The effect of anticholinergics on memory was studied using 32 male Sprague-Dawley rats. In the control group the trained rats were tested the first performance time of T-maze and the second performance time checked 4-6 hours after injection of 1.0-1.5 mL of normal saline via penile vein. For the experimental groups, after checking the first performance time, 0.1 mg/kg of atropine sulfate in group B, and 1.0 mg/kg in group C was injected via penile vein.And 30 mg/kg injected into intraperitoneal cavity in group D. But for the group E, the mixture of 1.0 mg/kg of atropine and 0.01 mg/kg of neostigmine was injected into the penile vein. 4-6 hours after injection the second performance time was checked and continued these sets of experiment once a day for 6 days. To compare the number of errors (the qualitative effect) the accuracy rate (Number of right trials/Number of total trials x 100) was checked. To eompare the running time (the quantitative effect) the mean performance ratio (II/I x 100) (i.e., I is the score in the first performance time and II is the score in the second performance time) was compared between control and experimental groups. The results were as follows ; 1) The percentage of correct performance was 84.2% in control group, but 86.1% in group B, 91.0% in C, 96.0% in D and 89.6% in E was noted. 2) The performance ratio of control group A was 100.2 but 82.4 in B, 94.7 in C, 83.2 in D and 89.4 in E was recorded. 3) These results suggest that posttraining exposure to atropine sulfate facilitates the accuracy of performance and shortens the running time and no different effect was observed by additional injection of neostigmine in rats.
Animals ; Atropine* ; Cholinergic Antagonists ; Humans ; Male ; Memory* ; Neostigmine* ; Rats* ; Rats, Sprague-Dawley ; Running ; Veins

It is a widespread clinical practice to administer large doses of corticosteroids to patients in cases of shock and or neurosurgery; corticosteroids given intravenously have been proposed and used. Corticosteroids, when administered in this way during surgery have been implicated in intera- ctions with neuromuscular blocking agents. Therefore, the effects of Solu-cortef in the neuromuscular blockade produced by vecuronium were studied in vivo on the indirectly stimulated tibialis anterior muscles of the rabbits aneth- etized with urethane and pentothal sodium. Control group of rabbits was given intravenous boius of 0.1 mg/kg vecuronium to produce twitch depression and recovery as recorded by biophysiograph and measured at anterior tibialis muscle twitch in response to common peroneal nerve by double burst stimulation (DBS). First study group (S-l group) of rabbits was given intravenous bolus of 16 mg/kg Solu- cortef thirty minutes before, and then 0.1 mg/kg vecuronium intravenous bolus was given. Twitch depression and recovery was measured as control group. Seeond study group (S-2 group) of rabbits was given intravenous bolus of 0.1 mg/kg vecuronium during recovery phase, intravenous bolus of 16 mg/kg Solu-cortef was given at DBS ratio 0.5. Statistical analysis was confirmed by oneway ANOVA test,followed by Student- Newman-Keuls test. The results were as follows', 1) In control group,'recovery times to DRS ratio at 0.5 and 0.8 were 1,089.2+42.94 and 1,272.0 +'54.87 sec. 2) In first study group',axovery times to DBS ratio at 0.5 and 0.8 were 1,208.8>61.95 and 1,417.4+65.02 sec. It shows some what prolonged recovery time than control but statistically not significant. 3. In second study group;recovery times to DBS ratio at 0.5 was 1,218.4+/-61.16 sec. DBS ratio was deereased to 0.22 when intravenous bolus of Solu-cortef was given,thereafter DBS ratio was gradually increased Recovery times to DBS ratio at 0.5 and 0,8 were 1,444.0 and 1,633.8+/-65.02 sec. More prolonged recovery times were observed. It was statistically significant to compare with control and first study group (P<0,05). By the above results ; acute intravenous bolus Solu-cortef may affeet the vecuronium induced neuromuscular block in rabbits.
Adrenal Cortex Hormones ; Depression ; Humans ; Muscles ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Neurosurgery ; Peroneal Nerve ; Rabbits ; Shock ; Sodium ; Thiopental ; Urethane ; Vecuronium Bromide*

During central venous catheterization, a guidewire may cause various complications ranging from temporary arrhythmia to a pericardial tamponade. The arrhythmia occurring during the insertion of a guidewire is not uncommon and requires almost no therapy. However, persistent atrial fibrillation during and after central venous catheterization is a rare complication. We report a case of persistent atrial fibrillation that occurred during the insertion of a guidewire and was, treated with electric cardioversion.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cardiac Tamponade ; Catheterization, Central Venous* ; Central Venous Catheters* ; Electric Countershock*

BACKGROUND: It is evident that inhalational anesthetics, such as nitrous oxide, possess a certain degree of myelodepressive effect in humans. However, unlike nitrous oxide, propofol is frequently recommended for the anesthesia of oncologic patients or for harvesting bone marrow from donors. To evaluate the possible toxicity of propofol on hematopoietic stem cells, the in vitro sensitivity of colony growth to propofol was assessed using murine clonogenic hematopoietic progenitor cells. METHODS: Femoral and tibial marrow cells were obtained from 4- to 6-week-old male BALB/c mice. Propofol was diluted in culture medium (30microM, 300microM and 1 mM) and added into methylcellulose semi-solid culture media. After 14 days of culturing, the numbers of colony-forming unit granulocyte/monocyte (CFU-GM) colonies were counted. An advance liquid culture (RPMI 1640) of 5 hours duration was also applied prior to culturing in semisolid media to assess the short term exposure toxicity. RESULTS: The colony counts were significantly decreased compared to the control at higher concentrations than 1 mM (P<0.05). The pre-exposure to propofol did not affect the number CFU-GM colony count at the concentrations of 30microM and 300microM or under conditions of co-culture. CONCLUSIONS: No myelodepressive effect was observed in mouse bone marrow cells with exposure of propofol at concentrations under 300microM.
Anesthesia ; Anesthetics ; Animals ; Bone Marrow Cells ; Bone Marrow* ; Coculture Techniques ; Culture Media ; Granulocyte-Macrophage Progenitor Cells ; Hematopoiesis* ; Hematopoietic Stem Cells ; Humans ; Male ; Methylcellulose ; Mice* ; Nitrous Oxide ; Propofol* ; Stem Cells ; Tissue Donors

BACKGROUND: The possibility that anesthesia may alter the course of an infection has been under consideration for more a century. Alterations have been found in every component of the immune response during anesthesia and surgery. In this work, we have investigated the effect of lidocaine and propofol on interleukin-2 (IL-2), interleukin-4 (IL-4), and nitric oxide (NO) production in mice. METHODS: The culture supernatants of splenocytes exposed with anesthetics and lipopolysaccharide (LPS), or sera from mice injected with these agents were harvested to assay IL-2, IL-4, and NO. RESULTS: We detected that IL-2 productions of splenocytes culture supernatants and mice sera after exposure with lidocaine or propofol were decreased while IL-4 productions were increased. In addition, NO of mice sera was increased after lidocaine or propofol exposures. CONCLUSIONS: These findings suggest that lidocaine and propofol interfere with IL-2, IL-4, and NO production. This may explain the clinically well-recognized disturbance of human immunity after surgery and anesthesia.
Anesthesia ; Anesthetics ; Animals ; Humans ; Interleukin-2 ; Interleukin-4* ; Interleukins* ; Lidocaine* ; Mice* ; Nitric Oxide* ; Propofol*

BACKGROUND: Hydromorphone, a derivative of morphine, has the same actions and uses as morphine, has about eight times more potency on a milligram basis. Hydromorphone is used for the relief of moderate to severe pain. There has been no report in Korea on patient controlled analgesia (PCA) using hydromorphone. Here, the efficacy and incidence of side effects of PCA, with hydromorphone, were investigated. METHODS: 68 patients scheduled for spinal, urological, gynecological and general surgery were enrolled. Patients received standardized general anesthesia, with the PCA initiated at the end of surgery. Parameters for PCA were a 0.1 mg bolus and 0.05 mg/hr infusion of hydromorphone, with a 10 min lockout interval. A verbal rating scale (1: none, 2: very mild, 3: mild, 4: moderate, 5: severe) of pain, nausea (mild, moderate, severe), vomiting, dizziness and somnolence were assessed at 6, 12, 24 hr postoperatively. The amount of hydromorphone used and the requirements for symptomatic relief were also recorded. RESULTS: The mean pain scores were 3.5+/-0.8, 2.9+/-0.8 and 2.5+/-0.7, and the amounts of hydromorphone delivered were 1.0+/-0.1, 1.8+/-1.0 and 2.7+/-1.3 mg, 6, 12 and 24 hr postoperatively, respectively. The incidence of nausea, vomiting, dizziness and somnolence were 17.6, 4.4, 8.8 and 1.5%, respectively. CONCLUSIONS: Intravenous PCA, with hydromorphone, was effective in controlling postoperative pain, with fewer eide effects than morphine, as reported in the literature.
Analgesia, Patient-Controlled* ; Anesthesia, General ; Dizziness ; Humans ; Hydromorphone* ; Incidence* ; Korea ; Morphine ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Vomiting

BACKGROUND: The bispectral index (BIS) is a processed EEG information that has been validated as a means to measure the hypnotic effect of anesthetic drugs. The aim of this study was to evaluate the BIS changes during anesthesia induction with ketamine in children. METHODS: Eighty-four ASA class I and II pediatric patients, aged 3-8 years, were enrolled in this study. In each patient the BIS value was recorded before anesthesia induction. Without premedication, eighty-four patients received ketamine bolus, 1.0 mg/kg (Group 1, n = 28) or 1.5 mg/kg (Group 2, n = 28) or 2.0 mg/kg (Group 3, n = 28). When unresponsiveness to verbal commands (UVC) and loss of eyelash reflex (LER) were ascertained, intubation was performed after administration of succinylcholine 1.5 mg/kg and anesthesia was maintained with 2.0% enflurane and 50% N2O-50% O2. RESULTS: Ketamine bolus induced UVC and LER at which the BIS values were, 92.5+/-5.6 and 93.9+/-3.0 for Group 1, 92.5+/-6.3 and 92.6+/-4.4 for Group 2, and 93.0+/-4.3 and 91.0+/-4.1 for Group 3. BIS from UVC and LER to three minutes after ketamine bolus remained above 90 for Group 1 and 2, whereas lower than Group 1 for Group 3 (P<0.05). However, the BIS for Group 3 showed above 85 as patient entered into clinical anesthetic state. CONCLUSIONS: Our study showed that there is a lack of correlation between the BIS and the anesthetic state induced by ketamine in children aged 3-8 years. Monitoring the depth of ketamine anesthesia remains difficulty.
Anesthesia* ; Anesthetics ; Child* ; Electroencephalography ; Enflurane ; Humans ; Hypnotics and Sedatives ; Intubation ; Ketamine* ; Premedication ; Reflex ; Succinylcholine

BACKGROUND: The patients with end-staged liver failure are subjected to various and complex coagulopathies during liver transplantation. Particularly, fibrinolysis can occur preoperatively and is more prominent and aggravated right after reperfusion to the donated liver. It becomes the main cause of bleeding intraoperatively and postoperatively. We examined the effect of low dose aprotinin on the fibrinolysis and the transfusion amount of the packed red cell during operation. METHODS: We divided the patients into an experimental group, administrating aprotinin (n = 20) and a control group, administrating same volume of normal saline (n = 28). Heparinase-guided thromboelastograph (h-TEG) of preanhepatic 60 minutes was done as basic value. Then we administrated 1 million KIU aprotinin for 20 minutes and infused 0.25 million KIU /hr aprotinin for 3 hours of preanhepatic period in the experimental group. Just after the reperfusion to donated liver, another h-TEG of postanhepatic 10 minutes was done. We obtained CL 60 (clot lysis 60) and MA (maximum amplitude) among the TEG parameters and counted the total number of packed red cell transfused before and after the reperfusion period. RESULTS: The results showed that the experimental group had significantly higher value of CL 60 and MA in the h-TEG of postanhepatic 10 minutes and lower amount of packed red cell transfusion during the period after the reperfusion. CONCLUSIONS: The administration of low dose aprotinin during preanhepatic period reduced the activation of fibrinolysis and the total packed red blood cell transfusion after the reperfusion in liver transplantation.
Aprotinin* ; Erythrocyte Transfusion ; Fibrinolysis* ; Hemorrhage ; Humans ; Liver Failure ; Liver Transplantation* ; Liver* ; Reperfusion

BACKGROUND: Clinical studies suggest that postoperative morbidity and possibly mortality may be reduced when regional anesthesia is used. Use of regional anesthesia in renal transplantation is still controversial but promising. We assessed the effect of regional anesthesia for 20 cases of renal transplantation. METHODS: 13 patients were operated on under subarachnoid block with continuous epidural anesthesia. Bupivacaine was used for subarachnoid block and lidocaine was used for continuous epidural anesthesia. 7 patients were operated on under only continuous epidural anesthesia. Lidocaine was used for only continuous epidural anesthesia. RESULTS: In 20 cases of renal transplantation regional anesthesia was sufficient for performance of the operation. Stable intraoperative hemodynamics and absence of serious postoperative pulmonary complications were observed in patients operated on under regional anesthesia. Their postoperative analgesia was successfully maintained epidurally. CONCLUSIONS: Our cases show that regional anesthesia has the advantage of stable hemodynamics, fewer postoperative complications and postoperative analgesia.
Analgesia ; Anesthesia, Conduction* ; Anesthesia, Epidural ; Bupivacaine ; Hemodynamics ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation* ; Lidocaine ; Mortality ; Postoperative Complications

BACKGROUND: When attempting a unilateral spinal anesthesia, many factors must be considered including patient's position, density and amount of the local anesthetics, needle design, injection speed. We evaluated a duration of lateral decubitus with low dose hyperbaric bupivacaine for maximizing the benefit. METHODS: Hyperbaric 0.5% bupivacaine 6 mg was administered slowly through a 25-gauge Whitacre needle to 60 ASA 1-2 patients undergoing unilateral lower extremity surgery. The patients were randomly allocated to four groups based on the duration of lateral decubitus after spinal anesthesia: 5 minutes in Group I; 10 minutes in Group II; 15 minutes in Group III; 20 minutes in Group IV. Circulatory variables, sensory and motor block level were recorded. RESULTS: The circulatory variables were stable in all patients. In the Group I, the success rate of unilateral motor block was significantly lower than other groups. In the Group IV, the success rate of unilateral sensory block was significantly higher than group I. In the Group II, III, IV, the patient's satisfaction scores were significantly higher than Group I. CONCLUSIONS: When unilateral spinal anesthesia was attempted with 0.5% hyperbaric bupivacaine 6 mg, cardiovascular stability was achieved in the groups that patients are kept in a lateral decubitus for more than 5 minutes after spinal injection, and patient's higher satisfaction scores were achieved in the unilateral motor block and in the groups that patients are kept in a lateral decubitus for more than 15 minutes after spinal injection.
Anesthesia* ; Anesthesia, Spinal ; Anesthetics, Local ; Bupivacaine* ; Humans ; Injections, Spinal ; Lower Extremity ; Needles