No abstract available.
Anesthetics, Intravenous*

No abstract available
Anesthetics, Intravenous* ; Pharmacogenetics*

BACKGROUND: Korean Journal of Anesthesiology was published in 1968 and its volume has been increased every year. The purpose of this study was to investigate and to clarify the trend of increasing volumes for 28 years (1968~1996) as quantitative analysis. METHODS: Using computerized index of Korean Journal of Anesthesiology (""ART""), the trend, volumes and cumulative records (top ranked 22 frequently cited key words, 16 persons and 10 departments of University) were calculated. Some key words such as ""Anesthetic techniques: spinal, Anesthetics, intravenous:, Anesthetics, volatile: halothane, Complications:"" was traced every year for grasping the trend of academic concerns. RESULTS: 1. Total volumes of articles were about 3,000 (1968~1996). The volumes were increased slowly until 1976 and steeply since 1986. 2. The ratio of clinical case reports has been decreased every year. 3. Key words ""Anesthetic techniques"", ""Surgery"" and ""Complications"" were more frequently cited than the others. 4. Tracing some key words showed their vitality in anesthetic fields. 5. The personal top ranked number of records revealed each author's contribution to Korean Journal of Anesthesiology and the number of records in each department of University could be used as an index of academic activity. CONCLUSIONS: The extent of the increasing volumes was great especially from 1986 to 1996 and the proportion of original articles has been increased every year. The frequency of the investigated key words showed their own vitality in the field of anesthesiology. The rank according to personal and departmental records suggested the possibility of reflecting a measure of academic concerns and activity.
Anesthesiology* ; Anesthetics ; Anesthetics, Intravenous ; Halothane ; Hand Strength ; Humans

BACKGROUND: The methods of arrangement of combined intravenous parallel infusions using anti-reflux valve (ARV), with and without anti-syphon valve (ASV) that could decrease occlusion alarm delay were investigated. METHODS: Occlusion challenge tests were mainly performed as bench experiments of four kinds of multiple parallel infusions (10 ml/h and 50 ml/h infusions), which were connected at the proximal or distal portion of ARV, with or without ASV. Alarm threshold was set to 1000 mmHg. Occlusion alarm delays and the compliances of the infusion systems were compared among groups. RESULTS: Without ASV, compared to 10 ml/h infusion alone distal to anti-reflux valve, 50 ml/h infusion distal to anti-reflux valve reduced the mean alarm delay from 416 +/- 7 s to 81 +/- 3 s (P < 0.001). Compared to 50 ml/h infusion alone, combined 10 ml/h and 50 ml/h infusion distal to ARV prolonged the alarm delay from 81 +/- 3 s to 133 +/- 6 s (P < 0.001). However, combined infusions distal to ARV with ASV significantly reduced the alarm delay from 133 +/- 6 s to 74 +/- 5 s (P < 0.001), and also reduced the compliance of the infusion system from 2.31 +/- 0.12 to 1.20 +/- 0.08 microl/mmHg (P < 0.001). CONCLUSIONS: The infusion setup of faster infusion rate, lower compliant system using ASV could effectively decrease occlusion alarm delay during multiple intravenous parallel infusions using ARV.
Anesthetics ; Compliance ; Equipment Safety ; Infusions, Intravenous

BACKGROUND: An automatic procedure to detect and recognize the specified drugs for a target controlled infusion system based on the absorption ratio of the optical signals (red and infrard light) was proposed. METHODS: A red (660 nm) and infrared (925 nm) light emitting diode (R-IR LED) and photodiode was established at two perforated holes on a 50 ml syringe horizontally and opposite. The syringe was isolated from extra-light sources, such as sun-light or fluorescent light, with a dark sheet. First, the light of the R-IR LED was emitted into free space without insertion of any other syringe. After measuring the intensity of radiation, a 30 ml syringe containing a drug solution was pushed into the 50 ml syringe and again the intensity of light was measured. We measured intensities of light for 1% or 2% propofol and 0.5% thiopental sodium three times and compared it to the measurement of the free space. In order to investigate mechanical error, we measured it again two days later. We calculated errors among each measurement, simple errors and ratios between first and second time measurements and whether the error was within a permissible error range (less than 1%). After all of this, we evaluated the accuracy and clinical usefulness of this new method. RESULTS: Ratio of intensities of transmission of light in each drug solution to free space showed thiopental, 1% propofol and 2% propofol in order. Considering permissible error between the first and second time measurements, this method showed no problem in recognition of kinds and concentrations of drugs. CONCLUSIONS: We supposed that this simple optical method for drug recognition can be applied for target controlled infusion operation instead of the currently available magnetic recognition tag combined to a syringe.
Absorption ; Anesthetics, Intravenous* ; Propofol ; Syringes ; Thiopental

Pharmacokinetics is the study of the rate and degree of drug transport to various tissues in the human body. Pharmacokinetic parameters summarize drug kinetics and ideally predict a clinical situation. A single kinetic profile may be summarized by peak concentration, peak time, half-life and area under the curve. Dosage regimens are designed to confer the maximum desired effects for the required time period with minimal toxicity. Target-controlled infusions use pharmacokinetic models to titrate intravenous anesthetic administration to achieve a desired drug concentration. Context-sensitive half time is used to predict the clinical time course, rather than terminal half-life. It is important that anesthesiologists understand the basic pharmacological principles and apply them in their daily clinical practice. This review discusses the ways in which anesthesiologists can design a patient-specific dosage regimen of intravenous anesthetics by utilizing basic concepts of pharmacokinetics and pharmacodynamics using pharmacokinetic simulations.
Anesthetics, Intravenous ; Half-Life ; Human Body ; Pharmacokinetics*

BACKGROUND: There are situations in anesthesia in which it may be desirable to achieve rapid tracheal intubation. Rapid tracheal intubation with rocuronium has been studied using a probability-based approach. But these studies used intravenous anesthetics for anesthetic induction. Therefore, we aimed to predict doses of rocuronium giving 90% and 95% probabilities of intubation within 60 seconds and to estimate their action durations using sevoflurane for anesthetic induction. METHODS: Anesthesia was induced in sixty patients with sevoflurane. Patients received randomly rocuronium, 0.0, 0.3, 0.6, 0.9 or 1.2 mg/kg (n = 12/dose). Laryngoscopy began 40 seconds later, aiming for intubation at 60 seconds, and conditions were graded as either perfect, acceptable or unacceptable, with the first two conditions being taken as successful intubation. Duration of action was accepted as time until a twitch height recovery of 15%. The dose versus the fraction of patients showing successful intubation was analyzed by logistic regression. Doses giving 90% and 95% (D90 and D95) probabilities of successful intubation were calculated. RESULTS: Of the 12 patients in each group (0.0, 0.3, 0.6, 0.9 or 1.2 mg/kg), intubation was successful in 4, 10, 12, 12 and 12 patients, respectively. The D90 and D95 doses were determined to be 0.34 and 0.43 mg/kg, respectively. CONCLUSIONS: After induction with sevoflurane, rocuronium at 0.43 mg/kg, gives a 95% probability of successful intubaton at 60 seconds.
Anesthesia* ; Anesthetics, Intravenous ; Humans ; Intubation* ; Laryngoscopy ; Logistic Models

Potassium-selective channels are the largest and most diverse group of ion channels in the human. Also, potassium-selective channels are important in many cells during anesthesia. Many researches have focused on potassium channel and intravenous anesthetics.
Anesthesia ; Anesthetics, Intravenous ; Humans ; Ion Channels ; Potassium Channels

In the human isolated arm preparation applied tourniquet on the upper arm, the neuromuscular blocking effects of ketamine were confirmed with the changes of first twitch height (T1) and train of four ratio (T4R) induced from 2Hz ulnar nerve stimulation (ABM Datex Co.) at 20 minutes after administration of ketamine. The results obtained were as follows; In the control group administered of saline, T1 was elevated to 6.48% compared with before tourniquet applied but T4R was not changed through the whole of the process. In the group I administered of ketamine 1 mg/kg, T1 and T,R were depressed of 8.68% and 29.59% respectively but T1 was not significant. In the group II administered of ketamine 2 mg/kg, T1 and T4R were depressed of 43.4% and 40.4% respectively. T1 and T4R in the group I and II were significantly depressed comparing with control group.
Anesthetics, Intravenous ; Arm ; Humans ; Ketamine* ; Neuromuscular Blockade* ; Tourniquets ; Ulnar Nerve

The proliferation of high-technology infusion devices has greatly influenced the practice of anesthesia by allowing precise delivery intraoperatively and postoperatively of intravenous anesthetics, analgesics, and vasopressors. During continuous drug administration to pediatric patients, unfavorable pharmacologic effects have occured. These effects were attributed to variations in flow from infusion devices. The intent of this investigation was to evaluate the influence of infusion devices on the accuracy and continuity effused fluid. Hartmann's solution was run through eight infusion pump at 5, 10, 15, 20, 25, 30, 40, 60, 80 and 100ml/hr. The volume of the fluid was measured for one hour at each flow rate using a infusion device analyzer(IDA-2) in vitro. Flow accuracy(ml/hr) was calculated by dividing the effused volume by the effusion time ; this value was subsequently expressed as a percentage of the desired flow rate. Flow continuity was expressed by the coefficient of variance(CV); analysis of variance with SAS was used for comparisons. Results were as follows ; 1) The flow accuracy values ranged from 98.8% to 114.2% of the desired rate. 2) Seven infusion pumps had flow rates within 5% of the desired rates at each flow rate but one pump had more than 10% of desired rate. 3) Each of the respective infusion pumps produced various levels of flow continuity and ranged from 0.7% to 2.5%(CV value). Conclusion , further evaluations are needed to differentiate continuity from other infusion devices(e.g., syringe infusion pump) in vitro and evaluations are needed to define the clinical significance in vivo. Future use of flow-rate data will likely be of significant value in establishing policies and procedures for the utilization of infusion devices and guidelines for product selection.
Analgesics ; Anesthesia ; Anesthetics, Intravenous ; Humans ; Infusion Pumps ; Syringes