• The Korean Journal of Physiology and Pharmacology
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• v.23 no.1
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• pp.81-87
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• 2019

Ketamine has long been used as an anesthetic agent. However, ketamine use is associated with numerous side effects, including flashbacks, amnesia, delirium, and aggressive or violent behavior. Ketamine has also been abused as a cocktail with ecstasy, cocaine, and methamphetamine. Several studies have investigated therapeutic applications of ketamine, demonstrating its antidepressant and anxiolytic effects in both humans and rodents. We recently reported that neonatal maternal separation causes enhanced anxiety- and aggressive-like behaviors in adolescent. In the present study, we evaluated how acute and chronic ketamine administration affected the behavioral consequences of neonatal maternal separation in adolescent mice. Litters were separated from dams for 4 hours per day for 19 days beginning after weaning. Upon reaching adolescence (post-natal day 35-49), mice were acutely (single injection) or chronically (7 daily injections) treated with a sub-anesthetic dose (15 mg/kg) of ketamine. At least 1 h after administration of ketamine, mice were subjected to open-field, elevated-plus maze, and resident-intruder tests. We found that acute ketamine treatment reduced locomotor activity. In contrast, chronic ketamine treatment decreased anxiety, as evidenced by increased time spent on open arms in the elevated-plus maze, and remarkably reduced the number and duration of attacks. In conclusion, the present study suggests that ketamine has potential for the treatment of anxiety and aggressive or violent behaviors.

• Archives of Plastic Surgery
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• v.46 no.3
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• pp.189-197
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• 2019

There has been an exponential increase in plastic surgery cases over the last 20 years, surging from 2.8 million to 17.5 million cases per year. Seventy-two percent of these cases are being performed in the office-based or ambulatory setting. There are certain advantages to performing aesthetic procedures in the office, but several widely publicized fatalities and malpractice claims has put the spotlight on patient safety and the lack of uniform regulation of office-based practices. While 33 states currently have legislation for office-based surgery and anesthesia, 17 states have no mandate to report patient deaths or adverse outcomes. The literature on office-base surgery and anesthesia has demonstrated significant improvements in patient safety over the last 20 years. In the following review of the proceedings from the PRS Korea 2018 meeting, we discuss several key concepts regarding safe anesthesia for office-based cosmetic surgery. These include the safe delivery of oxygen, appropriate local anesthetic usage and the avoidance of local anesthetic toxicity, the implementation of Enhanced Recovery after Surgery protocols, multimodal analgesic techniques with less reliance on narcotic pain medications, the use of surgical safety checklists, and incorporating "the patient" into the surgical decision-making process through decision aids.

• Journal of Yeungnam Medical Science
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• v.36 no.1
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• pp.50-53
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• 2019

Awareness during general anesthesia occurs in approximately 0.1-0.2% of cases; nevertheless, particular attention is required because it can lead to critical complications including insomnia, depression, anxiety, and post-traumatic stress disorder. To prevent these complications, bispectral index (BIS) and end-tidal anesthetic gas (ETAG) concentration monitoring are commonly used to examine patient consciousness during surgery. In the present case, an 80-year-old man was scheduled for total gastrectomy. Anesthesia was maintained using desflurane 4.0-5.0% vol, oxygen, and nitrous oxide. The authors simultaneously monitored BIS, which was maintained between 37 and 43, and ETAG, which was maintained between 0.9 and 1.2 minimum alveolar concentration (MAC). After the operation, however, the authors were surprised to learn that the patient complained of awareness during anesthesia. Although BIS and ETAG concentration monitoring are useful in preventing awareness during anesthesia, they cannot be completely trusted. Even though BIS was maintained at approximately 40 and ETAG at 0.7-1.3 MAC, awareness during anesthesia occurred.

• Kosin Medical Journal
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• v.33 no.3
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• pp.468-476
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• 2018

Perioperative anaphylaxis, although rare, is a severe, life-threatening unexpected systemic hypersensitivity reaction. Simultaneous administration of various drugs during anesthesia, the difficulty of communicate with patients in sedation and anesthesia, and coverage of the patient with surgical drapes are considered to be factors that impede early recognition of anaphylactic reactions. It is very important to perform an intradermal skin test because antibiotics are the most common cause of perioperative anaphylaxis. We report a case of negative-intradermal skin test antibiotic anaphylaxis mistaken for local aesthetic systemic toxicity without increase of serum tryptase for confirmative diagnostic biomaker during surgery under brachial plexus block. It is not possible to exclude the danger of anaphylaxis completely, even if it is negative-intradermal skin test and normal tryptase level. Therefore, anesthesiologists should be closely monitored and treated early for antibiotics related hypersensitive reaction, like other medicines during anesthesia.

• Journal of Aquaculture
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• v.18 no.4
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• pp.236-244
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• 2005

Experiments were performed to investigate the effects of the different anesthetic MS-222 and lidocaine-HCl doses on the blood physiological responses, on the time required for anesthesia and recovery, and on the survival rates of black rockfish (Sebastes schlegeli). Plasma cortisol was its highest levels (96.1$\pm$12.1 ng/ml) at 6 hours after the administration of 300 ppm of MS-222, and in all groups, plasma cortisol levels were higher than the initial levels during the anesthetic experiment. Fish receiving lidocaine-HCl also exhibited higher than initial plasma cortisol levels at almost experimental intervals. The middle size fish exhibited the highest glucose level (143.3$\pm$14.5 mg/dl) at 50 ppm of anesthesia after 1 hour, and every level was significantly higher than the initial level for at least 12 hours. Glucose levels in fish to which lidocaine-HCl was administered were comparable to the levels seen in conjunction with MS-222 treatment. In fish anesthetized with MS-222, K+ levels in the small size fish were significantly elevated after 1 hour, while Na+ levels did not change in any of the groups throughout the experiment. Anesthetic time was significantly attenuated with increases in the concentrations of MS-222 and lidocaine-HCl. We also noted a correlation between anesthetic time and fish size, in that larger fish took a longer time, followed by the middle size and then the small size fish. The all fish size groups showed above $95\%$ survival rates at every experimental concentration in MS-222 and 300-400 ppm in lidocaine-HCl. The results may indicate that 100-200 ppm MS-222 and 400 ppm lidocaine-HCl are the most effective doses as sedatives for the black rockfish and these doses could be used as the suitable anesthetics doses.

• Journal of Aquaculture
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• v.21 no.4
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• pp.304-308
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• 2008

Strength of juvenile black seabream (Acanthopagrus schlegeli) produced in the different types of hatchery for wild stock enhancement was evaluated in terms of resistances against anesthetizing agent, tricaine methane sulfonate (MS-222), and dry exposure. The working dosages of MS-222 varied significantly with two different water temperature and hatchery populations. Namely, water temperature $22^{\circ}C$ populations were less resistant against the chemical over water temperature $12^{\circ}C$ ones. MS-222 effects also differed with the fish with different growth histories. The fish seeds in collected from wild showed stronger resistances, earlier recoveries, and lower mortalities, compared to those cultured in land-based tank. Similar results were achieved in the juveniles challenged to dry exposure. These results suggest that wild population of black seabream are more resistant against anesthetic stress, expressed as anesthesia, recovery, and mortality, and further that the population are "healthier" than others.

• The Journal of Korean Physical Therapy
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• v.10 no.1
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• pp.1-6
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• 1998

The purpose of this study was to determine the of effective concentration of procaine iontophoresis for durarion of cutaneous local anesthesia. Forty-five healthy students with an age range of 19 to 34 years$(21\pm2.7)$, were participated in this study. The subjects were randomly assigned into 5 groups. Bach 9 subjects received iontophoresis on the flexor surface of dominant forearm with soft cotton pad $(3.5\times3.5cm)$ soaked in 2ml of $2\%$ (pH 5.28), $4\%$ (pH 5.12), $8\%$ (pH 4,98), $16\%$ (pH 4.72), $32\%$ (pH 4.52) procaine hydrochloride solution at 4mA for 10 minutes (total current 40mA min) using anodal direct current. The study was performed in a randomized, double-blind design, After procaine iontophoresis, the duration of anesthesia were evaluated at five minute intervals on five random locations in the iontophoretically area using a 21-gauge sterile hypodermic needle pressed with 1mm invagination unitl sharp pin-pricking pain sensation returned. The data were analyzed with one-way ANOVA to determine significant differences between groups. Duncan post hoc was performed at level .01. The relationship between anesthetic duration and procaine concentration was assessed with Pearson Product-Moment Correlation Coefficients. ANOVA tests showed significant differences in the anesthetic duration between the concentration of procaine solution (p<.001). Procaine iontophoresis with $4\%$ concentration produced cutaneous Socal anesthesia of significantly longer duration(15.56 min) than iontophoresis with $2\%,\;8\%,\;16\%$, and $32\%$ of procaine GCl(p<.01). Whereas the anesthetic duration had no correlation with concentration of procaine solution (r=-0.41, NS). These results support the $4\%$ procaine solution was an effective concentration of iontophoresis for induced cutaneous local anesthesia.

• Child Health Nursing Research
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• v.20 no.3
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• pp.142-148
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• 2014

Purpose: This study was done to evaluate the effectiveness of EMLA cream on pain related to venipuncture among children. Methods: In this study, 48 children were evaluated using a sequential measurement for level of pain by Skin Conductance Level (SCL) based on Galvanic Skin Response (GSR), heart rate, and the Visual Analogue Scale (VAS) at four times. Results: The maximum and mean of the SCL were each significantly different between the experimental and control groups and furthermore, the two were also significantly different among observed times. In addition there was a significant interaction between group and time. The children's perceived pain using VAS was not significantly different between the experimental and control groups. There was no significant difference in the heart rate between the experimental and control groups; however, the interaction between group and time was significant. Conclusion: In conclusion, applying topical anesthetic cream to the venipuncture site to reduce pain was effective among the children and therefore it is highly recommended that topical anesthetic cream be applied at the venipuncture site as a nursing intervention to reduce pain when a child has to undergo a venipuncture.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.30 no.4
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• pp.589-594
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• 1997

This study was performed to clarify the effect of anesthesia killing and non-bleeding on the physicochemical and rheological properties of plaice, Paralichthys olivaceus muscle at early period after death. Live plaice was killed by the two different methods: spiking at the brain instantly with bleeding and dipping In seawater containing anesthetic (2,000 ppm ethyl-aminobenzoate) for 10 min without bleeding. These samples were stored at $0^{\circ}C$ and used in checking rigor-mortis, ATP breakdown, the content of ATP and its related compounds, breaking strength, and lactate accumulation through storage. The rigor-mortis, ATP breakdown, and lactate accumulation was faster in samples killed by spiking than in samples killed by anesthesia. ATP in samples killed by anesthetic showed little breakdown until 22.5 hrs, but it was decomposed completely after 30 hrs storage. Breaking strength of samples killed by spiking at the brain instantly with bleeding decreased steadily and showed the maximum value over 10 hrs $(2207.3{\pm}60.2g)$. However, in case of the dipping fresh flesh without bleeding in seawater containing anesthetic, the value and time reached around the maximum breaking strength were $2147.8{\pm}29.0g$ and 13 hrs respectively, but it maintained constantly until 20 hrs passed. From these results, it could be suggested that anesthesia killing and non-bleeding is more effective in maintaining firmness of fresh plaice muscle than spiking killing with bleeding at the early period after death.

• Archives of Plastic Surgery
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• v.39 no.5
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• pp.540-545
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• 2012

Background Patients have anxiety and fear of complications due to general anesthesia. Through new instruments and local anesthetic drugs, a variety of anesthetic methods have been introduced. These methods keep hospital costs down and save time for patients. In particular, the target-controlled infusion (TCI) system maintains a relatively accurate level of plasma concentration, so the depth of anesthesia can be adjusted more easily. We conducted this study to examine whether intravenous anesthesia using the TCI system with propofol and remifentanil would be an effective method of anesthesia in breast augmentation. Methods This study recruited 100 patients who underwent breast augmentation surgery from February to August 2011. Intravenous anesthesia was performed with 10 mg/mL propofol and 50 ${\mu}g/mL$ remifentanil simultaneously administered using two separate modules of a continuous computer-assisted TCI system. The average target concentration was set at 2 ${\mu}g/mL$ and 2 ng/mL for propofol and remifentanil, respectively, and titrated against clinical effect and vital signs. Oxygen saturation, electrocardiography, and respiratory status were continuously measured during surgery. Blood pressure was measured at 5-minute intervals. Information collected includes total duration of surgery, dose of drugs administered during surgery, memory about surgery, and side effects. Results Intraoperatively, there was transient hypotension in two cases and hypoxia in three cases. However, there were no serious complications due to anesthesia such as respiratory difficulty, deep vein thrombosis, or malignant hypertension, for which an endotracheal intubation or reversal agent would have been needed. All the patients were discharged on the day of surgery and able to ambulate normally. Conclusions Our results indicate that anesthetic methods, where the TCI of propofol and remifentanil is used, might replace general anesthesia with endotracheal intubation in breast augmentation surgery.