Journal of Cellular & Molecular Anesthesia

In Collaboration with Anesthesiology Research Center, SBMU


Journal of Cellular and Molecular Anesthesia (JCMA) is a scientific quarterly and peer-reviewed journal, with particular attention to translational anesthesiology and perioperative medicine. Disease-oriented basic research in cellular and molecular aspects of anesthesiology, including laboratory investigations, bench-to-bedside studies, or clinical research that yield new findings in molecular and cellular anesthesia and improve our diagnosis and therapeutics in clinical anesthesia are among the main targets in JCMA. Researches about Personalized Anesthesiology and Perioperative Medicine are other among the main areas of interest in the JCMA.

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Recent Submissions

Now showing 1 - 20 of 356
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    Midazolam-induced learning and memory impairment is modulated by cannabinoid CB1 receptor agonist and antagonist
    (Brieflands, 2016-03-31) Hedayatollah Elyasi; Nima Naderi
    Background: Memory impairment is a well-known effect of many benzodiazepine compounds which is mediated through their action on gamma-aminobutyric acid type A (GABAA) receptors. On the other hand, cannabinoids can affect learning and memory process through presynaptic modulation of the release of both excitatory glutamate and inhibitory GABA transmitters in brain regions involved in learning and memory. The aim of the present study was to investigate the effect of cannabinoids on memory impairment and long-term potentiation (LTP) reduction properties of the short acting benzodiazepine midazolam.Materials and Methods: One week after insertion of guide cannula by stereotaxic surgery, cannabinoid compounds or midazolam were administered by intracerebroventricular (i.c.v.) injection into lateral ventricle of male rats. Spatial memory task was evaluated using Morris water maze (MWM) test. Electrophysiological evaluation was done by field potential recording of hippocampal neurons in unconscious rats.Results: In MWM test, while i.c.v. administration of AM251 (200 and 500 ng) per se could not change learning and memory function in rats, pretreatment of rats with AM251 (500 ng; i.c.v.) attenuated midazolam-induced memory impairment. In field potential recording, while i.c.v. administration of AM251 (500 ng) and WIN55212-2 (10 ?g) did not have any effect on population spike amplitude, pretreatment of rats with both AM251 and WIN55212-2 significantly diminished midazolam-induced PS amplitude reduction in hippocampal neurons.Conclusion: OurOur results suggest the involvement of cannabinoid CB1 receptors in both memory impairment and LTP reduction in hippocampal neurons which was produced by midazolam. This interaction is likely through their effect on both GABAergic and glutamatergic receptors in hippocampus.
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    Anti-hyperalgesic and anti-inflammatory effects of long term calcium administration during adjuvant-induced arthritis in rats
    (Brieflands, 2016-03-31) Hedayatollah Elyasi; Jalal Zarringhalam
    Introduction: Inflammation and edema Symptoms are physiological responses to triggers induced by different mediators such as cytokines. Rheumatoid arthritis is the most common form of arthritis which is characterized by chronic inflammation of the synovial membrane, severe and debilitating pain, and progressive cartilage injury. It is clear that cytokines are involved in different stages of inflammation by inducing pro-inflammatory effects; TNF-? is a cytokine involved in the pathogenesis of rheumatoid arthritis. In this study, we attempted to investigate the role of the prescription of calcium to reduce inflammatory edema and serum TNF-? levels during different stages of arthritic inflammation induced by Complete Freund Adjuvant (CFA) injection in males Wistar rats. Methods: In this Applicable-Fundamental study, we used male Wistar rats and adjuvant arthritis was created by once the subcutaneous injection of CFA in the right hind paw of animals on day zero in experimental groups. Various doses of calcium were prepared and injected within 21 days of the study. Hyperalgesia and paw volume changes were assessed by radiant heat and plethysmometer over several days, respectively. The serum levels of TNF-? were studied by ELISA standard kit of rats during various phases and were measured according to the kit. Results: The results indicated dose-related effects of long-term calcium administration on edema, hyperalgesia, and serum TNF-? level reduction. Daily treatment with an effective dose of calcium (5 mg/kg) in the AA+ Ca group significantly decreased paw edema, hyperalgesia, and serum TNF-? level in comparison to AA and AA+ Vehicle groups on days 7, 14, and 21 of the study. Conclusions: Findings of this study showed; long-term administration of calcium in the proper dosage can act as an anti-inflammatory agent and pain modulator during adjuvant-induced arthritis. A part of those effects may be conducted by decreasing serum TNF-? levels.
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    Opium abuse and its problems in anesthesia practice: a review from bench to bedside
    (Brieflands, 2016-06-30) Ali Dabbagh; Samira Rajaei
    Opium is a derivative of opium poppy; the species of plant which its extract is used for preparing opium. Opium abuse is considered under drug dependency classification of psychiatric diseases and opium abusers have a number of major challenges before, during and after anesthesia for surgical operations (i.e. the perioperative period). This article reviews these clinical challenges during the perioperative period to discuss the new clinical findings for these patients and to demonstrate some of the main problems that physicians are encountered with.Keywords: opium, abuse, anesthesia
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    Comparison of retrolaminar paravertebral infiltration of a non steroid mixture with conventional epidural steroid infiltration in patients suffering from chronic radicular Pain a retrospective study
    (Brieflands, 2017-06-30) Sadegh Abdolmohammadi; Alireza Nekoui; Gilbert Blaise
    Introduction:Chronic radicular pain is often treated by epidural steroid infiltration (ESI). In 2014, Food and Drug Administration (FDA) issued a letter warning that ESI may result in rare but serious adverse events, including “loss of vision, stroke, paralysis, and death”. In this retrospective study, we compare retrolaminar paravertebral infiltration (PVI) of a non-steroid-mixture with ESI.
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    How to Use Non-Invasive Ventilation in Acute Respiratory Failure due to Covid 19? Early, Short-Time, Low Drive Pressure
    (Brieflands, 2021-09-30) Parviz Amri
    How to use non-Invasive ventilation in acute respiratory failure due to  Covid 19? Early, short-time, low drive pressure.
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    Homocysteine Levels and Ischemic Stroke: A Systematic Review
    (Brieflands, 2021-09-30) Meisam Akhlaghdoust; Pourya Pezeshgi; Alireza Zali; Saeed Safari; AmirRez Sharghi Marandi
    The most common type of stroke is ischemic stroke. Given that death due to stroke is one of the three leading causes of death globally, it is essential to identify its risk factors, especially modifiable risk factors. Nowadays, High homocysteine is recognized as one of the risk factors for stroke. Our aim in this study was to investigate the association between homocysteine levels and ischemic stroke. We searched the keywords in Scopus, Web of Science, Google Scholar, PubMed, and Science Direct with a 15-year time limit. At first, 3884 studies were found, and after further investigation and based on inclusion and exclusion criteria, only nine studies were selected. Of the nine selected studies was a clinical trial and eight observational studies, and in total, there were 16227 participants in these studies. The prevalence of ischemic stroke was higher in people with high homocysteine levels than in people with normal homocysteine levels (14.1% vs. 9.8%). The prevalence was generally higher in men, but among people with high homocysteine levels, the prevalence of ischemic stroke was slightly higher in women than in men (12% vs. 11%), and also, in women and men, the prevalence of ischemic stroke was higher in people with high homocysteine levels than in people with normal levels. Based on selected studies, increased homocysteine levels in men and women increases the risk of ischemic stroke. Because homocysteine levels are a modifiable risk factor, diet and prevention of vitamin B12 decrease can help prevent an increased risk of ischemic stroke.
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    The Potential Use of “Magnoliae flos” Against COVID-19
    (Brieflands, 2022-03-31) Siukan Law
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    Anesthetic Management of Rapid Ventricular Response Atrial Fibrillation in an Elderly Woman Using Remifentanil; A Case Report
    (Brieflands, 2022-03-31) Mahtab Poor Zamany Nejat Kermany; Fereshte Kimia; Fatemeh Roodneshin
    Atrial fibrillation (AF) is the most common cardiac Arrhythmia in all clinical settings. In the setting of atrial fibrillation with rapid ventricular response (AFib with RVR), early rate control (with or without restoration of the sinus rhythm) is the center of management. Several drugs are used for the management of rapid ventricular response AF but the optimal one is unknown yet. In this case report we present an elderly woman undergoing urgent ophthalmic surgery whose rapid ventricular response AF was controlled by Remifentanil.
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    Regenerative Medicine And Perioperative Hypoxic Organ Damage: Targeting Hypoxia-Inducible Factors
    (Brieflands, 2022-03-31) Soudeh Tabashi; Ardeshir Tajbakhsh; Mastaneh Dahi Taleghani; Shide Dabir; Maryam Vosoughian; Mohammadreza Moshari
    Regenerative medicine is defined by utilizing body’s own repair mechanisms in order to restore normal function of tissues. An important perioperative cause of organ injury is hypoperfusion mostly due to hypoxia. Hypoxia can promote genomic pathway and increase the level of hypoxia-inducible factors (HIF). In this review we introduce HIF as a pioneer role of regenerative medicine for prevention of perioperative complications.
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    Uncovering Systemic Lupus Erythematosus Candidate Proteomic Biomarkers: A Bioinformatics Approach
    (Brieflands, 2022-03-31) Mona Zamanian Azodi; Mostafa Rezaei Tavirani; Mohammad Rostami-Nejad; Babak Arjmand; Mohhamadreza Razzaghi
    Introduction: Molecular analysis of different types of disease could be helpful to understand the mechanisms of the related abnormal functions at that level of disorder. Lupus is not an exception, by the use of protein-protein interaction network analysis, it is possible to investigate the molecular basis and malfunctions in this kind of disease.
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    Anesthetic Management of a Patient with Ebstein's Anomaly for Obstructed Inguinal Hernia
    (Brieflands, 2022-06-30) Raghuraman M Sethuraman; selvamani Subramanian; Sharanya Padmanabhan; Meera Rani Nayak
    Ebstein’s anomaly is a rare congenital heart disease constituting less than 1% of patients with congenital heart diseases.  It has diverse presentations, severity, and consequently, the management too. These patients are at increased risk of developing ventricular and supraventricular tachycardias, congestive heart failure, and even death. Here, we report a case of a 32-year old man with Ebstein’s anomaly, who had successfully undergone emergency open inguinal hernioplasty under nerve blocks.
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    Predictive Molecular Blood Biomarkers in Non-Small Cell Lung Cancer
    (Brieflands, 2022-06-30) Abdolreza Mohamadnia; Mohammad Hoseine Talischi; Minoo Mahmoodi; Naghmeh Bahrami; Abdollah Farhadinasab
    Background: Lung cancer is characterized by the uncontrolled growth of cells in the lung tissue. The purpose of the present study was to investigate the expression of MUC1 mRNA and CK19 mRNA biomarkers in patients with non-small-cell lung carcinoma (NSCLC).Materials and Methods: In this case-control research, thirty samples of cancer blood, thirty samples of cancer tissue, and the same number of healthy samples were prepared. Samples were collected and RNA was extracted, then cDNA was made and gene expression was measured using Real-Time PCR.Results: Among non-small-cell lung carcinoma patients, the MUC1 mRNA marker was positive for 19 individuals while in the healthy group, it was reported positive in 5 out of 30 individuals. In the patients' group, the CK19 mRNA marker was positive for 16 individuals while in the healthy group, in 6 out of 30 individuals.Conclusion: The MUC1 mRNA and CK19 mRNA as lung cancer tumor markers were reliable and sensitive; however, further studies are recommended
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    Introducing Markers which are Involved in COVID-19 Disease: Severe Condition Versus Mild State, a Network Analysis
    (Brieflands, 2022-06-30) Mosatafa Rezaei-Tavirani; Dr Vahid Mansouri; farshad okhovatian; Hojjat Allah Abbaszadeh
    Background: Coronavirus disease 2019 (COVID-19) had a pandemic spread worldwide. Most infected patients had a good prognosis, but some developed severe illnesses, which led to fatalities. It is urgent to define markers that reveal the severity of the disease. This study aimed to introduce the main plasma protein biomarkers involved in severe conditions versus mild infection states.
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    A Comparative Study of Efficacy of Clonidine and Fentanyl as Adjuvant to Intrathecal 2- Chloroprocaine in Lower Limb Surgeries: A Randomized, Double-Blind Trial
    (Brieflands, 2022-06-30) Heena Gupta; Vaishno devi Vaish; Mushtaq Wani; Anju Jamwal
    BACKGROUND: Preservative free 1% 2-chlorprocaine is a short acting local anesthetic agent that has a favourable profile for day care surgical procedures. Various adjuvants can be added to local anesthetics to potentiate their action. In this study, we compared the effect of intrathecal clonidine and fentanyl as an adjuvant to 1% 2-chloroprocaine (2-CP) in patients undergoing elective lower limb surgeries.
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    Myotonic Dystrophy and Volvulus: Anesthetic Considerations For an Urgent Situation And the Role of Sugammadex; A Case Report
    (Brieflands, 2022-09-30) Masoud Nashibi; Kamran Mottaghi; Arash Tafrishinejad; Sogol Asgari
    Myotonic dystrophy (MD), although not a common disorder, is a challenge for anesthesiologists as it restricts choices of medication and involves some organs other than muscles. Here we report a known case of MD underwent laparatomy for bowel obstruction. Anesthesia was induced rapidly and muscle relaxation achieved by using high dose of rocuronium. Reversal of muscle relaxation was done with sugammadex successfully with no residual relaxation. Rocuronium could be used as a safe mean of rapid muscle relaxation in MD and reversal could be achieved with sugammadex.
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    Role of Ultrasound-Guided Hemidiaphragm Sparing Brachial Plexus Block in the Morbidly Obese Patient
    (Brieflands, 2022-12-31) Vinod K; Raj Murugan; Arulmozhi Shanmuga Priya; Richards Sam
    Patients with Grade III obesity pose unique challenges to the treating anesthesiologists. The challenges range from difficulty in intravenous cannulation to airway management. Regional anesthesia is advantageous over general anesthesia as it avoids airway manipulation, prevents reduction in functional residual capacity, and provides good postoperative analgesia. Regional anesthesia has its pitfalls like identifying the landmarks accurately and hemi diaphragmatic palsy following brachial plexus block. Hemi diaphragmatic palsy is poorly tolerated in grade III obese patients leading to increased peri-operative morbidity which undermines the advantages of regional over general anesthesia. Ultrasound-guided costoclavicular brachial plexus block(CCBPB) has the benefit of reduced hemi diaphragmatic palsy, avoiding pleural injury, and wider distribution of sensory blockade. Costoclavicular block has been administered to obese patients in the past with great success. We are reporting a successful case of ultrasound-guided costoclavicular brachial plexus block performed in an obese patient with a BMI of 51.56Kg/m2.
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    Olfactory and Gustatory Dysfunctions as Prognostic Factors in Patients with the SARS-CoV-2 Virus
    (Brieflands, 2022-12-31) meh gou; Mehrdad Haghighi; Hossein Hatami; Ehsan Asadi; Seyed Shayan Ebadi; hussein soleimantabar; Atefe Shadkam; Seyed Alireza Ebadi
    Background: COVID-19 neurologic symptoms such as anosmia and ageusia are considered the most challenging issues for patients in the first steps of viral infection. Herein, we aimed to investigate the olfactory and gustatory dysfunction and their association with prognostic factors in patients with COVID-19.Materials and Methods: The current retrospective study was performed on patients admitted to a hospital with a definite diagnosis of COVID-19 between March and November 2020. Based on the study criteria, information of 150 eligible participants (89 males and 61 females) was completely collected. The olfactory and gustatory symptoms including anosmia, hyposmia, ageusia, and dysgeusia were assessed, and five main COVID-19 prognostic factors including level of D-dimer, C-reactive protein (CRP), lymphocyte count (LC), lactic acid dehydrogenase (LDH) and COVID-19 related lung involvement were measured.Results: Among all patients, 102 (68%) participants were completely treated and 48 (32%) died. Compared to treated patients, all prognostic factors including CRP, LDH, LC, D-dimer, and lung involvement were significantly higher in death cases. We found that 97 (64.7%) patients experienced at least one olfactory or gustatory dysfunction. The level of CRP, LC, D-dimer, and lung involvement showed a better prognosis among patients with at least one sensory dysfunction. Moreover, a better outcome was observed in patients with sensory dysfunction.Conclusion: It can be concluded the evaluation of CRP, LDH, D-dimer, and LC together with the HRCT scan score contributes to a better prognosis in COVID-19 patients with sensory dysfunction.
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    A Comparative Study Between Ultrasound-Guided Erector Spinae Plane Block and Paravertebral Block in Thoracic Surgeries For Postoperative Analgesia
    (Brieflands, 2022-12-31) Prem Singh; TANMAY TIWARI; Akanksha Jain; Vinod Digraskar
    Background: Regional analgesia has an important role in the multimodal analgesia approach for postoperative pain management. Recently, the use of PVB is increased for providing effective analgesia. ESP block is a comparatively newer modality, established as a good analgesic technique. This study aimed to compare the postoperative analgesic efficacy of ultrasound-guided ESP block and PVB in thoracic surgeries.Materials and Methods: This prospective randomized comparative open-label study involved 60 patients who underwent different thoracic surgeries and were randomized to receive ultrasound-guided ESP block (group A) or PVB (group B) with 20 ml 0.25% bupivacaine before induction of general anesthesia. Postoperatively, all patients received 1gm intravenous paracetamol injection every 8 hours. The primary outcome was to compare VAS scores at 0, 1, 3, 6, 12, and 24h, and secondary outcomes were assessed in terms of analgesic consumption and hemodynamic stability postoperativelyResults: Group A had a significantly lower VAS score at 0h, 1h, 3h, and 6h postoperatively (p=0.026, 0.003, 0.003, and 0.002, respectively) than group B. Thereafter, comparable VAS scores were found at 12 and 24h. However, the mean VAS in either of the group was 0.05) in both groups. All patients exhibited stable hemodynamic profiles postoperatively.Conclusion: Ultrasound-guided ESP block along with round-the-clock NSAIDs can be a better and safe alternative to PVB in thoracic surgeries with reduced analgesic consumption and hemodynamic stability.
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    Anesthetic Management of a Four-Year-Old Child Affected by Marinesco-Sjogren Syndrome Scheduled for Cataract Surgery: A Case Report
    (Brieflands, 2023-03-31) Dr Azar Ejmalian; Elham Memary; Nader Nassiri
    Marinesco-Sjogren syndrome (MSS) is a rare autosomal recessive disorder with different clinical signs and symptoms. Neurological dysfunction, especially in the cerebellum, ataxia, dysarthria, muscle atrophy, progressive hypotonia, skeletal deformity with scoliosis, mental retardation, and failure to thrive are common. Congenital cataracts and strabismus may need to be corrected via surgery. This disorder requires unique anesthetic consideration for myopathy, malignant hyperthermia, and respiratory depression. The neurodevelopmental delay also makes anesthetic management challenging in these patients. Muscle weakness and poor respiratory reserve in these patients may be associated with adverse effects if muscle relaxants are used during anesthesia. Case reports of anesthetic management of this syndrome are scarce. We report a child with MSS scheduled for lens removal surgery and anesthetic management.
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    Evaluation of the Neuroprotective Effect of Thiopental and Its Effect on Serum NSE Level in Neurocritical Care Patients
    (Brieflands, 2023-03-31) Mehran Kouchek; Sara Salarian; Mohammad Sistanizad; Fatemeh Babaei; Mir Mohammad Miri
    Background: This study aimed to evaluate the neuroprotective effect of thiopental and its effect on serum NSE levels in neurocritical care patients.Materials and Methods: Patients were divided into two groups (intervention and control). Thiopental administration as the intervention was started at a dose of 3-6 mg/Kg every 30 minutes and continued until 0.3-3 mg/Kg/hour. Sedation with fentanyl and midazolam as control was also performed in 35 patients. After three days, thiopental was discontinued. On the fifth day, the desired indicators were compared between the two groups.Results: On the third and fifth days, patients in the intervention group had a greater drop in serum NSE levels (P