Effects of remote ischemic postconditioning on hepatic injury in lipopolysaccharide-induced endotoxemic rats / 대한마취과학회지

Background@#Remote ischemic postconditioning (RIPoC) is induced by several cycles of brief, reversible, mechanical blood flow occlusion, and reperfusion of the distal organs thereby protecting target organs. We investigated if RIPoC ameliorated liver injury in a lipopolysaccharide (LPS)-induced endotoxemic rats. @*Methods@#Protocol 1) Rats were administered LPS and samples collected at 0, 2, 6, 12, and 18 h. 2) After RIPoC at 2, 6, and 12 h (L+2R+18H, L+6R+18H, and L+12R+18H), samples were analyzed at 18 h. 3) RIPoC was performed at 2 h, analysis samples at 6, 12, 18 h (L+2R+6H, L+2R+12H, L+2R+18H), and RIPoC at 6 h, analysis at 12 h (L+6R+12H). 4) Rats were assigned to a control group while in the RIPoC group, RIPoC was performed at 2, 6, 10, and 14 h, with samples analyzed at 18 h. @*Results@#Protocol 1) Liver enzyme, malondialdehyde (MDA), tumor necrosis factor-α (TNF-α), and nuclear factor-κB (NF-κB) levels increased while superoxide dismutase (SOD) levels decreased over time. 2) Liver enzyme and MDA levels were lower while SOD levels were higher in L+12R+18H and L+6R+18H groups when compared with L+2R+18H group. 3) Liver enzyme and MDA levels were lower while SOD levels were higher in L+2R+6H and L+6R+12H groups when compared with L+2R+12H and L+2R+18H groups. 4) Liver enzyme, MDA, TNF-α, and NF-κB levels were lower while SOD levels were higher in RIPoC group when compared with control group. @*Conclusions@#RIPoC attenuated liver injury in the LPS-induced sepsis model by modifying inflammatory and oxidative stress response for a limited period.

Beneficial Role of Hydrogen Sulfide in Renal Ischemia Reperfusion Injury in Rats

PURPOSE: Hydrogen sulfide (H2S) is an endogenous gaseous molecule with important physiological roles. It is synthesized from cysteine by cystathionine γ-lyase (CGL) and cystathionine β-synthase (CBS). The present study examined the benefits of exogenous H2S on renal ischemia reperfusion (IR) injury, as well as the effects of CGL or CBS inhibition. Furthermore, we elucidated the mechanism underlying the action of H2S in the kidneys. MATERIALS AND METHODS: Thirty male Sprague-Dawley rats were randomly assigned to five groups: a sham, renal IR control, sodium hydrosulfide (NaHS) treatment, H2S donor, and CGL or CBS inhibitor administration group. Levels of blood urea nitrogen (BUN), serum creatinine (Cr), renal tissue malondialdehyde (MDA), and superoxide dismutase (SOD) were estimated. Histological changes, apoptosis, and expression of mitogen-activated protein kinase (MAPK) family members (extracellular signal-regulated kinase, c-Jun N-terminal kinase, and p38) were also evaluated. RESULTS: NaHS attenuated serum BUN and Cr levels, as well as histological damage caused by renal IR injury. Administration of NaHS also reduced oxidative stress as evident from decreased MDA, preserved SOD, and reduced apoptotic cells. Additionally, NaHS prevented renal IR-induced MAPK phosphorylation. The CGL or CBS group showed increased MAPK family activity; however, there was no significant difference in the IR control group. CONCLUSION: Exogenous H2S can mitigate IR injury-led renal damage. The proposed beneficial effect of H2S is, in part, because of the anti-oxidative stress associated with modulation of the MAPK signaling pathways.

Effect of preoperative pregabalin on postoperative pain after gastrectomy / 영남의대학술지

BACKGROUND: Pregabalin has been studied as a single or multimodal analgesic drug for postoperative pain management in different types of surgeries. We evaluated the analgesic effect of 150 mg of pregabalin in resolving post-gastrectomy pain.METHODS: Forty-four patients were randomized into two groups: a pregabalin group that received oral pregabalin (150 mg) 2 h before anesthetic induction, and a control group that received placebo tablets at the same time. Data on postoperative pain intensity (visual analog scale [VAS], at 30 min, 2 h, 4 h, and 24 h), consumption of fentanyl in patient-controlled analgesia (PCA), and the proportion of patients requiring rescue analgesics at different time intervals (0–2 h, 2–4 h, and 4–24 h) were collected during the 24 h postoperative period.RESULTS: The VAS scores did not show significant differences at any time point and consumption of fentanyl in PCA and the proportion of patients requiring rescue analgesics did not differ between the two groups. The groups did not differ in the occurrence of dizziness, sedation, and dry mouth.CONCLUSION: A preoperative 150 mg dose of pregabalin exerts no effect on acute pain after gastrectomy.

Effect of preoperative pregabalin on postoperative pain after gastrectomy / 영남의대학술지

BACKGROUND@#Pregabalin has been studied as a single or multimodal analgesic drug for postoperative pain management in different types of surgeries. We evaluated the analgesic effect of 150 mg of pregabalin in resolving post-gastrectomy pain.@*METHODS@#Forty-four patients were randomized into two groups: a pregabalin group that received oral pregabalin (150 mg) 2 h before anesthetic induction, and a control group that received placebo tablets at the same time. Data on postoperative pain intensity (visual analog scale [VAS], at 30 min, 2 h, 4 h, and 24 h), consumption of fentanyl in patient-controlled analgesia (PCA), and the proportion of patients requiring rescue analgesics at different time intervals (0–2 h, 2–4 h, and 4–24 h) were collected during the 24 h postoperative period.@*RESULTS@#The VAS scores did not show significant differences at any time point and consumption of fentanyl in PCA and the proportion of patients requiring rescue analgesics did not differ between the two groups. The groups did not differ in the occurrence of dizziness, sedation, and dry mouth.@*CONCLUSION@#A preoperative 150 mg dose of pregabalin exerts no effect on acute pain after gastrectomy.

Postoperative nausea and vomiting after thyroidectomy: a comparison between dexmedetomidine and remifentanil as part of balanced anesthesia / 대한마취과학회지

BACKGROUND: Postoperative nausea and vomiting (PONV) is the major complication related to general anesthesia, occurring in 60–80% of patients after thyroidectomy. The objective of this study was to compare the effects of an intraoperative dexmedetomidine infusion with remifentanil, as anesthetic adjuvants of balanced anesthesia, on PONV in patients undergoing thyroidectomy. METHODS: Eighty patients scheduled for thyroidectomy were randomized into the following two groups: 1) The dexmedetomidine group (Group D), who received an initial loading dose of dexmedetomidine (1 µg/kg over 10 min) during the induction of anesthesia, followed by a continuous infusion at a rate of 0.3–0.5 µg/kg/h; 2) the remifentanil group (group R), who received remifentanil at an initial target effect site concentration of 4 ng/ml during the induction of anesthesia, followed by a target effect site concentration of 2–3 ng/ml. PONV was assessed during the first 24 hours in 2 time periods (0–2 h and 2–24 h). The pain intensity, sedation score, extubation time, and hemodynamics were also assessed. RESULTS: During the 2 time periods, the incidence and severity of PONV in group D were significantly lower than in group R. In addition, the need for rescue antiemetics was significantly lower in group D than in group R. The effect of dexmedetomidine on postoperative pain relief (2–24 h) was superior to that of remifentanil. The hemodynamics were similar in both groups, whereas eye opening and extubation time were delayed in group D. CONCLUSIONS: Adjuvant use of intraoperative dexmedetomidine infusion may be effective for the prevention of PONV.

Anesthetic management of a patient with hypertrophic cardiomyopathy and patent ductus arteriosus / 대한마취과학회지

No abstract available.

Antiallodynic effects of vitamin C and vitamin E in chronic post-ischemia pain rat model / 대한마취과학회지

BACKGROUND: Recent research has shown that reactive oxygen species (ROS) play a significant role in the development and persistence of neuropathic pain through central sensitization via N-methyl-D-aspartate (NMDA) receptor activation. In the present study, we examined whether the intraperitoneal administration of vitamins C and E alone or together could alleviate mechanical allodynia in a chronic post-ischemia pain (CPIP) rat model. METHODS: Vitamins C and E were administered intraperitoneally to 48 male Sprague Dawley rats once per day for 3 days before hindpaw ischemia-reperfusion (I/R) injury was induced. On the third day, the CPIP rat model was produced by inducing ischemia in the left hindpaw by applying an O-ring for 3 h, followed by reperfusion. Three days after reperfusion, hindpaw mechanical allodynia was assessed by measuring the withdrawal response to von Frey filament stimulation. The rats were sacrificed immediately after behavioral testing to determine the phosphorylated NMDA receptor subunit 1 (pNR1) and extracellular-signal-regulated kinases (pERK) levels in the spinal cord. RESULTS: When the antioxidant vitamins C and E were administered intraperitoneally to CPIP rats, I/R injury-induced mechanical allodynia was attenuated, and pNR1 and pERK levels were decreased in the rat spinal cord. Additionally, the co-administration of both vitamins had an increased antiallodynic effect. CONCLUSIONS: The reduced phosphorylated NR1 and ERK levels indicate that vitamins C and E inhibit the modulation of spinal cord neuropathic pain processing. Co-administration of vitamins C and E had a greater antiallodynic effect.

Refractory status epilepticus occurred at the end of sevoflurane anesthesia in patient with epilepsy / 대한마취과학회지

No abstract available.

Effect of superoxide on the development and maintenance of mechanical allodynia in a rat model of chronic post-ischemia pain / 대한마취과학회지

BACKGROUND: Reactive oxygen species and inflammatory responses contribute to the development of neuropathic pain. Superoxide serves to mediate cell signaling processes and tissue injury during inflammation. We examined the effects of superoxide on the development and maintenance of mechanical allodynia, as well as its contribution to central sensitization in a superoxide-rich animal model of neuropathic pain. METHODS: Chronic post-ischemia pain (CPIP) was induced via the left hindpaw ischemia for 3 h, followed by reperfusion. Superoxide dismutase (4,000 U/kg, i.p.) was administered either 5 min before ischemia (BI), 5 min before reperfusion (BR), or 3 days after reperfusion (3AR). Withdrawal thresholds of the four paws were measured to assess the mechanical allodynia and the effects of circulating xanthine oxidase (XO)-mediated superoxide production. In addition, we measured the levels of N-methyl D-aspartate receptor subunit 1 phosphorylation (p-NR1) in the ipsilateral and contralateral spinal cord (L4-6), by Western blotting, to examine the superoxide-mediated central sensitization. Superoxide production was assessed by allopurinol-sensitive, XO-mediated lipid peroxidation of the spinal cord and gastrocnemius muscles. RESULTS: Withdrawal thresholds of forepaws did not vary across the 7 days of testing. In the hindpaws, both ipsilateral and contralateral mechanical allodynia was most attenuated in the BR group, followed by the BI and 3AR groups. The degree of NR1 activation was in contrast to the changes in the withdrawal thresholds. CONCLUSIONS: These data suggest that superoxide is involved in the development and maintenance of mechanical allodynia, particularly via central sensitization in the spinal cord.

Analysis of expert consultation referrals for anesthesia-related issues (December 2008-July 2010): KSA legislation committee report / 대한마취과학회지

BACKGROUND: Since 2009, database construction of anesthesia-related adverse events has been initiated through the legislation committee of the Korean Society of Anesthesiologists (KSA), based on expert consultation referrals provided by police departments, civil courts, and criminal courts. METHODS: This study was a retrospective descriptive analysis of expert consultation referrals on surgical anesthesia-related cases between December 2008 and July 2010. RESULTS: During the given period, 46 surgical anesthesia-related cases were referred to the KSA legislation committee for expert consultation. Because six cases were excluded due to insufficient data, 40 cases were included in the final analysis. Of 40 cases, 29 (72.5%) resulted in death. Respiratory events were most common in both surviving/disabled and dead patients (36.4 vs. 51.7%, respectively; P > 0.05). Overall, respiratory depression due to the drugs used for monitored anesthesia care (MAC) was the most common specific mechanism (25%), in which all but one case (profound brain damage) resulted in death. In all of these cases, surgeons or physicians provided MAC without the help of anesthesiologists. CONCLUSIONS: Overall, the most common damaging mechanism was related to respiratory depression due to sedatives or anesthetics used for MAC. Almost all MAC injury cases are believed to be preventable with the use of additional or better monitoring and an effective response to initial physiological derangement. Thus, it is essential to establish practical MAC guidelines and adhere to these guidelines strictly to reduce the occurrence of severe anesthesia-related adverse outcomes.

Superoxide and Nitric Oxide Involvement in Enhancing of N-methyl-D-aspartate Receptor-Mediated Central Sensitization in the Chronic Post-ischemia Pain Model

BACKGROUND: Recent studies indicate that reactive oxygen species (ROS) are involved in persistent pain, including neuropathic and inflammatory pain. Since the data suggest that ROS are involved in central sensitization, the present study examines the levels of activated N-methyl-D-aspartate (NMDA) receptors in the dorsal horn after an exogenous supply of three antioxidants in rats with chronic post-ischemia pain (CPIP). This serves as an animal model of complex regional pain syndrome type-I induced by hindpaw ischemia/reperfusion injury. METHODS: The application of tight-fitting O-rings for a period of three hours produced CPIP in male Sprague-Dawley rats. Allopurinol 4 mg/kg, allopurinol 40 mg/kg, superoxide dismutase (SOD) 4,000 U/kg, N-nitro-L-arginine methyl ester (L-NAME) 10 mg/kg and SOD 4,000 U/kg plus L-NAME 10 mg/kg were administered intraperitoneally just after O-ring application and on the first and second days after reperfusion. Mechanical allodynia was measured, and activation of the NMDA receptor subunit 1 (pNR1) of the lumbar spinal cord (L4-L6) was analyzed by the Western blot three days after reperfusion. RESULTS: Allopurinol reduced mechanical allodynia and attenuated the enhancement of spinal pNR1 expression in CPIP rats. SOD and L-NAME also blocked spinal pNR1 in accordance with the reduced mechanical allodynia in rats with CPIP. CONCLUSION: The present data suggest the contribution of superoxide, produced via xanthine oxidase, and the participation of superoxide and nitric oxide as a precursor of peroxynitrite in NMDA mediated central sensitization. Finally, the findings support a therapeutic potential for the manipulation of superoxide and nitric oxide in ischemia/reperfusion related pain conditions.

Contralateral allodynia and central change in the chronic post-ischemic pain model rats / 대한마취과학회지

BACKGROUND: Mirror-image allodynia is a mysterious phenomenon that occurs in association with many clinical pain syndromes including complex regional pain syndromes (CRPS). Underlying mechanisms for the development of such pain are still a matter of investigation. Several studies suggest that activation of the N-methyl-D-aspartate (NMDA) receptor is essential for central sensitization as a base for persistent pain. The aim is to assess whether alteration of NMDA receptor expression correlates with the contralateral allodynia in the chronic post-ischemia pain (CPIP) model rats representing CRPS-Type I. METHODS: Application of a tight-fitting tourniquet for a period of 3 hours before reperfusion produced CPIP in male Sprague-Dawley rats. The mechanical paw withdrawal thresholds to von Frey stimuli (using a dynamic plantar aesthesiometer) were measured as pain indicators in ipsilateral and contralateral hindpaws. Phosphorylation of the NMDA receptor 1 subunit (pNR1), assessed with Western blot, was measured in the contralateral L4-6 spinal cord. RESULTS: Ipsilateral and contralateral mechanical allodynia is present at 4 hours after reperfusion, peaked at 3 days, and continued for 7 days after reperfusion. The relative density of pNR1 of CPIP rats significantly decreased in the contralateral L4-6 spinal cord compared to baseline value (P < 0.05). There was significant correlation between paw withdrawal threshold and the relative density of pNR1 (ipsilateral; R2 = 0.75, P < 0.01, contralateral; R2 = 0.60, P < 0.01). CONCLUSIONS: These data suggest that pNR1 is correlated to the contralateral mechanical allodynia in CPIP rats.

Reactive oxygen species and N-methyl-D-aspartate receptor-mediated central sensitization in hindlimb ischemia/reperfusion injury-induced neuropathic pain rats / 대한마취과학회지

BACKGROUND: Reactive oxygen species (ROS) contribute to development of neuropathic pain. A neuropathic pain syndrome was produced in rats following prolonged hindpaw ischemia/reperfusion injury, creating an animal model of complex regional pain syndrome-Type I (CRPS-I). This study was designed to evaluate the validity of this model for ROS and pain research. Herein we show superoxide produces N-methyl-D-aspartate (NMDA) mediated mechanical allodynia. METHODS: Male adult SD rats were used for neuropathic pain model. Plasma superoxide production rates of before ischemia (BI) and 5 min after reperfusion (JR) were measured via cytochrome C reduction in the presence of xanthine (without xanthine oxidase, kinetics, 550 nm). Mechanical allodynia was measured in both hindpaws. Activation of NMDA receptor subunit 1 (P-NR1) of lumbar spinal cord (L4-L6) in accordance with the change of allodynia was analyzed by the Western blot. RESULTS: Allopurinol-inhibitable, xanthine oxidase-mediated plasma superoxide production was increased at AR. Mechanical allodynia was present in both hindpaws as early as 1 hr after reperfusion, and lasted at least 1 week. The expression of P-NR1 was the highest at 3 days after reperfusion when the withdrawal threshold was the lowest point. SOD significantly blocked P-NR1 activation. CONCLUSIONS: This study suggests that ischemia/reperfusion injury induced neuropathic pain model is a good candidate for the research fields of ROS and pain mechanism. The generation of ROS, especially superoxide is partly responsible for NMDA-mediated mechanical allodynia.

The effects of superoxide dismutase on the expression of c-fos gene in the chronic post-ischemic pain model rats / 대한마취과학회지

BACKGROUND: Chronic post-ischemia pain (CPIP) model is reported to represent the complex regional pain syndrome type I. The administration of non-specific free radical scavengers reduced mechanical allodynia, but it is not evident which type of free radical is responsible for the development of CPIP. This study was investigated to elucidate the role of superoxide on the development of CPIP and the relationship with the expression of c-fos gene. METHODS: Male Sprague-Dawley rats weighing 290-310 g were housed in one cage with food and water ad libitum. CPIP model was made by placing a tourniquet on the left hindpaw of rats. The tourniquet maintained for 3 hours, then released to allow reperfusion. Thirty minutes before reperfusion, superoxide dismutase (SOD) or normal saline (control group) was injected. Mechanical allodynia and cold allodynia were measured at 1, 3, 5, 7, 14 and 28 days after reperfusion and compared. Also, spinal cord was harvested and the expression of c-fos gene was measured through the real time reverse transcription polymerase chain reaction. RESULTS: Superoxide dismutase reduced mechanical allodynia (1, 3, 5 and 14 day) and cold allodynia (1, 3 and 7 day) compared with control rats in left hindpaw. Expression of c-fos was significantly reduced in the SOD rats at the day 14 and 28 compare to the control rats. CONCLUSIONS: The administration of superoxide dismutase suppressed the allodynia and c-fos gene expression of CPIP model rats and it may be suggested that the superoxide has an important role in the development of CPIP.

Effect of N-acetyl-cysteine on Allodynia in a Chronic Post-ischemia Pain Model of Rat

BACKGROUND: Complex regional pain syndrome type I (CRPS-I) is a clinical syndrome that is poorly understood and difficult to treat. Reactive oxygen species (ROS) and inflammatory responses may contribute to the development of CRPS-I. This study evaluated the effect of N-acetyl-cysteine (NAC) on both mechanical and cold allodynia in a rat CRPS-I model. METHODS: Male adult SD rats were used for the CRPS-I model that was produced following prolonged hindpaw ischemia/reperfusion. The rats were divided into 3 groups, Group O (-) (n = 8): rats without a tourniquet; Group O (+) (n = 8): rats received ischemic injury with a tourniquet on the hindpaw and they were reperfused 3 hours after the tourniquet application; and Group ON (+) (n = 8): rats received ischemic injury with a tourniquet ring on the hindpaw and they were reperfused 3 hours after the tourniquet application and they received intraperitoneal N-cetyl-ysteine (500 mg/kg) injection just after the tourniquet application and at 1 day and 2 days after the reperfusion. RESULTS: In the Group O (+), mechanical (von Frey hair) and cold (acetone exposure) allodynia were evident in the affected hindpaw as early as 1 day after reperfusion; this was extended for 2 weeks and it spread to the uninjured contralateral hindpaw. In the Group ON (+), the mechanical and cold allodynia were attenuated compared to those rats of Group O (+). CONCLUSIONS: NAC, a free radical scavenger, was able to reduce mechanical and cold allodynia in this model, and the generation of ROS is partly responsible for CRPS-I.

Change of Post-anesthetic Recovery Time after Colorectal Surgery with N-acetyl-cysteine Infusion / 대한마취과학회지

BACKGROUND: The gut is an important area for inflammatory responses. Gut manipulation during open laparotomy compared with laparoscopic surgery, increases the inflammatory responses. Laparoscopic assisted colectomy (LC) with less bowel manipulation might minimize the inflammatory responses and oxidative stress, and offer a faster postanesthetic recovery than an open colectomy (OC). This study evaluated the effect of N-acetyl-cysteine (NAC), an antioxidant, on the recovery after colectomy. METHODS: 116 colorectal tumor patients were reviewed retrospectively. The patients were divided into 3 groups; LC by surgeon A (A - L), OC by surgeon A (A - O) and OC by surgeon B (B - O). The postanesthetic recovery scores (PARS) were compared. In the prospective randomized controlled trial, the colorectal tumor patients were assigned to one of four groups; laparoscopic assisted colectomy (L - N) with NAC infusion (L + N), open colectomy (O - N) with NAC infusion (O + N). In the NAC groups, NAC (5 mg/kg/h) was infused after intubation to extubation. The PARS were compared. RESULTS: In the retrospective study, the time to reach 10 points, which satisfies the discharge criteria in the PACU, was significantly lower in the A-L group than in the other groups. In the prospective study, the time to 10 points was shorter in the O + N group than in the O-N group. NAC offered no added benefits to the L + N and L-N groups. CONCLUSIONS: NAC offered faster recovery in the OC group but not in the LC group.

Unusual Capnography due to Incorrect Assembly of Spring with Absorber Valve into Breathing Circuit - Experience of Normocarbia: A Case Report / 대한구급학회지

A focus on patient safety has heightened the awareness of pateint mornitoring. The importantce of clinical application of capnography continues to grow, as reflected by the increasing number of medical societies recommending its use. We recently encountered an abnormal capnography undergoing gastrectomy. It was noted that the waveform was not sustained zero-baseline formation as seen during inspiratory phase, immediately upsloping for expiratory plateau followed by inspiratoy downsloping as like a shape of curare cleft. But PaCO2 was within normal range. We found that the source of the problem was the incorrect (bottom up) assembly of spring with absorber valve into the CUBE, the circle breathing system of Dameca Ventilator. Spring with absorber valve divides CUBE circle into inspiratory and expiratory space. We concluded that the unusual capnography was resulted from the incorrect assembly of it, subsequently mixing of inspiratory and exhaled gases and rebreathing was occurred with the block of a gas flow to CO2 canister. After correcting assembly, the capnography was normalized.

Vascular Response of Isolated Rat Thoracic Aorta after Chemical Hypoxia/Reoxygenation / 대한마취과학회지

BACKGROUND: Hypoxia/reoxygenation (H/R) results in formation of toxic reactive oxygen species (ROS), which can impair the vascular pathophysiology. Nitric oxide (NO) is an important free radical in many physiological or pathological processes including H/R injury. The loss of NO after H/R might be one of the major causes of an impaired vascular response. METHODS: Isolated rat aortic rings were prepared and NaCN was used to induce chemical hypoxia. The NaCN concentration and the hypoxia/reoxygenation time were determined by the responsiveness of phenylephrine (Phe), sodium nitroprusside (SNP) and acetylcholine (Ach). A cumulative doses of Phe and SNP (10(-9)-10(-5.5) M) were added to construct the vascular contraction and relaxation curves. The cumulative doses of Ach (10(-9)-10(-5) M) were added to construct the relaxation after precontraction with Phe (10(-6) M). The effects of the N(G)-nitro-L-arginine methyl ester (L-NAME, 10(-4) M) and the superoxide dismutase (SOD, 50 unit) pretreatment during chemical H/R were evaluated. RESULTS: The NaCN concentration and H/R time were 1 mM, 30 minutes/5 minutes, respectively. Chemical hypoxia reduced the Phe-induced vascular contraction significantly. However chemical H/R increased the Phe-induced contraction significantly, and impaired the relaxation by SNP and Ach. A pretreatment with L-NAME increased the Phe-induced contraction and impaired the relaxation by SNP as well as Ach. The SOD pretreatment reduced the Phe-induced increased vascular contraction after NaCN-induced chemical H/R. CONCLUSIONS: NO plays a key role in endothelial-dependent relaxation and the recovery of the augmented contractility by vasoconstrictors after chemically-induced H/R.

Effect of Preventive Nicardipine on Hemodynamics Induced by Pneumoperitoneum during Laparoscopic Cholecystectomy / 대한마취과학회지

BACKGROUND: Pneumoperitoneum for a laparoscopic cholecystectomy induces hemodynamic changes. The present study investigated the effect of preventive nicardipine on the hemodynamics induced by pneumoperitoneum during a laparoscopic cholecystectomy. METHODS: Forty five patients, scheduled to undergo laparoscopic cholecystectomy, were selected, and divided into three groups; the control group (C; normal saline infusion), the nicardipine bolus injection group (NB; 20microgram/kg nicardipine infusion, 1 min before skin incision) and the nicardipine continuous infusion group (NI; 2microgram/kg/min continuous infusion, from the time of endotracheal intubation to pneumoperitoneum). The blood pressure, heart rate, cardiac output and systemic vascular resistance were measured; at preincision, and at 5, 10 and 15 min after insufflation and at 5 min after exsufflation. RESULTS: Nicardipine injection attenuated increases in the blood pressure, systemic vascular resistance after pneumoperitoneum, and didn't attenuate decrease in the cardiac output. CONCLUSIONS: A preventive nicardipine injection is effective in attenuating the hemodynamic change after pneumoperitoneum during a laparoscopic cholecystectomy, especially attenuated the systemic vascular resistance and blood pressure increase.

Oxidative Stress; Reactive Oxygen Species and Nitric Oxide / 대한구급학회지

No abstract available.