• Title/Summary/Keyword: induction anesthesia

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The Effects of Thiopental, Propofol, Etomidate and Diazepam-Ketamine Combination on Isoflurane Anesthesia in Dogs (개의 Isoflurane 흡입마취 시 Thiopental, Propofol, Etomidate 및 Diazepam-Ketamine 병용투여의 영향)

  • Lee, Jae-Yeon;Jee, Hyun-Chul;Kim, Myung-Cheol;Jeong, Seong-Mok
    • Journal of Veterinary Clinics
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    • v.23 no.4
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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.

Bradycardia after Dobutamine Administration in a Dog (Dobutamine 투여 후 발생한 개의 서맥 1례)

  • Jang, Min;Son, Won-Gyun;Hwang, Hyeshin;Jo, Sang-Min;Yi, Kang-Jae;Yoon, Junghee;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.31 no.4
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    • pp.350-353
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    • 2014
  • A 13-year-old, castrated male, Shih Tzu dog with a history of acute ataxia was referred to veterinary medical teaching hospital and anesthetized for diagnostic magnetic resonance imaging of cervical intervertebral disk disease. After preanesthetic evaluation including physical examination, blood chemistry, radiography and ultrasound, the patient was premedicated with intravenous butorphanol (0.2 mg/kg). Anesthesia was induced by intravenous propofol (6 mg/kg) and maintained with isoflurane at 1.2 minimal alveolar concentrations. Because the mean arterial pressure (MAP) decreased from 70 to 58 mmHg at 70 minutes after induction, dobutamine was administered by constant rate infusion ($5{\mu}g/kg/min$) to treat hypotension. However MAP did not increase, and heart rate rapidly decreased from 100 to 55 beats per minute (bpm). To treat bradycardia, intravenous glycopyrrolate ($5{\mu}g/kg$) was administered, and heart rate increased to 165 bpm. After extubation of endotracheal tube, the patient showed normal recovery without any problems related to cardiovascular system. Unexpected dobutamine-induced bradycardia was considered as Bezold-Jarisch reflex. It is recommended that clinicians know and prepare the possibility of bradycardia during dobutamine therapy under general anesthesia.

A Comparison of the Effect of Lidocaine or Sodium Bicarbonate Mixed with Rocuronium on Withdrawal Movement, Mean Arterial Pressure and Heart Rate during Rocuronium Injection (Rocuronium과 Lidocaine 또는 Sodium Bicarbonate의 혼합투여가 Rocuronium 정맥주사 동안의 회피 반응, 평균 동맥압 및 심박수에 미치는 효과 비교)

  • Lee, Sung-Suk;Yoon, Hae-Sang
    • Journal of Korean Academy of Nursing
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    • v.39 no.2
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    • pp.270-278
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    • 2009
  • Purpose: This study was performed to find out the effects of lidocaine or 8.4% sodium bicarbonate mixed with rocuronium on mean arterial pressure, heart rate and withdrawal movement. Methods: Data collection was performed from December 15, 2006 through May 31, 2007. Seventy-five patients with American Society Anesthesiologist (ASA) physical status I & II, under general anesthesia, were randomly assigned to 1 of 3 groups: R group (RG) received rocuronium 0.6 mg/kg; RL group (RLG), rocuronium 0.6 mg/kg mixed with 2 mL of 2% lidocaine; RS group (RSG), rocuronium 0.6 mg/kg with the same volume of 8.4% sodium bicarbonate. Mean arterial pressure, heart rate and withdrawal movement were observed from its injection until 5 min after endotracheal intubation. Results: The incidence of withdrawal movement with its corresponding injections was 72%, 40% and 4% in RG, RLG and RSG, respectively (p<.001). Score of withdrawal movement was the lowest in RSG of all groups (p<.001). While mean arterial pressure (p=.011) in RSG decreased significantly, and heart rate (p=.003) in RG increased more with its injection than before induction of anesthesia. Conclusion: Administration of the equivalent volume of 8.4% sodium bicarbonate with rocuronium is more effective than that of lidocaine with rocuronium compared with rocuronium only, in preventing withdrawal movement and in stabilizing mean arterial pressure and heart rate.

Effect of Music Therapy on Anxiety and Vital Sign of Nasal Closed Reduction Under General Anesthesia (전신마취 하 비골골절 수술 환자에서 음악요법이 환자의 불안 및 활력징후에 미치는 영향)

  • Suh, Bum-Sin;Na, Young-Cheon
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.369-374
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    • 2010
  • Purpose: Most of the patients who underwent surgery feels variable kinds of fear or anxiety; an uncomfortable mood state that happens without specific object affects patient's satisfaction before and after the surgery. As music therapy is rather noninvasive method generally used in reducing patient's anxiety, the authors researched about the extent of anxiety with the change of vital sign before the operation while comparing with the cases of patients who took the music therapy at closed reduction under general anesthesia. Method: We divided the patients in 4 groups; A with the premedication (Midazolam, Dormicum$^{(R)}$) before the operation, B with the premedication and music therapy, C with only music therapy, D with no premedication or therapy. And we measured the vital signs after the arrival at the operation room, after induction and 20 minutes after the operation. Also we observed the changes of anxiety index with the STAI (State Trait Anxiety Inventory)-K (Korea)YZ 1 hour before and 8 hours after the surgery. Result: The group B showed the least changes in blood pressure as the group D showed the highest change. Both group C and A showed increase in blood pressure but the upswing in group A was lower than group C. At the change of pulse rate group B showed the lowest upswing also group D showing the highest. Group B showed quite a few upswing but lower than group D, but, at the same time, group A showed lower upswing when comparing two cases. After analysis of STAI-KYZ score, the anxiety relatively decreased in group B and C in comparison with group D. And the index of anxiety state of group A showed just as much to group D. Conclusion: The music therapy is better healthcare method compared to other therapies in reducing anxiety also with satisfying effect who underwent operation. The authors recommend music therapy assisted with use of premedication for better relief of anxiety.

Aprepitant in combination with palonosetron for the prevention of postoperative nausea and vomiting in female patients using intravenous patient-controlled analgesia

  • Yoo, Jae Hwa;Kim, Soon Im;Chung, Ji Won;Jun, Mi Roung;Han, Yoo Mi;Kim, Yong Jik
    • Korean Journal of Anesthesiology
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    • v.71 no.6
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    • pp.440-446
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    • 2018
  • Background: The aim of this study was to evaluate aprepitant in combination with palonosetron as compared to palonosetron alone for the prevention of postoperative nausea and vomiting (PONV) in female patients receiving fentanyl-based intravenous patient-controlled analgesia (IV-PCA). Methods: In this randomized single-blinded study, 100 female patients scheduled for elective surgery under general anesthesia were randomized to two groups: Group AP (80 mg aprepitant plus 0.075 mg palonosetron, n = 50) and Group P (0.075 mg palonosetron, n = 50). The patients in group AP received 80 mg aprepitant per oral 1-3 h before surgery, while all patients received 0.075 mg palonosetron after induction of standardized anesthesia. All patients had postoperative access to fentanyl-based IV-PCA. The incidence of nausea and vomiting, use of rescue medication, and severity of nausea were evaluated at 6 and 24 h after surgery. Results: The incidence of nausea (54%) and vomiting (2%) in group AP did not differ significantly from that in group P (48% and 14%, respectively) during the first 24 h after surgery (P > 0.05). Patient requirements for rescue medication in group AP (29%) were similar to those in group P (32%) at 24 h after surgery (P > 0.05). There was no difference between the groups in severity of nausea during the first 24 h after surgery (P > 0.05). Conclusions: Aprepitant combined with palonosetron did not reduce the incidence of PONV as compared to palonosetron alone within 24 h of surgery in women receiving fentanyl-based IV-PCA.

Medetomidine Sedation and Its Antagonism by Yohimbine in Dogs (개에서 Medetomidine 진정에 대한 Yohimbine의 길항작용)

  • Heo, Keong-Hee;Lee, Jae-Yeon;Choi, Kyeong-Ha;Cho, Jin-Haeng;Park, Chang-Sik;Kim, Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.343-347
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    • 2010
  • The purpose of this study was to determine the antagonistic effects of yohimbine on sedation induced in dogs with medetomidine. Six mixed breed dogs were repeatedly used at a 2 weeks withdrawal time in this study. The dogs received $40\;{\mu}g/kg$ of medetomidine followed 15 minutes later by 0.2 ml/kg saline solution (group M) or 0.11 mg/kg yohimbine (group MY). All the dogs were examined before and 5, 15, 30, 45, 60, 75, 90, 120 and 150 minutes after the injection of medetomidine, and the induction and recovery times, vital signs, blood biochemistry and anesthetic quality were recorded. There were significant differences in the recovery of anesthesia between the groups. In both groups the heart rate decreased rapidly down to five minutes after the administration of medetomidine. The activity of ALT, AST and the protein concentration did not change significantly in either group and there was no significant difference between them at any time. Response to noise, muscle tone and analgesic score in the MY group at 30 minutes were significantly lower than those of the M group. When recovering from anesthesia, the dogs treated with yohimbine took less time to achieve sternal recumbency and less time to be able to stand and walk. It was concluded that yohimbine reversed effectively medetomidine sedation in dogs.

Anesthetic and Cardiopulmonary Effects of Butorphanol-Tiletamine-Zolazepam-Medetomidine and Tramadol-Tiletamine-Zolazepam-Medetomidine in Dogs (개에서 Butorphanol-Tiletamine-Zolazepam-Medetomidine과 Tramadol-Tiletamine-Zolazepam-Medetomidine 합제의 마취효과 및 심폐에 미치는 영향)

  • Nam, Seung-Wan;Shin, Beom-Jun;Jeong, Seong Mok
    • Journal of Veterinary Clinics
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    • v.30 no.6
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    • pp.421-427
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    • 2013
  • There are many intramuscularly injectable drugs commonly used for anesthesia in dogs and combination of drugs were used for decrease the side effects. The objective of this study was to evaluate the anesthetic and cardiopulmonary effects of butorphanol-tiletamine-zolazepam-medetomidine and tramadol-tiletamine-zolazepam-medetomidine in dogs. Ten healthy beagle dogs (intact male; mean body weight : $9.5{\pm}1.60$ kg) were used in the study. Experimental animals were divided into two groups (n=5, each) and received 0.2 mg/kg of butorphanol (BZM) and 2 mg/kg of tramadol (TZM) according to the group after injection of $Zoletil^{(R)}$ (5 mg/kg) and medetomidine (10 ug/kg). All drugs were administered intramuscularly. Anesthesia and recovery, sedation and analgesia score, cardiovascular and respiratory parameters were measured. Induction and recovery time were not significantly different between the groups. Anesthesia time was $117.4{\pm}25.64$ minute and $81.2{\pm}12.50$ minute in BZM and TZM groups, respectively. Sedation and analgesia were satisfied in both groups. In both groups, common side effects related to the medetomidine, significant bradycardia and hypertension were not observed. There were no significant changes in respiratory data. In conclusion, tiletamine-zolazepam-medetomidine in combination with either butorphanol or tramadol can be suitable anesthetic protocol for minor procedures in dogs. They produced adequate anesthesia characterized by rapid induction, adequate analgesia and muscle relaxation without remarkable side effects.

Effect of Intravenous Administration of Tramadol on the Minimum Alveolar Concentration of Isoflurane in Dogs (개에서 트라마돌의 정맥투여가 아이소플루란의 최소폐포농도에 미치는 영향)

  • Seok, Seong-Hoon;Park, Se-Jin;Lee, Seung-Yong;Jin, So-Young;Kim, Young-Ki;Hwang, Jae-Min;Lee, Hee-Chun;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.308-312
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    • 2015
  • This study was aimed to evaluate the effects of tramadol hydrochloride on the minimum alveolar concentration of isoflurane ($MAC_{ISO}$) in dogs. Six healthy, female German shepherd dogs (aged 1-2 years) were used in this study. Anesthesia was induced by mask induction and maintained with isoflurane in oxygen. Mechanical ventilation maintained the end-tidal $CO_2$ partial pressure ($P_{ET}CO_2$) from 35 to 45 mmHg throughout the study. A baseline $MAC_{ISO}$ ($MAC_{ISO}B$) was determined starting 45 minutes after induction of anesthesia by clamping a pedal digit until gross purposeful movement was detected. After $MAC_{ISO}B$ determination, dogs received a tramadol loading dose of 3 mg/kg followed by a continuous rate infusion (CRI) of 2.6 mg/kg/h. The determination of $MAC_{ISO}$ after administration of tramadol ($MAC_{ISO}T$) began 20 min after the start of the CRI. Arterial blood pressure and heart rate were recorded continuously and arterial blood samples for blood gas analysis were collected at the end of the equilibration period. Mean ${\pm}$ SD values for the $MAC_{ISO}B$ and $MAC_{ISO}T$ were $1.33{\pm}0.04%$ and $1.23{\pm}0.04%$, respectively. The $MAC_{ISO}B$ decreased significantly by $7.5{\pm}0.2%$ (P < 0.05) after administration of tramadol. The mean heart rate and arterial blood pressure of six dogs were not changed significantly after tramadol administration. The blood gas levels remained constant during the study. In conclusion, tramadol could significantly reduce $MAC_{ISO}$ without depression of cardiorespiratory function. Thus, the use of tramadol on inhalation anesthesia with isoflurane in dogs can improve the stability of anesthesia and the quality of recovery.

Acute postoperative myelopathy caused by spontaneous developed cervical disc herniation: Case report & literature review (수술후 자연발생 경추간판탈출에 의한 척수병증: 증례보고 및 문헌고찰)

  • Lee, Jeong-Woo;Lee, Keun Hyeong;Lee, Ju-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.10
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    • pp.303-308
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    • 2019
  • Non-traumatic acute myelopathy caused by cervical disc herniation is rare. To date, no case has been reported to be caused by extrusion cervical disc herniation, unrelated to patient posture during surgery. Here, we report the case of a 65-year-old male patient with cervical myelopathy who underwent subsequent arthroscopic rotator cuff surgery under general anesthesia; non-cervical spine surgery. Ed. Notes: I am unable to understand the insertion of the highlighted phrase. Please delete if not required, or revise the sentence appropriately. Patient showed acute postoperative tetraplegia in spite of optimal anesthetic management. He showed no limitation of neck movement at pre-operative airway evaluation, and had no history of trauma to the cervical spine. During surgery, there had been no overextension or twisting of the neck, including at the time of anesthetic induction by tracheal intubation. However, cervical disc herniation causing spinal canal cord compression was detected in the postoperative magnetic resonance imaging, which probably resulted in tetraplegia of the patient. Motor and sensory functions were recovered after 21 days of conservative treatment, including steroid pulse intravenous therapy without any surgical intervention. In this report, the disease is described after reviewing other reported cases; furthermore, we also discuss the pathophysiology of the disease. Based on our report, we propose that under general anesthesia, clinicians should pay attention to the possibility of pre-existing cervical disease, even in non-cervical spine surgeries of geriatric patients.

Effective points for acupuncture are different from induction methods in rat models of arthiritis (관절염 유발 방법에 따른 경혈의 진통효과 차이)

  • Koo, Sung-Tae;Kim, Yu-Sung;Lee, Ji-Eun;Hwang, Hye-Suk;Han, Kyung-Ju;Choi, Sun-Mi
    • Korean Journal of Oriental Medicine
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    • v.12 no.3 s.18
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    • pp.49-58
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    • 2006
  • Although the usage of acupuncture for pain has increased in recent years, the mechanisms of acupuncture analgesia (AA) remain unclear. The lack of suitable experimental animal models for persistent pain, which show clear AA, has been the major stumbling block in the investigation of the physiological mechanisms of AA. In the present study, we test AA in two knee arthritis models induced by injection of CFA or carrageenan as persistent pain models. After induction of arthritis, the rat subsequently showed a reduced stepping force of the affected limb for the next several days. Electroacupuncture (EA) was applied to an acupuncture point each on the contralateral forelimb for 30 minutes under gaseous anesthesia. After the termination of EA, behavioral tests measuring stepping force were periodically conducted during the next several hours. EA produced a significant improvement of stepping force of the foot lasting for at least 2 hours when applied to LR2 in CFA model, and applied to ST36 in carrageenan model, but both points did not produce any significant effects in each other model. Further experiments showed that intraperitoneal pretreatment of naltrexone, a non-selective opioid antagonist, did not reduced the EA-induced improvement of stepping force in both of two models. These data suggest that EA produce analgesic effect in knee arthritic pain and the analgesic effect is specific to the acupuncture point depending on painful conditions.

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