitive dysfunction. IL-6 plays a crucial role in therapies for neuronal inflammation and cognitive dysfunction. Remifentanil, an ultra-short-acting opioid, controls inflammatory reactions in the periphery, but not in the brain. Therefore, the anti-inflammatory effects of remifentanil in neuronal tissue and the involvement of cAMP in these effects were investigated in the present study. ⋯ Remifentanil suppressed increase in IL-6 mRNA levels in the brain in an inflammatory state, and this effect may be attributed to its direct action on neuronal cells through the inhibition of intracellular cAMP rather than corticosterone.
-
Journal of anesthesia · Oct 2018
Observational StudyAge is a predictive factor in the femoral nerve positioning: an anatomical ultrasound study.
Precise identification of the femoral nerve (FN) is essential for an ultrasound-guided femoral nerve block. We hypothesized that the distance between the FN and the femoral artery (FA) is correlated with patient age. In this prospective observational study, we evaluated the FN-FA (from the lateral edge of the FA to the medial edge of the FN) distance [0.42 ± 0.42 (mean ± standard deviation) cm] in 102 patients using ultrasound. ⋯ Multiple regression analyses revealed that age was significantly and positively correlated with the FN-FA distance (R2 = 0.72, p < 0.001) and that this correlation was greater than that between height, weight, or gender and the FN-FA distance. Further, the cross-sectional area of the iliopsoas muscle per weight was significantly correlated with age (R2 = 0.54, p < 0.001) and the FN-FA distance (R2 = 0.50, p < 0.001). These findings may help refine the ultrasound techniques used for the femoral nerve block.
-
Journal of anesthesia · Oct 2018
Dexmedetomidine mitigates sevoflurane-induced cell cycle arrest in hippocampus.
Epidemiologic studies suggest the possibility of a modestly elevated risk of adverse neurodevelopmental outcomes in children exposed to anesthesia during early childhood. Sevoflurane is widely used in pediatric anesthetic practice because of its rapid induction and lower pungency. However, it is reported that sevoflurane leads to the long-term cognitive impairment. Some evidence revealed that the selective α2-adrenoreceptor agonist dexmedetomidine (DEX) exerts neuroprotective effects in various brain injury models of animals. But the role of DEX on sevoflurane-induced neuro-damage remains elusive. ⋯ Sevoflurane suppressed neuron cell proliferation via inhibiting the expression of BDNF and TrkB, and DEX relieved the neurotoxicity induced by sevoflurane via α2 adrenergic receptor. These findings provided new evidence that DEX exerted as a neuroprotective strategy in sevoflurane-induced neuro-damage, and provided new basis for the clinical application of DEX.