British journal of anaesthesia
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Prehabilitation aims to enhance preoperative functional capacity through exercise, nutrition, and psychological programs. Home-based prehabilitation represents an alternative to hospital prehabilitation, with the advantage of not utilising hospital resources. This review aims to evaluate adherence and clinical effectiveness of home-based prehabilitation. ⋯ PROSPERO (CRD42024591208).
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Remimazolam is a novel anaesthetic and sedative agent that offers several advantages, including minimal adverse haemodynamic effects and availability of a specific antidote, flumazenil. Flumazenil can induce seizures as an adverse effect; however, the incidence of seizures after flumazenil reversal after total intravenous anaesthesia with remimazolam (remimazolam-flumazenil) remains unknown. We compared the risk of seizures between total i.v. anaesthesia with remimazolam-flumazenil or propofol. ⋯ We observed no significant differences in perioperative seizures between remimazolam-flumazenil and propofol in patients undergoing non-neurological surgery. This suggests that remimazolam-flumazenil is a possible alternative to total i.v. anaesthesia with propofol.
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Sevoflurane and propofol are the most widely used inhaled and i.v. general anaesthetics, respectively. The mechanisms by which sevoflurane and propofol induce loss of consciousness (LOC) remain unclear. Recent studies implicate the brain dopaminergic circuit in anaesthetic-induced LOC and the cortical-striatal-thalamic-cortical loop in decoding consciousness. We investigated the contribution of the dorsal striatum, which is a critical interface between the dopaminergic circuit and the cortical-striatal-thalamic-cortical loop, in sevoflurane and propofol anaesthesia. ⋯ Striatal D1R neurones modulate the state of consciousness in sevoflurane anaesthesia, but not in propofol anaesthesia.