• Title/Summary/Keyword: induction anesthesia

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Use of Web-Based Evidence-based Clinical Practice Guidelines for Patients following Gastrectomy: Effects on Body Temperature, Shivering, Perceived Thermal Comfort, and Satisfaction with Temperature Management (웹기반 체온 관리 근거중심 간호실무 가이드라인이 위절제술 환자의 체온, 전율, 체온 불편감, 체온 관리 만족도에 미치는 효과)

  • Hong, Sung-Jung;Lee, Eunjoo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.21 no.2
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    • pp.112-122
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    • 2014
  • Purpose: The purpose of this study was to examine the effects on body temperature, shivering, and perceived thermal comfort of web-based evidence-based practice guideline for patients undergoing gastrectomy. Methods: Eighty patients scheduled for gastrectomy were recruited and assigned to the control or experimental group by sequential order. Before collecting data from the experimental group, a systematic educational program on evidence-based guidelines was provided to the nurses as well anesthesiologists. Data were analyzed using t-test and repeated measured ANOVA. Results: The experimental group showed higher body temperature from the induction of anesthesia until four hours after surgery compared to the control group. In addition, the levels of thermal comfort as well as satisfaction with thermal management were significantly higher in the experiment group. Conclusion: Use of evidence-based guidelines was effective in maintaining body temperature, lowering sensitivity to shivering, and promoting perceived thermal comfort. Therefore, adoption of evidence-based interventions in nursing practice is recommended.

Appropriate Duration of Prophylactic Antibiotics in Acute Nonperforated Appendicitis (급성 비천공성 충수염 수술시 예방적 항균제의 사용기간)

  • Suh, Ok Kyung;Kang, Sung Hee;Yang, Dae Hyun;Shin, Wan Gyoon
    • Korean Journal of Clinical Pharmacy
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    • v.12 no.2
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    • pp.65-70
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    • 2002
  • Prophylactic antibiotics in acute nonperforated appendicitis have been used for preventing infection after appendectomy. However, duration of antibiotic administration for surgical prophylaxis in Korea has been noted to be longer than those recommended in other countries. The objective of this study was to identify appropriate duration of prophylactic antibiotics in acute nonperforated appendicitis by comparing two different antibiotic regimens for their wound infection rates. Eighty-four acute nonperforated appendicitis patients were enrolled in this prospective, randomized, open trial and were assigned to one of two antibiotic regimens: cefoxitin 1 g every 8 hours given intravenously for 24hours or cefoxitin 1 g every 8 hours given intravenously plus sisomicin 75 mg every 12 hours given jntramuscularly for 72 hours. First doses were given just prior to the induction of anesthesia. Postoperative wound infections were detected in $4.8\%$ of the 72-hour-treated group (n=42), whereas none occurred in the 24-hour-treated group (n=42). However, the difference in the rates of wound infections between two groups was not statistically significant. The most frequently isolated microorganism from appendiceal tissues was E coli. In conclusion, administration of cefoxitin alone for 24 hours is sufficient as surgical prophylaxis in nonperforated appendicitis.

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Pedunculated Fibrolipoma of the Hypopharynx: A Case Report (하인두 내에 발생한 유경성 섬유지방종 1예)

  • Eo, Tae Seong;Shin, Hyang Ae;Kie, Jeong Hae;Kim, Ji-Hoon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.2
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    • pp.115-118
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    • 2022
  • Fibrolipomas are a rare microscopic variant of lipomas, characterized by mature adipose tissue interspersed with dense fibrous connective tissue. These lesions are rarely observed in the head and neck region and represent <0.6% of all benign tumors of the larynx and hypopharynx. Their clinical presentation depends on the location and size of lesions. Patients present with variable symptoms; however, fibrolipomas of the larynx and hypopharynx are clinically important because these tumors can cause unpredictable airway obstruction, particularly during general anesthesia induction. We present a case of a hypopharyngeal fibrolipoma in a 61-year-old patient with frequent dyspnea, dysphagia, and muffled voice. Laryngoscopy revealed a well-demarcated pedunculated ovoid mass involving the larynx. We performed laryngomicrosurgery using a carbon dioxide laser for surgical excision and subsequent evaluation confirmed the diagnosis of fibrolipoma. We report a case of hypopharyngeal fibrolipoma, together with a literature review.

Micropipette tip intubation in rats as a replacement for conventional endotracheal tube intubation

  • Myung-Good Kim;Jeong-Ho Ryu;Dong Min Lee;Tae-Seo Park;Ji-An Choi
    • Archives of Craniofacial Surgery
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    • v.24 no.2
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    • pp.87-90
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    • 2023
  • Endotracheal intubation is often necessary in the course of animal experiments, especially in craniofacial surgery. However, endotracheal intubation can be a major burden in this context. The authors performed simple and cost-saving method using a 200 µL yellow micropipette tip, and the success of this method was demonstrated by X-ray and autopsy. We used a total of 30 rats. After the rats were fixed with a plaster, the trachea and vocal cords were visualized with the tongue pulled back. Under direct visualization of the vocal cords, a curving micropipette tip was advanced into the trachea. This method can be learned quickly and applied successfully by general experimenters. We successfully intubated all 30 rats without any complications. The success rate of micropipette tip intubation was 100%. This procedure was performed by one experimenter within 2 to 3 minutes after induction of anesthesia. We demonstrated its superiority by X-ray and autopsy. Herein, we describe endotracheal intubation of rats using micropipette tips. To the best of our knowledge, this method is novel and represents the simplest and most efficient means of intubation in rats, providing an alternative to conventional endotracheal intubation.

Ovarian response and surgical collection of embryos after induction of estrus in the bitch (발정유기견(發情誘起犬)의 난소반응(卵巢反應)과 수정란(受精卵)의 외과적(外科的) 회수(回收))

  • Kang, Byong-kyu;Choi, Han-sun;Na, Jin-su;Oh, Ki-seok;Son, Chang-ho;Lee, Cha-bum
    • Korean Journal of Veterinary Research
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    • v.29 no.3
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    • pp.373-381
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    • 1989
  • The aim of the present study was to test the efficiency of estrous induction in the premature, metestrous and anestrous bitches. The estrus was induced with prostaglandin $F_{2{\alpha}}$, estradiol-$17{\beta}$, pregnant mare serum gonadotropin (PMSG) and human chorionic gonadotropin(HCG) in the treatment A, and with PMSG and HCG in the treatment B. Day 0 was the first day of estrone injection in the treatment A and the day of PMSG injection in the treatment B. Twenty three of the twenty six bitches were laparotomized under general anesthesia between 11 and 18 days after onset of behavioral estrus, whereas three bitches were not laparotomized and remained until parturition. Ovarian responses were evaluated with the total number of corpora lutea or ovulation sites. The uterine horns were flushed with phosphate-buffered saline added heat treated canine serum(10%), the flushing media was collected into watch glass and the ova were examined under stereomicroscope. The results obtained were as follows: 1. Standing estrus was observed on the day $17.7{\pm}1.5$ after injection of estrone in the treament A, but ovarian responses were not detectable. 2. Standing estrus was observed on the day $12.2{\pm}0.2$ after injection of PMSG in the treament Band 14 of 17 bitches showed ovarian responses. Ova were recovered in 9 of the 14 bitches. 3. Ovarian responses were observed in one of the three premature bitches. two of the three metestrous bitches and all of the 11 anestrous bitches. The average number of the ova collected from 9 bitchs were $12.2{\pm}1.4$. 4. Three bitches in the treament B exhibited behavioural estrus and all of them were mated with fertile male dog, resulting the pregnancy in only one bitch. The pregnant bitch gave the birth of two pups.

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Cardiopulmonary Effects of Enflurane Combined with Propofol in Dogs (개에서 Enflurane과 Propofol의 병용이 심폐기능에 미치는 영향)

  • Chae, Hyung-gyu;Jang, Kwang-ho;Jang, In-ho
    • Journal of Veterinary Clinics
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    • v.18 no.3
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    • pp.249-256
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    • 2001
  • This study was performed to evaluate cardiopulmonary depressant effects of enflurane (1.0 vol%) combined with propofol(0.25 mg/kg/min) compared with enflurane inhalation, and propofol infusion, respectively, in 18 healthy dogs premedicated with acepromazine and atropine. After bolus injection of propofol 5 mg/kg for induction and tracheal intubation, they were randomly assigned to 3 groups: propofol 0.5 mg/kg/min infusion (Group I, n=6), enflurane 2.5 vol% (Group II, n=6) and enflurane 1.0 vol% combined with propofol 0.25 mg/kg/min (Group III, n=6). Mean arterial Pressure (MAP), systolic arterial pressure (SAP) and diastolic arterial pressure (DAP) were depressed significantly in all groups, especially in Group II. MAP, SAP and DAP values of Group IIIwere higher than those of Group II, but lower than those of Group I. The changes of PaO$_2$, Pa$CO_2$and pHa were similar in all groups. Respiration rates were decreased in all groups 5 minutes after induction but maintained in normal range. Those of Group I were less depressant than those of Group II and Group III. Concentrations of $Na^+ and Cl^-$ were increased and those of $K^+$ were decreased in all groups, but their values were quitely similar. Heart rate was changed in small range and the value of Group I was higher than those of Group II and Group III. Body temperature was decreased significantly in all groups. Adverse effects like as muscle rigidity, nausea or vomiting and shivering were not appeared and apnea at induction was occured 6 dogs. From the these results, enflurane 1.0 vol% combined with propofol 0.25 mg/kg/min also could be applied for anesthesia in dogs.

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Studies on the Antidotal Effect of Panax ginseng The Therapeutic Effect of Ginseng on the Acute Alcoholism (인삼의 해독작용에 관한 연구 급성 알코을 중독에 대한 인삼의 치료 효과)

  • 신만륜
    • Journal of Ginseng Research
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    • v.1 no.1
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    • pp.59-78
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    • 1976
  • In order to investigate the influences of Panax ginseng (white ginseng and red ginseng) on the anesthetic effect and toxic effect of alcohol, experimental studies .had been carried out with albino rabbits, mongolian dogs and mice. The anesthetic effect of alcohol was observed by measuring the induction time, .anesthetic time, recovery time and duration from the beginning of induction to , the recovery of anesthesia (total time), respectively. and toxic effect ($LD_{50}$) of alcohol was measured. In addition to these experiments, al cohol concentration in .blood, blood sugar level, serum transaminase (GOT and GPT) activities and serum alkaline phosphatase activity were measured. Also in order to study the clinical effect of alcohol in healthy students, code .substitution, response time and muscle coordination were tested. The results were obtained as follows. 1. In the rabbits and mongolian Jags, the induction time of anesthesia by the administration of alcohol was delayed by the pretreatment of ginseng but recovery time and total time of anestksia were markedly shortend. 2. The bleed alcohol concentration was decreased by the pretreatment of ginseng , but not affected in mongolian dogs. 3. The blood sugar level, serum transaminase (GOT and GPT) activities and alkaline phoshatase activity in rabbits and dogs induced by the administration of alcohol were affected by the Pretreatment of ginseng. Because those were included within normal ranges, the differnces have no remarkable significance. 4. Liver alcohol dehydrogenase activity of rabbit was increased by the treatment of ginseng, especially it was markedly increased by the treatment of red ginseng 5. The average lethal dose of alcohol to mice was increased by the pretreatment. of ginseng, especially it was markedly increased by the pretreatment of red .ginseng. 6. In the clinical experiments, the blood alcohol concentration induced by alcohol administration was not affected by the pretreatment of ginseng whereas the bleed sugar level was increased. Blood alcohol concentration and bleed sugar level were measured after three hours alcohol administration. 7. The response time of healthy students administered with alcohol was markedly shortened by the pretreatment of ginseng but the experiments on the code substitution and muscle coordination were not affected.

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Cardiovascular Effects of Free Movement of Abdominal Muscle in Prone Positioning during General Anesthesia (전신마취동안에 복와위시 자유로운 복근 움직임이 심혈관계에 미치는 영향)

  • Kim, Ji-Yoon;Lee, Dong-Won;Seo, Il-Sook;Kim, Sae-Yeon
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.206-215
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    • 2007
  • Background : The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. Materials and Methods : Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by $NICO^{(R)}$. We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. Results : In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. Conclusion : The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

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Effect of Intraoperative Glucose Fluctuation and Postoperative IL-6, TNF-α, CRP Levels on the Short-term Prognosis of Patients with Intracranial Supratentorial Neoplasms

  • Liu, Tie-Cheng;Liu, Qi-Ran;Huang, Ying
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10879-10882
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    • 2015
  • Objective: To investigate the effect of intraoperative glucose fluctuation and postoperative interlukin-6 (IL-6), tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), C-reactive protein (CRP) levels on the short-term prognosis of patients with intracranial supratentorial neoplasms. Materials and Methods: Eighty-six patients undergoing intracranial excision were selected in The Second Hospital of Jilin University. According to the condition of glucose fluctuation, the patients were divided into group A (glucose fluctuation <2.2 mmol/L, n=57) and group B (glucose fluctuation ${\geq}2.2mmol/L$, n=29). Glucose was assessed by drawing 2 mL blood from internal jugular vein in two groups in the following time points, namely fasting blood glucose 1 d before operation ($T_0$), 5 min after anesthesia induction ($T_1$), intraoperative peak glucose ($T_2$), intraoperative lowest glucose ($T_3$), 5 min after closing the skull ($T_4$), immediately after returning to intensive care unit (ICU) ($T_5$) and 2 h after returning to ICU ($T_6$). 1 d before operation and 1, 3 and 6 d after operation, serum IL-6 and TNF-${\alpha}$ levels were detected with enzyme-linked immunosorbent assay (ELISA), and CRP level with immunoturbidimetry. Additionally, postoperative adverse reactions were monitored. Results: There was no statistical significance between two groups regarding the operation time, anesthesia time, amount of intraoperative bleeding and blood transfusion (P>0.05). The glucose levels in both groups at $T_1{\sim}T_6$ went up conspicuously compared with that at $T_0$ (P<0.01), and those in group B at $T_2$, $T_4$, $T_5$ and $T_6$ were significantly higher than in group A (P<0.01). Serum IL-6, TNF-${\alpha}$ and CRP levels in both groups 1, 3 and 6 d after operation increased markedly compared with 1 d before operation (P<0.01), but the increased range in group A was notably lower than in group B (P<0.05 or P<0.01). Postoperative incidences of hypoglycemia, hyperglycemia and myocardial ischemia in group A were significantly lower than in group B (P<0.05), and respiratory support time obviously shorter than in group B (P<0.01). Conclusions: The glucose fluctuation of patients undergoing intracranial excision is related to postoperative IL-6, TNF-${\alpha}$ and CRP levels and those with small range of glucose fluctuation have better prognosis.

Examinations on sedation, anaesthetic and toxic effect of Isoeugenol for olive-flounder (Paralichthys olivaceus) (Isoeugenol의 넙치(Paralichthys olivaceus)에 대한 진정, 마취 및 독성효과 검토)

  • Shin, Gee-wook;Shin, Yong-seung;Kim, Young-rim;Lee, Eun-young;Yang, Hyang-hee;Palaksha, K.J.;Huh, Nam-eung;Yeon, Seong-chan;Lee, Hee-chun;Oh, Myung-ju;Joh, Seong-joon;Kang, Seung-won;Jung, Tae-sung
    • Korean Journal of Veterinary Research
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    • v.45 no.2
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    • pp.303-309
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    • 2005
  • Olive flounder (Paralichthys olivaceus) is the major mariculture fish in Korea. The annual aquaculture production of olive flounder in Korea during the period of 2003 was 300,000 ton (2002 Statistics, Ministry of Maritime Affairs & Fisheries, Korea Government). Anesthetics is very necessary in aquaculture to minimize stress and damage during harvesting, grading, transportation, spawning induction and handling to fish. In the present study, isoeugenol as new anesthetic in marine fish, especially olive flounder, was examined to know the efficacy and proper concentration. As a result, olive flounder adult was exhibited sedation at 5 ppm at 10 and $15^{\circ}C$, and 7.5 ppm at $20^{\circ}C$, respectively. Anesthesia was required at least 10, 7.5 and 10 ppm at $10^{\circ}C$, $15^{\circ}C$ and at $20^{\circ}C$, respectively. In case of fry, the effect of sedation was observed from 2.5 ppm at $10^{\circ}C$ and 5 ppm at 15 and $20^{\circ}C$, respectively. Anesthesia was observed from 2.5 ppm at $10^{\circ}C$, 5 ppm at 15 and $20^{\circ}C$, respectively. In acute toxicity test, it was impossible to explore $LD_{50}$ with the concentration of isoeugenol adult at $15^{\circ}C$ used, but over immersion volume of 15 ppm at $15^{\circ}C$ was observed mortality in fry. Based on the present study, isoeugenol was identified as a safe and active anesthetic to olive flounder.