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In captivity, the physiological condition of mature brood fish has a vital role for a successful artificial spawning. Therefore, the current study aimed to minimize endocrine and metabolic disruptions during routine handling, transportation, and acclimatization during artificial spawning in L. ramada. Here, we determined the impacts of transportation and handling, as well as the acclimation to different salinities on the levels of total thyroxine (T4), triiodothyronine (T3), cortisol, and glucose in the mature L. ramada females. The transportation procedures of cultured mature females of L. ramada without anesthesia induced physiological stress as reflected with a rapid elevation in serum cortisol and glucose concomitant with a decrease in T4 within 3 h. However, the anesthesia protocol and the gradual acclimatization to seawater (24 h) were successful in maintaining baseline concentrations of the measured hormones in mature L. ramada females. The recorded levels of thyroid hormones (T4 and T3) and cortisol proved that 40 mg l−1 of clove oil was superior to anesthetic tricaine methane sulfonate (MS-222). In parallel, clove oil as an anesthetic has a rapid induction time and longer recovery time compared to MS-222 in L. ramada anesthesia. So, the slow acclimation and clove oil anesthesia were crucial during the induction of spawning in L. ramada. Indeed, all injected females were physiologically stable and spawned within the appropriate time consistent with the histological observation of both ovary and liver. Together, these findings recommend that maintaining the physiological stability of broodstock is critical for the successful artificial spawning of mullet. [ABSTRACT FROM AUTHOR]

Postoperative pain management is an important aspect of the overall surgical care process. Effective pain management not only provides patient comfort but also promotes faster recovery and reduces the risk of complications. Bupivacaine (BUP) and Lidocaine (LID) transdermal drug deliveries via thermoplastic polyurethane matrix (TPU) and iontophoresis technique are proposed here as alternative routes for postoperative pain instead of the injection route. Under applied electric field, the amounts of BUP and LID released were 95% and 97% from the loaded amounts, which were higher than the passive patch of 40%. The time to equilibrium of BUP turned out to be faster than the time to equilibrium of LID by approximately 1.5 times. This was due to 2 factors namely the drug molecular weight and the drug pKa value; they play an important role in the selection of a suitable drug for fast-acting or long-acting for the postoperative patients. By using this transdermal patch via iontophoresis system, BUP was deemed as the suitable drug for fast-acting due to the shorter time to equilibrium, whereas LID was the suitable drug for long-acting. The in-vitro drug release – permeation study through a porcine skin indicated the efficiency and potential of the system with the amounts of drug permeated up to 76% for BUP and 81% for LID. The TPU transdermal system was demonstrated here as potential to deliver BUP and LID for postoperative patients. [ABSTRACT FROM AUTHOR]

In order to investigate the effects of MS-222 on anesthetic level, recovery rate and antioxidant enzyme activity of Carassius auratus gibelio (5.88±0.78g), seven different concentrations of MS-222 (50,60,70,80,90,100 and 110 mg/L) were set. The optimal anesthesia concentration and time of MS-222 to C. gibelio were determined based on the anesthesia stage and time, activities of antioxidant enzymes in the gill and mRNA expression of antioxidant-related genes. The result showed that C. gibelio could enter the stage I and stage II of anesthesia while anaesthetized at concentrations of 60, 70, 80, 90 and 100 mg/L, and could recover within 10 min. C. gibelio could not enter deep anesthesia while the anesthetic concentration lower than 50 mg/L, and the cumulative mortality was 40% while the concentration higher than 100 mg/L. Furthermore, two concentrations of MS-222 at 60 mg/L and 100 mg/L were set, and C. gibelio exposed for different time to study the oxidative damage of MS-222 to gills. Results showed that deep anesthesia with 100 mg/L MS-222 (about 4 min), GSH activity and MDA content in gills of C. gibelio were significantly increased (P<0.05). The mRNA relative expression of HSP70, keap1, PIK3A1, nrfl, MAPK3 and caspase3 were significantly up-regulated (P<0.05). The POD activity, and mRNA relative expression of caspase3 and LYZ in the gills were recovered to the basal level after 6 h of recovery. After deep anesthesia with 60 mg/L MS-222 (about 24 h), GSH activity in gills increased and POD de- creased significantly (P<0.05). The transcription of genes NQO, keap1, PIK3A1, Nrfl, MAPK3 and caspase3 were significantly up-regulated (P<0.05). After 1 min of recovery within water, there was no significant difference with them before anesthesia. This study suggested that the appropriate concentration of MS-222 in the transport process of C. gibelio is more than 60 mg/L, and the concentration in scientific researches is less than 100 mg/L. [ABSTRACT FROM AUTHOR]

The increasing prevalence of pathological cerebrovascular conditions, including stroke, hypertensive encephalopathy, and chronic disorders, underscores the importance of anesthetic considerations for affected patients. Preserving cerebral oxygenation and blood flow during anesthesia is paramount to prevent neurological deterioration. Furthermore, protecting vulnerable neurons from damage is crucial for optimal outcomes. Recent research suggests that anesthetic agents may provide a potentially therapeutic approach for managing pathological cerebrovascular conditions. Anesthetics target neural mechanisms underlying cerebrovascular dysfunction, thereby modulating neuroinflammation, protecting neurons against ischemic injury, and improving cerebral hemodynamics. However, optimal strategies regarding mechanisms, dosage, and indications remain uncertain. This review aims to clarify the physiological effects, mechanisms of action, and reported neuroprotective benefits of anesthetics in patients with various pathological cerebrovascular conditions. Investigating anesthetic effects in cerebrovascular disease holds promise for developing novel therapeutic strategies. [ABSTRACT FROM AUTHOR]

Introduction: The use of plant essential oils as anesthetics for fish has gained increasing attention, but ethanol, often used as a co-solvent, presents certain limitations. Recently, Magnolia denudata essential oil (MDO) has emerged as a promising alternative for fish anesthesia and sedation. Methods and results: To further improve MDO anesthesia efficacy, this study developed nanoemulsion (NE) and self-microemulsifying drug delivery system (SMEDDS) formulations of MDO. Transmission electron microscopy and stability tests confirmed that both NE and SMEDDS possess smaller particle sizes and are stable under various temperature conditions. Anesthetic trials on fish demonstrated that these formulations reduced the time needed to induce anesthesia compared with the non-formulations. Additionally, physiological assessments of the fish gills showed that neither NE nor SMEDDS caused irreversible damage to respiratory function. Discussion: Overall, NE and SMEDDS present a safe and effective delivery system for MDO, enhancing its anesthetic properties while minimizing potential harm to aquatic organisms compared to traditional methods. [ABSTRACT FROM AUTHOR]

Background: Anesthetic irrigation is an effective treatment for postoperative pain suppression in patients after molar extraction, but exerts a short period of extraction. The study aimed to evaluate the effect of lidocaine with epinephrine irrigation on acute pain relief in healthy volunteers with inferior alveolar nerve block (IANB) injection for the surgical removal of mesioangular (MA)-impacted third molars. Methods: A total of 28 patients (56 samples) with bilateral MA-impacted third molars were recruited. This study was a split-mouth, double-blind, randomized clinical trial. Surgical procedures were conducted over two separate appointments. Each patient randomly received 2% lidocaine with 1:100,000 epinephrine for the irrigation of the extraction site after surgery on one side of the mouth and normal saline solution on the other side. The postoperative visual analog scale (VAS) as a pain indicator was recorded and statistically analyzed for both treatments. Results: The VAS levels at 3 and 4 h after surgery in the lidocaine group were significantly lower than those of the normal saline group. Increases in pain scores were recorded five hours after surgery in both groups. No complications were recorded during this study. Conclusions: Continuous local anesthetic irrigation appears to be effective in reducing acute postoperative pain in patients with IANB for MA-impacted third molar surgery. Clinical Trial Registry: Reference number ISRCTN13866362, Date: 1 October 2024. [ABSTRACT FROM AUTHOR]

Background: Pediatric strabismus surgeries have frequently been linked to the occurrence of oculocardiac reflex (OCR). This study aimed to assess the efficacy and safety of peribulbar and sub-tenon blocks on the occurrence of OCR during pediatric strabismus surgeries. Materials and Methods: A randomized, double-blinded trial was conducted with 120 children (ASA I/II) scheduled for strabismus surgery. Patients were randomized into three groups: control (intravenous paracetamol 15 mg/kg), sub-tenon (0.08 mL/kg of 0.5% bupivacaine), and peribulbar (0.25 mL/kg of a 1:1 mixture of 0.5% bupivacaine and 2% lidocaine). The study assessed the incidence rate of OCR as well as the time of occurrence of OCR after induction, hemodynamic variables, postoperative pain and analgesic requirements, the incidence of postoperative vomiting (POV), complications resulting from the orbital regional anesthesia, and total intraoperative atropine requirements. Results: The OCR incidence did not differ significantly between groups. Twenty-three patients (57%) in the sub-tenon group, 14 patients (35%) in the peribulbar group, and 14 patients (35%) in the control group experienced OCR (P = 0.063 and 0.201). All OCR cases were treated with atropine. Pain scores at 4 h post-surgery were significantly higher in the sub-tenon and peribulbar groups compared to the control group (P = 0.001 and 0.041, respectively). The sub-tenon group had one case of POV, whereas the control group had five cases (P = 0.025). Conclusion: Both sub-tenon and peribulbar blocks effectively reduced POV and analgesic requirements in pediatric strabismus surgery, but did not prevent the occurrence of OCR.

Propofol (Pro), a prevalent intravenous anesthetic, has recently been recognized for its potential in mitigating ischemia–reperfusion (I/R) injuries. Despite a plethora of evidence suggesting the beneficial effects of low-dose Pro in renal I/R injury (RI/R), its role in modulating pyroptosis in renal tubular epithelial cells consequent to RI/R has not been thoroughly elucidated. In our investigation, we explored the therapeutic potential of Pro against pyroptosis in renal tubular epithelial cells under the duress of RI/R, employing both in vivo and in vitro models, while deciphering the intricate molecular pathways involved. Our results demonstrate an elevation in the expression of miR-143-3p, contrasted by a diminution in ATPase Na + /K + Transporting Subunit Alpha 2 (ATP1A2) under RI/R conditions. Pro effectively mitigates apoptosis in renal tubular epithelial cells induced by RI/R, principally characterized by the inhibition of pro-inflammatory cytokines interleukin (IL-)-1β and IL-18, enhancement of cellular viability, reduction in the ratio of pyroptotic cells, and suppression of nucleotide-binding domain and leucine-rich repeat-related family, pyrin domain containing 3 inflammasome activation along with the expression of cleaved caspase-1, and gasdermin D. Both knockdown and overexpression studies of miR-143-3p revealed its pivotal role in modulating RI/R-induced tubular cell pyroptosis. Notably, Pro's capacity to inhibit pyroptosis in renal tubular epithelial cells was found to be reversible following ATP1A2 knockdown. Furthermore, our study unveils miR-143-3p as a targeted regulator of ATP1A2 expression. From a mechanistic standpoint, Pro's therapeutic efficacy is attributed to its regulatory influence on miR-143-3p and ATP1A2 expression levels. In conclusion, our findings pioneer the understanding that Pro can significantly ameliorate pyroptosis in renal tubular epithelial cells in the context of RI/R, predominantly through the modulation of the miR-143-3p/ATP1A2 axis. This novel insight furnishes robust empirical support for the development of targeted therapeutics and clinical strategies in addressing RI/R. [ABSTRACT FROM AUTHOR]

Abstract Background Accidental intra-arterial administration of a medication can lead to serious iatrogenic harm. Most studies have discussed single cases of accidental intra-arterial administration of a medication, but only a few have described multiple cases occurring in a single, pediatric hospital setting. Methods The subjects were pediatric patients with an accidental intra-arterial administration of a medication. After obtaining approval from the institutional review board, the relevant cases were extracted from incident reports submitted to the patient safety office of the study center between November 2016 and April 2023. Results A review of 18,204 incident reports yielded 10 cases (patient age: 27 days to 13 years) of accidental intra-arterial administration of a medication. The most common site of the cannulation was the dorsum of the foot followed by the dorsum of the hand. The medications administered were narcotics, sedatives, muscle relaxants, antibiotics, and crystalloids. No serious adverse events occurred after injection. In some cases, the accidental arterial cannulation was not discovered immediately (53 min to 26 days). Seven patients had difficult intravenous access; in two of these, ultrasound-guided peripheral venous cannulation was used. Conclusions We experienced 10 cases of accidental intra-arterial administration of a medication. The dorsalis pedis artery and the radial artery around the anatomical tobacco socket were common sites of unintentional arterial cannulation. Difficult intravenous (IV) access may be associated with unintentional arterial cannulation. If IV access is difficult or the free IV drip is sluggish, strict vigilance and repeated confirmation are needed to prevent unintentional arterial cannulation.

Dexmedetomidine is an a2-adrenergic agonist that promotes deep sedation and analgesia. Ketamine is a dissociative anesthetic that exerts a negative inotropic effect, resulting in increased heart rate. Methadone, a full opioid agonist, causes mild respiratory depression and bradycardia. This study aimed to demonstrate the cardiovascular effects of the combination of dexmedetomidine, ketamine, and methadone in sedating a healthy dog undergoing echocardiographic and electrocardiographic examinations. The patient was sedated, and one hour after the sedative effects had subsided, the mentioned examinations were performed. Six months later, the examinations were repeated without the use of sedatives. The dog received 2 µg/kg of dexmedetomidine, 1 mg/kg of ketamine, and 0.3 mg/kg of methadone intramuscularly. The electrocardiogram showed sinus bradycardia, first-degree atrioventricular block, second-degree atrioventricular block Mobitz type II, and an increase in QRS duration, suggesting left ventricular overload. When performed without sedation, only sinus arrhythmia was observed. The echocardiogram showed normal parameters for the species in both evaluation periods. It can be concluded that the cardiovascular effects observed are attributable to dexmedetomidine, given that the dose of ketamine used was analgesic, and the sedative effect of dexmedetomidine was enhanced by methadone. [ABSTRACT FROM AUTHOR]

Purpose: New-generation anesthesia machines administer inhalation anesthetics and automatically control the fresh gas flow (FGF) rate. This study compared the administration of minimal flow anesthesia (MFA) using the automatically controlled anesthesia (ACA) module of the Mindray A9 (Shenzhen, China) anesthesia machine versus manual control by an anesthesiologist. Methods: We randomly divided 76 patients undergoing gynecological surgery into an ACA group (Group ACA) and a manually controlled anesthesia group (Group MCA). In Group MCA, induction was performed with a mixture of 40–60% O2 and air with a 4 L/min FGF until the minimum alveolar concentration (MAC) reached 1. Next, MFA was initiated with 0.5 L/min FGF. The target fraction of inspired oxygen (FiO2) value was 35–40%. In Group ACA, the MAC was defined as 1, and the FiO2 was adjusted to 35%. Depth of anesthesia, anesthetic agent (AA) consumption, time to achieve target end-tidal AA concentration, awakening times, and number of ventilator adjustments were analyzed. Results: The two groups showed no statistically significant differences in depth of anesthesia or AA consumption (Group ACA: 19.1 ± 4.9 ml; Group MCA: 17.2 ± 4.5; p-value = 0.076). The ACA mode achieved the MAC target of 1 significantly faster (Group ACA: 218 ± 51 s; Group MCA: 314 ± 169 s). The number of vaporizer adjustments was 15 in the ACA group and 217 in the MCA group. Conclusion: The ACA mode was more advantageous than the MCA mode, reaching target AA concentrations faster and requiring fewer adjustments to achieve a constant depth of anesthesia. [ABSTRACT FROM AUTHOR]

Background: Accidental intra-arterial administration of a medication can lead to serious iatrogenic harm. Most studies have discussed single cases of accidental intra-arterial administration of a medication, but only a few have described multiple cases occurring in a single, pediatric hospital setting. Methods: The subjects were pediatric patients with an accidental intra-arterial administration of a medication. After obtaining approval from the institutional review board, the relevant cases were extracted from incident reports submitted to the patient safety office of the study center between November 2016 and April 2023. Results: A review of 18,204 incident reports yielded 10 cases (patient age: 27 days to 13 years) of accidental intra-arterial administration of a medication. The most common site of the cannulation was the dorsum of the foot followed by the dorsum of the hand. The medications administered were narcotics, sedatives, muscle relaxants, antibiotics, and crystalloids. No serious adverse events occurred after injection. In some cases, the accidental arterial cannulation was not discovered immediately (53 min to 26 days). Seven patients had difficult intravenous access; in two of these, ultrasound-guided peripheral venous cannulation was used. Conclusions: We experienced 10 cases of accidental intra-arterial administration of a medication. The dorsalis pedis artery and the radial artery around the anatomical tobacco socket were common sites of unintentional arterial cannulation. Difficult intravenous (IV) access may be associated with unintentional arterial cannulation. If IV access is difficult or the free IV drip is sluggish, strict vigilance and repeated confirmation are needed to prevent unintentional arterial cannulation. [ABSTRACT FROM AUTHOR]

Abstract Background Anesthetic drugs may alter exosomal microRNA (miRNA) contents and mediate cancer progression and tumor microenvironment remodeling. Our study aims to explore how the anesthetics (sevoflurane and propofol) impact the miRNA makeup within exosomes in hepatocellular carcinoma (HCC), alongside the interconnected signaling pathways linked to the tumor immune microenvironment. Methods In this prospective study, we collected plasma exosomes from two groups of HCC patients (n = 5 each) treated with either propofol or sevoflurane, both before anesthesia and after hepatectomy. Exosomal miRNA profiles were assessed using next-generation sequencing (NGS). Furthermore, the expression data from The Cancer Genome Atlas-Liver Hepatocellular Carcinoma (TCGA-LIHC) was used to pinpoint the differentially expressed exosomal miRNAs (DEmiRNAs) attributed to the influence of propofol or sevoflurane in the context of HCC. Gene set enrichment analysis (GSEA) and gene set variation analysis (GSVA) were used to dissect the signaling pathways and biological activities associated with the identified DEmiRNAs and their corresponding target genes. Results A total of 35 distinct DEmiRNAs were exclusively regulated by either propofol (n = 9) or sevoflurane (n = 26). Through TCGA-LIHC database analysis, 8 DEmiRNAs were associated with HCC. These included propofol-triggered miR-452-5p and let-7c-5p, as well as sevoflurane-induced miR-24-1-5p, miR-122-5p, miR-200a-3p, miR-4686, miR-214-3p, and miR-511-5p. Analyses revealed that among these 8 DEmiRNAs, the upregulation of miR-24-1-5p consistently demonstrated a significant association with lower histological grades (p

Background: Anesthetic drugs may alter exosomal microRNA (miRNA) contents and mediate cancer progression and tumor microenvironment remodeling. Our study aims to explore how the anesthetics (sevoflurane and propofol) impact the miRNA makeup within exosomes in hepatocellular carcinoma (HCC), alongside the interconnected signaling pathways linked to the tumor immune microenvironment. Methods: In this prospective study, we collected plasma exosomes from two groups of HCC patients (n = 5 each) treated with either propofol or sevoflurane, both before anesthesia and after hepatectomy. Exosomal miRNA profiles were assessed using next-generation sequencing (NGS). Furthermore, the expression data from The Cancer Genome Atlas-Liver Hepatocellular Carcinoma (TCGA-LIHC) was used to pinpoint the differentially expressed exosomal miRNAs (DEmiRNAs) attributed to the influence of propofol or sevoflurane in the context of HCC. Gene set enrichment analysis (GSEA) and gene set variation analysis (GSVA) were used to dissect the signaling pathways and biological activities associated with the identified DEmiRNAs and their corresponding target genes. Results: A total of 35 distinct DEmiRNAs were exclusively regulated by either propofol (n = 9) or sevoflurane (n = 26). Through TCGA-LIHC database analysis, 8 DEmiRNAs were associated with HCC. These included propofol-triggered miR-452-5p and let-7c-5p, as well as sevoflurane-induced miR-24-1-5p, miR-122-5p, miR-200a-3p, miR-4686, miR-214-3p, and miR-511-5p. Analyses revealed that among these 8 DEmiRNAs, the upregulation of miR-24-1-5p consistently demonstrated a significant association with lower histological grades (p < 0.0001), early-stage tumors (p < 0.05) and higher survival (p = 0.029). Further analyses using GSEA and GSVA indicated that miR-24-1-5p, along with its target genes, were involved in governing the tumor immune microenvironment and potentially inhibiting tumor progression in HCC. Conclusions: This study provided bioinformatics evidence suggesting that sevoflurane-induced plasma exosomal miRNAs may have a potential impact on the immune microenvironment of HCC. These findings established a foundation for future research into mechanistic outcomes in cancer patients. [ABSTRACT FROM AUTHOR]

Introduction: The effectiveness of postoperative pain control following a Cesarean section influences mother–child attachment, improves early healing, and undoubtedly hastens discharge. Transverse abdominis plane (TAP) and ilioinguinal iliohypogastric (ILIH) blocks have been used to minimize postoperative opioid intake, although their relative effectiveness is unknown. The study aims to determine which procedure was more effective at reducing the need for postoperative rescue analgesics after lower segment Cesarean section (LSCS). TAP block or I TAP (TAP block plus ilioinguinal iliohypogastric nerve block). Both procedures used the same amount of local anesthetic. Methods: A sealed envelope technique was used to randomly assign 210 patients who received LSCS into two equal groups to receive either ultrasound (US)-guided TAP block or US-guided ILIH nerve block with US-guided TAP block at the conclusion of the procedure. As per the study protocol, the charge nurse in the postoperative ward gave rescue analgesics to patients who complained of discomfort. At hours 0, 2, 4, 6, 8, 10, and 24 following surgeries, a blinded observer checked on the patient and noted the effectiveness of pain management, the quantity of rescue analgesics used, and patient satisfaction. Results: While there was a substantial decrease in pain score while resting at 2, 3, 4, 8, 12, 16, 20, and 24 postoperative hours in the ITAP group, there was not a significant change in visual analogue scale (VAS) score at the first postoperative hour. However, there was a large delay in the first request for analgesia in the ITAP group (13.15 ± 1.85) as opposed to the TAP group (10.06 ± 1.61) and there was a significant decline in nalbuphine use as well as a higher satisfaction score in the ITAP group. Conclusions: Following LSCS, ITAP block offered better postoperative analgesia than TAP block in terms of quality. [ABSTRACT FROM AUTHOR]

IntroductionThe use of plant essential oils as anesthetics for fish has gained increasing attention, but ethanol, often used as a co-solvent, presents certain limitations. Recently, Magnolia denudata essential oil (MDO) has emerged as a promising alternative for fish anesthesia and sedation.Methods and resultsTo further improve MDO anesthesia efficacy, this study developed nanoemulsion (NE) and self-microemulsifying drug delivery system (SMEDDS) formulations of MDO. Transmission electron microscopy and stability tests confirmed that both NE and SMEDDS possess smaller particle sizes and are stable under various temperature conditions. Anesthetic trials on fish demonstrated that these formulations reduced the time needed to induce anesthesia compared with the non-formulations. Additionally, physiological assessments of the fish gills showed that neither NE nor SMEDDS caused irreversible damage to respiratory function.DiscussionOverall, NE and SMEDDS present a safe and effective delivery system for MDO, enhancing its anesthetic properties while minimizing potential harm to aquatic organisms compared to traditional methods.

Abstract Background Postoperative nausea and vomiting (PONV) following atrial fibrillation (AF) ablation can cause considerable distress. Aim Continuous intravenous propofol sedation with adaptive servo‐ventilation (ASV) with or without an analgesic, pentazocine, during AF ablation was studied in 272 consecutive patients with paroxysmal, persistent, and long‐standing persistent AF. The study objectives were to determine the incidence of PONV after AF ablation and to assess the predictive value of factors for PONV using the area under the receiver operating characteristic curve (AUC). Results The present sedation maneuver was successfully accomplished with a low incidence of hypotension and without discontinuation of ablation or switching to general anesthesia, while maintaining an acceptable procedural time (102 ± 32 min). The incidence of PONV was 5.5% (15/272). Nausea occurred in nine patients after an average of 4.6 ± 3.5 h (range: 2–12 h) postablation, and vomiting with nausea occurred in six patients after an average of 4.5 ± 3.1 h (range: 1–9 h) postablation. The postablation interval did not differ significantly between the occurrence of nausea and nausea accompanied by vomiting. AUCs based on various factors, including the Apfel score, ranged from 0.55 to 0.67, indicating low accuracy in predicting PONV occurrence. Conclusions The incidence of PONV after propofol sedation with ASV was the lowest (5.5%) reported to date. Scoring systems, which included the Apfel score, were ineffective in predicting PONV. The low PONV incidence in addition to the efficacy of propofol sedation with ASV revealed the adequacy of this regimen for AF ablation.

Background: Anesthetic irrigation is an effective treatment for postoperative pain suppression in patients after molar extraction, but exerts a short period of extraction. The study aimed to evaluate the effect of lidocaine with epinephrine irrigation on acute pain relief in healthy volunteers with inferior alveolar nerve block (IANB) injection for the surgical removal of mesioangular (MA)-impacted third molars. Methods: A total of 28 patients (56 samples) with bilateral MA-impacted third molars were recruited. This study was a split-mouth, double-blind, randomized clinical trial. Surgical procedures were conducted over two separate appointments. Each patient randomly received 2% lidocaine with 1:100,000 epinephrine for the irrigation of the extraction site after surgery on one side of the mouth and normal saline solution on the other side. The postoperative visual analog scale (VAS) as a pain indicator was recorded and statistically analyzed for both treatments. Results: The VAS levels at 3 and 4 h after surgery in the lidocaine group were significantly lower than those of the normal saline group. Increases in pain scores were recorded five hours after surgery in both groups. No complications were recorded during this study. Conclusions: Continuous local anesthetic irrigation appears to be effective in reducing acute postoperative pain in patients with IANB for MA-impacted third molar surgery. Clinical Trial Registry: Reference number ISRCTN13866362, Date: 1 October 2024.

Simple Summary: Tail docking and castration are common procedures performed in lambs but are considered painful. Mitigation of the pain associated with these procedures is difficult, especially when using rubber ring castration. The objectives of this study were to compare castration and tail docking efficacy between lidocaine-impregnated ligation bands (LLBs) and control bands (CBs) under field conditions and identify the benefits of pain control provided by LLBs. In this study, 238 male lambs were randomly assigned to receive either LLBs or CBs on both their tail and scrotum. CBs and LLBs were both 100% effective with respect to casting success of the tail and scrotum. Lambs receiving LLBs gained more weight from d −3 to 7 following application, which may be an indication of pain control during the first week following band application. However, there were no differences observed in average daily gain over the entire study period. The primary objective of this study was to demonstrate the non-inferiority between lidocaine-impregnated ligation bands (LLBs) and control bands (CBs) with respect to the efficacy of castration and tail docking. Secondary objectives were to compare castration and tail-docking success, evaluate local site reactions, and compare average daily gain (ADG) between the treatment groups. A total of 238 male lambs were enrolled and randomly assigned to receive LLBs or CBs on their tail and scrotum. Lambs were weighed, had a health assessment, and the band site was observed on −3, 7, 14, 21, 28, 35, and 42 days after the bands were applied. A linear regression model was built to assess average daily gain, whereas a repeated measures model was used to evaluate body weight differences at each of the measured timepoints. Furthermore, logistic regression models were used to evaluate associations with casting outcomes. Few differences were noted between treatment groups with respect to casting success for the scrotum and tail and ADG over the entire experimental period. Non-inferiority calculations demonstrated no differences in tail docking and scrotal casting success, with casting occurring for the majority of animals by d 21 and d 42 for castration and tail docking, respectively. However, lambs receiving LLBs gained more weight from d −3 to 7 (+0.03 kg/d; 95% CI: 0 to 0.07), which may be an indication of effective pain control during the first week following band application. Overall, the use of an LLB does not affect the time to successful casting of the tail and could improve short-term growth when compared to a control band. Further studies are needed to compare LLBs to multimodal methods of pain relief. [ABSTRACT FROM AUTHOR]

Simple Summary: Castration is commonly performed in young dairy calves and results in pain and discomfort. This study aimed to assess the effective tissue concentrations of the current standard of care for pain mitigation in calves during castration (injectable lidocaine) and to assess the ability of lidocaine-loaded bands (LLBs) to deliver effective concentrations into the scrotal tissue over time. The injectable lidocaine provided effective anesthesia for up to 60 min, highlighting the importance of finding additional strategies to manage long-term pain. A ligation band impregnated with lidocaine could provide a suitable alternative, as it appears to deliver effective lidocaine concentrations starting as early as 2 h following application and lasting at least 28 days after application. Further studies are warranted to compare the use of LLBs to injectable local anesthetics. This study aimed to assess the effective tissue concentrations of the current standard of care for pain mitigation in calves during castration (injectable lidocaine) and to assess the ability of a lidocaine-loaded elastration band (LLB) to deliver effective concentrations into the scrotal tissue over time. This study comprised two different trials: (1) effective concentrations of injectable lidocaine in the scrotal tissue; and (2) the in vivo delivery of effective concentrations of lidocaine from LLBs placed on the calf scrotums. Sensation in the scrotal tissue was assessed by electrocutaneous stimulation. Injectable lidocaine allowed for short-term anesthesia for up to 60 min, highlighting the importance of finding additional strategies to mitigate long-term pain. An elastomeric ligation band impregnated with lidocaine could provide a suitable alternative, as it yielded tissue levels of lidocaine that approached EC50 and exceeded EC95 at 2 and 72 h following application, respectively, and remained above those levels for at least 28 days after application. Further studies are warranted to compare the use of LLBs to injectable local anesthetics. [ABSTRACT FROM AUTHOR]

Ultrasound guided peripheral nerve block (USgPNB) refers to anaesthetic techniques to deposit local anesthetic next to nerves, permitting painful surgery without necessitating general anesthesia. Needle tip position prior to local anesthetic deposition is a key determinant of block success and safety. Nerve puncture and intra-neural injection of local anesthetic can cause permanent nerve injury. Currently ultrasound guidance is not sufficiently sensitive to reliably detect needle to nerve proximity. Feedback with bioimpedance data from the smart needle tip might provide the anesthetist with information as to the relationship between the needle tip and the target nerve prior to local anesthetic deposition.

Background: A meticulously planned elective surgery list is a very important strategy of a hospital to ensure efficient utilization of its resources. Cancellation of surgery causes wastage of already scare tertiary care resources, and psychological and financial strain on the patient, the importance of which is felt even more if the cause is preventable. This study was executed to ascertain the incidence and causes for cancellation of elective surgeries on the scheduled day at a tertiary care hospital with the intention of maximally utilizing the available resources. Materials and Methods: The study was executed from January 1, 2019, to March 18, 2020. Data were obtained from each operating room of all specialties pertaining to patient details, planned surgery, and the reason for cancellation. Results: Total canceled cases were 206 (2.31%) out of 8937 cases. Most cases that were canceled belonged to the surgical gastroenterology (28.16% of the total canceled cases of all departments; n = 58) followed by neurosurgery department (19.41%; n = 40). Most cancellations were due to time constraints (~39%, n = 81). The second most common reason was surgeon related (34.6%), mainly overbooking. Patient-related issues caused cancellation in 16.5% (n = 39) of cases. Conclusions: Time constraints due to unexpected prolongation of previous cases and overbooking of operation theater were the significant reasons for the cancellation of elective cases on the day of surgery.

Abstract Transporting live fish is a common practice in fish farming, and is certainly one of the main problems that affect fish homeostasis. In this scenario, the use of natural additives has shown promise in improving fish resistance to adverse situations. This study aimed to assess the impact of Ocimum gratissimum L. essential oil (OGEO) on water quality, hematological parameters, and residue levels in the plasma, fillet, and liver of juvenile piraputanga (Brycon hilarii) during a two-hour transportation period. The fish were divided into plastic bags (4 L) and exposed to three different OGEO concentrations (10, 20, and 30 mg L-1), while a control group received no OGEO (three repetitions each). After the two-hour transportation, blood samples were collected, as well as portions of the fillet and liver for quantifying essential oil compounds, which were also measured in the plasma. Oxygen levels remained high throughout the transportation period, in all groups, while the pH decreased. Hemoglobin, MCHC, and MCH increased in fish exposed to OGEO concentrations of 20 and 30 mg L-1, compared to the control group. However, lymphocyte counts and the concentrations of essential oil compounds in plasma, fillet, and liver increased with higher OGEO concentrations. The use of 10 mg L-1 OGEO in the two-hour transport water is promising to ensure the survival and well-being of Brycon hilarii juveniles (weighing 16 g), showing to be safe and effective. The residual concentration of eugenol the major compound of OGEO in the fillet remains below the maximum limit of the recommended daily intake.

Aim: This study was intended to assess and relate the clinical anesthetic effectiveness of tramadol hydrochloride and lidocaine. Methodology: A clinical randomized split-mouth study was piloted among 40 patients who were otherwise healthy but needed to have their maxillary first premolars extracted bilaterally for orthodontic reasons were considered in the research. In each subject on one side (quadrant) of the arch 1.8 milliliters of lidocaine was given and on other side of the arch 1.8 milliliters of tramadol was given. On the basis of a list that was prepared by a computer, the randomization was done and the sides (quadrant) of the arches were decided for all the subjects, and the injections were given as local infiltration. Results: Lidocaine was found to be statistically more effective for overall anesthesia duration, despite the fact that there was no significant variance between the two drugs at the time when anesthetic effect began to take effect. Tramadol was found to be statistically more efficient than lidocaine when compared to the anesthetic activity at the 5th minute before extraction. Tramadol was found to be statistically more successful than lidocaine for both the patient's degree of satisfaction and the rate at which wounds healed. Conclusion: Based on the findings of this research, it appears that tramadol and epinephrine could be used as a substitute to conventional local anesthetics during extractions of maxillary first premolar teeth during oral-maxillofacial surgery.

Simple Summary: Tail docking and castration in lambs are common husbandry practices, both of which cause pain and discomfort, for which many industries recommend or require pain management. The objectives of this study were to assess the effects of the current standard-of-care for pain mitigation in lambs (injectable lidocaine) and assess the ability of a lidocaine-impregnated elastration ligation band to deliver the drug into the contacted tissues over time. The use of injectable lidocaine provides effective short-term anesthesia for 120 to 180 min following the injection; however, additional strategies are needed to manage long-term pain. The use of a ligation band impregnated with lidocaine could provide a useful alternative, as it appears to offer local anesthesia for at least 3 days when compared to a control band. Further studies are needed to compare the use of an injectable local anesthetic to the Lidocaine-Loaded Bands (LLBs). The objectives of this study were to assess the pharmacokinetics and pharmacodynamics of the current standard-of-care for pain mitigation in lambs during castration and tail docking (injectable lidocaine) and assess the ability of Lidocaine-Loaded Bands (LLBs) to deliver therapeutic concentrations into the contacted tissues over time. The study was comprised of four different trials: (1) investigation of in vitro release of lidocaine from LLBs; (2) pharmacokinetics and pharmacodynamics of injectable lidocaine in scrotal and tail tissue; (3) pharmacokinetics and pharmacodynamics of in vivo delivery of lidocaine with LLBs placed on the tail and scrotum of lambs; and (4) a "proof-of-concept" study comparing the sensation of control- versus LLB-banded tail tissue over time. The use of injectable lidocaine provides effective short-term anesthesia for 120 to 180 min following the injection; however, additional strategies are needed to manage long-term pain. The use of an LLB could provide an alternative where tissue lidocaine concentrations meet or exceed the EC50 for at least 21–28 days and, based on electrostimulation data, provides local anesthesia for at least 3 days when compared to a control band. Further studies are needed to compare the use of an injectable local anesthetic to the LLBs. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the anesthetic effect and safety issues when lidocaine is combined with dexmedetomidine in laparoscopic hysterectomy. Methods: The data for 100 patients from the Anesthesiology Department of Changzhou Second People's Hospital Affiliated to Nanjing Medical University who underwent laparoscopic total hysterectomy were randomly but equally divided into a control group and a combination group. Lidocaine hydrochloride was administered by infusion in the control group, while dexmedetomidine and lidocaine were administered together in the combination group. Inflammatory factors and stress hormone levels before and after the operation, as well as the incidence of adverse reactions following the operation, hemodynamic index, visual pain simulation (VAS) score, and sedation score at various times after the operation were evaluated in the two groups. Furthermore, the incidence of postoperative adverse reactions were also recorded and compared between the two groups. Results: The combination group's recovery time was significantly longer than that of the control group (p < 0.05). At the point of extubation and 10 min after, mean arterial pressure (MAP) and heart rate (HR) in the combination group were significantly lower than those of the control group, respectively (p < 0.05), while the combination group's VAS and Ramsay scores were statistically lower than those of the control group at 30 min, 24 h, and 48 h following surgery, respectively (p < 0.05). The incidence of nausea and vomiting in the combination group was significantly lower than that in the control group (28.0% vs 58.0%, p < 0.05). Conclusion: Lidocaine and dexmedetomidine, when combined, enhance hemodynamics, postoperative analgesia, and sedation in laparoscopic hysterectomy patients. The combination also lowers inflammatory stress and stress hormone levels, as well as the risk of nausea and vomiting, leading to better safety in the patients. However, multicenter trials are recommended to validate these findings prior to its use clinical practice. [ABSTRACT FROM AUTHOR]

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Background: Ciprofol, a novel sedative–hypnotic drug, has been approved for its use in inducing and maintaining general anesthesia, as well as for providing sedation.Methods: In this phase I, single-center, parallel, controlled, open-label clinical trial, our objective was to analyze the pharmacokinetics (PK), pharmacodynamics (PD), and safety of ciprofol emulsion in 24 participants with mild and moderate renal impairment (n = 8 per group) and matched healthy participants (n = 8). An initial loading infusion of ciprofol was administered at 0.4 mg/kg for 1 min, followed by a maintenance infusion at a rate of 0.4 mg/kg/h for 30 min. We collected plasma and urine samples from the participants to assess the PK of ciprofol and its metabolite M4. The evaluation of PD involved using a modified observer’s alertness/sedation scale (MOAA/S) in combination with bispectral index (BIS) monitoring. Safety assessments were conducted throughout the trial process.Results: The plasma concentration–time curve of ciprofol in participants with renal impairment was similar to that in participants with normal kidney function. The area under the curve (AUC) and maximum concentration (Cmax) of total and unbound ciprofol in plasma for participants with renal impairment were only slightly higher (0.7–1.2-fold) than those in participants with normal renal function. In contrast, for the metabolite M4, AUC values were 1.3- and 2.1-fold greater in participants with mild and moderate renal impairment, respectively, than in healthy controls. However, renal impairment had no significant impact on the PD parameters. The study found that ciprofol was well-tolerated, with all adverse events (AEs) reported being mild or moderate in severity.Conclusion: Based on these findings, we can conclude that no dosage adjustment of ciprofol is necessary for patients with mild–moderate renal impairment who receive the injection. [ABSTRACT FROM AUTHOR]

Anesthesia with isoflurane prior to carbon dioxide euthanasia is recommended as a refinement, but vaporizer access can be limited. An alternative to vaporizers is the 'drop' method, introducing a fixed volume of isoflurane into the induction chamber. Previous work suggests that isoflurane administered at a concentration of 5% via the drop method is effective but aversive to mice; lower concentrations have not been tested. We assessed mouse behavior and insensibility with induction using the drop method for isoflurane concentrations below 5%. Male Crl:CD-1 (ICR) mice (n = 27) were randomly allocated to one of three isoflurane concentrations: 1.7%, 2.7%, and 3.7%. During induction, measures of insensibility and stress-related behaviors were recorded. All mice reached a surgical plane of anesthesia, and mice exposed to higher concentrations did so more quickly; as concentrations increased from 1.7 to 2.7 and 3.7%, the time to recumbency (Least squares means ± SE: 120.5 s ± 8.1, 97.9 s ± 8.1, and 82.8 s ± 8.1, respectively), loss of righting reflex (149.1 s ± 8.5, 127.7 s ± 8.5, and 100.7 s ± 8.5, respectively), and loss of pedal withdrawal reflex (214.5 s ± 8.3, 172.2 s ± 8.3, and 146.4 s ± 8.3, respectively) all declined. Rearing was the most frequently performed stress-related behavior, and was most pronounced immediately following isoflurane administration for all treatments. Our results indicate that the drop method can be used to effectively anesthetize mice with isoflurane concentrations as low as 1.7%; future work should assess mouse aversion. [ABSTRACT FROM AUTHOR]

Anesthesia serves as an effective method to mitigate the stress response in aquatic animals during aquaculture and product transportation. In this study, we assessed the anesthetic efficacy of clove oil, tricaine methane-sulfonate (MS-222), ethanol, and magnesium chloride by anesthesia duration, recovery time, 24-hour survival rate, and the behavior of mud crabs (Scylla paramamosain). Additionally, the optimal anesthetic concentration for varying body weights of mud crabs was also investigated. The results revealed that clove oil emerged as the optimal anesthetic for mud crabs, with a 24-hour survival rate surpassing those observed in MS-222 and magnesium chloride treatments. Ethanol caused amputation and hyperactivity in mud crabs. Regression analyses between the optimal anesthetic concentration of clove oil and the weight categories of 0.03–27.50 g and 27.50–399.73 g for mud crabs yielded the following equations: y = 0.0036 x3 − 0.1629 x2 + 1.7314 x + 4.085 (R2 = 0.7115) and y = 0.0437 x + 2.9461 (R2 = 0.9549). Clove oil exhibited no significant impact on serum cortisol, glucose, lactate content, aspartate aminotransferase (AST), alanine aminotransferase (ALT) activities, or superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) levels in mud crabs across different treatment groups. Anesthesia induced by clove oil in mud crabs resulted in an increase in inhibitory neurotransmitters such as glycine. However, the recovery from anesthesia was associated with elevated levels of the excitatory neurotransmitters L-aspartic acid and glutamate. In conclusion, clove oil proves to be a safe and optimal anesthetic agent for mud crabs, exerting no physiological stress on the species. [ABSTRACT FROM AUTHOR]

Yanyan Ma,1,&ast; Ying Cao,2,&ast; Hong Gao,3 Rui Tong,1 Jing Yi,3 Zhongwei Zhang,1 Rui Chen,1 Zhijun Pan1 1School of Anesthesia, Guizhou Medical University, Guiyang, People’s Republic of China; 2Department of Anesthesiology, The Second People’s Hospital of Guiyang, Guiyang, People’s Republic of China; 3Department of Anesthesiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hong Gao, Department of Anesthesiology, The Affiliated Hospital of Guizhou Medical University, No. 9 Beijing Road, Guiyang, People’s Republic of China, Email 2169617@qq.com; anesth@qq.comPurpose: This study investigated the effect of exosomes derived from sevoflurane-treated cardiac fibroblasts (Sev-CFs-Exo) on reperfusion arrhythmias (RA), ventricular conduction, and myocardial ischemia-reperfusion injury (MIRI).Methods: Primary cardiac fibroblasts (CFs) were isolated from the hearts of neonatal rats and identified by morphology and immunofluorescence. Exosomes were isolated from CFs at passages 2– 3 after they had been treated with 2.5% sevoflurane for an hour and cultivated for 24– 48 hours. The control group was CFs that did not receive any treatment. The hypothermic global ischemia-reperfusion injury model was established using the Langendorff perfusion technique following injection with exosomes through the caudal vein. Multi-electrode array (MEA) mapping was used to investigate the changes in RA and ventricular conduction in isolated hearts. Western blots and immunofluorescence were used to examine the relative expression and location of connexin 43 (Cx43). In addition, the MIRI was evaluated with triphenyl tetrazolium chloride and Hematoxylin-Eosin staining.Results: The primary CFs had a variety of morphologies, no spontaneous pulsation, and were vimentin-positive, which confirmed their successful isolation. Sev-CFs-Exo increased the heart rate (HR) at reperfusion for 15 minutes (T2) and 30 minutes (T3) and lowered the score and duration of RA and the time for restoration of heartbeat in reperfusion. Meanwhile, Sev-CFs-Exo increased conduction velocity (CV), decreased absolute inhomogeneity (P5-95) and inhomogeneity index (P5-95/P50) at T2 and T3, as well as promoted the recovery of HR, CV, P5-95 and P5-95/P50 after hypothermic global ischemia-reperfusion injury. Furthermore, Sev-CFs-Exo raised expression and reduced lateralization of Cx43, and improved myocardial infarct sizes and cellular necrosis. However, while cardiac fibroblast-derived exosomes (CFs-Exo) showed similar cardioprotective effects, the outcomes were not as significant.Conclusion: Sevoflurane reduces the risk of RA and improves ventricular conduction and MIRI by CFs-Exo, and this may be driven by the expression and location of Cx43.Keywords: anesthetic, extracellular vesicles, arrhythmia, electrophysiology, electrical mapping, connexin 43, Cx43

Background and purpose: In this study, we aimed to elucidate the action mechanisms of propofol, particularly those underlying propofol-induced protein kinase C (PKC) translocation. Experimental approach: Various PKCs fused with green fluorescent protein (PKCGFP) or other GFP-fused proteins were expressed in HeLa cells, and their propofol-induced dynamics were observed using confocal laser scanning microscopy. Propofol-induced PKC activation in cells was estimated using the C kinase activity receptor (CKAR), an indicator of intracellular PKC activation. We also examined PKC translocation using isomers and derivatives of propofol to identify the crucial structural motifs involved in this process. Key results: Propofol persistently translocated PKCα conventional PKCs and PKCδ from novel PKCs (nPKCs) to the plasma membrane (PM). Propofol translocated PKCδ and PKCη of nPKCs to the Golgi apparatus and endoplasmic reticulum, respectively. Propofol also induced the nuclear translocation of PKCζ of atypical PKCs or proteins other than PKCs, such that the protein concentration inside and outside the nucleus became uniform. CKAR analysis revealed that propofol activated PKC in the PM and Golgi apparatus. Moreover, tests using isomers and derivatives of propofol predicted that the structural motifs important for the induction of PKC and nuclear translocation are different. Conclusion and implications: Propofol induced the subtype-specific intracellular translocation of PKCs and activated PKCs. Additionally, propofol induced the nuclear translocation of PKCs and other proteins, probably by altering the permeability of the nuclear envelope. Interestingly, propofol-induced PKC and nuclear translocation may occur via different mechanisms. Our findings provide insights into the action mechanisms of propofol. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Airway management in patients with maxillary carcinoma presents unique challenges. To ensure safety, a tailored and collaborative approach is essential. This is a case where anesthetic plan of awake fiberoptic oral endotracheal intubation was chosen. [ABSTRACT FROM AUTHOR]

Objective: Anesthetics are of great importance in avoiding severe pain and suffering in animals and ensuring experimental progress. This study was aimed at elucidating the anesthesia score of phenobarbital sodium as a general anesthetic at different concentrations and doses in BALB/c mice, and finding the suitable anesthesia strategies for experimental surgeries. Methods: Phenobarbital sodium was administrated intraperitoneally at the doses of 75, 100, 125, 150, and 200 mg/kg and randomly in different concentrations (2%, 5%, and 10%) to female BALB/c mice. The anesthesia score was evaluated based on the stimulus index including tail-pinch, front and hind limb withdrawal, and eyelid reflexes. The speed and duration of anesthesia in different groups were recorded per the occurrence and duration of the righting reflex. Results: The anesthetic effect of phenobarbital sodium on female BALB/c mice showed an obvious dose-dependency. Respiratory suppression caused by high-dose anesthesia may lead to mouse death. Based on the anesthesia score, when the phenobarbital sodium treatment was greater than or equal to five percent or 200 mg/kg, more than 80% mice meet the anesthesia depth that surgical operation needed. The rates of achieving surgical anesthesia depth (standard-reaching rate) in mice treated with 2% sodium phenobarbital were 0% in the 75 mg/kg group, 0% in the 100 mg/kg group, 50% in the 125 mg/kg group, 66.7% in the 150 mg/kg group, and 100% in the 200 mg/kg group. The standard-reaching rate of mice treated with 5% concentration of phenobarbital sodium were: 0% in the 75 mg/kg group, 0% in the 100 mg/kg group, 83.33% in the 125 mg/kg group, 100% in the 150 mg/kg group, and 100% in the 200 mg/kg group. The standard-reaching rate of mice treated with 10% concentration of phenobarbital sodium were: 50% in the 75 mg/kg group, 66.7% in the 100 mg/kg group, 100% in the 125 mg/kg group, 100% in the 150mg/kg group, and 100% in the 200 mg/kg group. Sedation and hypnosis were induced in the low-concentration dose group, and anesthesia was induced in the highconcentration dose group. In the 5% and 125 mg/kg phenobarbital sodium groups, the mortality rate of mice was 0, the anesthesia induction time was (35.5 ± 7.92) minutes, and the anesthesia duration was (106 ± 39.59) minutes. In the 5% and 150 mg/kg phenobarbital sodium groups, the mortality rate of mice was 0, the anesthesia induction time was (34.83 ± 5.27) minutes, and the anesthesia duration was (131.7 ± 36.75) minutes. Conclusion: Phenobarbital sodium alone can provide appropriate general anesthesia in female BALB/c mice. Both the concentration and dose of phenobarbital sodium can affect the anesthetic effect. On the basis of our findings, we recommend the 5% and 125 mg/kg and 5% and 150 mg/kg concentration-dose combinations of phenobarbital sodium for anesthetizing mice according to the surgical requirement. [ABSTRACT FROM AUTHOR]

Shan Sasidharan,1,2 Asha Nair Kaveri,3 M S Sithara,2 Hareendran Nair J4 1Department of R&D, Pankajakasthuri Herbal Research Foundation, Thiruvananthapuram, Kerala, India; 2Small Animal Research Centre, Department of Toxicology and Pharmacology, CARe KERALA, Thrissur, Kerala, India; 3Department of Shalyatantra, Pankajakasthuri Ayurveda Medical College & P.G. Centre, Thiruvananthapuram, Kerala, India; 4Pankajakasthuri Herbal India Pvt. Ltd, Thiruvananthapuram, Kerala, IndiaCorrespondence: Shan Sasidharan, Pankajakasthuri Herbal Research Foundation, Thiruvananthapuram, Kerala, India, Email drshansasidharan@yahoo.co.inBackground: Local anaesthetics are medications that cause numbness that can be reversed by applying them topically. Local anaesthetics are clinically used to control pain during minor surgeries or to treat other acute and chronic pain. The present investigation intended to investigate the anesthetic as well as analgesic potential of Injection Harsha 22, a novel polyherbal formulation in Wistar albino rats.Methods: The anesthetic potential of Injection Harsha 22 was evaluated by a heat tail-flick latency (TFL) test, whereas the analgesic effect was elevated by electrical stimulation testing. Here, lignocaine (2%) was used as the standard anesthetic drug.Results: In TFL, Injection Harsha 22 showed anesthetic effects up to 90 minutes after application. Also, the duration of anesthesia in rats that were administered subcutaneously with Injection Harsha 22 was comparable to that of the rats treated with commercial lignocaine (2%). In an electrical stimulation test, single administration of Injection Harsha 22 to rats significantly prolonged analgesia compared with the normal control group. The median duration of analgesia in rats administered subcutaneously with Injection Harsha 22 and lignocaine solution was 40 minutes and 35 minutes, respectively. Furthermore, Injection Harsha 22 does not interfere with the hematopoietic system of the experiment animals.Conclusion: Thus, the present investigation established the in vivo anesthetic and analgesic potential of Injection Harsha 22 in experimental animals. Hence, it can be concluded that Injection Harsha 22 can become a prominent substitute for lignocaine as a local anaesthetic agent after establishing its efficacy through stringent clinical trials in humans.Keywords: anesthetic, analgesic, local anesthetic, polyherbal anesthetic formulation, Wistar rats

Abstract Anesthesia and analgesia are major components of many interventional studies on laboratory animals. However, various studies have shown improper reporting or use of anesthetics/analgesics in research proposals and published articles. In many cases, it seems “anesthesia” and “analgesia” are used interchangeably, while they are referring to two different concepts. Not only this is an unethical practice, but also it may be one of the reasons for the proven suboptimal quality of many animal researches. This is a widespread problem among investigations on various species of animals. However, it could be imagined that it may be more prevalent for the most common species of laboratory animals, such as the laboratory mice. In this review, proper anesthetic/analgesic methods for routine procedures on laboratory mice are discussed. We considered the available literature and critically reviewed their anesthetic/analgesic methods. Detailed dosing and pharmacological information for the relevant drugs are provided and some of the drugs’ side effects are discussed. This paper provides the necessary data for an informed choice of anesthetic/analgesic methods in some routine procedures on laboratory mice.

BackgroundCombined epidural-general anesthesia (GA + EA) has been recommended as a preferred technique for both thoracic and abdominal surgery. The epidural anesthesia on the general anesthetic (GA) requirements has not been well investigated. Therefore, we conducted the present study to explore the predicted effect-site concentration of propofol (Ceprop) required for achieving the loss of consciousness (LOC) in 50% of patients (EC50) with or without epidural anesthesia.MethodsSixty patients scheduled for gastrectomy were randomized into the GA + EA group or GA alone group to receive general anesthesia alone. Ropivacaine 0.375% was used for epidural anesthesia to achieve a sensory level of T4 or above prior to the induction of general anesthesia. The EC50 of predicted Ceprop for LOC was determined by the up–down sequential method. The consumption of anesthetics, emergence time from anesthesia, and postoperative outcomes were also recorded and compared.ResultsThe EC50 of predicted Ceprop for LOC was lower in the GA + EA group than in the GA alone group [2.97 (95% CI: 2.63–3.31) vs. 3.36 (95% CI: 3.19–3.53) μg mL−1, (p = 0.036)]. The consumption of anesthetics was lower in the GA + EA group than in the GA alone group (propofol: 0.11 ± 0.02 vs. 0.13 ± 0.02 mg kg−1 min−1, p = 0.014; remifentanil: 0.08 ± 0.03 vs. 0.14 ± 0.04 μg kg−1 min−1, p

Simple Summary: Changes in the heart activity of bees have been correlated with several stressors. However, this has been studied in just a few species within Apoidea. The purpose of our study was to evaluate several parameters of heart activity in a stingless bee species from the Amazon region, Melipona flavolineata, during a 30 min stress period. Workers of the species were restrained and anesthetized using isoflurane. The basal heartbeat at the first five minutes of the records was about 600 beats per minute, which generally increased over the restraining period. The contention stress also changed other parameters of heart activity in the species. Our study was the first to evaluate the cardiac activity in a stingless bee, an important group of tropical pollinators, and showed that heart activity was altered by stress. Thus, heart monitoring using ECG is a feasible technique to show some of the effects of different stressors, such as pesticides, in the physiology of worker bees. We also showed that isoflurane can be used as an anesthetic, an alternative to narcosis induced by CO2 and cold, although its effects must still be studied. The hemodynamic activity of Melipona flavolineata workers was evaluated during restraint stress for a period of 30 min. The observed parameters were power variation in the elapsed time, and subsequently, six periods of one second were divided and called A, B, C, D, E and F; in each period, the electrocardiographic parameters were evaluated: spike frequency, amplitude, spike intervals and spike duration. The experiment was carried out with eight worker bees of M. flavolineata, for which electrodes of a nickel–chromium alloy were made. The bees were previously anesthetized with isoflurane and properly contained and fixed in a base for stereotaxis in which the electrode was implanted. All these procedures were performed inside a Faraday cage. The results showed power oscillations during the recording, with the highest energy level being between 300 and 600 s. Spike frequency, spike amplitude, interval between spikes and spike duration parameters underwent changes during the restraint stress period. Thus, the cardiac activity of M. flavolineata can be used as a biomarker and can be used to clarify physiological issues or alterations caused by toxic agents and indicate risk factors for these animals. [ABSTRACT FROM AUTHOR]

Patients awake during staged cutaneous surgery procedures may experience procedure-related pain. To determine whether the level of pain associated with local anesthetic injections prior to each Mohs stage increases with subsequent Mohs stages. Multicenter longitudinal cohort study. Patients rated pain (visual analog scale: 1-10) after anesthetic injection preceding each Mohs stage. Two hundred fifty-nine adult patients presenting for Mohs who required multiple Mohs stages at 2 academic medical centers were enrolled; 330 stages were excluded due to complete anesthesia from prior stages, and 511 stages were analyzed. Mean visual analog scale pain ratings were nominally but not significantly different for subsequent stages of Mohs surgery (stage 1: 2.5; stage 2: 2.5; stage 3: 2.7: stage 4:2.8: stage 5: 3.2; P =.770). Between 37% and 44% experienced moderate pain, and 9.5% and 12.5% severe pain, during first as versus subsequent stages (P >.05) Both academic centers were in urban areas. Pain rating is inherently subjective. Patients did not report significantly increased anesthetic injection pain level during subsequent stages of Mohs. [ABSTRACT FROM AUTHOR]

Background and Objectives: Patients experience severe pain after surgical correction of ankle fractures. Although their exact mechanism is unknown, dexamethasone and epinephrine increase the analgesic effect of anesthetics in peripheral nerve blocks. This study aimed to compare the postoperative pain control efficacy of peripheral nerve blocks with ropivacaine combined with dexamethasone/epinephrine and peripheral nerve blocks with only ropivacaine and added patient-controlled analgesia in patients with ankle fractures. Materials and Methods: This randomized, controlled prospective study included patients aged 18–70 years surgically treated for ankle fractures between December 2021 and September 2022. The patients were divided into group A (n = 30), wherein pain was controlled using patient-controlled analgesia after lower extremity peripheral nerve block, and group B (n = 30), wherein dexamethasone/epinephrine was combined with the anesthetic solution during peripheral nerve block. In both groups, ropivacaine was used as the anesthetic solution for peripheral nerve block, and this peripheral nerve block was performed just before ankle surgery for the purpose of anesthesia for surgery. Pain (visual analog scale), patient satisfaction, and side effects were assessed and compared between the two groups. Results: The patients' demographic data were similar between groups. Pain scores were significantly lower in group B than in group A postoperatively. Satisfaction scores were significantly higher in group B (p = 0.003). There were no anesthesia-related complications in either group. Conclusions: Dexamethasone and epinephrine as adjuvant anesthetic solutions can effectively control pain when performing surgery using peripheral nerve blocks for patients with ankle fractures. [ABSTRACT FROM AUTHOR]