Literature Updates from November 2012

Hypnotic Hypersensitivity to Volatile Anesthetics and Dexmedetomidine in Dopamine β-Hydroxylase Knockout Mice

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.

http://www.ncbi.nlm.nih.gov/pubmed/23042227

GABAergic Inhibition of Histaminergic Neurons Regulates Active Waking but Not the Sleep-Wake Switch or Propofol-Induced Loss of Consciousness

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.

http://www.ncbi.nlm.nih.gov/pubmed/22993424

GABA-to-ACh Ratio in Basal Forebrain and Cerebral Cortex Varies Significantly During Sleep

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.

http://www.ncbi.nlm.nih.gov/pubmed/23007730

Pediatric Lingual Tonsillectomy

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.

http://www.ncbi.nlm.nih.gov/pubmed/22472240

Thermal Welding Versus Cold Knife Tonsillectomy: A Prospective Randomized Study

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.

http://www.ncbi.nlm.nih.gov/pubmed/22531306

Perioperative Outcomes of Severely Obese Children Undergoing Tonsillectomy

Severe obesity in children undergoing tonsillectomy is independently associated with an increased risk of perioperative complications.

http://www.ncbi.nlm.nih.gov/pubmed/22776351

Systematic Review of Complications of Tonsillotomy Versus Tonsillectomy

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.

http://www.ncbi.nlm.nih.gov/pubmed/22394550