• The Korean Journal of Pharmacology
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• v.32 no.3
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• pp.381-388
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• 1996

The hemodynamic changes in septic patients produced by inhalational anesthetics are sufficient to threaten the anesthesiologists. The effect of hydroxocobalamin, a vitamin $B_{12a}$, on contractile responses to phenylephrine during administration of inhalational anesthetics were evaluated in aortic ring preparations obtained from LPS-treated rats. The sepsis was developed by intraperitoneal injection of LPS (1.5 mg/kg for l8h) and confirmed by iNOS expression using RT-PCR. Statistical significances (P<0.05) were analyzed by Student's t-test or paired t-test according to data characteristics. The blood pressure, but not heart rate, was decreased in LPS-treated rats as compared to control rats. The contractile response to phenylephrine were dose-dependently increased from the doses of $10^{-8}\;M$ to that of $10^{-5}$ and were attenuated in LPS-treated rings. Both halothane and enflurane, at the doses of 1 MAC, decreased the contractile responses to phenylephrine while isoflurane did not significantly affect the contractile responses. Hydroxocobalamin ($10^{-5}$ M) significantly potentiated the contractile responses in the LPS-treated aortic ring preparations during administration of each inhalational anesthetic or not. From these results, it is suggested that hydroxocobalamin may improve the hemodynamics of septic patients during inhalational anesthesia. Abbreviations: LPS, lipopolysaccharide; RT-PCR, reverse transcription-polymerase chain reaction; MAC, minimum alveolar concentration; iNOS, inducible nitric oxide synthase; GAPDH, glyceraldehyde 3-phosphate dehydrogenase

• Journal of Yeungnam Medical Science
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• v.4 no.1
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• pp.65-74
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• 1987

This study deals with the changes in the concentrations of blood glucose and electrolytes during open heart surgery. Blood glucose and electrolytes in connection with age, disease and anesthetic period were measured in 25 patients about to undergo heart surgery which were performed between June 1986 and August 1986 in Yeungnam University Hospital. Because glucose solution is commonly used as priming solution, and the priming solution is hyperglycemic and hyperosmolar, glucose level of priming solution in this study was adjusted to 100-200mg% level to minimize hyperglycemic and hyperosmolar effect. The following results were obtained. 1. Glucose level of priming solution before extracorporeal circulation was $151.6{\pm}3.13mg%$. 2. With body cooling, blood glucose level was elevated. As duration of extracorporeal circulation is prolonged, blood glucose level was elevated more, but no difference between age and diseases were observed. On warming, blood glucose level was progressively lowered. 3. Despite the low serum potassium level during by pass, the potassium level was progressively elevated following by-pass, cut the serum potassium level was low compared to control values. Elevated calcium level was maintained during by pass.

• Journal of Pharmaceutical Investigation
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• v.35 no.6
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• pp.417-422
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• 2005

This study was aimed to design and formulate the moisture-activated patches containing ofloxacin and lidocaine for antibacterial and local anesthetic action. The solubility of lidocaine at $32^{\circ}C$ in various vehicles decreased in the rank order of PG $759.5{\pm}44.5\;mg/mL$ > PGL > IPM > PEG 300 > PEG 400 > Ethanol > PGMC > DGME > PGML > OA > $Captex^{\circledR}\;300$ > $Captex^{\circledR}\;200$ > water $(4.0{\pm}0.1\;mg/mL)$. Ofloxacin revealed very low solubility, which the highest solubility was obtained from PEG 400 $(18.7{\pm}6.3\;mg/mL)$ among the vehicles used. The addition of lactic acid increased the solubility of ofloxacin dramatically; the solubility at 5% lactic acid was $133.7{\pm}9.7\;mg/mL$. As $2-hydroxypropyl-{\beta}-cyclodextrin$ was added at the concentrations of 40, 80, 120, 160 and 200 mM, the solubilities of lidocaine and ofloxacin were enhanced up to three and two times, respectively, with concentration-dependent pattern. Gel intermediates for filmtype patches were prepared with mucoadhesive polymer, viscosity builders, lidocaine or ofloxacin at pH values from 5 to 7. Gels were cast onto a release liner and dried at room temperature. Dried patch was attached onto an adhesive backing layer, thus forming a patch system. Patches containing a single drug component were characterized by in vitro measurement of drug release rates through a cellulose barrier membrane. The release study was carried out at $37^{\circ}C$ using a Franz-type cell. Receptor solutions were isotonic phosphate buffers (pH 7.4). Samples $(100\;{\mu}L)$ were taken over 24 hours and quantitated by a verified HPLC method. The releases from all tested were proportional to the square root of time. The release rates were 0.9, 157.3 and $281.7\;{\mu}g/cm^{2}/min^{1/2}$ for the lidocaine patches and 19.8,37.2 and $50.7\;{\mu}g/cm^{2}/min^{1/2}$ for the ofloxacin patches at the concentrations of 0.3, 0.5 and 1 %, respectively. The release rates were dose dependent in both drug patches $(R^{2}\;=\;0.9077\;for\;lidocaine;\;R^{2}\;=\;0.9949\;for\;ofloxacin)$ and those were also thickness-dependent $(R^{2}\;=\;0.9246\;for\;lidocaine;\;R^{2}\;=\;0.9512\;for\;ofloxacin)$.

• The Korean Journal of Physiology and Pharmacology
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• v.20 no.6
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• pp.605-611
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• 2016

Ketamine is an anesthetic with hypertensive effects, which make it useful for patients at risk of shock. However, previous ex vivo studies reported vasodilatory actions of ketamine in isolated arteries. In this study, we reexamined the effects of ketamine on arterial tones in the presence and absence of physiological concentrations of 5-hydroxytryptamine (5-HT) and norepinephrine (NE) by measuring the isometric tension of endothelium-denuded rat mesenteric arterial rings. Ketamine little affected the resting tone of control mesenteric arterial rings, but, in the presence of 5-HT (100~200 nM), ketamine ($10{\sim}100{\mu}M$) markedly contracted the arterial rings. Ketamine did not contract arterial rings in the presence of NE (10 nM), indicating that the vasoconstrictive action of ketamine is 5-HT-dependent. The concentration-response curves (CRCs) of 5-HT were clearly shifted to the left in the presence of ketamine ($30{\mu}M$), whereas the CRCs of NE were little affected by ketamine. The left shift of the 5-HT CRCs caused by ketamine was reversed with ketanserin, a competitive 5-$HT_{2A}$ receptor inhibitor, indicating that ketamine facilitated the activation of 5-$HT_{2A}$ receptors. Anpirtoline and BW723C86, selective agonists of 5-$HT_{1B}$ and 5-$HT_{2B}$ receptors, respectively, did not contract arterial rings in the absence or presence of ketamine. These results indicate that ketamine specifically enhances 5-$HT_{2A}$ receptor-mediated vasoconstriction and that it is vasoconstrictive in a clinical setting. The facilitative action of ketamine on 5-$HT_{2A}$ receptors should be considered in ketamine-induced hypertension as well as in the pathogenesis of diseases such as schizophrenia, wherein experimental animal models are frequently generated using ketamine.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.363-366
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• 2012

Objective : Meralgia paresthetica (MP) is a syndrome of pain and/or dysesthesia in the anterolateral thigh that is caused by an entrapment of the lateral femoral cutaneous nerve (LFCN) at its pelvic exit. Despite early accounts of MP, there is still no consensus concerning the effectiveness of neurolysis or transaction treatments in the long-term relief for medically refractory patients with MP. We retrospectively analyzed available long-term results of LFCN neurolysis for medically refractory MP in an effort to clarify this issue. Methods : During the last 7 years, 11 patients who had neurolysis for MP were enrolled in this study. Nerve entrapment was confirmed preoperatively by electrophysiological studies or a positive response to local anesthetic injection. Decompression of the LFCN was performed at the level of the iliac fascia, inguinal ligament, and fascia of the thigh distally. The outcome of surgery was assessed 8 weeks after the procedure followed at regular intervals if symptoms persisted. Results : Twelve decompression procedures were performed in 11 patients over a 7-year period. The average duration of symptoms was 8.5 months (range, 4-15 months). The average follow-up period was 33 months (range, 12-60 months). Complete and partial symptom improvement were noted in nine (81.8%) and two (18.2%) cases, respectively. No recurrence was reported. Conclusion : Neurolysis of the LFCN can provide adequate pain relief with minimal complications for medically refractory MP. To achieve a good outcome in neurolysis for MP, an accurate diagnosis with careful examination and repeated blocks of the LFCN, along with electrodiagnosis seems to be essential. Possible variation in the course of the LFCN and thorough decompression along the course of the LFCN should be kept in mind in planning decompression surgery for MP.

• Journal of Korean Ophthalmic Optics Society
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• v.18 no.4
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• pp.525-531
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• 2013

Purpose: To identify the apoptosis caused by Proparacaine hydrochloride (PPC), a topical anesthesia, applied to conjunctival cell lines and determine whether pigallocatechin-gallate (EGCG), has protective effects on. Methods: The conjunctival cell lines were treated with 0.5% of Alcaine$^{(R)}$, 0.5% of PPC and 0.01% of Benzalkonium chloride (BAC) for 15 minutes, respectively in order to investigate the effects of topical anesthesia on cells, and followed by cultured for 12 and 24 hours. The recovery effects were investigated by measuring level of cellular proliferation inhibiting using MTT assay and LDH assay. The conjunctival cell lines were pre-treated with EGCG $10{\mu}M$ for 3 hrs and post-treated with 0.5% PPC for 15 mins in order to investigate whether EGCG has protective effects, flow cytometry were performed in order to observe apoptosis. Results: A result of the additional culture of 12 and 24 hours and again immediately after the treatment for 15 minutes 0.5% of Alcaine$^{(R)}$, 0.5% of PPC, the 0.01% of BAC, cell viability was not increased in all groups (p<0.05). The cell viabilities were higher than in cells 3 hours post-treated with $10{\mu}M$ of EGCG and pre-treated PPC 0.5% (68.2%), compared to cells ($32.2{\pm}2.0%$) treated only with 0.5% of PPC. PPC 0.5% also induced apoptosis in the treated group was reduced by the addition of EGCG. Conclusions: It is considered that the EGCG has cell protective effects when it is added to PPC, a topical anesthesia, by improving cell viability and inhibiting apoptosis.

• The Korean Journal of Pharmacology
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• v.10 no.1 s.15
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• pp.55-59
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• 1974

Further elucidation of the mechanism of halothane's negative inotropic action has resulted from a study of the effect of various substrates on halothane-depressed rat atria. Approximately 6 mg% halothane was required to maintain a 50% depression of the contractility of rat atria suspended in a modified Krebs-Ringer bicarbonate glucose medium, pH 7.4, $30^{\circ}C$ for 2hr. Both lactate and acetate were found to restore partially the contractility of halothane-depressed atria. The maximally effective concentration of lactate was 5 mM; for acetate it was 2.5mM. Neither 5 nor 20 mM of additional glucose was effective in restoring the force of contraction of halothane-depressed atria. The results are consistent with the hypothesis that halothane exerts at least a part of its negative inotropic effect on rat atria by inhibiting either the uptake or utilization of glucose by the myocardium. The site of blockade must be prior to the conversion of pyruvate to acetyl CoA. In our previous report dealing with the mechanism of cardiac depressant action of inhalation anesthetic halothane, it has been demonstrated that: 1) approximately 6 mg/100 ml halothane is required to maintain 50% depression of the force of contraction of isolated rat atria in Krebs-Ringer bicarbonate glucose medium; 2) pyruvate partially restores the contractility of halothane-depressed atria, but has no effect on normal atria; the partial recovery of depressed atria by the addition of sodium pyruvate is due to the effect of the pyruvate ion itself, not to the sodium ion; 4) addition of pyruvate, to atria depressed with hypertonic medium, produced only further depression. From these findings we concluded that the cardiac depressant action of halothane on rat atria is a manifestation of inhibition of glucose uptake or utilization. The present studies were undertaken to observe the effect of other substrates on halothane-depressed atria in order to substantiate our conclusion. As with the case of pyruvate, lactate and acetate also partially restored the force of contraction of halothane-depressed atria. These data are consistent with the hypothesis that halothane inhibits glucose uptake or utilization in the glycolytic cycle of the myocardium.

• The Korean Journal of Physiology and Pharmacology
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• v.4 no.3
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• pp.243-251
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• 2000

In order to provide a basis for studying the molecular mechanism of pharmacological action of local anesthetics and to develop a fluorescence spectroscopic method which can detect the microviscosity of native and model membranes using intramolecular excimerization of 1,3-di(l-pyrenyl)propane (Py-3-Py), we examined the effect of lidocaine HCl on the microviscosity of model membranes of phosphatidylcholine fraction extracted from synaptosomal plasma membrane vesicles (SPMVPC). The excimer to monomer fluorescence intensity ratio (I'/I) of Py-3-Py in liquid paraffin was a simple linear function of $T/{\eta}.$ Based on this calibration curve, the microviscosity values of the direct probe environment in SPMVPC model membranes ranged from $234.97{\pm}48.85$ cP at $4^{\circ}C$ to %19.21{\pm}1.11$ cP at $45^{\circ}C.$ At $37^{\circ}C,$ a value of $27.25{\pm}0.44$ cP was obtained. The lidocaine HCl decreased the microviscosity of SPMVPC model membranes in a concentration-dependent manner, with a significant decrease in microviscosity value by injecting the local anesthetic even at the concentration of 0.5 mM. These results indicate that the direct environment of Py-3-Py in the SPMVPC model membranes is significantly fluidized by the lidocaine HCl. Also, the present study explicitly shows that an interaction between local anesthetics and membrane lipids is of importance in the molecular mechanism of pharmacological action of lidocaine HCl.

• Journal of Chest Surgery
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• v.52 no.6
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• pp.392-399
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• 2019

Background: The surgical strategies for carotid endarterectomy (CEA) vary in terms of the anesthesia method, neurological monitoring, shunt usage, and closure technique, and no gold-standard procedure has been established yet. We aimed to analyze the feasibility and benefits of CEA under regional anesthesia (RA) and CEA under general anesthesia (GA). Methods: Between June 2012 and December 2017, 65 patients who had undergone CEA were enrolled, and their medical records were prospectively collected and retrospectively reviewed. A total of 35 patients underwent CEA under RA with cervical plexus block, whereas 30 patients underwent CEA under GA. In the RA group, a carotid shunt was selectively used for patients who exhibited negative results on the awake test. In contrast, such a shunt was used for all patients in the GA group. Results: There were no cases of postoperative stroke, cardiovascular events, or mortality. Nerve injuries were noted in 4 patients (3 in the RA group and 1 in the GA group), but they fully recovered prior to discharge. Operative time and clamp time were shorter in the RA group than in the GA group (119.29±27.71 min vs. 161.43±20.79 min, p<0.001; 30.57±6.80 min vs. 51.77±13.38 min, p<0.001, respectively). The hospital stay was shorter in the RA group than in the GA group (14.6±5.05 days vs. 18.97±8.92 days, p=0.022). None of the patients experienced a stroke or restenosis during the 27.23±20.3-month follow-up period. Conclusion: RA with a reliable awake test reduces shunt use and decreases the clamp and operative times of CEA, eventually resulting in a reduced length of hospital stay.

• The Korean Journal of Malacology
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• v.19 no.1
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• pp.71-79
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• 2003

After the juvenile octopus individuals being discharged, it is hard to separately capture them because they attach strongly to the wall of the aquarium by the suckers on the arms. Therefore, anaesthetics (MS-222 or lidocaine-HCl) are usually used for capture from attachment. The anaesthetized time of the octopus by lidocaine-HCl was more faster 1.6 to 4.5 times under 200 ppm and 6.0 to 6.5 times in 300 to 500 ppm than those in MS-222. In the anaesthetized and recovery rates (%) by the exposed time, the juvenile octopuses were anesthetized by lower concentrations of lidocaine-HCl within the short time, and rapidly recovered from anesthesia. In the secondary anesthesia of the juvenile octopuses exposed with lidocaine-HCl by the elapsed time after the primary anesthesia, the anesthetized time was later in case of lower concentrations and long elapsed times, However, the anesthetized time was faster when their concentrations were higher and the elapsed time after anesthesia were shorter. Recovery from the secondary anesthesia was faster when the elapsed time was long in lower concentration, and was later when the elapsed time was shorter. In case of Octopus ocellatus, anaesthetic effects by lidocaine-HCl concentrations were better than those of MS-222. Doses of lidocaine-HCl and critical time for works at the indoor laboratory were proper in concentration of 100 ppm within 15 min.