Chronic pain defined as pain that persists beyond the period of healing, in the absence of ongoing pathology, usually means pain over 3 to 6 months after the cure of the original disease. In this situation, the pain itself loses its protective function only to fall into a disease entity. There have been many efforts to treat chronic pain, with analgesics being the most commonly used modality, which include non-steroidal anti-inflammatory drug, opioids, antidepressant, and anxiolytic agents. Pain clinicians especially use nerve blocks for the control of intractable pain. Although the effect of nerve block or trigger point injection with local anesthetics is temporary, its effect of breaking the vicious cycle of pain patheway gives a long-term effect of analgesia. There are many diseases managed at pain clinics, including headache, trigeminal neuralgia, neck and shoulder pain, low back pain, complex regional pain syndrome, herpes zoster and postherpetic neuralgia, fantom pain, peripheral neuralgia, and vascular disease. The main nerve indicated for pain control may be any kind of somatic and sympathetic nerves and ganglions responsible for the pain.
Analgesia ; Analgesics ; Analgesics, Opioid ; Anesthetics, Local ; Anti-Anxiety Agents ; Chronic Pain* ; Ganglion Cysts ; Headache ; Herpes Zoster ; Low Back Pain ; Neck ; Nerve Block ; Neuralgia ; Neuralgia, Postherpetic ; Pain Clinics ; Pain, Intractable ; Pathology ; Shoulder Pain ; Trigeminal Neuralgia ; Trigger Points ; Vascular Diseases

The effect of isoflurane and propofol anesthesia upon the infarct size after middle cerebral artery occlusion was studied using 18 male Sprague-Dawley rat. The infarct area was calculated using Quantimet autoradiography and compared between conscious control and anesthe-tized rats. The results were as follows; 1) Slightly increased volume of infarction was noted in anesthetized rat with no significancy compare to conscious control rats, but the caudate nucleus revealed statistically significant increased vloume of infarction in isoflurane anesthesia rats. 2) The protective effect for cerebral ischaemia of isoflurane or propofol seems insignificant, but we can use them in the neuroanesthetic field without difficulty because they do not increase the infarcted volume. 3) Durging iaoflurane anesthesia the elevated brain glucose and glucose-6-phosphate may increase neurological damage after ischaemia. Furthermore the change of CBF/Metabolism relationship may affect to the infarction.
Anesthesia ; Animals ; Autoradiography ; Brain ; Brain Ischemia* ; Caudate Nucleus ; Glucose ; Glucose-6-Phosphate ; Humans ; Infarction ; Infarction, Middle Cerebral Artery ; Isoflurane* ; Male ; Propofol* ; Rats ; Rats, Sprague-Dawley

The effect of isoflurane and propofol anesthesia upon the infarct size after middle cerebral artery occlusion was studied using 18 male Sprague-Dawley rat. The infarct area was calculated using Quantimet autoradiography and compared between conscious control and anesthe-tized rats. The results were as follows; 1) Slightly increased volume of infarction was noted in anesthetized rat with no significancy compare to conscious control rats, but the caudate nucleus revealed statistically significant increased vloume of infarction in isoflurane anesthesia rats. 2) The protective effect for cerebral ischaemia of isoflurane or propofol seems insignificant, but we can use them in the neuroanesthetic field without difficulty because they do not increase the infarcted volume. 3) Durging iaoflurane anesthesia the elevated brain glucose and glucose-6-phosphate may increase neurological damage after ischaemia. Furthermore the change of CBF/Metabolism relationship may affect to the infarction.
Anesthesia ; Animals ; Autoradiography ; Brain ; Brain Ischemia* ; Caudate Nucleus ; Glucose ; Glucose-6-Phosphate ; Humans ; Infarction ; Infarction, Middle Cerebral Artery ; Isoflurane* ; Male ; Propofol* ; Rats ; Rats, Sprague-Dawley

No abstract available.
Cryptococcosis* ; Hybridomas* ; Immunity, Cellular* ; T-Lymphocytes*

No abstract available.
Cryptococcosis* ; Hybridomas* ; Immunity, Cellular* ; T-Lymphocytes*

The influence of Propofol on regional cerebral function and CBF were studied using 24 male Spragus-Dawley rat by quantitative autoradiographic technique for glucose ( (14C)deoxyglucose) and (14C) Iodoantipyrine. Rats had both femoral artery and vein cannulated and were placed on lead weight. Propofol was infused intravenously at a rate of 0.35 mg/kg/min. for induction and 0.3 mg/kg/min for maintenance untill loss of corneal reflex with stable vital signs. Local cerebral glucose utilization and CBF were checked from conscious control rats and propofol anesthetized rats. The results were as follows; 1) There was no physiologically significant effect of propofol on body temperature, MAP, PaCO, and pH. 2) Regional cerebral glucose utilization was markedly decreased in many, but not all, cerebral structures. 3) The order of decreased glucose utilization was Diencephalone>Telencephalone>Mesence-phalone>Mylencephalone. which means the forebrain was more affected than hindbrain. 4) The most affected area of glucose utilization were cerebral association area, visual system and sensory motor cortex, but the auditory system was not so much affected. 5) During combined use of N,O and propofol, there was no significant stimulation effect of N,O to propofol in glucose utilization. 6) Regional CBF were markedly decreased in many brain regions which means low local cerebral glucose utilization with low CBF. 7) Propofol has specific effect of lowering cerebral metabolic rate, CBF, and intracranial pressure but no signigicant effect on cardiovascular system, pulmonary system, or temperature.
Anesthesia* ; Animals ; Body Temperature ; Brain ; Cardiovascular System ; Femoral Artery ; Glucose* ; Humans ; Hydrogen-Ion Concentration ; Intracranial Pressure ; Male ; Motor Cortex ; Propofol* ; Prosencephalon ; Rats* ; Reflex ; Rhombencephalon ; Veins ; Vital Signs

Many investigators have studied the effects of commonly used general anesthetic agents on CNS and found that a variety of congintive functions including psychomotor activity, assciative learning and short-term tasks were affected by anesthetice, and the ability of inhalstional anesthetics to depress or ebhance neuronal excitibility depends on the anesthetics, the anesthetic conectration, and particular brain region examined. To study the effects of inhalational snesthetics on meomory and congnitive function in human, we selected 123 patients scheduled for elective surgery, in ASA Phyaical Status Class I or II, for experimental group. But the patients undergoing a major surgery and with previous neuropsychiatrie history were excluded. As control group, 92 healthy volunteers were selected. Three tests Bender Gestalt Test, Trail Making B Test and Cognitive Cspacity Screening Examination-were performed on the properative day and the 4-5th postoperative day in experimental group. In control group these tests were performed tow times at the aame intervals. The mean performance ratos (II/ IX100) (i.e I is the score in the first examination and 3 id the score in the second examination)in experimental group were compared with those in control group. Results were as follows; 1. Bender Gestalt Test The mean performance ratios of control group 104.2+/-8.8 in man, 104.7+/-9.8 in woman and 104.5+/-9.4 in total control group. In experimental group they were 102.6+/-9.2 in man, 105.3+/-9.5 in woman and 104.9+/-9.2 in total experimental group. 2. Trail Making B Test The mean performance ratios of control group were 99.8+/-8.3 in ma, 97.6+/-10.0 in woman and 98.8+/-10.0 in total control group. In experimental group they were 99.2+/-13.5 in man, 97.9+/-14.0 in woman and 98.5+/-14.7 in total experimental group. 3. Cognitive Capacity Screening Examination The mean performance ratios of control group were 100.9+/-3.9 in man, 100.2+/-3.4 in woman snd 100.5+/-3.3 in total control group. In experimental group they were 99.4+/-2.1 in man, 101.6+/-3.7 in woman and 101.2+/-3.6 in total experimental The performance ratios of Congitive Capacity Sereening Examination in woman were signifi- cantly increased in experimental group, compared with control group. (p<0.05), but no differences were observed in total experimental group. The performance ratios of Bender Gestalt Test and Trail Making B Test in experimental group were increased more thatn those in control group but no statistical singificance was observed. According to these results we could confirm that inhalational anesthetics hsve no significant effects on memory and congnitive function.
Anesthetics* ; Bender-Gestalt Test ; Brain ; Female ; Healthy Volunteers ; Humans ; Learning ; Mass Screening ; Memory* ; Neurons ; Research Personnel

The effect of inhalation anesthetics on memory was studied using 26 male Sprague-Dawley rats. In the control group the trained rats were tested the first performance time of T-maze and left them to anesthetic chamber for 120min. and checked second performance time 24hours later (Group A). For the experimental group the first performance time was tested and animals were exposed to the anesthetics (1% Halothane with N20:02=2:1) for 120min. and checked second performance time 24hours after cessation of exposure to evaluate retrograde amnesia (Group B). For the test of anterograde amnesia (Group C) rats were anesthetized before test the first performance time and checked second performance time 24hours later. The mean perfor- mance ratio (II/I) (i.e., I is the score in the first performance time and II is the score in the second performance time) was compared between anesthetized and non-anesthetized control group. In the group A the ratio was 102.8+/-19 but in group B it was 96.4+/-13 during anesthesia, 79.+/-19 after anesthesia and 92.3+/-11 in overaU anesthetized group, and was 100.2+/-17 in group C. All data of group B were significantly different with group A (p<0.01). But no statistical difference between group C and A was observed (p=0.174). These results suggest that post- training exposure to volatile anesthetics facilitates memory and no anterograde amnesia observed by pretraining exposure. These may be volatile anesthetics facilitate memory by enhancement of memory consolidation and/or retention or interference reduction.
Amnesia, Anterograde ; Amnesia, Retrograde ; Anesthesia ; Anesthetics ; Anesthetics, Inhalation* ; Animals ; Halothane ; Humans ; Inhalation* ; Male ; Memory* ; Rats* ; Rats, Sprague-Dawley

The effect of repeat exposure to 1soflurane on cerebral glucose utilization was studied by quantita-tive autoradiography using 19 male Sprague-Dawley rats. Local cerebral glucose utilization was compared between a conscious control and an Isoflurane anesthetized rat (single exposure, repeat exposure for 1 week and repeat exposure for 2 weeks) The results were as follows: 1) There was a small decrease of blood pressure in the anesthetized group, but it was within the range of autoregulation. The PaO2and PaCO2 were influenced by artificial ventilation in the anesthetized group but remained in normal range. 2) 1-CMRg decreased in most regions of the anesthetized group. A larger decreased glucous utilized region was observed with repeat exposure for 1 week than 2 weeks when compared to comscious control. but more regions involved decreased glucose utilization in the 2 week exposure group when compare to the single exposure. In particular the sensory motor cortex, and cerebral assocition areas were most severely affected. 3) There was no statistical significant difference between the 1 week and the 2 week exposure group. However significant decreased glucous utilization was seen on anterior thalamus in the 2 week exposure group. 4) Some regions with increased glucose utilization were the cerebellum nucleus, vestibular nucleus, hippocampus molecular layer and havenula in the single exposure group, Ansignifecant increase was seen in superior colliculus superficialis, anterior thalamus and hippocampus molecular layer in the repeat exposure group. 5) The order of decreased glucose utilization by funtional unit was: myelinated fiber>auditory system>visual system: other regions were ordered differently between groups. 6) The order of decreased glucose utilization according to anatomical regions were: telence- phalone > diencephalon > mesencephalone > metencephalone > myelencephalone in all three groups; i. e, rostral to caudal gradient of glucous utilization was well-maintained in-single or repeat-exposured groups. 7) There were significantly prominent regions appearing in anesthetized rat brains. They were havenular, havenulo-interpeduncular nucleus, and fornix. They were all preserved in repeat-exposure rats.
Animals ; Autoradiography ; Blood Pressure ; Brain ; Cerebellum ; Diencephalon ; Glucose* ; Hippocampus ; Homeostasis ; Humans ; Isoflurane ; Male ; Mesencephalon ; Metencephalon ; Motor Cortex ; Myelencephalon ; Myelin Sheath ; Rats* ; Rats, Sprague-Dawley ; Reference Values ; Superior Colliculi ; Thalamus ; Ventilation

The influence of Halothane on local cerebral glucose utilization was studid by quantitative autoradiography using 15 male Sprague-Dawley rats. The Rats had both the femoral artery and vein cannulated and anesthetized with 1.0 MAC and 2.0 MAC Halothane. Local cerebral glucose utilization (1-CMRg) was compared betweeen conscious control and the Halothane-anesthetized rat. The result was as follows; 1) There was a slight decrease of blood pressure in the anesthetized group, but it was within the range of autoregulation. The PaO2 and PaCO2 were influenced by artificial ventilation in anesthetized group but remained in normal range. 2) Fluctuation of 1-CMRg was noted according to the region during 1.0 MAC halothane anesthesia, the limbic system and basal ganglia showed increased 1-CMRg, but other discrete regions revealed decreased glucose utilization. Most regions showed decreased glucose utilization, except the subtantia nigra during 2.0 MAC halothane anesthesia. 3) The order of decreased glucose utilization was: Auditory system = Cerebral association area > Myelinated fiber > Sensory motor system > Limbic system > Extrapyramidal system in 1.0 MAC anesthesia group and Auditory system > Cerebral association area > Visual system > Sensory motor system > Limbic system = Extrapyramidal system > Myelinated fiber in 2.0 MAC anesthesia group. 4) Ther were no specific anatomical characteristics during 1.0 MAC or 2.0 MAC halothane anesth- esia. 5) Some regions showed increased glucose utilization during anesthesia which did not appeared in the conscious control animals. These regions were Habenulo-interpeduncular system, limbic system, and basal ganglia.
Anesthesia* ; Animals ; Autoradiography ; Basal Ganglia ; Blood Pressure ; Femoral Artery ; Glucose ; Halothane* ; Homeostasis ; Humans ; Limbic System ; Male ; Myelin Sheath ; Nervous System* ; Rats ; Rats, Sprague-Dawley ; Reference Values ; Veins ; Ventilation