• Title/Summary/Keyword: benzodiazepine

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Influence of Midazolam and Glycopyrrolate on Intra-operative Body Temperature in Abdominal Surgical Patients

  • Kim, Eun-Ju;Yoon, Hae-Sang
    • Journal of Korean Biological Nursing Science
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    • v.14 no.1
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    • pp.25-32
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    • 2012
  • Purpose: influence of benzodiazepine (midazolam)or cholinergic inhibitor (atropine or glycopyrrlate) on intra-operative body temperature remains unclear and controversial. This study compares intra-operative body temperature in 50 abdominal surgical patients under general anesthesia between the administration of midazolam and glycopyrrolate in combination, or glycopyrrolate alone. Methods: Patients who underwent abdominal surgery were recruited from September 2008 through October 2009 at Gachon University Gil hospital in incheon. Core body temperature was measured in the right ear using a tympanic membrane thermometer at induction of general anesthesia and at 1 hr, 2 hr, and 3 hr after induction. Results: There were no differences in core body temperature at any measurement point between either patient group (F=1.08, $p$=.377). Core body temperature decreased throughout the 3 hr after induction in both groups (F=9.22, $p$ <.001). Specially, core temperatures at induction of general anesthesia (p<.001), 1 hr (p<.001), 2 hr ($p$ <.001), and 3 hr ($p$ <.001) after induction were lower than before administration of midazolam and glycopyrrolate, or glycopyrrolate alone. Conclusion: We conclude that a cholinergic inhibitor (glycopyrrolate, 0.1 mg) therefore seems not to affect intra-operative body temperature of patients given a benzodiazepine (midazolam, 0.04 mg $kg^{-1}$), and not to increase body temperature in patients not given a benzodiazepine during the 3 hr after the induction of general anesthesia. Intra-operative warming therefore is needed to prevent hypothermia in surgical patients who receive pre-operative administration of midazolam and/or glycopyrrolate.

CLINICAL STUDY ON THE SIDE EFFECTS OF THE CONSCIOUS SEDATION (약물을 이용한 의식진정시 발생한 부작용에 대한 치험례)

  • Kim, Hyun-Sik;Han, Gook-Jae;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.4
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    • pp.823-829
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    • 1997
  • The patients visiting pediatric dental office have been being younger than the previous, and they were often combined with systemic disease. But, we aren't able to perform the verbal communication, because of their impediment and youthfullness. And, we can't carry out the behavior control via physical restraint, as the developed social structure and the attitude of children and their parents. So, the importance and concerning of conscious sedation using sedative medicine are increased by time and time. Among the various conscious sedation, Chloral Hydrate and Nitrous Oxide inhalation are most popularly used, and barbiturates, benzodiazepine, opioids and hydroxyzine are used often. But, these medications have some side-effects and adverse reactions, may be failed to sedate the children. And limited use of medically compromised patients, especially for ASA class III, IV or more dangerous patients. We, the Department of Pediatric Dentistry, Chosun University have met some dangerous situation due to unfavorable pharmacogenic reactions, but we can control the situation and get well healed results. The below results are common situations and their solutions during conscious sedation. 1. By the intravenous administration, thrombophlebitis is the most common side-effects, but it may be healed with time without any special treatment. 2. Under the definitive guidelines about conscious-sedation, we can perform a safe conscious sedation for ASA class III patients. 3. When adversed reaction of Benzodiazepine is occured, it could be cared effectively with benzodiazepine antagonist, named Flumazenil.

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Synthesis and Biodistribution of Flumazenil Derivative [F-18](3-(2-Fluoro) flumazenil for Imaging Benzodiazepine Receptor (벤조디아제핀 수용체 영상용 양전자 방출 핵종 표지 플루마제닐 유도체 [F-18](3-(2-Fluoro)flumazenil의 합성과 생체 내 분포)

  • Hong, Sung-Hyun;Jeong, Jae-Min;Chang, Young-Soo;Lee, Dong-Soo;Chung, June-Key;Cho, Jung-Hyuck;Lee, Sook-Ja;Kang, Sam-Sik;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.6
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    • pp.527-536
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    • 1999
  • Purpose: Radiotracers that bind to the central benzodiazepine receptor are useful for the investigation of various neurological and psychiatric diseases. [C-11]Flumazenil, a benzodiazepine antagonist, is the most widely used radioligand for central benzodiazepine receptor imaging by PET. We synthesized 3-(2-[F-18]fluoro)flumazenil, a new fluorine-18 ($t_{1/2}$= 110 min) labeled analogue of benzodiazepine receptor imaging agent, and evaluated in vivo for biodistribution in mice. Materials and Methods: Flumazenil (Ro 15-1788) was synthesized by a modification of the reported method. Precursor of 3-(2-[F-18]fluoro)flumazenil, the tosylated flumazenil derivative was prepared by the tosylation of the ethyl ester by ditosylethane. [F-18] labeling of tosyl substitued flumazenil precursor was performed by adding F-18 ion at $85^{\circ}C$ in the hot ceil for 20 min. The reaction mixture was trapped by C18 cartridge, washed with 10% ethanol, and eluted by 40% ethanol. Bidistribution in mice was determined after intravenous injection. Results: The total chemical yield of tosylated flumazenil derivative was ${\sim}40%$. The efficiency of labeling 3-(2-[F-18]fluoro)flumazenil was 66% with a total synthesis time of 50 min. Brain uptakes of 3-(2-[F-18]fluoro)flumazenil at 10, 30, 60 min after injection, were $2.5{\pm}0.37,\;2.2{\pm}0.26,\;2.1{\pm}0.11$ and blood activities were $3.7{\pm}0.43,\;3.3{\pm}0.07,\;3.3{\pm}0.09%ID/g$, respectively. Conclusion: We synthesized a tosylated flumazenil derivative which was successfully labeled with no-carrier-added F-18 by nucleophilic substitution.

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THE EFFECTS OF DIAZEPAM ON THE CARBACHOL INDUCED CONTRACTION OF THE ISOLATED RAT ILEUM (Diazepam이 흰쥐 회장 평활근의 Carbachol 유발 수축에 미치는 영향)

  • Kim, Jung-Ok;Kwon, Oh-Cheol;Ha, Jeoung-Hee;Lee, Kwang-Youn;Kim, Won-Joon
    • Journal of Yeungnam Medical Science
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    • v.6 no.2
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    • pp.13-22
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    • 1989
  • To investigate the effect of diazepam on the contractility of the intestinal smooth muscle, longitudinal muscle strip isolated from rat ileum was prepared for myography in isolated organ bath. 1) Basal tone of ileal muscle was reduced by diazepam concentration-dependently. 2) Higher concentrations(30 and 100 microM) of diazepam inhibited(p<0.05, p<0.001) the carbachol-induced contraction in a concentration-dependent manner ; but lower concentration of diazepam(10 microM) enhanced(p<0.05). 3) Histamine-induced contraction was inhibited by pretreatment with diazepam in a concentration-dependent manner. 4) $Ca^{++}$-induced tension recovery in calcium-free solution was inhibited in the presence of diazepam concentration-dependently. These results suggest diazepam reduces the contractility of the longitudinal muscle isolated from rat ileum via interference with influx of calcium into the muscle cells.

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Two Cases of Insomnia in Stroke Patiens Treated with Changpoulgeumtang (창포울금탕(菖蒲鬱金湯)으로 호전된 중풍환자 불면증(不眼症) 치험 2례)

  • Oh Yong-Seong;Lim Myung-Hyun;Jang Woo-Seok;Lee So-Yeon;Park Chi-Sang;Park Chang-Gook
    • The Journal of Internal Korean Medicine
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    • v.24 no.4_2
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    • pp.1055-1061
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    • 2003
  • Insomnia is a disorder of initiation and maintenance of sleep that is derived from multiple factors such as psychologic, physiological and environmental problems. A number of stroke patients suffer from insomnia classified as one of the sleep disorders associated with physical illness and on the contrary insomnia may have profound deleterious effects on the natural course of stroke. Sedative-hypnotics including benzodiazepine and non-benzodiazepine have widely been used in chronic insomniacs. However, most hypnotics cause dependence, tolerance, impaired daytime function and rebound insomnia. Therefore, we are looking forward to proposing an effective oriental treatment for insomnia. We report two cases of insomniacs, treated with Changpoulgeumtang. After the treatment, insomnia and other accompanied symptoms were improved.

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Low Dose Propofol with Dexmedetomidine is Effective for Monitored Anesthesia Care in Outpatients Undergoing Invasive Oral Surgery

  • Lee, Do-Won;Yoon, Ji-Uk;Ok, Young-Min;Byeon, Gyeong-Jo;Kim, Cheul-Hong;Yoon, Ji-Young
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.1
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    • pp.19-22
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    • 2013
  • Certain oral surgery can be performed safely under monitored anesthesia care (MAC) with local anesthesia. Several drugs, such as propofol, benzodiazepine, and opioids have been used for MAC either alone or in combination. Benzodiazepine may cause excessive sedation and confusion, and propofol can also result in disorientation and excessive sedation. Low dose propofol anesthesia with the concomitant use of dexmedetomidine is an effective technique for MAC in patients who are scheduled for intraoral surgery.

Sleep Inducing Effect of Gastrodia elata Fermented with Lactic Acid Bacteria (유산균 발효 천마의 수면유도 효과)

  • Lee, Keyong Ho;Rhee, Ki-Hyeong;Kim, Byung-Soo;Choi, Yong-Ho;Kim, Choong-Hwan
    • Korean Journal of Pharmacognosy
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    • v.44 no.3
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    • pp.281-285
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    • 2013
  • Ethanol extract of Gastrodia elata fermented with Lactobacillus brevis was highly effective on the duration of pentobarbital hypnosis in mice. Pretreatment of mice with ethanol extract of the fermented Gastrodia elata (200 mg/kg, p.o.) prolonged markedly the duration of pentobarbital sleeping time and reduced the sleep latency. The mechanism of the extract of the fermented Gastrodia elata was investigated to inhibit the binding of $^3H$-Flumazenil, a selective benzodiazepine receptor antagonist, to benzodiazepine receptor of mice cortices. $IC_{50}$ value from displacement of $^3H$-Flumazenil binding was 62 ${\mu}g/mL$ at the treatment of the fermented Gastrodia elata. Therefore, these finding, such as increase of sleeping time and reduction of sleep latency, was examined by elevated concentration of GABA and parishin C, which were increased by Lactobacillus brevis.