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Anaesthetics - Science topic

Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general ANESTHESIA, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site.
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Hello everyone.
I am attempting to do visual cortex imaging in mice anesthetized with halothane, but the survival rate of these mice is quite low, even compared to other mice anesthetized with halothane.
I realized the batch of halothane in my lab is quite old, and I'm trying to find out if it's the reason why the mice are not surviving long enough, or whether it's viable to use. Calling the manufacturing company did not help.
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use a lower dose and ensure that breathing is unobstructed; may be better to give them a dose of i.m. ketamine instead of halothane or ip ketamine
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1. What are some of the recommended anesthetic techniques and medications for CKD patients, and how do they contribute to improved perioperative outcomes?
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Do you really need an answer to this question while you attach your article including everything about it?
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Congenital heart disease (CHD) significantly impacts anesthesia management in pediatric patients due to the complex interplay between cardiac physiology, surgical interventions, and anesthetic drugs. Anesthesia for children with CHD requires a comprehensive understanding of the underlying cardiac anatomy and physiology, as well as careful perioperative planning to optimize outcomes and minimize risks.
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Congenital heart disease (CHD) significantly impacts anesthesia management in pediatric patients due to the complex interplay between cardiac physiology, surgical interventions, and anesthetic drugs. Anesthesia for children with CHD requires a comprehensive understanding of the underlying cardiac anatomy and physiology, as well as careful perioperative planning to optimize outcomes and minimize risks. Here are some key considerations for anesthesia management in pediatric patients with CHD:
  1. Preoperative Assessment: A thorough preoperative evaluation is essential to assess the severity and complexity of the CHD, evaluate cardiac function, and identify any associated comorbidities. Detailed history-taking, physical examination, and diagnostic studies such as echocardiography and electrocardiography help guide anesthesia management decisions.
  2. Cardiac Physiology: Anesthesia providers must have a deep understanding of the underlying cardiac anatomy and physiology in children with CHD. This includes knowledge of shunt physiology, ventricular function, pulmonary vascular resistance, and hemodynamic parameters such as systemic and pulmonary pressures.
  3. Hemodynamic Monitoring: Continuous hemodynamic monitoring is critical during anesthesia for children with CHD. This may include invasive monitoring with arterial and central venous catheters to assess blood pressure, cardiac output, and central venous pressure. Non-invasive monitoring modalities such as echocardiography and pulse oximetry are also important for assessing cardiac function and oxygenation.
  4. Optimization of Cardiac Function: Anesthesia management aims to optimize cardiac function and maintain hemodynamic stability throughout the perioperative period. This may involve judicious fluid management, use of vasoactive medications to support cardiac output, and avoidance of factors that increase myocardial oxygen demand.
  5. Airway Management: Airway management in children with CHD requires careful consideration of potential anatomical abnormalities, airway obstruction, and risks of hemodynamic instability. Intubation should be performed with caution to minimize changes in intrathoracic pressure and avoid exacerbating cardiac compromise.
  6. Anesthetic Agents: Anesthetic agents should be selected based on their hemodynamic effects and potential interactions with cardiac function. Inhalational agents such as sevoflurane and intravenous agents such as propofol are commonly used for maintenance of anesthesia, while opioids and muscle relaxants should be used cautiously to avoid respiratory depression and hemodynamic effects.
  7. Temperature Management: Temperature regulation is crucial during anesthesia for children with CHD to minimize the risk of perioperative hypothermia, which can exacerbate hemodynamic instability and increase the risk of adverse cardiac events.
  8. Postoperative Care: Close monitoring in the postoperative period is essential for early detection of complications such as arrhythmias, myocardial dysfunction, and inadequate cardiac output. Continuous hemodynamic monitoring and frequent reassessment of cardiac function are important for optimizing postoperative care and facilitating early intervention if necessary.
  9. Multidisciplinary Approach: Anesthesia management for children with CHD requires close collaboration among anesthesia providers, pediatric cardiologists, cardiac surgeons, and critical care specialists. Multidisciplinary teams with expertise in pediatric cardiac anesthesia and critical care ensure comprehensive care and optimal outcomes for these complex patients.
By addressing these considerations and implementing evidence-based practices, anesthesia providers can optimize perioperative care and outcomes for pediatric patients with CHD undergoing surgical procedures. Individualized anesthesia plans tailored to the specific needs of each patient are essential for ensuring safe and effective care for this vulnerable population.
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The anesthesia circle breathing system operates on the principle of delivering a controlled mixture of gases, usually oxygen and a volatile anesthetic agent, to the patient while minimizing waste and ensuring patient safety.
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The anesthesia circle breathing system operates on the principle of delivering a controlled mixture of gases, usually oxygen and a volatile anesthetic agent, to the patient while minimizing waste and ensuring patient safety. Here's how it typically works:
  1. Gas Delivery: The anesthesia machine supplies medical gases, typically oxygen and air, to the breathing circuit. The oxygen may be supplemented with other gases as needed for the specific procedure.
  2. Vaporization of Anesthetic: If a volatile anesthetic agent, such as isoflurane or sevoflurane, is being used, it is vaporized using a vaporizer within the anesthesia machine. The vaporizer ensures that the concentration of the anesthetic agent in the gas mixture is precisely controlled according to the patient's needs.
  3. Gas Mixture Delivery to the Patient: The blended gases, including the vaporized anesthetic agent, are delivered to the patient through the breathing circuit. The patient breathes in this mixture via a face mask, endotracheal tube, or other airway device, inducing and maintaining anesthesia.
  4. Exhalation and CO2 Absorption: As the patient exhales, the exhaled gases, including carbon dioxide (CO2), are returned to the anesthesia machine via the breathing circuit. The exhaled gases pass through a CO2 absorbent canister, where the CO2 is removed, ensuring that the patient does not rebreathe excessive CO2.
  5. Re-circulation and Conservation: After CO2 removal, the exhaled gases, now consisting primarily of oxygen and the anesthetic agent, are reintroduced into the breathing circuit. This closed-loop system allows for the efficient re-circulation of gases, conserving anesthetic agents and minimizing waste.
  6. Scavenging of Excess Gases: Any excess gases that are not inhaled by the patient are removed from the system through a scavenging system. This prevents the buildup of anesthetic gases in the operating room, reducing the risk of exposure to healthcare providers and other individuals.
  7. Continuous Monitoring and Adjustment: Throughout the procedure, the anesthesia provider monitors the patient's vital signs and adjusts the flow rates and concentrations of gases as necessary to maintain anesthesia depth and ensure patient safety.
Overall, the anesthesia circle breathing system provides a controlled and efficient method for delivering anesthesia during surgical and medical procedures, while also minimizing environmental impact and ensuring the well-being of both patients and healthcare providers.
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Uterine rupture is a rare but serious obstetric complication characterized by the tearing of the uterine wall, often leading to life-threatening hemorrhage and fetal distress. The anaesthetic management of uterine rupture requires prompt recognition, aggressive resuscitation, and timely intervention to optimize maternal and fetal outcomes.
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Uterine rupture is a rare but serious obstetric complication characterized by the tearing of the uterine wall, often leading to life-threatening hemorrhage and fetal distress. The anaesthetic management of uterine rupture requires prompt recognition, aggressive resuscitation, and timely intervention to optimize maternal and fetal outcomes. Here's an outline of the anaesthetic management:
  1. Preoperative Assessment:Obtain a detailed obstetric history, including any previous uterine surgeries (e.g., cesarean section, myomectomy) or uterine scar formation (e.g., previous uterine rupture). Evaluate the gestational age, fetal status, and maternal comorbidities. Assess for signs and symptoms of uterine rupture, including sudden abdominal pain, vaginal bleeding, fetal distress, and maternal hemodynamic instability. Review any relevant imaging studies (e.g., ultrasound) to assess fetal well-being and confirm the diagnosis of uterine rupture.
  2. Emergency Resuscitation:Initiate immediate resuscitative measures, including supplemental oxygen administration, establishment of large-bore intravenous access, and aggressive fluid resuscitation with crystalloids or blood products as needed. Monitor maternal vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation, continuously to assess hemodynamic stability and response to resuscitation efforts.
  3. Choice of Anaesthesia:General anaesthesia is usually indicated for emergency cesarean section in cases of uterine rupture, as it allows for rapid maternal airway control and delivery of the baby. Neuraxial anaesthesia (spinal or epidural) may be considered if the patient is stable and there is no evidence of maternal or fetal compromise, although it may not be appropriate in the setting of severe hemorrhage or fetal distress.
  4. Intraoperative Management: General Anaesthesia:Use rapid sequence induction (RSI) technique to minimize the risk of aspiration and ensure rapid maternal airway control. Administer induction agents and neuromuscular blocking agents cautiously, considering maternal hemodynamics and potential for hemorrhage. Ensure rapid sequence intubation with gentle airway manipulation to minimize the risk of bleeding and ensure adequate oxygenation and ventilation. Neuraxial Anaesthesia:Neuraxial anaesthesia may be considered if the patient is stable and there is no evidence of maternal or fetal compromise, as it provides effective surgical anaesthesia with minimal maternal and fetal effects. Use a lower sensory block height to avoid sympathetic blockade and maintain maternal blood pressure. Monitor maternal vital signs, uterine tone, and fetal heart rate continuously throughout the procedure to assess maternal and fetal well-being and detect signs of worsening uterine rupture or fetal distress.
  5. Surgical Intervention:Perform emergency cesarean section promptly to deliver the baby and address the source of hemorrhage. Minimize uterine manipulation and avoid excessive traction on the uterus to reduce the risk of further uterine injury and hemorrhage. Consider the use of uterotonics (e.g., oxytocin, prostaglandins) to promote uterine contraction and control postpartum hemorrhage.
  6. Postoperative Care:Monitor the mother closely in the immediate postoperative period for signs of bleeding, hemodynamic instability, and other complications. Provide appropriate pain management while considering the risk of respiratory depression and maternal-fetal effects of analgesic medications. Monitor the newborn for signs of neonatal depression, respiratory distress, and other complications requiring intervention or observation.
  7. Multidisciplinary Collaboration:Collaborate closely with obstetricians, maternal-fetal medicine specialists, neonatologists, and other members of the healthcare team to coordinate care and optimize outcomes for both mother and baby. Communicate effectively regarding the maternal condition, anaesthetic plan, and perioperative management strategies to ensure a comprehensive and integrated approach to care.
By following these principles and strategies, healthcare providers can effectively manage the anaesthetic care of patients with uterine rupture, optimizing maternal and fetal outcomes while addressing the unique challenges associated with this obstetric emergency.
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Describe strategies for minimizing fetal exposure to anaesthetic agents and optimizing fetal well-being during obstetric anaesthesia.
Minimizing fetal exposure to anaesthetic agents and optimizing fetal well-being during obstetric anaesthesia requires careful planning, monitoring, and intervention.
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Minimizing fetal exposure to anaesthetic agents and optimizing fetal well-being during obstetric anaesthesia requires careful planning, monitoring, and intervention. Here are strategies to achieve these goals:
  1. Preoperative Assessment and Planning:Conduct a thorough preoperative assessment of the pregnant patient, including obstetric history, gestational age, fetal well-being, and maternal medical conditions. Review medications and allergies to minimize the risk of adverse drug reactions or interactions. Consider the urgency of the procedure and maternal-fetal status when selecting the appropriate anaesthesia technique. Discuss anaesthetic options, risks, and benefits with the patient, involving shared decision-making in the choice of anaesthesia technique.
  2. Optimizing Maternal Physiology:Ensure adequate maternal hydration and positioning to optimize maternal hemodynamics and uteroplacental perfusion. Administer intravenous fluids judiciously to maintain maternal preload and prevent hypotension during neuraxial anaesthesia. Consider prophylactic vasopressor administration (e.g., phenylephrine) to counteract neuraxial-induced hypotension and maintain maternal blood pressure.
  3. Minimizing Fetal Exposure to Anaesthetic Agents:Use regional anaesthesia techniques (spinal or epidural) whenever feasible for both labour analgesia and cesarean section to minimize fetal exposure to systemic medications. Limit the use of systemic medications with high placental transfer and potential for fetal depression (e.g., opioids, sedatives) to cases where neuraxial anaesthesia is contraindicated or unavailable. Use the lowest effective dose of medications and avoid unnecessary drug administration to minimize fetal exposure and adverse effects.
  4. Continuous Monitoring of Maternal and Fetal Parameters:Continuously monitor maternal vital signs, including blood pressure, heart rate, and oxygen saturation, throughout the perioperative period. Utilize continuous electronic fetal heart rate monitoring during labour and cesarean section to assess fetal well-being and detect signs of fetal distress. Maintain vigilant surveillance for nonreassuring fetal heart rate patterns or other signs of fetal compromise, prompting timely intervention to optimize fetal oxygenation and perfusion.
  5. Optimizing Maternal Oxygenation:Ensure adequate preoxygenation and ventilation during intubation and general anaesthesia induction to minimize maternal and fetal hypoxia. Consider the use of high-flow nasal oxygenation or noninvasive ventilation techniques to optimize maternal oxygenation and prevent maternal hypoxemia.
  6. Postoperative Monitoring and Neonatal Care:Provide appropriate postoperative monitoring and care for both the mother and newborn, including assessment of maternal recovery, pain management, and neonatal respiratory status. Implement neonatal resuscitation protocols as needed to manage neonatal depression or respiratory distress, ensuring prompt recognition and intervention to optimize neonatal outcomes.
  7. Communication and Collaboration:Foster effective communication and collaboration among obstetricians, anaesthesiologists, neonatologists, and other members of the healthcare team to coordinate care and optimize outcomes for both mother and baby. Discuss management plans and contingency measures for potential complications, ensuring readiness to address emergent situations promptly and effectively.
By implementing these strategies, healthcare providers can minimize fetal exposure to anaesthetic agents and optimize fetal well-being during obstetric anaesthesia, ensuring the safest possible outcomes for both mother and baby.
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Describe the anaesthetic considerations for elective and emergency cesarean section deliveries. Anaesthetic considerations for elective and emergency cesarean section deliveries involve careful planning, assessment, and management to ensure maternal and fetal safety during the procedure.
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Anaesthetic considerations for elective and emergency cesarean section deliveries involve careful planning, assessment, and management to ensure maternal and fetal safety during the procedure. Here's a comprehensive overview:
  1. Preoperative Assessment:Obtain a detailed medical history, including any pre-existing medical conditions, allergies, previous surgeries, and obstetric history. Assess airway status, including predictors of difficult intubation or mask ventilation (e.g., Mallampati score, thyromental distance). Evaluate cardiovascular function, including blood pressure, heart rate, and signs of volume status (e.g., jugular venous distention, peripheral edema). Review laboratory investigations, including coagulation profile, complete blood count, and biochemical tests as indicated. Consider the urgency of the cesarean section (elective vs. emergency) and the presence of any fetal or maternal indications for delivery.
  2. Choice of Anaesthesia: Elective Cesarean Section:Neuraxial anaesthesia, such as epidural or spinal anaesthesia, is the preferred choice for elective cesarean sections due to its rapid onset, effectiveness, and minimal impact on maternal and fetal physiology. General anaesthesia may be considered if neuraxial anaesthesia is contraindicated or unavailable, but it carries higher risks and should be reserved for specific indications. Emergency Cesarean Section:Neuraxial anaesthesia remains the preferred choice whenever feasible, as it allows for rapid induction of anaesthesia, maternal awareness, and avoidance of maternal airway manipulation. General anaesthesia may be necessary in emergent situations with limited time for neuraxial placement or in cases of maternal hemodynamic instability, failed neuraxial anaesthesia, or fetal compromise.
  3. Neuraxial Anaesthesia:Ensure adequate preoperative hydration and positioning for neuraxial anaesthesia, with left uterine displacement to prevent aortocaval compression. Perform neuraxial blockade (spinal or epidural) using aseptic technique and appropriate local anaesthetic and opioid medications. Monitor maternal vital signs, oxygen saturation, and fetal heart rate continuously during the procedure. Administer intravenous fluids judiciously to maintain maternal preload and prevent hypotension. Consider prophylactic vasopressor administration (e.g., phenylephrine infusion) to counteract neuraxial-induced hypotension, especially in patients at risk.
  4. General Anaesthesia:Preoxygenate the patient with 100% oxygen for 3-5 minutes before induction of anaesthesia to prolong the apnoea time and reduce the risk of hypoxia. Use rapid sequence induction (RSI) technique to minimize the risk of aspiration pneumonitis, including cricoid pressure application during induction. Administer induction agents (e.g., propofol, thiopental) and neuromuscular blocking agents (e.g., succinylcholine, rocuronium) based on maternal and fetal considerations. Intubate the trachea with an appropriately sized endotracheal tube, ensuring proper cuff inflation and tube fixation. Monitor maternal vital signs, end-tidal carbon dioxide, oxygen saturation, and fetal heart rate continuously throughout the procedure. Maintain anesthesia with inhalational agents and adjust depth of anesthesia based on maternal hemodynamics and surgical stimulation. Ensure proper postoperative reversal of neuromuscular blockade and extubation when appropriate.
  5. Postoperative Care:Monitor maternal vital signs, pain levels, and uterine tone in the immediate postoperative period. Provide adequate analgesia (e.g., opioids, nonsteroidal anti-inflammatory drugs) for postoperative pain relief while considering breastfeeding compatibility and neonatal effects. Assess maternal recovery, including return of motor function, sensation, and bowel function, before discharge from the recovery area. Monitor the newborn for signs of respiratory depression, neonatal adaptation syndrome, or other complications requiring intervention or observation. Ensure appropriate follow-up care for both mother and newborn, including postoperative instructions, pain management, and lactation support as needed.
By addressing these anaesthetic considerations for elective and emergency cesarean section deliveries, healthcare providers can optimize maternal and fetal outcomes while minimizing risks and complications associated with the procedure. Close communication and collaboration among obstetricians, anaesthesiologists, and other members of the healthcare team are essential for providing safe and effective anaesthesia care during cesarean sections.
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Discuss the safety and efficacy of commonly used anaesthetic agents during pregnancy, including opioids, local anaesthetics, and sedatives. During pregnancy, the safety and efficacy of commonly used anaesthetic agents, including opioids, local anaesthetics, and sedatives, are important considerations due to potential risks to both the mother and the fetus.
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During pregnancy, the safety and efficacy of commonly used anaesthetic agents, including opioids, local anaesthetics, and sedatives, are important considerations due to potential risks to both the mother and the fetus. Here's a discussion of each group of anaesthetic agents:
  1. Opioids:Safety: Opioids are generally considered safe for use during pregnancy, particularly for acute pain management or labour analgesia. However, chronic use of opioids during pregnancy may be associated with risks such as neonatal opioid withdrawal syndrome (NOWS) or respiratory depression in the newborn. Efficacy: Opioids are effective analgesics for managing moderate to severe pain during pregnancy, including labour pain, postoperative pain, and acute traumatic injuries. They provide rapid pain relief and can be administered via various routes, including intravenous, intramuscular, or neuraxial (e.g., epidural or spinal). Considerations: When using opioids during pregnancy, clinicians should carefully weigh the potential benefits of pain relief against the risks of adverse effects, such as respiratory depression, sedation, or dependence. Opioid dosages should be titrated carefully, and neonates born to mothers receiving opioids should be monitored closely for signs of withdrawal or respiratory depression.
  2. Local Anaesthetics:Safety: Local anaesthetics, such as lidocaine, bupivacaine, or ropivacaine, are generally considered safe for use during pregnancy when administered in recommended doses and with appropriate techniques. Systemic absorption of local anaesthetics from regional blocks is minimal and unlikely to cause fetal harm. Efficacy: Local anaesthetics are effective for providing regional analgesia or anaesthesia during labour, cesarean section, or other obstetric procedures. They offer targeted pain relief while preserving maternal consciousness and minimizing fetal exposure to systemic medications. Considerations: Clinicians should adhere to standard guidelines for regional anaesthesia techniques, including meticulous aseptic technique, aspiration before injection, and dose adjustment based on patient characteristics and procedure requirements. Monitoring for local anaesthetic toxicity and complications, such as inadvertent intravascular injection or neurologic injury, is essential to ensure patient safety.
  3. Sedatives:Safety: Sedatives, such as benzodiazepines (e.g., midazolam) or propofol, may be used cautiously during pregnancy for procedural sedation or anesthesia induction when indicated. However, their use should be limited to situations where the benefits outweigh potential risks to the mother and fetus. Efficacy: Sedatives can provide anxiolysis, amnesia, and sedation for pregnant patients undergoing diagnostic or therapeutic procedures, such as imaging studies, endoscopy, or minor surgeries. They help alleviate anxiety and discomfort while facilitating patient cooperation and procedural success. Considerations: The choice of sedative agent and dosage should be individualized based on patient characteristics, gestational age, procedure complexity, and maternal-fetal risks. Short-acting agents with minimal placental transfer and neonatal effects (e.g., midazolam) are preferred for procedural sedation in pregnant patients. Continuous monitoring of maternal vital signs, fetal heart rate, and oxygenation is essential during sedation to detect and manage potential complications, such as respiratory depression or hemodynamic instability.
In summary, the safety and efficacy of anaesthetic agents during pregnancy depend on careful consideration of maternal and fetal risks, dosage adjustments, and adherence to best practices for medication administration. Close collaboration between obstetricians, anaesthesiologists, and other healthcare providers is essential for optimizing pain management and anaesthesia care while ensuring maternal and fetal well-being during pregnancy.
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Discuss the anaesthetic considerations for paediatric patients with comorbidities respiratory conditions?Paediatric patients with respiratory conditions present unique challenges for anaesthesia management due to the potential for airway compromise, ventilation-perfusion abnormalities, and increased susceptibility to respiratory complications.
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Paediatric patients with respiratory conditions present unique challenges for anaesthesia management due to the potential for airway compromise, ventilation-perfusion abnormalities, and increased susceptibility to respiratory complications. Here are some key anaesthetic considerations for paediatric patients with respiratory conditions:
  1. Preoperative Assessment:Perform a thorough preoperative evaluation of the child's respiratory status, including assessment of baseline lung function, severity of respiratory disease, recent exacerbations, and current medications. Review previous respiratory investigations, such as pulmonary function tests, chest imaging, and arterial blood gas analysis, to understand the child's respiratory physiology and potential complications. Identify and address modifiable risk factors for perioperative respiratory complications, such as smoking exposure, poorly controlled asthma, or upper respiratory tract infections.
  2. Airway Management:Assess the child's airway anatomy, including the presence of anatomical abnormalities (e.g., adenotonsillar hypertrophy, craniofacial anomalies) that may predispose to airway obstruction or difficult intubation. Consider the need for awake intubation or the use of fiberoptic bronchoscopy in children with significant airway obstruction or distortion. Use appropriate airway devices and techniques to minimize airway trauma and maintain airway patency during induction, maintenance, and emergence from anaesthesia.
  3. Ventilatory Support:Optimize preoperative respiratory function through bronchodilator therapy, chest physiotherapy, and pulmonary rehabilitation as indicated. Consider the use of non-invasive ventilation techniques such as continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) for children with chronic respiratory insufficiency or obstructive sleep apnea. Ensure appropriate ventilator settings and monitoring during mechanical ventilation, taking into account the child's respiratory mechanics, gas exchange, and lung compliance.
  4. Intraoperative Management:Maintain spontaneous ventilation whenever possible to preserve respiratory drive and minimize the risk of atelectasis or ventilation-perfusion mismatch. Use low tidal volumes and limited peak airway pressures during mechanical ventilation to prevent barotrauma and minimize lung injury. Consider the use of volatile anaesthetic agents with bronchodilator properties (e.g., sevoflurane) to maintain bronchodilation and reduce the risk of bronchospasm. Monitor respiratory parameters closely, including oxygen saturation, end-tidal carbon dioxide, and respiratory rate, to detect hypoventilation, hypercapnia, or desaturation early.
  5. Postoperative Care:Provide adequate analgesia and postoperative respiratory support to minimize pain-related splinting and atelectasis. Monitor for signs of respiratory distress, such as increased work of breathing, retractions, or oxygen desaturation, in the post-anesthesia care unit (PACU). Implement postoperative respiratory therapy, incentive spirometry, and early mobilization to promote lung expansion and prevent postoperative pulmonary complications. Consider the need for prolonged observation or admission to a high-dependency unit for children at high risk of respiratory decompensation or delayed recovery.
  6. Emergency Preparedness:Anticipate and prepare for potential respiratory emergencies, such as bronchospasm, laryngospasm, or aspiration, by ensuring the availability of appropriate airway equipment, medications (e.g., bronchodilators, corticosteroids), and advanced airway management techniques. Establish a clear communication plan and designated roles for managing respiratory emergencies among anesthesia providers, nursing staff, and respiratory therapists.
In summary, anaesthetic management of paediatric patients with respiratory conditions requires careful preoperative assessment, individualized perioperative planning, and vigilant intraoperative monitoring to optimize respiratory function, minimize complications, and ensure safe and effective anaesthesia care. Close collaboration among anaesthesia providers, respiratory specialists, and surgical teams is essential for achieving optimal outcomes in this patient population.
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Discuss the anaesthetic considerations for paediatric patients with comorbidities congenital heart disease.
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Anaesthetic considerations for paediatric patients with comorbidities congenital heart diseases ,are complex and require careful preoperative assessment, planning, and intraoperative management to ensure safe anesthesia and optimal perioperative outcomes.Here's a discussion of the anaesthetic considerations :
  1. Congenital Heart Disease (CHD):Preoperative Assessment: Conduct a thorough evaluation of the child's cardiac anatomy, physiology, and functional status. Obtain relevant cardiac imaging studies (e.g., echocardiography) and consult with a pediatric cardiologist for risk stratification and optimization of cardiac function. Hemodynamic Management: Maintain hemodynamic stability during induction, maintenance, and emergence from anesthesia to minimize fluctuations in systemic vascular resistance, preload, and afterload. Use invasive monitoring (e.g., arterial catheter, central venous catheter) as indicated to guide fluid and vasopressor management. Avoidance of Hemodynamic Stressors: Minimize factors that may increase myocardial oxygen demand or compromise cardiac function, such as tachycardia, hypovolemia, acidosis, or hypercarbia. Use gentle airway manipulation and consider regional anesthesia techniques to reduce sympathetic activation and maintain stable hemodynamics. Inotropic and Vasopressor Support: Be prepared to provide inotropic or vasopressor support if needed to maintain adequate cardiac output and perfusion pressure. Select agents with minimal negative inotropic effects and titrate carefully to avoid exacerbating myocardial dysfunction. Antibiotic Prophylaxis: Administer antibiotic prophylaxis as recommended to prevent infective endocarditis in children with high-risk cardiac lesions undergoing invasive procedures.
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Complications associated with paediatric anaesthesia can arise due to various factors, including the child's physiological differences, underlying medical conditions, surgical procedures, and anaesthetic agents used. Three common complications encountered in paediatric anaesthesia are emergence delirium, postoperative nausea and vomiting (PONV), and respiratory complications.
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Complications associated with paediatric anaesthesia can arise due to various factors, including the child's physiological differences, underlying medical conditions, surgical procedures, and anaesthetic agents used. Three common complications encountered in paediatric anaesthesia are emergence delirium, postoperative nausea and vomiting (PONV), and respiratory complications. Here's an explanation of each complication along with management strategies:
  1. Emergence Delirium:Definition: Emergence delirium refers to a transient state of agitation, confusion, or disorientation that occurs during the early recovery phase from anaesthesia. It is characterized by restlessness, inconsolability, thrashing, hallucinations, and aggressive behavior. Causes: Emergence delirium can result from multiple factors, including the effects of anaesthetic agents, pain, hypoxemia, discomfort, preexisting anxiety, and individual susceptibility. Management Strategies:Provide a calm and soothing environment in the post-anesthesia care unit (PACU) to minimize stimulation and promote relaxation. Use non-pharmacological interventions such as gentle reassurance, distraction techniques, and parental presence to alleviate anxiety and agitation. Administer low-dose sedative medications such as benzodiazepines (e.g., midazolam) or alpha-2 agonists (e.g., dexmedetomidine) to facilitate smooth emergence and sedation if necessary. Address underlying causes of agitation such as pain, hypoxemia, or urinary retention promptly. Monitor closely for signs of respiratory depression, airway obstruction, or hemodynamic instability during management of emergence delirium.
  2. Postoperative Nausea and Vomiting (PONV):Definition: PONV refers to the sensation of nausea and the act of vomiting that occurs in the postoperative period following anaesthesia and surgery. Causes: PONV can result from multiple factors, including the effects of anaesthetic agents, opioids, surgical stimulation, patient factors (e.g., female gender, history of motion sickness), and perioperative factors (e.g., fasting status, duration of surgery). Management Strategies:Administer prophylactic antiemetic medications before the end of surgery, especially in patients at high risk for PONV based on individual risk factors and surgical characteristics. Utilize multimodal analgesia techniques to minimize opioid requirements and opioid-related nausea. Encourage early oral intake and ambulation postoperatively to promote gastrointestinal motility and reduce the risk of PONV. Provide adequate hydration and electrolyte replacement to prevent dehydration and metabolic imbalances associated with vomiting. Consider alternative antiemetic agents or combination therapy if initial prophylaxis is ineffective, and tailor treatment based on patient response and tolerability.
  3. Respiratory Complications:Definition: Respiratory complications encompass a range of adverse events related to ventilation and oxygenation during anaesthesia and the immediate postoperative period. Causes: Respiratory complications may arise from factors such as airway obstruction, hypoventilation, atelectasis, aspiration, bronchospasm, or respiratory depression due to anaesthetic agents or opioids. Management Strategies:Ensure proper airway management and positioning during induction, maintenance, and emergence from anaesthesia to prevent airway obstruction and optimize ventilation. Monitor respiratory parameters closely, including oxygen saturation, end-tidal carbon dioxide, respiratory rate, and chest excursion, using appropriate monitoring devices. Maintain adequate depth of anaesthesia and analgesia to prevent coughing, breath-holding, or laryngospasm during surgery and emergence. Administer supplemental oxygen and provide respiratory support (e.g., positive pressure ventilation, airway maneuvers) as needed to correct hypoxemia or hypoventilation. Promptly identify and manage respiratory complications such as bronchospasm or laryngospasm with appropriate interventions, including bronchodilators, positive pressure ventilation, or reintubation if necessary.
In summary, complications associated with paediatric anaesthesia such as emergence delirium, postoperative nausea and vomiting, and respiratory complications require vigilant monitoring, prompt recognition, and targeted management strategies to ensure optimal patient outcomes. Close communication among anaesthesia providers, surgical teams, and nursing staff is essential for early intervention and coordinated care in the perioperative period.
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Physiological differences between paediatric and adult patients significantly impact anaesthetic management.
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Physiological differences between paediatric and adult patients significantly impact anaesthetic management. Here are some key distinctions:
  1. Respiratory System:Children have proportionally smaller airways compared to adults, making them more prone to airway obstruction. Higher metabolic rates in children result in increased oxygen consumption and carbon dioxide production, requiring careful monitoring and adjustment of ventilation during anaesthesia. Pediatric patients have a higher respiratory rate and lower functional residual capacity, which affects the choice of anaesthetic induction agents and ventilation strategies.
  2. Cardiovascular System:Children have a higher cardiac output per body weight compared to adults, which affects drug distribution and clearance rates. Differences in vascular tone and compliance influence hemodynamic responses to anaesthetic agents and surgical stimuli. Neonates and infants are particularly susceptible to changes in preload, afterload, and contractility, requiring close monitoring and precise fluid management during anaesthesia.
  3. Renal Function:Renal function matures with age, affecting the metabolism and excretion of anaesthetic drugs. Neonates and infants have lower glomerular filtration rates and reduced renal blood flow compared to older children and adults, leading to slower drug elimination and potential accumulation of metabolites.
  4. Central Nervous System:The developing brain in paediatric patients is more susceptible to the effects of anaesthetic agents, necessitating careful titration of drugs to avoid adverse neurodevelopmental outcomes. Differences in cerebral blood flow and intracranial compliance influence the management of intracranial pressure and cerebral perfusion during anaesthesia.
  5. Metabolic Rate:Children have higher metabolic rates and lower energy reserves compared to adults, affecting their response to fasting and stress during the perioperative period. Neonates and infants are particularly vulnerable to hypoglycemia and hypothermia, requiring vigilant monitoring and interventions to maintain metabolic homeostasis.
  6. Temperature Regulation:Children have a larger body surface area relative to body weight, making them more susceptible to heat loss during anaesthesia. Neonates and infants have limited thermoregulatory mechanisms and are at increased risk of hypothermia, which can have deleterious effects on metabolism, coagulation, and immune function.
Overall, understanding the physiological differences between paediatric and adult patients is essential for tailoring anaesthetic management to the unique needs of children, ensuring safe and effective perioperative care. Close attention to factors such as airway management, cardiovascular dynamics, drug dosing, fluid management, and temperature regulation is crucial for optimizing outcomes in paediatric anaesthesia.
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Is a high epidural block the same as a low epidural block with a higher volume of the anesthesic or is a high epidural block administered more cranially between the lumbar vertebrae?
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Epidural block height is affected primarily by the level of injection. In the cervical region, drugs administered in the epidural space mostly spread caudally, while in the midthoracic region (level of Th2–Th6), the expansion is equally cranial and caudal. By administering the epidural drugs in the lower thoracic region (Th6-L1), the spread is only cranial. After a lumbar epidural, the spread is more cranial than caudal with a delay in the onset of anesthesia at the L5-S1 segments because of the larger size of these nerve roots. The position of the patient on the bed does not affect the spread of the medications in the epidural space, regardless of whether the patient is in a sitting or lateral position.
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Hi, I am wondering if anyone knows of any good techniques in which you can collect blood from the mouse saphenous vein without having to anesthetize it. Thanks!
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I think Saphenous venipuncture and Tail clip methods are the best way to collect a blood sample from unanesthetized mice .
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We are currently using Ketamine and Xylazine to anesthetize the mice for imaging purposes. However, upon injection, we see an increase in the blood glucose levels, which in turn, prevents us from inducing glucose stimulation at our desired time point. Is there any anesthetic material that doesn't interfere with pancreatic beta cells or elevate blood glucose levels?
Any insights will be very helpful.
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TIVA
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I want to take body size measurements of a few species of butterflies in the field, as well as to take their pictures with enough quality for morphometric analyses. However, I would like not to have to sacrifice so many individuals, for conservation reasons of couse, so I was wondering if anyone may have ideas or insights as to which anesthetic to use and/or their dosage. I've tried to do a literature search but had no luck. Thank you in advance!
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Hello Claudia; I've used a picnic ice chest to create a cold place. Cooling the butterflies to some low temperature will immobize them for a little while. Try it in the lab so you can tell how long it takes to cool them and how long they stay immobile. Good luck with your project; Jim Des Lauriers
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I would like to find an anesthetic that has the least effect on coagulation factor.
Thanks
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Dear Sajad , You can see study of Intravenous induction agent like Etomidate, Thiopentone ketamine and propofol effect on cogulation in human .if it is safe in human , definitely will safe in Rat.because Before the drugs to launched in market should be safely passed in animal model . As far as I know Propofol has nil effects on coagulation
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Before performing a bronchoscopy what are the best anesthetic procedurs able to increase tolerability of the exam, to determine a better chance of the operator to obtain the diagnosis, with the minimum impact of side effects.
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Propofol. Propofol (2,6-diisopropylphenol) is a short-acting anaesthetic agent with a rapid onset of action that has been used in bronchoscopy for moderate sedation.
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I have a problem about rat anesthesia, the situation is that I have Zoletil 50 1mg/ml + xylazine hydrochloride 23.32mg/ml solution that I prepare at the same time from the same source (from the same stock)
I give it to two Wistar rats that both weight 470g, IP 500ul, one rat anesthetizes without problem, but the other one rat fails to anesthetize and stay awake.
This is happening more and more often; I don’t know the reason or how to solve it.
Thank you.
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hi,
What is the injection method?!!!
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Hello dear researchers. I am a beginner researcher who faced the following problem. During the experiment on rats, the rats die within 40-60 minutes. This process is accompanied by a drop in blood pressure and an increase in heart rate. Urethane is used as an anesthetic at a dosage of 1.3 g/kg, and the rats are ventilated using a ventilator with oxygen. Ventilation volume 1 ml/100 g, frequency 60/min. We tried to change the anesthetic to thiopental, without a positive result. Perhaps someone has encountered a similar problem and can provide advice?
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Actually all anaesthetic drug can be used but should be used in proper dosing for different route if administration . For example Inj Ketamine 1-2 mg/kg i v and i.m dose 3-5 mg/kg . inj Propofol 1-2 mg /kg
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Do you:
1) Advise regional anesthesia instead of a GA?
2) Choose a specific anesthetic regime if a GA is required?
3) Manage the patient as if they were a neurosurgical case with tight control of ET CO2?
4) Carefully control hemodynamics and +/- consider transfusion more than you would otherwise?
5) Recommend that surgery not be undertaken for purely elective procedures?
Some other strategy for management?
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aprupt discontinuation alcohol or any other drug abuse may confuse with POD
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Do C57 mice have to be anesthetized by inhalation before removing the eye to extract blood? Does anyone know the exact anesthesia procedure and is there any relevant literature to recommend? Since the lab is not equipped with an anesthesia machine, is it possible to use the beaker inversion method for anesthesia? Or is there another easy way?
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YES: of course!!
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I heard the best method in this case is euthanasia by decapitation. But should I use anesthetic agents? Doesn't it have an impact on the cytokines levels?
Thank you very much.
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We routinely use Isofluorane combined with decapitation for euthanisation of rats where blood or tissue samples are used for analysis. The process itself shouldn't last more than 60 seconds and has good reproducible results. Hope it helps.
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I infected mice using 3.5% isoflurane in oxygen for about 5min or until their respirations have slowed to 1 second in between breaths.
I then quickly infect the mice with 100uL of my virus in PBS via oropharyngeal aspiration and place the mice back in their cage to recover.
This technique works well with young B6 mice (6-12wks), but each time I do this technique with the aged mice at least one ends up expiring after infection.
I'd like to avoid any deaths so please let me know if you have suggestions for ways to improve my technique.
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Hi there,
3.5% is , in my view too high for aged mice; I would try with 2.5% (max 3%) and following instillation keep them in a separate box with 100% oxygen, for a few minutes observation. until they can sit up again before returning them to the homecage
Kind regards
Flora
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We're trying to develop a more humane protocol for perfusion in laboratory mice. We had mice waking up during perfusion from anesthesia with avertin, but not with pentobarbital anesthesia using buprenorphine (for pain control) as a pre-med. Currently there is a shortage/backorder of pentobarbital so we are seeking alternative. We are considering a combination of ketamine and xylazine for anesthesia with buprenorphine + Acepromazine OR Midazolam pre-med.
We like this option because of its welfare benefits: 1) it can be given sub-Q, avoiding painful/uncomfortable IP, and 2) it provides excellent pain control.
But we are also concerned about potential effects of the drug combination (especially ketamine) on our outcome measures - primarily markers of neuronal activity and plasticity (e.g. IEGs, dendritic spine density, BDNF etc. though we are not sure precisely which assays we will be running yet).
  1. Is the use of ketamine as an anesthetic before brain collection accepted in broader neuroscientific community? Or specifically behavioural neuroscientists working with laboratory rodents? Or is it a hard no-go for various reasons (e.g. having affinity for many membrane-bound proteins potentially causing many unknown alterations in the post-mortem brain)?
  2. Are there dose dependent effects of ketamine (+/- xylazine) on readouts? For instance, we could reduce the dose of ketamine/xylazine by adding acepromazine to the induction protocol (leave ace out of the pre-med, and use ket/xyl/ace combo SQ to induce anesthesia), if a smaller dose of ket/xyl = less likely to impact outcomes.
  3. Do you have any other recommendations for anesthetics that can be administered sub-Q or IM (avoiding IP for welfare considerations)?
  4. Are there studies on rodents using ketamine + xylazine prior to perfusion and examining markers of neuronal activity and plasticity (please provide reference)? And/or are you (the reader) currently using this drug combination with mice or rats to do neuroscience? Or know anyone who is?
  5. Are there any studies examining the post-mortem effects of ketamine + xylazine on a variety of neuroscientific assays versus other anesthetic agents (please provide reference)?
Thank you all very much for your help!
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I do not consider it advisable: There are multiple better options
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Could anyone recommend the appropriate anesthetic procedure for BMT in mice?
I do bone marrow transplantation in mice as a part of my study.
The problem is, the engraftment rate got pretty low recently.
I suspect that it's due to the change of the drugs.
I'm currently using the mixture of three drugs, which are midazolam, medetomidine and butorphanol.
I used to use the combination of pentobarbital(i.p.) and sevoflurane(inhalation).
Would it be possible that it's because of this change ?
I do transplantation by retro orbital injection.
I know it's possible by tail vein injection with no anesthetic drug usage. I tried, but it was technically difficult for me.
I appreciate any suggestions.
Thank you.
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Thank you for the suggestion :)
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I have a survey with dichotomous variables and need tetrachoric/polycoric analysis.  I used R module but tried to run it also in SPSS and cannot do polycoric analysis (keep getting a message - could not find function "hetcor").  I checked on extensions and it is telling me that extension HETCOR is installed.  Any suggestions? I am running out of options.  Thank you so much!!!
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This is amazing video explains how to run factor analysis
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Hi everyone,
We will look at c-fos expression in different brain regions. As most of you know any new procedure or administration of a drug induce the expression of c-fos and various anesthetics have different effects. So I am trying to find the best drug combination that will not effect our results. Does anyone have any suggestions for anesthetics that can be safely used in a c-fos study?
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Since we are going to perfuse lots of animals within a limited time, it will be nice to have a fast-acting anesthetic. I’ll try to test the dose before the real study. Again thank you so much, this was so helpful.
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In a study there are some animal species need to implement a coronary stent from (femoral artery) and to undergo a laparotomy in order to place a telemetric transponder.
What are the recommended anesthetic drugs that induct anesthesia without affecting the cardiovascular system at the time of procedures for equine?
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Ketamine ,thiopentone has good cardiovascular safety profile .If monitor and anesthetic machine present propofol can be used cautiously.
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I am a bit confused. I am planning an experiment in the field where fish will be caught by electrofishing. Afterwards, they are supposed to be euthanised by using an anaesthetic.
I found literature which recommended 2-Phenoxyethanol and linked it to a low cortisol response. A bit late I found papers that claimed the opposite. I used glove oil before and I thought that this option is also the most environmentally friendly one since I am working in the field. I would like to ask you about your opinion and your experience. I want to measure the Cortisol response in the blood afterwards and oxidative stress. Thank you in advance.
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I think that the best option to work in the field is clove oil (eugenol). Cortisol response is very quick and is time-dependant, so you must anesthetize fish as faster as you can and do the management that you require.
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Using eugenol to anesthetize freshwater angelfish (Pterophyllum scalare), behavior is apparently affected not only during anesthesia, but also after anesthesia.
The study by Cooke et al. (2004) is interesting.
Cooke, S.J .; Suski, C.D .; Ostranda, K.G .; Tufts, B.L .; Wahl, D.H. Behavioral and physiological assessment of low concentrations of clove oil anesthetic for handling and transporting largemouth bass (Micropterus salmoides). Aquaculture, v.239, p.509-529, 2004.
Are there other studies that have evaluated the behavior of anesthetized fish?
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Hi everyone,
Where can I find some information regarding sterility requirements for topical dosage forms?
To the best of my knowledge sterile topical drugs are: ophtalmic drugs, for wound healing and burns, gels used in endoscopy (anesthetic mostly) and certain dermoscometics?
Are there other type of drugs that should be manufactured in sterile dosage forms? (only topical).
Thanks very much!
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EVERYONE!! Or, at least, antiseptics.
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Is anyone able to tell me why my anaesthetized rats often do a 'double breath', or diaphragmatic breath, like a hiccup (see video). This often begins after 1-2 hours under anesthesia, and can occur every 4th to 10th breath. The rats are anaesthetized with isoflurane (usually set to 1.5L/min). They are ventilated with a mixture of O2 and air (about 30:70). The ventilator is on volume control. When the rats 'double breathe' like this, I can sometimes stop it by turning the tidal volume right up, but this then leads to severe hypocapnia. There is no obvious cause for the development of this abnormal breathing (end tidal CO2 is in the normal range and the rats are not getting light in terms of anesthesia). Can anyone help?
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I too encountered same with ketamine and inhalant isoflurane as well seperately. To best of my knowledge If anaesthesia is adequate and getting such a pattern in respiration indicates sigh breathing in every few breaths in order to ventilate quiescent alveoli. Secondly an inadequate anaesthesia with imbalance of central diaphragmatic innervation and peripheral intercostal innervation on respiration leads asynchronous breathing. Kindly enlighten me if you found anything found interesting
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I will often use diagnostic blocks of various structures to diagnose pain syndromes.  Most medications I inject will last between 4-6 hours.  There are others that do not reach the peak of action until around 8 hours.  I wonder if there is a pain perception difference if I were to injection a faster acting/shorter duration anesthetic versus a slower acting/longer duration agent.
I've looked around but have not run across this research specifically.
Does anyone have insight or research to point me towards?
Thank you!
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Yes: Of course. In fact, one of the main classifications of pain is based precisely ON ITS DURATION TIME, being -according to the IAPS- considered as "ACUTE" that which lasts less than six months, this does not present special clinical or treatment problems and, as CHRONIC one that lasts more than six months and, unfortunately, does not respond well to painkillers, is usually associated -as a consequence- with depression, pain behaviors, hopelessness, a decrease in the capacity of the immune system, sleep disorder and a long etc., for all this it is a serious problem for Algiology and must be considered in itself and regardless of its etiology as a Disorder and a Health Problem in itself
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i wanna administer cigarette smoke extract to induce emphysema in mice, i am asking for the maximum volume of intranasal administration ? can i use ether or chlorofom to anesthetize mice?
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thank you
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Hello,
I also want to do some biochemical analyses and need to take some blood of the rats. To take the blood I need to use anesthetics. But I want to evaluate TNF-a and oxidative stress in the brain. Which anesthetic does no influence on this? I'm working on the model of VPA to induce austism.
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Oi!
I think that it's actually essential to use an anesthetic because of the ethical concerns (you could be authorized to not use it if you can prove that is could interfere with the quality of your data). Normally, it's preferable to use an aesthetic cocktail to ovoid the single high dose monoanesthesia toxicity.
Here I found you a comparative study of different methods of animal euthanasia to collect brain samples for metabolic profiling.
Good luck,
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What is the reason for the ineffective or insignificant effect of Neuromuscular relaxants such as Atracurium and anesthetics such as Ketamine on patients with Coronavirus hospitalized in the intensive care unit who have been treated with these drugs for a long time?
p.s: I saw in the hospital in the intensive care unit that these drugs do not work on patients, and I wanted to know the reason or be informed about other methods in this area.
Best Regards
Morteza
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Although 3 cases represent very little in a population, I was curious that they were all from the same place.
Managing mechanical ventilation dependent patients using multiple drugs offers numerous advantages, but requires that the physician (in addition to knowing in detail the mechanisms of action of each drug) admit the interaction between them - especially with regard to sedation and analgesia - and individual responses to it. The tube hurts.
I always worry when a patient's adaptation to the respirator depends on a neuromuscular blocker.
As an anesthetist, I have a lot more conditions to assess this minute by minute. But in a ICU, we need to manage multiple patients and cannot be around one person all the time.
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Hello everyone,
I am in search for an injectable anesthetic with less cardiovascular depressive effects like urethane. The issue with urethane is that you can only use it for non-survival surgeries. Does anybody know any injectable anesthetic like urethane that can be used for survival surgeries?
Thank you in advance for your helps.
Best
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I've never heard of using "urethane." Do you mean "Ultane" (Desflurane)? I never use Desflurane and believe it should be banned from use because of its dangerous pulmonary toxicity. Neither do I use etomidate because it notoriously undermines postoperative survival. Propofol is inherently dangerous and I never use it, either. I avoid paralysis whenever possible, for reasons that should be obvious. For anesthetic induction for short cases I use as little as 100mcg fentanyl administered IV at least three minutes before mask induction to allow it to reach peak effect, because it obtunds the sense of smell. Then I use mask induction with Sevoflurane, and increase the Sevo to maximum concentration (8%) until systolic blood pressure falls below 100 torr, which confirms adequate control of sympathetic nervous activity, and I am able to ventilate the patient by mask. This produces excellent vocal cord relaxation that is equivalent to paralysis but without the hazards associated with paralysis. Once the airway is secured, I switch to isoforane 1% (1/2 MAC) and maintain the end-tidal CO2 at a minimum of 50 torr to enable "permissive hypercarbia." I use "front-loading" with fentanyl or sufentanil to assure adequate analgesia, and/or spinal or epidural analgesia so as to minimize the toxic effects of the inhalation agents and optimize surgical outcome.
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Performing respirometry on Nile tilapia to quanitfy specific dynamic action (SDA). Fish eat like crazy while in a tank with others, but when isolated they hardly eat (very tough to estimate meal size). Am currently collecting any food and nitrogenous waste that gets flushed from the system but this is extremely tedious and I fear quite inaccurate as a tool to work back and get an accurate meal size estimate. Have tried force feeding with gavage, but this is obviously very stressful on the fish as they need to be anaesthetized and handled and as a result the MO2 spikes drastically after force feeding (undesired).
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Hi Mark,
I'm assuming my response is too late for the project detailed in your original question, but I am sharing this in hopes it can help you/others down the road who run into the same issue. If feed attractants, natural feed, or supplementation does not work, another thing you can try is the tube-feeding (also known as gavage) method. It is not uncommon for fish to not feed voluntarily in respirometers, as fish aren't often reared alone in a lab setting, so this is likely a stressor. To tube-feed, you will anaesthetize the fish and use a tube or forceps to administer (ideally pellets) into the stomach. This allows you to measure exactly how much food was consumed relative to the body mass of your fish. You can control for the aerobic cost of this (the increase in MR caused by elevated stress) by including a sham-fed fish (a fish that undergoes the same process as the tube-fed fish, with the exception of actual food delivery).
I currently have a manuscript under review that details this methodology if you're interested in learning more about the process:
The following paper also discusses tube-feeding, and it cites other studies which have used tube-feeding in their studies as it has become fairly common:
- Chabot D, Koenker R, Farrell AP. 2016. The measurement of specific dynamic action in fishes. Journal of Fish Biology 88: 152-172.
Hope this is helpful!
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Does anybody have any experience in introducing the A&E department to LAT (lidocaine, adrenaline, tetracaine) gel as a topical anaesthetic in children?
We are hoping to trial LAT gel in our department for children with wounds usually requiring conscious sedation or GA to close lacerations, but also to thoroughly clean large abrasions. As we know the former is a real challenge in the DGH and the latter can be very painful, especially in children, even with the gentlest 'paeds nurse' touch!
Thanks!
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We are hoping to trial LAT gel in our department for children with wounds usually requiring conscious sedation or GA to close lacerations, but also to thoroughly clean large abrasions. Do you have any upto date evidence that you could offer please
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I'm working with transgenic mice 3-12 months old. We anaesthetise them for an acute experiment (~10 hours, with top-ups as necessary), but they keep dying on me around 2-3 hours after the initial anaesthetic. We use an oxygen-isofluorane (gas) mixture for the initial loss of consciousness, then ketamine + dormitor (medetomidine) (ip) for the rest of the day.
Initial dose: ketamine 75ug/g dormitor 1ug/g
Top-up: ketamine 25ug/g dormitor 0.33ug/g
Any suggestions for how to prevent them from dying so early?
Thanks.
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I agree for the temperature regulation. Make sure they are kept warm and you can also inject ~0.5-0.8cc of warm saline SC every hour (especially if you get loss of blood). I would also try to use inhalants only. Isoflurane is easier to maintain depth of anesthesia and you can find the "sweet spot" to keep him/her at the ideal depth without having the vitals crash. Labs I work with who use injectables for long procedures had the same problem. Since they have changed to iso only the problem has been fixed.
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I would like to ask if it's possible to use BIS Quatro Sensor together with a standard 64-channel EEG Cap? What would be the recommended montage in that case?
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Without reason of use to compare topic with global.
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Awake craniotomy and related anesthetic techniques in the operating theatre
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This is "my topic"!! There are several anesthetic options (please see attached our editorial in BJA )
Asleep-awake-asleep approach with selective scalp block looks to be the best option: craniotomy is painful and general anesthesia with LMA during that step is highly comfortable for patients.. Propofol and remifentanil, specially with TCI, guided by processed or raw EEG, allows a very close titration of drug doses and fast intraoperative awakening ( PMID DOI: 10.1097/ANA.0b013e31805f66ad).
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Closed loop ansthesia delivery systems typically use TIVA, using propofol or other intra venous drugs. I want to now if there is any system which use inhalational anesthetics to alter the plane of anesthesia .
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Dear All,
How can I explain no significant difference in oxygen consumption rate, but a significant ammonia excretion reduction in shrimps exposed to different anesthetic concentrations?
Thank you in advance,
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Today I tried to induce and maintain the anesthetic state for a mouse using isoflurane vapor. Initially I followed the protocol that I composed with the dose below:
+ Induction: flow rate = 1000 mL/min - 4% isoflurane
+ Maintenance: flow rate = 500 mL/min - 1.75% - 2.5% isoflurane
However, the mouse was still moving and even woke up while it was inhaled with anesthetic agent. At that time, I decided to increase the dose like this:
+ Induction: the same as above
+ Maintenance:
    - Stage 1: 1000 mL/min - 3.5% isoflurane (in 2 minutes)
    - Stage 2: 1000 mL/min - 2.5% isoflurane (until it ends)
The total time of maintenance was 1 hour simulated to the previous surgery. After that I removed the mouse and let it recover. Unluckily, there were some muscle contractions that quite strong and then the mouse’s heart stopped beating and it died in a short time. During the maintenance time, I tried to count the heart beat of it, it’s 176 bpm. Finally, I could not save the mouse.
------
In our animal facilities, we don't have the mixture of oxygen and air, I just use only the 100% Oxygen as a carrier gas to supply for the vaporizer. So is it a problem?
Can anyone help me in this case? Thank you in advance.
---Huy Vu---
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Hello Vu Huy
I think all what happed will be explained through the coming problems :
1- Due to their high metabolic rate and likelihood of hypoglycaemia, rats and
mice need only be starved a matter of 40 – 60 min (mice) to 45 – 90 min (rats)
prior to anaesthetic induction.
2- These species will breath - hold during gaseous induction, to the point where
they become very cyanotic. In rabbits, the ‘ shock ’ organ is the lungs, and
during intense stress the pulmonary circulation can go into spasm, making the
hypoxia due to breath - holding even worse, even to the point of collapse and
cardiac arrest!
3- Volatile agents
However, their disadvantages
include the fact that there is a drying effect on the airways of the patient
when using inhalational anaesthetic agents that can cause dehydration during
long procedures. They also create problems if used as an induction agent, as
many species will breath - hold during this procedure.
Isofl urane
This is now becoming the most widespread volatile agent used for induction
and maintenance of general anaesthesia in small mammals as well as in dogs
and cats. A pre - anaesthetic medication incorporating an analgesic is usually
administered as isofl urane has no post - anaesthetic analgesic qualities and it is
irritant to the mucous membranes of many animals. Inspired concentrations
required for induction of anaesthesia vary from 2.5 – 4%. Breath - holding still
occurs, but the practice of supplying 100% oxygen to the patient for 2 min
prior to anaesthetic administration helps minimise hypoxia. After this pre -
oxygenation, gradually introduce the isofl urane, fi rst 0.5% for 2 min, then
assuming regular breathing, increase to 1% for 2 min and so on until anaesthetic
levels are reached allowing a smooth induction. Surgical anaesthesia can
usually be
4- Intermittent positive pressure ventilation
This may be necessary in some individuals who breath - hold during induction.
If intubation is not possible
5- Note the use of
a pulse oximeter probe, oesophageal stethoscope, intravenous catheter and supplemental heating is important.
Using a face mask for rodents such as this rat is often necessary owing to
the difficulty of intubation.
So I think that the Monitoring was deficient
6- Maintaining core body temperature is vitally important in all patients to
ensure successful recovery from anaesthesia, but is particularly important in
small mammals. This is primarily due to their increased surface area in relation
to their volume, so allowing more heat to escape per gram of animal.
Anaesthetic gases have a rapidly cooling effect on the oral and respiratory
membranes, and so patients maintained on gaseous anaesthetics will cool
down quicker than those on injectable ones: a situation that worsens as the
duration of anaesthesia increases.
7- Intra - , pre - and postoperative fl uid therapy is very important in small mammals,even for routine surgery. Again, as with the issue of maintaining core bodytemperature, the small size and relatively large body surface area in relationto the volume of these patients means that they will also dehydrate muchfaster, gram for gram, than a larger cat or dog. Studies have shown that theprovision of maintenance volumes of fl uids to small mammals during and immediately after routine surgery improved anaesthetic safety levels by as much as 15% in some cases, with greater improvement if the surgery was
being performed on severely debilitated animals. It is therefore to be strongly
recommended that all small mammal patients receive fl uids during and after
an anaesthetic whether it is routine or not.
8- Gaseous anaesthesia, particularly
with isofl urane, tends to result in more rapid recovery than the injectable
anaesthetics, but all forms of anaesthesia recovery are improved by maintaining
body temperature and fl uid balance during and after anaesthesia.
Reference:
Anaesthesia for Veterinary Nurses
Second edition, Edited by Liz Welsh
Chapter 12, Rabbits, Ferrets and Rodent Anaesthesia ( by Simon Girling)
Pages : 317- 335
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I want to monitor the tumor size. Does 4t1 needs to be labelled? What are the most common procedures used to monitor tumor size by imaging in a live/anasthetic mice ?
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Laura Brandolini and Silvia Di Loreto May answer this question for sure. Ask them.
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I am trying to study synaptic plasticity in hippocampus in urethane anesthetized rats (in vivo). Following are the coordinates recording electrode (Bregma −4.4, lateral 2.0–2.25, depth 2.0–2.7 mm), and the stimulation electrode (Bregma −3.4, lateral 2.5, depth 2–3 mm).
Is there any procedure to optimize the amplitude of the population spike. What are the factors to be considered for optimization.
Thanks
Pradeep
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Pradeep Jayarajan Where are your recordings from within the hippocampus?
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Hi everyone,
I perform gastric motility recording with drug microinjection in rats. The experiment lasts over 4-5 hrs, therefore I need an anesthetic that provides a prolonged action without influencing/depressing autonomic functions. I have tried urethane but it exhibited a substantial depressor action on vagally mediated actions. Thiopental seemed almost OK but its action lasts only half an hour then the rats died due to the applied additional doses.
I know that inactin appears to be the best way to go however due to some reason I cannot get it. Could anyone suggest an alternative anesthetic to inactin (thiobutabarbital)?
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Propofol, maybe with droperidol
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Can I please have you opinion about LOCAL treatment of primary burning syndrome of oral cavity? Do you have any experiences with using clonazepam in mouth rinse or is there any similar type of such treatment? Unfortunately, I cannot use clonazepam in rinse in my country for such indication so I would like to know if you have some another ideas how to help these patients using local treatment... My patients do not accept rinses with anaesthetics so well ..
I will be happy for every idea, magistraliter, type...
Thank you !!!!!!
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I suppose you have excluded a occult oral malignancy.
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I am involved as advisor in the development of equipment to administer feed-back controlled Xe at any concentration at a desired FiO2.
A combination with an agent end-tidal controlled will be available.
The device will be able from about 1 kg up.
On-line metabolic measurement shall be available as well (VO2;VCO2;RQ) So I am interested to your project and of course the results.
Kind regards,
Bart Westerkamp
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I am quite aware of John's equipment.
I developed the PhysioFlex in 1998. In 1997 it received the CE mark for Xe application and neonatal use from 1 kg up.
This was at that time already a fully feed-back controlled system. On-line O2 uptake at that time was already realized. It had end-tidal VA control also for the neonatal application.
Based on all the experience I started to develop not only a successor of the PhysioFlex, but a new generation with a big step forwards in technology and applications.
We did research in the application for neonates with small piglets to see if we were able to improve not only the gases (including Xe) and agent management but above all to improve neonatal ventilation. In Xe management one can set the FiO2 and FiXe.
Our first research showed we made a big improvement.
The device is capable to monitor the complete metabolic process, VO2, VCO2 and RQ.
At this moment the device is in the phase of all testing required for the CE mark.
So that is why my interest into your research and my question.
Kind regards, Bart
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I want a reliable and valid method
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Dear Sarhan Rashid Sarhan , nice topic of investigation! I'm a user of inhaled anesthetics. Volatiles have many aspects to evaluate... main are... pharmaco-kinetics & -dynamics. I believe you have to formulate your method according to the hypothesis of your research... animal model may be required. Clinical effectual experiments with therapeutical dosages are to be on the volunteers or selective patients. You may go through an old but interesting article of BJA. The Journal of Pharmacology and Experimental Therapeutics is quite useful in this regard. http://jpet.aspetjournals.org/content/349/1/21
- Rabiul
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Hello everyone!
I would kindly ask if there is someone who has some experience in taking BALF from mice. I´ve seen people taking BALF from deeply anesthetized mice but my impression is that most of the people are taking the BALF from dead/exsanguinated mice.
Are there any differences between these to ways regarding the cell-count or protein-level in the BALF? What would you recommend?
Many thanks in Advance!
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Anesthetized is better. You can use the following protocol:
- Prior to each allergen challenge, and following the 7th challenge, mice are administered an intraperitoneal injection of 48 mg/kg etomidate (2 mg/ml), prior to placement in a light-excluding receptacle.
-Subject remains in receptacle until a lack of observable neurological response is detected upon application of pressure to hind paws (5-10 min).
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I am hoping to start using this model, but need more details about LPS administration.
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Thank you so much Tanja!
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Hi,
In view of setting up in vivo recording in rodents in my lab, and being new to the subject, I would like to know if a thermostatic heating blanket placed in a faraday cage could cause electric noise during recordings in anaesthetised mice. If yes, does anyone know an alternative system, like water-heating pads which could prevent this noise?
Thanks in advance.
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Yes, a heating blanket inside the Faraday cage can produce substantial noise. Because of that, when I was doing anesthetized recordings some years ago, I used this isothermal pad (see below) instead. It worked well.
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I am trying to use heart beat as a developmental index to study the effect of environmental contaminants. I will be using MS-222 (Tricaine methanesulfonate) to anesthetize the larvae.
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You can also check
including MATLAB scripts for this task.
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I'm using isoflurane as the anaesthetic agent for my lab rats. The isoflurane provided by sigma is in mg form and I'm planning to dissolve it in ethanol (for drop jar method). But I'm not sure how many milligrams of isoflurane powder need to be dissolved in 100mL ethanol to give good anaesthetic effect. If anyone have prior experience with isoflurane powder, please advise me about the preparation. Thanks in advance
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There is relatively little know about late effects of general anesthesia exposures, by quantity of episodes, duration of episodes. There is a debate about post operative delirium, and persisting cognitive impairments after surgery and critical illness regarding how much of the variance in outcomes may be explained by specific disease factors, generalized inflammation, and specific toxic exposure to general anesthetics and other medications.
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I believe one of the reasons little Is known about gen anes is that to much is going on with the patient, his or her diseases, the peri and post-operative that gen anes gets overwhelmed in any study.
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I am currently working on ischemia- reperfusion-induced brain injury in Wistar rats, and as of now we are using Ketamin-Xylazine or low dose of Urethane for inducing anesthesia. I have over heard that these agents could greatly influence the ischemia-reperfusion-induced brain injury and hence looking for better and safe anesthetic agent.
Based on your experience and domain knowledge can any one refer better anesthetic agents for my experiments.
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Buenas noches
La pregunta parece va dirigida a anestésicos IV, indudablemente la ketamina lleva ventaja sobre otros anestésicos; en mi experiencia el segundo lugar sería para el propofol, luego el tiopental.
Para mejor opinión deberiamos conocer el objetivo de la investigación.
Gracias
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I am using Isoflurane anaesthesia on an insect, however due to the nature of my experiment it is not able to move/behave during the experiment.
I am looking for a way to confirm the anaesthesia had an effect during the experiment. For example, one possibility would be to use an antibody to stain the Anaesthetic agent and then image the brain (If there are Isoflurane antibodies out there?)
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There are plenty of references for inhibition of luciferase by general anesthetic agents
Might any of that work be translatable to your requirements?
Regards,
Ian
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Though there are several animal studies but detailed method of anesthesia was not mentioned. So I need a method with proper reference.
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Interesting answers…Opinions and philosophy are the last things that are needed here. I am really wondering who is doing "your" experiments? Some slave-students?
Dharmendra,
1. Any extreme overdose of an anesthetic given i.p. (intra peritoneal – which is easy for the beguilers) will do.
2. You may accelerate/induce the exitus when animal is deep in anesthesia, by quick laparatomy and section of aorta.
3. If the animal is in deep anesthesia already, intracardial injection of saturated KCL about 0.3ml or more is the best.
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Is there any effect of anesthetic on extraction of exosomes from blood? (I use ethyl carbamide, took bold from optic vessel) What are possible methods to extract mi.RNA from exosomes? I use trizole to extract but concentration is in negative absorbance, which is very surprising.
Thanks for expert opinion.
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then which site should i use to take blood
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I performed yesterday 6 subretinal injections using Isofurane as an anesthetic. The surgery lasted something less than an hour, isoflurane was set to 2% and mice were treated with Metamizol and Meloxicam as painkillers. I was checking the reflexes all way though because breathing was sometimes slow but intense and there was no respone. Even though all of them woke up and were behaving normally at least for 2 hours after the surgery, 2 of them died within 24h after the surgery. I cannot understand why this happened, since everything looked fine. I checked for injuries, bleeding but I found nothing. I am considering hypothermia (but why only 2 out of 6) or stress. Any other ideas or suggestions would be great so that I could take care next time. Thank you!!
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I incline toward intraperitoneal constant rate implantation of ketamine with or without xylazine for keeping up surgical anesthesia for a broadened timeframe.
If it's not too much trouble read about male C57BL/6J mice by utilizing ketamine (80 mg/kg) and xylazine (8 mg/kg) without or with acepromazine at 0.1 mg/kg or 0.5 mg/kg
regards
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It is observed that, not all, but a good number of surgeons have an obsession to involve or should it be said, to mess the liability with the anesthesiologist(s) following an unwanted surgical outcome which is absolutely outlying from anesthetic consequence. Instead, there are lot many surgeons who weigh & admit the affirmative contributions of perioperative management. Is it prevailing elsewhere?
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On the other hand, surgeon's mistakes are obvious, even to non-surgical eyes, while anesthesiologists' mistakes are harder to detect, sometimes carefuly hidden.
We all had scenarios like:"What did you give him/her?" Usual answer is : "Nothing!", and empty syringes are just being dropped.
C'mon guys, I am sick of this surgeon/anesthesiologist war. There is only one quiestion (and task!): Be honest to yourself, and the patient in your hands.
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Is genomics in Anesthesia practice evolving? When will genomic testing be part of the pre-anesthesia work up?
Simon Body published an interesting paper in 2009 but I haven't seen the conversation continue. I'm wondering if anyone in the community is working in this area.
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Christopher,
Yes, I believe one day we can achieve this when citizens' genomic/epigenome infomation (analyzed) are all ready and stored in a database. So, once a patience arrives, doctors can get the info in a jiffy. I recently watched a movie called 'Blade Runner 2049'. It involves some of this concept. A pretty good movie.
In the future, a lot of disease treatments will become 'individualized', including the use of the red-hot CRISPR/Cas9 technology. Recent report indicates that for a better treatment with CRISPR/Cas9 technology, a person's genomic data needs be known in advance (including SNPs). Only with these data, the patients can get the best results from this technology's treatment.
Thanks for your question.
Yuan-Yeu
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We are recording LFP in anesthetized mice, in the last few days and after analysis of the results there seems to be a loss of the high frequency band wave with a great decrease in power in comparison to several experiments before. We have checked all the system and anything that might be causing this issue however there is nothing to indicate that anything changed. Has anyone come across such an issue where the power of the high frequency in LFP was reduced severely without an explanation?
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Dear mahmoud
Hi, I think decrease of high frequency bands following LFP recording caused by; 1. Change the recording electrode tip impedance. 2. Change the level of anesthesia. 3. If you have used ketamine hydrochloride as an anesthetic agent, You know that it is affected NMDA receptore, so it can change the power of high frequency band. 4. Recording electrode has inserted in which area of brain? It also is one possible cause of current finding.Another cause may related to the selected the sampling rate as well as band pass filtering.
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I will apply the Nd:YAG 1064 nm laser for 20 second on the skin of anesthetized rat, then I will sacrifice them in 3, 6, 9, and 12 hours following laser irradiation.
The tissue will be collected for WB and IHC, and H&E staining.
For WB I will collect the sample and put it in liquid nitrogen and keep it in freezer.
For H&E , I put them in the OCT and do staining
For IHC , I need help that which way is better.
T-
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Dear Neda,
in my experience it works best to fix your rat skin samples in Bouin´s fluid (12hours) transfer them to 70 ethanol and than embed them in a conventional manner in paraffin. Usually you do not get good results for IHX from cryosections of rat skin.
Rgards, Fred
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By using them as anesthetics in my research activity, I'm looking for articles and reviews that explain well and in detail the mechanisms of action of urethane and ketamine on the central nervous system.
Studying spontaneous electrical activity (LFP) in the hippocampus, my problem now is to be able to characterize the combined effect.
Could you suggest some reading about it?
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Thank you for you help.
@Alice Gallo Moraes: now I try to take a look
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Hi there,
So far, I’ve recorded ECG traces in anesthetized rats using needle electrodes, however, I am about to start doing same thing on conscious rats.
I am wondering whether it is possible and/or reliable to implant the needle electrodes into muscles chronically, (or maybe using silver pellet surface electrodes). Any suggestions are welcome. Thanks in advance.
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Not very difficult, but I know, rats move... Telemetry is the best, otherwise use small fishing hooks that you would solder on your ECG cable. Put them in the right location in the skin and it works.
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How can we turn the selectivity of an anesthetic agent toward the sensory without the motor fibers?
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In animals expecially horses is very critical to avoid the motor block whan we do standin sedations, for example in horse in the field. The use of lower concentrations of bupivacaine (0.125%) usually works very well. Of course you should consider that generally lowering the concentration means also lowering the dose of the LA and thus the potency and duration of the block. The combination with oppioids and/or alpha 2 agonists often help to ensure a more potent sensory block without interfering with the motor function.
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For my research protocol I need to run experiments on 12 rats simultaneously, which requires me anesthetizing all 12 rats at once. I'll be using gaseous anesthesia for my method. Has anyone had experience doing something similar? If so, what did you use? Are there any papers that show a protocol that would help with this?
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Sorry, you are writing "the effects on rat physiology"? What do you mean by this?
Tracheostomy is a simple procedure and I have over 100 papers where we used it in the rats. All my microcirculation research was done in tracheostomized rats.
Your concept of simultaneous inhalation anesthesia is strange and needs justification. We performed it (in the below paper) because of some very specific need (simultaneous effects on diaphragm function and to have better controls) . Otherwise you hardly need it. Ever.
The issue is too complex to be explained here. I think you should discuss with your senior colleagues about all of this.
Le Bourdelles G1, Viires N, Boczkowski J, Seta N, Pavlovic D, Aubier M.
Effects of mechanical ventilation on diaphragmatic contractile properties in rats.
Am J Respir Crit Care Med. 1994 Jun;149(6):1539-44.
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Hi, I am currently doing single-unit recordings on mice visual cortex. I noticed that in some cases, the firing properties of neurons changed greatly. When I initially find the cell, it is quite sensitive to light stimulation, has obvious orientation selectivity, and has low spontaneous firing rate. However, after 1-2 hours of recording, the cell's spontaneous firing rate increases a lot, and lose the orientation selectivity partly or even entirely. The mouse is anaesthetized by isoflurane and the heart rate is kept between 360-420 beats/min. I wish to know if there is anything else that I need to take care of, and if this phenomenon suggests anything wrong with the cortex. Thanks in advance.
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What kind of electrodes are you using?
Do you get any change in the spike waveform over this time?
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I am planning a study using an anesthetized pig model to better understand bladder filling and motion. From the literature, it seems that urethane would be the best anesthetic for the study, because it does not change the bladder motion or bladder capacity as much as other anesthetics. In the literature, I've seen many different administration methods used, so would you recommend a slow, IV drip or a large bolus at the start of the study? If we do the large bolus (~1.2 g/kg seems common), who long does it last in a pig?
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I am not familiar with urethane as an anesthetic agent. I would recomment ketamine intramuscular with Vetranquil and Fluothane as inhalent.
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Dear Researchers,
We are working on acute hippocampal slice electrphysiology using MEA's.
We are able to get the spontaneous activity in slices made from vibrotome using isoflurane anaesthesia to decapitate and remove the brain. We are using sucrose cutting solution (with 10 mM Dextrose, pH -7.4) for slicing and ACSF (with 25 m M Dextrose, pH -7.4)for recordings.
However, the spontaneous activity is not persistent with the slices and is fading over the time.And we were not able to find EPSPs following the Schaffer Collateral fibers region stimulation at 2- 3 V.
Is this the problem with the anaesthetic (if so, what would be the best suited anaesthetic for slice electrophysiology?) or the preparations? 
Please give your suggestions in this regard.
Thanking you,
Best Regards,
Grandhi V Ramalingayya
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Hi, yes that's the right answer, the problem is the oxygen supply and thus the perfusion rate (see Hajos 2009; Ivanov 2011).
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Some clinicians recommend and even practice administering tea or hot chocolate to patients before procedures under local anaesthesia. Does it actually work? Is there any evidence? 
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 This kind of behaviour is psychological rather than bilological. Tea and coffee if works no harm in trying.
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Would it be bispectral index or exhausted anaesthetic gas from CPB circuit (analogue to end tidal anaesthetic gas)?
Many thanks for your time and atttention,
Ka
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