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British Journal of Pharmacology Aug 2020Volatile anaesthetics have been shown to differentially modulate mammalian Shaker-related voltage-gated potassium (K 1.x) channels. This study was designed to...
BACKGROUND AND PURPOSE
Volatile anaesthetics have been shown to differentially modulate mammalian Shaker-related voltage-gated potassium (K 1.x) channels. This study was designed to investigate molecular and cellular mechanisms underlying the modulatory effects of desflurane or sevoflurane on human K 1.5 (hK 1.5) channels.
EXPERIMENTAL APPROACH
Thirteen single-point mutations were constructed within pore domain of hK 1.5 channel using site-directed mutagenesis. The effects of desflurane or sevoflurane on heterologously expressed wild-type and mutant hK 1.5 channels were examined by whole-cell patch-clamp technique. A computer simulation was conducted to predict the docking pose of desflurane or sevoflurane within hK 1.5 channel.
KEY RESULTS
Both desflurane and sevoflurane increased hK 1.5 current at mild depolarizations but decreased it at strong depolarizations, indicating that these anaesthetics produce both stimulatory and inhibitory actions on hK 1.5 channels. The inhibitory effect of desflurane or sevoflurane on hK 1.5 channels arose primarily from its open-channel blocking action. The inhibitory action of desflurane or sevoflurane on hK 1.5 channels was significantly attenuated in T480A, V505A, and I508A mutant channels, compared with wild-type channel. Computational docking simulation predicted that desflurane or sevoflurane resides within the inner cavity of channel pore and has contact with Thr479, Thr480, Val505, and Ile508.
CONCLUSION AND IMPLICATIONS
Desflurane and sevoflurane exert an open-channel blocking action on hK 1.5 channels by functionally interacting with specific amino acids located within the channel pore. This study thus identifies a novel molecular basis mediating inhibitory modulation of hK 1.5 channels by desflurane and sevoflurane.
Topics: Anesthetics; Animals; Computer Simulation; Desflurane; Humans; Mutagenesis, Site-Directed; Sevoflurane
PubMed: 32436224
DOI: 10.1111/bph.15105 -
Annals of Cardiac Anaesthesia 2013
Topics: Anesthesia, Inhalation; Anesthesia, Intravenous; Anesthetics, Inhalation; Cardiomyopathies; Coronary Artery Bypass, Off-Pump; Desflurane; Female; Humans; Isoflurane; Male; Methyl Ethers; Postoperative Complications; Sevoflurane
PubMed: 23405441
DOI: No ID Found -
Minerva Anestesiologica Nov 2017Laryngeal mask (LM) and inhaled anesthesia combination is often deemed unsuitable. Actually the evolution of surgical procedures towards minimal invasiveness, the search...
Laryngeal mask (LM) and inhaled anesthesia combination is often deemed unsuitable. Actually the evolution of surgical procedures towards minimal invasiveness, the search of improved productivity, and the contemporary need for patient safety and faster recovery, push the anesthetists to get interested in their use in the daily practice. An Expert Panel composed by anesthetists coming from university and tertiary hospitals undertook to write an experts' opinion on the correct management of LM and desflurane in adult patients, with a view to issuing a simple operative protocol for their combined intraoperative usage. Main operative steps have been defined, which, if appropriately implemented, would successfully achieve safety objectives. Two aspects are considered crucial, first the educational role of Universities and Medical Schools to structure a systematic approach to the theoretical and practical teaching of the use of LM with desflurane; second an appropriate training for improving the skills in the use of LM also for more complicated patients.
Topics: Anesthesia, Inhalation; Anesthetics, Inhalation; Desflurane; Humans; Laryngeal Masks; Practice Guidelines as Topic
PubMed: 28607337
DOI: 10.23736/S0375-9393.17.11930-9 -
Korean Journal of Anesthesiology Dec 2018Cerebral state index (CSI) is an anesthesia depth monitor alternative to bispectral index (BIS). Published comparative studies have used propofol or sevoflurane.... (Comparative Study)
Comparative Study
BACKGROUND
Cerebral state index (CSI) is an anesthesia depth monitor alternative to bispectral index (BIS). Published comparative studies have used propofol or sevoflurane. However, studies using desflurane have not been reported yet. Different volatile anesthetics have different electroencephalography signatures. The performance of CSI may be different in desflurane anesthesia. Therefore, the objective of this study was to compare CSI and BIS during desflurane anesthesia.
METHODS
Thirty-three patients were recruited. Desflurane and remifentanil were used to maintain general anesthesia. BIS and CSI were recorded simultaneously every minute. End-tidal concentration of desflurane was maintained at 4% from the beginning of surgery for 5 minutes. Pairwise data of CSI and BIS were obtained five times at one-minute intervals. This process was repeated in the order of 6%, 8%, and 10%.
RESULTS
BIS and CSI were negatively correlated with the end-tidal concentration of desflurane with a similar degree of correlation (correlation coefficient BIS: -0.847, CSI: -0.844). The relationship between CSI and BIS had a good linearity with a slope close to 1 (R2 = 0.905, slope = 1.01). For the relationship between CSI and BIS at each end-tidal concentration of desflurane, CSI and BIS showed good linearity in 4% and 10% (R2 = 0.559, 0.540). However, the linearity and slope were decreased in 6% and 8% (R2 = 0.163, 0.014).
CONCLUSIONS
CSI showed an equivalent degree of overall performance compared to BIS in desflurane anesthesia. Accounting for previous literature, CSI can be used as a good substitute for BIS regardless of the kind of anesthetics used.
Topics: Adult; Aged; Anesthesia, General; Anesthetics, Inhalation; Cerebral Cortex; Consciousness Monitors; Desflurane; Female; Humans; Male; Middle Aged; Monitoring, Intraoperative
PubMed: 29739183
DOI: 10.4097/kja.d.17.00084 -
Medicine Mar 2022Hyperammonemia, metabolic derangement, and/or the prolonged effects of anesthetics may lead to delayed emergence from general anesthesia as well as the onset of type 2...
RATIONALE
Hyperammonemia, metabolic derangement, and/or the prolonged effects of anesthetics may lead to delayed emergence from general anesthesia as well as the onset of type 2 citrullinemia, even in compensated patients with citrin deficiency.
PATIENT CONCERN
A 5-year-old girl with citrin deficiency was scheduled for blepharoplasty under general anesthesia. She developed hyperammonemia with temporary interruption of medication for a few days before surgery.
DIAGNOSIS
The patient was genetically diagnosed as citrin deficiency with a mutation in the SLC25A13 gene via newborn screening for metabolic disorders. Her citrulline and ammonia levels were well-controlled with arginine medication and protein-rich diet. Her elevated ammonia level by temporary interruption of medication was corrected with resumption of arginine medication and protein-rich diet before surgery.
INTERVENTIONS
We used desflurane and remifentanil for general anesthesia to avoid hyperammonemia and delayed emergence. End-tidal desflurane concentration and anesthetic depth were carefully monitored to avoid excessive anesthesia.
OUTCOMES
She recovered consciousness with slightly increased ammonia level immediately after anesthesia.
LESSIONS
General anesthesia of the shortest duration with the least metabolized drugs using desflurane and remifentanil, would be beneficial for rapid emergence in surgical patients with citrin deficiency. Maintenance of nitrogen scavenging medication, a protein-rich diet, and serial measurement of ammonia levels in the perioperative period are also important for avoiding hyperammonemia-related neurological dysfunction.
Topics: Ammonia; Anesthesia, General; Arginine; Blepharoplasty; Calcium-Binding Proteins; Child, Preschool; Citrullinemia; Desflurane; Endotoxins; Female; Humans; Hyperammonemia; Mitochondrial Membrane Transport Proteins; Organic Anion Transporters; Remifentanil
PubMed: 35244055
DOI: 10.1097/MD.0000000000028954 -
Arhiv Za Higijenu Rada I Toksikologiju Jun 2011General anaesthetics are often used in patients who are under oxidative stress due to a critical illness or surgical trauma. Some anaesthetics may worsen oxidative...
General anaesthetics are often used in patients who are under oxidative stress due to a critical illness or surgical trauma. Some anaesthetics may worsen oxidative stress and some may act as antioxidants. The aim of this study was to evaluate liver, brain, kidney, and lung tissue oxidative stress in rats exposed to desflurane and sevoflurane and in unexposed rats. The animals were divided in three groups: control (received only air); sevoflurane (8 %), and desflurane (4 %). After four hours of exposure, we evaluated the levels of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), Cu, and Zn. Exposure to either of the anaesthetics significantly increased lung MDA levels compared to control (Mann-Whitney U test; P<0.05), probably because it is the tissue directly exposed to anaesthetic gases. Oxidative stress and antioxidant activity in other tissues varied between the desflurane and sevoflurane groups. Our results suggest that anaesthesiologist should not only be aware of the oxidative or antioxidative potential of anaesthetics they use, but should also base their choices on organs which are the most affected by their oxidative action.
Topics: Anesthetics, Inhalation; Animals; Antioxidants; Brain; Copper; Desflurane; Glutathione Peroxidase; Isoflurane; Kidney; Liver; Lung; Male; Malondialdehyde; Methyl Ethers; Oxidative Stress; Rats; Rats, Wistar; Sevoflurane; Superoxide Dismutase; Zinc
PubMed: 21705298
DOI: 10.2478/10004-1254-62-2011-2096 -
Mutation Research. Genetic Toxicology... Oct 2019The use of anesthetics during surgical interventions may contribute to disorders in the perioperative period. Desflurane is the newest volatile halogenated anesthetic to...
The use of anesthetics during surgical interventions may contribute to disorders in the perioperative period. Desflurane is the newest volatile halogenated anesthetic to be introduced in clinical practice. Considering that inflammation and genotoxicity are linked events, and that little is known regarding possible genetic and inflammatory effects of desflurane in surgical patients, this study evaluated DNA damage, systemic inflammatory cytokines and related gene expression in adult patients without comorbidities who underwent minor otorhinological surgeries under general anesthesia maintained with the inhalational anesthetic desflurane. This study involved a self-controlled design in which venous blood samples were collected from subjects before anesthesia administration and after the surgical procedure. The comet assay was applied to assess DNA lesions, while the cytokines IL-1β, IL-6, IL-8, IL-10, IL-17A and TNF-α were evaluated by flow cytometry. A genotoxic effect was observed (p = 0.027), and pro-inflammatory IL-6 and IL-8 levels were significantly increased after surgery (p = 0.001 and p = 0.02, respectively), whereas the levels of the other cytokines did not significantly change. Considering that serum IL-6 and IL-8 were increased, we further evaluated IL-6 and IL-8 gene expression by quantitative real-time polymerase chain reaction (qPCR). However, IL-6 and IL-8 gene expression was unaltered (p > 0.05). In conclusion, anesthetic maintenance with the modern agent desflurane during minor surgeries led to genotoxic and inflammatory effects without altering the expression of inflammation related-genes the day after surgery in patients without comorbidities.
Topics: Adult; Anesthetics, Inhalation; Comet Assay; DNA Damage; Desflurane; Female; Gene Expression Regulation; Humans; Inflammation; Interleukins; Male; Real-Time Polymerase Chain Reaction; Surgical Procedures, Operative; Tumor Necrosis Factor-alpha; Young Adult
PubMed: 31585635
DOI: 10.1016/j.mrgentox.2019.07.003 -
Anesthesiology Mar 1992To determine the induction and maintenance characteristics of desflurane in pediatric patients, the authors anesthetized 206 infants and children aged 1 month to 12 yr...
To determine the induction and maintenance characteristics of desflurane in pediatric patients, the authors anesthetized 206 infants and children aged 1 month to 12 yr with nitrous oxide plus desflurane and/or halothane in oxygen. Patients were assigned to one of four groups: anesthesia was 1) induced and maintained with desflurane after premedication with an oral combination of meperidine, diazepam, and atropine; 2) induced and maintained with desflurane; 3) induced with halothane and maintained with desflurane; or 4) induced and maintained with halothane. An unblinded observer recorded time to loss of consciousness (lid reflex), time to intubation, and clinical characteristics of the induction and maintenance of anesthesia. Moderate-to-severe laryngospasm (49%) and moderate-to-severe coughing (58%) occurred frequently during induction of anesthesia with desflurane; the incidence of these was not altered by premedication. In contrast, laryngospasm and coughing were rare during induction of anesthesia with halothane. In unpremedicated patients, time to loss of lid reflex (mean +/- SD) was similar for desflurane (2.4 +/- 1.2 min) and halothane (2.1 +/- 0.8 min). During induction of anesthesia, before laryngoscopy and intubation, mean arterial pressure less than 80% of baseline was more common with halothane; heart rate and mean arterial pressure greater than 120% of baseline were more common with desflurane. Intraoperatively, heart rate greater than 120% of baseline was more common with desflurane; blood pressures were similar for the two anesthetics. The authors conclude that the high incidence of airway complications during induction of anesthesia with desflurane limits its utility for inhalation induction in pediatric patients. Anesthesia can be safely maintained with desflurane if induced with a different anesthetic.
Topics: Anesthesia, Inhalation; Atropine; Child; Child, Preschool; Cough; Desflurane; Diazepam; Halothane; Humans; Infant; Isoflurane; Laryngismus; Meperidine; Nitrous Oxide; Preanesthetic Medication
PubMed: 1539848
DOI: 10.1097/00000542-199203000-00009 -
Drug Design, Development and Therapy 2020Kidney is sensitive to ischemia-reperfusion (I/R) injury because of its special structure and function. In this study, we aimed to explore the mechanism of desflurane...
Desflurane Preconditioning Protects Against Renal Ischemia-Reperfusion Injury and Inhibits Inflammation and Oxidative Stress in Rats Through Regulating the Nrf2-Keap1-ARE Signaling Pathway.
OBJECTIVE
Kidney is sensitive to ischemia-reperfusion (I/R) injury because of its special structure and function. In this study, we aimed to explore the mechanism of desflurane (DFE) preconditioning effecting on renal I/R injury in rats.
METHODS
Renal I/R injury rats model was constructed, and the expressions of serum renal function parameters (blood urea nitrogen (BUN) and serum creatinine (SCr)) and lipid peroxidation-related factors were detected using corresponding commercial kits to assess the degrees of renal functional damage and oxidative stress. Hematoxylin--eosin (HE) staining and Masson trichrome staining were applied to measure the renal histologic damage. The expressions of inflammation-related factors were determined by ELISA assay. The cell apoptosis was analyzed using TUNEL, Western blot and immunohistochemistry (IHC). IHC was also used to detect the number of myeloperoxidase (MPO)-positive cells. The expressions of proteins associated with the Nrf2-Keap1-ARE pathway were assessed by Western blot and IHC.
RESULTS
DFE preconditioning inhibited I/R injury-induced BUN and SCr increase and renal histologic injury in rats. Also, DFE suppressed the inflammation, apoptosis and oxidative stress caused by renal I/R injury in vivo. In addition, DFE preconditioning repressed peroxide-related factors (MDA, MPO and NO) expressions and promoted antioxidant-related factors (GSH, SOD, GPx and CAT) expressions. In addition, DFE promoted Nrf2-Keap1-ARE-related proteins including Nrf2, NQO1, HO-1, γ-GCS, GSR and GCLc expressions.
CONCLUSION
DFE preconditioning protected the kidney as well as inhibited the inflammation, cell apoptosis and oxidative stress in renal I/R injury rats by activating the Nrf2-Keap1-ARE signaling pathway.
Topics: Anesthetics, Inhalation; Animals; Apoptosis; Carboxylic Ester Hydrolases; Desflurane; Disease Models, Animal; Inflammation; Injections, Intraperitoneal; Ischemic Preconditioning; Kelch-Like ECH-Associated Protein 1; Male; NF-E2-Related Factor 2; Oxidative Stress; Protective Agents; Rats; Rats, Wistar; Reperfusion Injury; Signal Transduction
PubMed: 32308368
DOI: 10.2147/DDDT.S223742 -
Medicine Nov 2019Although surgical field visualization is important in functional endoscopic sinus surgery (FESS), the complications associated with controlled hypotension for surgery... (Randomized Controlled Trial)
Randomized Controlled Trial
Comparison of the effect of propofol and desflurane on S-100β and GFAP levels during controlled hypotension for functional endoscopic sinus surgery: A randomized controlled trial.
BACKGROUND
Although surgical field visualization is important in functional endoscopic sinus surgery (FESS), the complications associated with controlled hypotension for surgery should be considered. Intraoperative hypotension is associated with postoperative stroke, leading to subsequent hypoxia with potential neurologic injury. We investigated the effect of propofol and desflurane anesthesia on S-100β and glial fibrillary acidic protein (GFAP) levels which are early biomarkers for cerebral ischemic change during controlled hypotension for FESS.
METHODS
For controlled hypotension during FESS, anesthesia was maintained with propofol/remifentanil in propofol group (n = 30) and with desflurane/remifentanil in desflurane group (n = 30). For S-100β and GFAP assay, blood samples were taken at base, 20 and 60 minutes after achieving the target range of mean arterial pressure, and at 60 minutes after surgery.
RESULTS
The base levels of S-100β were 98.04 ± 78.57 and 112.61 ± 66.38 pg/mL in the propofol and desflurane groups, respectively. The base levels of GFAP were 0.997 ± 0.486 and 0.898 ± 0.472 ng/mL in the propofol and desflurane groups, respectively. The S-100β and GFAP levels were significantly increased in the study period compared to the base levels in both groups (P ≤ .001). There was no significant difference at each time point between the 2 groups.
CONCLUSION
On comparing the effects of propofol and desflurane anesthesia for controlled hypotension on the levels of S-100β and GFAP, we noted that there was no significant difference in S-100β and GFAP levels between the 2 study groups.
CLINICAL TRIAL REGISTRATION
Available at: http://cris.nih.go.kr, KCT0002698.
Topics: Adult; Anesthetics, Intravenous; Arterial Pressure; Carbon Dioxide; Chronic Disease; Desflurane; Endoscopy; Female; Glial Fibrillary Acidic Protein; Humans; Hypotension, Controlled; Male; Middle Aged; Propofol; Prospective Studies; Remifentanil; S100 Calcium Binding Protein beta Subunit; Sinusitis; Time Factors
PubMed: 31725655
DOI: 10.1097/MD.0000000000017957