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Effects of general anesthesia with remimazolam on immune function and quality of postoperative recovery in patients undergoing radical colorectal cancer surgery

ABSTRACT: Interventions: Group R:Remimazolam for induction and maintenance of anesthesia;Group P:Propofol for induction and maintenance of anesthesia Primary outcome(s): Immune function Study Design: Parallel

DISEASE(S): Colorectal Cancer

PROVIDER: 85063 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Disturbance of key cellular subproteomes upon propofol treatment is associated with increased permeability of the blood-brain barrier

Project description:Background: Propofol is a short-acting anesthetic, which is often used for induction and maintenance of general anesthesia, sedation for mechanically ventilated adults and procedural sedation. Several side effects of propofol are known and a substantial number of patients suffer from post-operative delirium after propofol application. In this study, we analyzed the effect of propofol on the function and protein expression profile on a proteome-wide scale. Methods: We cultured human brain microvascular endothelial cells in the absence and presence of propofol and analyzed the permeability of the blood-brain barrier (BBB) by fluorescein passage and protein expression on a proteome-wide scale by mass spectrometry. Results: Propofol interfered with the function of the blood-brain barrier. This was not due to de-creased adhesion of propofol-treated human brain microvascular endothelial cells. The proteomic analysis revealed that some key pathways in these cells were disturbed, such as oxygen metabolism, DNA damage recognition and response to stress. Conclusions: Propofol has strong effects on protein expression which could explain several side effects of propofol.

2022-10-13 | PXD033856 | Pride

Effect of EEG Dual Frequency Index on Postoperative Resuscitation, Pulmonary Blood Perfusion and Short-Term Prognosis during General Anesthesia for Rectal Cancer

Project description:Interventions: experimental group:Propofol closed loop target controlled infusion anesthesia;control group:Propofol ring opening infusion anesthesia Primary outcome(s): Pulmonary perfusion Study Design: Parallel

| 2705330 | ecrin-mdr-crc

Effect of epidural block combined with general anesthesia on perioperative NETosis expression in patients with colorectal cancer

Project description:Interventions: A group:Sevoflurane - opioid general anesthesia group;B group:Propofol - epidural block general anesthesia group Primary outcome(s): NETosis;neutrophil /lymphocyte ratio Study Design: Parallel

| 82852 | ecrin-mdr-crc

Suppressive effect of the anesthetic Propofol on the T cell function and T cell-dependent immune responses

Project description:General anesthesia is thought to suppress the immune system and negatively affect postoperative infection and the long-term prognosis of cancer. However, the mechanism underlying immunosuppression induced by general anesthetics remains unclear. In this study, we focused on propofol, which is widely used for sedation under general anesthesia and intensive care and examined its effects on the T cell function and T cell-dependent immune responses. We found that propofol suppressed T cell glycolytic metabolism, differentiation into effector T cells, and cytokine production by effector T cells. CD8 + T cells activated and differentiated into effector cells in the presence of propofol in vitro showed reduced antitumor activity. Furthermore, propofol treatment suppressed the increase in the number of antigen-specific CD8 + T cells during Listeria infection. In contrast, the administration of propofol improved inflammatory conditions in mouse models of inflammatory diseases, such as OVA-induced allergic airway inflammation, hapten-induced contact dermatitis, and experimental allergic encephalomyelitis. These results suggest that propofol may reduce tumor and infectious immunity by suppressing the T cell function and T cell-dependent immune responses while improving the pathogenesis and prognosis of chronic inflammatory diseases by suppressing inflammation.

2025-08-25 | GSE268453 | GEO

A comparative study of the effects of Remimazolam Tosilate and Sevoflurane on perioperative oxidative stress response in patients undergoing radical surgery for colorectal cancer

Project description:Interventions: The sevoflurane group (S group) :The S group received inhalational anesthesia with sevoflurane for induction and maintenance.;Remazolam group (R group):Induction and maintenance of anesthesia using remidazolam Primary outcome(s): Catalase;Glutathione;Oxidized glutathione;Malondialdehyde;Superoxide dismutase Study Design: Parallel

| 89547 | ecrin-mdr-crc

Cancer and Anesthesia: Survival After Radical Surgery - a Comparison Between Propofol or Sevoflurane Anesthesia

Project description:The purpose of this study is to determine whether anesthesia maintained with propofol results in better one- and five-year-survival than anesthesia maintained with sevoflurane.

| 2154097 | ecrin-mdr-crc

Effects of regional anesthesia aided sedation on patients’ psychological stress and postoperative recovery

Project description:Interventions: Sedation Group (Group S):Sedation with propofol;Control group:regional anesthesia Primary outcome(s): stress index;Nervousness index;Anxiety index;Wound healing Study Design: Randomized parallel controlled trial

| 2665415 | ecrin-mdr-crc

Metabolomics profiling of pre-and post-anesthesia plasma samples obtained via Ficoll separation

Project description:1H Nuclear Magnetic Resonance (NMR) spectroscopy was used to investigate the metabolic consequences of general anesthesia in the plasma of two groups of patients with diagnosis for non-metastatic colorectal cancer and metastatic colorectal cancer with liver-metastasis, respectively. Patients were treated with Etomidate or Propofol, two frequently used sedation agents. Plasma samples were obtained via Ficoll separation. Here, we demonstrated that this procedure introduces a number of limitations for NMR-based metabolomics studies, due to the appearance of spurious signals. Nevertheless, the comparison of the 1H NMR metabolomic profiles of patients treated with Etomidate or Propofol at equipotent dose ranges was still feasible and proved that both agents significantly decrease the plasma levels of several NMR-detectable metabolites. Consequently, samples collected during anesthesia are not suitable for metabolic profiling studies aimed at patient stratification, because interpersonal variability are reduced by the overall depression of metabolites levels. On the other hand, this study showed that plasma metabolomics could represent a valuable tool to monitor the effect of different sedation agents and/or the individual metabolic response to anesthesia, providing hints for an appropriate tuning of personalized sedation procedures. In our reference groups, the metabolomic signatures were slightly different in patients anesthetized with Etomidate versus Propofol. The importance of standardized collection procedures and availability of exhaustive metadata of the experimental design for the accurate evaluation of the significance of the observed changes in metabolites levels are critically discussed.

2015-11-17 | MTBLS172 | MetaboLights

Astrocytes modulate a specific paraventricular thalamus-prefrontal cortex projection to enhance consciousness recovery from sevoflurane anesthesia in mice

Project description:Previous studies have proved that astrocytes may be a key neural substrate that regulates wakefulness and consciousness recovery from general anesthesia, while the exact molecular target in astrocytes is still unclear. Using virus injection and in vivo fiber photometry in mice, we found both activating astrocytes and knocking down astrocytic Kir4.1 in paraventricular thalamus (PVT) promotes the consciousness recovery from sevoflurane anesthesia. Single-cell RNA sequencing of PVT reveals two distinct cellular subtypes of glutamatergic neurons: PVTGRM and PVTChAT neurons. Patch-clamp recording results proved that Astrocytic Kir4.1-mediated modulation of sevoflurane on PVT mainly works on PVTChAT neurons. Moreover, we found that PVTChAT neurons project mainly to the mPFC. This specific paraventricular thalamus to prefrontal cortex projection is involved in recovery of consciousness from sevoflurane anesthesia indirectly through modulation of astrocytes. In summary, our findings support the novel conception that the volatile anesthetic sevoflurane can inhibit PVT astrocytic Kir 4.1 to maintain and/or increase neuronal firing of PVTChAT neurons, which mainly projects to mPFC and promotes consciousness recovery from anesthesia.

2024-07-20 | GSE240388 | GEO

Dose combined spinal-general anesthesia improve postoperative quality of recovery in patients undergoing laparoscopic colorectal surgery?

Project description:Interventions: combined anesthesia group:Patient received intrathecal injection of 250 µg morphine with 15 mg ropivacaine combined general anesthesia;control group:Patient received simulate spinal anesthesia Primary outcome(s): Postoperative quality of recovery Study Design: Parallel

| 2741142 | ecrin-mdr-crc

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