No abstract available.
Anesthetics, General* ; Brain Injuries* ; Brain*

No abstract available.
Anesthetics, General ; Child ; Humans ; Propofol

No abstract available.
Anesthetics, General ; Child ; Humans ; Propofol

Many historical general anesthetics have been waxed and waned in the market of anesthetic field, mostly due to organ toxicities related to their metabolism, active metabolites and biodegradation, or other reasons. Modern anesthetics available now are known to undergo metabolism to the extent of clinical insignificance compared with the old ones. However, animal studies provided extensive evidences showing that general anesthetics are neurotoxic or neuroprotective in certain circumstances along with the advancement of knowledge on simultaneous neural injury and healing processes. Until now, there have been few prospective randomized clinical trials conducted to reveal these two issues. In fact, the concerns of the long-term effect of anesthetics on cognitive and behavior decline seem to be in arrears compared with those of the immediate effect of anesthetics, such as the rapidity of onset/offset of action, intraoperative hemodynamic controls or postoperative nausea and vomiting, etc. At present, we anesthesiologists, are challenged with the rapidly changing environments, in which the elderly population grows or a variety of sedation depth are required especially for patients of extreme ages. Concerns on anesthetics' effects with double edged sword are mounting from basic scientists and/or anesthesiologists, as well as public society, such as FDA in US. Therefore, I review the current findings from animal and human researches regarding the anesthetic potentials for neuroprotection and/or neurotoxicity under certain circumstances and their links with findings of clinical researches.
Aged ; Anesthetics ; Anesthetics, General ; Animals ; Hemodynamics ; Humans ; Postoperative Nausea and Vomiting

Various anesthetic agents have successfully used for patients undergoing surgery for pheochromocytoma removal. A review of the literature on the anenthetic marnagement of pheochromocytoma discloses no general agreement regarding choice of an anesthetic agent. It would appear that the selection of the anesthetic agent is not as important as the proper management of the patient Previously the anesthetic experience of a case of pheochromocythma removal managed under methoxyflurane anesthesis has been reported by us. Thereafter we have had another five eases of pheochromocytoma removal operation under general anesthesia, employing methoxyflmrane as a primary anesthetic, with relatively satisfactory results.
Anesthesia, General ; Anesthetics ; Humans ; Methoxyflurane* ; Pheochromocytoma*

BACKGROUND: Cerebral state index (CSI) is an anesthesia depth monitor alternative to bispectral index (BIS). Published comparative studies have used propofol or sevoflurane. However, studies using desflurane have not been reported yet. Different volatile anesthetics have different electroencephalography signatures. The performance of CSI may be different in desflurane anesthesia. Therefore, the objective of this study was to compare CSI and BIS during desflurane anesthesia. METHODS: Thirty-three patients were recruited. Desflurane and remifentanil were used to maintain general anesthesia. BIS and CSI were recorded simultaneously every minute. End-tidal concentration of desflurane was maintained at 4% from the beginning of surgery for 5 minutes. Pairwise data of CSI and BIS were obtained five times at one-minute intervals. This process was repeated in the order of 6%, 8%, and 10%. RESULTS: BIS and CSI were negatively correlated with the end-tidal concentration of desflurane with a similar degree of correlation (correlation coefficient BIS: –0.847, CSI: –0.844). The relationship between CSI and BIS had a good linearity with a slope close to 1 (R2 = 0.905, slope = 1.01). For the relationship between CSI and BIS at each end-tidal concentration of desflurane, CSI and BIS showed good linearity in 4% and 10% (R2 = 0.559, 0.540). However, the linearity and slope were decreased in 6% and 8% (R2 = 0.163, 0.014). CONCLUSIONS: CSI showed an equivalent degree of overall performance compared to BIS in desflurane anesthesia. Accounting for previous literature, CSI can be used as a good substitute for BIS regardless of the kind of anesthetics used.
Anesthesia* ; Anesthesia, General ; Anesthetics ; Electroencephalography ; Humans ; Propofol

BACKGROUND: We have used thiopental sodium as an induction agent traditionally, but a recently introduced induction agent, propofol, is gaining popularity among anesthesiologists. The purpose of this study was to compare the difference in induction time by measuring the hypnotic time. METHODS: Sixty adult patients (ASA class I or II) scheduled for elective surgery under general anesthesia were randomly assigned to receive 5 mg/kg of thiopental (Group I) or 2 mg/kg of propofol (Group II), respectively, as an induction agent. The induction time by using Eyelash reflex (from the start of administration of induction agent to the time of reflex loss) was measured after the administration of thiopental and propofol and compared between these two groups. RESULTS: The induction time using ER in Group II (52.2 +/- 12.0 s) was not significantly longer than Group I (50.4 +/-9.4 s). CONCLUSIONS: We concluded that propofol had the same induction time as thiopental for induction of general anesthesia.
Adult ; Anesthesia, General ; Anesthetics ; Humans ; Propofol* ; Reflex ; Thiopental*

BACKGROUND: Vaporizers convert liquid anesthetics into measured amount of vapor that are added to the fresh gas mixture to produce known concentrations of anesthetics. As with anesthesia machines, mordern precision vaporizers require regular checks with respect to technical safety by experts. Some private hospitals in Korea do not have had a anesthesiologist belong exclusively to hospital. Therefore it is difficult to perform a regular checks of anesthesia machine especially vaporizers. We had a question about the accuracy of vaporizer output which used in the private hospitals. METHODS: We investigated outputs of 47 vaporizers which used in 23 private hospitals and 5 general hospitals around Kangdong Gu and Kangnam Gu in Seoul, Korea. Anesthetic agent monitor(Biochem anesthetic agent monitor 8100, Waukesha, Wisc, USA) was used and its analysis value was 0.1 vo1%. 50 vo1% O2 and 50 vol% N2O were used as a carrier gas. The flow rates of the carrier gas were 4 1/min. Dial settings were 0.5, 1, 1.5, 2, 3 vo1%. RESULTS: The result was that vaporizers which had the inaccuracy ranges of concentration less than +/-0.5 vo1% was 76.6% of 47 vaporizers, +/-1 vo1% was 93.6%. And above +/-1 vol% was 6.4% of all. CONCLUSIONS: This research concludes that great care needed when the anesthesiologist strange to the vaporizers in the private hospitals operates the vaporizers.
Anesthesia ; Anesthetics ; Hospitals, General ; Hospitals, Private* ; Korea ; Nebulizers and Vaporizers* ; Seoul

Understanding depth of anesthesia is essential for the anesthesiologist. Although electroencephalogram (EEG) has been proposed and studied as a method of determining anesthetic depth, major limitations restrict its usefulness. For example, spectral edge frequency (SEF) dose not correlate well with the level of sedation. However, recently introduced bispectral index (BIS) which is derived from frequency, amplitude and coherence of the EEG is strongly correlated with clinical measurements of sedation and hypnosis. BIS monitoring may be used to guide the titration of anesthetic agents to achieve effective dosing without increasing the risk of awareness and to allow a better balance of hypnotic and analgesic administration. We report two cases of successful BIS monitoring for the measurement of intraoperative hypnotic state of patient during propofol target controlled infusion (TCI).
Anesthesia ; Anesthesia, General* ; Anesthetics ; Electroencephalography ; Humans ; Hypnosis ; Propofol*

This study was undertaken to evaluate the relationship between eye positions in the awake state and in the surgical plane of anesthesia induced with anesthetics and muscle relaxants in 167 non-paralytic horizontal strabismus patients. All 27 patients with esotropia demonstrated divergence under general anesthesia when compared with their pre-anesthetized state. In 140 patients with exotropia, 107 patients(76.4%) demonstrated convergence under general anesthesia, 6 patients(4.3%) demonstrated divergence, 27 patients demonstrated no change of the eye position. A statistically significant relationship was found between the preanesthetized position of the eyes(P) and the eye position under general anesthesia(A). The relationship is linear and can be written as the approximate regression fomula: A=0.44P+6.34, R=0.73(p<0.01). When surgical success was defined as an eso- or exodeviation within 10 delta of orthotropia at postoperative 12 weeks, final success rate revealed statistically significant difference between the following two groups of exotropic patients(p<0.05). The patients whose amount of vergence were under 15 delta had a success rate of 96.6%, while those over 16 delta had a success rate of 86.3%. In esotropia, surgical success was not satisfactory in patients whose amount of deviation were over 41 delta. These results suggest the significant relationship between eye positions in the awake state and those under general anesthesia, which could be clinically applied in deciding the surgical amount and predkting the success of strabismus surgery.
Anesthesia ; Anesthesia, General* ; Anesthetics ; Esotropia ; Exotropia ; Humans ; Strabismus