• 한국임상수의학회지
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• 제28권5호
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• pp.479-485
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• 2011

비글견에서 remifentanil/ketamine 점적 투여 병용마취법과 remifentanil/propofol 점적 투여 병용마취법이 심폐기능에 미치는 영향에 대하여 비교평가하였다. 14 마리의 비글견을 이용하였다. 실험견은 acepromazine (0.1 mg/kg, 피하)과 medetomidine (20 ${\mu}g$/kg, 정맥내)으로 전처치하고, Group P는 정맥 내 propofol 1 mg/kg, Group K는 정맥 내 ketamine 5 mg/kg으로 마취 유도 하고, 이 후 실험군별로 고정된 용량의 remifentanil (0.5 ${\mu}g$/kg/min)과 ketamine 0.1 mg/kg/min 또는 propofol 0.3 mg/kg/min을 3 시간 동안 투여하였다 (Group K와 Group P). 동맥혈압, 심박수, 호흡 수, 혈액가스분석과 마취회복기 동안의 행동변화를 측정하였다. 또한 toe-web clamping 검사를 통해 마취 깊이를 평가하였다. 외과적 마취기는 두 군 모두에서 전 시간 동안 유지가 되었다. Group K의 수축기 동맥혈압, 평균 동맥혈압, 동맥산소 분압, 동맥 산소 포화도는 Group P에 비해 정상 범위 내에서 현저히 높았으며 Group K의 이산화탄소 분압은 Group P에 비해 현저히 낮았다. 그러나 이완기 동맥혈압, 심박수, 호흡수에서는 현저한 차이가 없었다. 점적투여 중단시점부터 발관까지의 평균시간은 Group K에서 현저히 감소되었지만, 평균 sitting time은 Group P에서 현저히 감소되었다. 평균 head-up time과 평균 walking time은 현저한 차이가 없었다. Group K에서는 약간의 근강직, 머리 흔듬, 혀로 핥는 동작이 회복기에 관찰되었다. 결론적으로, Group K가 Group P보다 심폐 기능에서 더 좋았다. 즉, remifentanil/ketamine을 이용한 점적투여 병용마취법이 remifentanil/propofol을 이용한 점적투여 병용마취법 보다 3 시간의 마취 유지에서 보다 나은 방법으로 판단되었다.

• 대한치과의사협회지
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• 제11권1호
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• pp.45-52
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• 1973

Ketamine HC1(Phencyclidine derivative) is a white, crystalline substance with melting point 259℃. It is soluble in water to a 20% clear, colorless solution. a 10% aqueous solution has a pH 3.5. The chemical structure is 2-(O-chlorophenyl)-2-(methylamino) cyclohexanone hydrochloride. It is a rapid acting, nonhypnotic, nonbarbiturate drug with a wide safety margin. The author used the anesthetic ketamine hydrochloride for oral surgery procedure in 16 patients(2 to 33 years). Anesthesia was achieved with a single intramuscular injection by introduction of manufacture. Result obtained as follows : 1. It was easily administered. 2. Onset time was rapid and duration was short. 3. The mild cardiac stimulation resulted in moderate increase in the blood pressure and pulse. 4. There was no significant respiratory depression. 5. The airway can be maintained without artificial support or endotracheal intubation. 6. All protective reflex maintained, which was important in oral surgery. 7. The best results were achieved in pediatric patients than adults.

• 한국임상수의학회지
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• 제26권3호
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• pp.212-219
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• 2009

개의 마취에서 부작용을 예방하기 위하여 전마취제로 가장 일반적으로 사용되어지는 항콜린제는 심장에 부작용을 일으킬 수 있다. 비글견에서 케타민 마취 동안 심장의 교감신경과 부교감 신경의 균형에 대한 아트로핀과 글리코피롤레이트의 효과를 검증하기 위하여, 심박변이도, 마취 기간 그리고 행동 변화가 평가 되어졌다. 아트로핀과 글리코피롤레이트에서는 어떠한 일시적인 domain 차이도 없었다. 주파수 영역과 연관되어서는, 아트로핀과 글리코피롤레이트 효과는 모두 대조군에 비해 유의하게 낮게 나타났다(P<0.05). 그러나, 아트로핀의 RMSSD와 SD1은 기준선보다 낮았으며(P<0.05), 글리코피롤레이트의 LF:HF ratio는 기준선보다 높은 유의한 변화를 보였다(P<0.05). SD1의 변화는 주파수 도메인의 HF와 일치하는 변화를 보였으며 호흡수와 $SpO_2-R$의 변화와도 일치하는 변화를 보였다. 우리의 결과는 심장의 자율신경적 특성을 이용하여 글리코피롤레이트가 안전성과 작용 시간을 고려하여 개에서 케타민 마취 시 항콜린제로 더욱 적당하다는 것을 증명한 것이다.

• 대한치과마취과학회지
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• 제11권2호
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• pp.125-132
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• 2011

Background: Adult patients with intellectual disabilities often strongly resist the anesthetic administration for dental procedures. This study aimed to evaluate the effect of midazolam premedication in improving the cooperation level of patients who are likely to be combative and irritated during general anesthesia (GA) induction. Methods: The patients who had received dental treatment under ambulatory GA for more than two times were included. And we selected 13 patients total that needed physical restraint or ketamine IM prior to induction at the first GA, and were prescribed midazolam tablet (7.5-15 mg) at the following GA. We reviewed pre-anesthetic records and anesthesia records, and evaluated cooperative levels of patients (4 levels scale) during anesthesia induction and recovery time retrospectively. Results: All 13 patients (Male 11, Female 2) had severe mental disabilities. The average age of the patients was 24 ${\pm}$ 7 (13-37) years and their average weight was 58 ${\pm}$ 16 (34-91) kg. At the first GA, 10 patients needed physical restraint prior to induction (level 3). And 3 patients were so poorly cooperative that the induction procedure was performed after intramuscular injection of ketamine (level 4). But after the midazolam intake, 7 patients were willing to receive the anesthetic induction (level 1, 2), and 6 patient needed physical restraint (P < 0.05). There were no statistical differences in the duration of general anesthesia and postoperative recovery. Conclusions: Oral intake of midazolam was effective in improvement of cooperation without any complications.

• 한국임상수의학회지
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• 제16권2호
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• pp.519-522
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• 1999

This study was performed to determine the effects of anastomosis on the internal diameter and wall thickness of jugular vein. Tro shepherd dogs were used for this experiment. In dog 1, xylazine(2 mg/kg) and ketamine(5.5 mg/kg) were injected intramuscularly for induction followed by enflurane(3%) anesthesia. In dog 2, acepromazine(0.03 mg/kg) and ketamine(5 mg/kg) were injected intravenously for induction followed by enflurane(3%) anesthesia. The dogs were heparinized(1 mg/kg) for the prevention of thrombosis. After jugular vein was exposed by incision of left cervical area, two Johns Hopkins bulldog clamps were clamped. Jugular vein was cut between two clamps, and it was reanastomosed using 5-0 silk. Ultrasonography was done along the jugular vein on both sides of each dogs 21 days after anastomosis surgery. The internal diameter and circumference of the vein in the anastomosis area were markedly reduced with thickening of the vein wall, but no thrombi were observed.

• The Korean Journal of Pain
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• 제35권3호
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• pp.311-318
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• 2022

Background: Ketamine is widely used in infants and young children for procedural sedation and anesthesia. The aim of this study was to evaluate the efficacy and safety of low dose oral ketamine to control pain and distress in children during intravenous (IV) cannulation. Methods: This is a prospective, randomized, double-blind study, including children aged between 3 and 6 years requiring a non-emergent IV-line placement. Children were randomly assigned to two groups, treated either with oral ketamine or a placebo. All patients were monitored for vital signs. Pain was assessed using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) and Wong-Baker Faces Pain Rating Scale (WBFS) scales and sedation using a 5-point sedation score. The facility of IV-line placement was measured by a 3-point scale. Adverse effects were recorded after 1 and 24 hours. Results: A total of 79 and 81 children were entered in the ketamine and placebo groups, respectively. The heart and respiratory rates increased significantly in the placebo group. The median CHEOPS 4 (95% confidence interval [CI]: 3, 4, P < 0.001) and WBFS 6 (95% CI: 4, 6, P < 0.001) scores decreased statistically in the ketamine group. IV-line placement was 50% easier in the ketamine group (95% CI: 37%, 63%, P < 0.001). No serious adverse effects were observed in all cases. Conclusions: Low dose oral ketamine effectively decreased the pain and distress during IV cannulation in children without any significant adverse reactions.

• 한국임상수의학회지
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• 제23권4권
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• pp.447-452
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• 2006

This study was performed to compare propofol, thiopental, etomidate and diazepam plus ketamin as induction agents for the isoflurane anesthesia in dogs. Experimental groups were divided into low groups (thiopental group: thiopental 15 mg/kg IV, propofol group: propofol mg/kg IV, etomidate group: etomidate 1.5 mg/kg IV, DZP+KET group: diazepam 0.5 mg/kg + ketamine 5 mg/kg, IV) and each group was consisted of 4 dogs. Cardiorespiratory changes (heart rate, $SpO_2$, respiratory rate, End-tidal $CO_2$ and body temperature), blood serum chemistry values (alkaline phosphatase, alanine aminotransforase, and total protein), and recovery and walking time were measured. The end tidal carbon dioxide level was significantly increased in the thiopental group (P<0.05). Heart rate and respiratory rate higher in the DZP+KET groups. There was hypothermia in all groups and significant decrease in body temperature was showed in thiopental group (p<0.05). Mean arousal time and mean walking time were significantly longer in thiopental group (P<0.05). Cardiovascular stimulating effects were minimal in etomidate group. Etomidate provides uneventful and rapid recovery.

• Journal of Yeungnam Medical Science
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• 제37권3호
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• pp.159-168
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• 2020

The demand for drug-induced sedation for magnetic resonance imaging (MRI) scans have substantially increased in response to increases in MRI utilization and growing interest in anxiety in children. Understanding the pharmacologic options for deep sedation and general anesthesia in an MRI environment is essential to achieve immobility for the successful completion of the procedure and ensure rapid and safe discharge of children undergoing ambulatory MRI. For painless diagnostic MRI, a single sedative/anesthetic agent without analgesia is safer than a combination of multiple sedatives. The traditional drugs, such as chloral hydrate, pentobarbital, midazolam, and ketamine, are still used due to the ease of administration despite low sedation success rate, prolonged recovery, and significant adverse events. Currently, dexmedetomidine, with respiratory drive preservation, and propofol, with high effectiveness and rapid recovery, are preferred for children undergoing ambulatory MRI. General anesthesia using propofol or sevoflurane can also provide predictable rapid time to readiness and scan times in infants or children with comorbidities. The selection of appropriate drugs as well as sufficient monitoring equipment are vital for effective and safe sedation and anesthesia for ambulatory pediatric MRI.

• 한국임상수의학회지
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• 제29권3호
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• pp.220-225
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• 2012

Medetomidine과 xylazine은 수의 임상에서 많이 이용되고 있는 마취약물이다. Medetomidine-ketamine-butorphanol과 xylazine-ketamine-butorphanol의 개에 미치는 마취효과와 심폐 효과를 비교 연구하였다. Medetomidine-ketamine-butorphanol를 MKB군으로 xylazine-ketamine-butorphanol를 XKB군으로 분류하고 각각 5두의 개를 4주간의 휴약기간을 거쳐 실험하였다. 각각의 군에서 마취효과 점수는 자세와 진통에 대한 반응을 통해 평가하였고, 마취 시간은 XKB군 ($87.4{\pm}18.9$분)이 MKB군 ($62.6{\pm}15.0$분)에 비하여 유의성 있게 높은 시간의 결과를 보였다. 하지만, 기타 심폐 효과에서는 두 군 사이에 통계적으로 유의성 있는 차이를 보이지 않았다. 하지만 MKB군에서는 서맥을 보였으므로, 마취 모니터링 시 주의하여야 한다. 만약 서맥의 위험이 있는 환자라면 MKB 합제는 선택을 안 하는 것이 요구된다. 결론적으로, XKB군에서 더 긴 마취시간과 더 적은 부작용을 보였으며, MKB 합제 약물은 XKB군에 비하여 특별한 장점이 없으므로 XKB 합제가 더욱 유용한 것으로 판단하였다. 하지만 XKB군과 MKB군 모두에서 적절한 체온유지와 산소공급이 필요하다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권5호
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• pp.295-300
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• 2019

Complex regional pain syndrome (CRPS) is rare, characterized by pain from diverse causes, and presents as extreme pain even with minor irritation. General anesthesia may be required for dental treatment because the pain may not be controlled with local anesthesia. However, treatment under general anesthesia is also challenging. A 38-year-old woman with CRPS arrived for outpatient dental treatment under general anesthesia. At the fourth general anesthesia induction, she experienced severe pain resulting from her right toe touching the dental chair. Anesthesia was induced to calm her and continue the treatment. After 55 minutes of general anesthesia, the patient still complained of extreme toe pain. Subsequently, two administrations for intravenous sedation were performed, and discharge was possible in the recovery room approximately 5 h after the pain onset. The pain was not located at the dental treatment site. Although the major factor causing pain relief was unknown, ketamine may have played a role.