• The Transactions of the Korean Institute of Electrical Engineers D
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• v.55 no.1
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• pp.35-41
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• 2006

Although reachers have studied for a long time, they don't make criteria for anesthesia depth. anesthetists can't make a prediction about patient's reaction. Therefor, patients have potential risk such as poisonous side effect late-awake, early-awake and strain reaction. EEG are received from twenty-five patients who agreed to investigate themselves during operation with Enflurane-anesthesis in progress of anesthesia. EEG are divided pre-anesthesia, before incision of skin, operation 1, operation 2, awaking, post-anesthesia by anesthesia progress step. EEG is applied pre-processing, base line correct, linear detrend to get more reliable data. EEG data are handled by electronic processing and the EEG data are calculated by bicoherence. During pre-anesthesia and post anesthesia, appearance rate of bicoherence value is observed strong appearance rate in high frequency range($15\~30Hz$). During the anesthesia of patient, a strong appearance rate is revealed the low frequency area(0~10Hz). After bicoherence is calculated by percentage of a appearance rate, that is, Bicpara$\#$1, Bicpara$\#$2, Bicpara$\#$3 and Bicpara$\#$4 parameter are extracted. In result of bicoherence analysis, Bicpara$\#$2 and Bicpara#4 are considered that the best parameter showed progress of anesthesia effectively. And each separated bicoherence are calculated by average bicoherence's numerical value, divide by 2 area, appear by each BicHz$\#$1, BicHz$\#$2, and observed BicHz$\#$1/BicHz$\#$2's change. In result of bicoherence analysis, BicHz$\#$1, BicHz$\#$2 and BicHz$\#$1/BicHz$\#$2 are considered that the best parameter showed progress of anesthesia effectively. In conclusion, I confirmed the anesthesia progress phase, concluded to usefulness of parameter on bispectrum and bicoherence analysis and evaluated the depth of anesthesia. In the future, it is going to use for doctor's diagnosis and apply to protect an medical accident owing to anesthesia.

• Korean Journal of Acupuncture
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• v.22 no.1
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• pp.95-108
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• 2005

Objective : In the present study, the effect of electroacupuncture (EA) applied to several acupoints and non-acupoint in CFA-induced knee arthritis was examined. Methods : A common source of persistent pain in humans is arthritis. Arthritis was induced by injection of CFA $125\;{\mu}l$ into knee joint cavity under enflurane anesthesia. The rat subsequently showed swelling of the ankle and a reduced stepping force of the affected limb for the next several days. The reduced stepping force of the limb was presumably due to a painful knee. EA was applied to either of $LR_2,\;LI_4$, or non-acupoint on the contralateral forelimb for 30 min under gaseous anesthesia. After the termination of EA, behavioral tests measuring stepping force were periodically conducted during the next 4 h. Results : EA applied to $LR_2$ point produced a significant improvement of stepping force of the affected foot lasting for at least 2 h. However, neigher $LI_4$ point nor non-point produced any significant increase of weight bearing force. The improvement of stepping pressure was interpreted as an analgesic effect. The analgesic effect was specific to the acupuncture point since the analgesic effect on CFA-induced knee arthritic pain model could not be mimicked by EA applied to a point, $LI_4$ or non-acupoint. In addition, both NO production and iNOS protein expression increased by arthritis were suppressed by EA applied to $LR_2$ point. Conclusion : These data suggest that EA produces a potent analgesic effect in the rat model of CFA-induced knee arthritis. This analgesic effect is produced by applying EA to an acupoint at opposite side from the painful area in a stimulus point-specific way.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.165-170
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• 2005

Background: It is difficult to treat tourniquet-induced hypertension despite adequate anesthesia, and the mechanism of that is not known. And it may be possible that intraoperative continuous infusion of opioid induces preemptive analgesia postoperatively. We investigated the effect of intraoperative continuous i.v. fentanyl on tourniquet induced cardiovascular changes and postoperative preemptive analgesia in total knee replacements. Methods: Sixty patients were randomly assigned to two groups; In study group ($1.5{\mu}g/kg$ loading and $0.5{\mu}g/kg/hr$ continuous infusion of fentanyl before skin incision and tourniquet inflation) and control group (no treatment). Anesthesia was maintained with enflurane (1-2 MAC) and 50% nitrous oxide in oxygen. Arterial pressure and heart rate were compared between two groups. They received postoperative pain treatment with patient-controlled analgesia (PCA) with fentanyl during the postoperative 48 hours after total knee replacement. Visual analog scale (VAS) scores at either rest or movement were used to assess pain. Total fentanyl dose delivered, number of PCA requests, supplemental analgesics, overall satisfaction score and adverse events were evaluated. Results: There were no significant differences between the two groups on cardiovascular changes by tourniquet induced pain effect. VAS, PCA delivered dose and PCA demands at movement in the 24-48 hour decreased in study group compared with control group (P < 0.05). But there were no significant differences between the two groups on the other time periods except 24-48 hour's patient satisfaction and adverse events. Conclusions: We suggest that intraoperative continuous i.v. fentanyl infusion dose not affect cardiovascular change by tourniquet induced pain. But it may induce preemptive analgesia postoperatively.

• Korean Journal of Acupuncture
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• v.21 no.1
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• pp.113-127
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• 2004

Objectives : The usage of acupuncture has gained popularity as an alternative method of treatment for certain chronic pain conditions. However, the efficacy of acupuncture in various diseases has not been fully established and the underlying mechanism is not clearly understood. In the present study, the effect of electroacupuncture (EA) applied to foot samli$(ST_{36})$ on the carrageenan-induced knee arthritic pain was examined. Methods : A common source of persistent pain in humans is the knee arthritis. Knee arthritis was induced by injection of 2 % carrageenan $50\;{\mu}l$ into the knee joint cavity. When rats developed pain behaviors, EA was applied for 30 min. under enflurane anesthesia with repeated train stimuli at the intensity of 10X of muscle twitch threshold. The weight bearing force of the hind limb was measured for an indicator of pain level after each manipulation. Results : The average weight borne by the hind limb during normal gait was 55% of total body weight, which was reduced to less than 10% after knee arthritis. EA improved the weight bearing of the arthritic hind limb significantly for the duration of 4 hr. EA applied to $ST_{36}$ point produced a significant improvement of stepping force of the arthritic foot lasting for at least 4 h. However, $GB_{31}$ point did not produce any significant increase of weight bearing force. The analgesic effect was specific to the acupuncture point since the analgesic effect on the knee arthritis model could not be mimicked by EA applied to a nearby point, $GB_{31}$. The relations between EA-induced analgesia and endogenous nitric oxide(NO) and inducible NO synthase(iNOS)/neuronal NOS was also examined. Results were turned out that both NO production and nNOS/iNOS protein expression which is increased by arthritis were suppressed by EA stimulation applied to $ST_{36}$ point. Conclusions : The data suggest 1) that EA produces a potent analgesic effect on the rat model of chronic knee arthritis pain in a point specific manner and 2) that EA-induced analgesia modulate endogenous NO through the suppression of nNOS/iNOS protein expression.

• Korean Journal of Acupuncture
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• v.21 no.2
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• pp.47-67
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• 2004

Objectives : In the present study, the effect of Scolopendrid Water-Alcohol Extract (SWAE) applied to acupuncture point BL23 (Shinsu) on the neuropathic pain was examined. A common source of persistent pain in humans is the neuropathic pain. Anti-convulsant drugs are used to treat the neuropathic pain. In the oriental medicine, Scolopendrid was used for long time to treat convulsant syndrome and back pain, etc. Methods : On the bases of the Scolopendrid clinical application, the effect of SWAE applied to the acupuncture point was tested in the rat model of neuropathic pain. Neuropathic pain was induced by tight ligation of L5 spinal nerve. When rats developed pain behaviors, One hundred microliter of SWAE was applied into the ipsilateral BL23 point at a dose of 10 mg/ml under enflurane anesthesia. The foot withdraw latency of the hind limb was measured for an indicator of pain level after each manipulation. Results : SWAE injection increased the mechanical threshold of the foot in the rat model of neuropathic pain significantly for the duration of 4h, suggesting a partial alleviation of pain. SWAE applied to BL23 point produced a significant improvement of mechanical sensitivity of the foot lasting for at least 4h. However, neither contralateral BL23 point, ST25 (Chonchu) point, nor LR3 (Taechung) point produce as much increase of mechanical sensitivity as ipsilateral BL23 point. And, this increase of mechanical sensitivity was dose-dependent. The improvement of mechanical threshold was interpreted as an analgesic effect. In addition, the analgesic effect of Scolopendrid 4 mg/kg injection is equivalent to that of gabapentin 50 mg/kg injection. The relations between SWAE-induced analgesia and endogenous nitric oxide(NO), inducible NO synthase (iNOS)/neuronal NO synthase (nNOS) were also examined. Results were turned out that both NO production and nNOS/iNOS protein expression which are increased by nerve injury were suppressed by SWAE injection applied to BL23 point. Conclusions : The data suggest 1) that SWAE produces a potent analgesic effect on the neuropathic pain model in the rat and 2) that SWAE-induced analgesia modulate endogenous NO through the suppression of nNOS/iNOS protein expression.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.5
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• pp.1356-1362
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• 2005

The purpose of this study os to investigative the effect of Carrageenan-Induced Pain on lower limb muscle and ligament of rat. To evaluate pain mechanism in muscle and ligament, pain was induced by the injection of 2% $0.1m{\ell}$ carrageenan into the left lower limb muscle of rats after rats were anesthesized with 3% enflurane. Rats were killed on 72 hours after pain induction under the anesthesia. anterior rectus femoris muscle and its ligament were removed from rat hind limb. Morphological changes of them were peformed by the observation of light and electron microscopes. In the light microscopic findings, the muscle cells were polyheadral and situated with each other without small gap in control group. nucleus of cell was seen along the cell margin, and muscle cell groups were divided by regular narrow gap in cross section. In the pain-induced group, muscle cell groups were divided each other by the irregular gap, and some of groups formed larger than other cell groups by the fusion. Intercellular gap of most cell groups were increased compared with control groups. And also, perimysium of muscle cell groups was swollen in cross section. In control group, muscle cells contacted each other closely and each cell was divided by perimysium. The intracellular gaps were not seen between myofibrills, and also striations were well defined between muscle cells in longitudinal section. In pain-induced group, muscle cells were divided by the small intracellular gaps. And also, muscle cell showed many a short cross or longitudinal intercellular gaps in longitudinal section. In light microscopic findings of control group, tendon was composed with many tendon fibers contacted each other closely without gap. The free margin of tendon was fused, and apso the tendon fibers did not invaded between muscles. In pain-induced group, tendon was divided small groups by intertendinous gap, and also the margin of tendon divided by small groups. In the free margin, tendon invaded into muscle cells, and also fibroblasts between tendon fibers were long and lance-shaped. From these results, it is suggested that pain induction by carrageenan injured rat skeletal muscle and ligament by the morphological changes.

• Korean Journal of Acupuncture
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• v.21 no.3
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• pp.59-76
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• 2004

Objectives : The usage of acupuncture has gained popularity for certain chronic pain conditions. However, the efficacy of acupuncture in various diseases has not been fully established and the underlying mechanism is not clearly understood. In the present study, the effect of electroacupuncture (EA) applied to yangno$(SI_6)$ on the neuropathic pain was examined. Methods : A common source of persistent pain in human is a neuropathic pain. Neuropathic pain was induced by tight ligation of L5 spinal nerve. When rats developed pain behaviors, EA was applied for 30 min. under enflurane anesthesia with repeated train stimuli at the intensity of 10X of muscle twitch threshold. The foot withdraw latency of the hind limb was measured for an indicator of pain level after each manipulation. Results : EA increased the mechanical threshold of the foot in the rat model of neuropathic pain significantly for the duration of 1 hr. suggesting a partial alleviation of pain. EA applied to SI6 point produced a significant improvement of mechanical sensitivity of the foot lasting for at least 1 h. However, $ST_{36}$ point did not produce any significant increase of mechanical sensitivity. The improvement of mechanical threshold was interpreted as an analgesic effect. The analgesic effort was specific to the acupuncture point since the analgesic effect on the neuropathic pain model could not be mimicked by EA applied to a point, $ST_{36}$. In addition, this analgesic effect of EA is mediated by a adrenergic mechanism of descending control of spinal cord from the brain. Conclusions : The data suggest that EA produces a potent analgesic effect on the neuropathic pain model in the rat; and 2) that EA-induced analgesia is mediated by a adrenergic mechanism of descending control in a point specific manner.

• Korean Journal of Acupuncture
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• v.22 no.1
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• pp.7-21
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• 2005

Objectives : In the present study, the effect of electroacupuncture (EA) applied to SI6 and won-rak point on the ankle sprain model was examined. A common source of persistent pain in humans is the lateral ankle sprain. Methods : To model this condition, the rat's right ankle was bent repeatedly, overextending lateral ligaments, for 4 min under enflurane anesthesia. The rat subsequently showed swelling of the ankle and a reduced stepping force of the affected limb for the next several days. The reduced stepping force of the limb was presumably due to a painful ankle. EA was applied to the several acupuncture point on the contralateral forelimb for 30 min under gaseous anesthesia. After the termination of EA, behavioral tests measuring stepping force and Paw volume were Periodically conducted during the next 4 h and 18 h respectively. Results : EA applied to $SI_6$ with won-rak point produced more powerful improvement of stepping force of the sprained foot than to $SI_6$ alone lasting for at least 4 h. However, neigher $KI_4$ point nor $BL_{64}$ point produced any significant increase of weight bearing force. The improvement of stepping pressure was interpreted as an analgesic effect. The analgesic effect was specific to the acupuncture point since the analgesic effort on the ankle sprain pain model could not be mimicked by EA applied to $KI_4$ or $BL_{64}$. In addition, EA applied to $SI_6$ with won-rak combination point showed inhibitory effect on the paw edema induced by ankle sprain. Also, COX-2 protein expression increased by ankle sprain were suppressed by the EA stimulation. Conclusion : These data suggest that EA with won-rak combination point produces a more potent analgesic effect on the ankle sprain pain model in the rat and that EA with won-rak combination point induced anti-inflammatory effect through the suppression of COX-2 protein expression.

• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.206-215
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• 2007

Background : The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. Materials and Methods : Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by $NICO^{(R)}$. We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. Results : In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. Conclusion : The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.