This study shows promises of using extracellular lactate concentration as a reliable sleep/wake biomarker.
The authors set out to map the dopamine pathway that is required for sleep and arousal regulation.
Using adrenergic-deficient mice the authors showed that adrenergic signaling is essential for normal emergence from general volatile anesthesia. Dexmedetomidine-induced general anesthesia does not depend on inhibition of adrenergic neurotransmission.
This work provides more questions to the role of propofol in entering sleep circuitry. It suggests that a primary function of GABAA receptor-mediated inhibition is to dampen vigilant arousal and it does not appear to influence the loss of consciousness associated with either natural sleep or propofol-induced anesthesia.
Three of the brain regions that comprise the anatomically distributed, sleep-generating network have in common a GABA-mediated, sleep-dependent decrease in the GABA-to-ACh ratio.
Tonsillectomy and adenoidectomy are an effective surgical treatment of pediatric obstructive sleep apnea; however, up to 20% of these patients can have persistent disease. In this select patient population, the lingual tonsil may be an occult source of obstruction.
Compared with the cold knife technique, thermal welding was found to be a relatively new and safe technique for tonsillectomy as it results in significantly less postoperative pain and no remarkable blood loss.
Severe obesity in children undergoing tonsillectomy is independently associated with an increased risk of perioperative complications.
This article outline these practices as defined in the 2011 American Academy of Otolaryngology-Head and Neck Surgery Foundation clinical practice guideline “Tonsillectomy in Children.
Tonsillotomy appears to be a safe technique that may offer some advantages over tonsillectomy in terms of postoperative morbidity, but differences in hemorrhage and dehydration were not evident in high-quality studies.