• Journal of Korean Academy of Nursing
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• v.47 no.4
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• pp.456-466
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• 2017

Purpose: This study was designed to determine the effects of pre-warming on core body temperature (CBT) and hemodynamics from the induction of spinal anesthesia until 30 min postoperatively in surgical patients who undergo total hip replacement under spinal anesthesia. Our goal was to assess postoperative shivering and inflammatory response. Methods: Sixty-two surgical patients were recruited by informed notice. Data for this study were collected at a 1,300-bed university hospital in Incheon, South Korea from January 15 through November 15, 2013. Data on CBT, systemic blood pressure (SBP), and heart rate were measured from arrival in the pre-anesthesia room to 3 hours after the induction of spinal anesthesia. Shivering was measured for 30 minutes post-operatively. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured pre-operatively, and 1 and 2 days postoperatively. The 62 patients were randomly allocated to an experimental group (EG), which underwent pre-warming for 30 minutes, or a control group (CG), which did not undergo pre-warming. Results: Analysis of CBT from induction of spinal anesthesia to 3 hours after induction revealed significant interaction between group and time (F=3.85, p=.008). In addition, the incidence of shivering in the EG was lower than that in the CG ($x^2=6.15$, p=.013). However, analyses of SBP, heart rate, CRP, and ESR did not reveal significant interaction between time and group. Conclusion: Pre-warming for 30 minutes is effective in increasing CBT 2 and 3 hours after induction of spinal anesthesia. In addition, pre-warming is effective in decreasing post-operative shivering.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.3
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• pp.169-175
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• 2018

Background: The objective of this study was to compare hemodynamic and recovery characteristics of total intravenous anesthesia using propofol target-controlled infusion (TCI) versus sevoflurane for extraction of four third molar teeth. Methods: One hundred patients undergoing extraction of four third molar teeth under general anesthesia were randomized to one of two groups. Group 1 received propofol TCI-oxygen for induction and propofol TCI-oxygen-air for maintenance. Group II received a propofol bolus of 2 mg/kg for induction and sevoflurane-oxygen-air for maintenance. Heart rate, mean arterial pressure (MAP), operating time, time to emergence, nausea and vomiting, and sedation and pain scores were measured in each group. Results: Demographic data, including age, gender, weight, and height, were not significantly different between the two groups. The MAP was significantly higher after intubation (P = 0.007) and injection of anesthesia (P = 0.004) in the propofol group than in the sevoflurane group, with significant reflex bradycardia (P = 0.028). The mean time to emergence from anesthesia using propofol was 25 s shorter than that of sevoflurane (P = 0.02). Postoperatively, the propofol group was less sedated than the sevoflurane group at 30 min (0.02 versus 0.12), but this difference was not significant (P = 0.065). Conclusion: Both propofol TCI and sevoflurane are good alternatives for induction and maintenance of anesthesia for short day-case surgery. However, propofol TCI does not blunt the hemodynamic response to sudden, severe stimuli as strongly as sevoflurane, and this limitation may be a cause for concern in patients with cardiac comorbidities.

• Journal of Veterinary Clinics
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• v.15 no.2
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• pp.399-403
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• 1998

To clarify the anesthetic effect of acupoint injection(aquapupuncture) using general anasthetics in dogs, 18 mongrel dogs were divided into control and two experimental groups(Tian-ping+Bai-hui : Tian-ping group and San-yang-luo+Gong-sun group : San -yang- lux group). Control group was intramuscularly injected with ketamine hydrochloride, 22 mg/ kg of body weight into the thigh and experimental groups were injected into each acupoint with half volume of dosage, respectively. Clinical findings(recumbency time, induction time of anesthesia, time of head lift and standing time) and changes of vital sign(temperature, heart rate and respiration rate) were investigates at pre-anesthesia, during anesthesia and poststanding, respectively. In recumbency time San-yang-luo groupui<0.05) and Tian-ping group (p<0.05) were faster than that of control, respectively and Tian-ping group was the fastest. In induction time of anesthesia San-yang-luo group was similar to that of control, however, Tian-ping group was faster than that of control(p

• Journal of Veterinary Clinics
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• v.36 no.6
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• pp.306-313
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• 2019

It is important to identify the most suitable anesthetic agent that has minimal side effects to be able to control and perform surgeries on bears. In this study, we examined and compared the induction and recovery times as well as the physiological changes occurring during anesthesia induced by medetomidine-zolazepam/tiletamine (MZT) and xylazine-zolazepam/tiletamine (XZT) at general anesthesia for laparoscopic salpingectomy in 326 female Asiatic black bears. The body temperature, heart rate, respiratory rate, and levels of PaO₂ and EtCO₂ were the physiological changes measured during surgical procedures in female bears after anesthesia. In addition, the levels of pO₂, pCO₂, and sO₂ were measured using a portable blood gas analyzer. To induce recovery from anesthesia, bears anesthetized with MZT were intravenously administered atipamezole and bears anesthetized with XZT were intravenously administered yohimbine. The combination MZT, at dosages of 0.019 ± 0.001 mg/kg for medetomidine and 1.4 ± 0.1 mg/kg for ZT, or the combination XZT, at dosages of 2.0 ± 0.1 mg/kg for xylazine and 3.0 ± 0.1 mg/kg for ZT, proved to be reliable and effective in anesthetizing Asiatic black bears for a 40-min handling period for routine clinical procedures. The average anesthesia induction times were 16.5 ± 0.95 min for the bears in the MZT group and 12.0 ± 0.44 min for those in the XZT group. A significant difference was noted between the two drugs (P < 0.001) in terms of the average anesthesia induction time. The anesthesia induction time was shorter for bears with lower body weights than those with higher body weights (P < 0.05). The recovery time of MZT was significantly faster than that of XZT (11.3 ± 0.45 min vs. 18.5 ± 0.83 min) (P < .001). The bears anesthetized with MZT exhibited lower cardiopulmonary suppression than those anesthetized with XZT (P < 0.05). The body temperatures and EtCO₂ of bears in the M ZT group were significantly lower than those in the XZT group as time progressed after anesthesia (P < 0.05). The average pO₂ before the bears were supplied with oxygen was 64.8 ± 3.7 mmHg, but it increased to 211.5 ± 42.5 mmHg afterwards (P < 0.001). In conclusion, our results indicate that bears anesthetized with MZT have longer anesthesia induction time, shorter recovery time, slower heart and respiratory rates, and lower body temperatures and EtCO₂ than those anesthetized with XZT. These findings suggest that XZT is preferable to MZT, warranting further research on its uses and clinical responses in bears.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.3
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• pp.235-240
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• 2017

Pulseless electrical activity (PEA) is a clinical condition characterized by unresponsiveness and lack of palpable pulse in the presence of organized cardiac electrical activity and is caused by a profound cardiovascular insult (e.g., severe prolonged hypoxia or acidosis, extreme hypovolemia, or flow-restricting pulmonary embolus). Amyotrophic lateral sclerosis (ALS) is a disease that is characterized by progressive degeneration of all levels of the motor nervous system. Damage to the respiratory system and weakness of the muscles may increase the likelihood of an emergency situation occurring in patients with ALS while under general anesthesia. We report a case of PEA during the induction of general anesthesia in a patient with ALS who presented for dental treatment and discuss the causes of PEA and necessary considerations for general anesthesia in patients with ALS.

• Journal of Veterinary Clinics
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• v.18 no.4
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• pp.311-314
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• 2001

To elucidate the effect of dorsal acupoints for canine electroacupuncture anesthesia, mongrel dogs(6 heads: 2.6-10.5kg, 3 males and 3 females) were used. After needling perpendicularly to Tian-Ping(GV-5) and Bai-Hui(GV-20), the electrodes were connected with positive to Tian-Ping and negative to Bi-hui, respectively using with veterinary electroacupuncture apparatus(TEC AM-3000). The electric conditions were 2-4V and 30 Hz. The pain of body surface was checked by hemostatic forceps. The effect of electroacupuncture andesthesia was appreciated by application of laparotomy(2 heads), ear trimming and tail amputation(1 head), castration(2 heads) and enterotomy(1 head), respectively. Induction time, clinical findings and operation findings were investigated under the electroacupuncture anesthesia. The induction time of electroacupuncture anesthesia was very rapid, approximately 1 minute and the pain of body surface including the extremities was not detected. As for clinical findings during electroacupuncture anesthesia, consciousness was evident, pupil reflex was weak and blepharoreaction was existed. As for operation findings, pain was not detected during incision and suture, and bleeding was relatively small volume. The grade of electroacupuncture anesthesia was excellent in all cases applied with ear trimming and tail amputation, laparatomy, castration and enterotomy. Considering above all findings, it was thought that electroacupuncture stimulation at Tian-Ping and Bai-hui examined in the present study induced excellent electroacupuncture anesthesia for dogs.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.7
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• pp.2491-2496
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• 2010

The DFA(detrended fluctuation analysis) which is included the correlation property of the EEG is used to analysis the depth of anesthesia. We studied ASA I or II adult patients supported by the society of anesthesiologists. Patients with history of dementia and neurological disorder are excluded. Average age is $48.9{\pm}10.9$ old, average weight is $57.1{\pm}8.2$ kg and average hight is $158{\pm}6.6$cm of the patients under the operation. Anesthesia medicine is Sevoflurane and the stages of anesthesia are 6 stages, that is pre-operation, induction, right after induction, stop the medicine and post-operation. Among the scaling exponent ${\alpha}1$, ${\alpha}2$, ${\alpha}3$ we know that ${\alpha}1$, ${\alpha}3$, were well appeared to discriminate pre-operation, induction, right after induction, stop the medicine and post-operation. So we confirmed that the parameters is useful to the depth of anesthesia.

• Journal of Veterinary Clinics
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• v.15 no.2
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• pp.404-409
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• 1998

To elucidate the effect of the acupoints of the limbo for canine electroacupunhur anesthesial total 140 heads of dogs were used. The animals were divided into 3 experimental groups(Gong-sun, San-yin-jiao and Qiang-feng and contro1 group(non-acupoint). The induction time, clinical findings and the results of operation using laparatomy were investigated under the electroacupunture anesthesia and compared with those of control. The induction time of electroacupunture anesthesia was very rapids about 1 minute in experimental groups, while it is unable to succeed in anesthesia of control group. As far clinical Bindings during electroacupunture anesthesia, the experimental animals had vivid consciousness and stability without tumult and barking. The success rate of operation was high with decreasing order of Gong-sun group(50/50, 100%) > San-yin·jiao group(26/30, 86.7%) 1 Qiag-feng group(18/ 30, 60%) in experimental groups. Considering above findings collectively, the combination of Gong-sun and San-yang-luo is thought to be best method among the acupoints of the limbs for canine electroacupunture anesthesia.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.4
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• pp.313-316
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• 2017

Mask ventilation, the first step in airway management, is a rescue technique when endotracheal intubation fails. Therefore, ordinary airway management for the induction of general anesthesia cannot be conducted in the situation of difficult mask ventilation (DMV). Here, we report a case of awake intubation in a patient with a huge orocutaneous fistula. A 58-year-old woman was scheduled to undergo a wide excision, reconstruction with a reconstruction plate, and supraomohyoid neck dissection on the left side and an anterolateral thigh flap due to a huge orocutaneous fistula that occurred after a previous mandibulectomy and flap surgery. During induction, DMV was predicted, and we planned an awake intubation. The patient was sedated with dexmedetomidine and remifentanil. She was intubated with a nasotracheal tube using a video laryngoscope, and spontaneous ventilation was maintained. This case demonstrates that awake intubation using a video laryngoscope can be as good as a fiberoptic scope.

• 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.