Relationship between Diabetes Mellitus and Anemia in Korean Adults-Based on the Korean National Health and Nutritional Examination Survey VI

Anemia, defined as a reduction in the hemoglobin concentration of blood, is common in diabetes mellitus (DM) patients, can be potentially caused by diabetes complications such as nephropathy. Recent research suggests that diabetes mellitus (DM) itself may be a major risk factor of anemia. However, there are few Korean studies on the relationship between diabetes mellitus (DM) and anemia. This study was performed to investigate the association between anemia and diabetes mellitus (DM) in Korean adults. A total of 10,151 Korean adults over aged 19 years (4,422 male, 5,729 female) were selected from the participants of the Korean National Health and Nutrition Examination Survey VI (KNHANES VI). Korean adults with anemia had a higher prevalence of diabetes mellitus (DM) than the normal adults (11.4% vs. 30.4% in male, 8.8% vs. 9.4% in female). The unadjusted odds ratio (OR) for anemia was greater in adults with DM than in normal male (OR=3.28; 95% CI: 2.27~4.73). After adjusting for other risk factors including age, education, family income, smoking, drinking, and menstrual status, anemia and diabetes were not associated (OR=1.33; 95% CI: 0.84~2.09). Similarly, there was no association between anemia and diabetes in female. In conclusion, this study shows that the prevalence of anemia is similar in diabetic and non-diabetic Korean adults after adjusting for multiple risk factors. Further research is required to elucidate the mechanism of anemia caused as a consequence of diabetes mellitus (DM).

Effects of Remifentanil, Esmolol, and Lidocaine Administered before a Tracheal Intubation on the Heart Rate Variability

OBJECTIVE: The purpose of this study was to evaluate effects of remifentanil, esmolol, and lidocaine administered before a tracheal intubation on the autonomic nervous system using heart rate variability. METHODS: In a randomized, prospective trial, we enrolled 60 patients undergoing a tracheal intubation under general anesthesia. After an induction of anesthesia using propofol and rocuronium, patients received either remifentanil 1.0 microg/kg (group R), esmolol 1.0 mg/kg (group E), or lidocaine 1.5 mg/kg (group L). Standard deviation of the normal to normal interval (SDNN), low frequency power (LF), and high frequency power (HF) were measured before and after the administration of three drugs. Heart rate and mean arterial pressure were measured before and after the tracheal intubation. RESULTS: SDNN was not different between three groups. After the administration of drugs, LF mainly indicating the sympathetic nervous system activity was lower in the group E than in group R and L. HF indicating the parasympathetic nervous system activity was higher in group R than in group E and L. After the tracheal intubation, heart rate was lower in group R and E than in group L. Mean arterial pressure was lower in group R than in group E and L. CONCLUSION: Hemodynamic changes according to the tracheal intubation were attenuated by remifentanil 1 microg/kg or esmolol 1 mg/kg, not by lidocaine 1.5 mg/kg. Remifentanil stimulated parasympathetic nervous system and esmolol suppressed sympathetic nervous system.

Prophylactic effect of dexamethasone in reducing postoperative sore throat / 대한마취과학회지

BACKGROUND: This study was performed to compare the effectiveness of prophylactic dexamethasone and postintubation dexamethasone in reducing the incidence and severity of postoperative sore throat (POST). METHODS: This was a prospective, randomized, double-blind clinical trial. The study population consisted of 70 patients between 20 and 60 years old who were classified as American Society of Anesthesiologists I-II and were scheduled for elective laparoscopic cholecystectomy. The patients were divided randomly into two groups. Patients in the prophylactic and postintubation groups received intravenous injection of 10 mg of dexamethasone 30 min before or after tracheal intubation, respectively. The patients were interviewed 1, 6, and 24 h after the operation. The incidence and severity of POST were recorded. RESULTS: The severity scores of POST at 1 and 6 h after the operation were significantly lower in the prophylactic group than in the postintubation group. There were no significant differences in the incidence of POST during the 24 h after the operation between the two groups (22/32 in the prophylactic group vs. 27/34 in the postintubation group, P = 0.403). CONCLUSIONS: Intravenous injection of 10 mg of dexamethasone was more effective in reducing the severity of POST when administered before tracheal intubation compared with after tracheal intubation.