Myoclonic Seizures Occurred during the Brain Tumor Resection in a Patient of the Recurred Malignant Meningioma of Cerebral Frontal Lobe : A case report / 대한마취과학회지

Several suspected etiologies can cause seizures during the resection of a brain tumor via a craniotomy: the tumor itself, intracranial hypertension or the anesthetic agents used, etc. Generalized myoclonic seizures, during general anesthesia in a 44 year old man, who underwent a resection for a relapsed frontal meningioma, were experienced. Anesthesia was induced and maintained using propofol and remifentanil. The myoclonic seizures began 30 minutes after the induction of anesthesia. The administration of rocuronium was unable to stop the involuntary movement. Midazolam was given to cease the seizures, but they continued for a further 105 minutes. After opening the dura mater, the seizures immediately disappeared and did not recur thereafter.

The Influence of Propofol Concentration on the Generation of Reactive Oxygen Species after Reoxygenation in Rat Embryonic Heart H9c2 Cell / 대한마취과학회지

BACKGROUND: Reoxygenation of an ischemic heart causes a decrease in the cardiac function, which is known as reperfusion injury that is associated with an increase in the concentration of reactive oxygen species (ROS). This study examined the effect of the propofol concentration on the generation of ROS during reoxygenation in rat embryonic heart H9c2 cells. METHODS: Cultured H9c2 cells were examined in the following sequences: Prehypoxic, Hypoxic and Reoxygenation period. Each period required 60 minutes. The cells were exposed to propofol at the beginning of the prehypoxic period. Thirty minutes later, DCFH-DA (dichlorofluorescin diacetate) 10 micrometer was added to detect the ROS. The propofol concentrations used were 0, 5, 25, 50, 250 micrometer in the first experiment and 0, 1, 2, 3, 4, 5 micrometer in the second experiment. The ROS level was estimated using a fluorometer at 5-minute intervals from 5 to 60 minutes after reoxygenation. RESULTS: When the propofol concentrations was > 5 micrometer, the ROS levels were significantly lower than those of the untreated group (P0) (P 5 micrometer inhibited ROS production over the whole period, and even 1micrometer showed some inhibition of ROS.

Changes in Position and Intraabdominal Pressure do not Influence Oropharyngeal Leak Pressure in Laparoscopic Surgery Maintained with a ProSeal Laryngeal Mask Airway / 대한마취과학회지

BACKGROUND: It is known that pneumoperitoneum and changes of body position during laparoscopic surgery influenced peak inspiratory pressure (PIP). We asked the question whether oropharyngeal leak pressure (OLP) is changed by changes in intraabdominal pressure and position during laparoscopic surgery with a ProSeal laryngeal mask airway (PLMA). Since gynecological laparoscopic surgery (Lap-Gy) and laparoscopic cholecystectomy (Lap-C) require different surgical positions, we included both surgeries in this study so that we could investigate the effects of various positions on OLP. METHODS: Lap-Gy (n = 15) was performed in the trendelenburg position combined with the lithotomy position, whereas Lap-C (n = 10) was performed in the reverse trendelenburg position. The measured variables were PIP and OLP. We also marked the fiberoptic score to determine the intraoral position (FP) of the PLMA. OLP was measured using a manometric stability test. The variables were measured in a regular sequence as follows: S-0o-0, L-0o-0, L-0o-15, L-(-15o)-15, L-(-30o)-15 in Lap-Gy and S-0o-0, S-0o-15, S-(+15o)-15, S-(+30o)-15 in Lap-C. At each measured point, the capital S means supine and L lithotomy. Intermediate numbers with a 'o' superscript are table angles to the horizontal plane (degrees) , '-' means the trendelenburg position and '+', the reverse trendelenburg position, and the last number represents intraabdominal pressure (mmHg). RESULTS: PIP was significantly increased when L-0o-0 changed to L-0o-15, L-0o-15 to L-(-15o)-15 and L-(-15o)-15 to L-(-30o)-15 in Lap-G, and when S-0o-0 was changed to S-0o-15 in Lap-C (P < 0.05). But, OLP and FP were not significantly altered by changes in postion or intraabdominal pressure in both Lap-Gy and Lap-C. CONCLUSIONS: PIP was affected by pneumoperitoneum and positional changes. But, increases in intraabdominal pressure by pneumoperitoneum and changes in position during laparoscopic surgery had no effect on OLP and FP of PLMA.