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.

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.

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.

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.

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.

Perioperative Outcomes of Severely Obese Children Undergoing Tonsillectomy

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

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.