• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.4
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• pp.344-348
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• 2001

Isoflurane and enflurane are currently used on orthognathic surgery in Korea. Since starting to use enflurane and isoflurane in orthognathic surgery, we have questioned their effect on liver function. Many studies have reported liver function after enflurane and isoflurane anesthesia. Although both enflurane and isoflurane are less hepatotoxic than halothane, some cases of liver dysfunction have been reported after enflurane and isoflurane anesthesia. And, we know that isoflurane is less hepatotoxic than its predecessors, enflurane. But, fulminant liver failure and necrosis were also reported after isoflurane anesthesia. The purpose of this study was to compare immediate liver function in healthy orthognathic surgical patients receiving enflurane or isoflurane anesthesia. To assess the effect of enflurane and isoflurane on liver function, we measured pre-and post-operative serum concentrations of aspartate aminotransferase(AST), and alanine aminotransferase(ALT), alkaline phosphatase(ALP), total bilirubin(Tbil).

• The Korean Journal of Pain
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• v.7 no.2
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• pp.181-187
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• 1994

The MAC($ED_{50}$)values of enflurane, fentanyl, and nalbuphine-enflurane under 65% $N_2O$ were determined in 76 Sprague-Dawley rats using the tail-clamp technique to compare the equipotent effects of intravenous and inhaled anesthetics. The rats were divided into 3 groups: enfluarne, fentanyl, and nalbuphine-enflurane. Results were as follows: 1) The MAC value of enflurane under 65% $N_2O$ was $1.160{\pm}0.05%$ and after subcutaneous nalbuphine 20 mg/kg injection, the values were 1.08% at 60min and 0.99% at 90min. 2) The lowest $ED_{50}$ for fentanyl was 26.8 ${\mu}g$/kg at 15 min, and the $ED_{50}$, 30, 45, and 60min after the injection were 36.2, 39.7, and 44.7 ${\mu}g$/kg, respectively. 3) On arterial blood gas analysis under 65% $N_2O$-1MAC($ED_{50}$), fentanyl and nalbuphine-enflurane groups showed mild increase in $PaCO_2$, but there were no significant differences among 3 groups. Fentanyl group showed significant difference in pH compared with enfluarane and nalbuphine-enflurane groups. 4) Rats injected with high dose fentanyl(above $40{\mu}g$) displayed rigidity and respiratory depression.

• Journal of Veterinary Clinics
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• v.17 no.2
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• pp.395-402
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• 2000

흡입마취에서 마취를 유지하기 위해서는 도입 마취가 필수적이다. 도입 마취제는 작용시간이 짧고 기관 튜브를 용이하게 삽입할 수 있으며. 투여로 인한 생리적 영향이 적이야 한다 Acepromazine/ketamine(Group-AK) 병용 투여와 propofol(Group-P) 단독 투여로 마취 유도한 후 Enflurane으로 마취를 유지하였을 때 나타나는 생리적 변화를 비교하였다 체온, 호흡수, 평균 동맥압, Pa$CO_2$, PaO$_2$, pH, toe-wep pinch reflex 및 jaw tone reflex는 두 군간에서 유의성 있는 차이가 나타나지 않는다. Group-P은 group-AK보다 회복시간이 유의성 있게 짧았다 심박수는 group-AK군이 마취 추 5분에서 group-P보다 유의성 있게 증가하였다. 동성 빈 맥은 group-AK군에서는 5및 10분에 각각 2미터에서 관찰되었고 group-P에서는 5분에 2마리, 10분에 1마리가 관찰되었다. Acepromazine/ketamine propofol은 모두 enflurane 마취를 위한 도입마취제로서 양호한 효과를 나타내었다.

• Journal of The Korean Dental Society of Anesthesiology
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• v.4 no.1 s.6
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• pp.25-29
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• 2004

Anaphylactic reactions to anesthetic drugs could potentially produce life-threatening immune-mediated crisis. Most published reports are associated with neuromuscular blockers and anaphylactic reactions to inhalation anesthetics are rare. A 25-year-old male patient with no significant medical history and no previous abnormal drug reaction was scheduled for orthognathic surgery under general anesthesia. After uneventful anesthetic induction and nasotracheal intubation, generalized urticaria and erythema were detected during the maintenance period with $O_2-N_2O$-enflurane. No severe changes of vital signs and no ventilation problem were accompanied. The operation was cancelled and the cutaneous lesions were faded away during the recovery with 100% $O_2$. The skin-prick and intradermal tests showed that he was hypersensitive to all halogenated inhalation anesthetics including enflurane and not to intravenous anesthetics and neuromuscular blockers. The re-operation was safely carried out under intravenous anesthesia with propofol-fentanyl-vecuronium. We report this case of intraoperative anaphylactic reaction to enflurane with literature review.

• The Korean Journal of Pain
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• v.14 no.2
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• pp.186-192
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• 2001

Background: Epidural test doses containing epinephrine are an incomplete marker for the detection of inadvertent intravascular injection. Therefore, many investigators have attempted to find a more reliable marker as an alternative to epinephrine in adult patients anesthetized with enflurane. The present study was designed to test whether two different simulated intravenous test doses of isoproterenol could be used as a reliable marker for the detection of inadvertent intravascular injection in adult patients anesthetized with $O_2-N_2O$-enflurane. Methods: Forty healthy adult patients were anesthetized with 1% end-tidal enflurane and nitrous oxide after endotracheal intubation and were randomized to one of two groups according to the dose of isoproterenol. Group 1 and 2 (n = 20 each) received 3 ml of 1.5% lidocaine with 3 and 5 g isoproterenol intravenously, respectively, to simulate an intravascularly administered test dose. Heart rate (HR) and systolic blood pressure (SBP) were measured at 20-second intervals for 4 min after injection. Results: Mean maximal HR increases were $24{\pm}17$, $35{\pm}11$ bpm (P < 0.05), mean maximal SBP increases were $14{\pm}8$, $13{\pm}9$ mmHg and mean maximal SBP decreases $20{\pm}11$, $22{\pm}9$ mmHg following the IV injection of 3, $5{\mu}g$ isoproterenol, respectively. The incidence of hypotension was similar in both groups. Isoproterenol 3 and $5{\mu}g$ produced 75%, 100% sensitivity in the HR criteria ($\geq$ 20 bpm increase) and 60%, 70% sensitivity in the SBP criteria ($\geq$ 15 mmHg), respectively. Conclusions: These results indicate that based on the HR response, the epidural test dose containing $5{\mu}g$ isoproterenol to simulate an intravascular administration is a more reliable marker than $3{\mu}g$ isoproterenol in adult healthy patients during enflurane anesthesia.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.81-85
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• 1986

Observation of changing pattern of blood pressure and pulse rate of enflurane anesthesia for 200 cases operations, performed during the past 4 years(1983~1986) in Yeungnam University Hospital have been evaluated clinically. In order to observe the influence of enflurane upon the blood pressure and pulse rate during general anesthesia, the authors prepared a formula, expressing changing of blood pressure and pulse rate by time series and analyzed the types and distribution pattern in the experiment. The results obtained were as follows : 1. Blood pressure and pulse rate were increased at the time of intubation. 2. Generally, blood pressure and pulse rate were increased at the time of intubation and then stabilized withing 20 minutes. 3. Most common patterns were identified, ADEE type was 73~74%, Which is most common type and AEEE type was about 40%.

• Journal of Veterinary Clinics
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• v.18 no.3
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• pp.249-256
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• 2001

This study was performed to evaluate cardiopulmonary depressant effects of enflurane (1.0 vol%) combined with propofol(0.25 mg/kg/min) compared with enflurane inhalation, and propofol infusion, respectively, in 18 healthy dogs premedicated with acepromazine and atropine. After bolus injection of propofol 5 mg/kg for induction and tracheal intubation, they were randomly assigned to 3 groups: propofol 0.5 mg/kg/min infusion (Group I, n=6), enflurane 2.5 vol% (Group II, n=6) and enflurane 1.0 vol% combined with propofol 0.25 mg/kg/min (Group III, n=6). Mean arterial Pressure (MAP), systolic arterial pressure (SAP) and diastolic arterial pressure (DAP) were depressed significantly in all groups, especially in Group II. MAP, SAP and DAP values of Group IIIwere higher than those of Group II, but lower than those of Group I. The changes of PaO$_2$, Pa$CO_2$and pHa were similar in all groups. Respiration rates were decreased in all groups 5 minutes after induction but maintained in normal range. Those of Group I were less depressant than those of Group II and Group III. Concentrations of $Na^+ and Cl^-$ were increased and those of $K^+$ were decreased in all groups, but their values were quitely similar. Heart rate was changed in small range and the value of Group I was higher than those of Group II and Group III. Body temperature was decreased significantly in all groups. Adverse effects like as muscle rigidity, nausea or vomiting and shivering were not appeared and apnea at induction was occured 6 dogs. From the these results, enflurane 1.0 vol% combined with propofol 0.25 mg/kg/min also could be applied for anesthesia in dogs.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.3
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• pp.513-519
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• 1999

Chloral hydrate is one of the most widely used sedative agents to control the difficult to treat young age group in the dental clinic. We are often frustrated to see the patient still awake and cry with agitation even after far more than the normal onset time. In such a case, the patient has to be rescheduled for another sedation visit with different agents and/or routes which greatly disappoints the guardians. This case report presents a sedative regimen that can possibly help the clinician complete scheduled treatment without postponement. We have tried sleep induction with Enflurane (1-1.5vol%) for 60 seconds to 37 patients of those who failed to respond properly to the dose(70mg/kg)of oral Chloral hydrate. The average age and weight of the patients was 34.3 months(22-43mo.) and 14.9kg(11-21kg) respectively. It is suggested that sleep induction with low dose Eflurane produced a stable state during dental treatment with respect to vital sign and behavior. Evidence of adverse effect was not detected or reported during and/or after the procedures.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.16 no.3
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• pp.193-201
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• 2006

This study was performed to investigate employee exposures to waste anesthetic gases, such as enflurane and sevoflurane in operating rooms of general surgical, children's and dental clinics of a large hospital located in Seoul and to analyze factors affecting the concentrations of waste anesthetic gases. The results of the study are summarized below. 1. Based on results of personal and area samples for airborne enflurane, all of the employees investigated in this study were exposed to airborne enflurane concentrations below the ACGIH-threshold limit value (TLV) of 75 ppm. 2. However, based on results of personal samples for sevoflurane, employees of two (2) out of eleven (11) operating rooms were exposed to sevoflurane concentrations in excess of the NIOSH recommended exposure limit (REL) of 2 ppm. A similar trend was found in the area samples. 3. To investigate the source of sevoflurane emissions, airborne sevoflurane concentrations were measured on an anesthesia machine, a drug cabinet and a desk. It was indicated that the geometric means were 0.93 ppm, 0.83 ppm and 0.72 ppm, respectively. 4. Factors affecting waste anesthetic gas concentrations were the age of anesthesia machine, the volume of operating room and the extent of ventilation (p<0.05). 5. It is recommended that the use of anesthesia equipments be properly controlled, the operating room be well ventilated, and the airborne concentrations of anesthetic gases be continuously monitored.

• Journal of Yeungnam Medical Science
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• v.7 no.1
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• pp.121-126
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• 1990

Halothane is usually a safe and effective inhalation anesthetic agent but it rarely has damaged liver. The authors selected 11 patients who had HBsAg positive and increased SGOT, SGPT at Yeungnam university hospital. Their physical status was ASA class 1 and 2. They had no previous history of operation or liver disease. The liver function tests were performed before surgery, and on 3rd, 7th and 10th postoperative days. The result were as follows : 1) The values of SGOT and SGPT were gradually increased on 3rd postoperative day and markedly increased on the 7th and 10th postoperative day 2) Alkaline phosphatase, total protein, albumin, total bilirubin and direct bilirubin were not significantly changed.