Effect of Hyperbaric Bupivacaine Spinal Anesthesia with Epinephrine / 대한마취과학회지

The effect of spinal anesthesia with hyperbaric bupivacaine with and without 1: 1000 epinephrine were studied in 35 patients. Patients in group A received 0.4% hyperbaric bypivacaine 20 mg and patients in group B received the same anesthetic, only 0.2 mg of epinephrine was mixed to it. The following results were obtained. 1) The highest level of sensory loss was similar in both groups. 2) The duration of sensory loss was significantly longer in group B(391+/-12.9 vs 289+/-18.8min, p<0.05) The duration of motor block was also significantly longer in group B than group A(254 +/-13.7 vs 17l+/-4.4 min). 3) The systolic blood pressure significantly decreased at 20-40 minutes after spinal anesthesia in both groups. 4) The pulse rate in group A significantly increased at 2-10 minutes after spinal anesthesia and in group B, it decreased significantly at 45-50 minutes after spinal anesthesia.

Anesthetic Induction with Single Bolus Doses of Propofol / 대한마취과학회지

Propofol, by virtue of its favorable pharmacokinetic profile, has already achieved considerable popularity for induction and maintenance of anesthesia for short duration surgery. Short acting opioids are often used as part of balanced technique. Because of their similar pharmacodynamic characteristics(rapid onset and short duration of action), it seems that propofol and fentanyl would be a adequate complementary agents for total intravenous anesthesia when used in combination. The purpose of present study was to access the effect of fentanyl on the changes hemodynamic and respiratory responses when used in combination with propofol. Eighty patients of ASA grade l or 2 scheduled to undergo minor gynecological, abdominal and orthopedic procedures were allocated randomly to 4 groups. Group A, C was induced with pentothal sodium or propofol alone respectively and maintained using 60% nitrous oxide in oxygen. Cardiovascular and respiratory parameters were checked before induction, and 2, 4, 6, 8 minutes after injection. The results were as follows 1) Changes in mean arterial pressur, after 2 minutes were more significantly decreased in propofol with fentanyl group than propofol alone. 2) Changes in heart rate Minimal changes in propofol group, but showed significantly decrease in propofol-fentanyl group. 3) Resipiratory changes Propofol-fentanyl group produce a more frequent, long standing apnea than other group. 4) Side effect Excitatory effects, and pain on injection were more frequent in propofol group than pentothal sodium group. Nausea, vomiting were more frequent in pentothal sodium group than propofol group.

Effects of Enflurane Anesthesia and Surgery on Thyroid Function / 대한마취과학회지

This study was performed to investigate the effects of enflurane anesthesia and surgery on thyroid function by determining the plasma concentration of thyroxid(T4) and trilodothyronine(T3) in 10 patients who had neither hepatic disorder nor endocrine disease. Each patient was premedicated with diazepam 10mg and atropine sulfate 0.5mg intramuscularly one hour before induction of anesthesia. Anesthesia was induced with pentohal sodium and maintained with enflurane and oxygen supplemented with pancuronium bromide in divided dose as needed. plasma concentrations of thyroxine and triiodothyronine were measured by means of radiommunoassay. The results obtained were as follows: 1) No significant change in the plasma concentration of thyroxine was detected during enflurane anesthesia and surgery. 2) Plasma concentration of triidothyronine decreased significantly, compared with the control level, during enflurane anesthesia alone and anesthesia plus surgery. Although the precise mechanisms for the decrease in triiodothyronine following anesthesia and surgery remain unknown, decreased peripheral conversion from T4 to T3 may be responsible for this decline. Our data imply that enflurane anesthesia did not stimulate thyroid funcion judged by plasma concentration of T4 or T3. Therefore, enflurane anesthesia may be an useful anesthetics for patients with hyperthyroidism.