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: 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: 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

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

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

BACKGROUND: Microemulsion propofol produces more frequent and severe pain upon injection than lipid emulsion propofol. This study examined the analgesic effect of lidocaine-premixed microemulsion propofol in patients pretreated with remifentanil. The induction of anesthesia with this combination was compared with microemulsion propofol accompanied with either remifentanil or lidocaine. METHODS: One hundred twenty patients aged between 20-65 years old were allocated randomly into one of three groups (n = 40, in each). The patients in the remifentanil group received remifentanil 0.5 microgram/kg IV for 30 seconds before a microemulsion propofol injection. The patients in the lidocaine group received propofol 2 mg/kg premixed with 40 mg lidocaine over a 60 second period. The patients in the combination group received both remifentanil and lidocaine. RESULTS: There was a significantly lower incidence of microemulsion propofol injection pain (severity 2 or more) in the combination group (12.5%) than in the remifentanil and lidocaine groups (90% and 65%, respectively, P < 0.05). The incidence of moderate pain disappeared completely in the combination group (0%) compared to that in the remifentanil and lidocaine group (32.5% and 20%, respectively, P < 0.05). Severe pain did not appear in any of the three groups. There were no complications on the injection site in the lidocaine alone and combination groups. CONCLUSIONS: The combination of microemulsion propofol premixed with lidocaine after a pretreatment with remifentanil was more effective in reducing the incidence of pain upon the injection of microemulsion propofol than either treatment alone.
Aged ; Anesthesia ; Anesthetics, Intravenous ; Humans ; Incidence ; Lidocaine ; Piperidines ; Propofol

Propofol has become a popular intravenous agent for the induction and maintenance of total intravenous anesthesia (TIVA). However, the pro- or anticonvulsant properties of propofol remain controversial and abnormal muscle movement and convulsive activity are possible side-effects. We report a case in which a healthy 42-year-old man developed myoclonic and tonic-clonic seizures related to the use of propofol for sedation during a brachial plexus block.
Adult ; Anesthesia, Intravenous ; Anesthetics ; Brachial Plexus* ; Humans ; Propofol* ; Seizures*