Predictive factors of the contracture test for diagnosing malignant hyperthermia in a Brazilian population sample: a retrospective observational study

Abstract Introduction Malignant Hyperthermia (MH) is a pharmacogenetic, hereditary and autosomal dominant syndrome triggered by halogenates/succinylcholine. The In Vitro Contracture Test (IVCT) is the gold standard diagnostic test for MH, and it evaluates abnormal skeletal muscle reactions of susceptible individuals (earlier/greater contracture) when exposed to caffeine/halothane. MH susceptibility episodes and IVCT seem to be related to individual features. Objective To assess variables that correlate with IVCT in Brazilian patients referred for MH investigation due to a history of personal/family MH. Methods We examined IVCTs of 80 patients investigated for MH between 2004‒2019. We recorded clinical data (age, sex, presence of muscle weakness or myopathy with muscle biopsy showing cores, genetic evaluation, IVCT result) and IVCT features (initial and final maximum contraction, caffeine/halothane concentration triggering contracture of 0.2g, contracture at caffeine concentration of 2 and 32 mmoL and at 2% halothane, and contraction after 100 Hz stimulation). Results Mean age of the sample was 35±13.3 years, and most of the subjects were female (n=43 or 54%) and MH susceptible (60%). Of the 20 subjects undergoing genetic investigation, 65% showed variants in RYR1/CACNA1S genes. We found no difference between the positive and negative IVCT groups regarding age, sex, number of probands, presence of muscle weakness or myopathy with muscle biopsy showing cores. Regression analysis revealed that the best predictors of positive IVCT were male sex (+12%), absence of muscle weakness (+20%), and personal MH background (+17%). Conclusions Positive IVCT results have been correlated to male probands, in accordance with early publications. Furthermore, normal muscle strength has been confirmed as a significant predictor of positive IVCT while investigating suspected MH cases.

A Comparative Study of Single Breath Induction of Anaesthesia Using a Vital Capacity Breath of Halothane Nitrous Oxide and Oxygen Mixture with Intravenous Sodium Pentothal

Background: Induction of anaesthesia is accompanied byintravaneous sodium pentothal or inhalation of an appropriatemixture of Halothane, Nitrous oxide and oxygen.Aims and Objectives: 1) To study the vital capacity singlebreath induction using Halothane, Nitrous oxide and OxygenMixture. 2) To compare the efficiency and acceptance of abovemethod with i/v Sodium Pentothal induction.3) To access anycomplication arising from above technique.Methods: Patients were randomly divided in two equal of 25each belonging to ASA grade 1.Group A: Patient was given intravenous sodium Pentothal withan intravenous drip of 5% dextrose solution.Group B: Patients were given a mixture of 4% Halothane in66%N2o and 33% oxygen by using mapleson. A breathingsystem (Vital Capacity Breath)Results: It has been observed that there was no clinicallysignificant fluctuation in pulse rate and arterial pressure at anytime during induction. 1) No patient developed arrhythmiaduring induction in thiopentone group while one patient inhalothane group developed transient ventricular ectopic 1minute after starting the induction. 2) Except one patient whohad coughing during induction with thiopentone, induction wassmooth in all. Nausea and vomiting were more withthiopentone group as compared to halothane group. 3) The

A Comparative Study on General Anaesthetics: Sevoflurane Versus Halothane in Paediatrics Patients

Background: In pediatric patients, induction and maintenance of anesthesia can be done using inhalational method or intravenous method. Though, absence of intravenous access in these patients makes inhalational anesthesia the commonly used modality. In pediatric patients, sevoflurane and halothane are both inhalational anesthetic agents used for general anesthesia. Methods: This study was conducted in the Department of Anesthesia in Krishna Mohan Medical College & Hospital, Mathura, U.P, India.. The duration of study was over a period of six month. Result: The difference was statistically significant (P value <0.05). The mean intubation time was significantly lower in group-A (226.37±14.23 sec) in comparison to group-B (281.33±7.01). The emergence time was also significantly lower in group-A (237.97±11.36 sec) in comparison to group-B (373.70±14.54 sec). Conclusion: This study concludes that rapid recovery in sevoflurane group in comparison to halothane group. Therefore, tis study found that in children for smooth and faster induction and early recovery, sevoflurane is a safe inhalation induction agent than halothane without causing any adverse effect.

Effects of seven sevoflurane and propofol anesthesia on heart rate and myocardial enzymes in elderly patients with coronary heart disease / 中国生化药物杂志

Objective To investigate the effects of seven halothane and propofol anesthesia on heart rate and myocardial enzymes in elderly patients with coronary heart disease (CHD), and to analyze the safety of clinical application of the two kinds of anesthetic drugs.MethodsA total of 70 cases of elderly patients with coronary heart disease treatment January 2012 to December 2014 general anesthesia surgery as the research object, randomly divided into A group and B group were 35 patients in.A group were treated with seven sevoflurane anesthesia, group B patients were given propofol anesthesia, observe the change of the two groups of patients before and after anesthesia hemodynamic index and myocardial enzyme etc.index.ResultsA group of patients with HR 5min after induction and 10min were significantly lower than before the surgery, and the difference was statistically significant (P<0.05);HR stabilized after the induction of 15min and 20min, and compared with before surgery had no significant difference;patients in group B HR and 10min 5min after induction there was no obvious change compared with that before operation, no statistical significance;and after the induction of 15min and 20min HR increased, the difference was statistically significant (P<0.05).A group and B group in patients with systolic and diastolic blood pressure were lower than before anesthesia in varying degrees, and group B more significantly, the difference was statistically significant (P<0.05).A group and B group of patients after 6 h, cTnl and CK-MB in 12h and 24h than 15min before surgery has increased significantly, and A group cTnl and CK-MB were lower than B group, the difference was statistically significant (P<0.05).ConclusionThe clinical application of seven sevoflurane anesthesia for elderly patients with coronary heart disease during propofol is feasible, but seven halothane on blood pressure and heart rate of patients affected with propofol, improve the myocardial enzyme level, and better reduce the damage of perioperative myocardial, more suitable for anesthesia in elderly coronary heart disease.

Effects of seven sevoflurane or propofol combined with remifentanil anesthesia on patients undergoing laparoscopic surgery / 中国生化药物杂志

Objective To study the effect of seven sevoflurane or propofol combined with remifentanil anesthesia on patients undergoing laparoscopic surgery.Methods In Taizhou Tumor Hospital from January 2015 to December 2016 were 100 cases of patients with laparoscopic surgery as the research object in the course of the study, were randomly divided into control group and experimental group two were 50 cases each.Patients in the control group were treated with propofol and remifentanil anesthesia.The experimental group was given seven sevoflurane and remifentanil anesthesia.Comparative analysis of the experimental group and the control group of patients with anesthesia effect.Results After the corresponding anesthesia, patients in the experimental group extubation time, recovery time was significantly better than the control group, with statistical difference(P<0.05).In the experimental group, 15 minutes after extubation, the Steward recovery score was(5.04±0.65), while the control group score was(4.12±0.54).Can be obtained, the quality of patients' recovery was significantly higher than that of the control group, with statistical difference(P<0.05).The cognitive function scores of the experimental group were significantly higher than those of the control group after extubation(2 h), and the difference was statistically significant(P<0.05).Conclusion Compared with propofol remifentanil anesthesia, seven sevoflurane remifentanil anesthesia effect is good, can improve the patient's recovery quality, to help with the recovery of cognitive function, with further clinical promotion and application significance.

Tiopental altera a resposta nociceptiva de ratos jovens em longo prazo / Thiopental alters long term nociceptive response of young rats

The objective of this study was to evaluate the long term nociceptive response determined by use of two general anesthetics, one intravenous and the other inhalatory, in young animals. In the first experiment, the animals of 21 days of age were divided into control (saline) and thiopental (35 mg/kg, i.p.) groups. In the second experiment, rats of the same age were divided in two groups ­ halothane (2%) and control. In experiment 1, there was difference between groups ­ reduction of tail-flick latency in the group thiopental (P< 0.05). In experiment 2, there were no differences between groups or interaction between time versus group (F(1,19)=0.11 for groups, P>0.05; F(1,19)=0.032 for the interaction, P>0.05). The results obtained in this study showed that halothane did not alter the nociceptive response in young animals. However, the thiopental induced hyperalgesic response in rats. (AU)

O objetivo desse estudo foi avaliar a resposta nociceptiva a longo prazo relacionada ao uso de dois anestésicos gerais ­ um intravenoso e outro inalatório, em animais jovens. No primeiro experimento, os animais de 21 dias de idade foram divididos nos grupos controle (solução salina) e tiopental sódico (35 mg/kg, i.p.). No segundo experimento, animais de mesma idade foram divididos em dois grupos ­ halotano (2%) e controle. No Experimento 1, houve redução da latência de retirada da cauda no grupo tiopental (P<0,05). No Experimento 2, não houve diferença entre os grupos ou interação entre grupo x tempo (F(1,19)=0,11 para grupos, P>0,05; F(1,19)=0,032 para a interação, P>0,05). Os resultados obtidos nesse estudo demonstraram que o halotano não altera a resposta nociceptiva em animais jovens. Entretanto, o tiopental induziu resposta hiperalgésica nestes ratos.(AU)

Effect of dexmedetomidine combined with seven isoflurane for elderly patients with rectal cancer radical operation on recovery quality / 中国基层医药

Objective To investigate the effects of dexmedetomidine combined with sevoflurane on elderly patients with postoperative recovery quality.Methods Selected 60 cases of abdominal rectal cancer resection for elderly patients,which were ASA I or II,were randomly divided into two groups by a random number table method, while each groupincluded 30 cases:the control group( group N) and the dexmedetomidine group( group D) .Before the induction of anesthesia,group D vein was injected with micro pump ( more than 10 min) of dexmedetomidine 1μg/kg ( which was formulated with physiological saline as 4μg/mL) ,and then was given to maintain the dexmedetomidine 0.5μg/h and N group was injected with micro pump of the same volume of normal saline.The two groups of anesthesia were same,by which the static inhalation of composite general anesthesia.Observation were recorded before induction of anesthesia(T0),given dexmedetomidine(TI),after intubation 1 min(T1),5 min(T2),drawing tube immediately (T3),extubation after 5min(T4),30min(T5)the time of HR,BP,SpO2,BIS;propofol and remifentanil dosage,opera-tive time,operation time,a nesthesia time,recovery time,drawing tube time,extubation after Ramsay Sedation score, pain score,patient satisfaction and adverse reactions were recorded.Results In T3 period,the changes of HR (82 ± 14)times/min,SBP (130 ±8)mmHg,DBP (85 ±13)mmHg in group N were more obvious than (70 ±12)timse/min, SBP (121 ±7)mmHg,DBP (79 ±9)mmHg in group D,the difference between the two groups had statistical signifi-cance(t=6.28,4.63,2.08,all P0.05).In group N,postoper-ative restlessness in 8 cases,nausea and vomiting in 10 cases,chills in 9 cases,which were significantly higher than 2 cases,2 cases,2 cases in group D(χ2 =4.32,6.67,5.45,all P<0.05).At the same time,the satisfaction score of patient in group D (3.0 ±0.3)point,which was significant higher than (2.7 ±0.5)points in group N (t=1.88,P<0.05).Conclusion Dexmedetomidine detomidine composite sevoflurane anesthesia can improve the postoperative re-covery quality of elderly patients with rectal cancer radical surgery.

Application of dexmedetomidine combined with sevoflurane in elderly patients undergoing percutaneous nephrolithotomy / 中国医师杂志

Objective To investigate the clinical efficacy and safety of dexmedetomidine combined with sevoflurane in elderly patient undergoing percutaneous nephrolithotomy.Methods Forty ASA Ⅰ ～ Ⅱ elderly patients of both sexes,aged 65 ～ 76 (71.0 ± 6.0)yr,scheduled for elective surgery of percutaneous nephrolithotomy under general anesthesia,were randomly divided into two groups (n =20 each):dexmedetomidine/sevoflurane group (group D) and propofol/sevoflurane group (group P).All patients received fentanyl,propofol,and cisatracurium for anesthesia induction.After endotracheal intubation,patients in group D received an initial loading dose of 0.5 μg/kg (4 μg/ml) of dexmedetomidine over 10 min,followed by a continuous infusion of 0.3 ～ 0.6 μg/(kg · h).Patients in group P received an initial loading dose of 1 mg/kg of propofol over 10 min,followed by a continuous infusion of 3 ～ 6 mg/(kg · h).All patients received the inhalation of sevoflurane for maintenance.Bispectral index was used to maintain a similar level of hypnosis in both groups (40 ～ 60).The heart rate (HR),blood pressure (BP) [systolic blood pressure (SBP)/diastolic blood pressure (DBP)],oxygen saturation (SpO2),end-tidal carbon dioxide partial pressure (PETCO2) at different time points before anesthesia (T0),10 min after prone position (T1),30 and 60 min started lithotripsy (T2-3),and at the end of operation (T4) were recorded,respectively.The operation time,amount of blood loss,and volume of fluid infusion were recorded.Recovery time of spontaneous ventilation,awaking time (open eyes by calling),extubation time,staying time at postanesthesia care unit (PACU),and relevant complications were also recorded.Results Compared to the baseline value at T0,SBP and DBP were significantly decreased at T1 in both groups(P ＜0.05),and no significant differences in the SBP,DBP,SpO2,and PETCO2 were found between two groups(P ＞ 0.05).Compared to the baseline value at T0,the HR was significantly decreased at T1 ～ T4 in group D (P ＜ 0.05),the HR was significantly lower at T1 ～ T4 in group D than that of group P (P ＜ 0.05).No significant differences in operation time,amount of blood loss,and volume of fluid infusion were found between two groups (P ＞ 0.05).No significant differences in recovery time of spontaneous ventilation,staying time at PACU,nausea,vomit,and agitation were found between two groups (P ＞ 0.05),while awaking time and extubation time were significantly longer in group D than that of group P(P ＜ 0.05).The shivering was significantly less in group D than that of group P (P ＜ 0.05).Conclusions Both dexmedetomidine/sevoflurane and propofol/sevoflurane anesthesia are suitable for elderly patients undergoing percutaneous nephrolithotomy.Dexmedetomidine/sevoflurane makes time of awake and extubation longer,but dexmedetomidine can reduce the shivering and the attendant complications caused by shivering.

Effects of Sevoflurane Postconditioning on Lung Function in Patients Undergoing Cardiac Valve Replacement with Cardiopulmonary Bypass / 天津医药

Objective To investigate the effects of sevoflurane postconditioning on lung function in patients undergo-ing heart valve prosthesis implantation with cardiopulmonary bypass (CPB). Methods Thirty patients, scheduled for heart valve prosthesis implantation, were randomly divided into control group (C, n=15) and sevoflurane postconditioning group (S, n=15). Anesthesia was maintained by intermittent intravenous injection of midazolam, fentanyl and pipecuronium. In group S, 2%sevoflurane was inhaled continuously for 15 min , 2 min before aortic unclamping. Blood samples were taken at 30 min before CPB (T2), 30 min after CPB (T3), 6 h (T4), 12 h (T5) and 24 h (T6) after operation. The values of p(O2), SaO2, airway peak pressure (Ppeak) and airway plateau (Pplat) pressure during the time of mechanical ventilation were recorded. Oxygen index (OI), alveolar arterial oxygen tension difference (AaDO2), dynamic pulmonary compliance (Cdyn) and static pulmonary compli-ance (Cstat) were calculated. Results Compared with group C, the values of SaO2 and Cdyn were significantly higher in group S after 30 min of CPB. The values of OI, p(O2), Cdyn and Cstat were significantly higher in group S than those of group C after 6 h of operation. The value of AaDO2 was significantly lower 12 h and 24 h after operation than that of group C (P＜0.05). Conclusion CPB led to the lung injury. The sevoflurane postconditioning has a protective effect on lung function in pa-tients undergoing cardiac valve replacement with CPB.

O efeito dos anestésicos inalatórios halotano e sevoflurano em um modelo experimental de lesão hepática / Effects of the inhalational anesthetics halothane and sevoflurane on an experimental model of hepatic injury

JUSTIFICATIVA E OBJETIVOS: A lesão hepática pós-anestesia inalatória ainda é controversa. Estudos sugerem que agentes inalatórios geram uma resposta imune que pode provocar lesões hepáticas. O objetivo deste estudo é analisar o efeito dos anestésicos inalatórios halotano e sevoflurano no fígado de ratos submetidos à hipóxia e à reperfusão. MÉTODO: Foram utilizados 30 ratos Wistar pré-tratados com fenobarbital 0,1 por cento por cinco dias, com suspensão da medicação 24 horas antes do experimento, a fim de provocar a lesão hepática. Os animais foram distribuídos em cinco grupos com seis ratos cada. O Grupo C foi o de controle, sem qualquer tipo de tratamento; o Grupo F foi aquele no qual se induziu lesão hepática com fenobarbital; o Grupo Hipóxia foi exposto a 14 por cento de oxigênio (O2); o Grupo H recebeu halotano 1 por cento e 14 por cento de O2; e o Grupo S recebeu sevoflurano 2 por cento e 14 por cento de O2. Contadas 24 horas após a exposição dos gases, realizaram-se coletas de sangue para avaliação de transaminases (AST e ALT) e de amostras de fígado para avaliação histológica. Foram usados os testes de Análise de Variância não paramétrica de Kruskal-Wallis e, para comparação de médias, os testes de Newman-Keuls. RESULTADOS: A atividade enzimática revelou que os valores de média amostral de AST (280,33 para halotano, 181 para sevoflurano) e ALT (235 para halotano e 48,33 para sevoflurano) não indicaram diferença estatística significativa; os grupos testados apresentaram valores elevados. O sevoflurano, quando comparado com o halotano à microscopia óptica, apresentou índices menores de alteração morfológica, com p = 0,045 para esteatose, p = 0,0075 para infiltrado inflamatório e p = 0,0074 para necrose. CONCLUSÕES: O Grupo sevoflurano, quando comparado ao Grupo halotano, não apresentou lesão no parênquima hepático quando avaliado por microscopia óptica.

BACKGROUND AND OBJECTIVES: Hepatic injury after inhalational anesthesia is controversial. Studies have suggested that inhalational agents generate an immune response that can provoke hepatic injury. The objective of this study was to analyze the effects of the inhalational agents halothane and sevoflurane on the liver of rats submitted to hypoxia and reperfusion. METHODS: Thirty Wistar rats, pretreated with 0.1 percent phenobarbital for 5 days, with discontinuation of the drug 24 hours before the experiment to cause hepatic injury, were used. Animals were distributed in five groups of six rats each. The control group (C) did not receive any treatment; in the F group, phenobarbital was used to induce hepatic injury; the Hypoxia group was submitted to 14 percent oxygen (O2); the H group received 1 percent halothane and 14 percent O2; and the S group received 2 percent sevoflurane and 14 percent O2. Twenty-four hours after exposure to the gases, blood samples were collected to evaluate transaminases (AST and ALT), and liver samples were collected for histological evaluation. Kruskal-Wallis Analysis of Variance and the Newman-Keuls test were used. RESULTS: Enzymatic activity mean values of AST (280.33, for halothane, 181, for sevoflurane) and ALT (235 for halothane, and 48.33, for sevoflurane) did not show significant differences, and all groups showed elevated values. Compared to halothane on optical microscopy, sevoflurane had lower indices of morphologic changes with p = 0.045, for steatosis, p = 0.0075, for inflammatory infiltrate, and p = 0.0074, for necrosis. CONCLUSIONS: Compared to the halothane group, sevoflurane did not show injuries of the liver parenchyma on optical microscopy.

JUSTIFICATIVA Y OBJETIVOS: La lesión hepática postanestesia inhalatoria todavía es algo controversial. Algunos estudios sugieren que los agentes inhalatorios generan una respuesta inmune que puede provocar lesiones hepáticas. El objetivo de este estudio fue analizar el efecto de los anestésicos inhalatorios halotano y sevoflurano en el hígado de ratones que fueron sometidos a la hipoxia y a la reperfusión. MÉTODO: Fueron utilizados 30 ratones Wistar tratados previamente con fenobarbital al 0,1 por ciento durante cinco días, con suspensión de la medicación 24 horas antes del experimento para provocar la lesión hepática. Los animales fueron distribuidos en cinco grupos con seis ratones cada uno. El grupo C fue el de control, sin ningún tipo de tratamiento; el grupo F fue aquel en el cual se indujo la lesión hepática con fenobarbital; el grupo Hipoxia se expuso a un 14 por ciento de oxígeno (O2); el grupo H recibió halotano al 1 por ciento y al 14 por ciento de O2; y el grupo S recibió sevoflurano al 2 por ciento y al 14 por ciento de O2. Contadas 24 horas después de la exposición de los gases, se realizó la recolección de sangre para la evaluación de las transaminasas (AST y ALT), y de las muestras de hígado para la evaluación histológica. Fueron usados los test de Análisis de Variancia no paramétrica de Kruskal-Wallis, y para la comparación de los promedios se usaron los test de Newman-Keuls. RESULTADOS: La actividad enzimática arrojó valores de promedio de muestra de AST (280,33 para halotano, 181 para sevoflurano y ALT 235 para halotano y 48,33 para sevoflurano), que no indicaron diferencia estadística significativa: los grupos testados presentaron valores elevados. El sevoflurano, cuando fue comparado con el halotano a la microscopía óptica, presentó índices menores de alteración morfológica, con p = 0,045 para esteatosis, p = 0,0075 para infiltrado inflamatorio y p = 0,0074 para necrosis. CONCLUSIONES: El grupo sevoflurano, cuando se comparó con el grupo h...

Recuperação anestésica e efeitos hemodinâmicos da infusão contínua de tiopental versus halotano na manutenção da anestesia em pacientes submetidos à cirurgia ocular / Anesthetic recovery and hemodynamic effects of continuous thiopental infusion versus halothane for maintenance anesthesia in patients undergoing ocular surgery

PURPOSE: To investigate anesthesia recovery and hemodynamic status in patients under thiopental infusion or halothane maintenance anesthesia undergoing ocular surgery. METHODS: Fifty-nine voluntary patients undergoing ocular surgery in Farabi hospital were allocated to one of two maintenance anesthesia groups: inhaled halothane, 0.8 to 1 per cent, (group I, n=37) and thiopental infusion, 10 to 12 mg/kg/hour, (group II, n=22). Hemodynamic parameters were recorded at the time of patient entrance to the operation room and at the 1, 2, 5, 10, 15, 20, 25, 30, 35, and 40 minutes following anesthesia. Anesthesia recovery variables were also compared between the two groups. RESULTS: In group I, arterial blood pressure at 10 to 40 min and heart rate at 1 and 25 min after the administration of anesthetics were significantly lower when compared with group II (W ²= 25.10, p= 0.005). Arterial oxygen saturation was similar in the two groups over the whole points of time. The time intervals between the end of surgery and beginning of the first body movements and respiratory efforts were significantly longer in group received halothane (p<0.001). CONCLUSION: Continuous infusion of thiopental can be applied effectively and safely for maintenance of anesthesia. In comparison with halothane, it is associated with lower changes of intraoperative hemodynamics and faster anesthesia recovery.

OBJETIVO: Investigar a recuperação anestésica e as condições hemodinâmicas em pacientes submetidos a infusão de tiopental ou hatotano na manutenção da anestesia na cirurgia ocular. MÉTODOS: Cinquenta e nove voluntários submetidos a cirurgia ocular no Hospital Farabi foram distribuídos em dois grupos de manutenção anestésica: Grupo I (n=37) inalação halotano, 0,8 a 1 por cento e Grupo II (n=22) infusão de tiopental, 10 a 12 mg/kg/hora. Foram registrados parâmetros hemodinâmicos da entrada dos pacientes na sala operatória até 1, 2, 5, 10, 15, 20, 25, 30, 35 e 40 minutos durante a anestesia. Variáveis de recuperação anestésica foram também comparados entre ambos os grupos. RESULTADOS: No Grupo I a pressão arterial nos 10 a 40 minutos e avaliação cardíaca em um e 25 minutos após a administração dos anestésicos foram significantes mais baixos comparados com o Grupo II (W²=25.10, p=0.005). A saturação de oxigênio foi similar nos dois grupos durante todos procedimentos. Os intervalos de tempo entre o final da cirurgia e início dos primeiros movimentos e a respiração foram significativamente mais prolongados no grupo que recebeu halotoano (p<0.001). CONCLUSÃO: A infusão continua de tiopental pode ser aplicado efetivamente e com segurança na manutenção da anestesia. Em comparação com halotano as mudanças hemodinâmicas foram menores e a recuperação anestésica mais rápida.

Survey of malignant hyperthermia in Korea: Report for the necessity of establishing the center for caffeine and halothane contracture test in Korea: a questionnaire

BACKGROUND: Malignant hyperthermia (MH) has a high mortality rate and a family history. Then, caffeine and halothane contracture test (CHCT), generally used to detect MH susceptibility, is needed for early detection. The aim of this survey is to collect the opinion about establishment of the center for CHCT in Korea. METHODS: A people who were anesthesiologists working in the training hospital of Korea participated the survey between January and March 2011. Usual anesthetic drug during general anesthesia including volatile agents, opioids, muscle relaxants, incidence, diagnoses and treatments of MH, and opinion about establishment of the center for CHCT, were investigated. RESULTS: A total of 105 people who were anesthesiologists working in Korea were registered, they answered that 33 anesthesiologists (32%) met MH patient, and MH occurred once in a decade. If there is a diagnostic method such as CHCT in Korea, 89 anesthesiologists (89%) will recommend the test for the patients and their family. CONCLUSIONS: Many anesthesiologists want to recommend the CHCT for patients and their family. But, in Korea, it is impossible because there is no laboratory available for CHCT. Now, we considered carefully to establish the laboratory available for CHCT.

Estudo comparativo dos parâmetros cardiorrespiratórios e tempo de recuperação em cadelas submetidas a ovariosalpingohisterectomia e anestesiadas com halotano, isofluorano ou sevofluorano / Comparative study of clinical cardiorespiratory parameters and recovery times in bitches submitted to ovariohysterectomy and anesthetized with halothane, isoflurane or sevoflurane

Objetivou-se comparar os efeitos cardiorrespiratórios, bem como sobre a recuperação em cadelas submetidas à ovariosalpingohisterectomia, e anestesiadas pelo halotano, isofluorano ou sevofluorano. Para tanto, utilizaram-se vinte e quatro cadelas sem raça definida, com peso médio de 15,03 e idade média de 3,93 anos, clinicamente saudáveis, avaliadas por meio de hemograma completo, contagem de plaquetas, bioquímica hepática e renal e teste de coagulação, sendo distribuídas em três grupos de oito animais. Todos os animais receberam acepromazina na dose de 0,1 mg/kg i.m., como pré-tratamento e após 15 minutos a anestesia foi induzida com propofol na dose de 5 mg/kg i.v.. Para a manutenção utilizou-se halotano (grupo GAH), isofluorano (GAI) ou sevofluorano (GAS). Não houve diferença estatística entre os grupos em relação aos parâmetros cardiovasculares, observando redução discreta dos valores pressóricos após a indução, devido provavelmente a ação do propofol. A temperatura retal diminuiu gradativamente em função do tempo de anestesia, não apresentando diferença entre os grupos, porém GAI e GAS obtiveram valores inferiores dessa variável. Houve depressão respiratória nos três grupos, evidenciada pelo aumento da PaCO2 com consequente diminuição do pH arterial, porém sem diferença entre os grupos. O período obtido para extubação foi semelhante entre os grupos, no entanto, GAS apresentou menor tempo para posição quadrupedal comparado com GAH e GAI. A partir desses dados, conclui-se que diante dessa categoria animal e procedimento cirúrgico, o halotano, isofluorano e sevofluorano apresentaram características similares em relação aos parâmetros cardiovasculares, todos promoveram depressão respiratória e a recuperação foi mais rápida quando se optou pelo sevofluorano.

The cardiopulmonary effects and recovery times of halothane, isoflurane and sevoflurane were compared in bitches submitted to ovariohysterectomy. Twenty-four mongrel dogs were assigned in three groups of eight animals, with medium weight 15.03 kg and 3.93 years of age, designed groups GAH, GAI and GAS. All dogs received acepromazine (0.1 mg/kg, i.m.) as premedication and after 15 minutes, anesthesia was induced with propofol (5.0 mg/kg, i.v.) and maintenance anesthetics were halothane (GAH), isoflurane (GAI) and sevoflurane (GAS). No statistic difference was observed in cardiovascular parameters, but the SAP, DAP and MAP decreased slighty in moment M1 and this effect was associated with propofol. The rectal temperature decreased in function of the time of anesthesia, without difference among groups, but the AI and AS groups presented the lowest values of this parameter. Respiratory rate decreased in all groups, with an increase in the PaCO2 and a decrease in the pH, without statistic differences. The extubation times were similar in the three groups. Time to standing was shorter in the AS group when compared with the GAH and GAI groups. On the basis of the results, for this animal category and surgical procedure halothane, isoflurane and sevoflurane were similar in cardiovascular parameters. All agents caused respiratory depression and the recovery times were shorter in sevofluorano group.

Development of a gas chamber for detecting broiler chicken halothane sensitivity and PSE (Pale, Soft, Exudative) meat formation

The objective of this work was to investigate the use of a halothane to screen broiler chickens prone to develop PSE (Pale, Soft, Exudative) meat through a special gas chamber connected to a veterinarian anaesthetic apparatus developed in our laboratory. Anaesthesia was induced with approx. 3.0 percent halothane at a flow rate of 6.0 Lm-1 in pure oxygen for 5 min. Commercial male broilers (n=342) aged 46 days old were evaluated and classified as either halothane sensitive (HAL+) or insensitive (HAL-), depending on the leg rigidity response. Approximately 27.5 percent (n=94) of broilers were HAL+ and 72.5 percent (n=248) were HAL-. This is a simple and rapid technique to evaluate broiler sensitivity to halothane and identify broilers prone to develop PSE meat. The occurrence of PSE meat in HAL insensitive broiler chicken samples suggests that other factors are related to PSE occurrence.

O objetivo deste trabalho foi investigar o uso do halotano para avaliar e identificar frangos propensos ao desenvolvimento de carnes PSE (Pálida, Flácida, Exsudativa) por meio de uma câmara desenvolvida em nossos laboratórios. Esta foi conectada a um equipamento de anestesia veterinária e a anestesia foi então induzida com aproximadamente 3,0 por cento de halotano a um fluxo de 6,0 L/min em puro oxigênio. A sensibilidade de três frangos foi avaliada simultaneamente. Os frangos de linhagem comercial (n=352) com 46 dias de idade foram expostos à 3,0 por cento de halotano por 5 min e classificados como halotano sensível (HAL +) e não-sensível (HAL -), baseado no enrijecimento dos seus membros inferiores. Aproximadamente 27,5 por cento (n=94) frangos foram HAL+ e 72,5 por cento (n=248) HAL-. Amostras do músculo Pectoralis major (n=75) foram coletadas após o abate dos animais para as medidas de pH e cor, determinadas nos filés mantidos a 4 C por 24 h postmortem. Frangos HAL+ apresentaram maior porcentagem de carnes PSE quando comparadas ao grupo HAL-. Este é um teste simples e rápido para a avaliação da sensibilidade das aves ao halotano e identificar frangos propensos ao desenvolvimento de carnes PSE embora amostras de HAL - também apresentaram carnes PSE sugerindo que outros fatores estão relacionados com a formação da anormalidade.

Comparação entre a lidocaína e a acupuntura no tratamento da taquicardia ventricular induzida com dopamina em equinos anestesiados com halotano / Comparative study between lidocaine and acupunture in the treatment of ventricular tachycardia induced by dopamine in horses anesthetized with halothane

Os efeitos da lidocaina e da acupuntura nos pontos bilaterais associados ao pericárdio 6 (Pc6-Neiguan) e ao coração 7 (C7-Shenmen), no tratamento da taquicardia ventricular (TV) induzida por dopamina em equinos anestesiados com halotano, foram avaliados e comparados. Seis equinos, distribuídos em três grupos: grupo-controle (GC), grupo tratado com acupuntura (GA) e grupo tratado com lidocaína (GL), foram anestesiados três vezes cada, com intervalo de uma semana entre cada anestesia. Avaliaram-se os parâmetros cardiovasculares (frequência cardíaca, pressão arterial e eletrocardiografia), os respiratórios (frequência respiratória, capnografía, saturação de hemoglobina e hemogasometria) e o escore de recuperação. A dose arritmogênica da dopamina (DAD) foi determinada a partir da infusão de 70µg/kg/min IV durante 10 minutos, sem interrupção, preenchendo o critério arritmogênico: quatro ou mais complexos ventriculares prematuros seguidos, com duração de pelo menos 15 segundos ou TV sustentada. O tempo médio de aparecimento da DAD ou da TV foi de 6,05±0,45 minutos nos animais não tratados, e a TV se reverteu espontaneamente aos 2,7±0,2 minutos. O grupo tratado com acupuntura reverteu a TV no tempo médio de 1,8±0,2 (P<0,05) em relação ao grupo tratado com lidocaina 1,3±0,2 (P<0,01). Os tratamentos mostraram-se eficientes na reversão TV.

The effects of lidocaine and acupuncture in the associated bilateral points, i.e. pericardium 6 (Pc 6- Neiguan) and heart 7 (H7 - Shenmen), on the ventricular tachycardia (VT) induced by dopamine were evaluated in horses anesthetized with halothane. Six horses were distributed in three groups: control group (CG), acupuncture treated group (AG), and lidocaine treated group (LG). They were anesthetized three times each one using halothane with one week interval between each anesthesic procedure. Cardiovascular (heart rate, arterial pressure, and ECG) and respiratory (respiratory rate, capnometry, hemoglobin saturation, and blood gas analysis) parameters and recovery score were evaluated. The arrhythmogenic dose of dopamine (ADD) was determined by the infusion of 70mg/kg/min during 10 minutes without interruption fulfilling the arrhythmogenic criterion by the presence of four or more ectopic ventricular contractions during at least 15 seconds or maintained VT. The mean time for the occurrence of ADD or VT was 6.05 ± 0.45 minutes in no treated animals and the VT reverted spontaneously in 2.7 ± 0.2 minutes. The group treated with acupuncture reverted the VT in a mean time of 1.8 ± 0.2 (P<0.05) compared to the group treated with lidocaine 1.3±0.2 (P<0.01), both of them were efficacious for the treatment of VT.

Amino acid residues involved in agonist binding and its linking to channel gating, proximal to transmembrane domain of 5-HT3A receptor for halothane modulation / 대한마취과학회지

BACKGROUND: The 5-hydroxytryptamine type 3 (5-HT3) receptor is a member of the Cys-loop superfamily of ligand-gated ion channels (LGICs) and modulated by pharmacologic relevant concentrations of volatile anesthetics or n-alcohols like most receptors of LGICs. The goal of this study was to reveal whether the site-directed single mutations of E-106, F-107 and R-222 in 5-HT3 receptor may affect the anesthetic modulation of halothane known as positive modulator. METHODS: The wild-type and mutant receptors, E106D, F107Y, R222F, R222V, were expressed in Xenopus Laevis oocytes and receptor function was assessed using two electrode voltage clamp techniques. RESULTS: E106D, F107Y, R222F, R222V mutant 5-HT3A receptors were functionally expressed. F107Y mutant 5-HT3A receptors displayed decreased sensitivity to 5-HT compared to the wild type 5-HT3A receptor (P < 0.05). Halothane showed positive modulation in both wild and F107Y mutant 5-HT3A receptors but F107Y mutant 5-HT3 receptor showed greater enhancing modulation comparing to wild-type receptor. Meanwhile, R222F and R222V mutant 5-HT3 receptor lost positive modulation with 1 and 2 MAC of halothane. Most interestingly, positive modulation by halothane was converted into negative modulation in E106D mutant 5-HT3A receptor. CONCLUSIONS: The present study implicate the amino acid residues known for agonist binding and linking agonist binding to channel gating might also have important role for anesthetic modulation in 5-HT3A receptor.

Molecular Diagnostics of Porcine Stress Syndrome Susceptibility Associated with the Arg615Cys Mutation Using Real-Time PCR with Fluorescent Hybridization Probes / Molecular Diagnostics of Porcine Stress Syndrome Susceptibility Associated with the Arg615Cys Mutation Using Real-Time PCR with Fluorescent Hybridization Probes

Objective : The purpose of the presera study was to devélop a molecular genotyping method test by using a real time PCR hybridization probé and applying it to the analysis of C1843T mutations of the Sus scrofa RYR1 gene. Animáis population Three PSS-susceptible and PSS non-susceptible crossbred swine races were used for the experiments: Pietrain X Landrace Belga, Pietrain X Large White and Pietrain X Duroc. Methods: We have devéloped a genotyping method by using a hybridization probé and applied it to the analysis of C1843T mutations of the RYR1 gene, associated with PSS susceptibility. Genotyping results obtained by hybridization probé strategies were confirmed by restriction analysis and sequencing. In addi-tion, phenotype/genotype correlation analyses were devéloped by using the in vitro contracture test and confirmed the in vivo hálothane-succinylcholine challenge. Results: The real-time PCR with fluorescent hybridization probé methodology was designed to identify ho-mozygous PSS-resistant, PSS-susceptible animáis as well as heterozygous carriers. All cases genotyped by fluorescent hybridization probes were in agreement with PCR restriction enzyme digestión and sequencing and showed a 100% concordance between the in vivo and in vitro porcine stress syndrome (PSS) susceptibility results. Conclusions and clinical relevance: The real-time PCR with fluorescent hybridization probé method described here provides a rapid, easily interpretable and réliáble tool for genotyping the C1843T (Arg615-Cys) polymorphism of the RYR1 gene. This new methodology may be useful in the wide-scale genotyping of PSS-susceptibility and genetic selection.

The Effect of Halothane on Hearing Loss and Apoptosis in Noise Exposing Mouse / 대한마취과학회지

BACKGROUND: In large clinical series, noise induced hearing loss (NIHL) following middle ear surgery has been demonstrated in 1.2% to 4.5% of patients and it is associated with a lower incidence than expected. The aim of the present work was to analyze the effect of halothane anesthesia on NIHL and hair cell morphological change. METHODS: We used 40 BALB/c mice with normal Preyer's reflex to investigate the effect of halothane on the NIHL. Control (n = 20) and halothane group (n = 20, respectively) were exposed to 120 dB SPL (sound pressure level), broad band white noise 3 hours daily for 3 consecutive days. The halothane group was anesthetized with halothane while exposed to noise. Hearing thresholds were determined with the auditory brainstem response (ABR). On day 7 post-noise, mice were sacrificed and the cochlea were collected for the histological study. RESULTS: ABR thresholds in the halothane group were less elevated after noise exposure than in the control group and then gradually recovered. In control group, the damage to the outer hair cell and supporting cell was noticeable, but not in halothane group. The expression of Bcl-2 protein was detected in halothane group, the expression of Bax protein was seen in control group. As a result in TUNEL stain, the result is positive in the control group but negative in the halothane group. CONCLUSIONS: The occurrence of NIHL decreased and the tissue damage was suppressed while anesthetized by halothane. And the noise-induced cell death of hair cell was also suppressed during anesthesia.

The Effect of Halothane and Isoflurane on KCNK2 Transfected HEK-293 Cells / 대한마취과학회지

BACKGROUND: According to the report that KCNK activity in transfected COS-7 and HEK-293 cells was modulated by volatile anesthetics and activation of KCNK channels by neuroprotectants, the importance of KCNK2 were emphasized. In this study, we studied the effect of halothane and isoflurane on KCNK2 in the KCNK2 transfected HEK-293 cells. METHODS: Multiple patch clamp experiments with halothane and isoflurane were conducted to characterize KCNK2 in the KCNK2 transfected HEK-293 cells. KCNK2 cDNA were transiently transfected with FuGENE6 transfection reagents and whole cell recordings were made using predesigned pulse protocol. RESULTS: KCNK2 transfected HEK cells exhibited rapid rising, a time-independent, non-inactivating, outward-rectifying currents and had no threshold for activation by voltage. Multiple patch clamp experiments showed the presence of outward-rectifying K+ selective channels with a conductance of 1.31 +/- 0.59 nS (n = 16) at positive potentials. Recordings of halothane 448microM (-2 MAC) increased outward currents from control by 218% in standard saline perfusate (n = 4, P<0.05, paired t-test) and that of isoflurane 822microM (-3 MAC) increased outward currents by 172% in standard saline perfusate (n = 12, P<0.05, paired t-test). Channel activity enhanced during the duration of the exposure to volatile anesthetics returned to the baseline quickly upon wash. CONCLUSIONS: Considering the activation of KCNK2 by neuroprotectants such as riluzole and PUFA, we might think of the possibility of halothane and isoflurane as neuroprotectants because these anesthetics activated background K+ channels in KCNK2 transfected HEK-293 cells.

Hipotensão controlada induzida por halotano em coelhos / Halothane induced controlled hypotension in rabbits

Objetivo: Descrever e analisar um estudo experimental com o objetivo de pesquisar o uso do halotano em diferentes concentrações, visando à obtenção de hipotensão induzida ou controlada e à análise das repercussõeshemodinâmicas decorrentes do método. Método: Foram utilizados vinte e nove coelhos (Oryctolagus cuniculus), do tipo Nova Zelândia subdivididos em quatro grupos, dentre os quais havia um controle composto por cinco animais, e outros três contendo oito coelhos cada um. Os grupos I,II e III (n=8 cada)) foram submetidos a um período de hipotensão induzida, utilizando-se o halotano em concentrações de 1,0%, 1,5% e 2,0%, respectivamente. Foram avaliadas as freqüências cardíaca (FC) e respiratória (FR), a pressão arterial média (PAM) e a temperatura corporal. No sangue arterial analisaram-se os valores do potencial hidrogeniônico (pH), da pressão parcial do oxigênio (PaO2), da pressão parcial do gás carbônico (PaCO2), do bicarbonato (-HCO3), do excesso de bases (BE),da saturação do oxigênio da hemoglobina (Sat.O2). Estes parâmetros foram obtidos em três momentos: antes (MAnH), durante (MDuH) e após (MApH) a hipotensão induzida. Acompanhou-se, periodicamente, os reflexos corneano e pupilar e, de forma contínua, o eletrocardiograma. Resultados : A análise estatística dos resultados evidenciou hipotensão e redução de frequência cardíaca com o uso do halotano. O pH dos coelhos é mais alcalino que o do homem. Não obstante haver uma tendência à acidose metabólica, esta decorreu de uma condição transitória, sem comprometer a homeostase. Conclusão: O halotano é um anestésico seguro e eficaz para promover a hipotensão induzida ou controlada, em coelhos.

Background: The authors describe haemodynamic changes secondary to controlled and induced hypotension during anesthesia with different halothane concentrations. Methods: Twenty-nine New Zealand white rabbits (Oryctolagus cuniculus) were divided into four groups. A control group, composed by five animals, was compared to groups I, II, and III, with eight rabbits each one (n=8), that underwent anesthesia with halothane in concentrations of 1,0%, 1,5% and 2,0% respectively. Cardiac and respiratory rates, body temperature, average arterial blood pressure, pH values, arterial oxygen tension (PaO2), arterialcarbon dioxide tension (PaCO2), bicarbonate concentrations ( -HCO3), base excess (BE), and haemoglobinoxygen saturation (Sat O2) were studied. All parameters were registered before, during and after halothane anesthesia induced hypotension. Corneal and pupilary reflexes and cardiogram were followed continuously. Results: Halothane resulted in hypotension and reduced heart rate. Rabbits have an alcaline blood pH. The metabolic acidosis trend observed was of transient character. Halothane did not modifySatO2..Conclusion: Halothane is a safe and efficient anaesthetic to promote induced or controlled hypotension in rabbits.