• The Korean Journal of Pain
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• 제27권4호
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• pp.313-320
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• 2014

Dexmedetomidine, an imidazoline compound, is a highly selective ${\alpha}_2$-adrenoceptor agonist with sympatholytic, sedative, amnestic, and analgesic properties. In order to minimize the patients' pain and anxiety during minimally invasive spine surgery (MISS) when compared to conventional surgery under general anesthesia, an adequate conscious sedation (CS) or monitored anesthetic care (MAC) should be provided. Commonly used intravenous sedatives and hypnotics, such as midazolam and propofol, are not suitable for operations in a prone position due to undesired respiratory depression. Dexmedetomidine converges on an endogenous non-rapid eye movement (NREM) sleep-promoting pathway to exert its sedative effects. The great merit of dexmedetomidine for CS or MAC is the ability of the operator to recognize nerve damage during percutaneous endoscopic lumbar discectomy, a representative MISS. However, there are 2 shortcomings for dexmedetomidine in MISS: hypotension/bradycardia and delayed emergence. Its hypotension/bradycardiac effects can be prevented by ketamine intraoperatively. Using atipamezole (an ${\alpha}_2$-adrenoceptor antagonist) might allow doctors to control the rate of recovery from procedural sedation in the future. MAC, with other analgesics such as ketorolac and opioids, creates ideal conditions for MISS. In conclusion, dexmedetomidine provides a favorable surgical condition in patients receiving MISS in a prone position due to its unique properties of conscious sedation followed by unconscious hypnosis with analgesia. However, no respiratory depression occurs based on the dexmedetomidine-related endogenous sleep pathways involves the inhibition of the locus coeruleus in the pons, which facilitates VLPO firing in the anterior hypothalamus.

• 수면정신생리
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• 제24권1호
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• pp.5-11
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• 2017

The use of alcohol is associated with the development and worsening of sleep disorder. Alcohol is generally known to have a sedative effect, but it has an arousal or sedative effect depending on the timing and drinking dose and directly affects REM sleep physiology. Alcohol acts on the central nervous system (CNS) to interfere with the sleep-wake cycle and to affect sleep-related hormone secretion. In addition, the ingestion of alcohol pre-sleep is associated with deterioration and development of sleep related breathing disorders (SBD). The increase in resistance of the upper respiratory tract and the decrease in sensitivity of the CNS respiratory center and the respiratory muscles are major mechanisms of alcohol-induced SBD, and result in snoring or apnea in healthy men or aggravating apnea in patients with OSA. Sleep-related restless leg syndrome and circadian rhythm disorders are common in alcohol use disorder patients. This review provides an assessment of scientific studies that investigated on the impact of alcohol ingestion on nocturnal sleep physiology and sleep disorders.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권3호
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• pp.173-179
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• 2015

Issues related to the control of seizures and bleeding, as well as behavioral management due to mental retardation, render dental treatment less accessible or impossible for patients with Sturge-Weber syndrome (SWS). A 41-year-old man with SWS visited a dental clinic for rehabilitation of missing dentition. A bilateral port-wine facial nevus and intraoral hemangiomatous swollen lesion of the left maxillary and mandibular gingivae, mucosa, and lips were noted. The patient exhibited extreme anxiety immediately after injection of a local anesthetic and required various dental treatments to be performed over multiple visits. Therefore, full-mouth rehabilitation over two visits with general anesthesia and two visits with target-controlled intravenous infusion of a sedative anesthesia were planned. Despite concerns regarding seizure control, bleeding control, and airway management, no specific complications occurred during the treatments, and the patient was satisfied with the results.

• 생약학회지
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• 제30권2호
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• pp.211-215
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• 1999

This study was aimed to evaluate an agonistic activity to benzodiazepine receptor of several medicinal plants, which have been used as sedatives in oriental medicine. Methanol extracts of medicinal plants which were used in this study inhibited the binding of $[^3H]Ro15-1788$, a selective benzodiazepine receptor antagonist to benzodiazepine receptor of rat cortices. Inhibitory activity of Cyperus rotundus was observed to be the highest among the tested medicinal plants. Methanol extracts of Cyperus rotundus and Zizypus jujuba inhibited a $[^3H]flunitrazepam$, a selective benzodiazepine receptor agonist, binding to benzodiazepine receptor. GABA significantly enhanced the inhibition of $[3H]flunitrazepam$ binding by Cyperus rotundus and Zizypus jujuba, and these positive GABA shifts supported the strong possibility of agonistic activity to benzodiazepine receptor. From these results, it may be concluded that the substance or substances with neurochemical properties characteristic of a benzodiazepine receptor agonist may be important components and contribute to the sedative property of these medicinal plants.

• 생약학회지
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• 제14권3호
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• pp.107-112
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• 1983

Experimental studies were made to evaluate clinical efficacy and validate Oriental medicine description of 'Banhabaikchulchenma-Tang' which has been used for controlling of headache, heartburn and giddiness, etc. The results of these studies were as follows; 1) Suppressive actions were not shown on convulsion due to spine and diencephatic causes. 2) Analgesic action was recognized in mice and rats. 3) Sedative actions due to prolongation of hypnosis time, muscle relaxation and decreasing locomotive function were noted. 4) Relaxing action was noted in the ileum of mice, also antagonistic antispasmodic action was recognized on contraction of the ileum induced by acteylcholine and $BaCl_2$. In connection with results of these studies, efficacy based on the Oriental medical reference were consistant with actual experimental results. It is considered that 'Banhabaikchulchenma-Tang' has the therapeutic effect on the headache and giddiness, etc.

• Journal of Pharmaceutical Investigation
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• 제15권2호
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• pp.63-72
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• 1985

Analgesic, anticonvulsive, sedative and antipyretic actions of Yangkyuksanwhatang which is composed of nine crude drugs including Rehmanniae Radix, and its effects on isolated ileum and blood vessel were investigated. The results of the studies were summerized as follows; 1. Analgesic and antipyretic effects were observed. 2. Suppressive actions were not shown on the convulsion induced by strychnine, but significant effects were noted on the convulsion induced by picrotoxin. 3. A prolongation of anesthetic time induced by pentobarbital sodium was significantly observed. 4. Relaxing actions were noted on the ileum of mice, and also, same effects were recognized on the contraction of the ileum due to acetylcholine chloride and barium chloride. 5. The expansion of blood vessels by relaxation of smooth muscle and hypotensive effects were noted.

• 대한전기학회논문지:시스템및제어부문D
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• 제49권6호
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• pp.334-338
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• 2000

Even though it is not practical, yet there is a trend of the researches related to the anesthesia on the determination of depth of anesthesia and level of consciousness in the view point of neurophysiological aspects. That is, quantification of physiological signals which represent human brain function and pharmacological response could be used to find the level of consciousness based on the changes in physiological signals. This research was performed to analyze the relationship between parameters extracted from LAEP(long latency auditory evoked potential) and the amount of sedatives injected to the patients. Seventeen patients were participated for the experiment. Two different sedatives, midazolam and diazepam, were injected intramuscularly, and LAEPs caused by 1KHz and 2KHz auditory tone bust were obtained. It was found that amplitude of extracted parameters from LAEP, N100 and P300, were reduced as dose of sedatives were increased. Results of this study could be used for extracting more meaningful index and establishing algorithm for predicting changes of level of consciousness induced by sedatives.

• 대한간호학회지
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• 제44권5호
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• pp.573-580
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• 2014

Purpose: This study was conducted to analyze intubation survival rates according to characteristics and to identify the risk factors affecting deliberate self-extubation. Methods: Data were collected from patients' electronic medical reports from one hospital in B city. Participants were 450 patients with endotracheal intubation being treated in intensive care units. The collected data were analyzed using Kaplan-Meier estimation, Log rank test, and Cox's proportional hazards model. Results: Over 15 months thirty-two (7.1%) of the 450 intubation patients intentionally extubated themselves. The patients who had experienced high level of consciousness, agitation. use of sedative, application of restraints, and day and night shift had significantly lower intubation survival rates. Risk factors for deliberate self-extubation were age (60 years and over), unit (neurological intensive care), level of consciousness (higher), agitation, application of restraints, shift (night), and nurse-to-patient ratio (one nurse caring for two or more patients). Conclusion: Appropriate use of sedative drugs, effective treatment to reduce agitation, sufficient nurse-to-patient ratio, and no restraints for patients should be the focus to diminish the number of deliberate self-extubations.

• 대한한방소아과학회지
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• 제10권1호
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• pp.245-263
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• 1996

In order to investigate the effects of Yangsymtang on the activities of central nervous system, we observed the effects on convulsions induced by pentylenetetrazole, strychnine and picrotoxin. The sedative those on spontaneous motor activity and by rota rod method, the those on sleeping time induced by barbiturate and the alleviative those on pain induced by acetic acid and hind limb pressure also were analyzed. The results were as follows: 1. The solid extracts of Yangsymtang showed no anticonvulsive effects on convulsions induced by pentylenetetrazole, strychnine and picrotoxin. 2. As to the sedative effects by rota rod method, th solid extracts of Yangsymtang were recognized as significance(P<0.01). 3. The sleeping time induced by thiopental sodium was not prolonged by the oral administration of the solid extracts of Yangsymtang. 4. The oral administration of Yangsymtang did not influenced the sleeping induced by pentobarbital sodium significantly. 5. As to the effects on spontaneous motor activity, the oral administration of Yangsymtang made spontaneous motor activity decrease significantly(P<0.05). 6. The oral administration of Yangsymtang was significant on pain induced by acetic acid(P<0.001). 7. As to alleviative effects on pain induced by hind limb pressure. The solid extracts of Yangsymtang were not significant.

• Natural Product Sciences
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• 제19권4호
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• pp.281-285
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• 2013

This study was designed to investigate the nervous sedative effects of green tea. The sedative effect was evaluated by examination of Monoamine oxidases (MAOs) inhibitory activity in vitro in the brain and liver of rat fed on green tea cultivated and harvested from the different regions and periods. It showed that methanol extracts of green tea inhibited significantly the brain MAO-A activity. Especially late harvested green tea extracts showed potential inhibitory activity. The liver MAO-B activity was also inhibited by all of the green tea extracts with strong intensity. This study confirmed that major compounds of green tea such as catechin, epigallocatechin-3-gallate (EGCG) and L-theanine, which were well known for the main bioactive components in the tea plants, were not associated with the MAO inhibitory activities of green tea. These results suggested that a MAO inhibition activity comes from other minor tea components we have to search in the future.