Spectral Analysis of Heart Rate Variability Following Endoscopic Thoracic Sympathicotomy / 대한마취과학회지

BACKGROUND: In general, we know that a thoracic sympathicotomy may have influence an cardiac autonomic nervous activity to change vital signs. The purpose of this study was to analyse preoperative and postoperative heart rate variability to evaluate the influence of a sympathicotomy on cardiac autonomic activity. METHODS: We studied 14 healthy patients, ASA physical status I and II, undergoing an endoscopic thoracic sympathicotomy. A laryngeal airway mask was performed on all patients for tracheal intubation. Intravenous anesthesia was induced by administration of propofol 10 mg/kg, and fentanyl 2ng/kg and was maintained with propofol 10ng/kg/hr and N2O-O2 (2 L/min-2 L/min). An electrocardiogram was checked in the supine position with Biopac Student Lab. at an hour before anesthetic induction, after a left and right sympathicotomy and at 3 - 4 hours after emergence. A spike 2 version 3.0 was used for analyzing heart rate variability and a Fast Fourier Transform was used to yield a power spectrum. Frequency bands were divided to low frequency (0.02 - 0.09 Hz), middle frequency (0.1 - 0.15 Hz), and high frequency (0.16 - 1.0 Hz) components. RESULTS: There were no significant changes of heart rate, high frequency component, low frequency component and ratio of low to high frequency component. CONCLUSIONS: Influence of a thoracic sympathicotomy on cardiac autonomic activity was less in the supine position at rest. However, we think that the response of the cardiac autonomic activity to sympathetic stimulation like position change and exercise after a sympathicotomy may yield different results and studies about this must be done.

Analgesic Effect of Transplanted Adrenal Medullary Chromaffin Cells in Rats Spinal Cord / 대한마취과학회지

BACKGROUND: Despite of numerous researches on the mechanisms and new therapeutic methods of chronic pain, patients are still suffering even with the help of opioids. In recent years, however, with the development of molecular-biology cell transplantation gives us a new chance for treating intractable chronic pain. The major purpose of the present study was to determine if the chromaffin cells have robust analgesic effects in the spinal atlanto-occipital subarachnoid space even without nicotine stimulation. METHODS: In order to determine whether cultured bovine adrenal medullary chromaffin cells transplanted in the spinal cord can produce analgesic effects, we purified adrenal medullary chromaffin cells and implanted them into the subarachnoid space of rats' (n = 10) spinal cord without immunosuppression, and investigated the hot sensitivity of rats' hind-paw by a light-beam test. RESULTS: It was found that compared with the control group, hot response latency of the group which received adrenal medullary chromaffin cells had increased at 14 days and the analgesic efficacy was maintained for at least 3 months. CONCLUSIONS: Adrenal medullary chromaffin cells transplanted in the rats' spinal cord may provide a permanent and locally available source of neuropeptides for the relief of intractable pain. Furthermore, these kinds of analgesic effect even produced without any stimulation such as nicotine.