Diabetes mellitus (DM) is a major risk factor for the development of endothelial dysfunction which affects the ability of blood vessels to regulate vascular tone. The study aimed to investigate the mechanisms of vasodilator action of the anaesthetic agents ketamine and propofol in diabetic rat aorta. 30 male Sprague-Dawley rats were randomly divided into two equal groups: (i) non-diabetic control (ii) Streptozotocin-induced diabetic group. DM was induced by a single intra-peritoneal injection of streptozotocin at 50 mg/kg body weight. Blood samples were taken from the tail vein after 24 hours and tested for glucose level using an automated glucose analyser. A blood glucose ≥10 mmol/L confirmed hyperglycaemia and the development of DM. Rats were sacrificed, and the aortae excised. The vascular responses of aortic rings from both groups to ketamine, propofol in the presence of vasoactive agents were studied using standard organ bath procedures. Ketamine and propofol reduced Phe-induced contraction similarly in the diabetic and control groups. Barium chloride, attenuated the relaxation response to propofol in diabetic aorta when compared to ketamine. 4-aminopyridine significantly attenuated the relaxation response to ketamine and propofol in diabetic aorta. Glibenclamide, significantly reduced ketamine-induced relaxation in diabetic aorta when compared to propofol. Activation of K+ channels with nicorandil or NS1619 did not affect the relaxation response to ketamine or propofol in diabetic aorta. The results recommend that propofol can be effective in mitigating the consequences of hemodynamic instability in glibenclamide treated diabetics when compared to ketamine. This response is mediated by propofol-induced inhibition of intracellular calcium influx.
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Crit Care Med
November 2024
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.
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.
J Clin Med
December 2024
Department of Medical and Health Sciences Tarnobrzeg, State Higher Vocational School Memorial of Prof. Stanislaw Tarnowski in Tarnobrzeg, 39-400 Tarnobrzeg, Poland.
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Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Cancer recurrence and metastasis remain critical challenges following surgical resection, influenced by complex perioperative mechanisms. This review explores how surgical stress triggers systemic changes, such as neuroendocrine responses, immune suppression, and inflammation, which promote the dissemination of residual cancer cells and circulating tumor cells. Key mechanisms, such as epithelial-mesenchymal transition and angiogenesis, further enhance metastasis, while hypoxia-inducible factors and inflammatory responses create a microenvironment conducive to tumor progression.
View Article and Find Full Text PDFbioRxiv
December 2024
Department of Anaesthesiology and Critical Care, University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, United States.
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