Park, Chan Yoon;Park, Sol Hee;Lim, Dong Gun;Choi, Eun Kyung
Journal of Yeungnam Medical Science
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v.35
no.1
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pp.40-44
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2018
Background: Pregabalin has been studied as a single or multimodal analgesic drug for postoperative pain management in different types of surgeries. We evaluated the analgesic effect of 150 mg of pregabalin in resolving post-gastrectomy pain. Methods: Forty-four patients were randomized into two groups: a pregabalin group that received oral pregabalin (150 mg) 2 h before anesthetic induction, and a control group that received placebo tablets at the same time. Data on postoperative pain intensity (visual analog scale [VAS], at 30 min, 2 h, 4 h, and 24 h), consumption of fentanyl in patient-controlled analgesia (PCA), and the proportion of patients requiring rescue analgesics at different time intervals (0-2 h, 2-4 h, and 4-24 h) were collected during the 24 h postoperative period. Results: The VAS scores did not show significant differences at any time point and consumption of fentanyl in PCA and the proportion of patients requiring rescue analgesics did not differ between the two groups. The groups did not differ in the occurrence of dizziness, sedation, and dry mouth. Conclusion: A preoperative 150 mg dose of pregabalin exerts no effect on acute pain after gastrectomy.
Chronic postoperative inguinal pain (CPIP) is a major complication after inguinal herniorrhaphy. We report the treatment of CPIP using ultrasonography-combined with nerve stimulator for injection of the genitofemoral nerve (GFN). A 59-year-old man underwent laparoscopic herniorrhaphy and presented with numbness from the inguinal region to the scrotum after operation. In the pain clinic, ultrasonography-guided GFN block and pharmacological treatments had little effect. Six month after operation, patient was referred to the Department of Physical Medicine and Rehabilitation, and ultrasonography-combined with nerve stimulator for GFN injection underwent to enhance the accuracy of neural approach. The induction of scrotal contraction and paresthesia on the GFN distribution was monitored by nerve stimulator and local anesthetic was injected. After the block, pain relief lasted for 6 months without analgesic use. Ultrasonography-combined with nerve stimulator is an effective approach to treat CPIP as it enhances precise localization and injection of small peripheral nerve like GFN.
There are many intramuscularly injectable drugs commonly used for anesthesia in dogs and combination of drugs were used for decrease the side effects. The objective of this study was to evaluate the anesthetic and cardiopulmonary effects of butorphanol-tiletamine-zolazepam-medetomidine and tramadol-tiletamine-zolazepam-medetomidine in dogs. Ten healthy beagle dogs (intact male; mean body weight : $9.5{\pm}1.60$ kg) were used in the study. Experimental animals were divided into two groups (n=5, each) and received 0.2 mg/kg of butorphanol (BZM) and 2 mg/kg of tramadol (TZM) according to the group after injection of $Zoletil^{(R)}$ (5 mg/kg) and medetomidine (10 ug/kg). All drugs were administered intramuscularly. Anesthesia and recovery, sedation and analgesia score, cardiovascular and respiratory parameters were measured. Induction and recovery time were not significantly different between the groups. Anesthesia time was $117.4{\pm}25.64$ minute and $81.2{\pm}12.50$ minute in BZM and TZM groups, respectively. Sedation and analgesia were satisfied in both groups. In both groups, common side effects related to the medetomidine, significant bradycardia and hypertension were not observed. There were no significant changes in respiratory data. In conclusion, tiletamine-zolazepam-medetomidine in combination with either butorphanol or tramadol can be suitable anesthetic protocol for minor procedures in dogs. They produced adequate anesthesia characterized by rapid induction, adequate analgesia and muscle relaxation without remarkable side effects.
This study was performed to examine the anesthetic and cardiopulmonary effects of medetomidine, midazolam and ketamine (MMK) combination in ten beagle dogs. Dogs were randomly allocated to two groups. Treatment group MMK-L received 0.015 mg/kg medetomidine followed by 0.3 mg/kg midazolam and 5 mg/kg ketamine by intramuscular injection. Treatment group MMK-H received 0.02 mg/kg medetomidine followed by 0.3 mg/kg midazolam and 5 mg/kg ketamine by intramuscular injection. Induction, anesthesia, sternal recumbency, standing, walking time, heart rate, arterial blood pressure, rectal temperature, respiratory rate and arterial blood gases were measured. Mean anesthesia time was significantly different between MMK-L group ($52.4{\pm}11.08$ minutes) and MMK-H group ($78.2{\pm}20.72$ minutes). Sedative scores and noxious stimuli were raised to the maximum value at 5 minutes after administration of the test dose and maintained until 40 minutes in both groups. In both groups, the heart rate significantly decreased after MMK administration. The blood pressures (MAP, SAP and DAP) increased after MMK administration but there were no significant differences in blood pressures between two groups. In conclusion, intramuscular administration of medetomidine followed by intramuscular injection of midazolam and ketamine in beagle dogs, leads immediate and sufficient anesthesia and proper doses of medetomidine for minimal adverse effects in intramuscular MMK combination will be 0.015 mg/kg in dogs.
This study was performed to evaluate anesthetic and cardiovascular effects of xylazine/fentanyl/azaperone and medetomidine/midazolam as preanesthetics and their combinations with antagonists in halothane-anesthetized dogs. Eight clinically healthy dogs($4.54{\pm}2.16kg$) were used at the interval of more than 14 days between experiments in turn for propionyl promazine(PP 0.3mg/kg, IM), xylazine/fentanyl/azaperone(XFA 2mg/kg, 0.0137mg/kg, 0.11mg/kg, IM), medetomidine/midazolam(MM 0.02mg/kg, 0.3mg/kg, IM), combination of XFA and their antagonists (yohimbine 0.05mg/kg, naloxon 0.0005mg/kg, IV) and combination of MM and their antagonist(atipamezole 0.08mg/kg IM). The sedation induction times in XFA($2.56{\pm}1.01min$) and MM($5.44{\pm}2.07min$) groups were significantly better than that of PP group($10.75{\pm}2.38min$)(p < 0.05). The thiopental sodium dose required for tracheal intubation in XFA($2.38{\pm}3.38mg/kg$) and MM($3.91{\pm}3.47mg/kg$) groups were significantly less than that of PP group($12.57{\pm}2.13mg/kg$)(p < 0.05). All time indices expressing the recovery(pedal reflex recurrence time, extubation time, arousal time, standing time and walking time) were significantly shorter in the combination groups of XFA or MM with their antagonists than in PP, XFA and MM groups(p < 0.05). The suppressions of cardiovascular function of XFA and MM were more than that of PP. Heart rate and cardiac output were recovered by the antagonists of XFA and MM, but mean arterial pressure were not recovered by the antagonists. PP induced apnea in 4 out of 8 dogs, but XFA in none and MM in one. The present study suggested that for rapid sedation, prevention of apnea after intubation and rapid recovery after halothane cessation, combinations of xylazine/fentanyl/azaperone or medetomidine/midazolam with their antagonists are recommendable as preanesthetic method in gas anesthetised dogs with normal cardiovascular function.
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.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.10
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pp.303-308
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2019
Non-traumatic acute myelopathy caused by cervical disc herniation is rare. To date, no case has been reported to be caused by extrusion cervical disc herniation, unrelated to patient posture during surgery. Here, we report the case of a 65-year-old male patient with cervical myelopathy who underwent subsequent arthroscopic rotator cuff surgery under general anesthesia; non-cervical spine surgery. Ed. Notes: I am unable to understand the insertion of the highlighted phrase. Please delete if not required, or revise the sentence appropriately. Patient showed acute postoperative tetraplegia in spite of optimal anesthetic management. He showed no limitation of neck movement at pre-operative airway evaluation, and had no history of trauma to the cervical spine. During surgery, there had been no overextension or twisting of the neck, including at the time of anesthetic induction by tracheal intubation. However, cervical disc herniation causing spinal canal cord compression was detected in the postoperative magnetic resonance imaging, which probably resulted in tetraplegia of the patient. Motor and sensory functions were recovered after 21 days of conservative treatment, including steroid pulse intravenous therapy without any surgical intervention. In this report, the disease is described after reviewing other reported cases; furthermore, we also discuss the pathophysiology of the disease. Based on our report, we propose that under general anesthesia, clinicians should pay attention to the possibility of pre-existing cervical disease, even in non-cervical spine surgeries of geriatric patients.
Journal of Practical Agriculture & Fisheries Research
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v.17
no.1
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pp.125-132
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2015
The report about equine anesthesias in Korea are very rare. This paper aimed at the mortality rate during anesthesia in Thoroughbred horses at Equine Hospital of Busan Race Park, KRA in South Korea from 2005 to 2010. Drugs used in anesthesia was IV injection of detomidine hydrochloride (0.01 mg/kg) or xylazine(0.5mg/kg) for sedation and premedication, Guaifenesin(50-100 mg/kg) for muscle relaxation, ketamine hydrochloride(2 mg/kg) for induction of anaesthesia and Inhalational isoflurane(1.3-1.5 %) to maintain anesthesia. Total number of anesthetic cases was 190, 150 of inhalational anesthesia and 40 of general anesthesia, repectively. The purpose of anesthesia was highest in the disorder of musculoskeletal system, followed by urogenital system and respiratory system Mortality case due to anesthesia was one during arthroscopic surgery for removal of osteochondral chip fragments. The time of anesthesia was 150 min, fatal sign was hypoxemia and the reason was improper machine operation of the anesthetist. In conclusion, the perianesthetic mortality rate during anesthesia in Thoroughbred horses at Busan Race Park was 0.52%(1 death per 190 anesthetics).
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.42
no.2
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pp.84-89
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2016
Objectives: To compare the efficacy of intravenous ondansetron (4 mg, 2 mL) and granisetron (2 mg, 2 mL) for preventing postoperative nausea and vomiting (PONV) in patients during oral and maxillofacial surgical procedures under general anesthesia. Materials and Methods: A prospective, randomized, and double blind clinical study was carried out with 60 patients undergoing oral and maxillofacial surgical procedures under general anesthesia. Patients were divided into two groups of 30 individuals each. Approximately two minutes before induction of general anesthesia, each patient received either 4 mg (2 mL) ondansetron or 2 mg (2 mL) granisetron intravenously in a double blind manner. Balanced anesthetic technique was used for all patients. Patients were assessed for episodes of nausea, retching, vomiting, and the need for rescue antiemetic at intervals of 0-2, 3, 6, 12, and 24 hours after surgery. Incidence of complete response and adverse effects were assessed at 24 hours postoperatively. Data was tabulated and subjected to statistical analysis using the chi-square test, unpaired t-test, or the Mann-Whitney U-test as appropriate. A P-value less than 0.05 was considered statistically significant. Results: There was no statistically significant difference between the two groups for incidence of PONV or the need for rescue antiemetic. Both study drugs were well tolerated with minimum adverse effects; the most common adverse effect was headache. The overall incidence of complete response in the granisetron group (86.7%) was significantly higher than the ondansetron group (60.0%). Conclusion: Granisetron at an intravenous dose of 2 mg was found to be safe, well tolerated, and more effective by increasing the incidence of complete response compared to 4 mg intravenous ondansetron when used for antiemetic prophylaxis in maxillofacial surgery patients receiving general anesthesia. Benefits of granisetron include high receptor specificity and high potency, which make it a valuable alternative to ondansetron.
A 9-years old spayed female Maltese was referred for the treatment of mass on the right 1st mammary gland and acute weight bearing lameness of right hindlimb. It was diagnosed as malignant mammary tumor and cranial cruciate ligament rupture of right stifle joint. Right upper regional mastectomy followed by cranial closing wedge osteotomy (CCWO) of the right tibia were planned for the present problems. Preanesthetic work-up did not show any remarkable abnormalities. Forty-five minutes after induction of anesthesia dobutamine was administered at a rate of 5 ㎍/kg/min by constant rate infusion due to gradual decrease of blood pressure below MAP 60 mmHg during surgical procedure. Despite of the increase of dobutamine infusion rate up to 20 ㎍/kg/min, blood pressure didn't recover. At the end of regional mastectomy generalized skin redness and eyelid edema were identified. Anesthesia was stopped and CCWO procedure was cancelled. To recover from the anaphylactic reactions dexamethasone and diphenhydramine were administered. After about one hour, the patient completely recovered from hypotension and anaphylactic reactions. After 4 weeks, intradermal skin test (IDST) was performed for all the drugs used during anesthesia. Only dobutamine showed positive reaction in IDST. Therefore, dobutamine was considered as the causative agent of anaphylaxis in this patient during the anesthesia. In case of perioperative anaphylactic reaction, postoperative investigation should be performed to identify causative agent and to provide safe recommendations for future anesthetic procedure.
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