Effects of Thiopental or Midazolam , Alone and in Combination , on the Induction Time and the Cardiovacular Responses / 대한마취과학회지

There was a report that midazolam-thiopental coinduction reduced ED99 of thiopental for hypnosis from 5.75 mg to 2.37 mg. This study was designed to test whether the former study can be used clinically and to compare midazolam-thiopental coinduction with thiopental or midazolam induction. After 120 patients of ASA calss I, II classified into 3 groups randomly, 5.75 mg/kg of thiopental was injected intravenously to each patient for Group I while 0.23 mg/kg of midazolam was injected intravenously to each patient for Group II. For Group III, 2.37 mg/kg of thiopental was injected intravenously to each patient one minute after 0.02 mg/kg of midazolam was injected. Induction rate, induction time, and the changes of cardiovascular response for each group have been compared and the results are as follows: 1) Induction rate was 100%, 75%, 75% for each group. 2) Time for the spontaneous eye closure and loss of the eyelid reflex for Group I were 12.2+/-8.0 seconds, 20.36.9 seconds respectively, while for Group II 51.5+/-26.5 seconds, 69.3+/-29.5 seconds, and for Group III, 25.3+/-7.4 seconds, 37.0+/-10.8 seconds (G. I< G. III < G. II). 3) However, heart rate was relatively higher in Group I at the point of induction but there were no significant differences between groups statistically. 4) It was also impossible to prove that the changes of blood pressure were more stable in one group than others statistically. By judging from the results above, midazolam-pentothal coinduction can be a useful means of induction but coinduction is not superior to thiopental or midazolam induction.

A Case Report of Central Nervous System Toxicity following Accidental Injection of Tranexamic acid into Subarachnoid space / 대한마취과학회지

Neurologic Sequelae after spinal anesthesia are extrenely rare, due in part to use of prepackaged and sterile kits and the small doses of local anesthectics employed. We have experienced 42 years old healthy male developed cental nervous system toxicity due to injection of wrong substance into subarachnoid space. And the patient recovered 3 days later with mild pulmonary edema and about 72 hour anterograde amnesia after symptomatic treatment.