Medikamente zur intravenösen Narkoseinduktion: Propofol

Bolkenius, D.; Dumps, C.; Halbeck, E.

doi:10.1007/s00101-017-0397-y

Cited by 5 publications

(2 citation statements)

References 57 publications

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“…Because of an increased content of body fat, the majority of morbidly obese patients receive volatile anesthetics to maintain general anesthesia [8]. In addition, remifentanil is frequently used in order to keep postoperative respiratory depression as low as possible.…”

Section: Introductionmentioning

confidence: 99%

Postoperative nausea and vomiting in bariatric surgery in comparison to non-bariatric gastric surgery.

Groene¹,

Eisenlohr²,

Zeuzem³

et al. 2018

Videosurgery and Other Miniinvasive Techniques

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IntroductionPostoperative nausea and vomiting (PONV) are complications of general anesthesia. Patient-specific factors, type of surgery and a variety of drugs determine the frequency. Clinical experience shows nausea and vomiting to be very frequent in morbidly obese patients undergoing bariatric surgery.AimTo detect the onset and extent of nausea and vomiting in the group of morbidly obese patients undergoing laparoscopic bariatric surgery.Material and methodsWe conducted a retrospective data bank analysis (since 2004) of all patients with body mass index > 35 kg/m2 undergoing laparoscopic bariatric surgery in comparison to patients with a body mass index < 35 kg/m2 undergoing gastric surgery. Propensity score matching was applied to minimize bias effects. The frequency of postoperative nausea was defined as the primary outcome parameter.ResultsOne hundred and thirty-eight patients were included. There was a significant difference between the morbidly obese group and the control group concerning the frequency of postoperative nausea (15.9% vs. 55.1%; p < 0.001). In patients receiving volatile anesthetics a significant difference between groups concerning frequency of PONV was not observed. Intravenous anesthetics were suitable to reduce PONV in the control group but not in the morbidly obese group (12.5% vs. 56.8%, p < 0.001). With given prophylaxis PONV events still occurred in 15.6% vs. 48.8% (p = 0.003).ConclusionsMorbidly obese patients undergoing laparoscopic bariatric surgery are at higher risk of suffering from PONV than non-morbidly obese patients. To reduce the PONV incidence in morbidly obese patients, further research, especially focusing on more efficient use of antiemetic drugs, seems to be necessary.

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Section: Introductionmentioning

confidence: 99%

Postoperative nausea and vomiting in bariatric surgery in comparison to non-bariatric gastric surgery.

Groene¹,

Eisenlohr²,

Zeuzem³

et al. 2018

Videosurgery and Other Miniinvasive Techniques

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“…Propofol (2,6-diisopropylphenol) has been commonly used in pediatric and obstetric patients as an intravenous anesthetic and sedative drug because of its rapid onset, continuous infusion without accumulation and quick recovery 1,2. However, fetal and neonatal exposure to antagonists for N-methyl-D-aspartate (NMDA) receptors or agonists for γ-aminobutyric acid (GABA) receptors may lead to accelerated neurodegeneration 3.…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine attenuates the propofol-induced long-term neurotoxicity in the developing brain of rats by enhancing the PI3K/Akt signaling pathway

Xiao

Zhou

et al. 2018

NDT

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BackgroundPropofol induces short- and long-term neurotoxicity. Our previous study showed that dexmedetomidine (Dex) can attenuate the propofol-induced acute neurotoxicity in rodents by enhancing the PI3K/Akt signaling. However, whether treatment of young rats with Dex could protect them from long-term neurotoxicity induced by propofol is unclear.Materials and methodsSeven-day-old male Sprague Dawley rats were randomized and injected intraperitoneally with saline (100 μL, NS), propofol (100 mg/kg), Dex (75 μg/kg), propofol (100 mg/kg) plus Dex (25, 50 or 75 μg/kg), 10% dimethyl sulfoxide (DMSO, 100 μL) or TDZD-8 (a GSK3β inhibitor, 1 mg/kg), or intracerebroventricularly with DMSO (5 μL) or LY294002 (a PI3K inhibitor, 25 μg/5 μL DMSO). Other rats in the experimental group were injected with the same doses of propofol, Dex and LY294002 or TDZD-8. All the rats were monitored until they were 9 weeks old. Their spatial learning and memory were tested by Morris water maze. The neuronal apoptosis, expression of PSD95, expression and phosphorylation of Akt and GSK3β and synaptic ultrastructures were determined by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling, immunohistochemistry, Western blot and transmission electron microscopy assays, respectively.ResultsCompared with the NS control group, young rats injected with intralipid, Dex, TDZD-8, LY294002 or DMSO alone did not show any significant change as they aged. Propofol significantly increased the escape latency time, hippocampal neuroapoptosis and synaptic ultrastructural changes but decreased the relative levels of PSD95 expression, and Akt and GSK3β phosphorylation in the developing hippocampus of the rats. The neuronal toxic effects of propofol were significantly mitigated by the pretreatment with a higher dose of Dex. The neuroprotective effect of Dex was enhanced by the treatment with TDZD-8, but was completely abrogated by the treatment with LY294002.ConclusionOur results indicated that the pretreatment of young rats with Dex attenuated the propofol-induced long-term neurotoxicity in their developing hippocampus by enhancing the PI3K/Akt signaling.

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67/m nach Verkehrsunfall zur Versorgung im Schockraum

Dumps

Bolkenius

2019

Anaesthesist

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Medikamente zur intravenösen Narkoseinduktion: Propofol

Cited by 5 publications

References 57 publications

Postoperative nausea and vomiting in bariatric surgery in comparison to non-bariatric gastric surgery.

Postoperative nausea and vomiting in bariatric surgery in comparison to non-bariatric gastric surgery.

Dexmedetomidine attenuates the propofol-induced long-term neurotoxicity in the developing brain of rats by enhancing the PI3K/Akt signaling pathway

67/m nach Verkehrsunfall zur Versorgung im Schockraum

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