• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.5
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• pp.369-376
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• 2022

Background: Nonobstetric surgery is sometimes required during pregnancy, and neck abscess or facial bone fracture surgery cannot be postponed in pregnant women. However, dental surgery can be stressful and can cause inflammation, and the inflammatory response is a well-known major cause of preterm labor. Propofol is an intravenous anesthetic commonly used for general anesthesia and sedation. Studies investigating the effect of propofol on human amnion are rare. The current study investigated the effects of propofol on lipopolysaccharide (LPS)-induced inflammatory responses in human amnion-derived WISH cells. Methods: WISH cells were exposed to LPS for 24 h and co-treated with various concentrations of propofol (0.01-1 ㎍/ml). Cell viability was measured using the MTT assay. Nitric oxide (NO) production was analyzed using a microassay based on the Griess reaction. The protein expression of cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE 2), p38, and phospho-p38 was analyzed using western blotting. Results: Propofol did not affect the viability and NO production of WISH cells. Co-treatment with LPS and propofol reduced COX-2 and PGE₂ protein expression and inhibited p38 phosphorylation in WISH cells. Conclusion: Propofol does not affect the viability of WISH cells and inhibits LPS-induced expression of inflammatory factors. The inhibitory effect of propofol on inflammatory factor expression is likely mediated by the inhibition of p38 activation.

• Annals of Clinical Neurophysiology
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• v.23 no.2
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• pp.108-116
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• 2021

Background: Nitrous oxide (N₂O) is used in surgery and dentistry for its anesthetic and analgesic effects. However, neurological and psychiatric manifestations of N₂O abuse have been increasingly reported among Korean adults. The aim of this study was to demonstrate laboratory findings of N₂O abuse in Korean patients. Methods: Patients diagnosed with N₂O-induced neuropathy or myelopathy from August 2018 to December 2019 were enrolled. Their clinical presentations and laboratory and imaging findings were analyzed. Results: Sensory changes and limb weakness were present in nine of the enrolled patients. The laboratory findings revealed that seven patients had high homocysteine levels and five had high methylmalonic acid levels in their blood. Nerve conductions studies indicated that axonal neuropathy was present in four cases and longer F-wave and Hoffman's-reflex latencies were present in two cases. Signal changes in cervical spine imaging occurred in five patients, while two had normal results. Conclusions: Chronic N₂O abuse can cause neurological damage or psychiatric problems. Because N₂O is illegal for recreational use in Korea, patients tend to hide their history of use. Even though the spinal imaging results were normal, clinicians should consider the possibility of N₂O use, and further electrophysiological tests should be applied for precise evaluations.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.4
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• pp.285-295
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• 2024

Background: In human dentition, the most commonly impacted teeth are the mandibular third molars (M3M). The removal or extraction of these teeth often causes anxiety in patients due to the perceived pain involved in the process. Therefore, pain must be effectively managed using anesthesia. The use of newer local anesthetic drugs can help minimize side effects and drug interactions. Traditionally, adrenaline is used as a vasoconstrictor along with lignocaine. When combined with lignocaine, the alpha agonists dexmedetomidine and clonidine can extend the duration of anesthesia, thereby reducing the need for additional pain-relieving medications. Methods: This study used a randomized, triple-blind, parallel-arm design. Sixty patients were screened, and 45 systemically healthy patients requiring unilateral surgical removal of impacted mandibular third molars with similar difficulty (moderate-to-difficult according to the Modified Pederson's Index) were included in the study. Patients were allocated into three groups as follows: Group A: 2% Lignocaine Hydrochloride with 1:100,000 Adrenaline, Group C: 2% Lignocaine Hydrochloride with 15 ㎍/mL Clonidine, and Group D: 2% Lignocaine Hydrochloride with 1 ㎍/mL Dexmedetomidine. The evaluated parameters were the time of onset of anesthesia, depth of anesthesia, hemodynamic parameters, and duration of postoperative analgesia. Results: Group D had a faster onset of action and prolonged duration of postoperative analgesia compared with Groups A and C. No statistically significant differences were observed between the three groups in terms of the depth of anesthesia and hemodynamic parameters. Conclusion: Group D exhibited a significantly more rapid onset of anesthesia than Groups A and C, and the postoperative analgesic effect in Group D was significantly prolonged (7.22 hours) compared with that in Groups A (4.54 hours) and C (2.1 hours). Patients receiving the Group D solution experienced an extended period of comfort without the need for analgesics for up to 7.22 hours post-procedure.

• Journal of Yeungnam Medical Science
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• v.1 no.1
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• pp.95-100
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• 1984

In the beginning of anesthetic training, one of the clinical practices that anesthetists have to learn is manually controlled ventilatory techniques. The popularity of manually controlled ventilatory techniques has been gradually decreased with increased use for anesthetic ventilators. However it is important and basic for the anesthetists to master manually controlled ventilatory techniques skillfully. Recently, we analyzed the arterial blood gas in 30 cases before and during general anesthesia, and studied the effects of the manually controlled ventilation on the pulmonary gas exchange. The results were as follow; 1) Mean value of $PaCO_2$ during the manually controlled ventilation, $29.9{\pm}2.9mmHg$ was decreased statistically comparing with that of $PaCO_2$ before the anesthesia, $39.8{\pm}2.8mmHg$. 2) Mean values of pH and ${HCO_3}^-$ during the manually controlled ventilation were $7.48{\pm}0.03$, $22.2{\pm}2.4mEq/l$, respectively and values before the anesthesia were $7.41{\pm}0.02$, $25.2{\pm}1.8mEq/l$, respectively. 3) Mean values of $PaO_2$ and $O_2$ saturation during the manually controlled ventilation were $270.0{\pm}28.8mmHg$, $99.6{\pm}0.2%$, respectively and values before the anesthesia were $92.5{\pm}4.0mmHg$, $96.9{\pm}1.0%$ respectively. These results indicates that manually controlled ventilation at our department of anesthesiology produced mild hyperventilatory state. However these were no significant changes in cerebral blood flow and other biochemical parameters.

• Journal of Veterinary Clinics
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• v.27 no.6
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• pp.668-673
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• 2010

This study was to evaluate the effects of tramadol and medetomidine administration on minimum alveolar concentration (MAC) of isoflurane in dogs. MAC of isoflurane was determined in four occasions; 1 ml saline (Control), $2{\mu}g$/kg medetomidine (M2), 4 mg/kg tramadol (T4), $2{\mu}g$/kg medetomidine-4 mg/kg tramadol combination (M2T4). Heart rate, blood pressure, respiratory rate, end-tidal carbon dioxide concentration, saturation of hemoglobin with oxygen and body temperature were recorded. After administration of M2 ($0.81{\times}0.18%$), T4 ($0.81{\times}0.14%$) and M2T4 ($0.62{\times}0.12%$), less isoflurane was required than the control value ($1.13{\times}0.19%$). Significantly lower heart rate than the control value was detected after treatment of M2, T4, and M2T4. When only M2T4 was administered, blood pressure was significantly higher than the control value. In conclusion, administrations of tramadol, medetomidine and medetomidine-tramadol combination decreased the MAC of isoflurane in dogs. Especially, medetomidine-tramadol combinations could be useful as a premedication because of the anesthetic sparing effect and moderate changes in cardiovascular system.

• 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.

• 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.

• Korean Journal of Veterinary Research
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• v.47 no.1
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• pp.103-115
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• 2007

The aim of this study was to compare the reaction of the cardiovascular system, and the anesthetic effect among 3 experimental groups, epidural administration of medetomidine as a single agent, the combination of buprenorphine and medetomidine, and the combination of fentanyl and medetomidine. Twenty one dogs were anesthetized with isoflurane and allowed to breathe spontaneously. Epidural, arterial, and venous catheters were inserted. The tip of epidural catheter was positioned at the level of the space between the sixth and seventh lumbar vertebra. After a stable plane of anesthesia was achieved, these dogs were each administered one of the following treatments epidurally : medetomidine $10{\mu}g/kg$ (Group M), a combination of medetomidine $5{\mu}g/kg$ and buprenorphine $10{\mu}g/kg$ (Group M/B), and a combination of medetomidine $5{\mu}g/kg$ and fentanyl $10{\mu}g/kg$ (Group M/F). Heart rate (HR), Respiratory rate (RR), End-tidal carbon dioxide (EtCO2), and arterial blood pressure were measured before drug administration (base line) and 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, and 60 min postinjection. Blood gas analysis was performed before injection and 5, 15, 25, 35, 45, 60 min postinjection. Isoflurane was discontinued 80 min postinjection and pain/motor function were evaluated up to 260 min postinjection every 15 min. At the early stage of drug introduction (until 5 min), the HR was decreased significantly in all 3 groups compared with base line. In Group M, HR was significantly decreased compared with the other 2 groups. With time (starting 20 min after drug introduction), the HR was decreased significantly in Group M/B in respect to base line. However, no significant difference was seen number-wise in all 3 groups. During 60 min after drug introduction, the systolic, diastolic and mean arterial pressures were highest in Group M and lowest in Group M/F. Among 3 groups, drug action and motor loss duration were longest in Group M/F. Analgesic effect observed in the M/F group was the most prominent and long-lasting, compared to those seen in the other 2 groups. Given the fact that the recovery of motor function takes place in a short period of time after analgesic effects disappeared, additional use of M/F depending on the patient's condition would be a good way to achieve effective pain management. However, proper care should be taken to ensure the function of cardiovascular system in the patient because the administration of M/F under isoflurane anesthesia results in a significant decline in arterial blood pressure ($65{\pm}10mmHg$).

• Korean Journal of Veterinary Research
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• v.39 no.1
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• pp.77-84
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• 1999

Anesthetic agents are useful in inducing the anesthesia for surgical operations and various biological experiments, but they can disturb the body homeostasis and cause the stress in animals. Much efforts have been directed on reducing such side effects of anesthesia. In this work, we measured the serum ACTH, corticosterone and glucose concentration in rabbits to compare the degree of stress induced by two commonly-used anesthetics, ketamine, xylazine, and the combination of xylazine and ketamine. 1. The anesthesia was induced in about 10 min in the rabbits treated with xyalzine, ketamine and xylazine-ketamine. The duration of complete loss of righting reflex were 12, 13 and 115 min in the groups treated with xylazine, ketamine and xylazine-ketamine, respectively. 2. Serum ACTH concentrations in all treatment groups were higher than those in control group. At 30 min after the administration of the drugs, serum ACTH levels in ketamine-treated group were significantly higher than those in control, xylazine- and xylazine-ketamine-treated groups. However, at 1, 2, 5 and 9 hours after the drug administration, serum ACTH levels in xylazine-treated-group were higher than those in control. 3. Serum corticosterone levels in xylazine- and xylazine-ketamine-treated groups were lower than those in control or ketamine-treated groups at 0.5 and 1 hour after the administration. However, at 5 and 9 hours after the administration, serum corticosterone levels in xylazine- and xylazine-ketamine-treated groups were significantly higher than those in ketamine-treated group or control. 4. Serum glucose levels transiently increased to 3 times of the pre-injection levels at 0.5 and 1 hours after the administration in xylazine or xylazine-ketamine-treated groin, but were not changed in control and ketamine-treated group. These results indicate that xylazine-induced stress lasts longer than ketamine-induced, suggesting that the difference in stress-related hormone levels during anesthesia could be due to the differences in modes of actions of individual drugs used and the depth of anesthesia.

• Journal of Veterinary Clinics
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• v.19 no.3
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• pp.283-289
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• 2002

The effects of electroacupuncture (EA) at SP-6 with different durations on the minimum alveolar concentration (MAC) and on the cardiovascular system were evaluated in dogs under isoflurane anesthesia. Eight healthy male beagles were randomly assigned to four study groups (n = 5/group) with washout period of 7 days for recovery and anesthetic withdrawal between experiments. Four study groups were control, nonacupoint electrical stimulation (NA), EA for 30 minutes (SP-6) and continuous EA for 70 or 90 minutes (SP-6C). For the nonacupoint electrical stimulation group, needles were inserted into the nonacupoint at the muscle bellies of left triceps brachii and right quadriceps femoris. MAC and cardiovascular parameters were determined after EA at SP-6 acupoint and at nonacupoint. Thirty minutes of EA and continuous EA until re-determination of MAC at SP-6 acupoint lowered the MAC of isoflurane by 21.3$\pm$8.0% and 16.1$\pm$4.6%, respectively (p<0.05). The decrements in MAC values were not significantly different between two EA groups. However, electrical stimulation of nonacupoint did not induce a significant change in MAC. In SP-6 and SP-6C groups, significant changes in cardiovascular parameters were not observed. These results indicate that EA at SP-6 have an advantage in isoflurane anesthesia in terms of reducing the requirement for anesthetics and minimizing cardiovascular side effects. EA for 30 minutes at maximum might be the sufficient time to produce acupuncture analgesia.