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TheScientificWorldJournal May 2011Urinalysis is an integral part of a thorough patient evaluation. Change in urine characteristics can give clues to help solve some of the diagnostic challenges faced by...
Urinalysis is an integral part of a thorough patient evaluation. Change in urine characteristics can give clues to help solve some of the diagnostic challenges faced by physicians. We discuss a case of a benign cause of green discoloration of urine caused by propofol infusion, which reversed following its discontinuation.
Topics: Diagnosis, Differential; Humans; Male; Middle Aged; Propofol; Urine
PubMed: 21623455
DOI: 10.1100/tsw.2011.101 -
British Journal of Anaesthesia Nov 2006
Topics: Anesthetics, Intravenous; Attitude of Health Personnel; Awareness; Humans; Memory; Propofol
PubMed: 17032664
DOI: 10.1093/bja/ael258 -
British Journal of Anaesthesia Jan 1994We have used Median Power Frequency (MPF) to study changes in the electroencephalogram during propofol infusions in 52 women about to undergo gynaecological surgery....
We have used Median Power Frequency (MPF) to study changes in the electroencephalogram during propofol infusions in 52 women about to undergo gynaecological surgery. Patients were allocated to receive propofol by one of nine different manually-controlled infusion schemes designed to achieve and maintain a stable blood propofol concentration between 1.0 and 6.0 micrograms ml-1, covering a range of states between conscious sedation and full anaesthesia. We recorded the changes in MPF and the response to clinical signs of loss of consciousness at these different doses and concentrations of propofol. Using probit analysis, we derived MPF values corresponding to 50% and 95% suppression of response to verbal (9.3 Hz and 6.8 Hz), eyelash (8.9 Hz and 6.7 Hz) and venepuncture (5.7 Hz and 3.0 Hz) stimuli. Likewise, we obtained dose and concentration requirements for propofol to suppress these stimuli. The mean (95% confidence intervals) ED50 (5.8 (3.5-6.8) mg kg-1 h-1) and ED95 (8.3 (7.1-16.9) mg kg-1 h-1) propofol doses for suppression of consciousness were similar to the values for suppression of the eyelash reflex (6.2 (5.3-6.8) mg kg-1 h-1 and 8.6 (7.8-10.8) mg kg-1 h-1, respectively). The EC50 for loss of consciousness was a propofol concentration of 2.3 (1.8-2.7) micrograms ml-1 and for 50% suppression of MPF was 3.1 (2.7-3.5) micrograms ml-1. The dose required for 50% suppression of MPF was 7.1 (6.2-8.0) mg kg-1 h-1. After 30 min, at blood propofol concentrations > 4.0 micrograms ml-1, consistent with stable anaesthesia, the mean MPF was 5.6 (4.5-6.3) Hz.
Topics: Adolescent; Adult; Anesthesia, General; Auditory Perception; Blood Pressure; Consciousness; Dose-Response Relationship, Drug; Electroencephalography; Female; Humans; Middle Aged; Pain Measurement; Propofol; Time Factors
PubMed: 8110547
DOI: 10.1093/bja/72.1.35 -
Medicine Sep 2021In newborns, propofol anesthesia is commonly utilized. Propofol is increasingly being shown to be effective and safe in treating procedural sedation and anesthesia in...
BACKGROUND
In newborns, propofol anesthesia is commonly utilized. Propofol is increasingly being shown to be effective and safe in treating procedural sedation and anesthesia in neonates. This research aims to evaluate the efficacy and safety of propofol in neonates using systematic review and meta-analysis methodologies.
METHODS
A thorough review and meta-analysis of studies on propofol anesthesia in neonates will be conducted. Conduct comprehensive searches in Web of Science, PubMed, Cochrane Library, EMBASE database, WanFang database, and Chinese biomedical literature database before May 25, 2021, to obtain published and qualified research. Two reviewers will assess the quality of the included papers and extract the data independently. Then, for meta-analysis, we will utilize RevMan 5.3 software.
RESULTS
This study will pool the data of separate trials to analyze the efficacy and safety of propofol in the treatment of procedural sedation/anesthesia in neonates.
CONCLUSION
Our findings will give strong data for determining whether propofol is an effective treatment for procedural anesthesia in neonates.
Topics: Clinical Protocols; Humans; Hypnotics and Sedatives; Infant, Newborn; Meta-Analysis as Topic; Patient Safety; Pediatrics; Propofol; Self Efficacy; Systematic Reviews as Topic; Treatment Outcome
PubMed: 34664839
DOI: 10.1097/MD.0000000000027147 -
Oxidative Medicine and Cellular... 2022Hypoxia may induce mitochondrial abnormality, which is associated with a variety of clinical phenotypes in the central nervous system. Propofol is an anesthetic agent...
BACKGROUND
Hypoxia may induce mitochondrial abnormality, which is associated with a variety of clinical phenotypes in the central nervous system. Propofol is an anesthetic agent with neuroprotective property. We examined whether and how propofol protected hypoxia-induced mitochondrial abnormality in neurons.
METHODS
Primary rat hippocampal neurons were exposed to propofol followed by hypoxia treatment. Neuron viability, mitochondrial morphology, mitochondrial permeability transition pore (mPTP) opening, mitochondrial membrane potential (MMP), and adenosine triphosphate (ATP) production were measured. Mechanisms including reactive oxygen species (ROS), extracellular regulated protein kinase (ERK), protein kinase A (PKA), HIF-1, Drp1, Fis1, Mfn1, Mfn2, and Opa1 were investigated.
RESULTS
Hypoxia increased intracellular ROS production and induced mPTP opening, while reducing ATP production, MMP values, and neuron viability. Hypoxia impaired mitochondrial dynamic balance by increasing mitochondrial fragmentation. Further, hypoxia induced the translocation of HIF-1 and increased the expression of Drp1, while having no effect on Fis1 expression. In addition, hypoxia induced the phosphorylation of ERK and Drp1, while reducing the phosphorylation of PKA and Drp1. Importantly, we demonstrated all these effects were attenuated by pretreatment of neurons with 50 M propofol, antioxidant -tocopherol, and ROS scavenger ebselen. Besides, hypoxia, propofol, -tocopherol, or ebselen had no effect on the expression of Mfn1, Mfn2, and Opa1.
CONCLUSIONS
In rat hippocampal neurons, hypoxia induced oxidative stress, caused mitochondrial dynamic imbalance and malfunction, and reduced neuron viability. Propofol protected mitochondrial abnormality and neuron viability via antioxidant property, and the molecular mechanisms involved HIF-1-mediated Drp1 expression and ERK/PKA-mediated Drp1 phosphorylation.
Topics: Animals; Antioxidants; Cell Hypoxia; Disease Models, Animal; Hippocampus; Mitochondrial Dynamics; Neurons; Propofol; Rats
PubMed: 35087616
DOI: 10.1155/2022/6298786 -
ENeuro 2020Maintenance of memory across time is crucial for adaptive behavior. Current theories posit that the underlying consolidation process depends on stabilization of synapses...
Maintenance of memory across time is crucial for adaptive behavior. Current theories posit that the underlying consolidation process depends on stabilization of synapses and reorganization of interactions between hippocampus and neocortex. However, the temporal properties of hippocampal-neocortical network reconfiguration during consolidation are still a matter of debate. Translational research on this issue is challenged by the paucity of techniques to transiently interfere with memory in the healthy human brain. Here, we report a neuro-pharmacological approach with the GABAergic anesthetic propofol and a memory task sensitive to hippocampal dysfunction. Patients undergoing minor surgery learned word lists before injection of an anesthetic dose of propofol. Results show that administration of the drug shortly after learning (∼13 min) impairs recall after awakening but spares recognition. By contrast, later administration (∼105 min) has no effect. These findings suggest significant changes in memory networks very early after learning that are decisive for later recall. Propofol general anesthesia provides an experimental tool to modulate the first steps of hippocampus-mediated memory consolidation in humans.
Topics: Hippocampus; Humans; Memory; Memory Consolidation; Mental Recall; Propofol
PubMed: 32295771
DOI: 10.1523/ENEURO.0537-19.2020 -
Biopharmaceutics & Drug Disposition Jul 2010Compared with traditional macroemulsion propofol formulations currently in clinical use, microemulsion formulations of this common intravenous anesthetic may offer...
PURPOSE
Compared with traditional macroemulsion propofol formulations currently in clinical use, microemulsion formulations of this common intravenous anesthetic may offer advantages. The pharmacokinetics and coagulation effects as assessed by thromboelastography of these formulations were characterized in swine.
METHODS
Yorkshire swine (20-30 kg, either sex, n=15) were sedated, anesthetized with isoflurane, and instrumented to obtain a tracheostomy, internal jugular access and carotid artery catheterization. Propofol (2 mg/kg, 30 s) was administered as a macroemulsion (10 mg/ml; Diprivan; n=7) or a custom (2 mg/kg, 30 s) microemulsion (10 mg/ml; n=8). Arterial blood specimens acquired pre- and post-injection (1 and 45 min) were used for thromboelastography. Arterial blood specimens (n=12 samples/subject, 60 min) were serially collected, centrifuged and analysed with solid-phase extraction with UPLC to determine propofol plasma concentrations. Non-compartmental pharmacokinetic analysis was applied to plasma concentrations.
RESULTS
No changes were noted in the thromboelastographic R time (p=0.74), K time (p=0.41), alpha angle (p=0.97), or maximal amplitude (p=0.71) for either propofol preparation. Pharmacokinetic parameters k (p=0.45), t(1/2) (p=0.26), C(o) (p=0.89), AUC(0-infinity) (p=0.23), CL (p=0.14), MRT (p=0.47), V(ss) (p=0.11) of the two formulations were not significantly different.
CONCLUSION
The microemulsion and macroemulsion propofol formulations had similar pharmacokinetics and did not modify thromboelastographic parameters in swine.
Topics: Anesthetics, Intravenous; Animals; Emulsions; Female; Male; Microtechnology; Propofol; Random Allocation; Swine; Thrombelastography
PubMed: 20578214
DOI: 10.1002/bdd.709 -
Anaesthesia May 2014
Topics: Anesthetics, Intravenous; Dose-Response Relationship, Drug; Humans; Propofol
PubMed: 24738794
DOI: 10.1111/anae.12642 -
Critical Care (London, England) Nov 2022Sedative agents may variably impact the stress response. Dexmedetomidine is a sympatholytic alpha-adrenergic agonist mainly used as a second-line sedative agent in... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Sedative agents may variably impact the stress response. Dexmedetomidine is a sympatholytic alpha-adrenergic agonist mainly used as a second-line sedative agent in mechanically ventilated patients. We hypothesised that early sedation with dexmedetomidine as the primary agent would result in a reduced stress response compared to usual sedatives in critically ill ventilated adults.
METHODS
This was a prospective sub-study nested within a multi-centre randomised controlled trial of early sedation with dexmedetomidine versus usual care. The primary outcome was the mean group differences in plasma levels of stress response biomarkers measured over 5 days following randomisation. Other hormonal, biological and physiological parameters were collected. Subgroup analyses were planned for patients with proven or suspected sepsis.
RESULTS
One hundred and three patients were included in the final analysis. Baseline illness severity (APACHE II score), the proportion of patients receiving propofol and the median dose of propofol received were comparable between groups. More of the usual-care patients received midazolam (57.7% vs 33.3%; p = 0.01) and at higher dose (median (95% interquartile range) 0.46 [0.20-0.93] vs 0.14 [0.08-0.38] mg/kg/day; p < 0.01). The geometric mean (95% CI) plasma level of the stress hormones, adrenaline (0.32 [0.26-0.4] vs 0.38 [0.31-0.48]), noradrenaline (4.27 [3.12-5.85] vs 6.2 [4.6-8.5]), adrenocorticotropic hormone (17.1 [15.1-19.5] vs 18.1 [15.9-20.5]) and cortisol (515 [409-648] vs 618 [491-776)] did not differ between dexmedetomidine and usual-care groups, respectively. There were no significant differences in any other assayed biomarkers or physiological parameters Sensitivity analyses showed no effect of age or sepsis.
CONCLUSIONS
Early sedation with dexmedetomidine as the primary sedative agent in mechanically ventilated critically ill adults resulted in comparable changes in physiological and blood-borne parameters associated with the stress-response as with usual-care sedation.
Topics: Adult; Humans; Critical Illness; Dexmedetomidine; Propofol; Conscious Sedation; Prospective Studies; Respiration, Artificial; Intensive Care Units; Hypnotics and Sedatives; Adrenergic alpha-2 Receptor Agonists; Sepsis
PubMed: 36419197
DOI: 10.1186/s13054-022-04237-0 -
Biomedicine & Pharmacotherapy =... May 2024Propofol, a commonly used intravenous anesthetic, has demonstrated potential in protecting against myocardial ischemia/reperfusion injury (MIRI) based on preclinical... (Meta-Analysis)
Meta-Analysis Review
Propofol, a commonly used intravenous anesthetic, has demonstrated potential in protecting against myocardial ischemia/reperfusion injury (MIRI) based on preclinical animal studies. However, the clinical benefits of propofol in this context are subject to debate. We conducted a systematic search across eight databases to identify all relevant animal studies investigating the preventive effects of propofol on MIRI until October 30, 2023. We assessed the methodological quality of the included studies using SYRCLE's bias risk tool. Statistical analysis was performed using STATA 15.1. The primary outcome measures analyzed in this study were myocardial infarct size (IS) and myocardial injury biomarkers. This study presents a comprehensive analysis of 48 relevant animal studies investigating propofol's preventive effects on MIRI. Propofol administration demonstrated a reduction in myocardial IS and decreased levels of myocardial injury biomarkers (CK-MB, LDH, cTnI). Moreover, propofol improved myocardial function parameters (+dp/dtmax, -dP/dtmax, LVEF, LVFS), exhibited favorable effects on inflammatory markers (IL-6, TNF-α) and oxidative stress markers (SOD, MDA), and reduced myocardial cell apoptotic index (AI). These findings suggest propofol exerts cardioprotective effects by reducing myocardial injury, decreasing infarct size, and improving heart function. However, the absence of animal models that accurately represent comorbidities such as aging and hypertension, as well as inconsistent administration methods that align with clinical practice, may hinder its clinical translation. Further robust investigations are required to validate these findings, elucidate the underlying mechanisms of propofol, and facilitate its potential translation into clinical practice.
Topics: Propofol; Animals; Myocardial Infarction; Myocardial Reperfusion Injury; Oxidative Stress; Biomarkers; Anesthetics, Intravenous; Humans; Apoptosis
PubMed: 38640712
DOI: 10.1016/j.biopha.2024.116629