Background: Propofol is a short-acting intravenous anesthetic agent. In rare conditions, a life-threatening complication known as propofol infusion syndrome can occur. The pathophysiologic mechanism is still unknown. Some studies suggested that propofol acts as uncoupling agent, others suggested that it inhibits complex I or complex IV, or causes increased oxidation of cytochrome c and cytochrome aa(3), or inhibits mitochondrial fatty acid metabolism. Although the exact site of interaction is not known, most hypotheses point to the direction of the mitochondria. Methods: Eight rats were ventilated and sedated with propofol up to 20 h. Sequential biopsy specimens were taken from liver and skeletal muscle and used for determination of respiratory chain activities and propofol concentration. Activities were also measured in skeletal muscle from a patient who died of propofol infusion syndrome. Results: In rats, authors detected a decrease in complex II+III activity starting at low tissue ...

Propofol (2,6-diisopropylphenol), an intravenous sedative-hypnotic approved by the FDA for the induction and maintenance of sedation and anesthesia, is one of the most commonly utilized medications in the ICU setting secondary to its anti-epileptic and neuro-protective properties. Propofol infusion syndrome (PRIS) is a rare, but potentially fatal, adverse effect of propofol administration. First described in children in 1992, and subsequently named by Bray in 1998, PRIS was classically defined as acute bradycardia progressing to asystole status post propofol administration; occurring in the setting of one of the following: ...

TY - JOUR. T1 - Effects of propofol sedation on seizures and intracranially recorded epileptiform activity in patients with partial epilepsy. AU - Samra, S. K.. AU - Sneyd, J. R.. AU - Ross, D. A.. AU - Henry, T. R.. PY - 1995/1/1. Y1 - 1995/1/1. N2 - Background: Case reports suggesting both pro- and anticonvulsant effect(s) of propofol have been published in recent years. The effects of sedative doses of propofol on epileptiform activities in patients suffering from intractable partial epilepsy were systematically investigated. Methods: Fourteen patients suffering from complex partial seizures were studied. Electroencephalogram (EEG) was recorded from intracranial electrodes implanted in the hippocampi and temporal neocortex. Propofol was given as a computer-controlled infusion in four steps to achieve target plasma propofol concentrations of 0.3, 0.6, 0.9, and 1.2 μg/ml. Each concentration was maintained for 30 min, and steady-state kinetics were confirmed by blood levels drawn at 10th and ...

In humans, prolonged sedations with propofol or using high doses have been associated with propofol infusion syndrome. The main objective of this study was to evaluate the effects of prolonged high-dose administration of a specific propofol emulsion (Propofol Lipuro) and an improved lipid formulation (SMOFlipid) in liver mitochondrial bioenergetics and oxidative stress of rabbits, comparatively to a saline control. Twenty-one male New Zealand white rabbits were randomly allocated in three groups that were continuously treated for 20 h. Each group of seven animals received separately: NaCl 0.9 % (saline), SMOFlipid (lipid-based emulsion without propofol) and Lipuro 2 % (propofol lipid emulsion). An intravenous propofol bolus of 20 mg kg−1 was given to the propofol Lipuro group to allow blind orotracheal intubation and mechanical ventilation. Anesthesia was maintained using infusion rates of: 20, 30, 40, 50 and 60 mg kg−1 h−1, according to the clinical scale of anesthetic depth and the index of

Propofol is a widely used intravenous anesthetic agent with antioxidant properties secondary to its phenol based chemical structure. Treatment with propofol has been found to attenuate oxidative stress and prevent ischemia/reperfusion injury in rat heart. Here, we report that propofol protects cardiac H9c2 cells from hydrogen peroxide (H2O2)-induced injury by triggering the activation of Akt and a parallel up-regulation of Bcl-2. We show that pretreatment with propofol significantly protects against H2O2-induced injury. We further demonstrate that propofol activates the PI3K-Akt signaling pathway. The protective effect of propofol on H2O2-induced injury is reversed by PI3K inhibitor wortmannin, which effectively suppresses propofol-induced activation of Akt, up-regulation of Bcl-2, and protection from apoptosis. Collectively, our results reveal a new mechanism by which propofol inhibits H2O2-induced injury in cardiac H9c2 cells, supporting a potential application of propofol as a preemptive ...

Background: The use of clinical signs may not be reliable to measure the hypnotic component of anaesthesia. Bispectral Index monitoring provides a direct measurement of the hypnotic effect of the anaesthetic agent used and it may have certain clinical advantages over clinical signs. Objective: This study consists of dose requirement of propofol with bispectral Index monitoring and without bispectral Index monitoring. Material and Methods: In the present study, 100 patients were randomly divided into two groups (50 in each group), one group received Standard dose of propofol while the other received propofol infusion with BIS monitoring. Results: Mean amount of propofol for induction used was 1.6 vs 2.24 mg/kg in bispectral index group and standard group respectively. The inference was that the induction dose of propofol by Bispectral index and by standard practice was statistically highly significant with P. Key words: Bispectral Index monitoring system, propofol, anaesthetic drug consumption, ...

Background: Propofol is widely used for the induction and maintenance of general anaesthesia and offers many key attractive pharmacological qualities that make it suitable for these indications. However, pain on injection is one of its major drawbacks and can be very distressing to patients. There is a paucity of studies that have looked at the effect of lornoxicam on propofol injection pain either as a sole intervention or in combination with any other method. Primary objective: To determine whether premedication with intravenous lornoxicam had any effect on the intensity of propofol injection pain at induction of general anaesthesia in adult patients. Secondary Objectives: (I)To determine whether premedication with lornoxicam had any effect on the incidence of propofol injection pain at induction of general anaesthesia in adult patients.(II)To document any adverse events (allergic reactions, nausea, vomiting, gastritis and/or gastrointestinal bleeding, dizziness, phlebitis) that resulted from the

TY - JOUR. T1 - Effects of propofol on nociceptive response and power spectra of electroencephalographic and systemic arterial pressure signals in the rat. T2 - Correlation with plasma concentration. AU - Yang, Chen Hsein. AU - Shyr, M. H.. AU - Kuo, T. B.J.. AU - Tan, P. P.C.. AU - Chan, S. H.H.. PY - 1995. Y1 - 1995. N2 - We applied simultaneous spectral analysis of electroencephalographic (EEG) and systemic arterial pressure signals in Sprague-Dawley rats to monitor the status of consciousness and cardiovascular functions during intravenous anesthesia with propofol and to assess their correlations with plasma propofol concentration. Our results support the hypothesis that a threshold plasma concentration (1.7-1.8 μg/ml) exists for propofol anesthesia. This threshold level, we further showed, may be attained by both i.v. bolus injection and continuous infusion, although the pharmacokinetic profiles, as well as EEG and hemodynamic correlates, may be different. Continuous, on- line power ...

TY - JOUR. T1 - Anesthetic propofol reduces endotoxic inflammation by inhibiting reactive oxygen species-regulated Akt/IKKβ/NF-κB signaling. AU - Hsing, Chung-Hsi. AU - Lin, Ming-Chung. AU - Choi, Pui-Ching. AU - Huang, Wei-Ching. AU - Kai, Jui-In. AU - Tsai, Cheng-Chieh. AU - Cheng, Yi-Lin. AU - Hsieh, Chia-Yuan. AU - Wang, Chi-Yun. AU - Chang, Yu-Ping. AU - Chen, Yu-Hong. AU - Chen, Chia-Ling. AU - Lin, Chiou-Feng. PY - 2011. Y1 - 2011. N2 - Background: Anesthetic propofol has immunomodulatory effects, particularly in the area of anti-inflammation. Bacterial endotoxin lipopolysaccharide (LPS) induces inflammation through toll-like receptor (TLR) 4 signaling. We investigated the molecular actions of propofol against LPS/TLR4-induced inflammatory activation in murine RAW264.7 macrophages. Methodology/Principal Findings: Non-cytotoxic levels of propofol reduced LPS-induced inducible nitric oxide synthase (iNOS) and NO as determined by western blotting and the Griess reaction, respectively. ...

Background and study aims : In endoscopic procedures, propofol can be safely administered either alone or in conjunction with remifentanil. The aim of the study is to compare the effects of the administration of propofol alone and the administration of remifentanil in addition to propofol on patient and endoscopist satisfaction, preoperative hemodynamic response, and propofol consumption. ...

TY - JOUR. T1 - Induction dose of propofol for pediatric patients undergoing procedural sedation in the emergency department. AU - Jasiak, Karalea D.. AU - Phan, Hanna. AU - Christich, Anna C.. AU - Edwards, Christopher J.. AU - Skrepnek, Grant H.. AU - Patanwala, Asad E.. PY - 2012/5/1. Y1 - 2012/5/1. N2 - Objective: This study aimed to determine if patient age is an independent predictor of the propofol dose required for the induction of sedation in pediatric patients for procedures performed in the emergency department (ED). Methods: This is a retrospective study conducted in an academic, tertiary ED between May 2005 and October 2009. Medical records of patients younger than 18 years who received propofol for procedural sedation were evaluated. Data collected included patient demographics, procedure type, propofol doses administered, time to sedation induction, pain scores before procedure, opioid administration, and adverse effects. Factors predictive of propofol induction dose were analyzed ...

Uncertainty exists as to the most suitable pharmacokinetic parameter sets for propofol target-controlled infusions (TCI). The pharmacokinetic parameter sets currently employed are clearly not universally applicable, particularly when patient attributes differ from those of the subjects who participated in the original research from which the models were derived. Increasing evidence indicates that the pharmacokinetic parameters of propofol can be scaled allometrically as well as in direct proportion to lean body mass (LBM). Appraisal of hitherto published studies suggests that an allometrically scaled pharmacokinetic parameter set may be applicable to a wide range of patients ranging from children to obese adults. On the other hand, there is evidence that propofol pharmacokinetic parameters, scaled linearly to LBM, provide improved dosing in normal and obese adults. The Schnider pharmacokinetic parameter set that has been programmed into commercially available TCI pumps cannot be employed at ...

Seizures or seizure-like phenomena which are mostly convulsive have been observed during the induction, maintenance and withdrawal phases of propofol administration. The nature and mechanism of this phenomenon are not well understood and several case reports on these phenomena have presented only indirect evidence. We report on a patient who was administered propofol in order to control status epilepticus with success. However, every attempt at propofol withdrawal was followed by convulsive seizure-like activity. Continuous EEG monitoring showed muscle artefacts without any ictal discharges. Based on this finding, the propofol treatment was withdrawn and the seizure-like activity eventually attenuated and resolved. We propose that seizure-like phenomena associated with propofol withdrawal may not be ictal in nature and should not lead to unnecessary resumption of propofol infusion without documentation of an epileptic origin by EEG.. ...

BACKGROUND: The Narcotrend is a new electroencephalographic monitor designed to measure depth of anesthesia, based on a six-letter classification from A (awake) to F (increasing burst suppression) including 14 substages. This study was designed to investigate the impact of Narcotrend monitoring on recovery times and propofol consumption in comparison to Bispectral Index (BIS) monitoring or standard anesthetic practice.. METHODS: With institutional review board approval and written informed consent, 120 adult patients scheduled to undergo minor orthopedic surgery were randomized to receive a propofol-remifentanil anesthetic controlled by Narcotrend, by BIS(R), or solely by clinical parameters. Anesthesia was induced with 0.4 micro x kg-1 x min-1 remifentanil and a propofol target-controlled infusion at 3.5 microg/ml. After intubation, remifentanil was reduced to 0.2 micro x kg-1 x min-1, whereas the propofol infusion was adjusted according to clinical parameters or to the following target values: ...

OBJECTIVE: To evaluate the effects of three different target-controlled remifentanil infusion rates during target-controlled propofol infusion on hemodynamic parameters, pain, sedation, and recovery score during oocyte retrieval. ...

This project was designed to compare the dose requirements and the development of tolerance on the sedative/analgesic effect of propofol versus propofol plus remifentanil administered in rabbits under prolonged mechanical ventilation (PMV).. Eight male, clinically healthy New Zealand White rabbits were intubated under xylazine-ketamine-isoflurane anesthesia. After isoflurane discontinuation, the animals received either propofol (group P, n=4) or propofol plus remifentanil (group P/R, n=4) by continuous intravenous infusion for a maximum period of 38 hours. Arterial pressure (AP), heart rate (HR), respiratory rate (RR), electrocardiograph (ECG) and spO2 were continuously measured while arterial blood gases were analysed periodically. Initial doses were adjusted in order to achieve adequate level of sedation and analgesia based on reflexes, HR, arterial pressure and attempt for spontaneous breathing. Tolerance on the sedative/analgesic effect of the agents was indicated by the increase of their ...

Propofol is a general anesthetic commonly used in pediatric clinical practices. Experimental findings demonstrate that anesthetics induce widespread apoptosis and cognitive decline in a developing brain. Although anesthesia-mediated neurotoxicity is the most prominent during intense period of synaptogenesis, the effects of an early anesthesia exposure on the synapses are not well understood. The aim of this study was to examine the effects of neonatal propofol anesthesia on the expression of key proteins that participate in synaptogenesis and synaptic plasticity and to evaluate long-term neurobehavioral abnormalities in the mature adult brain. Propofol-injected 7-day-old rats were maintained under 2-, 4-, and 6-h-long anesthesia and sacrificed 0, 4, 16, and 24 h after the termination of each exposure. We showed that propofol anesthesia strongly influenced spatiotemporal expression and/or proteolytic processing of crucial presynaptic (GAP-43, synaptophysin, α-synuclein), trans-synaptic ...

Objectives This study evaluated the effects of sevoflurane and propofol anesthesia on renal function of dogs with naturally acquired chronic renal failure. Materials & Methods The anesthetic procedures included: three hours using sevoflurane (1.5CAM) in O2 flow of 30mL/kg/min, in a semiclosed-circuit, after induction with propofol at 10mg/kg, in bolus (P-S group), or after induction with sevoflurane (S-S group), and for the P group it was used only propofol in the same dose employed for induction. Evaluations were performed in six sessions and included creatinine clearance, serum creatinine and ureia, protein and glucose urinary excretion. The renal function evaluations were performed 30 minutes before anesthesia, two times during anesthesia, and one, two and five days after. Results All anesthetic procedures were well succeeded and animals recovered uneventfully. No renal toxicity were observed in any of the anesthetic protocols. However, during the transanesthetic period it was observed ...

2,6‑diisopropylphenol (propofol) is a commonly used intravenous anesthetic drug, which has been reported to serve an antitumor role in human cancers. The current study aimed to assess the effects of propofol on the biological behaviors of human bladder cancer cells and to elucidate its potential molecular mechanism. The results of MTT, wound healing and Matrigel invasion assays demonstrated that propofol significantly inhibited the viability, migration and invasion of bladder cancer T24 cells in vitro. Reverse transcription‑quantitative PCR and western blotting revealed that propofol decreased the expression levels of microRNA (miR)‑10b and increased the expression levels of homeobox D10 (HOXD10) in T24 cells. Luciferase reporter assay revealed that HOXD10 was a direct target of miR‑10b in T24 cells. T24 cells transfected with a miR‑10b mimic significantly reduced the mRNA and protein expression levels of HOXD10. In addition, overexpression of miR‑10b partly reversed the inhibitory ...

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Propofol reportedly possesses potential antioxidant properties caused by its chemical structure similar to that of phenol-based free-radical scavengers such as vitamin E.10 Previous in vivo or in vitro studies documented that this intravenous anesthetic reduces oxidative stress toward blood vessels.11,12 These results suggest that this anesthetic may be protective against the vascular dysfunction caused by increased oxidative stress. Indeed, propofol (3 × 10−7to 10−6m) recovered vascular ATP-sensitive K+channel function via reduction of superoxide levels within arterial walls. In addition, 10−6m of this agent completely inhibited protein expression of a Nox2-related NADPH oxidase subunit p47phox. The plasma concentration of propofol during induction of anesthesia in humans has been reported as up to 3 × 10−5m, and burst suppression doses of propofol for cerebral protection are up to 6 × 10−5m.20-22 Effective concentrations of propofol (3 × 10−7to 10−6m) to inhibit NADPH oxidase ...

Methods: Preparation of propofol nanoemulsion using NEMS™ technology has been performed for propofol 1% in NEMS™ (P1%), and propofol 2% in NEMS™ (P2%). Determination of free propofol concentration in aqueous phase was conducted using HPLC and rat paw lick test was evaluated as in vivo test to assay the intensity of pain on injection site. The sleep recovery test was conducted to evaluate the pharmacological effect and erythrocyte hemolysis test also conducted to ensure the safety of propofol in NEMS™. All of the test results were compared with Diprivan®1% as a positive standard. ...

Propofol is ideal for bronchoscopy sedation because of its fast onset and quick recovery effect. Our research and reports from different investigators demonstrate that patients received propofol sedation recover fast with excellent satisfaction for bronchoscopy. However, the amount of propofol for induction and maintenance is calculated simply by patients body weight and physicians experience. For those non-anesthesiologists, who perform sedative work outside the operating room, and inexperienced anesthesiologist without fully considering the individual pharmacokinetic and pharmacodynamic differences may generate unstable drug plasma concentration and increase cardio-respiration suppression. Therefore, a manner which can assess and measure objectively individual pharmacokinetic differences may improve the sedative quality and decrease the complication rate.. A model called Target-controlled infusion(TCI), built from massive pharmacokinetic samples of propofol, could now give precise ...

Background:Endoscopic retrograde cholangiopancreatography ERCP is a painful and long procedure requiring transient deep analgesia and conscious sedation. An ideal anaesthetic that guarantees a rapid and smooth induction, good quality of maintenance, lack of adverse effects and rapid recovery is still lacking.This study aimed to compare safety and efficacy of a continuous infusion of low dose remifentanil plus ketamine combined with propofol in comparison to the standard regimen dose of remifentanil plus propofol continuous infusion during ERCP.Material/Methods:322 ASAI-III patients, 18-85 years old and scheduled for planned ERCP were randomized. Exclusion criteria were a predictable difficult airway, drug allergy, and ASA IV-V patients.We evaluated Propofol 1 mg/kg/h plus Remifentanil 0.25 µg/kg/min (GR) vs. Propofol 1 mg/kg/h plus Ketamine 5 µg/kg/min and Remifentanil 0.1 µg/kg/min (GK).Main outcome measures were respiratory depression, nausea/vomiting, quality of intraoperative conditions, and

Introduction: less invasive surfactant administration (LISA) limits tracheal invasive ventilation in premature infants but adequate premedication which preserves respiratory function needs to be evaluated. The aim of this study was to compare the efficacy and tolerance of intravenous administration of ketamine or propofol. Methods: we retrospectively included premature infants with respiratory distress syndrome below 30 weeks of gestational age (wGA), hospitalised in the neonatal intensive care unit of Montpellier treated with LISA procedure. -Primary outcome: comparison of the intubation rate within 2 hours following intravenous ketamine versus propofol administration. -Secondary outcomes: intubation rate within 24 and 72hours, pain scores, haemodynamic tolerance and morbi-mortality. Results: 77 infants were included from January 2016 to February 2019, with a mean (SD) wGA and birth weight of 27 (1.4) and 990 (265) g. LISA in ketamine and propofol group was performed at (70(95) vs 62(97) min; p=0

Anesthesia is the procedure to ensure the absence of pain, the inhibition of autonomic reactions and a good surgical. Today, most anesthetic procedures involve the combination of different drugs, using anesthetics at considerably lower concentrations if compared to those that would be needed if they were used without association; modern anesthetic techniques typically involve the association of hypnotics, analgesics, and muscle relaxants [1].. The use of barbiturates as intravenous anesthetics have been tested in the last 70 years; among these, propofol (2,6-diisopropylphenol) was introduced clinically in 1977 and demonstrates many positive effects [2]. Because of its unique pharmacological properties [3], it is an anesthetic drug used in the induction and maintenance of anesthesia in adults, being popular for providing an easy induction and recovery is faster than other drugs, such as thiopental [4]. Sedation with propofol does not provide relief from pain, however it provides anxiolysis, ...

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Brain Derived Neurotrophic Factor (BDNF) is a brain protein implicated in learning, memory and other cognitive functions. Changes in cellular brain functions as well as cognitive defects have been observed the days following anaesthesia, even for short-duration anaesthesia with/without surgery. Despites the role of neurotrophic factors in cognition, no data are still available on brain effects after anaesthesia. Purpose: To study the effect of minor surgery under short duration anaesthesia on cognition by investigating BDNF levels in plasma, hippocampus and cortex. METHODS: Male rats received an intra-peritoneal injection of either 120 mg/kg of propofol or intralipids solution or minor surgery was performed under propofol anaesthesia. The animals were euthanized at ZT5 (peak of the circadian profile of brain BDNF in rat) after 3 days and brain homogenates of prefrontal Cortex and Hippocampus were prepared and blood was also collected for plasma. The amount of BDNF was assessed using ELISA (Millipore) on

The intravenous sedation with propofol is very useful for patients with mental retardation and challenging behavior. However, it is very difficult to titrate the dose of propofol for maintaining the adequate sedation depth because of the difficulty of verbal communication with them. Most of them have a epilepsy and take antiepileptic drugs. Antiepileptic drugs are thought to influence on the effect of anesthetics. Valproate is reported to inhibit the metabolism of propofol. Therefore, we divide the patients into two groups : patients receiving valproate (valproate group), patients receiving no antiepileptic drugs (control group), and compare the required dose of propofol and the recovery time ...

BACKGROUND: Subclinical doses of propofol produce anterograde amnesia, characterized by an early failure of memory consolidation. It is unknown how propofol affects the amygdala-dependent emotional memory system, which modulates consolidation in the hippocampus in response to emotional arousal and neurohumoral stress. We present an event-related functional magnetic resonance imaging study of the effects of propofol on the emotional memory system in human subjects.. METHODS: Thirty-five healthy subjects were randomized to receive propofol, at an estimated brain concentration of 0.90 μg ml(-1), or placebo. During drug infusion, emotionally arousing and neutral images were presented in a continuous recognition task, while blood-oxygen-level-dependent activation responses were acquired. After a drug-free interval of 2 h, subsequent memory for successfully encoded items was assessed. Imaging analysis was performed using statistical parametric mapping and behavioural analysis using signal detection ...

On the morning Jackson died, Murray tried to induce sleep without using propofol, according to the affidavit. He said he gave Jackson valium at 1:30 a.m. When that didnt work, he said, he injected lorazepam intravenously at 2 a.m. At 3 a.m., when Jackson was still awake, Murray administered midazolam. Over the next few hours, Murray said he gave Jackson various drugs. Then at 10:40 a.m., Murray administered 25 milligrams of propofol after Jackson repeatedly demanded the drug, according to the court records. Although Murray acknowledged to police that he administered propofol, authorities said they could find no evidence that he had purchased, ordered or obtained the medication under his medical license or Drug Enforcement Administration tracking number. However, police detectives saw about eight bottles of propofol in the house along with other vials and pills that had been prescribed to Jackson by Dr. Murray, Dr. Arnold Klein and Dr. Allan Metzger. Other drugs that were confiscated in the ...

On the morning Jackson died, Murray tried to induce sleep without using propofol, according to the affidavit. He said he gave Jackson valium at 1:30 a.m. When that didnt work, he said, he injected lorazepam intravenously at 2 a.m. At 3 a.m., when Jackson was still awake, Murray administered midazolam. Over the next few hours, Murray said he gave Jackson various drugs. Then at 10:40 a.m., Murray administered 25 milligrams of propofol after Jackson repeatedly demanded the drug, according to the court records. Although Murray acknowledged to police that he administered propofol, authorities said they could find no evidence that he had purchased, ordered or obtained the medication under his medical license or Drug Enforcement Administration tracking number. However, police detectives saw about eight bottles of propofol in the house along with other vials and pills that had been prescribed to Jackson by Dr. Murray, Dr. Arnold Klein and Dr. Allan Metzger. Other drugs that were confiscated in the ...

Background: Propofol is known to interact with the γ-aminobutyric acidA (GABAA) receptor, however, activating the receptor alone is not sufficient for producing anaesthesia. Propofol tyresine phosphorylates the GABAA receptor and reorganises the actin cytoskeleton, eausing ring structures and rnembrane ruffles. Propofol, but not GABA, the endogenous tigand for the GABAA receptor, tyresine phosphorylates actin, both in the membrane and cytoskeletal fractions of the neuron.. Aim: How does propofol cause the actin reorganisation and is this a specific effect of propofol? Is the small membrane associated G-protein rho involved in the signal cascade towards the actin reorganisation?. Methods: Westem blotting (WB) was used to visualize tyresine phosphorylated immunoprecipitated proteins and changes in actin between the different cellularcompartments after inhibition with rho (C3 exotoxin) and rho kinase (ROK) (HA-1077) inhibitors. Fluoreseenee mireoscopy after rhodamine-phalloidin labelling of actin ...

OBJECTIVES: Propofol is an agent commonly used for procedural sedation and analgesia (PSA) in the emergency department (ED), but it can cause respiratory depression and hypotension. The combination of ketamine-propofol (K-P) is an alternative that theoretically provides a reduction in adverse events compared to propofol. The primary objective of this review was to determine if K-P has a lower frequency of adverse respiratory events in patients undergoing PSA in the ED than propofol alone. Secondary objectives were to compare the proportion of overall adverse events, sedation time, procedure time, and recovery time between K-P and propofol.. METHODS: Electronic searches of Medline, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL were conducted and reference lists were hand-searched. Randomized controlled trials (RCTs) published in English comparing the use of K-P to propofol alone for PSA in the ED were included.. RESULTS: Six RCTs were included with a combined total of 932 ...

Author: Driscoll David F, Deaconess Beth Israel, Lawrence Kenneth R, Lewis Keith, Bistrian Bruce R, Year: 1997, Abstract: The Centers for Disease Control has identified intravenous propofol, a lipid-based medication, as a cause of postoperative infections in hospitalized patients. It appears the increased risk results from poor aseptic technique in the preparation, storage and administration of extemporaneously prepared propofol infusions. An additional risk of preparing propofol injection includes glass particulate contamination when the ampule dosage form is used. The current study, therefore, examines th

We all know what happens when the drugs we use in practice become controlled substances. Were faced with more paperwork and tighter Drug Enforcement Agency restrictions in terms of access, use and logging of our drug inventory, and how we dispose of them. The DEA is considering placing propofol on Schedule IV of the Controlled Substances Act. Considering how important propofol is in veterinary practice, the AVMA has concerns about what this might mean for veterinarians. At the same time, part of the AVMAs mission is to improve human health, so we were also concerned when we saw the DEAs alarming information about the dangers of propofol when its used inappropriately. More specifically, the DEA cited research showing that 28 percent of propofol abusers die from this abuse. Thats why we recently sent a letter to the DEA expressing our understanding of DEAs scheduling of drugs with high-abuse potential, while also expressing our concerns that adding propofol as a Schedule IV controlled ...

The aim of this study was to determine whether pretreatment with alkalinised lignocaine reduced the incidence and severity of pain during propofol injection. This prospective, randomised, double-blind study included 300 adult, American Society of Anesthesiologists physcial status I to II patients undergoing elective surgery. Patients were randomly allocated to one of three groups: Group L received 0.05 ml/kg of 1% lignocaine (5 ml normal saline + 5 ml 2% lignocaine), Group A received 0.05 ml/kg alkalinised lignocaine (5 ml 2% lignocaine + 1 ml 8.4% NaHCO3 + 4 ml normal saline), and Group S, the control group, was given the same amount of normal saline (NaCl 0.9%). All drugs were given as a bolus over 20 seconds before propofol administration. A blinded researcher assessed the patients pain level using a four-point scale. The pain score [median (range)] and the incidence of pain in Group A (6%) was significantly lower than in groups L (41%) and S (88%, P ...

The effects of thiopental and propofol were comparatively evaluated about its influence on cardiovascular and respiratory parameters, blood gas, blood glucose levels, cell kinetics and recovery period in 20 rabbits of New Zealand White, adults, male and female, with weight between 3,67±0,43 Kg. After a random selection, they were shared into two groups of 10 animals, called propofol group (GP) and thiopental group (GT). For GP, general anesthesia was induced by intravenous (IV) administration of propofol (10 mg/Kg) and then began continuous infusion at an initial dose 1 mg/Kg/min, and then was adjusted as necessary to the bispectral index values vary between 65 and 75. The same method was employed for GT, using thiopental instead propofol, at the dose of 10 mg/Kg for induction followed the initial dose of 1 mg/Kg/min. Data collection of the variables of interest in both groups began 20 minutes after induction of anesthesia (M0) and new measurements were made at 15 minutes intervals for a period ...

Fospropofol (INN), often used as the disodium salt (trade name Lusedra) is an intravenous sedative-hypnotic agent. It is currently approved for use in sedation of adult patients undergoing diagnostic or therapeutic procedures such as endoscopy. Several water-soluble derivatives and prodrugs of the widely used intravenous anesthetic agent propofol have been developed, of which fospropofol has been found to be the most suitable for clinical development thus far. Purported advantages of this water-soluble chemical compound include less pain at the site of intravenous administration, less potential for hyperlipidemia with long-term administration, and less chance for bacteremia.[citation needed] Often, fospropofol is administered in conjunction with an opioid such as fentanyl.[citation needed] Fospropofol is a prodrug of propofol; it is metabolized by alkaline phosphatases to an active metabolite, propofol. Initial trial results on fospropofol pharmacokinetics were retracted by the investigators. As ...

Very interesting. I have some caveats, though. The deficiency observed in the GABA-A alpha-1 receptors of ALS patients is a logical target for therapeutic drugs. However, there are good reasons to suppose that GABA-A deficiency is not common to all ALS patients. This is why propofol works for some but not others. Still, I disagree with the claim that the effect of propofol is as short lasting as they make it out to be. Various reports from those who have tried it point to a beneficial effect (e.g., a recovery of a lost function) lasting up to a month or more. So, its certain that propofol can continue to cause the potentiation of GABA-A receptors long after the hypnotic effect is gone. What this research is showing is that it should be possible to make the potentiation permanent, which would be an enormous breakthrough ...

Aim: This study aimed to characterize the pharmacokinetics and pharmacodynamics of lipid emulsion propofol administered by a target-controlled infusion (TCI) anesthesia in pediatric surgery.. Method: Forty patients (ASA PS 1,2) aged 2-12 years were given an intravenous bolus of 2% propofol (Fresofol?, Fresenius Kabi Korea Ltd., Korea) 3 mg/kg, followed by continuous infusion at the rate of 200 mg/kg/min for variable periods. Arterial concentrations of propofol were measured at preset intervals and bispectral index (BIS) values were recorded throughout the study period. Pharmacokinetic and pharmacodynamic characteristics were evaluated using a population analysis with nonlinear mixed effects modeling.. Results: Pharmacokinetics and pharmacodynamics of propofol in children were best described by a two compartment model and inhibitory sigmoid Emax with effect-compartment model, respectively. The pharmacokinetic and pharmacodynamic models were directly connected by effect compartment. The final ...

0183;&32;Like other opioids, Narcan can be given to block and reverse the effects of an overdose of fentanyl. Unfortunately Propofol is very irritating and causes a burning pain in the arms of many people when injected. &0183;&32;These formulas are typically rich in choline and methionine, two important nutrients for the liver, along with supportive nutrients and/or what are the after effects of propofol herbals. Seven, or what are the after effects of propofol 28%, had died using the drug. Dosage for propofol, as for all licensed drugs, is governed by the FDA. If you feel that the scope is. Even then, some need to have their arms and legs restrained to.. Conclusions: We conclude that propofol functions as a reward; that patients enjoy its acute effects; and that no residual after-effects should arise. &0183;&32;Effects of Anesthesia on Elderly Patients General anesthesia does carry a higher risk for the elderly population, admits Damon Raskin, MD, a board-certified internist what and medical ...

TY - JOUR. T1 - Modulation of the GABAA receptor by propofol is independent of the gamma subunit. AU - Jones, M V. AU - Harrison, N L. AU - Pritchett, D B. AU - Hales, T G. PY - 1995/8. Y1 - 1995/8. N2 - Many anxiolytics, anticonvulsants and general anesthetics modulate gamma-aminobutyric acid type A (GABAA) receptors. The anxiolytic benzodiazepines potentiate the actions of GABA, and this only at GABAA receptors with gamma subunits. The general anesthetics both potentiate GABA and activate GABAA receptors directly, but their binding sites on the receptor are poorly defined. We examined whether the gamma 2 subunit was required for the modulation of GABAA receptors by the general anesthetic 2,6-diisopropylphenol (propofol). Using the patch-clamp technique, we recorded membrane currents from HEK293 cells transfected with human alpha 2, beta 1 and gamma 2 cDNAs and with alpha 2 and beta 1 cDNAs alone. Both forms of the receptor were activated by GABA and by propofol at low concentrations. At ...

Second, whatever the cause of pain in veins, the perception of pain is the same because of the polymodal nociceptors that transmit their information via A [Greek small letter delta] fibers [3]; to abolish the injection pain of propofol, a method that can block A [Greek small letter delta] fibers must be used. Unfortunately, we do not think that propofol at 4 [degree sign]C or 37 [degree sign]C has such an effect. So we do not think that the effect of changes in the temperature of propofol are relevant.. ...

Dosage Calculations This unit looks at drug calculations. -Maintenance (Titrated to Clinical Response): 100 mcg/kg/min to 150 mcg/kg/min IV -When an opioid is used as the primary agent, propofol maintenance rates should not be less than 50 mcg/kg/min, and care should be taken to ensure amnesia. -Safety and efficacy have not been established in patients younger than 16 years for intensive care unit (ICU) sedation of intubated, mechanically ventilated patients. Nevertheless, the exact propofol dosage in CF Dexdomitor/Ketamine/Torbutrol (Kitty Magic) Dosing. -This drug is not recommended by the manufacturer for obstetrics, including Cesarean section deliveries as it crosses the placenta, and may be associated with neonatal depression. Uses: Propofol (Propofol Injectable Emulsion) may treat, side effects, dosage, drug interactions, warnings, patient labeling, reviews, and related medications including drug comparison and health resources. 10. F. As with propofol, the ketamine infusion rate was ...

Prenatal propofol exposure induced neurotoxicity in the developing brains and led to persistent learning deficits in the offspring. Our goal was to use zebrafish to explore whether the decline in learning and memory was correlated with inhibition of neuronal growth after propofol exposure. Zebrafish embryos at 6 hours postfertilization (hpf) were exposed to control or 1, 2 or 4 μg/mL propofol until 48 hpf. Spontaneous locomotor activity and swimming behavior in response to dark‐to‐light photoperiod stimulation were studied in zebrafish larvae at 6 days postfertilization (dpf). The adaptability to repeated stimulation was used to indicate learning and memory function of larvae. Transgenic NBT line zebrafish was used to quantitate the effect of propofol on motor neuronal growth of embryos in vivo. Six dpf transgenic zebrafish larvae went through photoperiod stimulation after their neuronal length had been analyzed during the embryonic period. Our data indicate that embryonic exposure to 1, 2 ...

TY - JOUR. T1 - Propofol may increase caspase and MAPK pathways, and suppress the Akt pathway to induce apoptosis in MA‑10 mouse Leydig tumor cells. AU - Kang, Fu Chi. AU - Wang, Shu Chun. AU - So, Edmund Cheung. AU - Chang, Ming Min. AU - Wong, Kar Lok. AU - Cheng, Ka Shun. AU - Chen, Yung Chia. AU - Huang, Bu Miin. N1 - Funding Information: This work was supported by Chi Mei-NCKU hospital grant CMNCKU10705 (FCK and BMH) and Ministry of Science and Technology MOST 105-2320-B-006-028 (BMH), Taiwan, Republic of China.. PY - 2019/6. Y1 - 2019/6. N2 - In the western world, there is an increasing trend of occurrence in testicular cancer. Treatment of malignant testicular cancer is primarily combined surgery with various chemical drugs. Propofol has been frequently used as an anesthetic and sedative induction agent, which could modulate different γ-aminobutyric acid receptors in the central nervous system. Studies demonstrated that propofol activates endoplasmic reticulum stress to induce ...

title:Comparison Of haemodynamic fluctuation of intravenous Ketamine with intravenous Propofol - Fentanyl combination in short surgical procedure. Author:Madhavi S Mavani, Sudevi Desai. Keywords:Ketamine, Propofol, Fentany, Minor Surgical Procedures, Haemodynamic Fluctuation. Type:Original Article. Abstract:Background: An increasing interest in intravenous anesthetic agent has resulted from the availability of more effective intravenous agents. Objectives: Comparison of intravenous Ketamine with combination of intravenous Propofol and Fentanyl in ASA Gr. 1 patients of middle age in minor surgical procedures, To compare the haemodynamic fluctuation of intravenous Ketamine with intravenous propofol - fentanyl combination in short surgical procedure and to compare recovery and side-effective in postoperative period of intravenous Ketamine with intravenous propofol- Fentanyl combination in short surgical procedures. Methodology: This observational study includes 20 patients of ASA Grade I of either ...

title:Comparison Of haemodynamic fluctuation of intravenous Ketamine with intravenous Propofol - Fentanyl combination in short surgical procedure. Author:Madhavi S Mavani, Sudevi Desai. Keywords:Ketamine, Propofol, Fentany, Minor Surgical Procedures, Haemodynamic Fluctuation. Type:Original Article. Abstract:Background: An increasing interest in intravenous anesthetic agent has resulted from the availability of more effective intravenous agents. Objectives: Comparison of intravenous Ketamine with combination of intravenous Propofol and Fentanyl in ASA Gr. 1 patients of middle age in minor surgical procedures, To compare the haemodynamic fluctuation of intravenous Ketamine with intravenous propofol - fentanyl combination in short surgical procedure and to compare recovery and side-effective in postoperative period of intravenous Ketamine with intravenous propofol- Fentanyl combination in short surgical procedures. Methodology: This observational study includes 20 patients of ASA Grade I of either ...

General anaesthesia in pigs maintained with intravenous drugs such as propofol may cause respiratory depression. Alfaxalone gives less respiratory depression than propofol in some species. The aim of the investigation was to compare respiratory effects of propofol-ketamine-dexmedetomidine and alfaxalone-ketamine-dexmedetomidine in pigs. Sixteen pigs premedicated with ketamine 15 mg/kg and midazolam 1 mg/kg intramuscularly were anaesthetised with propofol or alfaxalone to allow endotracheal intubation, followed by propofol 8 mg/kg/h or alfaxalone 5 mg/kg/h in combination with ketamine 5 mg/kg/h and dexmedetomidine 4 µg/kg/h given as a continuous infusion for 60 min. The pigs breathed spontaneously with an FIO2 of 0.21. Oxygen saturation (SpO2), end-tidal CO2 concentration (PE′CO2), respiratory rate (fR) and inspired tidal volume (VT) were measured, and statistically compared between treatments. If the SpO2 dropped below 80% or if PE′CO2 increased above 10.0 kPa, the pigs were recorded as failing to

Some additional limitations deserve special emphasis. First, our models assume steady-state conditions. This assumption is violated whenever drug concentrations are rapidly changing (e.g. , such as after a bolus). The respiratory depression associated with bolus doses of ventilatory depressants is greater than when the same drugs are administered by infusion to similar target concentrations.39,40 Thus, the simulations involving bolus drug administration are likely to be associated with more respiratory compromise than our models predict. Second, pharmacokinetic models are associated with substantial variability. For example, using target-controlled infusions, median absolute performance errors for propofol and remifentanil alone of 25%41 and 22%42, respectively, have been reported. The median performance error of propofol in the presence of remifentanil has been reported at 49%.42 Third, some published dosing regimens did not provide weight-adjusted dosing. When conducting our simulations, we ...

This study aimed to compare dexmedetomidine and propofol, in terms of haemodynamic parameters, respiratory rates and offset times, when used for sedation in patients undergoing elective orthopaedic and surgical procedures under regional anaesthesia. This was a prospective, randomised, single-blind study where 88 patients were recruited. Patients were randomised into two groups to receive either dexmedetomidine or propofol infusion. Central neuraxial blockade (spinal, epidural or combined spinal epidural) was performed. After ensuring an adequate block and stable haemodynamic parameters, dexmedetomidine was infused 15 minutes later at 0.4 μg/kg/hr, and propofol, at a target concentration of 2.5 μg/ml. Both drugs were titrated to achieve a bispectral index score of 70 before surgery commenced. Sedation level was monitored using the bispectral index score and assessed by the Observer Assessment of Alertness Scale score. Drug infusion was adjusted to maintain bispectral index scores ranging ...

To compare the effects of sub-anaesthetic concentrations of propofol and halothane on the respiratory control system, we have studied the acute ventilatory response to isocapnic hypoxia (AHVR) in 12 adults with and without three different concentrations of propofol and halothane. Target doses for propofol were 0, 0.05, 0.1 and 0.2 of the effective plasma concentration (EC50 = 8.1 micrograms ml-1). Target doses for halothane were 0, 0.05, 0.1 and 0.2 minimum alveolar concentration (MAC = 0.77%). The doses achieved experimentally were 0.01, 0.06, 0.13 and 0.26 of the EC50 for propofol and 0, 0.05, 0.11 and 0.20 MAC for halothane. During the experiment subjects breathed via a mouthpiece from an end-tidal forcing system. End-tidal PO2 (PEO2) was held at 13.3 kPa for 5 min, and then at 6.7 kPa for 5 min. End-tidal PCO2 (PECO2) was held constant at 0.13-0.27 kPa greater than the subjects natural level throughout. The mean values for AHVR with propofol were: 12.8 (SEM 2.4) litre min-1 (0.01 EC50), 10.0 (1.9

To compare the effects of sub-anaesthetic concentrations of propofol and halothane on the respiratory control system, we have studied the acute ventilatory response to isocapnic hypoxia (AHVR) in 12 adults with and without three different concentrations of propofol and halothane. Target doses for propofol were 0, 0.05, 0.1 and 0.2 of the effective plasma concentration (EC50 = 8.1 micrograms ml-1). Target doses for halothane were 0, 0.05, 0.1 and 0.2 minimum alveolar concentration (MAC = 0.77%). The doses achieved experimentally were 0.01, 0.06, 0.13 and 0.26 of the EC50 for propofol and 0, 0.05, 0.11 and 0.20 MAC for halothane. During the experiment subjects breathed via a mouthpiece from an end-tidal forcing system. End-tidal PO2 (PEO2) was held at 13.3 kPa for 5 min, and then at 6.7 kPa for 5 min. End-tidal PCO2 (PECO2) was held constant at 0.13-0.27 kPa greater than the subjects natural level throughout. The mean values for AHVR with propofol were: 12.8 (SEM 2.4) litre min-1 (0.01 EC50), 10.0 (1.9

TY - JOUR. T1 - Potential impact of propofol immediately after motor vehicle accident on later symptoms of posttraumatic stress disorder at 6-month follow up. T2 - a retrospective cohort study. AU - Usuki, Masato. AU - Matsuoka, Yutaka. AU - Nishi, Daisuke. AU - Yonemoto, Naohiro. AU - Matsumura, Kenta. AU - Otomo, Yasuhiro. AU - Kim, Yoshiharu. AU - Kanba, Shigenobu. PY - 2012/10/28. Y1 - 2012/10/28. N2 - Introduction: Critically injured patients are at risk of developing posttraumatic stress disorder (PTSD). Propofol was recently reported to enhance fear memory consolidation retrospectively. Thus, we investigated here whether administration of propofol within 72 h of a motor vehicle accident (MVA) affects the subsequent development of PTSD symptoms.Methods: We examined data obtained from a prospective cohort study of MVA-related injured patients, admitted to the intensive care unit of a general hospital. We investigated the effect of propofol administration within 72 h of MVA on outcome. ...

TY - JOUR. T1 - Propofol for emergency department procedural sedation and analgesia. T2 - A tale of three centers. AU - Burton, John H.. AU - Miner, James R.. AU - Shipley, Eric R.. AU - Strout, Tania D.. AU - Becker, Chris. AU - Thode, Henry C.. N1 - Copyright: Copyright 2008 Elsevier B.V., All rights reserved.. PY - 2006/1. Y1 - 2006/1. N2 - Objectives: To characterize propofol procedural sedation and analgesia (PSA) encounters for a large patient population at multiple emergency department (ED) sites. The authors sought to assess the frequency of respiratory and cardiovascular events during propofol PSA within these settings. Methods: This study was a prospective, descriptive series of a consecutive sample of ED patients receiving propofol for PSA at three study sites. Patients were monitored for PSA-related events, including predefined clinically relevant cardiovascular and respiratory events. Data collection was performed during PSA with a standardized data collection sheet unique to each ...

TY - JOUR. T1 - Influence of midazolam on induction dose of propofol. AU - Kapoor, Ruchi. AU - Gopalakrishna, K.. AU - Ambareesha, M.. PY - 2009/1/1. Y1 - 2009/1/1. N2 - Patients & Methods: Fifty ASA Class 1 and 2 adult patients posted for elective surgery were randomly allocated to control and study groups with 25 patients in each groups. The control groups received 10ml of saline while the study group received 0.04mg kg-1 of midazolam diluted to 10ml of saline over one minute. Three minutes later in both the groups, general anaesthesia was induced with propofol 10mg boluses every 15 seconds till endpoint is achieved. The endpoint was defined as first lack of response to command i.e the patient is unable to lift the hand when asked to do so. The dose at which end is achieved is noted. The results were analysed by chi-square test. Results: The dose of propofol required for induction in control group was 2.23mg Kg-1 compared to study group which required 1.3mg kg -1. Thus a 42% reduction in ...

Enting et al. are to be congratulated for their report of a possible thiopental infusion syndrome with similar clinical characteristics to the syndrome we recently reported (1). Unfortunately, their patient succumbed to multisystem organ failure. In our case of cardiogenic shock associated with large-dose propofol infusion, the patient survived after institution of extracorporeal circulation and termination of the propofol infusion (1). This syndrome has not been reported in association with thiopental.. As these authors noted, the propofol infusion syndrome has been extensively reviewed in children and adults (2-14). Although the associations of this syndrome have been described, the exact pathogenesis remains to be determined. There is the possibility that this syndrome may be attributable not only to propofol but also to pentothal. Indeed, this syndrome has been described previously in the setting of status epilepticus (15,16). The possibility exists that this syndrome in status epilepticus ...

Background : Patient safety during sedation for closed rhizotomies is improved when analgesia is optimised, rather than relying on deep sedation for patient comfort. This retrospective study determined the appropriate effect-site concentration (Ce) for alfentanil, in combination with a constant propofol infusion, for optimal pain control during sedation for closed rhizotomies. Airway maintenance is ensured by keeping patients responsive to verbal commands, albeit at the price of inevitable ventilatory depression. Method : The records of patients who received rhizotomies over a six-month period were studied retrospectively. Sixty-three outpatients were included. Patients rated the level of analgesia with each needle placement. If the Ce for alfentanil was adequate, it was kept constant. Otherwise, it was increased in 5 ng/ml increments with each needle placement until analgesia was effective, or up to the maximum Ce for alfentanil of 100 ng/ml. Propofol infusion at a constant Ce of 200 ng/ml was added.

Nurse-administered propofol sedation for gastrointestinal endoscopic procedures: first Nordic results from implementation of a structured training ...

Movie buffs and science fiction fans certainly remember HAL, the computer in 1968s hit movie 2001: A Space Odyssey. Considered one of the greatest villains in film history, HAL was capable of reasoning and language processing to assist the astronauts on their space mission. Ultimately, however, HAL decided that its best course of action was to kill all the astronauts. I am putting myself to the fullest possible use, said HAL, which is all I think that any conscious entity can ever hope to do.. Forty-five years later, the FDA in its wisdom has given premarket approval to the Sedasys® Computer-Assisted Personalized Sedation System, developed by Ethicon Endo-Surgery Inc. The device has the potential to redefine sedation delivery, according to Ethicons press release, with propofol sedation personalized to the needs of each patient, by precisely integrating drug delivery and comprehensive patient monitoring. The Sedasys device is designed for healthy adult patients who undergo ...

In opening statements, prosecutors said that Dr. Murray was an incompetent physician who improperly used a dangerous anesthetic called propofol to help Jackson sleep and that this misuse ultimately caused Jacksons death.. The defense countered by arguing that Jackson took several pills of the sedative lorazepam on the morning of his death which would be enough to put six people to sleep. They further argued that Jackson then took a self-administered dose of propofol. This final dose, the defense explained, killed Jackson instantly. The defense argued that Jackson accidently killed himself after Doctor Murray refused to administer any more propofol to Jackson for his sleep disorders. They explained that Murray had been attempting to wean Jackson off of propofol by administering other sleep aids (benzodiazepines) to him. Jackson did not want to change the drugs he was taking and therefore began administering the drugs to himself which caused his death.. The defense said, What we will hear is ...

Complex regional pain syndrome (CRPS) is related to microcirculation impairment caused by tissue hypoxia and peripheral cytokine overproduction in the affected human limb and chronic post-ischemic pain (CPIP) is considered as an animal model for this intractable disease. Previous studies suggest that the pathogenesis of CPIP involves the hypoxia inducible factor-1α (HIF-1α) and an exaggerated regional inflammatory and free radical response. The inhibition of HIF-1α is known to relieve CPIP. So, propofol, as a free radical scavenger, is very likely to be beneficial in terms of relieving CPIP. We set up a CPIP model using the hindpaw of mice. We administered propofol (10 mg/kg) just after the reperfusion period (early stage) and also on the second day (late stage), as treatment. The analysis evaluated the expression of HIF-1α, free radicals, and inflammasome. Propofol administration produced obvious analgesia in both mechanical and thermal evaluation in the early stage of CPIP (2 h after reperfusion).

The mechanisms underlying anesthesia-induced loss of consciousness remain a matter of debate. Recent electrophysiological reports suggest that while initial propofol infusion provokes an increase in fast rhythms (from beta to gamma range), slow activity (from delta to alpha range) rises selectively during loss of consciousness. Dynamic causal modeling was used to investigate the neural mechanisms mediating these changes in spectral power in humans. We analyzed source-reconstructed data from frontal and parietal cortices during normal wakefulness, propofol-induced mild sedation, and loss of consciousness. Bayesian model selection revealed that the best model for explaining spectral changes across the three states involved changes in corticothalamic interactions. Compared with wakefulness, mild sedation was accounted for by an increase in thalamic excitability, which did not further increase during loss of consciousness. In contrast, loss of consciousness per se was accompanied by a decrease in ...

Yet another drugmaker has agreed to settle a large backload of product liability lawsuits. In the latest instance, Teva Pharmaceutical will pay more than $250 million to settle more than 80 lawsuits alleging the drugmaker intentionally sold its Propofol anesthetic in vials that were large enough to be reused by doctors, but led some colonoscopy patients to develop hepatitis C, Bloomberg News reports.. The deal also resolves a May 2010 case that prompted a jury award of more than $500 million in punitive damages and $5 million in compensatory damages against the Israeli drugmaker, according to the news service, citing sources and a filing with the Nevada Supreme Court. A private school principal charged the sedative lacked appropriate warnings and large vials should not have provided to doctors (back story).. So far, Teva has settled about 120 Propofol lawsuits and reserved $270 million for the litigation, according to a filing with the US Securities and Exchange Commission (see page 39). A Teva ...

Propofol is one of the most commonly used anesthetics in the world, but much remains unknown about the mechanisms by which it induces loss of consciousness. In this resting-state functional magnetic resonance imaging study, we examined qualitative and quantitative changes of resting-state networks (RSNs), total brain connectivity, and mean oscillation frequencies of the regional blood oxygenation level-dependent (BOLD) signal, associated with propofol-induced mild sedation and loss of responsiveness in healthy subjects. We found that detectability of RSNs diminished significantly with loss of responsiveness, and total brain connectivity decreased strongly in the frontal cortex, which was associated with increased mean oscillation frequencies of the BOLD signal. Our results suggest a pivotal role of the frontal cortex in propofol-induced loss of responsiveness.

BACKGROUND: For decades thiopental has been considered as the hypnotic drug of choice for intracranial surgery. However, total intravenous anesthesia performed with thiopental is associated with delayed recovery, whereas early post-operative neurological evaluation is critical. For this reason, target controlled infusion (TCI) of propofol is increasingly used for maintenance of anesthesia. However, a thiopental TCI has never been assessed for this purpose. We tested the hypothesis that a thiopental TCI provides an acceptable way to achieve early recovery compared to a propofol TCI during supratentorial surgery ...

Combinations of medetomidine with either propofol or ketamine were compared for the sedation and induction of anaesthesia in dogs undergoing a variety of surgical (60 per cent) and non.surgical (40 per cent) procedures. Eighty.four dogs were used at four sites. Medetomidine was administered intramuscularly at a dose of 1000 μg/m2 body surface area 10 to 15 minutes before the induction of anaesthesia by the administration of propofol (n = 44) or ketamine (n = 40) dosed to effect. The dogs became sedated by medetomidine after a mean (sd) time of 6.7 (5.4) minutes, and their heart rates and respiration rates decreased. Sixteen of the dogs suffered an adverse effect, 13 of them vomited. Anaesthesia was induced by the intravenous administration of propofol (2.1 [0.7] mg/kg) or ketamine (3.7 [1.9] mg/kg), and further doses of the anaesthetic were given, depending on the length of the operation, once in 17 per cent, twice in 11 per cent and three or more times in 24 per cent of the cases. The heart ...

Actavis documents ANDA to advertise Propofol Injection Actavis, Inc. today confirmed that it has filed an Abbreviated New Drug Program with the U priligy online .S. Food and Medication Administration seeking authorization to market Propofol Injection 10mg/mL. Fresenius Kabi USA, On June 6 LLC filed suit against Actavis, 2013, in the U.S. District Courtroom for the District of Delaware seeking to prevent Actavis from commercializing its ANDA item before the expiration of certain U.S. Patents. Related StoriesMylan announces U.S. Release of generic AXERT tabletsMylan announces U.S.S.. It is not recommended to scrub the affected section of the skin as it could aggravate the problem. If nothing seems to work, it is advisable to visit a dermatologist and seek medical assistance. There are numerous medications to cure the nagging problem of acne. The antibiotics as well as retinoids are of help in treating acne on the hands. So far as the medicines are concerned, there are oral and topical formulations ...

Headache is a common and frequently disabling clinical disorder that accounts for nearly 2% of all emergency department presentations. Often patients are experiencing a headache that is not responding to commonly available medications. However, there is no good evidence to support which available hospital medications consistently offer effective pain relief to individuals with these types of refractory headache. Understandably this is a challenging scenario in the emergency department setting for both the patient and physician that often leads to inadequate or unsatisfactory symptom relief.. In a few small trials, there has been promising evidence that the medication propofol is potentially an effective, safe and quick treatment alternative for stubborn headaches. It is important to note that propofol is not a new medication and is routinely used on a daily basis throughout hospitals for both general anaesthesia and procedural sedation.. It is the intention of this research project to ...

Prior multicenter clinical studies have confirmed propofol as a fast-acting anesthetic agent, with a favorable recovery and safety profile [1, 3]. The single-use formulations of this drug, however, do not allow multiple withdrawals for more than six hours from first penetration which can result in wastage of the unused drug. The purpose of this study was to demonstrate the safety and efficacy of MDP under a wide range of clinical circumstances. Results of this study suggest that the addition of benzyl alcohol to the formulation of the sterile injectable has the potential to reduce wastage by allowing a shelf-life of up to 28 days after the initial withdrawal/needle penetration without altering the safety or efficacy of the preparation. While direct comparisons cannot be made in the absence of control groups in which preservative-free propofol was used, results of dosing and prevalence of side effects can be compared to those from published studies on single-use propofol.. The population in this ...

Propofol prevents electroconvulsive-shock-induced memory impairment through regulation of hippocampal synaptic plasticity in a rat model of depression Jie Luo, Su Min, Ke Wei, Jun Cao, Bin Wang, Ping Li, Jun Dong, Yuanyuan Liu Department of Anesthesiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China Background: Although a rapid and efficient psychiatric treatment, electroconvulsive therapy (ECT) induces memory impairment. Modified ECT requires anesthesia for safety purposes. Although traditionally found to exert amnesic effects in general anesthesia, which is an inherent part of modified ECT, some anesthetics have been found to protect against ECT-induced cognitive impairment. However, the mechanisms remain unclear. We investigated the effects of propofol (2,6-diisopropylphenol) on memory in depressed rats undergoing electroconvulsive shock (ECS), the analog of ECT in animals, under anesthesia as well as its mechanisms.Methods: Chronic

The American Veterinary Medical Association reported today that it sent a letter to the Drug Enforcement Agency offering guidance on the DEAs proposal of designating propofol as a Schedule IV drug under the Controlled Substances Act. The DEA issued the proposal in late October based on reports it received concerning the increased abuse of propofol and that the abuse potential is comparable to other Schedule IV substances. Propofol abuse also has a high …

BACKGROUND. Differentiating drug-related changes and state-related changes on the electroencephalogram during anesthetic-induced unconsciousness has remained a challenge. To distinguish these, we designed a rigorous experimental protocol with two drugs known to have distinct molecular mechanisms of action. We hypothesized that drug- and state-related changes can be separated.. METHODS: Forty-seven healthy participants were randomized to receive dexmedetomidine (n = 23) or propofol (n = 24) as target-controlled infusions until loss of responsiveness. Then, an attempt was made to arouse the participant to regain responsiveness while keeping the drug infusion constant. Finally, the concentration was increased 1.5-fold to achieve presumable loss of consciousness. We conducted statistical comparisons between the drugs and different states of consciousness for spectral bandwidths, and observed how drug-induced electroencephalogram patterns reversed upon awakening. Cross-frequency coupling was also ...

In the present study, we investigated the influence of etomidate and propofol on haemodynamics in patients who underwent ERCP. The results showed that etomidate anesthesia during ERCP caused more stable haemodynamic responses compared with propofol.. In our endoscopy center, as a rule, the patients underwent ERCP in the prone position without tracheal intubation. It is known that the prone position may lead to inhibition of breathing because of airway obstruction. To reduce the incidence of respiratory depression caused by opioid agents, patients received pethidine pretreatment (100mg i.m.) instead of intravenous opioids. The absorption of intramuscular injection of drugs may be irregular and a confounding factor to the hemodynamic stability. Patients in both groups received pethidine pretreatment, therefore, the analgesia level could be comparable between two groups. In the present study, no patient experienced desaturation or apnoea, and the incidence of respiratory depression was much lower ...

Definition of intravenous anesthetic in the Definitions.net dictionary. Meaning of intravenous anesthetic. What does intravenous anesthetic mean? Information and translations of intravenous anesthetic in the most comprehensive dictionary definitions resource on the web.

To explore the effects of propofol post-conditioning (PPC) on hepatic ischaemia/reperfusion injury (HIRI) and the potential mechanisms that might be involved in the interaction of Brahma-related gene1(BRG1) and Nuclear-related factor 2(Nrf2). Patients were randomized into PPC(n = 16) and non-PPC(NPC)( n = 21) groups. Propofol(2 mg/kg) was infused within 10 min. of the onset of liver reperfusion during liver transplantation in the PPC group. Liver function tests, as well as Brg1, Nrf2, Heme oxygenase-1(HO-1) and NADPH:quinone oxidoreductase1(NQO1) expression levels were evaluated. CMV-Brg1 mice were designed to investigate the role of Brg1 overexpression during HIRI. Brg1 and Nrf2 siRNA were used to examine the relationship between Brg1 and Nrf2/HO-1 pathways in propofol-mediated effects in a human hepatocyte(L02) hypoxia/reoxygenation(H/R) model. In patients, PPC attenuated both donor liver pathological and function injury, and reducing oxidative stress markers, compared to the NPC group, 24 hrs ...

Autism Spectrum Disorder - NIMH - NIH www.nimh.nih.gov › health › autism-spectrum-disorder. Pathophysiology of autism spectrum disorders: Revisiting gastrointestinal involvement and immune imbalance Mohtashem Samsam, Raheleh Ahangari, and Saleh A NaserWorld J Gastroenterol. 2014 Aug 7; 20(29): 9942-9951. Published online 2014 Aug 7. doi: 10.3748/wjg.v20.i29.9942. Age-Dependent Changes in the Propofol-Induced Electroencephalogram in Children With Autism Spectrum Disorder Elisa C. Walsh Johanna M. Lee1 Front. Syst. Neurosci., 22 June 2018 ,. Eliez S, Reiss AL 2000 MRI neuroimaging of childhood psychiatric disorders: a selective review. J Child Psychol Psychiatry 41: 679-694. Sury MR, Smith JH. Deep sedation and minimal anesthesia. Paediatr Anaesth 2008; 18: 18 - 24. Krauss B, Green SM. Sedation and analgesia for procedures in children. N Engl J Med 2000; 342: 938 -45. Wakasugi M, Hirota K, Roth SH, Ito Y. the effects of general anesthetics on excitatory and inhibitory synaptic transmission in ...

Emergency physicians routinely perform emergency department procedural sedation (EDPS) with propofol and its safety is well established. However, in 2009 the Centers for Medicare and Medicaid Services (CMS) enacted guidelines defining propofol as deep sedation and requiring administration by a physician.

TY - JOUR. T1 - Propofol Modulates γ-Aminobutyric Acid-mediated Inhibitory Neurotransmission to Cardiac Vagal Neurons in the Nucleus Ambiguus. AU - Wang, Xin. AU - Huang, Zheng Gui. AU - Gold, Allison. AU - Bouairi, Evguenia. AU - Evans, Cory. AU - Andresen, Michael C.. AU - Mendelowitz, David. PY - 2004/5/1. Y1 - 2004/5/1. N2 - Background: Although it is well recognized that anesthetics modulate the central control of cardiorespiratory homeostasis, the cellular mechanisms by which anesthetics alter cardiac parasympathetic activity are poorly understood. One common site of action of anesthetics is inhibitory neurotransmission. This study investigates the effect of propofol on γ-aminobutyric acid-mediated (GABAergic) and glycinergic neurotransmission to cardiac parasympathetic neurons. Methods: Cardiac parasympathetic neurons were identified in vitro by the presence of a retrograde fluorescent tracer, and spontaneous GABAergic and glycinergic synaptic currents were examined using whole cell ...

Background. Numerous animal studies have shown that all commonly used intravenous anaesthetic drugs and volatile agents may cause neuronal apoptosis following exposure in early life. Most studies have focussed on detecting increased apoptosis but their methods are not always readily transferrable to humans.. The lipid formulation of etomidate represents an alternative to the currently established intravenous anaesthetic agents but there is no animal or human data on apoptosis or long-term behavioural changes. The aim of our study was to investigate the effects of etomidate on cerebral neuronal apoptosis and long-term behavioural effects using an established mouse model that represents the clinically relevant period of anaesthesia during early infancy in humans.. Methods. Six groups of 10 day old mice (P10) were injected with either etomidate 0.3, 3 or 10 mg/kg, propofol 60 mg/kg, ketamine 50 mg/kg or placebo only. Apoptosis in the cerebral cortex and hippocampus was assessed 24 h after treatment ...

Rocuronium Kabi is the drug of choice for muscle relaxation during rapid sequence induction because of its fast onset similar to suxamethonium. It offers flexibility in usage and patient groups, and superior safety (less histamine release, better haemodynamical stability). Rocuronium Kabi is an excellent partner for combination with our world-leading intravenous general anaesthetic propofol.. ...

No definitive outcomes study has explored whether administering a total intravenous anesthetic via TCI or with conventional continuous infusion rates impacts emergence. One might hypothesize that if administering a lengthy anesthetic, TCI would provide a more economical anesthetic and avoid unnecessary drug delivery that would perhaps delay emergence. Figure 30-1 presents a simulation of 2 intravenous techniques: one using TCI and the other set infusion rates for 2, 4, 6, and 8 hours. Both approaches used a high-dose remifentanil and low dose propofol technique. In fact the TCI target effect-site concentrations were selected to be near the effect-site concentrations that resulted from propofol infusions of 100 mcg/kg/min and remifentanil 0.2 mcg/kg/min. In general, with increasing duration of the anesthetic, the simulation predicted the time to emergence would become longer. Time to emergence was defined as the time required for the model of loss of responsiveness to predict that only 1 out of ...

Some types of anaesthetics cause an increase in the level of lactate production in unconscious childrens brains, causing delirium.. Two commonly used anaesthetics produce different metabolic patterns in the brains of children, according to a study from Anesthesiology. Researchers from Stony Brook University, New York, found the inhalant gas anaesthetic sevoflurane produced more lactate, a marker for enhanced or changed brain metabolism, compared to the intravenous anaesthetic propofol.. While past paediatric literature has reported that sevoflurane may be associated with emergence delirium, a state of consciousness in which a child is inconsolable, irritable or uncooperative, the study explored the potential association between emergence delirium and specific brain metabolites like lactate.. Applied proton magnetic resonance spectroscopy (1HMRS) was used to investigate the metabolic consequences of general anaesthesia in the brains of rodents. Findings revealed inhalant gas anaesthetic was ...

Colorectal cancer is a leading cause of cancer death in the United States (Mandel, Tanner, Lichtenstein, Metz, Katzka, Ginsberg, & Kochman, 2008; Siegel, DeSantis, & Jemal, 2014). Because this lethal disease claims lives of many people every year, more patients are undergoing screening colonoscopies, which have greatly aided in decreasing the number of colorectal cancer deaths (Siegel et al., 2014). The most common form of sedation for colonoscopies is moderate sedation with a benzodiazepine and an opioid (Cohen, Hightower, Wood, Miller, & Aisenberg, 2004; Lera dos Santos, et. al., 2013). However, sedation by anesthesia providers using propofol is becoming more common and may aid in reducing recovery and discharge times from the postoperative anesthesia care unit (PACU) as well as reducing overall costs. A retrospective chart review (N=176; 88 in propofol group and 88 in benzodiazepine and opioid group) was performed to determine if propofol sedation did reduce discharge times and decrease overall costs

Data were extracted from each manuscript. The following outcomes were identified as important before the literature search was started: (1) time from discontinuation of anesthesia until patients followed simple (i.e., hand-squeezing) commands, (2) time from discontinuation of anesthesia until patients left the first stage (i.e., higher acuity level) of recovery, (3) time from discontinuation of anesthesia until ambulatory surgery patients were discharged from the hospital, (4) group sample size, (5) duration of anesthesia, and (6) dose of volatile anesthetic. Criteria for transfer from the first to the second stage of recovery were inconsistent among studies. Therefore, times to leaving first stage were eliminated from the analysis. However, several papers comparing desflurane to propofol included time from discontinuation of anesthesia until patients sat. We therefore added this outcome to the study but did not analyze it statistically. For the comparison of desflurane to isoflurane, only one ...