• The Korean Journal of Pain
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• v.9 no.1
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• pp.260-263
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• 1996

High spinal block is a rare complication during epidural block, but it may result in serious events. 56-year-old man with gall stones was scheduled for cholecystectomy under general anesthesia. After operation, lumbar epidural catheterization was done at $T_{8-9}$ interspace for postoperative pain control. At the recovery room, initial bolus drug (0.1% bupivacaine 10 ml containing fentanyl $100{\mu}g$) was administered via epidural catheter and observed carefully. 15 minutes later, hypotension and bradycardia ouccurred. Hartman' solution was administered rapidly and ephedrine 5 mg was injected. 30 minutes after drug administration, loss of consciousness and respiratory arrest developed. Tracheal intubation was done immediately. Cardiovascular and respiratory functions were monitored continuously. The location of intrathecal catheter was confirmed by cerebrospinal fluid (CSF) seen in syringe after aspiration of catheter. The patient recovered gradually and was placed in the ward 4 hours after drug administration, without any problems. He was discharged 1 week later in good health.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.159-163
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• 1995

Accidental high epidural block is a rare but serious complication. It can result from many factors, which include the volume and concentration of drug, posture, puncture site, age, pregnancy or intra-abdominal mass, and patients' height and weight. We had a case of accidental high epidural block recently. This is a case report which was confirmed by an epiduragram. A healthy 50-year-old woman with a huge uterine myoma was scheduled for a total abdominal hysterectomy under continous epidural analgesia. Epidural catheterization was carried out smoothly. However, an unexpected hypotension was noticed after an epidural injection of 2% lidocaine 25 ml. Thereafter, the patient was intubated and her respiration was controlled during the operation. Using the 5mg of ephedrine, her blood pressure and pulse were well maintained. The scheduled operation was carried out for one hour uneventfully, but after the operation, she felt paresthesia on her hands in the recovery room. To differentiate between the high epidural and the subdural blocks. We injected 5 ml of a water soluble Niopam 300 through the catheter postoperatively. It was observed on the epiduragram that the catheter was placed in the epidural space. It was suggested that the high epidural block was induced from the widespread diffusion through the narrowed epidural space due to the engorgement of the epidural venous plexus by the patient's huge uterine myoma.

• Journal of Physiology & Pathology in Korean Medicine
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• v.17 no.4
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• pp.1116-1119
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• 2003

Ma huang, the dried plant stem of Ephedra Intermedia Schrenk et CA, is one of the well known medicinal herbs, and has been used for the diaphoretic, antiasthmatic, and diuretic actions. Ma huang is an ephedrine type alkaloid used for the weight loss and energy expenditure. Medications based on the Ma huang have been found to be effective in the treatment of obesity. Neuropeptide Y (NPY), a 36-amino-acid peptide and concentrated in the hypothalamus, stimulates feeding desire and decrease energy expenditure. In the present study, the effect of Ma huang on the expression of NPY in the rat hypothalamus was investigated using immunohistochemistry. The present results demonstrated that Ma huang treatment suppressed weight gain and NPY expression in the hypothalamus depending upon the dosage used. Based on the results, it can be suggested that Ma huang treatment is effective in curbing the desire for food via modulation of NPY expression under the normal conditions.

• Toxicological Research
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• v.21 no.3
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• pp.255-261
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• 2005

Gami-Samhwang-San, a herbal prescription for obesity treatment, is composed of seven crude herbs such as Rehmanniae Radix Preparata, Ephedrae Herba, Scutellariae Radix, Acori Gramineri Rhizoma, Polygalae Radix, Typhae Pollen, Armeniacae Semen, Menthae Herba. In this study, marker substances in n-butanol fraction (SH-21-B) from Gami-Samhwang-San were analyzed by high performance liquid chromatography (HPLC) and acute toxicity of standardized SH-21-B was evaluated by good laboratory practices (GLP) guideline of Korea Food and Drug Administration. Therefore we confirmed that there were baicalin of 15.92%, amygdalin of 6.57% and ephedrine of 2.49% in SH-21-B. SH-21-B was administered in rats at dose of 0 mg/kg, 2,000 mg/kg, and 5,000mg/kg. Clinical signs of both sexes of rats were observed daily for 14 days after single oral administration. Two female rats one administered at 2,000 mg/kg and the other administered at 5,000 mg/kg, died, but no dead animal was observed among male rats. Therefore $LD_{50}$ in the female rat is observed to be 8,710 mg/kg, and MLD (Minimun Lethal Dose) of the male rat is observed to be more than 5,000 mg/kg.

• Herbal Formula Science
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• v.26 no.1
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• pp.43-57
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• 2018

Objective : This study's purpose was to review the clinical studies of Socheongryong-Tang. Method : We searched papers about Socheongryong-Tang using KISS, KTKP, PUBMED, Embase, Science Direct, and the key words "Socheongryong-Tang", "Shoseiryuto", "Xiao Qing Long Tang", and "Minor Green-Blue Dragon Decoction" were used. Papers not matched with inclusion criteria were excluded. Until today, there have been 143 studies on the effects of asthma, allergic rhinitis, common cold, eczema and other various effects of Socheongryong-Tang. Of these, 15 were classified as clinical research papers. Results : There were 4 cases of asthma, 2 cases of allergic rhinitis, 2 cases of common cold, 1 case of pneumonia in patients with dementia, 1 case of eczema, 1 case of drug interaction study, 1 case of ephedrine drug removal, 3 cases of side effects causing pneumonia. Conclusion : It can be seen that Socheongryong-Tang has established the basis for application for the purpose of asthma, allergic rhinitis, wind-cold type cold, preventing pneumonia in patients with dementia, dyshidrotic eczema. On the other hand, considering three cases that cause side effects of pneumonia, it is necessary to confirm whether or not the symptoms of pneumonia are certainly progressing when observing the progress of the patient.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.4
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• pp.762-765
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• 2008

Ephedrae herba(Ma-huang) has been used to treat respiratory conditions for over 5,000 years. The early 1990s, the herbal ephedra and other products containing ephedrine began to be promoted as weight loss aids in United States. The objective of this study was to evaluate the acute toxicity of hebal ephedra in rats. SPF Sprague-Dawley male and female rats were administered orally with herbal ephedra extract of 2,500 mg/kg(low dosage group), and 5,000 mg/kg(high dosage group). We daily examined number of deaths, clinical signs, body weights and gross findings for 14 days. No dead animal and no significant changes of body weights were found during the experimental period. In addition, no differences were found between control and treated groups in clinical signs, hematology, serum biochemistry, and other findings. In conclusion, herbal ephedra extract did not show any toxic effects and oral LD50 value was over 5,000 mg/kg in SD rats.

• The Korea Journal of Herbology
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• v.23 no.4
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• pp.1-7
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• 2008

Objectives: Ephedrae herba, also known as Ma-huang, is a traditional Korean medicinal herb. It has been used to treat asthma, nose and lung congestion, and fever with anhidrosis for centuries. Recently, Ma-huang was used as a source of ephedrine in many dietary supplements for weight reduction in the United States. The objective of this study was to investigate the subacute toxicity of ephedrae herba extract in rats. Methods: SPF Sprague-Dawley male rats were administered orally with ephedrae herba extract for 4 weeks as several doses(0, 125, 250, 500, 1,000, and 2,000 mg/kg). We examined number of deaths, clinical signs, body weights and gross findings for experimental period. Results: No dead animals were found during the experimental period. In addition, no differences were found between control and treated groups in clinical signs, hematology, serum biochemistry, and other findings. Conclusions: In conclusion, above data suggest that no observed adverse effect level of ephedrae herba extract in SD rats might be over 2,000 mg/kg/day in this study.

• The Journal of Internal Korean Medicine
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• v.27 no.4
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• pp.836-844
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• 2006

Background: Mahuang (Ephedra sinica STAPF) is well known as an herbal medicine and has been widely used to reduce body weight and increase athletic ability. However, as a result of reporting many cases of adverse effects on the cardiovascular system, use of dietary supplements containing ephedra was prohibited by the FDA. Objectives : The object of this study was to find the effectiveness of ephedra on weight loss without severe adverse effect. Methods : 16 healthy volunteers consisting of an ephedra group (N=8) and a placebo group (N=8) were investigated. Study form was a randomized, controlled, double-blind clinical trial. The ephedra group took 12g of ephedra while the placebo group took 12g of glutinous rice powder. Both groups were measured with BCA (body composition analysis) on weight loss and with HRV (heart rate variability) on its adverse effect before and after medication. Results : The following results were obtained after taking 12g of ephedra for 14 days. In the ephedra group, body weight reduced significantly. In the placebo group, there were no significant differences of body weight between before and after placebo treatment. There was a slight increase of heart beat rate and deactivation of cardiac activity. Parasympathetic nerves were deactivated, but balances of autonomic nervous system were well maintained. Conclusions : The results suggest that ephedra in healthy adults tends to reduce body weight and deactivation of autonomic nervous system and cardiac activity.

• The Journal of Korean Medicine
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• v.28 no.1 s.69
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• pp.63-71
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• 2007

Objectives : To provide an objective assessment of the effectiveness for weight loss of Mahuang. Methods : Effects were assessed by measuring changes in body weight, body mass index (BMI), body fat (kg, %),body muscle, and abdominal f3t ratio. The subjects of this study were healthy adults who agreed to participate in this study. Eligibility requirements include age between 20 and 50 and BMI more than 18.5 kg/m2. One hundred subjects were randomly assigned to two groups (control and Mahuang group) in a double-blind manner. Mahuang group subjects took 8g of Mahuang capsule/day for two weeks; control subjects took the same amount of indistinguishable placebo. We analyzed the body weight, body mass index, body fat, abdominal fat, body muscle and BMR (basal metabolic rate) before and after the study. Result After two weeks of clinical trial, body weight and BMI decreased in both groups, but the Mahuang group showed more significant decrease. On body fat, the Mahuang group showed significant decrease. while it increased in the placebo group. Although body muscle, body fat ratio and basic metabolic rate showed differences between the two groups, there was no statistical significance. Conclusion : It is suggested that intake of Mahuang may induce weight loss and body f3f decrease in healthy adults.

• The Korean Journal of Pain
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• v.24 no.1
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• pp.7-12
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• 2011

Background: Adenosine has been shown to have a wide spectrum of unique pain-relieving effects in various clinical situations. The aim of this study was to investigate the effects of intraoperative adenosine infusion on acute opioid tolerance and opioid induced hyperalgesia induced by remifentanil in adult patients undergoing tonsillectomy. Methods: For this study, ninety patients were randomly allocated into groups that receive either adenosine (adenosine group) or saline (remifentnail group) intravenously under remifentanil based anesthesia and saline (sevoflurane group) under sevoflurane anesthesia. The patients in adenosine group received adenosine at dose of $80\;{\mu}g$/kg/min, and those in remifentnail group and sevoflurane group received an equal volume of saline 10 minutes after the induction of anesthesia until the end of surgery. Intraoperative evaluation included time weighted mean remifentanil dose, and postoperative evaluations included degree of pain severity at 1, 6, 12, and 24 hours, time to first postoperative requirement, and analgesic dose required during 24 hours after operation. Results: Time weighted mean remifentanil dose during intraoperative period in adenosine group was significantly lower than that of remifentnail group (P = 0.00). The first postoperative analgesic were required earlier in remifentanil group than sevoflurane group or adenosine group (P = 0.00). Pethidine requirement during 24 hours in sevoflurane group and adenosine group was significantly lower than that of remifentnail group (P = 0.00). The visual analog scale scores for pain in sevoflurane group and adenosine group were significantly lower than those of remifentnail group for 12 hours after operation (P = 0.00). Incidence of hypotension (P = 0.024) and number of ephedrine administered (P = 0.011) in adenosine group were significantly higher than those of sevoflurane group. Conclusions: The above results suggest that intraoperative adenosine infusion prevent acute opioid tolerance and opioid induced hyperalgesia induced by remifentanil.