Intravalvular regurgitation of the mitral bioprosthetic valve detected by intraoperative transesophageal echocardiography : A case report / 대한마취과학회지

Intraoperative transesophageal echocardiography (IOTEE) is an invaluable diagnostic method for management of cardiac surgical patients, including patients undergoing valve replacement surgery. We report a patient who underwent reoperation for mitral valve replacement due to intravalvular regurgitation following mitral valve replacement with a bioprosthetic valve. The condition was detected by IOTEE and caused by suture entrapment.

The effects of prophylactic dolasetron and induction with propofol on postoperative nausea and vomiting after thyroidectomy / 대한마취과학회지

BACKGROUND: Postoperative nausea and vomiting (PONV) is a common problem in patients undergoing thyroidectomy. In this study we evaluated the effects of prophylactic dolasetron and/or induction with propofol on PONV. METHODS: Two hundred three patients scheduled thyroidectomy under general anesthesia with sevoflurane were included and were randomly allocated to one of four groups. In control (group C) and dolasetron groups (group D), the patients received thiopental sodium 4-5 mg/kg intravenously for the induction of anesthesia, and the patients in group D received prophylactic intravenous dolasetron 210 microgram/kg. In propofol (group P) and dolasetron + propofol groups (group D + P), the patients received propofol 2 mg/kg intravenously for the induction of anesthesia, and the patients in group D + P received prophylactic intravenous dolasetron 210 microgram/kg. The incidence and severity of PONV, the need for rescue antiemetics, adverse events were assessed during 0 to 1 hour and 1 to 24 hours postoperatively. RESULTS: During the first 24 hours after anesthesia, the incidences of PONV and postoperative vomiting were significantly reduced in group D + P compared with group C (P < 0.05, respectively). There were no significant differences in postoperative nausea, need for rescue antiemetics, severity of PONV, and adverse events of antiemetics among the four groups. CONCLUSIONS: In patients with thyroidectomy, combination of prophylactic dolasetron administration and induction with propofol was found to reduce the incidence of PONV during the first 24 hours after anesthesia, compared with that of routine induction with thiopental sodium.

The individual and combined neuroprotective effects of propofol and ketamine on rat mixed cortical cultures exposed to oxygen-glucose deprivation-reperfusion injury / 대한마취과학회지

BACKGROUND: Propofol and ketamine are have been known to have neuroprotective effects. However, the effect of combined therapy with these 2 drugs is not well known with in vitro model. This study was conducted to determine whether combined administration of propofol and ketamine could have additive effects in protecting cortical neurons from the oxygen-glucose deprivation (ischemia) - reoxygenation (reperfusion) injury. METHODS: Thirteen-day-old primary mixed cortical cultures were exposed to a 5-min combined oxygen-glucose deprivation (OGD, in vitro ischemia model), followed by 2 hr of reperfusion. Propofol (1, 10, 25, 50, 100micrometer) and ketamine (1, 2.5, 5, 10, 50micrometer) were added as alone or combination from the initiation of the OGD injury to the end of the reperfusion periods. The survived cells were counted using trypan-blue staining. The data were converted to the cell death rate. Statistical analysis was done by oneway-ANOVA tests and Bonferroni's test. P < 0.05 was considered as statistically significant. RESULTS: OGD-reperfusion demonstrated about a 70% cell death rate. 5-50micrometer of ketamine decreased the cell death rate compared with the no drug treated group (P < 0.05). 10-100micrometer of propofol decreased the cell death rate compared with the no drug treated group (P < 0.05). Combined administration of ketamine 2.5micrometer + propofol 50, 100micrometer, ketamine 10micrometer + propofol 100micrometer and propofol 1, 10micrometer + ketamine 5, 10micrometer decreased cell death rate compared with the same dosage of propofol or ketamine alone treated group (P < 0.05). CONCLUSIONS: Propofol or ketamine demonstrated neuroprotective effects. And, combined administration ofpropofol and ketamine demonstrated additive neuroprotective effects against OGD-reperfusion injury.