• 제목/요약/키워드: Anesthetic effects

검색결과 220건 처리시간 0.031초

성형외과 영역의 수술 시 마취하 감시관리의 응용에 대한 고찰 (Consideration on Application of Modified Monitored Anesthetic Care in Plastic Surgery)

  • 조건;서인석;최영룡;정미화;탁경석;박영규;김재현;고응열;성하민
    • Archives of Plastic Surgery
    • /
    • 제38권1호
    • /
    • pp.7-14
    • /
    • 2011
  • Purpose: Many patients have fear for surgery owing to the injection of lidocaine and the possible pain in the course of the operation. To resolve such a problem the cases to do plastic surgery with monitored anesthetic care are increasing, in which something like sedatives is injected into vein without endotracheal intubation and under voluntary respiration, but the usage is now under the controversy. Methods: There were 25 patients who had surgery with local anesthesia, and another 25 patients who had surgery with monitored anesthetic care which belongs to ASA class 1 and 2 from January to April, 2009. Their anesthesia records were collected and surveys were given before and after the surgery and the surgery staff recorded OAA/S during the surgery. The postoperative surveys included the awakening during the surgery, pain, anxiety, and the degree of patient's satisfaction through visual analogue scale to identify the difference between the two methods. Results: The OAA/S results according to time lapse show that it is possible to lead a fast effective sedation and recovery with monitored anesthetic care, and monitored anesthetic care enhances both surgeon's convenience level and patient's satisfaction level, and reduces awakening, pain, and anxiety, compared to local anesthesia. Conclusion: The current paper shows about the plastic surgery, particularly the outpatient surgery, when monitored anesthetic care method is applied, it could gain a fast sedation and recovery or an effective sedation of patients. The method also has some affirmative effects in regard with surgeon's convenience and the patients' satisfaction degree and the reduction of their awakening, pain, and anxiety. With careful and adequate watch on the measures about vital signs like electrocardiogram, the degree of oxygen saturation, and blood pressure, it could clinically be very useful.

척추경막외 병용마취시 경막외강으로 주입된 생리식염수와 부피바카인의 감각차단 범위에 대한 효과 (Effects of Saline and Bupivacaine for Epidural Top-up on Sensory Blockade Level during Combined Spinal Epidural Anesthesia)

  • 김동연;한종인
    • The Korean Journal of Pain
    • /
    • 제13권1호
    • /
    • pp.84-88
    • /
    • 2000
  • Background: An increase in the maximum level of sensory blockade (MLSB) following an epidural top-up in combined spinal epidural anesthesia (CSE) may be achieved by a volume effect as the volume of local anesthetic compresses the dural sac, by a local anesthetic effect, or by a combination of both effects. This study was conducted to investigate the contribution of each of these effects. Methods: Sixty patients scheduled for lower limb surgery under CSE were randomly allocated to one of three groups of twenty patients each. Using the needle-through needle technique, all patients received a subarachnoid dose of 10 mg hyperbaric 0.5% bupivacaine. At 30 min after subarachnoid injection, an epidural top-up with saline 10 ml (group II) or 0.5% bupivacaine 10 ml (group III) was administered; patients in group I received no epidural top-up. The level of sensory blockade was assessed at 5, 10, 15, 20, 25, 30 min after subarachnoid injection and at 5, 10, 15, 20, 25, 30 min after epidural top-up. Results: There was no significant difference in the MLSB and the onset time of MLSB among group I-III. Conclusions: We concluded that the epidural top-up with saline 10 ml or 0.5% bupivacaine 10 ml which injected at 30 min after subarachnoid injection did not significantly increase the level of subarachnoid block in lower extremity surgical patients.

  • PDF

Comparison of the hemodynamic effects of propofol and ketamine as anesthetic induction agents during high-dose remifentanil administration: a single-center retrospective comparative study

  • Sanuki, Takuro;Mishima, Gaku;Kurata, Shinji;Watanabe, Toshihiro;Kiriishi, Kensuke;Tachi, Mizuki;Ozaki, Yu;Okayasu, Ichiro;Kawai, Mari;Matsushita, Yuki;Miura, Keiichiro;Ayuse, Takao
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • 제15권3호
    • /
    • pp.129-134
    • /
    • 2015
  • Background: We hypothesized that ketamine, when administered as the anesthetic induction agent, may prevent cardiovascular depression during high-dose remifentanil administration, unlike propofol. To test our hypothesis, we retrospectively compared the hemodynamic effects of ketamine, during high-dose remifentanil administration, with those of propofol. Methods: Thirty-eight patients who underwent oral surgery at the Nagasaki University Hospital between April 2014 and June 2015 were included in this study. Anesthesia was induced by the following procedure: First, high-dose remifentanil ($0.3-0.5{\mu}g/kg/min$) was administered 2-3 min before anesthesia induction;next, the anesthetic induction agent, either propofol (Group P) or ketamine (Group K), was administered. Mean arterial pressure (MAP) and the heart rate were recorded by the automated anesthesia recording system at four time points: immediately before the administration of high-dose remifentanil (T1);immediately before the administration of propofol or ketamine (T2);2.5 min (T3), and 5 min (T4) after the administration of the anesthetic induction agent. Results: In Group P, the MAP at T3 ($75.7{\pm}15.5mmHg$, P = 0.0015) and T4 ($68.3{\pm}12.5mmHg$, P < 0.001) were significantly lower than those at T1 ($94.0{\pm}12.4mmHg$). However, the MAP values in the K group were very similar (P = 0.133) at all time points. The heart rates in both Groups P (P = 0.254) and K (P = 0.859) remained unchanged over time. Conclusions: We showed that ketamine, when administered as the anesthetic induction agent during high-dose remifentanil administration, prevents cardiovascular depression.

마취제가 개의 Somatosensory Evoked Potentials (SEPs)에 미치는 영향 (Effects of Anesthetics on Somatosensory Evoked Potentials (SEPs) in Dogs)

  • Hong, Yeon-Jung;Jeong, Seong-Mok;Nam, Tchi-Chou
    • 한국임상수의학회지
    • /
    • 제19권3호
    • /
    • pp.277-282
    • /
    • 2002
  • 본 실험은 각각의 마취방법이 체성감각유발전위 (SEPs) 파형에 미치는 영향을 알아보고 SEP의 측정에 적절한 마취방법을 찾고자 시행하였다. 임상적으로 건강하고 크기와 나이가 비슷한 다섯 마리의 잡종견을 대상으로 SEPs를 측정하고 각각의 측정값을 분석하였다. SEPs측정을 위해 후 경골신경을 자극하였고 요추 5-6번 사이에서 channel 1의 LP1과 LN1, 흉추 11-12사이에서 channel 2의 TP1, TN1을 기록하였다. 실험에 사용한 마취방법 중. Acepromazine + Thiopental Na + Isoflurane, Acepromazine + Propofol + Isoflurane, Diazepam + Xylazine, Xylazine + Ketamine, Acepromazine + Propofol infusion, 및 Propofol infusion등의 방법만이 SEPs측정이 가능하였고, 파형은 명확하였으며, 측정에 요구되어지는 일정 시간인 25분 이상 동안 마취 유지가 가능하였다. 또한 각 마취군에서의 SEPs 파형을 Acepromazine + Thiopental Na + Isoflurane군과 비교해 보았을 때 latency의 경우, Acepromazine + Propofol + Isoflurane군의 ST(stimulating point)-LN1, SP-TP1, Diazepam + Xylazine 군의 Chl-Ch2, Xylazine + Ketamine군의 Chl-Ch2, Acepromazine + Propofol infusion군의 ST-LP1와 Chl-Ch2에서 부분적으로 유의적인 차가 있었다. Conduction velocity의 경우, Acepromazine + Propofol + Isoflurane군의 ST-LN1, Diazepam + Xylazine군의 Chl-Ch2, Xylazine + Ketamine군의 Chl-Ch2, Acepromazine + Propofol infusion군의 ST-LP1, 그리고 Propofol infusion군의 ST-LN1의 측정값에서 유의적인 차가 있었지만 전반적으로는 전체적인 파형의 유의적인 변화는 없었다. 이상의 결과를 토대로 SEPs 측정시 흡입마취로는 Acepromazine + Thiopental + Isoflurane과 Acepromazine + Propofol + Isoflurane, 주사마취로는 Diazepam + Xylazine과 Xylazine + Ketamine, 점적마취로는 Acepromazine + Propofol infusion과 Propofol infusion 방법이 사용 가능한 것으로 확인되었다.

개에서의 Tiletamine-Zolazepam 마취의 임상경험 (Clinical Use of Tiletamine-Zolazepam Anesthesia in Dogs)

  • 남치주;서강문;윤정희
    • 한국임상수의학회지
    • /
    • 제10권2호
    • /
    • pp.215-220
    • /
    • 1993
  • The anesthetic effects by dosages of Tiletamlne-Zolazepam in the dogs were investigated and then the optimal dosages for the operation of patients were suggested. 1. In groups of T+Z 20, 10 and 5 mg/kg administration, anesthetic periods are 180~300, 33~47 and 40~50 minutes, respectively and complete recovery from anesthesia was shorted with taking 53~72 minutes in the group of 5 mg/kg administration. 2. Reflex responses to eyelids, cornea and pharyngolarynx were maintained but pedal reflexes became considerably sluggish 3. It showed tachycardias on ECG but there were no specific dysrhythmias. On EEG, it showed low voltage-fast waves before anesthesia, high voltage-fast waves in induction stage, low voltage-slow waves in anesthetic stage and high voltage-fast waves again in recovery stage. 4. Surgical procedures could be performed satisfactorily in 6 cases of the 10 mg/kg administration group, but in 3 of 5 cases of 5 mg/kg administration group it could be completed after additional administration. 5. In conclusion, it was considered desirable for anesthetizing dogs that for healthy cases T+Z at the level of 10 mg/kg B.W. was administered, and for poor risk patients, 5 mg/kg B.W., followed by an additional administration in unsatisfied cases.

  • PDF

2-chloroprocaine에 의한 쥐좌골신경 차단시 발생한 급성내성에 대한 Dextromethorphan의 영향 (Effects of Dextromethorphan on the Development of Tachyphylaxis to Sciatic Nerve Blockade Induced by 2-Chloroprocaine in the Rat)

  • 박명수;이강창;김태요
    • The Korean Journal of Pain
    • /
    • 제9권1호
    • /
    • pp.39-45
    • /
    • 1996
  • Tachyphylaxis to local anesthetics has shown to be promote longer interanalgesic intervals between injections. Previous study demonstrated thermal hyperalgesia accelerates development of tachyphylaxis to sciatic nerve blockade in rats, while MK-801 prevents development of tachyphylaxis. Dextromethorphan is one of NMDA receptor antagonist similar to MK-801. A hypothesis that dextromethorphan would prevent the development of tachyphylaxis was tested in this study. A catheter was surgically implanted along the sciatic nerve a in rat. After recovery from surgery, the animal received repeated injections of 3% 2-chloroprocaine followed by motor block testing with or without hot-plate testing at $56^{\circ}C$. In other experiments, dextromethorphan was administrered by intraperiotneal injection prior to an injection of local anesthetic therough the implanted catheter. Sensory and motor testing was then carried out. Rats injected with 2-chloroprocaine and subjected to hot-plate testing, developed tachyphylaxis to motor and sensory blockade. However, animals pretreated with dextromethorphan did not develop tachyphylaxis over series of three injections. Dextromethorphan seems to prevent development of tachyphylaxis to sciatic nerve blockade in this rat model. Dextromethorphan, one of N-Methyl-D-aspartate receptor antagonist, can be applied to prolong the effect of local anesthetic.

  • PDF

우측 경련성 사경 수술적 치료 후 좌측에 발병한 경련성 사경 환자에서 시행된 국소마취제 신경차단술의 임상효과 - 증례보고 - (Positive Effects of Local Anesthetic Nerve Blocks for a Patient with Newly Developed Left Side Spasmodic Torticollis after Surgical Intervention of Right Side Spasmodic Torticollis - A case report -)

  • 최창훈;최진환;성춘호
    • The Korean Journal of Pain
    • /
    • 제20권2호
    • /
    • pp.246-250
    • /
    • 2007
  • We report here on a case of right side spasmodic torticollis (ST) that was refractory to botulinum toxin type A injection and medication. The patient finally underwent a selective ramisectomy with ipsilateral sternocleidomastoid muscle (SCM) resection, but the remaining symptoms slowly aggravated, and a contralateral left side SCM spasm began. As conservative therapy for reducing the spasmodic symptoms, accessory nerve block, upper cervical plexus block and stellate ganglion block were performed twice in a week. After 6 months, the spasmodic symptoms significantly decreased. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) decreased by more than 70%. After one year of serial intermittent local anesthetic blockade therapy, the patient became almost free from the original ST symptoms (TWSTRS = 1). Serial local anesthetic interventions for the ST patient may have a beneficial role on the pathological peripherocentral neural activity of the ST patient and can modulate motor-sensory integration in the patient.

생약(生藥) 복합제제(複合製劑)의 약효(藥效) 연구(硏究)(제25보)(第25報) -소음인소합원(小陰人蘇合元)이 항경련(抗痙攣), 진통(鎭痛), 해열(解熱), 진정(鎭靜), 적출장관(摘出腸管), 혈관(血管) 및 혈압(血壓)에 미치는 영향(影響)- (Studies on the Efficacy of Combined Preparation of Crude Drug (XXV) -Effects of Soeuminsowhapwon on Anticonvulsion, Analgesic, Antipyretic, Sedative, Isolated Ileum, Blood Vessels and Blood Pressure-)

  • 전진상;김남재;원도희;송일병;홍남두
    • 생약학회지
    • /
    • 제16권4호
    • /
    • pp.199-205
    • /
    • 1985
  • In order to investigate experimentally the clinical effects of Soeuminsohapwon that was prescribed to cure cerebral hemorrhage, palpitation etc, the author tested various activities of extract from the Soeuminsohapwhangwon by the method prescribed in the experimental part. The results of the studies were summarized as follows: Suppressive action was not shown on the convulsion induced by strychnine, but significant effect was noted on the convulsion induced by picrotoxin and caffeine. In acetic acid method, analgesic effect was noted. A prolongation of anesthetic time by pentobarbital sodium and antipyretic effect was observed. Relaxing action was noted on the ileum of mice, also same effect was recognized on contraction of the ileum due to acetylcholine, barium chloride and histamine. The expansion of blood vessels by relaxation of smooth muscle and hypotensive action were noted. According to the above results, effects based on oriental medical references were approximate to the actual experimental results.

  • PDF

Anesthetic Effect of Different Ratio of Ketamine and Propofol in Dogs

  • Lee, Mokhyeon;Kim, Sohee;Moon, Chawnghwan;Park, Jiyoung;Lee, Haebeom;Jeong, Seong Mok
    • 한국임상수의학회지
    • /
    • 제34권4호
    • /
    • pp.234-240
    • /
    • 2017
  • Use of ketamine and propofol combination (so-called Ketofol) anesthesiain a fixed ratio (1:1 mg/ml) was reported in dogs. The use of ketofol reduced cardiovascular suppression, but respiratory-related side effects was not significantly different from propofol alone. In this study, we evaluated the quality of ketofol anesthesia and changes in cardiopulmonary function according to the ratio of ketamine to propofol. The experimental groups were divided into three groups: propofol alone (P group), 3:7 ketofol group (PK1 group) and 1:1 ketofol group (PK2). For each group, the dose of 0.8 ml/kgwas administered intravenously at a constant rate until the tracheal intubation was possible and anesthesia was maintained with isoflurane for 120 minutes after induction of anesthesia. There was no significant difference in the anesthetic quality among three groups. Also, there was no difference in respiratory rate, tidal volume, end-tidal carbondioxide, and oxygen saturation. In group P, heart rate was not changed significantly during anesthesia, but arterial blood pressure decreased, while heart rate and arterial blood pressure increased significantly in group PK2. In the PK1 group, heart rate and arterial blood pressure during anesthesia remained similar to pre-anesthetic values. In conclusion, ketofol might be used as induction agent, and 3:7 ratioof ketofol showed more safe and effective anesthetic effect in dogs. Additionally, 1:1 ketofol may be used in patients with severe bradycardia orhypotension with close monitoring during anesthesia.