• Bulletin of the Korean Chemical Society
• /
• 제34권9호
• /
• pp.2707-2710
• /
• 2013

The present communication deals with development of ten novel N-Phenyl-3-Pyridin-2-yl imino derivatives as vascular smooth muscle relaxants. The derivatives were prepared and optimized using pocket modelling and pharmacophore modelling. The 4 hydroxy substituted derivatives are showed potent activity comparable to the sildenafil.

• 대한임상검사과학회지
• /
• 제52권4호
• /
• pp.317-326
• /
• 2020

마취는 의식의 차단 역할을 하는 주 마취제와 감각, 운동, 반사의 차단을 하는 부 마취제인 근이완제로 구분된다. 깊은 의식의 차단만으로는 심한 자극에 대한 반응을 막을 수 없고, 다량의 진통제만으로는 무의식을 보장할 수 없다. 그러므로 마취는 동시에 두 가지를 모두 만족시켜야 한다. 근 이완제는 흡입 또는 정맥마취제의 투여 용량을 감소시키면서 기관지내 삽입관, 수술 시야 및 수술적 환경(operating conditions)을 향상시킬 수 있으며, 수술 중 기계적 조절 환기(controlled mechanical ventilation) 시 호흡 관리를 위하여 매우 중요하다. 이러한 근이완제는 투여 용량이 과다하면 수술 중 신경 검사가 안 되는 영향을 줄 수 있고, 투여 용량이 부족하게 되면 환자가 수술 중 움직일 수 있어서 근 이완 마취 심도와 수술 중 감시 검사는 밀접한 관계가 있다. 근 이완제를 많이 사용하면, 수술 중 신경생리학적 검사가 원활하게 되지 않는 단점과 수술 이후에 완전히 근 이완효과를 제거하기 어렵다는 단점도 갖고 있다. 수술 중 감시 검사를 하는 수술에서 마취과에서는 어떠한 기준으로 근 이완제를 투여하며 유지하는지에 대하여 국내뿐만 아니라 전 세계적인 동향을 살펴 봄으로써 보다 원활한 수술 중 신경 검사가 되길 바란다.

• 대한치과마취과학회지
• /
• 제4권2호
• /
• pp.100-103
• /
• 2004

Spinal muscular atrophies are inherited neurodegenerative disorders affecting anterior hem cells. There are various problems, especially weakness of respiratory muscle and abnormal reaction to muscle relaxants during the general anesthesia. And gingival hyperplasia can make the proper airway management difficult. Experience with anesthetic management in a patient with spinal muscular atrophy combined with gingival hyperplasia has been very rare. We report the anesthetic experience of a wheel-chair-bound child, who underwent gingivectomy under general anesthesia. The child was safely managed with fibroscopic nasotracheal intubation under sevoflurane without muscle relaxants. Also, there was no deterioration of her underlying neurologic conditions.

• The Korean Journal of Physiology and Pharmacology
• /
• 제18권6호
• /
• pp.461-467
• /
• 2014

The hypothesis of this study was that diabetes-induced desensitization of rat soleus (SOL) and extensor digitorum longus (EDL) to non-depolarizing muscle relaxants (NDMRs) depends on the stage of diabetes and on the kind of NDMRs. We tested the different magnitude of resistance to vecuronium, cisatracurium, and rocuronium at different stages of streptozotocin (STZ)-induced diabetes by the EDL sciatic nerve-muscle preparations, and the SOL sciatic nerve-muscle preparations from rats after 4 and 16 weeks of STZ treatment. The concentration-twitch tension curves were significantly shifted from those of the control group to the right in the diabetic groups. Concentration giving 50% of maximal inhibition ($IC_{50}$) was larger in the diabetic groups for all the NDMRs. For rocuronium and cisatracurium in both SOL and EDL, $IC_{50}$ was significantly larger in diabetic 16 weeks group than those in the diabetic 4 weeks group. For SOL/EDL, the $IC_{50}$ ratios were significantly largest in the diabetic 16 weeks group, second largest in the diabetic 4 weeks group, and smallest for the control group. Diabetes-induced desensitization to NDMRs depended on the stage of diabetes and on the different kind of muscles observed while was independent on different kind of NDMRs. The resistance to NDMRs was stronger in the later stage of diabetes (16 versus 4 weeks after STZ treatment). Additionally, when monitoring in SOL, diabetes attenuated the actions of neuromuscular blockade more intensely than that in EDL. Nonetheless, the hyposensitivity to NDMRs in diabetes was not relevant for the kind of NDMRs.

• The Korean Journal of Pain
• /
• 제31권1호
• /
• pp.3-9
• /
• 2018

Long QT syndrome is a cardiac repolarization disorder and is associated with an increased risk of torsades de pointes. The acquired form is most often attributable to administration of specific medications and/or electrolyte imbalance. This review provides insights into the risk for QT prolongation associated with drugs frequently used in the treatment of chronic pain. In the field of pain medicine all the major drug classes (i.e. NSAIDs, opioids, anticonvulsive and antidepressant drugs, cannabinoids, muscle relaxants) contain agents that increase the risk of QT prolongation. Other substances, not used in the treatment of pain, such as proton pump inhibitors, antiemetics, and diuretics are also associated with long QT syndrome. When the possible benefits of therapy outweigh the associated risks, slow dose titration and electrocardiography monitoring are recommended.

• 한국임상약학회지
• /
• 제28권2호
• /
• pp.101-106
• /
• 2018

Objective: The purpose of the study was to investigate the time from the injection of muscle relaxants to the first spontaneous respiration between sugammadex and conventional reversal for patients undergoing laparoscopic cholecystectomy. Methods: This study was retrospectively conducted on patients who were diagnosed with gallbladder stone (N802) between January 2014 and April 2017. The data were collected from the electronic medical records of a total of 186 patients (84 patients in the neostigmine group and 102 patients in the sugammadex group). Results: The time required for the first spontaneous respiration in the sugammadex group was shorter than that in the neostigmine group (3.6 min vs 4.9 min; p<0.05). After the injection of intermediate muscle relaxants, the comparison of heart rate and mean arterial pressure in the sugammadex and neostigmine groups revealed that the heart rate in the neostigmine group was higher than in the sugammadex group after 5 min (p<0.05). The mean arterial pressure in the neostigmine group was higher than in the sugammadex group after 10 min (p<0.05). A significant adverse effect of tachycardia was observed in the neostigmine group (p<0.05), but the frequency of rescue antiemetic in the sugammadex group was significantly higher than in the neostigmine group (p<0.05). Conclusion: In this study, the unwanted effect of neostigmine group was tachycardia; therefore, in the case of patients with hemodynamic instability, sugammadex is recommended. At 12 hours after the injection of sugammadex to patients, more antiemetics were required than in the neostigmine group; therefore, more research should be conducted on postoperative nausea and vomiting.

• 대한약리학회지
• /
• 제26권2호
• /
• pp.135-144
• /
• 1990

Propylthiouracil(PTU)을 4주 및 12주간 투여한 흰쥐의 대동맥을 적출하여 혈관수축제와 이완제에 대한 반응을 관찰하여 다음과 같은 결과를 얻었다. PTU를 처치한 실험군에서는 대조군에 비해 현저한 체중저하와 혈중 갑상선호르몬의 감소를 보였다. PTU를 처치한 흰쥐의 대동맥에 대한 norepinephrine (NE)과, calcium및 potassium 이온에 의한 최대수축 반응은 대조군에 비하여 유의하게 감소되었다. 그러나 NE에 대한 중간유효량은 증가되었으나, calcium이온에 대한 중간 유효량은 유의한 차이가 없었다. 그리고 acetylcholine, histamine, isoproterenol 및 nitroprusside에 의한 대동맥의 이완작용은 대조군에 비해 증가된 경향을 보였다. PTU를 12주간 처치한 군에 있어서 acetylcholine에 의한 최대 이완반응은 대조군에 비해 유의하게 증가되었지만 다른 이완제에 의해서는 유의한 차이가 없었다. PTU를 4주간 처치한 군에 있어서는 대조군에 비하여 혈관이완제에 대한 중간억제량은 유의한 차이가 없었지만, 12주 처치군에 있어서는 isoproterenol 및 nitroprusside에 대한 중간억제량은 감소 되었으나 acetylcholine 및 histamine에 대한 중간억제량은 유의한 차이가 없었다. 이상의 결과로 미루어 보아 PTU-처치에 의한 혈관 반응성의 변화는 혈관 내피세포보다는 혈관 평활근세포자체의 변화에 기인되며, 이러한 세포내의 변화는 갑상선 기능이 저하된 후에도 계속되고 있음을 알 수 있었다.

• The Korean Journal of Pain
• /
• 제21권1호
• /
• pp.66-70
• /
• 2008

Opioid-induced rigidity is a potentially life-threatening complication that can occur after treatment with large doses of opioids, but with early recognition it can be treated effectively with naloxone or with muscle relaxants. Regarding its onset time, there have been few case reports that have described delayed manifestations of opioid-induced rigidity. The mechanism of this complication is not well understood. In this report we describe a case of incidental overdose injection of sufentanil and subsequently review the confusing clinical features that require immediate diffenrentiation and the possible mechanim of this complication.

• Annals of Clinical Neurophysiology
• /
• 제14권1호
• /
• pp.1-6
• /
• 2012

Low back pain is a common clinical condition with heterogeneous causes and challenges to manage. High prevalence and numerous assessments result in an enormous socioeconomic burden. Clinician must conduct efficient and stepwise evaluation process to rule out serious spinal pathology, neurologic involvement, and identify risk factors for chronicity. The process can be achieved through the focused history taking and physical examination. Certain factors related to serious spinal pathology include age (>50 years), trauma, unexplained fever, recent urinary or skin infection, unrelenting night or rest pain, unexplained weight loss, osteoporosis, immunosuppression, steroid use, and widespread neurological symptoms. In non-specific low back pain, diagnostic imaging and laboratory studies are often unnecessary and can disturb an appropriate management. For the management of acute low back pain, patient education and medication such as acetaminophen, non-steroidal anti-inflammatory drugs, and muscle relaxants are recommended. For chronic low back pain, behavior therapy, back exercise, and spinal manipulation are beneficial. The evidence based approach could improve success rate of management, result in prevention of acute low back pain from being chronic intractable pain.

• The Korean Journal of Pain
• /
• 제5권2호
• /
• pp.249-257
• /
• 1992

It is general knowledge that knee joint pain can be attributed to trauma and degenerative change around the knee joint. However most patients who have suffered from pain or limited range of motion of the knee joint show no definite pathology on X-ray or laboratory examination. We examined 242 patients with knee joint pain and found compression or entrapment of the articular nerve fiber by the tissue around the knee joint resulted in pain in almost all cases. Conclusion: by relieving the compression of the articular nerve fiber with just physical therapy and LASER stimulation on the identified trigger points, in conjunction with NSAIDs, muscle relaxants, were found to be very effective in the treatment of knee joint pain.