Effects of Adusted Dose of Local Anesthetic Considered Patient's Characteristics for Spinal Anesthesia for Elective Cesarean Section / 대한마취과학회지

BACKGROUND: Dosage influences distribution of a local anesthetic solution in cerebrospinal fluid. The dose of intrathecal local anesthetic was investigated, taking into account the patient's weight and height, to see whether this would stabilize the hemodynamics and provide adequate spinal anesthesia for Cesarean section. METHODS: In this double-blind prospective study, 60 patients undergoing elective Caesarean delivery were randomized to receive either fentanyl 25microgram in hyperbaric 0.5% bupivacaine 2.5 ml (Group 1) or fentanyl 25microgram and 0.9% normal saline in a volume of hyperbaric 0.5% bupivacaine, taking into account the patient's weight and height (Group 2). The patient's hemodynamics, time to sugical incision, supplementary analgesia and conversion to general anesthesia, etc were recorded. RESULTS: The incidence of hypotension and use of ephedrine were decreased, and the administration of fluid and the duration of motor blockade were significantly shorter in Group 2. The time to surgical incision was faster and the peak sensory level was higher in Group 1. Others effects were similar in both groups. CONCLUSIONS: The dose of intrathecal local anesthetic, taking into account the patient's weight and height stabilized the hemodynamics and provided adequate spinal anesthesia for elective Cesarean section.

Inhibitory Effects of Propofol Mixed with Lidocaine on Fentanyl Induced Cough Reflex / 대한마취과학회지

BACKGROUND: Propofol and lidocaine have been purported to attenuate bronchoconstriction induced by fentanyl administration during induction of anesthesia. The purpose of the present study was to study the synergic bronchodilation effect of propofol mixed with lidocaine. METHODS: Two hundred and thirty four patients were randomly allocated to five groups: Group 1 (n = 60, normal saline 0.25 ml/kg followed by fentanyl 3ng/kg), Group 2 (n = 30, propofol 2 mg/kg mixed with normal saline 0.05 ml/kg followed by normal saline 0.06 ml/kg), Group 3 (n = 50, propofol 2 mg/kg mixed with normal saline 0.05 ml/kg followed by fentanyl 3ng/kg), Group 4 (n = 33, propofol 2 mg/kg mixed with lidocaine 1 mg/kg followed by normal saline 0.06 ml/kg) and Group 5 (n = 61, propofol 2 mg/kg mixed with lidocaine 1 mg/kg followed by fentanyl 3ng/kg). All patients were injected with fentanyl or normal saline two minutes after administration of propofol premixed with lidocaine or normal saline, respectively. We checked the cough reflex, injection pain, oxygen desaturation and chest wall rigidity. RESULTS: There was a significant difference in the incidence of cough reflex between group 1 and 3 or 5. The incidience of group 5 was significantly lower than in group 3. CONCLUSIONS: This study suggests that a propofol-lidocaine mixture should be considered when patients require bronchodilation during induction of anesthesia.