• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9505-9509
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• 2014

Objective: To investigate the effects of stellate ganglion block (SGB) on the peri-operative vasomotor cytokine content and intrapulmonary shunt in patients with esophagus cancer who underwent thoracotomy. Materials and Methods: Forty patients undergoing elective resection of esophageal cancer patients who had I~II American Society of Anesthesiologist (ASA) were randomly divided into total intravenous anesthesia group (group N, n=20) and total intravenous anesthesia combined with SGB group (group S, n=20, 0.12 mL/kg 1% lidocaine was used for SGB 10 min before induction). Heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), mean pulmonary arterial pressure (MPAP) and continuous cardiac output (CCO) were continuously monitored. The blood from internal jugular vein was drawn respectively before induction ($T_0$), and 30 min ($T_1$), 60 min ($T_2$) and 120 min ($T_3$) after one-lung ventilation (OLV), and 30 min (T4) after two-lung ventilation. The contents of plasma endothelin (ET), nitric oxide (NO) and calcitonin gene-related peptide (CGRP) were detected with enzyme linked immunosorbent assay (ELISA). Meanwhile, arterial and mixed venous blood samples were collected for determination of blood gas and calculation of intrapulmonary shunt fraction (Qs/Qt). Results: During OLV, ET contents were increased significantly in two groups (P<0.05), and no significant difference was presented (P>0.05). NO content in group S was obviously higher than in group N at T3 (P<0.05), whereas CGRP content in group N was markedly lower than in group S at each time point (P<0.05). Qs/Qt was significantly increased in both groups after OLV, but there was no statistical significant regarding the Qs/Qt at each time point between two groups. Conclusions: Total intravenous anesthesia combined with SGB is conducive to regulation of perioperative vasomotor cytokines in thoracotomy, and has little effect on intrapulmonary shunt at the time of OLV.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3977-3980
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• 2015

Background: To investigate the effects of preemptive analgesia with parecoxib sodium on haemodynamics and plasma stress hormones in surgical patients with thyroid carcinoma. Materials and Methods: Fifty-seven patients with thyroid carcinoma who underwent thyroidectomy selectively in Laiwu Hospital Affiliated to Taishan Medical University and Binzhou People's Hospital were selected and randomly divided into three groups, 19 cases in each group. The control group was intravenously injected 0.9% sodium chloride injection before anesthesia induction; trial group I was intravenously injected with parecoxib sodium 20 min before anesthesia induction; based on trial group I, trial group II was injected with parecoxib sodium again 12 h after surgery. The levels of plasma norepinephrine (NE), cortisol (Cor) and blood glucose before, 12 and 24 h after surgery and changes of haemodynamics before surgery, at the end of surgery and 12, 24 and 48 h after surgery were compared in the three groups. Besides, visual analogue scale (VAS) scores were recorded 4, 8, 12 and 24 h after surgery. Results: 12 and 24 h after surgery, the levels of plasma NE and Cor in three groups rose dramatically (P<0.05 or (P<0.01); The levels of plasma NE and Cor in trial groups I and II were evidently lower than in control group (P<0.05 or P<0.01), and those in trial group II slightly lower than in trial group I. 12 h after surgery, the heart rates (HR) and systolic pressures (SBP) in trial groups I and II increased obviously by comparison to surgery before (P<0.05 or P<0.01), but gradually returned to the preoperative level. HR, SBP and diastolic pressures (DBP) in trial groups I and II at the end of surgery and 12 h after surgery were all lower than in the control group, and significant differences were present (P<0.05 or (P<0.01). At 4, 8, 12 and 24 h after surgery, VAS scores in trial groups I and II were markedly lower than in the control group (P<0.05 or (P<0.01), the scores in trial group II being the lowest. Conclusions: Combined application of parecoxib sodium for preemptive analgesia before anesthesia and after surgery can effectively reduce the levels of plasma stress hormones and improve analgesic effects in surgical patients with thyroid carcinoma, and without conspicuous impact on haemodynamics.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.4
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• pp.508-513
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• 2018

Tidal volume by sevoflurane in small amounts is stable due to the increase in the breathing rate. But alveolus ventilation decreases due to sevoflurane as the degree of sedation increases; this ultimately causes $PaCO_2$ to rise. The occurrence of suppression of breath increases the risk of severe hypoxia and hypercapnia in deeply sedated patients with disabilities. Sevoflurane inhalation anesthesia has a number of risks and may have unexpected problems with hemodynamic changes depending on the underlying state of the body. This study was conducted to examine the stability of internal acid-base system caused by respiratory depression occurring when patients with disabilities are induced by sevoflurane. Anesthetic induction was carried out by placing a mask on top of the patient's face and through voluntary breathing with 4 vol% of sevoflurane, 4 L/min of nitrous oxide, and 4 L/min of oxygen. After the patient's loss of consciousness and muscle relaxation, IV line was inserted by an expert and intravenous blood gas was analyzed by extracting blood from vein. In a deeply sedated state, the average amount of pH of the entire patients was measured as $7.36{\pm}0.06$. The average amount of $PvCO_2$ of the entire patients was measured as $48.8{\pm}8.50mmHg$. The average amount of $HCO_3{^-}$ of the entire patients was measured as $27.2{\pm}3.0mmol/L$. In conclusion, in dental treatment of patients with disabilities, the internal acid base response to inhalation sedation using sevoflurane is relatively stable.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.5
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• pp.357-367
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• 2022

Background: Low-dose dexmedetomidine may be a suitable alternative to opioids for pediatric ambulatory procedures under general anesthesia (GA). However, the recovery profile remains unclear. Herein, we aimed to evaluate the effects of low-dose dexmedetomidine on the recovery profile of children. Methods: Seventy-two children undergoing ambulatory oral rehabilitation under GA were randomly and equally distributed into two groups (D and F). Group D received an infusion of dexmedetomidine 0.25 ㎍/kg for 4 min for induction, followed by maintenance of 0.4 ㎍/kg/h. Group F received an infusion of fentanyl 1 ㎍/kg over 4 min for induction, followed by maintenance at 1 ㎍/kg/h. The primary outcome was the extubation time. The secondary outcomes were awakening time, end-tidal sevoflurane (ET-Sevo) requirement, change in hemodynamic parameters, Richmond Agitation-Sedation Scale (RASS), Children's Hospital of Eastern Ontario pain scale (CHEOPS) score, length of PACU stay, and incidence of adverse events. Results: Statistically significant differences were observed in the recovery profile between the groups: the median time for extubation was 3.65 (3.44-6.2) vs. 6.25 (4.21-7) minutes in groups D vs. F (P=0.001), respectively, while the corresponding awakening times were 19 (18.75-21) and 22.5 (22-24) minutes, respectively (P < 0.001). The mean ET-Sevo was low in group D (1.1 vs. 1.2; P < 0.001). The heart rate was significantly low across all time points in group D, without resulting in bradycardia. The median RASS and CHEOPS scores were also significantly lower in group D. No significant differences were observed in the mean arterial pressure, incidence of adverse events, or length of PACU stay. Conclusion: Low-dose dexmedetomidine was more effective than fentanyl as an opioid substitute at providing a better recovery profile in pediatric ambulatory oral rehabilitation under GA. Dexmedetomidine also significantly reduced sevoflurane consumption without causing adverse events or prolonging hospital stay.

• Journal of Veterinary Clinics
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• v.25 no.3
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• pp.170-175
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• 2008

The present study was performed to investigate the anesthetic or analgesic effect of tiletamine-zolazepam (TZ) and electro acupuncture analgesia (EAA) in cats. Twelve healthy cats were randomly assigned to receive either TZ or EA. TZ group cats with weight of $3.65{\pm}0.48kg$ received 10.0 mg/kg of TZ intramuscularly. EA group cats with weight of $3.62{\pm}0.52kg$ received 5V, 30Hz and 60 minutes of EA. The acupoints used were Tian-ping (GV-5, +), Bai-hui (GV-20, -). Therefore, after and before experiment, some serum chemistry profiles (alkaline phospatase, aspartate aminotransferase, alanine aminotransferase, glucose and total protein) and change of vital signs (rectal temperature, heart rate, respiratory rate) were examined. All cats were examined pre, and 5, 25, 65 and 105 minutes after administration of TZ or operation of EA. The cats in EA group showed a smaller change in rectal temperature, heart rate and respiratory rate than in the TZ group (p<0.05). In both groups, total protein concentration was constant throughout the period of anesthesia, and the serum glucose increased gradually throughout the period of anesthesia. However, the cats in EA group showed a smaller change in alkaline phospatase, aspartate aminotransferase and alanine aminotransferase within the limit of safety than in the TZ group (p<0.05). While coming to induction, the TZ group took a mean $2.4{\pm}0.7$ minutes to achieve sternal recumbency, compared with $10.5{\pm}2.1$ minutes by the EA group, and $3.2{\pm}0.6$ minutes to achieve lateral recumbency, compared with $18.8{\pm}1.9$ minutes by the EA group (p<0.05). When recovering from anesthesia, the TZ group took $164.3{\pm}17.9$ minutes to achieve sternal position time, compared with $67.7{\pm}4.6$ minutes by the EA group, and $202.0{\pm}15.7$ minutes to stand, compared with $73.0{\pm}6.1$ minutes for the EA group (p<0.05). In this study, the cats anesthetized with EA showed a more rapid recovery rather than the cats under TZ anesthesia. Also, there do not appear to be any negative physiologic effects associated with acupuncture-induced surgical analgesia. So, it was considered that EAA may be used effectively in shock, debilitated cats, as compared to TZ.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.19-25
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• 2004

Dentally disabled person means one who have difficulty in cooperating voluntarily with a dentist for routine dental care. Seoul National University Dental Hospital (SNUDH) Dental Clinic for Disabled has worked for them under outpatient anesthesia concept. The aim of this study was to determine the anesthetic characteristics of the patients attending for dental treatment at SNUDH Dental Clinic for Disabled in order to establish better future treatment plans. The data were drawn from the patients who visited SNUDH Dental Clinic for Disabled from January 1999 to October 2002. Total 93 dental treatments for 83 patients were enrolled in this study. Most patients had mental retardation and the conservative treatments were carried out under general anesthesia. Thiopental and vecuronium were mostly used for induction agent and neuromuscular blocker, respectively. Enflurane, with oxygen and nitrous oxide, was mostly used to maintain the anesthesia. Mean total anesthetic time was $164.4{\pm}57.2$ minutes and mean duration at the post-anesthetic care unit was $106.2{\pm}50.5$ min. Serious postoperative complications were not observed. These results showed our successful anesthetic outcomes without any severe side effect or complication and the needs of more outpatient centers for dental care for disabled.

• Journal of Veterinary Clinics
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• v.28 no.2
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• pp.211-218
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• 2011

The aims of this study were to investigate the anesthetic effects of medetomidine-midazolam-ketamine (MMK) combination and to compare antagonistic effects of atipamezole and yohimbine in dogs anesthetized with MMK. Eighteen adult male healthy beagles were used in this study. All dogs were anesthetized with intramuscular (IM) administration of medetomidine (0.04 mg/kg), midazolam (0.2 mg/kg) and ketamine (5 mg/kg) in one syringe. Intravenous (IV) administration of atipamezole (0.24 mg/kg, MMKA), yohimbine (0.2 mg/kg, MMKY) or saline solution (0.1 ml/kg, MMK) was administered 20 minutes after MMK combination anesthesia. Induction and recovery times, scores of sedation and analgesia, heart rate, blood pressure, rectal temperature, respiratory rate and blood gases were determined and recorded for each dog. Mean anesthesia times, sternal recumbency times, standing times and walking times in the MMKA and MMKY groups were significantly shorter than those in the MMK group. But there were not significantly different between MMKA and MMKY groups. In all groups, MMK administration produced a satisfactory sedation and analgesia for all dogs. However, after administration of atipamezole or yohimbine the scores for posture and response to noxious stimuli were significantly lower in the MMKA or MMKY group than those in the MMK group. MMK produced good sedation and anesthesia effects, and atipamezole or yohimbine can be used as a safe and effective agent for antagonizing the MMK anesthesia in dogs.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.145-150
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• 1996

The purpose of this study was to evaluate and compare the effectiveness of ilioinguinal-hypogastric nerve blocks(IHNB) and caudal block in producing post-orchiopexy and post-heniorrhaphy analgesia in children. Forty consenting healthy children, ages 3~10yr, were randomly assigned to receive caudal bupitvacaine (0.125%, 0.5ml/kg), or IHNB bupivacaine (0.25%, 0.3 ml/kg). Blocks were performed following the induction of general anesthesia, be fore the operation. Pre-anesthetic medication in form of atropine 0.01 mg/kg, droperidol 0.05 mg/kg were given intramuscularly one hour before induction to 40 children. Children were induced with thiopental sodium 5 mg/kg and succinylcholine 1 mg/kg intravenously. Anesthesia was maintained with oxygen-nitrous oxide ($FiO_2$ 0.3) and ethrane. When the patients stabilized after induction. IHNB was done in the supine position and caudal block was done in the lateral position. The local anaesthetic was injected after negative aspiration. Postoperative pain was assessed with face pain rating scale (RPRS) at rest on discharge of recovery room, and 5 hours after discharge of recovery room, and the "red and white" visual analogue scale (VAS) at rest and mobilization from supine to sitting position on discharge of recovery room, and 5 hours after discharge of recovery room. Post-operative recovery was quiet and comfortable, without side effect. Relief of ain was complete in both IHNB group and caudal group. Surgeons, parents and recovery room personnel were satisfied. There were no surgical or anesthetic complications. In our study, the postpoerative pain scores were similar in both IHNB group and caudal group. IN conclusion, we found that both IHNB and caudal blocks before the start of surgery for orchiopexy & herniorrhaphy are safe and effective in controlling the postoperative pain of children.

• Journal of Veterinary Clinics
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• v.27 no.4
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• pp.330-335
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• 2010

This study was performed to compare the anesthetic and cardiorespiratory effects of the tiletamine/zolazepam/xylazine (TZX) combination and tiletamine/zolazepam/midazolam (TZM) combination. Eight healthy Landrace $\times$ Yorkshire pigs were randomly assigned to two groups. Each group was composed of four pigs. The pigs in group 1 (TZX) received tiletamine/zolazepam (2 mg/kg, IM) and xylazine (2 mg/kg, IM). The pigs in group 2 (TZM) received tiletamine/zolazepam (2 mg/kg, IM) and midazolam (0.5 mg/kg, IV). Induction time, anesthesia time and standing time were recorded for each pig. The scores of anesthetic effects were subjectively evaluated every 15 minutes during anesthesia. Cardiopulmonary parameters (heart rate, arterial blood pressure, respiratory rate and rectal temperature) were monitored and recorded 0, 5, 15, 30, 45 and 60 minutes after administration of drugs. Arterial blood gases ($pH_a$, $P_aCO_2$ and $P_aO_2$) and oxygen saturation ($SO_2$) were analyzed at same times. The scores of anesthetic effects decreased in the TZX group compare with the TZM group. From 5 to 85 minutes the mean heart rate in the TZX group was significantly lower than those in the TZM group. Mean arterial blood pressure in the TZX group was significantly higher than those in the TZM group at 5, 15 and 30 minutes. Both drug combinations provided a smooth induction and good immobilization. Scores of anesthetic effects in the TZM group were better than those in the TZX group. The effects to the cardiorespiratory function and temperature were lesser in the TZM group than those in the TZX group. In conclusion, when the two drug combinations were compared, the TZM group showed better anesthetic effects and less cardiorespiratory effects.

• Journal of Embryo Transfer
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• v.25 no.2
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• pp.89-92
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• 2010

We report herein the successful results of estrus induction, sperm cryopreservation and kids born by transcervical insemination of frozen-thawed semen in a Saanen goat. Flugestone acetate (FGA: 60 mg) was inserted into vagina for 15 days. The goat was intramuscularly injected with 400 IU PMSG and 200 IU hCG ($PG600^{(R)}$: Intervet, Korea) a day before withdrawal of the FGA sponge. Follicles and corpora lutea were identified on both ovaries by laparoscopy. Artificial insemination was performed 46 hours after removal of FGA sponge. The concentration of frozen-thawed semen was $3.975{\times}10^8/ml$ and 0.5 ml of frozen-thawed semen was transcervically inseminated into uterine body under anesthesia. Three kids, all females, were born 144 days after artificial insemination. This is the first report producing kids by transcervical insemination of frozen-thawed semen in a Saanen goat of which the estrus was induced by FGA sponges, PMSG and hCG during non-breeding season in Korea.