Seth's Wiki - Recent changes [en]

Methadone

Aesetholephews — Thu, 24 Sep 2026 18:15:37 GMT

Methadone

Aesetholephews — Thu, 24 Sep 2026 17:25:30 GMT

Created page with "[https://ovidsp-dc2-ovid-com.ezproxy.lib.utah.edu/ovid-new-a/ovidweb.cgi?WebLinkFrameset=1&S=828c5f44-ae52-45b8-81d6-fb8b88a3683d%7cmain&returnUrl=ovidweb.cgi%3f%26Titles%3dS...."

New page

[https://ovidsp-dc2-ovid-com.ezproxy.lib.utah.edu/ovid-new-a/ovidweb.cgi?WebLinkFrameset=1&S=828c5f44-ae52-45b8-81d6-fb8b88a3683d%7cmain&returnUrl=ovidweb.cgi%3f%26Titles%3dS.sh.92%257c21%257c100%26FORMAT%3dtitle%26FIELDS%3dTITLES%26S%3d828c5f44-ae52-45b8-81d6-fb8b88a3683d%257cmain&fromjumpstart=0&directlink=https%3a%2f%2fovidsp.dc2.ovid.com%2fovftpdfs%2fFPEBIPGHJEIKGD00%2ffs047%2fovft%2flive%2fgv038%2f00000542%2f00000542-197609000-00022.pdf&filename=Prolonged+Depression+of+Respiratory+Rate+Following+Methadone+Analgesia.&navigation_links=NavLinks.S.sh.92.21&PDFIdLinkField=%2ffs047%2fovft%2flive%2fgv038%2f00000542%2f00000542-197609000-00022&link_from=S.sh.92%7c21&pdf_key=B&pdf_index=S.sh.92&D=medall Case report from 1972] showed that single dose of IV methadone could lead to prolonged respiratory depression. Here's the thing though, it was an 81 year old woman who was 43 kg and getting an open aortic valve replacement, in addition to 3 mg of morphine, she also got 30 mg of IV methadone!

Teaching Points

Aesetholephews — Thu, 24 Sep 2026 17:23:02 GMT

September 2026

Aesetholephews — Wed, 23 Sep 2026 20:37:19 GMT

9/22

September 2026

Aesetholephews — Tue, 22 Sep 2026 21:00:59 GMT

Created page with "'''Annual Goals:''' *Finish Brandon's study *RISE 1 application *Methohexital analysis '''Monthly Goals:''' *Meet w/ Nina *Think deeply about research directions and goals..."

New page

'''Annual Goals:'''
*Finish Brandon's study
*RISE 1 application
*Methohexital analysis

'''Monthly Goals:'''
*Meet w/ Nina
*Think deeply about research directions and goals
*Literature review to refine research aims
*Figure out organizational system to be more productive with research time

== 9/22 ==
*Learned about [https://fooof-tools.github.io/fooof/auto_motivations/index.html FOOOF motivations].
**Aperiodic components of a signal will spread out their power in all frequencies, when doing FFT it can appear as if there is oscillatory activity when in fact there is none.
**Band analysis, including band power ratios, are rife with potential for misinterpretation unless you break out the aperiodic components
**Changes in the aperiodic exponent or offset can mimic changes in band power
*Read through the RISE application.
**Mentoring plan is the most important single component.
**Met with Norm Taylor to discuss timing and considerations for project directions and mentors, identify successful applicants.
*Met Coby
**From UCLA, now a 2nd year PhD student in Christian's lab, focusing on SWARM analysis.
**They are getting frontal EEG data from SEEG explants and correlating LFPs and single neuron activity with SO/SW data from frontal EEG.
**Implanted electrodes attract glia which adhere to the electrodes and make a local inflammatory response that increases impedance and reduces data quality.
*Met w/ Talmage
**BIS study that he is starting with Christian in the next few months. I should get on board.
**Respiration AI startup (as good as a PACU nurse at reminding post-op patients to breath). He wants me to be the clinical PI for the upcoming study.
**20 years ago he licensed some PK/PD software to GE but no one bought it. A Norwegian company tried the same thing, also without success. He is now trying to get it integrated into EPIC. Is it just a marketing problem that no one wants to buy it? They've shown that it changes how people deliver anesthesia (typically they use less, specifically opioid).
**He thinks the big thing that is lacking from Christian's research is volunteer studies.
*Initial assessment of feasibile/high-impact research ideas:
**Depression
***What is the disease burden of depression in the general surgical population?
***What is the incidence of post-operative depression in general surgical patients without pre-existing depression? What if they have a family or personal history of depression?
***Do ketamine, TIVA w/ propofol, TIVA w/ remimazolam, psychedelics, or burst suppression modulate the post-operative risk?
**CLAN
***When combined with SEEG electrodes or data from Parkinson's patients with deep-brain stimulators, can we resolve temporal and spatial activity of deep subcortical structures with ICA from frontal or full EEG? [https://pubmed.ncbi.nlm.nih.gov/28575667/ steerable non-invasive DBS]
***What are the EEG effects of benzos, opioids, precedex, and their respective reversal agents?
***What are the EEG effects of IV caffeine or methylphenidate? Do these cause emergence agitation?
***What is known about the EEG signature of methohexital?
**CO2
***Does permissive hypercapnia improve hemodynamic stability, deepen anesthesia, and speed recovery?
***Can we make a device or repurpose an existing ventilator to help accomplish that?
*High-impact, less feasible research ideas:
**Does TIVA prevent cancer recurrence? Could be feasible if we are able to mine the data from someone else's data set.
**Does general anesthesia lead to post-op ileus and constipation?
**Mechanisms of anesthesia. Is it dogma that anesthesia works by disrupting neuronal circuitry? Can I disprove this by anesthetizing weird organisms?
**Cancer vaccine. Can we make an mRNA vaccine that increases p53 copy number. Peto's paradox. Elephants.
*Low-impact, very feasible research ideas:
**SCD-FR
**Better late than never PONV

← Older revision		Revision as of 18:15, 24 September 2026
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Line 1:		Line 1:
−	[https://ovidsp-dc2-ovid-com.ezproxy.lib.utah.edu/ovid-new-a/ovidweb.cgi?WebLinkFrameset=1&S=828c5f44-ae52-45b8-81d6-fb8b88a3683d%7cmain&returnUrl=ovidweb.cgi%3f%26Titles%3dS.sh.92%257c21%257c100%26FORMAT%3dtitle%26FIELDS%3dTITLES%26S%3d828c5f44-ae52-45b8-81d6-fb8b88a3683d%257cmain&fromjumpstart=0&directlink=https%3a%2f%2fovidsp.dc2.ovid.com%2fovftpdfs%2fFPEBIPGHJEIKGD00%2ffs047%2fovft%2flive%2fgv038%2f00000542%2f00000542-197609000-00022.pdf&filename=Prolonged+Depression+of+Respiratory+Rate+Following+Methadone+Analgesia.&navigation_links=NavLinks.S.sh.92.21&PDFIdLinkField=%2ffs047%2fovft%2flive%2fgv038%2f00000542%2f00000542-197609000-00022&link_from=S.sh.92%7c21&pdf_key=B&pdf_index=S.sh.92&D=medall Case report from ~~1972~~] showed that single dose of IV methadone could lead to prolonged respiratory depression. Here's the thing though, it was an 81 year old woman who was 43 kg and getting an open aortic valve replacement, in addition to 3 mg of morphine, she also got 30 mg of IV methadone!	+	[https://ovidsp-dc2-ovid-com.ezproxy.lib.utah.edu/ovid-new-a/ovidweb.cgi?WebLinkFrameset=1&S=828c5f44-ae52-45b8-81d6-fb8b88a3683d%7cmain&returnUrl=ovidweb.cgi%3f%26Titles%3dS.sh.92%257c21%257c100%26FORMAT%3dtitle%26FIELDS%3dTITLES%26S%3d828c5f44-ae52-45b8-81d6-fb8b88a3683d%257cmain&fromjumpstart=0&directlink=https%3a%2f%2fovidsp.dc2.ovid.com%2fovftpdfs%2fFPEBIPGHJEIKGD00%2ffs047%2fovft%2flive%2fgv038%2f00000542%2f00000542-197609000-00022.pdf&filename=Prolonged+Depression+of+Respiratory+Rate+Following+Methadone+Analgesia.&navigation_links=NavLinks.S.sh.92.21&PDFIdLinkField=%2ffs047%2fovft%2flive%2fgv038%2f00000542%2f00000542-197609000-00022&link_from=S.sh.92%7c21&pdf_key=B&pdf_index=S.sh.92&D=medall Case report from 1976] published in Anesthesiology showed that single dose of IV methadone could lead to prolonged respiratory depression. Here's the thing though, it was an 81 year old woman who was 43 kg and getting an open aortic valve replacement, in addition to 3 mg of morphine, she also got 30 mg of IV methadone!
		+
		+	[https://journals-lww-com.ezproxy.lib.utah.edu/anesthesiology/pdf/10.1097/00000542-198212000-00005~pharmacodynamics-and-pharmacokinetics-of-methadone-during A 1982 study] published in Anesthesiology reported that 23 general surgery and orthopedic patients were given 20 mg IV methadone bolus at induction, 100% required no additional opioids in the first 18 hrs post-op. 25% required only non-opioid analgesics. 40% did not need any additional treatment for post-op pain. There was no respiratory depression.
		+
		+	Ovid MEDLINE(R) ALL <1946 to September 23, 2026>
		+
		+	1 Methadone/ 14563
		+	2 (nature or science or new england journal of medicine or british journal of anaesthesia or anaesthesia or anesthesiology or anesthesia & analgesia).jn. 520093
		+	3 1 and 2 233
		+	4 limit 3 to humans 198
		+	5 limit 4 to "all adult (19 plus years)" 72
		+	6 from 5 keep 1,3,6-9,11,13-14,16-17,22,25,28,30,44,47-49,51,58,66 22

@@ Line 1: / Line 1: @@
 * [[DL vs. VL]]
-* Methadone
+* [[Methadone]]
 * pEEG
 * Ketorolac 15 vs. 30
 * Modified Bier block for propofol infusion pain
 * Permissive hypercapnia

@@ Line 1: / Line 1: @@
 '''Annual Goals:'''
-*Finish Brandon's study
+*Get a manuscript ready for submission
 *RISE 1 application
-*Methohexital analysis
+*Identify additional funding sources
 '''Monthly Goals:'''
@@ Line 9: / Line 10: @@
 *Literature review to refine research aims
 *Figure out organizational system to be more productive with research time
 == 9/22 ==
-*Learned about [https://fooof-tools.github.io/fooof/auto_motivations/index.html FOOOF motivations].
+*Talked to Hamilton (re: how do you know that a worm is anesthetized)?
-**Aperiodic components of a signal will spread out their power in all frequencies, when doing FFT it can appear as if there is oscillatory activity when in fact there is none.
+**Schedule another phone call on 10/2. He's interested in collaborating on a high-throughput screen in C. elegans.
-**Band analysis, including band power ratios, are rife with potential for misinterpretation unless you break out the aperiodic components
 *Met Coby
-**From UCLA, now a 2nd year PhD student in Christian's lab, focusing on SWARM analysis.
+**From UCLA, now a 2nd year PhD student in Christian's lab, focusing on SWARM (slow-wave analysis something modulation?)
 **They are getting frontal EEG data from SEEG explants and correlating LFPs and single neuron activity with SO/SW data from frontal EEG.
 **Implanted electrodes attract glia which adhere to the electrodes and make a local inflammatory response that increases impedance and reduces data quality.
 *Met w/ Talmage
 **BIS study that he is starting with Christian in the next few months. I should get on board.
@@ Line 27: / Line 28: @@
 **20 years ago he licensed some PK/PD software to GE but no one bought it. A Norwegian company tried the same thing, also without success. He is now trying to get it integrated into EPIC. Is it just a marketing problem that no one wants to buy it? They've shown that it changes how people deliver anesthesia (typically they use less, specifically opioid).
 **He thinks the big thing that is lacking from Christian's research is volunteer studies.
-*Initial assessment of feasibile/high-impact research ideas:
+**He did a bunch of PD studies looking at responses to different noxious stimuli at various effect site concentrations. Still has the equipment.
 **Depression
-***What is the disease burden of depression in the general surgical population?
+*Read through the RISE application.
 ***What is the incidence of post-operative depression in general surgical patients without pre-existing depression? What if they have a family or personal history of depression?
-***Do ketamine, TIVA w/ propofol, TIVA w/ remimazolam, psychedelics, or burst suppression modulate the post-operative risk?
+***Do ketamine, TIVA w/ propofol, TIVA w/ remimazolam, psychedelics, or burst suppression modulate the post-operative risk? [https://ovidsp.dc2.ovid.com/ovid-new-a/ovidweb.cgi?&S=20719da3-5171-468d-a340-25cdcf20c6e6%7cmain&Complete+Reference=S.sh.50%7c2%7c1&Counter5=SS_view_found_complete%7c42657795%7cmedall%7cmedline%7cmedl&Counter5Data=42657795%7cmedall%7cmedline%7cmedl RCT happening in China right now]. Another RCT done in China with 142 cardiac surgery patients showed [https://ovidsp.dc2.ovid.com/ovid-new-a/ovidweb.cgi?&S=20719da3-5171-468d-a340-25cdcf20c6e6%7cmain&Complete+Reference=S.sh.50%7c23%7c1&Counter5=SS_view_found_complete%7c41285329%7cmedall%7cmedline%7cmed28&Counter5Data=41285329%7cmedall%7cmedline%7cmed28 significantly decreased post-operative depression] in patients who got a single dose of ketamine (0.3 mg/kg) at induction. After reviewing the first 51 results on Ovid Medline, I saved selected abstracts to Box.
 **CLAN
 ***When combined with SEEG electrodes or data from Parkinson's patients with deep-brain stimulators, can we resolve temporal and spatial activity of deep subcortical structures with ICA from frontal or full EEG? [https://pubmed.ncbi.nlm.nih.gov/28575667/ steerable non-invasive DBS]
@@ Line 40: / Line 52: @@
 ***Does permissive hypercapnia improve hemodynamic stability, deepen anesthesia, and speed recovery?
 ***Can we make a device or repurpose an existing ventilator to help accomplish that?
 *High-impact, less feasible research ideas:
 **Does TIVA prevent cancer recurrence? Could be feasible if we are able to mine the data from someone else's data set.
 **Does general anesthesia lead to post-op ileus and constipation?
-**Mechanisms of anesthesia. Is it dogma that anesthesia works by disrupting neuronal circuitry? Can I disprove this by anesthetizing weird organisms?
+**Mechanisms of anesthesia. Is it dogma that anesthesia works by disrupting neuronal circuitry? Can I disprove this by anesthetizing weird organisms? Light-emitting bacteria were anesthetized in [https://dx.doi.org/10.1093/bja/46.3.196 1974] (less light emission). There's 0 papers on anesthetizing amoeba.
 **Cancer vaccine. Can we make an mRNA vaccine that increases p53 copy number. Peto's paradox. Elephants.
 *Low-impact, very feasible research ideas:
 **SCD-FR
 **Better late than never PONV