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PubMed2005

The influence of a muscle relaxant bolus on bispectral and datex-ohmeda entropy values during propofol-remifentanil induced loss of consciousness.

Studies investigating the influence of muscle relaxants on the bispectral index have yielded contradictory results. In our prospective, randomized, double-blind experiments, patients received a fixed target concentration of remifentanil along with a target-controlled infusion of propofol, titrated until loss of consciousness. Two minutes after loss of consciousness, the study group received a bolus injection of atracurium, whereas the control group received a placebo. The following variables were recorded: bispectral index, spectral edge frequency, electromyographic activity, state entropy, and response entropy provided by the Datex-Ohmeda Entropy monitor. Similar values were obtained in both groups at loss of consciousness. Placebo administration induced a decrease in bispectral index (P < 0.002), spectral edge frequency (P < 0.05), electromyographic activity (P < 0.02), state entropy (P < 0.05), and response entropy (P < 0.01) compared with the values measured at loss of consciousness. Atracurium administration induced a decrease in bispectral index (P < 0.0001), spectral edge frequency (P < 0.01), electromyographic activity (P < 0.0001), state entropy (P < 0.0001), and response entropy (P < 0.0001) values. Decreases in bispectral index (P < 0.05), electromyographic activity (P < 0.0001), and response entropy (P < 0.01) were larger after atracurium than placebo injection. In lightly anesthetized patients, myorelaxant administration decreases bispectral index and response entropy, but not state entropy values.

Adult↗
PubMed1982

Hemodynamic responses to prostacyclin (PGI2) in the conscious sheep.

Hemodynamic responses to prostacyclin (PGI2) were studied in sheep in the conscious state as well as under pentobarbital-halothane anesthesia. PGI2 in doses of 0.02-1.0 microgram/kg were administered as a bolus into the right or left atrium in the conscious sheep. PGI2 decreased systemic arterial pressure (PSA), systemic (SVR) and pulmonary vascular resistance (PVR) and increased cardiac output (CO) and heart rate (HR) in a dose-dependent manner. The changes of each parameter were almost similar regardless of the sites of administration. Pulmonary arterial pressure (PPA) was increased. There was no change in left (PLA) or right atrial pressure (PRA). A bolus administration of 0.5 microgram/kg of PGI2 in the anesthetized sheep produced a decrease in PSA, SVR and PVR, and increase in CO and HR. PPA remained unchanged when administered into the right atrium and increased slightly when administered into the left atrium. PLA and PRA did not change. Comparing hemodynamic responses to 0.5 microgram/kg of PGI2 of the conscious and anesthetized states, decrease in PSA was smaller and increases in CO and HR were greater in the former. Decreases in SVR and PVR were similar in both states. Increase in PPA was greater in the conscious sheep. This data confirms that PGI2 dilates the systemic as well as the pulmonary circulation of the sheep and an inactivation of this compound in the lungs is minimal. Furthermore, it may be suggested that general anesthesia significantly alters hemodynamic responses to PGI2 in the sheep.

Animals↗
PubMed1989

Effects of various drugs on bladder function in conscious rats.

In the present study, we attempted to evaluate the effects of various intravenous administered drugs, which had been shown to influence bladder function in anesthetized animals, on the cystometrogram in conscious rats placed in a restraining cage. Thiopental, diazepam, baclofen, clonidine and flavoxate, considered to act on the micturition center in the brain stem, hardly increased bladder capacity (time to micturition in cystometrogram) in conscious rats, but morphine, indomethacin and lidocaine, considered to act on the micturition center in the sacral cord or bladder mechanoreceptors, increased it. In a chronic conscious rat, histopathological findings show that the bladder tissue at 2 days after implantation of the catheter to the bladder showed experimental cystitis characterized by severe edema in the submucosa and an increase in prostaglandin E2 content, which is thought to stimulate directly and/or indirectly the capsaicin-sensitive sensory fiber in the afferent branch of the micturition reflex, and there was hyperreflexia characterized by decreases in both bladder capacity and urine volume. In conclusion, cystometrography in conscious rats placed in a restraining cage is thought to be a useful model for evaluating the true effect of a newly developed agent on bladder function.

Animals↗
PubMed1990

Effects of various drugs on bladder function in conscious restrained-denervated rats placed in a restraining cage and produced by transection of the hypogastric nerve.

We evaluated the effects of various intravenously administered drugs, which had been shown to influence bladder function in anesthetized and/or conscious rats, on the cystometrogram in conscious restrained-denervated rats (produced by transection of the hypogastric nerve) placed in a restraining cage in comparison to those in conscious restrained-intact rats (with the hypogastric nerve intact) placed in a restraining cage. The bladder capacity in the restrained-denervated rats was smaller than that in restrained-intact rats and did not change when they were transferred to a wide cage, but the bladder capacity of the restrained-intact rats decreased following transfer to the wide cage. Therefore, the activity of the hypogastric nerve in conscious rats appears to be stimulated by restraint. Atropine suppressed the amplitude of the micturition contraction (time to micturition in the cystometrogram). In the restrained-denervated rats, thiopental and indomethacin increased the bladder capacity at almost the same doses as those in restrained-intact rats, but it took a higher dose of morphine to increase the bladder capacity than in restrained-intact rats. These findings suggest that cystometrography in restrained-denervated rats is a useful method for evaluating the effect of a newly developed agent on bladder function without any influence from the hypogastric nerve.

Animals↗
PubMed2000

New approach for measurement of sympathetic nervous abnormality in conscious, spontaneously hypertensive rats.

We previously reported a highly sensitive chemiluminescence high-performance liquid chromatographic method to determine catecholamines in plasma. In this study, we employed this method to measure the cardiac function and plasma norepinephrine (NE) concentration in conscious rats. Benidipine, 1,4-dihydropyridine calcium antagonist (4 mg/kg), and beta-blocker (propranolol, 30 mg/kg) were administered orally to conscious spontaneously hypertensive rats (SHRs) and Wistar-Kyoto (WKY) rats, and blood pressure, heart rate and plasma NE levels were measured. Plasma NE concentration was used as an index of sympathetic nervous system activity in conscious rats. The basal plasma NE levels were significantly higher in SHRs than in WKY rats (P<0.05), indicating the activity of the basal sympathetic nervous system in SHRs was elevated. The sensitivity of the baroreflex-mediated sympathetic nervous response was reduced in SHRs as compared to that in WKY rats. The concomitant administration of benidipine and a beta-blocker decreased heart rate without affecting the baroreflex-mediated sympathetic nervous response, indicating that propranolol might suppress mainly the cardiac beta-adrenoceptor. The present study suggested the high activity of the basal sympathetic nervous system and the reduced response of the baroreflex-mediated sympathetic nervous system in SHRs compared to WKY rats in the conscious condition.

Animals↗
PubMed2003

The influence of patient's consciousness regarding high blood pressure and patient's attitude in face of disease controlling medicine intake.

OBJECTIVE: To assess the relation between blood pressure control and the following: the Morisky-Green test, the patient's consciousness regarding high blood pressure, the patient's attitude in face of medicine intake, the patient's attendance at medical consultations, and the subjective physician's judgment. METHODS: We studied 130 hypertensive patients with the following characteristics: 73% females, 60 +/- 11 years, 58% married, 70% white, 45% retired, 45% with incomplete elementary schooling, 64% had a familial income of 1 to 3 minimum wages, body mass index of 30 +/- 7 kg/m , consciousness regarding the disease for a mean period of 11 +/- 9.5 years, and mean treatment duration of 8 +/- 7 years. RESULTS: Only 35% of the hypertensive individuals had blood pressure under control and a longer duration of treatment (10 +/- 7 vs 7 +/- 6.5 years; P<0.05). The retiree predominated. The result of the Morisky-Green test did not relate to blood pressure control. In evaluating the attitude in face of medicine intake, the controlled patients achieved significantly higher scores than did the noncontrolled patients (8 +/- 1.9 vs 7 +/- 2, P<0.05). The hypertensive patients had higher levels of consciousness regarding their disease and its treatment, and most (70%) patients attended 3 or 4 medical consultations, which did not influence blood pressure control. The physicians attributed significantly higher scores regarding adherence to treatment to controlled patients (6 +/- 0.8 vs 5 +/- 1.2; P<0.05). CONCLUSION: Consciousness regarding the disease, the Morisky-Green test, and attendance to medical consultations did not influence blood pressure control.

Blood Pressure Determination↗
PubMed1988

Pulsatile administration of gonadotrophin-releasing hormone stimulates, in oestrogen-treated anaesthetized ovariectomized ewes, a surge release of LH qualitatively and quantitatively different from that induced by oestradiol in conscious ovariectomized ewes.

The nature of the gonadotrophin-releasing hormone (GnRH) stimulus of the pituitary necessary for the oestrogen-induced plasma LH surge was studied in ovariectomized ewes. The sheep were treated with oestradiol benzoate (50 micrograms i.m.) at 0 h, and the hypothalamic contribution to the LH surge was blocked by pentobarbitone anaesthesia over the time during which the surge was expected (11-31 h). Pituitary responsiveness to exogenous GnRH (100 ng) administered i.v. in a pulsatile mode (once per hour or once per 20 min) over the period 15-30 h was assessed from plasma concentrations of LH. Neither of the GnRH treatments induced patterns of LH secretion similar to those seen in conscious ovariectomized ewes given oestrogen only. Plasma LH secretion in response to hourly GnRH pulses was less (P less than 0.01) than that associated with oestrogen-induced plasma LH surges in conscious control ewes. With pulses of GnRH administered every 20 min the amount of LH released was greater (P less than 0.05) than that in oestrogen-treated conscious control ewes. In contrast to the single surge induced by oestradiol in conscious ewes, GnRH pulses given every 20 min elicited phasic patterns of LH secretion consisting of two or three distinct surges. The failure of GnRH treatment to elicit an LH surge similar to an oestrogen-induced surge could reflect inappropriate GnRH treatment regimens, and/or inadequate priming of the pituitary with GnRH after induction of anaesthesia but before GnRH treatment.

Anesthesia, Intravenous↗
PubMed2003

The conscious perception of the sensation of fatigue.

In this review, fatigue is described as a conscious sensation rather than a physiological occurrence. We suggest that the sensation of fatigue is the conscious awareness of changes in subconscious homeostatic control systems, and is derived from a temporal difference between subconscious representations of these homeostatic control systems in neural networks that are induced by changes in the level of activity. These mismatches are perceived by consciousness-producing structures in the brain as the sensation of fatigue. In this model, fatigue is a complex emotion affected by factors such as motivation and drive, other emotions such as anger and fear, and memory of prior activity. It is not clear whether the origin of the conscious sensation of fatigue is associated with particular localised brain structures, or is the result of electrophysiological synchronisation of entire brain activity.

Awareness↗
PubMed1999

Health consciousness of young people in relation to their personality.

Personality of targeted individuals can be assumed to influence behavior modification by health education. In this study the influence of personality on health consciousness was analyzed by a questionnaire for lifestyle, health consciousness, and the NEO-FFI personality test. Subjects were 942 new students in the Tokyo University of Agriculture who were surveyed in April, 1998. Separately performed health examination data were used to verify reliability of answers to the questionnaire. Among students, 83.2% of males and 90.4% of females felt themselves to be healthy, and more than 80% students desired to improve their health more. The rate of having no physical complaints, however, was only 31.7% in males and 20.4% in females. Distribution of NEO-FFI scores of neuroticism (N), extraversion (E), openness (O), agreeableness (A), and conscientiousness (C) corresponded well between males and females, except for significantly higher scores of O and A in females. Odds ratios (ORs) between high and low tertial points of NEO-FFI score for health consciousness were significantly elevated in the high scoring groups of E and C (OR = 6.26, 95% CI = 1.46-26.82, and OR = 6.04, 95% CI = 1.42-25.71, respectively) in males. On the contrary, high N and O groups had low health consciousness. Smoking habit was associated with high E scores (OR = 2.24, 95% CI = 1.13-4.43). Dietary habits, regular eating time, and avoidance of salty foods were associated with high C scores in both males and females. The OR of regular eating time was 2.66 (95% CI = 1.42-1.98), and 2.20 (95% CI = 1.31-3.71) for males and females, respectively. The OR of avoidance of salty foods were 2.09 (95% CI = 1.11-3.91), 1.87 (95% CI = 1.11-3.16) for males and females, respectively. Significant associations between lifestyle and personality require further study for risk association analysis and for relationship to interventive practices for prevention of lifestyle associated diseases.

Adolescent↗
PubMed2006

Conscious sedation reduces distress in children undergoing voiding cystourethrography and does not interfere with the diagnosis of vesicoureteric reflux: a randomized controlled study.

OBJECTIVE: Voiding cystourethrography (VCU) is a distressing procedure for children. Conscious sedation using oral midazolam may reduce this distress, but its use may also alter the ability of the VCU to show vesicoureteric reflux (VUR). The objectives of our study were to assess the effectiveness of conscious sedation using oral midazolam when administered routinely in children undergoing VCU and to ensure that conscious sedation using oral midazolam does not alter the ability of VCU to show VUR. SUBJECTS AND METHODS: Our study was a randomized double-blind controlled trial performed at a university teaching hospital; our study group consisted of children over the age of 1 year who been referred for their first VCU examination from July 2001 to July 2003. Participants were randomized to receive a placebo or midazolam syrup (0.5 mg/kg) before the examination. The primary outcome measures were the Groningen Distress Rating Scale (GDRS) and grading of VUR, as defined by the international grading system established by the International Reflux Study Group. RESULTS: There were no serious adverse events. One hundred thirty-nine children were randomized in the study, and 117 underwent complete assessment. Eight who underwent VCU after the study day were included in a "complete case" intention-to-treat analysis. In the placebo group, 34 children (61%) experienced serious distress or severe distress (GDRS score, 3 or 4). In the midazolam group, 16 children (26%) experienced the same degree of distress. There was a significant difference between the GDRS scores (nonlinear mixed-model analysis, p < 0.001) of the two study groups. The number needed to treat to reduce serious or severe distress in one child was 2.9 (95% CI, 1.9-5.5). VUR was identified in 16% of all children. There was no difference in VUR grading between the groups (nonlinear mixed-model analysis, p = 0.31). CONCLUSION: Routine use of oral midazolam (0.5 mg/kg) for conscious sedation of children undergoing VCU reduces distress and does not alter the ability of VCU to show VUR well enough to allow diagnosis.

Adolescent↗
PubMed1990

Self-consciousness, self-esteem and depression of gifted school children.

38 gifted students from north central school districts were administered the Coopersmith Self-esteem Inventory--Short Form, the Self-consciousness Scale, and the Children's Depression Inventory. The gifted students' mean score on depression was below the cut-off and so did not indicate depression while their mean score on self-esteem was within average range. The Pearson correlation for self-esteem and lie scores was significant and positive, indicating, if the lie scores are high, the self-esteem scores tend to be high. The General Self-consciousness mean was low; students spend time examining their own behavior and thought. The Private Self-consciousness mean was low and suggests, however, these students tend to avoid thinking about themselves and are not so overly concerned with self-examination that this interferes with everyday function. On Public Self-consciousness a borderline low mean score allows the inference that these students display little concern about how others will react to them in social settings, how they appear to others, that is, they show some insensitivity associated with high self-confidence. The mean on Social Anxiety was within the normal limits.

Child↗
PubMed2000

Variability of Doppler ultrasound measurements of hindlimb blood flow in conscious horses.

Ultrasonography of the left and right femoral artery and vein was performed in 5 conscious horses. Velocity waveforms, recorded using low pulse repetition frequency, were used to calculate time-averaged mean velocity (TAV), velocity of component a (TaVa), velocity of component b (TaVb) and volumetric flow. Waveform analysis included calculation of early diastolic deceleration slope (EDDS) and pulsatility index (PI) and subjective description of the waveform. Measurements were recorded at monthly intervals for 6 months. The repeated measurements were used to determine the within-horse variation. Horses were then anaesthetised with halothane and the same measurements recorded 60 min after induction. Differences between measurements recorded in conscious and anaesthetised horses were determined. Within-horse variability for diameters of femoral arteries and veins was small (CV<10%). Within variability for all other measurements was marked (CV>11%), with within-horse variability being the largest for femoral venous flow (CV>35%). Source of variability was measurement error and biological variation. Despite variability in conscious horses it was possible to detect changes in blood flow during anaesthesia. In the femoral arteries, volumetric flow was lower and EDDS and PI was higher in anaesthetised horses. In the femoral veins, volumetric flow was also lower in anaesthetised horses. Therefore Doppler ultrasound appears to be a useful technique for studying blood flow in conscious and anaesthetised horses.

Animals↗
PubMed1994

Assessment of blood substitutes: I. Efficacy studies in anesthetized and conscious rats with loss of 1/3, 1/2 and 2/3 blood volume.

Acute and long-term recovery (14 days) studies were conducted in conscious rats bled 1/3, 1/2, and 2/3 blood volume, and in anesthetized rats bled 1/3 volume. Study I: bled 1/3 blood volume. Study Ia: Anesthetized rats bled 1/3 blood volume were in shock and most died within 1 hour; the group which received infusion of 3x volume Ringer's lactate regained blood pressure with 100% long-term recovery. Study Ib: In conscious rats bled 1/3 blood volume, blood pressure did not fall to shock levels, and the long-term recovery in both the control group and the group which received 3x volume Ringer's lactate was 100%. Study II: Bled 1/2 blood volume. In conscious rats bled 1/2 volume, the blood pressure of the control group was slightly above 70 mmHg. Infusion of 3x volume Ringer's lactate or 7 gm% human albumin in Ringer's lactate increased blood pressure to above 90 mmHg in the acute study. Long-term recovery and survival rate was 80% in both the controls and the Ringer's lactate group, and 100% in the albumin group. Study III: bled 2/3 blood volume. In conscious animals, loss of 2/3 blood volume resulted in fall of blood pressure to shock levels and death of the animal within 1 hour. Infusion of 3x volume Ringer's lactate did not increase blood pressure to above shock level. Stroma-free hemoglobin and polyhemoglobin increased blood pressure, and whole blood returned blood pressure to normal. In long-term recovery, poly-hemoglobin, but not SFHb, was as effective as whole blood with 100% long term recovery. Animal models in Study I and II are suitable only for studies of volume replacement. Animal models in Study III, especially using long-term recovery studies, are more suitable for studying both volume and red blood cells replacements.

Anesthesia, General↗
PubMed1985

[Loneliness and self-consciousness in high-school students].

To examine relationships between loneliness and various aspects of self-consciousness in high-school students, UCLA Loneliness Scale (Russell, Peplau, & Cutrona, 1980), Self-Esteem Scale (Rosenberg, 1979), Self-Consciousness Scale (Fenigstein, Scheier, & Buss, 1975), Self-Monitoring Scale (Synder, 1974), and a High-School Life Questionnaire were administered to the first grade students in a high school (N = 182). Loneliness (alpha = .885), higher for males than for females, was significantly correlated with various aspects of their high-school lives. Loneliness was negatively correlated with self-esteem and self-monitoring, and was positively correlated with social anxiety. Only for males, a positive correlation was obtained between loneliness and private self-consciousness. Discriminant analysis and other correlational analyses also suggested that loneliness in males was related to various aspects of self-consciousness.

Adolescent↗
PubMed2001

The oral efficacy of vardenafil hydrochloride for inducing penile erection in a conscious rabbit model.

PURPOSE: Inhibiting cyclic guanosine monophosphate metabolism may induce penile erection during concomitant nitric oxide production. Vardenafil hydrochloride is a new, highly selective, potent cyclic guanosine monophosphate phosphodiesterase 5 inhibitor. We determined the oral effectiveness of vardenafil in a simple and quantitative conscious rabbit model. MATERIALS AND METHODS: Vardenafil was given orally to conscious rabbits. Erection was assessed in a time dependent manner by measuring the length of the uncovered penile mucosa. Erection was evaluated in the absence and presence of intravenous sodium nitroprusside, a nitric oxide donor. RESULTS: Vardenafil induced dose dependent penile erection in conscious rabbits after the oral administration of 1 to 30 mg./kg. The efficacy of vardenafil was potentiated and effective doses were significantly reduced by the simultaneous administration of sodium nitroprusside. CONCLUSIONS: The effect of vardenafil on penile erection after oral administration was clearly demonstrated in the conscious rabbit model. The time course and early onset of activity indicate that it may be useful for treating erectile dysfunction. Potentiation of the effect by the nitric oxide donor sodium nitroprusside implies that it would have enhanced activity during sexual arousal, when nitric oxide is produced endogenously. The clinical development of this product for erectile dysfunction is proceeding.

Animals↗
PubMed2001

[The effects of conscious sedation by propofol on respiration during abdominal hysterectomy under spinal anesthesia].

The effects of conscious sedation by propofol on respiration were studied in 28 patients undergoing abdominal hysterectomy under spinal anesthesia. The patients were randomly assigned to receive conscious sedation by propofol (Group P, n = 20) or no sedation (Group C, n = 8). After a satisfactory level of analgesia had been achieved, a loading dose of propofol, 0.2 mg.kg-1 was administered every minute in Group P until patients exhibited spontaneous eye closure or nystagmus. Thereafter, the infusion rates were adjusted to maintain conscious sedation. Respiratory rate, SpO2 and nasal PETCO2 were measured every minute during the initial 30 minutes and subsequently at 5-min intervals. The patients were questioned on the 1st postoperative day concerning intraoperative recall and the level of satisfaction. The mean loading dose of propofol was 0.4 mg.kg-1 and the mean mainteinance rate was 1.7 +/- 0.5 mg.kg-1.h-1. Compared with Group C, the respiratory depression was less in Group P; SpO2 was significantly higher at 25 min after spinal tap and PETCO2 was significantly lower at 30 and 50 min after spinal tap in Group P. A score of patient satisfaction was significantly higher in Group P. Conscious sedation by propofol is a safe and useful supplement to spinal anesthesia for abdominal hysterectomy.

Adult↗
PubMed1998

Modification of Subdural Catheters for Long-Term Intracranial Pressure Monitoring of Conscious Rabbits.

Intracranial pressure monitoring of conscious rabbits poses major technical problems. Although surgical implantation of epidural, subdural, or parenchymal catheters is usually straightforward, the maintenance of such systems after surgery can be difficult. A simple and effective method of subdural intracranial pressure monitoring that used a modified catheter is described. This approach was used successfully in 12 conscious rabbits for which investigators required intermittent intracranial pressure monitoring during a 4 to 10-day period. An intracranial pressure transducer was modified by use of a protective sheath and fiberglass splinting material prior to implantation. After implantation, a modified jacket was used on rabbits to provide additional catheter protection. After surgery, rabbits remained conscious and were allowed to resume normal activity throughout the duration of the investigations, with the exception of infrequent need for light restraint. Our experience with the use of catheters before these modifications were introduced revealed an unacceptably high rate of fractured catheters, catheter migration, and problems associated with handling of rabbits by investigators. The modified system reduced these technical difficulties and allowed for successful completion of several investigations. Minor problems included increased tissue reactivity and slightly prolonged surgery time. Investigators interested in monitoring intracranial pressure of conscious rabbits for a period of several days may benefit from use of this technique.

Journal Article↗
PubMed2003

Dizziness and loss of consciousness. Cardiovascular causes.

BACKGROUND: Dizziness and loss of consciousness are common clinical problems presenting in general practice. OBJECTIVE: This article aims to provide the practitioner with a pragmatic and logical approach to identifying the cardiovascular causes of dizziness and loss of consciousness. DISCUSSION: A range of disorders with varying pathology cause a transient loss of consciousness associated with postural collapse (syncope) by interruption of blood flow to the brain. Syncope and seizures are the only common causes of recurrent episodes of loss of consciousness. The vasovagal reaction or 'common faint' and postural hypotension are both common and benign causes of syncope. Syncope can also result from cardiac causes that include disorders of cardiac rhythm and mechanical obstruction to cardiac output. Cardiac causes of syncope are associated with much higher morbidity and mortality than postural hypotension or fainting. Specific treatment is available for the various cardiac causes of syncope and thus accurate diagnosis is imperative.

Cardiovascular Diseases↗