Anesthetic management in an angiographic suite: a retrospective review of 88 cases / 대한마취과학회지

BACKGROUND: Advances in the field of interventional and diagnostic radiology have resulted in anesthesiologists becoming involved in angiographic suites. In the present study, we evaluated the characteristics of patients and the anesthetic management in an angiographic suite, to determine what factors influenced the patient outcome. METHODS: Data pertaining to patients that were anesthetized at an angiographic suite in a university hospital between 1 January 2007 and 31 December 2007 were evaluated retrospectively. Specifically, we evaluated the patient characteristics and the types of anesthesia administered, to determine which factors were related to patient outcome. RESULTS: Sixty-four percent of the patients enrolled in this study were women. Cases involving coiling for unruptured and ruptured aneurysm, embolization for intracranial arteriovenous malformation and fistula, pediatric diagnostic angiography, embolization for extracranial arteriovenous malformation, and implantable cardioverter-defibrillator (ICD) implantation all required the involvement of anesthesiologists. Major postoperatve complications included pneumonia, atelectasis, and hydrocephalus. In addition, GCS, net fluid balance, and anesthesia time had influence on patient outcome. CONCLUSIONS: We evaluated the characteristics of patient groups, procedures, and postoperative complications in an angiographic suite. The results of our analysis revealed that a through understanding of nervous and vascular pathology, as well as knowledge of current interventional radiology, neuroanesthesia and vascular anesthesia techniques is essential for development of safe and effective care.

Exposure to genistein does not adversely affect the reproductive system in adult male mice adapted to a soy-based commercial diet

Genistein, a soybean-originated isoflavone, is widely consumed by humans for putative beneficial health effects but its estrogenic activity may affect adversely the development of male reproductive system. Five-week-old ICR mice were purchased and fed with a soybean-based Purina Chow diet until 6 months of age. The animals were exposed by gavage to genistein (2.5 mg/kg/day) or 17beta-estradiol (7.5 microgram/kg/day) for five weeks. Corn oil was used for the negative control. The animals were fed the caseinbased AIN-76A diet throughout the experimental periods. There were no significant differences in body and organ weights of mice among experimental groups. No significant differences in sperm counts and sperm motile characteristics were found between the control and the genistein groups. Treatment of 17beta-estradiol caused a significant decrease in epididymal sperm counts compared to the control (p<0.05). The level of phospholipid hydroxide glutathione peroxidase in the epididymis of mice exposed to genistein was significantly higher than that of the control mice (p<0.05). 17beta-estradiol treatment caused a reduction of germ cells in the testis and hyperplasia of mucosal fold region in the prostate of mice. Genistein treatment did not cause any lesion in the testis, epididymis, and prostate. These results suggest that dietary uptake of genistein at adult stage of life may not affect male reproductive system and functions.

Effect of Doxapram on the Recovery from Vecuronium from Vecuronium of Mivacurium-induced Neuromuscular block in the Rabbit / 대한마취과학회지

Doxapram as a potent respiratory stimulant is one of attempts to solve respiratory problem and has been known to be effective for many years. But one study suggested that the presence of doxapram retarded neostigmine-induced antagonism of vecuronium effect. So we studied the effect of doxapram on the reverse of neuromuscular block when doxapram was injected with different dose. 60 rabbits were divided into 6 groups. Vecuronium was used in Group 1~3 and Mivacurium was used in Group 4~6 as a muscle relaxant. When the first twitch of TOF response reappeared from the complete block with a muscle relaxant (T1 onset), we administered neostigmine 0.05 mg/kg and saline 0.3 ml i.v. in Group 1, 4(VS, MS), neostigmine 0.05 mg/kg and doxapram 0.5 mg/kg i.v. in Group 2, 5(VDP1, MDP1), and neostigmine 0.05 mg/kg and doxapram 3 mg/kg i.v. in Group 3, 6(VDP2, MDP2). Two recovery time, from T1 onset to T1 25% and from T1 25% to T1 75%, and TR(ratio ; T4 twitch/T1 twitch) at T1 75% were measured. For the hemodynamic effect of doxapram, Blood pressure, heart rate and arrythmia were observed before and after doxapram injection too. The results are as follows. 1) Recovery time from T1 onset to T1 25% are 2'30"+/-0'29"(min'sec") in VS, 3'07"+/-0'4l"(minsec") in VDPl, 1'49"+/-0'17"(min'sec") in VDP2, 2'34"+/-0'17"(min'sec") in MS, 2'41"+/-0'25"(min'sec") in MDP1, 1'52"+/-0'39"(min'sec") in MDP2. 2) Recovery time from T1 25% to T1 75% are 4'58"+/-0'52"(min'sec") in VS, 6'10"+/-1'17"(min'sec") in VDP1, 3'38"+/-0'33"(min'sec") in VDP2, 4'38"+/-'0'57"(min'sec") in MS, 5'10"+/-0'55"(min'sec") in MDP1, 3'15"+/-0'38"(min'sec") in MDP2. 3) TR at T1 75% are 76.6+/-7.7% in VS, 82.4+/-3.4% in VDP1, 83.8+/-4.5% in VDP2, 81.4+/-2.3% in MS, 89.8+/-2.3% in MDP1, 89.8+/-1.5% in MDP2. 4) Heart rate, cardiac rhythm, systolic and diastolic pressure before and after doxapram injection were not significantly changed. In conclusion, simultaneous administration of neostigmine and low dose doxapram delayed recovery from the neuromuscular block, but high dose doxapram did not.