Remifentanil is a kind of synthetic opioid which has gained wide clinical acceptance by anesthesiologists. In this study, we attempted to test whether withdrawal effects on learning mechanisms can be triggered by repeated low-dose remifentanil treatment. Male Sprague-Dawley (SD) rats were subjected to remifentanil (50μg/kgs.c.) twice per day at 12h intervals for 15 days. When the animals of remifentanil group were withdrawn from remifentanil at 10h after the last injection, changes in open field test, Morris water maze test (MWM) and synaptic efficacy were examined in each group. We demonstrated that repeated exposure to 50μg/kg remifentanil produced enhanced locomotor activity indicating that a remifentanil addiction animal model in rats was established. MWM results showed that exposure to remifentanil had no influence on the spatial cognition. After withdrawal of remifentanil rats showed impaired spatial cognition. In electrophysiology test, remifentanil group rats showed a trend for a rightward shift of input/output relationship and significant deficits in maintenance of STP and LTP. Immunohistochemistry results demonstrated increased NR2A/NR2B ratio that should be included depression of LTP. In the whole-cell patch-clamp recording, after elimination from remifentanil incubation, mEPSC frequency was down regulated in hippocampal CA1 neurons, indicating that basal synaptic transmission were affected by remifentanil withdrawal. Taken together, the current findings demonstrate that the remifentanil withdrawn rats exhibit obvious impairment of hippocampus-dependent memory and synaptic plasticity. Increased hippocampal NR2A/NR2B expression ratio and the changes of basal synaptic transmission may participate in the impairment of LTP.
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http://dx.doi.org/10.1016/j.neuro.2016.01.005 | DOI Listing |
J Clin Med
January 2025
Department of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy.
Rigid bronchoscopy (RB) is the gold standard for managing central airway obstruction (CAO), a life-threatening condition caused by both malignant and benign etiologies. Anesthetic management is challenging as it requires balancing deep sedation with maintaining spontaneous breathing to avoid airway collapse. There is no consensus on the optimal anesthetic approach, with options including general anesthesia with neuromuscular blockers or spontaneous assisted ventilation (SAV).
View Article and Find Full Text PDFBr J Anaesth
January 2025
Department of Anaesthesiology, Peking University First Hospital, Beijing, China; Outcomes Research Consortium, Cleveland, OH, USA.
Background: The Qnox index is a novel monitor to quantify intraoperative nociception based on an electroencephalographic algorithm. We evaluated the ability of the Qnox index to discriminate noxious from non-noxious stimuli, respond to stimuli, and discriminate different levels of analgesia in patients under propofol anaesthesia with neuromuscular block.
Methods: Qnox was compared with heart rate and mean arterial pressure with five designated stimuli: tetanic stimulations without (tetanic 1) and with sufentanil (tetanic 2), skin incision, tracheal intubation, and a non-noxious period.
Korean J Anesthesiol
January 2025
Department of Anesthesiology & Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Background: Maintenance of stable blood pressure (BP) during cerebrovascular bypass surgery is crucial to prevent cerebral ischemia. We compared the effect of remimazolam anesthesia with that of propofol-induced and desflurane-maintained anesthesia on intraoperative hemodynamic stability and the need for vasoactive agents in patients undergoing cerebrovascular bypass surgery.
Methods: Sixty-five patients were randomized into remimazolam (n = 31, remimazolam-based intravenous anesthesia) and control groups (n = 34, propofol-induced and desflurane-maintained anesthesia).
Br J Anaesth
January 2025
Department of Anesthesiology, Duke University School of Medicine, Durham, NC, USA; Bermaride LLC, Durham, NC, USA. Electronic address:
Background: Patients with obstructive sleep apnoea (OSA) are considered more sensitive to opioids and at increased risk of opioid-induced respiratory depression. Nonetheless, whether OSA treatment (continuous positive airway pressure, CPAP; or bilevel positive airway pressure, BIPAP) modifies this risk remains unknown. Greater opioid sensitivity can arise from altered pharmacokinetics or pharmacodynamics.
View Article and Find Full Text PDFKorean J Anesthesiol
January 2025
Department of Anesthesiology, Ondokuz Mayis University, School of Medicine, Kurupelit, Samsun, Turkey, TR55139.
Background: Laparoscopic sleeve gastrectomy (LSG) causes significant postoperative pain, necessitating effective multimodal analgesia strategies. This study evaluated the efficacy of the external oblique intercostal block (EOIB) in this context.
Methods: This prospective, randomized, controlled, single-blind study conducted between April and December 2023 included 60 patients who underwent LSG.
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