• Journal of Chest Surgery
• /
• 제55권4호
• /
• pp.293-300
• /
• 2022

Lung transplantation is the only treatment option for patients with end-stage lung disease. Although more than 4,000 lung transplants are performed every year worldwide, the standardized protocols contain no guidelines for monitoring during lung transplantation. Specific anesthetic concerns are associated with lung transplantation, especially during critical periods, including anesthesia induction, the initiation of positive pressure ventilation, the establishment and maintenance of one-lung ventilation, pulmonary artery clamping, pulmonary artery unclamping, and reperfusion of the transplanted lung. Anesthetic management according to the special risks associated with a patient's existing lung disease and surgical stage is the most important factor. Successful anesthesia in lung transplantation can improve hemodynamic stability, oxygenation, ventilation, and outcomes. Therefore, anesthesiologists must have expertise in transesophageal echocardiography, extracorporeal life support, and cardiopulmonary anesthesia and understand the pathophysiology of end-stage lung disease and the drugs administered. In addition, communication among anesthesiologists, surgeons, and perfusionists during surgery is important to achieve optimal patient results.

• 대한수의학회지
• /
• 제56권3호
• /
• pp.133-137
• /
• 2016

Changes in the cardiovascular and bispectral index score were evaluated in dogs subjected to constant rate infusion (CRI) with alfaxalone. Fifteen dogs were assigned to three groups of 5. Groups and doses of alfaxalone were as follows: group 1, 3 mg/kg for induction and 6 mg/kg/h for CRI; group 2, 3 mg/kg for induction and 8 mg/kg/h for CRI; and group 3, 3 mg/kg for induction and 10 mg/kg/h for CRI. CRI was maintained for 1 h. Respiratory rates and blood pressures showed minimal changes; however, mild tachycardia and mild hypoxemia occurred, especially in group 3. There were some disparities between bispectral index score, electromyography and pedal withdrawal reflex test when measuring anesthetic depth. Additional premedications and/or analgesic agents would be helpful to avoid adverse effects of alfaxalone and provide improved cardiopulmonary functions.

• 한국발생생물학회지:발생과생식
• /
• 제20권3호
• /
• pp.255-266
• /
• 2016

The optimum concentrations of clove oil as an anesthetic for olive flounder (Paralichthys olivaceus) and the stress response of the fish to clove oil anesthesia were determined over a range of water temperatures, and investigated in a simulated transport experiment using analysis of various water and physiological parameters. While the time for induction of anesthesia decreased significantly as both the concentration of clove oil and water temperature increased, the recovery time increased significantly (P<0.05). The plasma cortisol concentration in fish at each temperature increased significantly up to 12 h following exposure (P<0.05), then decreased to 48 h (P<0.05). The DO dissolved oxygen concentrations, pH values, and the fish respiratory frequencies decreased over 6 h following exposure to clove oil in all experimental groups (P<0.05), whereas the $NH_4{^+}$ and $CO_2$ concentrations in all experimental groups increased up to 6 h (P<0.05). The pH values and DO concentrations increased with increasing clove oil concentration (P<0.05) in the 6 h following exposure, and the $CO_2$ and $NH_4{^+}$ concentrations and the respiratory frequencies decreased with increasing clove oil concentration (P<0.05). The results of this experiment suggest that clove oil reduced the metabolic activity of olive flounder, thus reducing $NH_4{^+}$ excretion and $O_2$ consumption. In conclusion, clove oil appears to be a cost-effective and efficient anesthetic that is safe for use and non-toxic to the fish and users. Its use provides the potential for improved transportation of olive flounder.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제18권4호
• /
• pp.235-244
• /
• 2018

Background: Patients with intellectual disability (ID) often require general anesthesia during oral procedures. Anesthetic depth monitoring in these patients can be difficult due to their already altered mental state prior to anesthesia. In this study, the utility of electroencephalographic indexes to reflect anesthetic depth was evaluated in pediatric patients with ID. Methods: Seventeen patients (mean age, $9.6{\pm}2.9years$) scheduled for dental procedures were enrolled in this study. After anesthesia induction with propofol or sevoflurane, a bilateral sensor was placed on the patient's forehead and the bispectral index (BIS) was recorded. Anesthesia was maintained with sevoflurane, which was adjusted according to the clinical signs by an anesthesiologist blinded to the BIS value. The index performance was accessed by correlation (with the end-tidal sevoflurane [EtSevo] concentration) and prediction probability (with a clinical scale of anesthesia). The asymmetry of the electroencephalogram between the left and right sides was also analyzed. Results: The BIS had good correlation and prediction probabilities (above 0.5) in the majority of patients; however, BIS was not correlated with EtSevo or the clinical scale of anesthesia in patients with Lennox-Gastaut, West syndrome, cerebral palsy, and epilepsy. BIS showed better correlations than SEF95 and TP. No significant differences were observed between the left- and right-side indexes. Conclusion: BIS may be able to reflect sevoflurane anesthetic depth in patients with some types of ID; however, more research is required to better define the neurological conditions and/or degrees of disability that may allow anesthesiologists to use the BIS.

• Restorative Dentistry and Endodontics
• /
• 제22권1호
• /
• pp.278-290
• /
• 1997

The purposes of this study were to evaluate and compare the pulpal anesthesia induced by an inferior alveolar nerve block and that by Gow-Gates technique, and to investigate the relationship between pulpal anesthesia and intraoral soft tissue responses. After one side of mandibule was anesthetized with inferior alveolar nerve block or Gow-Gates technique using 2 % lidocaine with 1 : 100,000 epinephrine in 19 volunteers of ages between 24 and 29 (16 males and 3 females, average age 25.9 yrs.), electric pulp tests were done on the canine teeth of the anesthetized side and contralateral one before, at 1 min, continued at every 5 minutes until 60 min, and every 10 minutes until 100 min after completion of local anesthetic injection. Degree of pulpal anesthesia was classified as anesthetic failure, possible anesthesia and complete anesthesia by the criteria based on the thresholds to electric pulp test of contralateral canine and the currents of the electric pulp tester. Subjective signs on the lower lip and tongue were checked and prick-pin tests were done on the buccal gingiva of the first molar, buccal and lingual gingiva of the canine tooth at 5, 10 and 20 min after the completion of anesthetic injection. Thresholds to electric pulp test, degree of pulpal anesthesia and relationship between the pulpal anesthesia and soft tissue responses were analyzed with SPSS, paired t-test, Wilcoxon matched-pairs signed-ranks test and correlation analysis. The results were as follows : No significant differences were found in the peak thresholds to electric pulp test, in the induction time to it and in the depth of pulpal anesthesia between inferior alveolar nerve block and Gow-Gates technique (p>0.05). There was no significant relationship between pulpal anesthesia and soft tissue responses in both inferior nerve block and Gow-Gates technique.

• 대한치과마취과학회지
• /
• 제11권1호
• /
• pp.22-26
• /
• 2011

Background: There is controversy regarding the relative perioperative benefits of desflurane when used for induction of anesthesia. Inhalation induction with desflurane alone causes adverse airway events, such as coughing, bronchospasm, laryngospasm, and copious secretion of varying severity. The aim of this study was to determine whether desflurane minimize cardiovascular activation during induction. Methods: Sixty ASA I and II patients were randomized to receive 1 MAC or 1.5 MAC of desflurane during manual vernilation or not. Patients received propofol (2 mg/kg) to induce loss of consciousness (LOC). Rocuronium (0.8 mg/kg) was given at LOC and the trachea was intubated after 90 seconds of manual breathing support with or without inhaled anesthetics. Vital signs and adverse airway events were recorded until 10 minutes post-intubation. Results: A significant increase in blood pressure and heart rate were seen in no desflurane group. The stable vital signs were seen in desflurane groups. The adverse airway events were increased in 1.5 MAC group but 1 MAC group. Conclusions: Desflurane was able to be stable blood pressure and heart rate at 1 MAC but adverse airway events were increased at 1.5 MAC of desflurane.

• 한국임상수의학회지
• /
• 제27권4호
• /
• pp.330-335
• /
• 2010

이 연구의 목적은 돼지에 있어서 zoletil/midazolam (TZM)과 zoletil/xylazine (TZX)의 2가지 병용마취를 사용하였을 때의 마취효과와 심혈관계 및 호흡에 미치는 영향을 비교하기 위하여 실시하였다. 총 8 마리의 Landrace $\times$ Yorkshire 교잡종 돼지 ($25.3{\pm}3.3\;kg$)를 사용하였으며, 각 군마다 4 마리씩 2개 군으로 실험을 실시하였다. 첫 번째 군은 xylazine과 tiletamine/zolazepam을 2 mg/kg 용량으로 근육 내 주사하였고(TZX군), 2번째 군은 midazolam 0.5 mg/kg의 용량을 정맥 내 주사 하고 tiletamine/zolazepam 2 mg/kg 용량으로 근육 내 주사하였다(TZM군). 마취시간에 대한 평가로 induction time, anesthesia time과 standing time을 각 돼지마다 측정하였으며, 마취효과에 대한 평가로 진정, 진통, 근 이완, 자세 그리고 청각반응을 점수화 하여 매 15분마다 측정하였다. 심폐기능에 대한 평가로 심박동수와 동맥혈압, 호흡수, 직장체온을 마취 전, 마취직후, 마취 후 5분, 15분, 30분, 45분 및 60분에 각각 측정하였고, 동맥혈 가스 분석을 동일시간대에 실시하였다. 실험 결과 모든 돼지에서의 마취는 성공적이었다. 2가지 병용마취 모두 부드러운 마취 유도와 적절한 운동억제 효과를 보였으나 마취효과점수에서는 TZM군이 TZX군보다 우수하였으며, TZM군이 TZX군 보다 심폐기능 및 체온에 미치는 영향이 적으며 안정적인 것을 확인하였다. 결론적으로, TZM군은 TZX군에 비하여 더욱 양호한 마취효과를 보였으며, 심폐기능에 미치는 영향은 보다 적게 나타내었다.

• 한국동물위생학회지
• /
• 제39권2호
• /
• pp.93-99
• /
• 2016

The anesthetic depth and cardiovascular effect of alfaxalone constant rate infusion in dogs premedicated with xylazine or acepromazine were evaluated. Ten dogs were randomly allocated into 2 groups. In group AA, dogs were premedicated with 0.02 mg/kg of intravenous acepromazine at 15 min before induction. In group XA 1.1 mg/kg of intravenous xylazine was premedicated at 5 min before induction. The anesthesia was maintained with 6 mg/kg/hr of alfaxalone after induction with 2 mg/kg alfaxalone in both groups. In both of groups, the qualities of induction were satisfactory without any adverse event, but adequate analgesia could not be provided, according to the withdrawal test. $PaO_2$ and $SaO_2$ implied a slight hypoxemia state in XA group, while those values of group AA were not significantly changed. The acepromazine and alfaxalone combination induce mild tachycardia. The bispectral index score were significantly decreased in group XA, compared with that in group AA. The premedication of xylazine before alfaxalone constant rate infusion in this study could provide adequate analgesia during 30 min, while the premedication with acepromazine could not.

• 대한전자공학회:학술대회논문집
• /
• 대한전자공학회 2002년도 하계종합학술대회 논문집(5)
• /
• pp.289-292
• /
• 2002

In this study, we measure and analyzed variation of EEG signal by anesthesiologist progress step. In an experiment, the EEG signal was acquired and analyzed as 5 steps(prior surgical operation, during induction, surgical operation, awakening, posterior surgical operation). As a result, we confirm the anesthesiologist progress phase, concluded the possibility of anesthesia depth because using SEF and MF, and Delta ratio confirmed that can presume operating patient's consciousness state.

• 한국임상수의학회지
• /
• 제36권6호
• /
• pp.306-313
• /
• 2019

It is important to identify the most suitable anesthetic agent that has minimal side effects to be able to control and perform surgeries on bears. In this study, we examined and compared the induction and recovery times as well as the physiological changes occurring during anesthesia induced by medetomidine-zolazepam/tiletamine (MZT) and xylazine-zolazepam/tiletamine (XZT) at general anesthesia for laparoscopic salpingectomy in 326 female Asiatic black bears. The body temperature, heart rate, respiratory rate, and levels of PaO₂ and EtCO₂ were the physiological changes measured during surgical procedures in female bears after anesthesia. In addition, the levels of pO₂, pCO₂, and sO₂ were measured using a portable blood gas analyzer. To induce recovery from anesthesia, bears anesthetized with MZT were intravenously administered atipamezole and bears anesthetized with XZT were intravenously administered yohimbine. The combination MZT, at dosages of 0.019 ± 0.001 mg/kg for medetomidine and 1.4 ± 0.1 mg/kg for ZT, or the combination XZT, at dosages of 2.0 ± 0.1 mg/kg for xylazine and 3.0 ± 0.1 mg/kg for ZT, proved to be reliable and effective in anesthetizing Asiatic black bears for a 40-min handling period for routine clinical procedures. The average anesthesia induction times were 16.5 ± 0.95 min for the bears in the MZT group and 12.0 ± 0.44 min for those in the XZT group. A significant difference was noted between the two drugs (P < 0.001) in terms of the average anesthesia induction time. The anesthesia induction time was shorter for bears with lower body weights than those with higher body weights (P < 0.05). The recovery time of MZT was significantly faster than that of XZT (11.3 ± 0.45 min vs. 18.5 ± 0.83 min) (P < .001). The bears anesthetized with MZT exhibited lower cardiopulmonary suppression than those anesthetized with XZT (P < 0.05). The body temperatures and EtCO₂ of bears in the M ZT group were significantly lower than those in the XZT group as time progressed after anesthesia (P < 0.05). The average pO₂ before the bears were supplied with oxygen was 64.8 ± 3.7 mmHg, but it increased to 211.5 ± 42.5 mmHg afterwards (P < 0.001). In conclusion, our results indicate that bears anesthetized with MZT have longer anesthesia induction time, shorter recovery time, slower heart and respiratory rates, and lower body temperatures and EtCO₂ than those anesthetized with XZT. These findings suggest that XZT is preferable to MZT, warranting further research on its uses and clinical responses in bears.