The Effect of Butorphanol on Propofol-N2O-O2 Anesthesia: Propofol Dose Requirements, Hemodynamic Responses, and Postoperative Recovery Profiles / 대한마취과학회지

BACKGROUND: This study was proposed to examine the effects of butorphanol on propofol dose requirements and hemodynamic responses during propofol-N2O-O2 anesthesia. In addition, the effects of butorphanol on the recovery time, sedation score and postoperative first analgesic request time were assessed. METHODS: Forty patients were allocated to 2 groups. Twenty patients received butorphanol (20 microgram/kg, group (B) and the others received an equal volume of placebo (group P) 3 minutes before induction with propofol. After induction, anesthesia was maintained with propofol (6 - 10 mg/kg, iv)-N2O (70%)-O2 (30%). Propofol doses for induction and maintenance and hemodynamic responses (blood pressure, heart rate) were checked. After surgery, sedation score, recovery profiles, and postoperative first analgesic request time were assessed. RESULTS: The induction doses of propofol were lower in group B than in group P. Diastolic pressure and heart rate decreased in group B compared to group P after endotracheal intubation and before skin incision. After skin incision, decreased diastolic pressure and heart rate returned to preanesthetic levels in group P, but the decreased level was sustained in group B. There were group differences in sedation score at 5 and 10 minutes after extubation. In group B, recovery was delayed and more time elapsed before the first analgesic request. CONCLUSIONS: Butorphanol co-administered with propofol reduces the induction dose of propofol and delays the first analgesic request time, but there are significant fluctuations in blood pressure and heart rate during endotracheal intubation and skin incision.

Spectral Analysis of EEG During Infusion of Propofol in the Rats / 대한마취과학회지

BACKGROUND: The dose-related effects of intravenous infusion of propofol on the rat EEG were evaluated quantitatively by spectral analysis of EEG recorded from the rat skull. METHODS: Propofol was infused into femoral vein at various concentrations ranging from 0 to 400 g/g body weight, and bipolar EEG was recorded from the rat skull and its spectrum were calculated by power spectrum analysis. The EEG electrodes were fixed at the right and left frontal, parieatal, and occipital bone on rat stereotaxic table. The density of each spectral bands(delta 1 3.25, theta 3.5 7.75, alpha 8 12.75, beta 13 31.75 Hz), total power density, median power frquency, and spectral edge frequency were derived from the spectra. RESULTS: In visual inspection of conventional EEG, low doses of propofol(100, 200 g/100 g) showed no significant changes except appearance of high frequency waves, but higher doses of propofol(300, 400 g/100 g) showed high amplitude with low frequency wave. In quantitative spectral analysis of EEG, low dose of propofol revealed no significant change except appearance of beta-waves in the frontal lobe especially. Significant EEG changes were identified during infusion of higher dose of propofol. 300 and 400 g/g of propofol revealed high amplitude and low frequency waves. Median power frequency and spectral edge frequency were significantly changed at 300 and 400 g/g of propofol in range 4.2Hz and 3.8Hz, and 12.4 Hz and 10.2 Hz respectively. CONCLUSIONS: Taken together, these findings suggest that analysis of EEG parameters derived from EEG power spectrum could be applied to determine the depth of propofol anesthesia in rats.

Clinical Anaylsis of Anesthetic Dosage and Use of Ephedrine in Epidural Anesthesia for Cesarean Section / 대한마취과학회지

BACKGROUND: Hypotension occurs frequently after epidural anesthesia. Intravenous fluid or vasopressors are among treatment methods to many suggested causes. This study was undertaken retrospectively to determine if the age, weight and height of parturients are related to the local anesthetic dosage in epidural anesthesia for the cesarean section, and if the dosage of local anesthetic influence the change of blood pressure and the requirement of fluid or epherine. METHODS: Sixty-nine parturients were studied by reviewing patients' anesthetic records. During lumbar epidural anesthesia to T4 sensory level, all patients were monitored with mean arterial blood pressure, and prevented from hypotension by administration of Ringer's lactated solution. But if hypotension has been sustained in spite of rapid fluid loading, intermittent ephedrine was injected. We studied the correlation of local anesthetic dosage, decrement of mean blood pressure and total required intravenous fluid volume, and difference of these variables between cases using ephedrine and not using. RESULTS: The volume of local anesthetic to achieve a T4 sensory level was 21.20 3.81ml, which did not correlate with age, weight and height, and did not influence the decrease of mean blood pressure and the volume of administered fluid. But the patients (n=30) who needed ephedrine were adminstered significantly larger dose of the local anesthetic and showed more decrease in the mean blood pressure than those (n=39) who did not. CONCLUSIONS: The dose requirement of local anesthetic during epidural anesthesia for the cesarean section is not determined by the age, weight and height of parturients. But when larger dose of local anesthetic is administered, the patients seem to be more hypotensive and need ephedrine as well as intravenous fluid administration.

Changes of Liver Function after Thyroidectomy in Patients Recieving Halothane and Enflurane / 대한마취과학회지

The livers can influence the distribution of the thyroid hormones between the intrace-llular and extracellular compartments, In order to evaluate the changes of liter function following thyroid surgery, 52 patients were chosen at random and divided into 4 groups i.e. 1) Thyroid cancer group, 2) non toxic nodular goiter group, 3) the group treated with T3 and T4, and 4) the group net treated with T3 and T4. The values of SGOT and LDH isoensrmes were measures before operration(control va lues), 1 day and 3 dars after operation. We analyzed the results according to anesthetic agents. The results were as follows : In the patients recieving halothane, the values of SGOT was 24.31+/-9.05 U/l at control. Those at 3 days after operation were 30.35+/-11,65 U/l (P<0.05) . The Values of LDH5 were 5.36+/-3.31% at control, 8.24+/-3. 80 at 1 day, 7.32+/-0.09% at 3 darts(p<0.75). In the group treated with T3 and T4, the values of_SGOT were 23.82+/-8.91 U/l at control, 37.84+/-13.51 U/l at 3 days(p<0.05). The values of LDH5 were 3.89+/-2.89% at control, 8.06+/-4.13 at 3 dara(P<0.05). In other groups in cluding these patients recieving enflurane, postoperative SGOT, SGPT and LDH isoengrmes levels were insignificant compared with preoperative value.