Conscious Sedation by Propofol TCi for Corrective Surgery of a Mandibular Fracture / 대한마취과학회지

BACKGORUND: infusion of propofol by a target-controlled infusion (TCi) system is effective in achieving conscious sedation for anxious patients presenting for dental surgery. However, there is no report of conscious sedation for mandibular fracture patients using propofol TCi. The objective of this study was to evaluate the appropriation of a conscious sedation using propofol for mandibular fracture patients. METHODS: Twenty patients with a mandibular fracture undergoing an open reduction and miniplate insertion operation were analyzed. We anesthetized patients using a propofol infusion by a TCi system (Diprifusor :Master TCi:Pilot Anesthesia is, France) with local anesthesia using lidocaine. The BiS score was evaluated continually during surgery using a microcomputer (A-2000 BiS monitor , Aspect Medical System, USA). We set the infusion machine at a target concentration 2mug/ml, and adjusted the propofol concentration for a BiS score range of 80-85. infusion rate, total dosage, duration of induction, recall of operative procedure and cooperation scores were checked. BiS, heart rate, noninvasive arterial blood pressure, and SpO2 were recorded during the operation. RESULTS: The mean BiS score was 82.95, the mean target concentration of propofol was 2.645mug/ml, the mean infusion rate was 136.3mug/kg/min, and the mean cooperation score was 2.5, the patients were cooperative. The score of amnesia was 0.2, almost patients did not recall the intraoperative event. The mean duration of stay in the recovery room was 22.2 minutes, and the most frequent side effect was pain on injecion of propofol. CONCLUSiONS: Conscious sedation with propofol TCi is an effective anesthesia method substitute for general anesthesia with quick emergence, few side effects, and safety for mandibular fracture patients.

The Effect of Lidocaine on the Onset Time of Rocuronium-induced Neuromuscular Blockade in Adults / 대한마취과학회지

BACKGROUND: Rapid-sequence intubation is a common technique to reduce anesthetic complication. Due to side effects of succinylcholine, nondepolarizing muscle relaxants have been tried. Rocuronium is a new nondepolarizing muscle relaxant with a brief onset of action, but devoid of the adverse reaction associated with succinylcholine. Most local anesthetics decrease neuromuscular transmission and pontentiate neuromuscular blocks of muscle relaxants. The purpose of this study was to examine the effect of lidocaine on the onset time of rocuronium-induced neuromuscular blockade in adults. METHODS: Fourty five patients, ASA physical status I or II, were randomly divided into three groups. Anesthetic induction with thiopental 5 mg/kg was made. Succinylcholine (1.0 mg/kg) was administered intravenously in group 1. Rocuronium (0.6 mg/kg) was given in group 2, additional lidocaine (1.0 mg/kg) was given intravenously 1 minute prior to the administration of rocuronium in group 3. Neuromuscular blockade was assessed by train-of-four at the adductor pollicis muscle with supramaximal stimulation of the ulnar nerve (2 Hz, 0.2 msec) every 10 seconds. The condition of intubation, the appearance of arrhythmias, side effects of drugs, and the changes of mean arterial pressure and heart rate were checked and compared in peri-induction periods. RESULTS: The onset time of group 1 (55.1 14.9 sec) was faster than that of group 2 (137.8 46.0 sec) and group 3 (139.3 41.0 sec), but there was no difference between the onset time of group 2 and that of group 3. Intubating conditions were good or excellent in all groups, but group 1 and 3 were better than group 2. There was no difference between the three groups in hemodynamics. More adverse effects were observed in group 1, that of group 2 and 3 were observed in only one case. CONCLUSIONS: The authors concluded that lidocaine is not effective on the onset time of rocuronium, but improves the intubating condition. Rocuronium is devoid of side effects of succinylcholine, but not a alternative to succinylcholine because its onset time is too slow when compared with succinylcholine.

The Effect of Lidocaine on the Onset Time of Rocuronium-induced Neuromuscular Blockade in Adults / 대한마취과학회지

BACKGROUND: Rapid-sequence intubation is a common technique to reduce anesthetic complication. Due to side effects of succinylcholine, nondepolarizing muscle relaxants have been tried. Rocuronium is a new nondepolarizing muscle relaxant with a brief onset of action, but devoid of the adverse reaction associated with succinylcholine. Most local anesthetics decrease neuromuscular transmission and pontentiate neuromuscular blocks of muscle relaxants. The purpose of this study was to examine the effect of lidocaine on the onset time of rocuronium-induced neuromuscular blockade in adults. METHODS: Fourty five patients, ASA physical status I or II, were randomly divided into three groups. Anesthetic induction with thiopental 5 mg/kg was made. Succinylcholine (1.0 mg/kg) was administered intravenously in group 1. Rocuronium (0.6 mg/kg) was given in group 2, additional lidocaine (1.0 mg/kg) was given intravenously 1 minute prior to the administration of rocuronium in group 3. Neuromuscular blockade was assessed by train-of-four at the adductor pollicis muscle with supramaximal stimulation of the ulnar nerve (2 Hz, 0.2 msec) every 10 seconds. The condition of intubation, the appearance of arrhythmias, side effects of drugs, and the changes of mean arterial pressure and heart rate were checked and compared in peri-induction periods. RESULTS: The onset time of group 1 (55.1 14.9 sec) was faster than that of group 2 (137.8 46.0 sec) and group 3 (139.3 41.0 sec), but there was no difference between the onset time of group 2 and that of group 3. Intubating conditions were good or excellent in all groups, but group 1 and 3 were better than group 2. There was no difference between the three groups in hemodynamics. More adverse effects were observed in group 1, that of group 2 and 3 were observed in only one case. CONCLUSIONS: The authors concluded that lidocaine is not effective on the onset time of rocuronium, but improves the intubating condition. Rocuronium is devoid of side effects of succinylcholine, but not a alternative to succinylcholine because its onset time is too slow when compared with succinylcholine.

A Study on Weight Control Attempt and Related Factors among College Female Students / 대한지역사회영양학회지

The purpose of this study was to investigate the weight control attempts and related factors among 220 female college students in Seoul. Factors examined included body image, body satisfaction, interest in weight control, beliefs related to weight control, social norms, social expectations regarding subjects' body size and weight change. Data were analyzed using t-test and chi-square test(at alpha=0.05). The average height and weight of subjects were 160.7 cm, 52.2 kg respectively. BMI and body fat(%) were 20.2 and 25.2%, respectively. One hundred seventy two students(78.2%) had attempted to control their weight, mainly to lose weight, and were categorized as the weight control attempt group. Subjects used diet modification as well as unhealthy method to control weight. 48.2% in the attempt group were underweight or normal weight(by BMI), suggesting that their weight control attempts were was unnecessary. Students in the attempt group described their own size as heavier than those in the no-attempt group(p<0.01) or other girls of their age(p<0.05) ; more dissatisfied with their body size(p<0.01), and showed more interest in weight control(p<0.01). Several differences in beliefs were also noted(p<0.001). The attempt group believed less strongly in the harmful effects or difficulties in weight control and believed more strongly in the advantages of weight control. With respect to social factors, the attempt group perceived that their family and friends wanted them to be smaller than they were(p<0.001), perceived that significant others felt that they should lose weight(p<0.05). These results suggest that educational programs for college female students should start focusing on the harmful effects of excessive dieting and information about desirable weight control methods. Students should be helped to have a correct body image. In addition, educational programs should incorporate strategies to change beliefs regarding weight control, as well as modifying social expectations from significant others.