General anesthetics (GAs) have transformed surgery through their actions to depress the central nervous system and blunt the perception of surgical insults. Counterintuitively, many of these agents activate peripheral nociceptive neurons. However, the underlying mechanisms and significance of these effects have not been explored. Here, we show that clinical concentrations of noxious i.v. and inhalation GAs excite sensory neurons by selectively activating TRPA1, a key ion channel in the pain pathway. Further, these GAs induce pain-related responses in mice that are abolished in TRPA1-null animals. Significantly, TRPA1-dependent neurogenic inflammation is greater in mice anesthetized with pungent compared with nonpungent anesthetics. Thus, our results show that TRPA1 is essential for sensing noxious GAs. The pronociceptive effects of GAs combined with surgical tissue damage could lead to a paradoxical increase in postoperative pain and inflammation.
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http://dx.doi.org/10.1073/pnas.0711038105 | DOI Listing |
Crit Care Med
January 2025
Department of Anesthesia and Critical Care, AOU S. Luigi Gonzaga, Orbassano, Turin, Italy.
Objectives: Concise definitive review of the use of induction agents in critically ill patients undergoing tracheal intubation and their association with outcomes.
Data Sources: Original publications were retrieved through a PubMed search with search terms related to induction agents for tracheal intubation in critically ill patients.
Study Selection: We included randomized controlled trials and observational studies that reported patient outcomes.
BMC Vet Res
January 2025
Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.
Background: Mixed exhaled air has been widely used to determine exhaled propofol concentrations with online analyzers, but changes in dead space proportions may lead to inaccurate assessments of critical drug concentration data. This study proposes a method to correct propofol concentration in mixed air by estimating pulmonary dead space through reconstructing volumetric capnography (Vcap) from time-CO and time-volume curves, validated with vacuum ultraviolet time-of-flight mass spectrometry (VUV-TOF MS).
Methods: Existing monitoring parameters, including time-volume and time-CO curves, were used to determine Vcap.
BMC Anesthesiol
January 2025
The Yancheng Clinical College of Xuzhou Medical University, No 166 Yulong Road, Yancheng, Jiangsu, 224000, China.
Background: Laparoscopic radical gastrectomy has been reported to be associated with substantial trauma and pain. This study compared the impact of ultrasound-(US)-guided, bilateral, double-injection intertransverse process block (ITPB) on postoperative analgesia with subcostal transversus abdominis plane block (TAPB) in patients who were undergoing laparoscopic radical gastrectomy.
Methods: Sixty-two patients who were undergoing laparoscopic radical gastrectomy surgery under general anesthesia were included.
Cleft Palate Craniofac J
January 2025
Global Smile Foundation, Norwood, MA, USA.
Objective: This study aims to assess the safety and efficacy of solely using local anesthetics for cleft lip repair and/or revision in adolescent and adult patients.
Design: Systematic review.
Setting: Clinical studies describing the use of local anesthetics in cleft lip repair procedures.
Sci Adv
January 2025
SciLifeLab, Department of Applied Physics, KTH Royal Institute of Technology, Tomtebodävagen 23, Solna, 17165 Stockholm, Sweden.
γ-Aminobutyric acid type A (GABA) receptors are ligand-gated ion channels in the central nervous system with largely inhibitory function. Despite being a target for drugs including general anesthetics and benzodiazepines, experimental structures have yet to capture an open state of classical synaptic α1β2γ2 GABA receptors. Here, we use a goal-oriented adaptive sampling strategy in molecular dynamics simulations followed by Markov state modeling to capture an energetically stable putative open state of the receptor.
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