Exploring Ciprofol Alternatives: A Comprehensive Review of Intravenous Anesthesia Options DOI Open Access

Nandha kumar Durai Samy,

Karuna Taksande

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: April 4, 2024

Ciprofol is a recently developed, short-acting γ-aminobutyric acid receptor agonist sedative that more potent than propofol. Still, there have been few clinical studies of this agent to date. This review explores alternative intravenous anesthesia options ciprofol, considering their pharmacology, efficacy, safety profile, and practical considerations. While ciprofol offers advantages such as rapid onset predictable offset, concerns regarding its profile individual variability in response prompted the search for alternatives. Propofol, etomidate, ketamine, dexmedetomidine are discussed established options, each with unique characteristics potential benefits. Emerging agents, including remimazolam, sufentanil, alfaxalone, brexanolone, examined role management. Recommendations future research include large-scale comparative studies, optimization dosing strategies, personalized approaches guided by pharmacogenomic insights. Ultimately, lies multifaceted approach integrates evidence-based practices, technological innovations, individualized patient care enhance safety, satisfaction across perioperative continuum. Collaboration among stakeholders will be crucial advancing field shaping landscape options.

Language: Английский

Long Non-coding RNAs and Circular RNAs: Insights Into Microglia and Astrocyte Mediated Neurological Diseases DOI Creative Commons
Miaomiao Chen,

Xing-Ning Lai,

Xifeng Wang

et al.

Frontiers in Molecular Neuroscience, Journal Year: 2021, Volume and Issue: 14

Published: Oct. 5, 2021

Microglia and astrocytes maintain tissue homeostasis in the nervous system. Both microglia have pro-inflammatory phenotype anti-inflammatory phenotype. Activated activated can contribute to several neurological diseases. Long non-coding RNAs (lncRNAs) circular (circRNAs), two groups of (ncRNAs), function as competing endogenous (ceRNAs) impair microRNA (miRNA) inhibition on targeted messenger (mRNAs). LncRNAs circRNAs are involved various disorders. In this review, we summarized that lncRNAs participate dysfunction, astrocyte neuron damage, inflammation. Thereby, positively or negatively regulate diseases, including spinal cord injury (SCI), traumatic brain (TBI), ischemia-reperfusion (IRI), stroke, neuropathic pain, epilepsy, Parkinson’s disease (PD), multiple sclerosis (MS), Alzheimer’s (AD). Besides, also found a lncRNA/circRNA-miRNA-mRNA regulatory network mediated Through hope cast light mechanisms diseases provide new insights for treatment.

Language: Английский

Citations

80
Perioperative dexmedetomidine administration to prevent delirium in adults after non-cardiac surgery: A systematic review and meta-analysis DOI

Chaosheng Qin,

Yihong Jiang, Cheng Lin

et al.

Journal of Clinical Anesthesia, Journal Year: 2021, Volume and Issue: 73, P. 110308 - 110308

Published: April 28, 2021

Language: Английский

Citations

65
The Current Role of Dexmedetomidine as Neuroprotective Agent: An Updated Review DOI Creative Commons
Zaara Liaquat, Xiaoying Xu, Prince Last Mudenda Zilundu

et al.

Brain Sciences, Journal Year: 2021, Volume and Issue: 11(7), P. 846 - 846

Published: June 25, 2021

Dexmedetomidine, selective α2-adrenergic agonist dexmedetomidine, has been widely used clinically for sedation and anesthesia. The role of dexmedetomidine an interesting topic neonatological anesthetic research since a series advantages such as enhancing recovery from surgery, reducing opioid prescription, decreasing sympathetic tone, inhibiting inflammatory reactions, protecting organs, were reported. Particularly, increasing number animal studies have demonstrated that ameliorates the neurological outcomes associated with various brain spinal cord injuries. In addition, growing clinical trials reported efficacy rates postoperative dysfunction, delirium stroke, which strongly highlights possibility functioning neuroprotective agent future use. Mechanism linked dexmedetomidine’s properties its modulation neuroinflammation, apoptosis, oxidative stress, synaptic plasticity via receptor, dependently or independently. By reviewing recent advances preclinical evidence on effects we hope to provide complete understanding above mechanism insights into potential this in use patients.

Language: Английский

Citations

63
Neuropathic pain: Mechanisms and therapeutic strategies DOI Creative Commons
Georg Petroianu, Lujain Aloum, Abdu Adem

et al.

Frontiers in Cell and Developmental Biology, Journal Year: 2023, Volume and Issue: 11

Published: Jan. 16, 2023

The physiopathology and neurotransmission of pain are an owe inspiring complexity. Our ability to satisfactorily suppress neuropathic or other forms chronic is limited. number pharmacodynamically distinct clinically available medications low the successes achieved modest. Pain Medicine practitioners confronted with ethical dichotomy imposed by Hippocrates: On one hand mandate primum non nocere , on hand, promise heavenly joys if successful divinum est opus sedare dolorem . We briefly summarize concepts associated nociceptive from input (afferents periphery), modulatory output [descending noradrenergic (NE) serotoninergic (5-HT) fibers] local control. control comprised “ inflammatory soup ” at site origin synaptic relay stations, ATP-rich environment promoting inflammation nociception while adenosine-rich having opposite effect. Subsequently, we address transition nociceptor (independent activation) process sensitization chronification (transient progressing into persistent pain). Having sketched a model perception processing attempt identify sites modes action drugs used in treatment, focusing adjuvant (co-analgesic) medication.

Language: Английский

Citations

33
Perioperative Dexmedetomidine Infusion Improves Perioperative Care of Bariatric-Metabolic Surgery: A Single Center Experience with Meta-Analysis DOI
Po‐Chih Chang,

Ivy Ya-Wei Huang,

Sian-De Liu

et al.

Obesity Surgery, Journal Year: 2024, Volume and Issue: 34(2), P. 416 - 428

Published: Jan. 5, 2024

Language: Английский

Citations

9
Trial watch: dexmedetomidine in cancer therapy DOI Creative Commons
Killian Carnet Le Provost, Oliver Kepp, Guido Kroemer

et al.

OncoImmunology, Journal Year: 2024, Volume and Issue: 13(1)

Published: March 11, 2024

Dexmedetomidine (DEX) is a highly selective α2-adrenoceptor agonist that widely used in intensive and anesthetic care for its sedative anxiolytic properties. DEX has the capacity to alleviate inflammatory pain while limiting immunosuppressive glucocorticoid stress during major surgery, thus harboring therapeutic benefits oncological procedures. Recently, molecular mechanisms of DEX-mediated anticancer effects have been partially deciphered. Together with additional preclinical data, these mechanistic insights support hypothesis DEX-induced are mediated via stimulation adaptive anti-tumor immune responses. Similarly, published clinical trials including ancillary studies described an immunostimulatory role perioperative period cancer surgery. The impact on long-term patient survival remains elusive. Nevertheless, immunostimulation offers interesting option onco-anesthesia. Our present review comprehensively summarizes data from as well ongoing distinct focus overcoming (tumor microenvironment (TME)-imposed) therapy resistance. objective this update guide clinicians their choice toward onco-anesthetic agents improve disease outcome.

Language: Английский

Citations

9
Intraoperative sensitization in trigeminal region caused by postherpetic neuralgia: a case report DOI Creative Commons

Gangwen Guo,

Dan Li,

Hongyan Li

et al.

Journal of Medical Case Reports, Journal Year: 2025, Volume and Issue: 19(1)

Published: Jan. 17, 2025

Interventional therapy of trigeminal neuropathic pain has been well documented; however, intraoperative monitoring and management hypersensitivity remains barely reported, which may pose a great challenge for physicians as anesthesiologists. A 77-year-old Han Chinese male, who suffered from severe craniofacial postherpetic neuralgia, underwent pulsed radiofrequency ganglion in the authors' department twice. The authors successfully placed needle through foramen ovale during first procedure with local anesthesia intravenous sedation (dexmedetomidine). patient reported about 50% reduction postoperatively, second was performed 1 week later. However, administration sedative agents suspended owing to hemodynamic instability session. As result, displayed percutaneous operation under failed place inside Meckel's cave uncontrollable breakthrough pain. still needed take oral medication control, oxycodone (10-20 mg, every 12 hours) pregabalin (75 two times day) last follow-up at 1.5 years after discharge. report failure case puncturing pain, potentially caused by sensitization. It is essential monitor prevent both innoxious noxious stimuli patients syndrome, especially surgical sites close area nerve injury.

Language: Английский

Citations

1
Efficacy of nonopioid analgesics and adjuvants in multimodal analgesia for reducing postoperative opioid consumption and complications in obesity: a systematic review and network meta-analysis DOI Creative Commons
Michele Carron, Enrico Tamburini, Federico Linassi

et al.

British Journal of Anaesthesia, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 1, 2024

Language: Английский

Citations

7
Dexmedetomidine alleviates host ADHD-like behaviors by reshaping the gut microbiota and reducing gut-brain inflammation DOI Creative Commons

Xiangzhao Xu,

Lixia Zhuo, Linjuan Zhang

et al.

Psychiatry Research, Journal Year: 2023, Volume and Issue: 323, P. 115172 - 115172

Published: March 20, 2023

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders that affects children and even continues into adulthood. Dexmedetomidine (DEX), a short-term sedative, can selectively activate α2-adrenoceptor. Treatment with α2-adrenergic agonists in patients ADHD becoming increasingly common. However, therapeutic potential DEX for treatment unknown. Here, we evaluated effect on ADHD-like behavior spontaneously hypertensive rats (SHRs), widely used animal model ADHD. ameliorated hyperactivity spatial working memory deficits normalized θ electroencephalogram (EEG) rhythms SHRs. We also found altered gut microbiota composition promoted enrichment beneficial bacterial genera associated anti-inflammatory effects The pathological scores permeability level inflammation observed brain were remarkably improved after administration. Moreover, transplantation fecal from DEX-treated SHRs produced mimicked Therefore, promising functions by reshaping reducing brain.

Language: Английский

Citations

12
Scientific rationale for the use of α2A-adrenoceptor agonists in treating neuroinflammatory cognitive disorders DOI Creative Commons
Amy F.T. Arnsten, Yumiko Ishizawa, Zhongcong Xie

et al.

Molecular Psychiatry, Journal Year: 2023, Volume and Issue: 28(11), P. 4540 - 4552

Published: April 7, 2023

Abstract Neuroinflammatory disorders preferentially impair the higher cognitive and executive functions of prefrontal cortex (PFC). This includes such challenging as delirium, perioperative neurocognitive disorder, sustained deficits from “long-COVID” or traumatic brain injury. There are no FDA-approved treatments for these symptoms; thus, understanding their etiology is important generating therapeutic strategies. The current review describes molecular rationale why PFC circuits especially vulnerable to inflammation, how α2A-adrenoceptor (α2A-AR) actions throughout nervous immune systems can benefit in needed cognition. layer III dorsolateral (dlPFC) that generate sustain mental representations cognition have unusual neurotransmission neuromodulation. They wholly dependent on NMDAR neurotransmission, with little AMPAR contribution, thus kynurenic acid inflammatory signaling which blocks NMDAR. Layer dlPFC spines also neuromodulation, cAMP magnification calcium spines, opens nearby potassium channels rapidly weaken connectivity reduce neuronal firing. process must be tightly regulated, e.g. by mGluR3 α2A-AR prevent loss However, production GCPII reduces markedly diminishes network Both basic clinical studies show agonists guanfacine restore firing function, through direct dlPFC, but reducing activity stress-related circuits, locus coeruleus amygdala, having anti-inflammatory system. information particularly timely, currently focus large trials treatment open label long-COVID.

Language: Английский

Citations

11