• 제목/요약/키워드: infusion anesthesia

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개에서 주사 및 도입마취제로서 Propofol의 마취효과 및 심폐기능에 미치는 영향 (Anesthetic and Cardiopulmonary Effects of Propofol as Infusion and Induction Anesthesia in Dogs)

  • 유준호;이충호;김완희;남치주;권오경
    • 대한수의학회지
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    • 제42권1호
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    • pp.123-130
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    • 2002
  • To investigate the cardiopulmonary and anesthetic effects of propofol in dogs, experimental dogs were randomly divided into 4 groups (propofol infusion anesthesia, P/INF, propofol intermittent anesthesia, P/INTER, propofol induction anesthesia, P/ISO, thiopental Na induction anesthesia, T/ISO) and monitored analgesic and anesthetic effects, recovery time, body temperature, heart rate, mean arterial pressure, respiratory rate, systolic and diastolic pressure. In all groups, apnea was not observed. In the P/INF group, the respiratory rate(RR) was slightly decreased, but in the P/INTER group, RR was increased and shallowing. In the groups of P/ISO and T/ISO, the respiratory rate was decreased. Heart rate(HR) was increased after induction anesthesia in all groups, but gradually decreased. Mean arterial pressure(MAP) was decreased after injection anesthesia in the groups of P/INF and P/INTER. In the groups of P/ISO and T/ISO, however, MAP was slightly increased. Systolic and diastolic arterial pressure were gradually decreased after induction anesthesia, but not significantly. In the groups of P/INF and P/ISO, recovery time was shorter than the groups of P/INTER and T/ISO. In all groups, body temperature of animals was decreased gradually according to time but no significant changes were observed. Propofol injection doesn't make the complete loss of responses of animals, especially, in the P/INTER group. In the P/INF group, deep pain was present until the end of anesthetic period. During recovery period, any other side effects except incoordination were not monitored. The present study suggested that infusion anesthesia was superior to intermittent anesthesia as injection anesthetic agent, and propofol was better than thiopental Na as induction anesthetic agent.

Comparative randomized study of propofol target-controlled infusion versus sevoflurane anesthesia for third molar extraction

  • Chung, Patrick K;Dhanrajani, Parmanand
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제18권3호
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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.

개에서 Propofol 점적투여율 변화에 따른 마취효과 (Comparative Anesthetic Effect as Propofol Infusion Rate During Maintenance of Anesthesia in Dog)

  • 장광호;임재현;장인호
    • 한국임상수의학회지
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    • 제17권1호
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    • pp.109-120
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    • 2000
  • To evaluate anesthetic effecto of propofol infusion after premedication with xylazine, 20 days were randomly assigned 4 groups. Propofol was infused (group 1: 0.2 mg/kg/min, group 2 : 0.4 mg/kg/min, group 3 : 0.6 mg/kg/min, group 4 : 0.8 mg/kg/min) for a period of 90 minute immediately after premedication with xylazine(1 mg/kg) and atropine(0.05mg/kg) under oxygen supplementation. Induction of anesthesia was rapid and smooth providing satisfactory conditions for intubation in all the dogs. No vomiting and cyanosis were observed after induction and during propofol infustion. There was pain reflex in group 1 but not in group 3 and 4. Mean arousal times (mins) were $6.18{\pm}3.65(group 1), 13.07{\pm}5.05(group 2), 22.06{\pm}6.48(group 3) and 23.33{\pm}9.28 (group 4) and Mean walking times were 16.20{\pm}6.15(group 1), 15.80{\pm}4.73(group 2), 28.27{\pm}7.55 (group 3), 39.10{\pm}13.75$ (group 4) respectively. In group 4, body temperature during total infusion period in group 3, 4. Hematologic values (WBC, RBC, PCV) and serum chemistry values(ALT, AST, BUN, creatinite) were monitored before anesthesia, 1 hour and 1 day after termination of infusion postanestesia. No significant changes were monitored in all experimental group. Although propofol infusions of 0.2 mg/kg/min and 0.4mg/kg/min were considered too low to maintain a suitable depth of anesthesia, but that of 0.6mg/kg/min were considered too low to maintain a suitable depth of anesthesia, but that of 0.6mg/kg/min proper to provide a light planes for minor surgical procedure during 90 minutes with xylazine premedication.

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Effects of Dexmedetomidine Infusion During Sevoflurane Anesthesia on Otoacoustic Emissions

  • Sahin, Mehmet Ilhan;Vural, Alperen;Akin, Aynur;Ketenci, Ibrahim;Unlu, Yasar
    • Journal of Audiology & Otology
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    • 제23권2호
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    • pp.89-95
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    • 2019
  • Background and Objectives: Knowing the ototoxic potential of the agents used in medical treatments is important for the protection of hearing. Although we have knowledge regarding some effects of dexmedetomidine, which is an anesthetic-sparing drug, its influence over the hearing system has never been studied and is obscure yet. The aim of this study is to determine the effects of intravenous dexmedetomidine application during sevoflurane anesthesia on otoacoustic emissions (OAEs). Subjects and Methods: This prospective randomized study was performed on 60 patients (34 male, 26 female, mean age: 30.6±9.2 years) who were scheduled for an elective surgery under general anesthesia and the patients were enrolled and randomly divided into 2 groups. They received dexmedetomidine (Group D) or Saline (Group S) infusion during a standardized Sevoflurane anesthesia. Transient and distortion product OAEs were measured preoperatively and postoperatively (24th hour). OAE results were compared within and between groups. Results: In group D postoperative OAEs were lower than preoperative OAEs and postoperative levels of group S, especially at low frequencies (p<0.05). Conclusions: Dexmedetomidine infusion affects the micromechanical function of cochlea especially in the low-frequency region. Dexmedetomidine should be carefully used during general anesthesia to avoid its probable harmful effects on cochlear micromechanics.

Effects of Dexmedetomidine Infusion During Sevoflurane Anesthesia on Otoacoustic Emissions

  • Sahin, Mehmet Ilhan;Vural, Alperen;Akin, Aynur;Ketenci, Ibrahim;Unlu, Yasar
    • 대한청각학회지
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    • 제23권2호
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    • pp.89-95
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    • 2019
  • Background and Objectives: Knowing the ototoxic potential of the agents used in medical treatments is important for the protection of hearing. Although we have knowledge regarding some effects of dexmedetomidine, which is an anesthetic-sparing drug, its influence over the hearing system has never been studied and is obscure yet. The aim of this study is to determine the effects of intravenous dexmedetomidine application during sevoflurane anesthesia on otoacoustic emissions (OAEs). Subjects and Methods: This prospective randomized study was performed on 60 patients (34 male, 26 female, mean age: 30.6±9.2 years) who were scheduled for an elective surgery under general anesthesia and the patients were enrolled and randomly divided into 2 groups. They received dexmedetomidine (Group D) or Saline (Group S) infusion during a standardized Sevoflurane anesthesia. Transient and distortion product OAEs were measured preoperatively and postoperatively (24th hour). OAE results were compared within and between groups. Results: In group D postoperative OAEs were lower than preoperative OAEs and postoperative levels of group S, especially at low frequencies (p<0.05). Conclusions: Dexmedetomidine infusion affects the micromechanical function of cochlea especially in the low-frequency region. Dexmedetomidine should be carefully used during general anesthesia to avoid its probable harmful effects on cochlear micromechanics.

Propofol Infusion Associated Metabolic Acidosis in Patients Undergoing Neurosurgical Anesthesia : A Retrospective Study

  • Choi, Yoon Ji;Kim, Min Chul;Lim, Young Jin;Yoon, Seung Zhoo;Yoon, Suk Min;Yoon, Hei Ryeo
    • Journal of Korean Neurosurgical Society
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    • 제56권2호
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    • pp.135-140
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    • 2014
  • Objective : Propofol and volatile anesthesia have been associated with metabolic acidosis induced by increased lactate. This study was designed to evaluate changes in pH, base excess (BE), and lactate in response to different anesthetic agents and to characterize propofol infusion-associated lactic acidosis. Methods : The medical records of patients undergoing neurosurgical anesthesia between January 2005 and September 2012 were examined. Patients were divided into 2 groups : those who received propofol (total intravenous anesthesia, TIVA) and those who received sevoflurane (balanced inhalation anesthesia, BIA) anesthesia. Propensity analysis was performed (1 : 1 match, n=47), and the characteristics of the patients who developed severe acidosis were recorded. Results : In the matched TIVA and BIA groups, the incidence of metabolic acidosis (11% vs. 13%, p=1) and base excess (p>0.05) were similar. All patients in the TIVA group who developed severe acidosis did so within 4 hours of the initiation of propofol infusion, and these patients improved when propofol was discontinued. Conclusions : The incidence of metabolic acidosis was similar during neurosurgical anesthesia with propofol or sevoflurane. In addition, severe acidosis associated with propofol infusion appears to be reversible when propofol is discontinued.

제왕절개술을 위한 척추 마취시 Ephedrine의 예방적 정맥적주에 관한 연구 (Prophylactic Intravenous Ephedrine Infusion during Spinal Anesthesia for Cesarean Section)

  • 구본업
    • Journal of Yeungnam Medical Science
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    • 제8권1호
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    • pp.72-78
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    • 1991
  • 척추 마취로 제왕절개술을 받은 건강한 30명의 산모를 대상으로 ephedrine sulfate의 정맥적 주군(15명)과 정맥내 주사군(15명)의 산모혈압과 심박, 오심, 구토, Apgar scores, 산모와 태아의 혈압가스압 등을 비교 관찰하였든바 다음과 같은 결론을 얻었다. 1) 척추마취후 적주군의 수축기 산모혈압은 의의있는 변화가 없었으나(p>0.1), 정주군에는 5, 7분 후 술전치에 비해 통계학적으로 의의있게 하강하였으며(p<0.005), 적주군과의 비교에서도 의의있는 변화를 나타내었다(p<0.001). 2) 적주군에서 정주근보다 오심, 구토의 발생 빈도가 낮았다(p<0.001). 3) 산모의 심박, Apgar scores, 산모와 태아의 혈액 가스압에는 양군간 유의한 차이는 없었다. 이상과 같이 제왕절개술을 위한 척추 마취시 ephedrine의 예방적 정맥내 적주가 안전하고 효과적일 것으로 사료된다.

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개에서 Propofol 점적투여율 변화가 심혈관계에 미치는 영향 (Cardiovascular Effects of Propofol Infused for Maintenance of Anesthesia in Dogs)

  • 권영삼;장광호;장환수;박현정;임재현;오태호;엄기동;장인호
    • 한국임상수의학회지
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    • 제19권2호
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    • pp.199-203
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    • 2002
  • Cardiovascular effects of propofol, were assessed after premedication with xylazine(1.0 mUkg, IM) under oxygen supply(200 ml/kg/min) via a endotracheal tube. Twelve adult mixed-breed dogs were divided into four groups; 0.2(Group 1), 0.4(Group 2), 0.6(Group 3) and 0.8 mg/kg/min(Group 4) of propofol respectively. Arterial blood pressure and electrocardiogram were monitored with a physiograph after an arterial catheter was inserted into the femoral artery. pH, arterial carbon dioxide tension($PaCO_2$and arterial oxygen tension($PaO_2$) were evaluated with arterial blood collected through the inserted catheter. Diastolic arterial pressure, systolic arterial pressure and mean arterial pressure were decreased slightly in Group I IIand III, but decreased significantly in Group IV. They were increased rapidly after stopping propofol infusion in Group IV pH was maintained in normal range in Group I, II and m, but was decreased in proportion to time passing in Group IV. $PaCO_2$ was increased significantly only in Group IV but $PaO_2$ was maintained in normal range in all groups Although heart rate was recorded in normal range for 90 minutes, arythmia was noted after stopping propofol infusion in all groups. It was concluded that propofol depressed the cardiovascular system in proportion to infusion dosage, and 0.8 mg/kg/min of propofol infusion rate was not appropriated in canine anesthesia with xylazine premedication.

Infusion Methods for Continuous Interscalene Brachial Plexus Block for Postoperative Pain Control after Arthroscopic Rotator Cuff Repair

  • Byeon, Gyeong Jo;Shin, Sang Wook;Yoon, Ji Uk;Kim, Eun Jung;Baek, Seung Hoon;Ri, Hyun Su
    • The Korean Journal of Pain
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    • 제28권3호
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    • pp.210-216
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    • 2015
  • Background: Infusion methods during regional analgesia using perineural catheters may influence the quality of postoperative analgesia. This study was conducted to compare the effects of combined or bolus-only infusion of 0.2% ropivacaine on the postoperative analgesia in interscalene brachial plexus block (ISBPB) with perineural catheterization. Methods: Patients scheduled for arthroscopic rotator cuff repair were divided into two groups, one that would receive a combined infusion (group C, n = 32), and one that would receive intermittent infusion (group I, n = 32). A perineural catheter was inserted into the interscalene brachial plexus (ISBP) using ultrasound (US) and nerve stimulation, and 10 ml of 0.2% ropivacaine was administered. After the operation, group C received a continuous infusion of 4 ml/h, and a 4 ml bolus with a lockout interval of 60 min. Group I received only a 4 ml bolus, and the lockout interval was 30 min. Postoperative pain by the numeric rating scale (NRS) and the forearm muscle tone by the manual muscle test (MMT) were checked and evaluated at the following timepoints: preoperative, and postoperative 1, 4, 12, 24, 36, and 48 h. Supplemental opioid requirements, total consumed dose of local anesthetic, and adverse effects were compared between the two groups. Results: Sixty-four patients completed the study and the postoperative values such as operation time, time to discharge, and operation site were comparable. There were no differences in NRS scores and supplemental opioid requirements between the two groups. The MMT scores of group I at 4 and 12 h after surgery were significantly higher than those of group C (P < 0.05). The total consumed dose of local anesthetic was significantly lower in group I than in group C (P < 0.05). The adverse effects were not different between the groups. Conclusions: The bolus-only administration of 0.2% ropivacaine provided a similar analgesic effect with a lower total volume of local anesthetic and decreased motor weakness compared to combined infusion. Therefore, bolus-only administration is an effective postoperative analgesic method in ISBPB with perineural catheterization after rotator cuff repair.

Optimal effect-site concentration of remifentanil for minimizing cardiovascular changes caused by fiberoptic nasotracheal intubation

  • Kim, Eun-Jung;Jeon, Hyun-Wook;Kim, Tae-Kyun;Baek, Seung-Hoon;Yoon, Ji-Uk;Yoon, Ji-Young
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제15권4호
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    • pp.221-227
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    • 2015
  • Background: Endotracheal intubation induces clinically adverse cardiovascular changes. Various pharmacological strategies for controlling these responses have been suggested with opioids being widely administered. In this study, the optimal effect-site concentration (Ce) of remifentanil for minimizing hemodynamic responses to fiberoptic nasotracheal intubation was evaluated. Methods: Thirty patients, aged 18-63 years, scheduled for elective surgery were included. Anesthesia was induced with a propofol and remifentanil infusion via target-controlled infusion (TCI). Remifentanil infusion was initiated at 3.0 ng/mL, and the response of each patient determined the Ce of remifentanil for the next patient by the Dixon up-and-down method at an interval of 0.5 ng/mL. Rocuronium was administered after propofol and remifentanil reached their preset Ce; 90 seconds later fiberoptic nasotracheal intubation was initiated. Non-invasive blood pressure and heart rate (HR) were measured at pre-induction, the time Ce was reached, immediately before and after intubation, and at 1 and 3 minutes after intubation. The up-and-down criteria comprised a 20% change in mean blood pressure and HR between just prior to intubation and 1 minute after intubation. Results: The median effective effect-site concentration ($EC_{50}$) of remifentanil was $3.11{\pm}0.38ng/mL$ by the Dixon's up-and-down method. From the probit analysis, the $EC_{50}$ of remifentanil was 3.43 ng/mL (95% confidence interval, 2.90-4.06 ng/mL). In PAVA, the EC50 and EC95 of remifentanil were 3.57 ng/mL (95% CI, 2.95-3.89) and 4.35 ng/mL (95% CI, 3.93-4.45). No remifentanil-related complications were observed. Conclusions: The $EC_{50}$ of remifentanil for minimizing the cardiovascular changes and side effects associated with fiberoptic nasotracheal intubation was 3.11-3.43 ng/mL during propofol TCI anesthesia with a Ce of 4 ug/mL.