The Effects of Acute Normovolemic Anemia Induced by Hemodilution on Tissue Oxygenation in Dogs: A Comparison of Systemic Oxygen Consumption, Arterial Lactate, Arterial Ketone Body Ratio and Gastric Intramucosal pH / 대한마취과학회지

BACKGROUND: The reduction in hematocrit (Hct) by hemodilution tends to cause an increase in cardiac output and a proportional decrease in arterial oxygen content. Additionally the reduction of systemic oxygen delivery (DO2) leads to significant differences in regional blood flow. It is therefore important to characterize the effects of hemodilution on regional oxygen metabolism in individual organs. This study was undertaken to evaluate and compare the effects of acute normovolemic anemia induced by hemodilution. METHODS: Six dogs were anesthetized and mechanically ventilated. Catheters were inserted in the right femoral and pulmonary arteries for blood sampling, and a gastric tonometer catheter was inserted into the gastric lumen. Baseline measurements of systemic hemodynamics, arterial ketone body ratio (AKBR), gastric intramucosal pH (pHi) and arterial lactate were recorded. Hemodilution was then begun by 6% pentastarch and was made in four levels of hematocrit values of 20%, 15%, 10% and 6%. RESULTS: Mean arterial pressures of Hct 10% and 6% was decresaed (P < 0.05) and Hct 15% and 10% increases in cardiac output and pulmonary capillary wedge pressure (PCWP) were observed. Central venous pressure and mean pulmonary arterial pressure were incresed (P < 0.05) at Hct 15%, 10% and 6%. DO2 progressively decreased (P < 0.05). AKBR and pHi began to decreased at Hct 15%. Arterial lactate decrease at Hct 15% and was above 7.4 mmol/L at Hct 6%. CONCLUSIONS: By the measurements of AKBR and pHi, the disturbance of splanchnic oxygenation can be detected early compared to those of O2 in terms of oxygen metabolism and the critical point of DO2 during acute normovolemic anemia induced by hemodilution.

Ureteroscopy with Intravenous Propofol Anesthesia for the Treatment of Lower Ureteral Calculi / 대한비뇨기과학회지

PURPOSE: We compared the safety and efficacy of ureteroscopy with intravenous propofol anesthesia with those with spinal anesthesia for the treatment of lower ureteral calculi. MATERIALS AND METHODS: Ureteroscopy with intravenous propofol anesthesia was performed in 38 patients with ureteral caluli, and spinal anesthesia was performed in 41. Ureteroscopy was performed with a 9.5Fr rigid ureteroscope. RESULTS: The overall success rate of stone removal was 99% (100% in IV propofol anesthesia cases and 98% in spinal anesthesia cases). Hospital stay times were significantly shorter for patients given propofol: 1.5 vs 3 days, respectively(p<0.05). CONCLUSIONS: Stone removal under intravenous propofol anesthesia does not increase the risk of complication or compromise the results of treatment and hospital stay times.

The Effects of Propofol as s Sole Intravenous Anesthetics on Endourologic Transurethral Lithotripsy / 대한마취과학회지

BACKGROUND: Propofol is an intravenous anesthetic characterized by rapid induction and prompt recovery. Recently, its is used widely in clinical practice, especially when early discharge is advisable. We conducted this study for the evaluation of the effects of propofol as a sole intravenous anesthetic on the operation with minimal pain such as TUL(transurethral lithotripsy). METHODS: Patients were recruited for ASA class 1 and 2 from those who received TUL operation. Propofol was administered 2 mg/kg for induction and continuously infused at the rate of 1.2~1.4 mg/kg/hr after the loss of consciousness. With the stabilization of the vital signs, we reduced the dose of propofol to 1.0~1.2 mg/kg/hr. We checked the patients' movement, vital signs, recovery time and monitored the appearance of the symtoms such as nausea, vomiting postoperatively. RESULTS: 1) The average time of operation was 15+/-12 minutes. 2) The average recovery time was 15+/-9 minutes(range 2~30 min). 3) Blood pressure and peripheral oxygen saturation(SpO2) were declined during anesthesia, but SpO2 was normalized in the recovery room. 4) No significant complications were observed. 5) Mild movement of the patient was noticed in the begining of operation, but it did not affect the surgical procedure. CONCLUSIONS: Propofol was effective as a sole intravenous anesthetic to minimize postoperative complications such as nauea, vomiting for TUL with minimal pain.