scholarly journals Effects of isoflurane and sevoflurane alone and in combination with butorphanol or medetomidine on the bispectral index in chickens

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Maria Luisa Velasco Gallego ◽  
Olga Martin Jurado ◽  
Jean-Michel Hatt
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Bispectral Index ◽  
Spinal Reflexes ◽  
Non Invasive ◽  
Central Nervous System Depression ◽  
Anaesthetic Depth ◽  
The Difference ◽  
The One ◽  
Anaesthesia Monitoring

Abstract Background The bispectral index (BIS) is an anaesthesia monitoring technique able to assess the level of central nervous system depression in humans and various animal species. In birds, it has been validated in chickens undergoing isoflurane anaesthesia. The aim of this study was to evaluate in an avian species the influence of isoflurane and sevoflurane on BIS, each at different minimum anaesthetic concentrations (MAC) multiples, alone or combined with butorphanol or medetomidine. Ten chickens (5 males and 5 females) underwent general anaesthesia with isoflurane or sevoflurane alone, and combined with either intramuscular administration of butorphanol (1 mg/kg) or medetomidine (0.1 mg/kg), in a prospective and cross-over study (i.e., 6 treatments per animal). BIS measurements were compared to heart rate (HR), non-invasive blood pressure (NIBP) and to a visual analogue scale (VAS) of anaesthesia depth. Results HR was significantly increased, and both NIBP and VAS were significantly reduced, with higher gas concentrations. NIBP (but not HR or VAS) was additionally affected by the type of gas, being lower at higher concentrations of sevoflurane. Butorphanol had no additional effect, but medetomidine led to differences in HR, NIBP, and in particular a reduction in VAS. With respect to deeper level of hypnosis at higher concentrations and the absence of difference between gases, BIS measurements correlated with all other measures (except with HR, where no significant relationship was found) The difference in BIS before (BISpre) and after stimulation (BISpost) did not remain constant, but increased with increasing MAC multiples, indicating that the BISpost is not suppressed proportionately to the suppression of the BISpre values due to gas concentration. Furthermore, neither butorphanol nor medetomidine affected the BIS. Conclusions The difference of degree of central nervous system depression monitored by BIS compared with neuromuscular reflexes monitored by VAS, indicate that BIS records a level of anaesthetic depth different from the one deducted from VAS monitoring alone. BIS provided complementary information such as that medetomidine suppressed spinal reflexes without deepening the hypnotic state. As a consequence, it is concluded that BIS improves the assessment of the level of hypnosis in chickens, improving anaesthesia monitoring and anaesthesia quality in this species.

scholarly journals Evaluation of Bispectral Index (BIS) as an Indicator of Central Nervous System Depression in Horses Anesthetized with Propofol

2009 ◽  
Vol 71 (11) ◽  
pp. 1465-1471 ◽  
Author(s):  
Kazuto YAMASHITA ◽  
Natsuki AKASHI ◽  
Yumiko KATAYAMA ◽  
Yosuke UCHIDA ◽  
Mohammed A. UMAR ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Bispectral Index ◽  
Central Nervous System Depression

Impact of Cranial Radiotherapy on Central Nervous System Prophylaxis in Children and Adolescents With Central Nervous System–Negative Stage III or IV Lymphoblastic Lymphoma

2006 ◽  
Vol 24 (3) ◽  
pp. 491-499 ◽  
Author(s):  
Birgit Burkhardt ◽  
Wilhelm Woessmann ◽  
Martin Zimmermann ◽  
Udo Kontny ◽  
Josef Vormoor ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Lower Limit ◽  
Lymphoblastic Lymphoma ◽  
Stage Iii ◽  
Cranial Radiotherapy ◽  
Free Survival ◽  
The Difference ◽  
The One

Purpose In the Non-Hodgkin's Lymphoma–Berlin-Frankfurt-Munster (NHL-BFM) 95 trial, we tested, against the historical control of the combined trials NHL-BFM90 and NHL-BFM86, whether prophylactic cranial radiotherapy (PCRT) can be omitted for CNS-negative patients with stage III or IV lymphoblastic lymphoma (LBL) with sufficient early response. Patients and Methods Apart from the removal of PCRT in NHL-BFM95, the chemotherapy of the three trials was identical except for the amount of l-asparaginase and daunorubicin during induction. The therapy in NHL-BFM95 was accepted to be noninferior when compared with trials NHL-BFM90/86 if the lower limit of the one-sided 95% CI for the difference in the 2-year probability of event-free-survival (pEFS) between target patients of NHL-BFM95 and the historical controls of NHL-BFM90/86 did not exceed −14%. The target patient group consisted of stage III and IV patients who were CNS negative and responded well to induction therapy. Results The number of target patients was 156 in NHL-BFM95 (median age, 8.6 years; range, 0.2 to 19.5 years) and 163 in NHL-BFM90/86 (median age, 8.4 years; range, 0.6 to 16.6 years). For the target group, the pEFS rates at 2 and 5 years were 86% ± 3% and 82% ± 3%, respectively, in NHL-BFM95 (median follow-up time, 5.1 years; range, 2.1 to 9.1 years) compared with 91% ± 2% and 88% ± 3%, respectively in NHL-BFM90/86 (median follow-up time, 10.7 years; range, 5 to 15.4 years). The lower limit of the one-sided 95% CI for the difference in pEFS was −11% at 2 years and −13% at 5 years. In NHL-BFM95, one isolated and two combined CNS relapses occurred compared with one combined CNS relapse in NHL-BFM90/86. Five-year disease-free-survival rate was 88% ± 3% in NHL-BFM95 compared with 91% ± 2% in NHL-BFM90/86. Conclusion For CNS-negative patients with stage III or IV LBL and sufficient response to induction therapy, treatment without PCRT may be noninferior to treatment including PCRT.

Central Nerve System Impairment, AMA Guides, Sixth Edition: An Overview

2018 ◽  
Vol 23 (1) ◽  
pp. 10-13
Author(s):  
James B. Talmage ◽  
Jay Blaisdell
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Neurological Impairment ◽  
Sixth Edition ◽  
Central Nerve System ◽  
The Central Nervous System ◽  
The One ◽  
Nerve System ◽  
The Brain

Abstract Injuries that affect the central nervous system (CNS) can be catastrophic because they involve the brain or spinal cord, and determining the underlying clinical cause of impairment is essential in using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), in part because the AMA Guides addresses neurological impairment in several chapters. Unlike the musculoskeletal chapters, Chapter 13, The Central and Peripheral Nervous System, does not use grades, grade modifiers, and a net adjustment formula; rather the chapter uses an approach that is similar to that in prior editions of the AMA Guides. The following steps can be used to perform a CNS rating: 1) evaluate all four major categories of cerebral impairment, and choose the one that is most severe; 2) rate the single most severe cerebral impairment of the four major categories; 3) rate all other impairments that are due to neurogenic problems; and 4) combine the rating of the single most severe category of cerebral impairment with the ratings of all other impairments. Because some neurological dysfunctions are rated elsewhere in the AMA Guides, Sixth Edition, the evaluator may consult Table 13-1 to verify the appropriate chapter to use.

scholarly journals COT-04 Circulating biomarker for glioblastoma and primary central nervous system lymphoma -Next Generation Sequencing of small noncoding RNA-

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii21-ii21
Author(s):  
Shumpei Onishi ◽  
Fumiyuki Yamasaki ◽  
Motoki Takano ◽  
Ushio Yonezawa ◽  
Kazuhiko Sugiyama ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Noncoding Rna ◽  
Central Nervous System Lymphoma ◽  
Serum Samples ◽  
Small Noncoding Rna ◽  
Non Invasive ◽  
Diagnostic Models ◽  
Healthy Control ◽  
Generation Sequencing

Abstract Objective: Glioblastoma (GBM) and Primary Central Nervous System Lymphoma (PCNSL) are common intracranial malignant tumors. They sometimes present similar radiological findings and diagnoses could be difficult without surgical biopsy. For improving the current management, development of non-invasive biomarkers are desired. In this study, we explored the differently expressed circulating small noncoding RNA (sncRNA) in serum for specific diagnostic tool of GBM and PCNSL. Material & Methods: Serum samples were obtained from three groups: 1) GBM patients (N=26), 2) PCNSL patients (N=14) 3) healthy control (N=114). The total small RNAs were extracted from serum. The whole expression profiles of serum sncRNAs were measured using Next-Generation Sequencing System. We analyzed serum levels of sncRNAs (15–55 nt) in each serum samples. The difference of sncRNAs expression profile among three groups were compared. Data analysis was performed by logistic regression analysis followed by leave-one-out cross-validation (LOOCV). The accuracy of diagnostic models of sncRNAs combination were evaluated by receiver operating characteristic (ROC) analysis. Results: We created the combination models using three sncRNA in each models based on the logistic regression analysis. The model 1 (based on sncRNA-X1, X2 and X3) enabled to differentiate GBM patients form healthy control with a sensitivity of 92.3% and a specificity of 99.2% (AUC: 0.993). The model 2 (based on sncRNA-Y1, Y2 and Y3) enabled to differentiate PCNSL patients form healthy control with a sensitivity of 100% and a specificity of 93.9% (AUC: 0.984). The model 3 (based on sncRNA-Z1, Z2 and Z3) enabled to differentiate GBM patients form PCNSL patients with a sensitivity of 92.3% and a specificity of 78.6% (AUC: 0.920). Conclusion: We found three diagnostic models of serum sncRNAs as non-invasive biomarkers potentially useful for detection of GBM and PCNSL from healthy control, and for differentiation GBM from PCNSL.

scholarly journals Influence of preoperative corticosteroid treatment on rate of diagnostic surgeries in primary central nervous system lymphoma: a multicenter retrospective study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Florian Scheichel ◽  
Franz Marhold ◽  
Daniel Pinggera ◽  
Barbara Kiesel ◽  
Tobias Rossmann ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Retrospective Study ◽  
Diagnostic Delay ◽  
Central Nervous System Lymphoma ◽  
Corticosteroid Treatment ◽  
Histopathological Diagnosis ◽  
Significant Difference ◽  
The Difference ◽  
Immunocompetent Patients

Abstract Background Corticosteroid therapy (CST) prior to biopsy may hinder histopathological diagnosis in primary central nervous system lymphoma (PCNSL). Therefore, preoperative CST in patients with suspected PCNSL should be avoided if clinically possible. The aim of this study was thus to analyze the difference in the rate of diagnostic surgeries in PCNSL patients with and without preoperative CST. Methods A multicenter retrospective study including all immunocompetent patients diagnosed with PCNSL between 1/2004 and 9/2018 at four neurosurgical centers in Austria was conducted and the results were compared to literature. Results A total of 143 patients were included in this study. All patients showed visible contrast enhancement on preoperative MRI. There was no statistically significant difference in the rate of diagnostic surgeries with and without preoperative CST with 97.1% (68/70) and 97.3% (71/73), respectively (p = 1.0). Tapering and pause of CST did not influence the diagnostic rate. Including our study, there are 788 PCNSL patients described in literature with an odds ratio for inconclusive surgeries after CST of 3.3 (CI 1.7–6.4). Conclusions Preoperative CST should be avoided as it seems to diminish the diagnostic rate of biopsy in PCNSL patients. Yet, if CST has been administered preoperatively and there is still a contrast enhancing lesion to target for biopsy, surgeons should try to keep the diagnostic delay to a minimum as the likelihood for acquiring diagnostic tissue seems sufficiently high.

scholarly journals QT Dispersion: A Predictor of Outcome Following Acute Neurologic Events

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 343-343
Author(s):  
Elzbieta J Wirkowski ◽  
Joseph Moonjely ◽  
Todd J Cohen ◽  
Stephanie M Manzella ◽  
Richard H Smith ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Functional Outcome ◽  
Qt Dispersion ◽  
Neurological Injury ◽  
Disease States ◽  
Qt Intervals ◽  
The Central Nervous System ◽  
The Difference ◽  
Adjusted Logistic Regression

P26 BACKGROUND: QT dispersion (QTD) reflects heterogeneity of myocardial repolarization, which is modulated by the central nervous system. Pervious studies have shown increased QTD to be a predictor of adverse outcome in various cardiac disease states. However, the central nervous system effects on QTD and its relation to functional outcomes have not been previously studied in patients with acute neurological events (NE). The objective of this study was to determine whether increased QTD is related to functional outcome in patients with cerebrovascular accidents (CVA) and transient ischemic attacks (TIA). METHODS: We studied 140 consecutive pts. aged 72±10 yrs. (48% male) admitted to our institution with NE from 1/98 to 4/98. QTD was calculated from admission EKG as the difference between maximum and minimum QT intervals. 120 pts. had interpretable EKGs with measurable QT intervals in at least 11 of 12 leads. Three separate functional scales (NIHSS, Barthel, and Rankin) were obtained on admission and discharge were recorded. RESULTS: QTD was higher in pts. with intracerebral hemorrhage as compared to CVA and TIA (70±15 vs. 53±27 vs. 48±31 msecs. p=0.03). Increased QTD was associated with lower functional outcome on all 3 scales (all p<0.05) and with higher mortality (p=0.02). QTD was higher in pts. with congestive heart failure (80±43 vs. 47±24 msecs. p=0.006) and carotid disease (59±32 vs. 46±27 msecs. p=0.045) as compared to those without. QTD was not associated with atrial fibrillation or coronary disease. All patients with TIA survived. On multivariate analysis, other independent predictors of poorer outcome were QTD (OR 1.35, 95% CI 1.08–1.68) and a trend towards age (OR 1.07, 95% CI 0.99–1.16). On age-adjusted logistic regression, mortality increased by an OR 1.28, 95% (CI 1.02–1.61) for every 10 msec increase in QTD. CONCLUSION: QTD is an independent predictor of functional outcome and mortality following acute neurological events. In this setting, QTD reflects acute neurological injury as well as underlying heart disease. The mechanism of these findings merits further study.

Spinal Reflexes in Ankle Flexor and Extensor Muscles After Chronic Central Nervous System Lesions and Functional Electrical Stimulation

2008 ◽  
Vol 23 (2) ◽  
pp. 133-142 ◽  
Author(s):  
Aiko K. Thompson ◽  
Kristen L. Estabrooks ◽  
SuLing Chong ◽  
Richard B. Stein
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Nerve Stimulation ◽  
Reciprocal Inhibition ◽  
Spinal Reflexes ◽  
Foot Drop ◽  
Emg Activity ◽  
Muscle Nerve ◽  
Voluntary Contractions ◽  
Cns Lesions

Objective. Spinal reciprocal inhibitory and excitatory reflexes of ankle extensor and flexor muscles were investigated in ambulatory participants with chronic central nervous system (CNS) lesions causing foot drop as a function of time after lesion and stimulator use. Methods. Thirty-nine participants with progressive (eg, secondary progressive MS) and 36 with generally nonprogressive (eg, stroke) conditions were studied. The tibialis anterior (TA) and soleus maximum H-reflex/M-wave (Hmax/Mmax) ratios and maximum voluntary contractions (MVC) were measured and compared with those in age-matched control participants. Reciprocal inhibition was measured as a depression of the ongoing electromyographic (EMG) activity produced by antagonist muscle—nerve stimulation. Results. Participants with CNS lesions had significantly higher soleus Hmax/Mmax ratios than control participants, and reduced voluntary modulation of the reflexes occurred in both muscles. Reciprocal inhibition of soleus from common peroneal (CP) nerve stimulation was not significantly different from controls in either group. Inhibition of the TA by tibial nerve stimulation decreased and was eventually replaced by excitation in participants with nonprogressive disorders. No significant change occurred in progressive disorders. Use of a foot drop stimulator increased the TA, but not the soleus MVC overall. H-reflexes only showed small changes. Reciprocal inhibition of the TA increased considerably, while that of the soleus muscle decreased toward control values. Conclusions. Disorders that produce foot drop also produce reflex changes, some of which only develop over a period of years or even decades. Regular use of a foot drop stimulator strengthens voluntary pathways and changes some reflexes toward control values. Thus, stimulators may provide multiple benefits to people with foot drop.

Opioids for Anesthesia and Postoperative Pain Control

2019 ◽  
Author(s):  
Bryan Cook ◽  
Krystina Geiger ◽  
Megan Barra
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Pain Management ◽  
Respiratory Depression ◽  
Acute Pain ◽  
Patient Controlled Analgesia ◽  
Opioid Agonist ◽  
Duration Of Action ◽  
Central Nervous System Depression ◽  
Organ Systems

Opioid agonists are frequently used to provide anesthesia in combination with sedatives and hypnotic agents and manage postoperative acute pain. There are many different opioid agents available that differ in their potency, onset and duration of action, metabolism, drug interactions, and side-effect profile. All opioids have distinct effects upon various organ systems, including central nervous system depression, respiratory depression, and decreased gastrointestinal motility. Fentanyl and fentanyl-derived agents (alfentanil, sufentanil, remifentanil) are most frequently used in the intraoperative period due to their quick onset and duration of action, allowing them to be easily titrated and discontinued at the completion of a procedure. Oral opioids with moderate durations of action, such as oxycodone, hydrocodone, and morphine, are commonly used for acute pain management in the postoperative setting. When oral analgesics cannot be used, intravenous patient-controlled analgesia is another option for pain management. This review contains 5 figures, 11 tables, and 59 references. Key Words: analgesia, anesthesia, central nervous system depression, fentanyl, morphine, opioid agonist, pain management, patient-controlled analgesia, perioperative, respiratory depression

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