Corrigendum: Occurrence bilateral bronchospasm consequently after unilateral bronchospasm (Korean J Anesthesiol 2013 December 65(6 Suppl): S28-S29) / 대한마취과학회지

The fourth author's name was misspelled as Doo Jae Min. The correct spelling is Too Jae Min.

Occurrence bilateral bronchospasm consequently after unilateral bronchospasm / 대한마취과학회지

No abstract available.

The effect of ketamine on the separation anxiety and emergence agitation in children undergoing brief ophthalmic surgery under desflurane general anesthesia / 대한마취과학회지

BACKGROUND: Emergence agitation (EA) frequently occurs after desflurane anesthesia in children. Ketamine, because of its sedative and analgesic properties, might be useful for the management of separation anxiety and EA. We investigated the preventive effect of ketamine on separation anxiety and EA after desflurane anesthesia in children for brief ophthalmic surgery. METHODS: Sixty children, ranging in age from 2-8 years old, undergoing brief ophthalmic surgery were randomly allocated to one of the 3 groups: group C received normal saline, group K1.0 received ketamine 1.0 mg/kg intravenously before entering the operating room, or group K0.5 received ketamine 0.5 mg/kg 10 min before the end of the surgery. Before induction, the separation anxiety score was evaluated. Extubation time, post-anesthesia care unit stay time, postoperative nausea and vomiting, emergence agitation, and pain were assessed. RESULTS: The group K1.0 had a lower separation anxiety score compared with groups K0.5 and C. Extubation time in group K0.5 was significantly prolonged compared with groups K1.0 and C. The incidence of EA and the modified Children's Hospital of Eastern Ontario Pain Scale were significantly lower in group K1.0 and group K0.5 compared to group C, but there was no significant difference between groups K1.0 and K0.5. CONCLUSIONS: In children undergoing brief ophthalmic surgery with desflurane anesthesia, ketamine 1.0 mg/kg administered before entering the operating room reduced separation anxiety, postoperative pain, and incidence of EA without delay in recovery.

Cerebral hemorrhage presenting as alteration of consciousness during the anesthesia recovery period: A case report

Catastrophic neurological events can occur rarely in anesthetic recovery period and they must be quickly diagnosed. We report here on a spontaneous intracerebral hemorrhage (SICH) that developed during the anesthesia recovery period in a 52-year-old man who had undergone uneventful orthopedic surgery. He had predisposing factors including 25 year history of heavy alcohol consumption and smoking. The risk of spontaneous intracerebral hemorrhage following non-cardiovascular and non-neurovascular surgery is exceedingly small during the anesthesia recovery period, especially for a patient with no history of hypertension and coagulopathy. We also describe the differential diagnosis of an altered mental status that occurs during anesthetic recovery period.

Effect of fentanyl on hemodynamic changes connected with a thigh tourniquet during knee arthroscopic surgery / 대한마취과학회지

BACKGROUND: The use of a tourniquet can produce pain and increase in blood pressure. It is known that fentanyl reduces central sensitization, however its effect on blood pressure increase due to tourniquet is unknown. So we investigated the effect of fentanyl on tourniquet-induced changes of mean arterial blood pressure (MBP), heart rate (HR), and cardiac index (CI). METHODS: ASA physical status I and II, who were scheduled for knee arthroscopic surgery using a tourniquet, were assigned into control (n = 30) and fentanyl group (n = 30). Anesthesia was maintained with enflurane, N2O and O2. Fentanyl was injected 1.5 ug/kg at 10 min before inflation of the tourniquet in the fentanyl group. Changes of the MBP, HR, CI were measured before and 10, 20, 30, 40, 50, 60 min after inflation of the tourniquet. RESULTS: There were no differences in the baseline values. MBP was increased at 40, 50, 60 min in the control group. At 60 min, MBP was lower in the fentanyl than the control group. HR was decreased at 10 min in the fentanyl group. CI was decreased in all groups after tourniquet inflation. At 60 min, CI was more decreased in the control than the fentanyl group. CONCLUSIONS: Fentanyl injection prior to tourniquet inflation can attenuate the tourniquet induced hemodynamic changes in the knee arthroscopic surgery patients.

Effect of Ketorolac on Blood Pressure Changes Connected with a Thigh Tourniquet during Knee Arthroscopic Surgery / 대한마취과학회지

BACKGROUND: The use of a tourniquet can produce pain and cause increased blood pressure. Ketorolac is known to have analgesic effects at the peripheral and central levels, however, its effect on the increased blood pressure due to a tourniquet is unknown. Therefore, the effects of ketorolac on the tourniquet-induced changes in the systolic, and diastolic blood pressures (SBP & DBP), as well as the heart rate (HR), were investigated. METHODS: ASA physical status I and II patients, who were scheduled for knee arthroscopic surgery using a tourniquet, were assigned to control (n = 20), K30 (n = 20) and K60 groups (n = 20). Anesthesia was maintained with enflurane, N2O and O2. Either 30 or 60 mg ketorolac was injected 10 min prior to tourniquet inflation in both the K30 and K60 groups. The changes in the SBP, DBP and HR were measured before and 10, 20, 30, 40, 50, and 60 min after tourniquet inflation. RESULTS: There were no differences in the baseline SBP, DBP, and HR values. The SBP was higher than the baseline value at 10, 20, 30, 40, 50, and 60 min in the control and at 30, 40, 50, and 60 min in the K30 groups, but only at 60 min in the K60 group. At 60 min, the SBP was lower in the K60 than the control group. The DBP was higher than the baseline value at 50, and 60 min in the control, but not in the ketorolac groups. CONCLUSIONS: A 60 mg ketorolac injection prior to tourniquet inflation can attenuate the tourniquet induced increase in blood pressure in knee arthroscopic surgery patients.

The Effect of Sevoflurane on Myocardial Function and Coronary Flow in an Isolated-Heart Rat Model / 대한마취과학회지

BACKGROUND: Ischemic preconditioning (IPC) and some volatile anesthetics have been shown to attenuate ischemia-reperfusion injury in an isolated-heart model. The aim of this study was to determine whether sevoflurane has a cardioprotective effect on isolated-heart models when given before prolonged periods of global ischemia. METHODS: 48 male Sprague-Dawley rat hearts were randomly subdivided into four groups. Rats were anesthetized with 25 mg ketamine. After hearts had been removed, and perfused with a modified Krebs solution gassed with 5% CO2 balanced O2 at a constant temperature (37oC) and pressure (55 mmHg), a latex balloon was placed into the left ventricle to obtain isovolumetric contraction. After 20 min of equilibration, hearts were randomly allocated to 1) a control group, 2) an IPC group, two 5 min ischemic periods interspersed with 5 min normal perfusion, 3) an SPC (sevoflurane preconditioning) group, two 5 min sevoflurane periods interspersed with 5 min normal perfusion, 4) an SPC with Glibenclamide group. All groups were subjected to 30 min of global ischemia and 75 min of reperfusion. Left ventricular pressure, dP/dt max, and coronary flow were measured. Also flow responses to bradykinin were tested 15 min before IPC or SPC and 60 min after reperfusion. RESULTS: Sevoflurane administration before global ischemia was found to have protective effects like IPC on functional recovery, to reduce infarct size, and to conserve coronary endothelial function. LVP was less depressed in the SPC and IPC groups. dP/dt max in both the IPC and SPC groups recovered after global ischemia. Coronary flow was depressed in the control and in the SPC with Glibenclamide groups, but it was slightly depressed in the IPC and SPC groups. Smaller infarct sizes were observed in IPC and SPC groups. Flow increases due to bradykinin were greater after SPC and IPC. Moreover, these beneficial effects of sevoflurane were blocked by glibenclamide administration. CONCLUSIONS: Preconditioning with sevoflurane, like IPC, improves post ischemic contractility basal flow, and bradykinin-induced flow increases. Moreover, the protective effects of SPC and IPC were reversed by KATP channel antagonism.

The Combined Use of the Timing Principle and LMA to Secure Airway Patency / 대한마취과학회지

BACKGROUND: The timing principle uses a single bolus dose of nondepolarizing neuromuscular blocker followed by an induction drug to reduce airway patency secure time. If anesthetic depth is adequate, the laryngeal mask airway (LMA) can be inserted with or without a low dose nondepolarizing neuromuscular blocker. So we investigated the combined use of the timing principle and LMA to secure airway patency. METHODS: One hundred and two patients were randomly allocated into three groups. Group RP (n = 34) patients received rocuronium followed by propofol and then a LMA was inserted. Group PR (n = 36) patients received propofol followed by rocuronium and group PS (n = 31) patients received propofol followed by succinylcholine before LMA insertion. Accelerographic response to single twitch and train-of-four (TOF) stimulation were measured. LMA insertional conditions were measured using the degree of jaw relaxation, gagging, cough, and aeration. RESULTS: Single twitch and TOF ratio were lower in the RP group than in the PR group. The LMA insertional conditions were similar for the group RP and PS, but were poor for group PR. One patient in group PR recalled discomfort during LMA insertion. CONCLUSIONS: The combined use of the timing principle and LMA is effective at securing airway patency.