• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.1
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• pp.275-284
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• 2013

With the propofol-induced accident such as adverse effects, abuse, death is becoming to the fore as a social issue, there is an increasingly loud call for self-examination about excessive propofol use. The purpose of this study was to identify the knowledge, attitudes and practices in health care professionals and awareness in the public toward propofol. Participants in this study were 359 health care professionals, and 682 publics who is going to undergo endoscopy. The collected data was analyzed using t-test, ANOVA, Scheffe for knowledge, attitude, and practice toward propofol in health care professionals, Pearson Correlation for its correlation. and frequencies, %, mean for others. Scores of knowledge, attitudes, and practices were 7.16 (11), 3.26 (5), 3.95 (5) respectively. Nurses' attitudes toward propofol was much more higher than doctors', doctors' practice toward propofol was higher than nurses'. There was a correlation among knowledge, attitudes, and practices toward propofol. 53.4% of the publics answered that never heard what is propofol. Considering these results, regular customized and standardized-education strategies for both groups need to be developed for the purpose of proper use and management of propofol.

• The Korean Journal of Physiology and Pharmacology
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• v.25 no.1
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• pp.69-77
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• 2021

Propofol infusion syndrome characterized by rhabdomyolysis, metabolic acidosis, kidney, and heart failure has been reported in long-term propofol use for sedation. It has been reported that intracellular adenosine triphosphate (ATP) is reduced in rhabdomyolysis. The study aims to investigate the protective effect of ATP against possible skeletal muscle damage of propofol in albino Wistar male rats biochemically and histopathologically. PA-50 (n = 6) and PA-100 (n = 6) groups of animals was injected intraperitoneally to 4 mg/kg ATP. An equal volume (0.5 ml) of distilled water was administered intraperitoneally to the P-50, P-100, and HG groups. One hour after the administration of ATP and distilled water, 50 mg/kg propofol was injected intraperitoneally to the P-50 and PA-50 groups. This procedure was repeated once a day for 30 days. The dose of 100 mg/kg propofol was injected intraperitoneally to the P-100 and PA-100 groups. This procedure was performed three times with an interval of 1 days. Our experimental results showed that propofol increased serum CK, CK-MB, creatinine, BUN, TP I, ALT, AST levels, and muscle tissue MDA levels at 100 mg/kg compared to 50 mg/kg and decreased tGSH levels. At a dose of 100 mg/kg, propofol caused more severe histopathological damage compared to 50 mg/kg. It was found that ATP prevented propofol-induced muscle damage and organ dysfunction at a dose of 50 mg/kg at a higher level compared to 100 mg/kg. ATP may be useful in the treatment of propofol-induced rhabdomyolysis and multiple organ damage.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.65-69
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• 2017

Patients with severe gag reflex (SGR) have difficulty getting the treatment they require in local clinics, and many tend to postpone the start of their treatment. To address this problem, dentists have used behavioral techniques and/or pharmacological techniques for treatment. Among the pharmacological methods available, propofol IV sedation is preferred over general anesthesia because it is a simpler procedure. Propofol in combination with remifentanil is characterized by stable sedative effects and quick recovery, leading to a deep sedation. Remifentanil acts to reduce the pain caused by lipid-soluble propofol on injection. The synergistic effects of propofol-remifentanil include reduction in the total amount of drug required to achieve a desired sedation level and anti-emetic effects. In this case report, we outline how the use of propofol-remifentanil IV sedation enabled us to successfully complete a wide range of dental treatments in a patient with SGR.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.39-47
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• 2016

Background: Oxidative stress occurs during the aging process and other conditions such as bone fracture, bone diseases, and osteoporosis, but the role of oxidative stress in bone remodeling is unknown. Propofol exerts antioxidant effects, but the mechanisms of propofol preconditioning on oxidative stress have not been fully explained. Therefore, the aim of this study was to evaluate the protective effects of propofol against $H_2O_2$-induced oxidative stress on a human fetal osteoblast (hFOB) cell line via activation of autophagy. Methods: Cells were randomly divided into the following groups: control cells were incubated in normoxia (5% $CO_2$, 21% $O_2$, and 74% $N_2$) without propofol. Hydrogen peroxide ($H_2O_2$) group cells were exposed to $H_2O_2\;(200{\mu}M)$ for 2 h, propofol preconditioning (PPC)/$H_2O_2$ group cells were pretreated with propofol then exposed to $H_2O_2$, 3-methyladenine (3-MA)/PPC/$H_2O_2$ cells were pretreated with 3-MA (1 mM) and propofol, then were exposed to $H_2O_2$. Cell viability and apoptosis were evaluated. Osteoblast maturation was determined by assaying bone nodular mineralization. Expression levels of bone related proteins were determined by western blot. Results: Cell viability and bone nodular mineralization were decreased significantly by $H_2O_2$, and this effect was rescued by propofol preconditioning. Propofol preconditioning effectively decreased $H_2O_2$-induced hFOB cell apoptosis. However, pretreatment with 3-MA inhibited the protective effect of propofol. In western blot analysis, propofol preconditioning increased protein levels of collagen type I, BMP-2, osterix, and TGF-${\beta}1$. Conclusions: This study suggests that propofol preconditioning has a protective effect on $H_2O_2$-induced hFOB cell death, which is mediated by autophagy activation.

• Journal of Veterinary Clinics
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• v.19 no.3
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• pp.277-282
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• 2002

This study was designed to evaluate the effects of anesthetics on waveform of SEPs and to authorize possible anesthetic protocol for measurement of the somatosensory evoked potentials (SEPs). Thirteen anesthetic methods were used. The SEPs were recorded on two channels (between the 5th and 6th lumbar vertebra as the channel 1 and between the 11th and 12th thoracic vertebra as the channel 2) following stimulation of posterior tibial nerve. ID analyze SEPs wave, latency and conduction velocity were measured. Among thirteen anesthetic methods, standard SEPs waveforms were observed in dogs anesthetized with following six methods: Acepromazine + Thiepfntal Na + Isoflurane, Acepronazine + Propofol + Isoflurane, Diazepam + Xylazine, Xylazine + Ketamine, Acepromazine + Propofol infusion and Propofol infusion. Above six methods could be used with sufficient anesthetic depth. The differences of latency and conduction velocity among six groups were minimal compared to general waveform of SEPs. These results indicate that the six anesthetic methods can be used for recording SEPs in the dog. In particular, Diazepam + Xylazine and XylaBine + Ketamine as injectable anesthesia are considered more convenient than other four methods in veterinary medicine.

• The Korean Journal of Physiology and Pharmacology
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• v.4 no.1
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• pp.73-79
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• 2000

This study investigated whether propofol, an intravenous, non-barbiturate anesthetic, could reduce brain damage following global forebrain ischemia. Transient global ischemia was induced in gerbils by occlusion of bilateral carotid arteries for 3 min. Propofol (50 mg/kg) was administered intraperitoneally 30 min before, immediately after, and at 1 h, 2 h, 6 h after occlusion. Thereafter, propofol was administered twice daily for three days. Treated animals were processed in parallel with ischemic animals receiving 10% intralipid as a vehicle or with sham-operated controls. In histologic findings, counts of viable neurons were made in the pyramidal cell layer of the hippocampal CA1 area 4 days after ischemia. The number of viable neurons in the pyramidal cell layer of CA1 area was similar in animals treated with a vehicle or a subanesthetic dose of propofol. In terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end-labeling (TUNEL) assay, semiquantitative analysis of dark-brown neuronal cells was made in the hippocampal CA1 area. There was no significant difference in the degree of TUNEL staining in the hippocampal CA1 area between vehicle-treated and propofol-treated animals. These results show that subanesthetic dose of propofol does not reduce delayed neuronal cell death following transient global ischemia in Mongolian gerbils.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.3
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• pp.151-158
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• 2019

Background: This study aimed to examine whether the combination of low-dose ketamine and propofol in deep sedation is clinically useful in controlling the behavior in intellectually disabled patients who are typically extremely noncooperative during dental procedures. Methods: A total of 107 extremely noncooperative intellectually disabled adult patients were analyzed. In all patients, deep sedation was performed using either propofol alone (group P) or using a combination of propofol and 0.2 mg/kg or 0.4 mg/kg ketamine (groups PK0.2 and PK0.4, respectively). The procedures were performed in the order of insertion of nasal cannula into the nostril, attachment of mouth gag, and mouth cleaning and scaling. The frequency of patient movement during the procedures, mean arterial pressure, heart rate, peripheral oxygen saturation, recovery time, discharge time, and postoperative nausea and vomiting were examined. Results: The three groups were significantly different only in the frequency of patient movement upon stimulation during single intravenous injection of propofol and scaling. Conclusion: For propofol deep sedation, in contrast to intravenous injection of propofol alone, prior intravenous injection of low-dose ketamine (0.4 mg/kg) is clinically useful because it neither affects recovery, nor causes side effects and can suppress patient movement and vascular pain during procedures.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.6
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• pp.437-442
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• 2022

Background: Propofol is a short-acting intravenous sedative widely used for procedural sedation and general anesthesia. However, pain during propofol injection is a distressing adverse effect. This study was designed to investigate whether transcutaneous electrical nerve stimulation (TENS) could reduce pain during propofol injection compared to sham TENS. Methods: In a randomized controlled trial, 80 patients were allocated to two groups: the active TENS group received electrical stimulation via two electrodes on the venous cannulation site, whereas the sham TENS group received no stimulus. After 20 min following TENS, propofol 0.5 mg/kg pain was injected intravenously and pain was evaluated using a four-point score (0 = none, 1 = mild, 2 = moderate, 3 = severe). Adverse effects associated with TENS were also recorded. Results: The overall incidence of pain during propofol injection was 47.5% in the TENS group and 87.5% in the sham group (P < 0.001). The incidence of moderate pain was significantly lower in the TENS group (7.5%) than in the sham TENS group (42.5%) (P < 0.001). There were no complications associated with TENS. Conclusion: Pre-treatment with TENS significantly reduced the incidence and intensity of pain during propofol injection.

• Journal of Korean Neurosurgical Society
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• v.56 no.2
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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.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.220-224
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• 1997

Background: The incidence of pain on injection of propofol varies between 30 and 100%. A variety of pretreatments have been tried to alleviate this problem such as a local anesthetics, cooling and opioids. However, none of these pharmacological maneuvers were satisfactory yet. In a recent study, subhypnotic doses of both thiopental sodium and propofol decrease the acute pain. We report a comparison of thiopental sodium, lidocaine and placebo on the incidence and severity of pain on injection of propofol. Method: A controlled, double-blind study was performed to compare the prior administration of intravenous saline 2 ml(n=30, group S), lidocaine 20 mg(n=30, group L) and thiopental sodium 50 mg(n=30, group T) in alleviating the pain by propofol. Injection pain was assessed with the four-point verbal categorical scoring system. Result: The incidence of injection pain during induction was lower in group L(30%) and T(17%) than group S(77%). The incidence of injection pain was lower in group T(17%) than group L(30%), but not significant statistically. The pain scores for recall of pain in the recovery room was simlar to those pain during propofol induction. Conclusion: The pretreatment of thiopental sodium can be effective in reducing both incidence and severity of propofol injection pain and has similar effect to lidocaine to prevent propofol injection pain.