• Biomolecules & Therapeutics
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• v.23 no.3
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• pp.251-260
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• 2015

Propofol is an anesthetic agent that gained wide use because of its fast induction of anesthesia and rapid recovery post-anesthesia. However, previous studies have reported immediate neurodegeneration and long-term impairment in spatial learning and memory from repeated neonatal propofol administration in animals. Yet, none of those studies has explored the sex-specific long-term physical changes and behavioral alterations such as social (sociability and social preference), emotional (anxiety), and other cognitive functions (spatial working, recognition, and avoidance memory) after neonatal propofol treatment. Seven-day-old Wistar-Kyoto (WKY) rats underwent repeated daily intraperitoneal injections of propofol or normal saline for 7 days. Starting fourth week of age and onwards, rats were subjected to behavior tests including open-field, elevated-plus-maze, Y-maze, 3-chamber social interaction, novel-object-recognition, passive-avoidance, and rotarod. Rats were sacrificed at 9 weeks and hippocampal protein expressions were analyzed by Western blot. Results revealed long-term body weight gain alterations in the growing rats and sex-specific impairments in spatial (female) and recognition (male) learning and memory paradigms. A markedly decreased expression of hippocampal NMDA receptor GluN1 subunit in female- and increased expression of AMPA GluR1 subunit protein expression in male rats were also found. Other aspects of behaviors such as locomotor activity and coordination, anxiety, sociability, social preference and avoidance learning and memory were not generally affected. These results suggest that neonatal repeated propofol administration disrupts normal growth and some aspects of neurodevelopment in rats in a sex-specific manner.

• Journal of Veterinary Clinics
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• v.30 no.6
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• pp.415-420
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• 2013

This study was performed to examine the anesthetic and cardiopulmonary effects of medetomidine, midazolam and ketamine (MMK) combination in ten beagle dogs. Dogs were randomly allocated to two groups. Treatment group MMK-L received 0.015 mg/kg medetomidine followed by 0.3 mg/kg midazolam and 5 mg/kg ketamine by intramuscular injection. Treatment group MMK-H received 0.02 mg/kg medetomidine followed by 0.3 mg/kg midazolam and 5 mg/kg ketamine by intramuscular injection. Induction, anesthesia, sternal recumbency, standing, walking time, heart rate, arterial blood pressure, rectal temperature, respiratory rate and arterial blood gases were measured. Mean anesthesia time was significantly different between MMK-L group ($52.4{\pm}11.08$ minutes) and MMK-H group ($78.2{\pm}20.72$ minutes). Sedative scores and noxious stimuli were raised to the maximum value at 5 minutes after administration of the test dose and maintained until 40 minutes in both groups. In both groups, the heart rate significantly decreased after MMK administration. The blood pressures (MAP, SAP and DAP) increased after MMK administration but there were no significant differences in blood pressures between two groups. In conclusion, intramuscular administration of medetomidine followed by intramuscular injection of midazolam and ketamine in beagle dogs, leads immediate and sufficient anesthesia and proper doses of medetomidine for minimal adverse effects in intramuscular MMK combination will be 0.015 mg/kg in dogs.

• Journal of Korean Physical Therapy Science
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• v.8 no.2
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• pp.1005-1013
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• 2001

The present study was designed to investigate the effect of low power GaAlAs laser on spinal Fos expression related to the anti-nociceptive effect of laser stimulation. Low power GaAlAs laser was applied to either acupoint or non-acupoint for 2 hour under light inhalation anesthesia. Spinal Fos expression in the dorsal horn was compared to that obtained in inhalation anesthesia control group. Furthermore, we analyzed the effect of the local treatment of lidocaine on the spinal Fos expression evoked by low power GaAlAs laser stimulation. The results were summarized as follows: 1. In the normal animals, only a few Fos like immunoreactive(Fos-IR) neurons were evident in the lumbar spinal cord dorsal horn. Similarly, following prolonged inhalation anesthesia, Fos-IR neurons were absent in the dorsal horn of the lumbar spinal cord. In animals treated with laser stimulation, Fos immunoreactive neurons were increased mainly in the medial half of ipsilateral laminae I-III at lumbar segments L3-5. These findings directly indicated that prolonged anesthesia used in this study did not affect the Fos expression in the spinal cord dorsal horn of intact animals and low power laser stimulation dramatically produced Fos expression in the spinal cord laminae that are related to the anti-nociceptive effect of laser stimulation. 2. In acupoint stimulated animals, 10mW of laser stimulation, not 3mW and 6mW intensity, significantly increased the number of Fos immunoreactive neurons in the spinal dorsal horn(p<0.05). However, laser stimulation on acupoint more dramatically increased the number of Fos immunoreactive neurons in the spinal cord rather than laser stimulatin on non acupoint. These result suggested that laser stimulatin on acupoint was more effective treatment to activate the spinal neuron than non acupoint stimulation. 3. The local treatment of lidocaine totally suppressed the activity of spinal neurons that were induced by lower power 1aser stimulation. These data indicated that the anti-nociceptive effect of laser stimulation was absolutely dependent upon the peripheral nerve activity in the stimulated location. In conclusion, these data indicate that 10mW of low power laser stimulation into acupoint is capable of inducing the spinal Fos expression in the dorsal horn related to the anti-nociceptive effect of laser stimulation, Furthermore, the induction of spinal Fos expression was totally related to the peripheral nerve activity in the laser stimulated area.

• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.3
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• pp.157-165
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• 2014

Background: Incisional site of surgical operation become transient ischemic state and then occur reoxygenation due to vasodilatation by inflammatory reaction, the productive reactive oxygen species (ROS) give rise to many physiologic results. Apoptosis have major role on elimination of inflammatory cell and formation of granulation tissue in normal wound healing process. Remifentanil can prevent the inflammatory response and can suppress inducible nitric oxide synthase expression in a septic mouse model. After cardiopulmonary bypass for coronary artery surgery, remifentanil can also inhibit the release of biomarkers of myocardial damage. Here we investigated whether remifentanil pretreatment has cellular protective effect against hypoxia-reoxygenation in HaCaT human keratinocytes, if so, the role of apoptosis and autophagy on this phenomenon. Methods: The HaCaT human keratinocytes were exposed to various concentrations of remifentanil (0.01, 0.05, 0.1, 0.5 and 1 ng/ml) for 2 h before hypoxia (RPC/HR group). These cells were cultured under 1% oxygen tension for 24h at $37^{\circ}C$. After hypoxia, to simulate reoxygenation and recovery, the cells were reoxygenated for 12 h at $37^{\circ}C$. 3-MA/RPC/HR group was treated 3-methyladenine (3-MA), autophagy inhibitor for 1h before remifentanil treatment. Cell viability was measured using a quantitative colorimetric assay with thiazolyl blue tetrazoliumbromide (MTT, amresco), showing the mitochondrial activity of living cells. To investigate whether the occurrence of autophagy and apoptosis, we used fluorescence microscopy and Western blot analysis. Results: The viability against hypoxia-reoxygenation injury in remifentanil preconditioning keratinocytes were increased, and these cells were showed stimulated expression of autophagy 3-MA suppressed the induction of autophagy effectively and the protective effects on apoptosis. Atg5, Beclin-1, LC3-II and p62 were elevated in RPC/HR group. But they were decreased when autophagy was suppressed by 3-MA. Conclusions: Remifentanil preconditioning showed the protective effect in human keratinocytes, and we concluded that autophagy may take the major role in the recovery of wound from hypoxia-reoxygenation injury. We suggest that further research is needed about the cell protective effects of autophagy.

• The Korean Journal of Pain
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• v.22 no.1
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• pp.58-64
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• 2009

Background: Magnesium is a noncompetitive antagonist of the N-methyl-D aspartate (NMDA) receptor. Magnesium is thought to be involved in opioid tolerance by way of inhibiting calcium entry into cells. Methods: The patients were randomly assigned to three groups according to the anesthetic regimens: Group M received magnesium sulfate and Group C received saline intravenously under remifentanil-based anesthesia. Group S received saline intravenously under sevoflurane based anesthesia in place of remifentanil. The patients in the group M received 25% magnesium sulfate 50 mg/kg in 100 ml of saline, and those patients in groups C and S received an equal volume of saline before induction of anesthesia; this was followed by 10 mg/kg/h infusion of either magnesium sulfate (group M) or an equal volume of saline (groups C and S) until the end of surgery. Pain was assessed on a visual analog scale at 1, 6, 12, 24, and 36 hours after the operation. The time to the first postoperative analgesic requirement and the cumulative analgesic consumption were evaluated in the three groups. Results: The visual analog scales for pain and the cumulative analgesic consumption were significantly greater in group C than in other groups. The time to first postoperative analgesic requirement was significantly shorter in group C than that in the other groups. There were no differences between group M and S for side effects. Conclusions: A relatively high dose and continuous remifentanil infusion is associated with clinically relevant evidence of acute opioid tolerance. NMDA-receptor antagonist, magnesium sulfate as an adjuvant analgesic prevents opioid tolerance in patients who are undergoing major abdominal surgery under high dose and continuous remifentanil infusion-based anesthesia.

• Journal of the Korea Convergence Society
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• v.11 no.10
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• pp.349-353
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• 2020

Background: The dosage of the anesthetic drugs is generally determined by the total body weight of the patients. However, the drugs can be overdosed when the patient is morbidly obese. We have determined anesthetic induction dose based on lean body mass estimated from bioelectrical impedance analysis (BIA). Case: We report a case of morbidly obese patient (161 cm, 138 kg and body mass index 53.1) who had an elective laparoscopic cholecystectomy. The dose of induction agent was determined by lean body mass estimated by BIA, and the sedation was assessed by the observer's assessment alertness/sedation scale. Conclusions: Dose determination through lean body mass measured by BIA is useful in highly obese patients.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.2
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• pp.51-54
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• 2013

A 30-year-old man with morbid obesity (height: 176 cm, body weight: 100 kg, body mass index: 32.28) was scheduled for reconstruction of the mandibular fracture. During induction of general anesthesia and nasotracheal intubation, we experienced massive epistaxis, hypoxemia and difficult airway management. Fortunately, we performed oro-tracheal intubation with direct laryngoscopy and it barely succeeded. He recovered without any residual complications and rescheduled seven days later and we successfully performed awake fiberoptic nasotracheal intubation. The patient discharged on the fourth postoperative day.

• Journal of Korean Academy of Nursing
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• v.36 no.1
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• pp.114-126
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• 2006

Purpose: This study was performed to evaluate the pre-emptive analgesic effects of a small dose of intravenous ketamine on postoperative pain in patients undergoing a hysterectomy. Method: Sixty patients undergoing a hystrectomy under general anesthesia were randomly allocated to 2 groups. The experimental group(30 patients) received 0.3mg/kg of ketamine after induction of anesthesia, approximately 5 min prior to surgery, but the control group(30 patients)did not receive ketamine. Data was collected in a double-blind manner from April 1st, to October 30th, 2004. Postoperatively, the patients used a patient-controlled analgesia(PCA) pump. Blood pressure, pulse rate, pain, anxiety, count of times pressing the PCA button, administeration of additional analgesics and side effects of ketamine were measured at 1 hour, 3 hours, 6 hours and 24 hours after the operation. Result: There were no statistical differences in blood pressure, pulse rate, pain and anxiety between the experimental and control groups. There were statistical differences in blood pressure, pulse rate, pain and anxiety during the 24 hours postoperatively. In the experimental group, the number of times pressing the PCA button and administering additional analgesic drugs were significantly lower than those of the control group. Conclusion: A 0.3 mg/kg dose of ketamine given at approximately 5 min before surgery resulted in decreasing the number of times pressing the PCA and the administration of additional analgesics.

• Development and Reproduction
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• v.20 no.3
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• pp.255-266
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• 2016

The optimum concentrations of clove oil as an anesthetic for olive flounder (Paralichthys olivaceus) and the stress response of the fish to clove oil anesthesia were determined over a range of water temperatures, and investigated in a simulated transport experiment using analysis of various water and physiological parameters. While the time for induction of anesthesia decreased significantly as both the concentration of clove oil and water temperature increased, the recovery time increased significantly (P<0.05). The plasma cortisol concentration in fish at each temperature increased significantly up to 12 h following exposure (P<0.05), then decreased to 48 h (P<0.05). The DO dissolved oxygen concentrations, pH values, and the fish respiratory frequencies decreased over 6 h following exposure to clove oil in all experimental groups (P<0.05), whereas the $NH_4{^+}$ and $CO_2$ concentrations in all experimental groups increased up to 6 h (P<0.05). The pH values and DO concentrations increased with increasing clove oil concentration (P<0.05) in the 6 h following exposure, and the $CO_2$ and $NH_4{^+}$ concentrations and the respiratory frequencies decreased with increasing clove oil concentration (P<0.05). The results of this experiment suggest that clove oil reduced the metabolic activity of olive flounder, thus reducing $NH_4{^+}$ excretion and $O_2$ consumption. In conclusion, clove oil appears to be a cost-effective and efficient anesthetic that is safe for use and non-toxic to the fish and users. Its use provides the potential for improved transportation of olive flounder.

• The Korean Journal of Pain
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• v.14 no.1
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• pp.76-82
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• 2001

Background: Postoperative nausea and vomiting (PONV) are common after general anesthesia and patient controlled analgesia (PCA) using opioids. This study was designed to compare the effectiveness of ondansetron plus dexamethasone versus ondansetron alone in the prevention of PONV in a patient undergoing a PCA. Methods: We studied 166 ASA I, and II in-patients undergoing general anaesthesia for major gynecological surgery. After induction of anesthesia, Group 1 (n = 64) received intravenous (IV) dexamethasone 10 mg and Group 2 (n = 102) received IV saline 2 ml before the surgical incision. Each patient received IV meperidine 50 mg as a loading dose. Meperidine 5 mg/kg, ketorolac 3.6 mg/kg and ondansetron 8 mg diluted in 40 ml solutions were connected to PCA pump for postoperative pain control. Mean arterial blood pressure, heart rate, pain score and symptom-therapy score were checked at 1, 4, 8, 16, 24, and 36 hours after the PCA connection. Results: For Group 1 and Group 2, respectively, the overall incidence of PONV was 12.5% and 23.5%. The pain scores were lower in patients receiving a combination of ondansetron and dexamethasone than those on ondansetron alone at 4 hr (P < 0.05), 8 hr (P < 0.05) and 16 hr (P < 0.05). Conclusions: This study suggests that the combination of ondansetron and dexamethasone is not more effective than ondansetron alone in the prevention of postoperative nausea and vomiting in women having PCA following major gynecological surgery but is more effective for pain control.