We chose enflurane as the primary anesthetic agent for the surgical removal of a pheochromocytoma (23 year old male) with the satisfactory results. A review of the literature on the anesthetic management of pheochromocytoma discloses no general agreement regarding choice of an anesthetic agent. Almost all agents have at some time been both praised and rejected. It would suggest that selection of an anesthetic agent is not as important as the adequate management of that agent.
Anesthesia* ; Enflurane* ; Pheochromocytoma*

BACKGROUND: The purpose of this study was to evaluate the safety and efficacy of low-flow anesthesia with a semi-closed circle anesthesia system in infants. METHODS: Twenty, ASA physical status 1 or 2, infants were randomly assigned into two groups: high-flow anesthesia (HFA) or low-flow anesthesia (LFA). An identical semi-closed Dr ger circle anesthesia system (Cato) was used to all patients. Initial fresh gas flow (FGF) was N2O 1.5 L/min and O2 1.5 L/min in both groups. This FGF of 3 L/min was maintained in the HFA group. After 10 min of HFA, the FGF was reduced to 500 ml/min (N2O 250 ml/min and O2 250 ml/min) in the LFA group. RESULTS: Hypoxic or hypercarbic gas concentrations were not observed in all patients. Enflurane consumption during LFA was about 1/3 of that during HFA (6.8 +/- 1.3 ml vs. 19.5 +/- 5.8 ml). The mean highest esophageal temperature was similar in both groups. The mean highest inspiratory gas and soda lime temperatures were significantly higher in the LFA group than in the HFA group. CONCLUSIONS: Low-flow anesthesia in a circle system with a fresh gas flow of N2O 250 ml/min and O2 250 ml/min could be performed safely and economically for infants.
Anesthesia* ; Enflurane* ; Humans ; Infant*

Enflurane* ; Metabolism* ; Methoxyflurane* ; Panax*

Plasma inorganic fluoride concentrations were measured in adult patients without hepatic or renal disease following sevoflurane-N2O anesthesia (n=7) or enflurane-N2O anesthesia (n=6). The anesthetic dosage of sevoflurane and enflurane was 6.48+/-2,15%-hour and 6.57+/-2.05%-hour, respectively. The mean peak plasma inorganic fluoride concentration in the sevoflurane group was 19.5+/-13.4 umol/L 1hour after anesthesia, which decreased to preanesthetic levels 24 hours after anesthesia. In the enflurane group the values were 13.2+/-5.8 umol/L at the end of anesthesia and decreased, but remained, still twice as high as the preanesthetic level 24 hours after anesthesia. The relationship of plasma inorganic fluoride concentration and anesthetic dosage was more pronounced in the sevoflurane group (r=0.68, slope=4.2) than in the enflurane group (r=0.39, slope=1.2). In conclusian, sevoflurane-N2O anesthesia results in similar subnephrotoxic levels of plasma inorganic fluoride as enflurane-N2O. anesthesia, and although the fluoride concentration had a better correlation to anesthetic dosage in the sevoflurane group than in the enflurane group, its excretion was faster in the sevoflurane group than in the enflurane group.
Adult ; Anesthesia* ; Enflurane ; Fluorides* ; Humans ; Plasma*

The required doses of gallamine (nondepolarizing neuromuscular bloeker) were measured in twelve patients under one MAC anesthesia of nitrous oxide-oxygen(50%)-enflurane with inductions of sodium pentothal (sleeping doses) and succinylcholine(1mg/kg). It was observed that the required dose of gallamine in nitrous oxide-oxygen(50%)-halothane (36. 5+/-3.54mg/hr/M2) is much higher than that in nitrous oxide-oxygen(50%)-enflurane (18.0+/-2.48mg/hr/M2) (p<0.01) and reviewed literaturea on the above result.
Anesthesia ; Enflurane* ; Gallamine Triethiodide ; Halothane* ; Humans ; Muscle Relaxation* ; Sodium ; Thiopental

Observation of changing pattern of blood pressure and pulse rate of enflurane anesthesia for 200 cases operations, performed during the past 4 years (1983~1986) in Yeungnam University Hospital have been evaluated clinically. In order to observe the influence of enflurane upon the blood pressure and pulse rate during general anesthesia, the authors prepared a formula, expressing changing of blood pressure and pulse rate by time series and analyzed the types and distribution pattern in the experiment. The results obtained were as follows: 1. Blood pressure and pulse rate were increased at the time of intubation. 2. Generally, blood pressure and pulse rate were increased at the time of intubation and then stabilized within 20 minutes. 3. Most common patterns were identified. ADEE type was 73~74%, which is most common type and AEEE type was about 40%.
Anesthesia* ; Anesthesia, General ; Blood Pressure* ; Enflurane* ; Heart Rate* ; Intubation

There are many disease entities which are associated with hemoglobinuria but the report of which is very rare during anesthesia except in the case of incompatible transfusion. The authors experienced a case of severe hemoglobinuria during general anesthesia with halothane, nitroud oxide, and thiopental sodium. The patient had no transfusion perioparatively, and no history of hemoltic problems except for prolonged oozing after ethrane anesthesia for tympanoplasty five monthes ago previously. The hemogiobinuria disappeared after two days of corticosteroid therapy, but afterwards the patient suffered from mild hepatitis which seemed to be due to repeated halothane anesthesia.
Anesthesia ; Anesthesia, General* ; Enflurane ; Halothane ; Hemoglobinuria* ; Hepatitis ; Humans ; Thiopental ; Tympanoplasty

In order to observe the effect on liver function after exposure to enlurane which has relatively minimal hepatotoxic effect, we evaluated the changes of the s-GOT & s-GPT levels caused by general anesthesia with enflurane. This study was undertaken to evaluate the effect of enflurane on liver function by comparing the preoperative and postoperative(1st day, 3rd day, 5th day, and 7th day) liver function(s-GOT & s-GPT) tests is il cases of the first general anesthesia with enflurane and 15 cases of a second general anesthesia with enflurane. The results were as folllows: 1) The 1st operative group. a. There are 5 cases (45%) of significant changes of s-GOT levels and no case of significant change in sGPT levels. b. In most of cases, the level of s-GOT & s-GPT have returned to normal values on the 7th postoperative day. 2) The 2nd operative group. a. The increase in the levels of s-GOT was found in 10 cases, and the s-GPT in 6 cases. b. Postoperatively, the simultaneous increase in the levels of s-GOT & s-GPT were found in 4 cases. c. On the 7th postoperative day, the levels of s-GOT & s-GPT was not normal in 3 cases, and not normal for s-GPT in 2 cases. The above results show that the higher of levels of s-GOT & s-GPT after the second general anesthesia with enflurane apparent compared to the levels after the first general anesthesia with enflurane. And it can be assumed that the extreme precaution is necessary in conduction the second general anesthesia with enflurane.
Alanine Transaminase ; Anesthesia, General ; Enflurane* ; Liver ; Reference Values

BACKGROUND: Various aspects of immunological homeostasis are affected by anesthesia and surgery, including the function of immunocompetent cells and the modulation of stress responses. To evaluate immunologic changes that occurred following propofol and enflurane anesthesia, we evaluated the proliferative responsiveness of peripheral blood mononuclear cells (PBMC) in patients undergoing laparoscopic gynecologic surgery. METHODS: PBMC were isolated from patients prior to anesthesia and on the first postoperative day (n = 10). The proliferative response was then evaluated based on the level of 5-bromo-2-deoxyunridine (BrdU) incorporation that occurred during DNA synthesisafter the induction of mitogenic stimulation by treatment with 1 microgram/ml lipopolysaccharides (LPS). To accomplish this, cell proliferation was assayed by enzyme-linked immuno-sorbent assay (ELISA), after which a stimulation index was calculated. RESULTS: Although the calculated stimulation index decreased in response to both propofol and enflurane anesthesia, the stimulation index did not differ significantly between groups. However, following stimulation with LPS, the stimulation index was significantly higher in the enflurane group than in the propofol group (P < 0.05). CONCLUSIONS: Propofol and enflurane anesthesia inhibit the PBMC proliferation. However, the decrease in proliferation that occurred in response to enflurane was attenuated by LPS.
Anesthesia ; Bromodeoxyuridine ; Cell Proliferation ; DNA ; Enflurane ; Homeostasis ; Humans ; Lipopolysaccharides ; Propofol

To evaluate the second gas effect and the effect of solubility of volatile anesthetics on the alveolar concentration, the ratio of the end-tidal to the inspired concentration(FET/F1) of enflurane and isoflurane with or without N2O were measured in 40 adult patients in ASA class I or Il. The patients were devided into four groups ; group 1 received 100% O2-1 vol% enflurane, group 2 received 50% O2-50% N2O-1 vol % enflurane, group 3 received 100 % O2-1 vo1% isoflurane and group 4 received 50% 0 50% N2O-1 vo1% isoflurane. The ratio of FET/F1 were measured at 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 16, 18, 20, 30 minute after administration of inhalation anesthetics in each group. The results were as follows. 1) The increase in FET/F1, compared with previous value in each group was significant at 2 minute in group 1 and 2(p<0.05), and at 2 minute and 3 minute in group 3 and 4(p< 0.05), respectively. 2) To compare between group 1 and 2, the significant differance of FET/F1 was noticed during entire observation period and between group 3 and 4, too(p<0.05). This is the result of the second gas effect. 3) The FET/F1 ratio of isoflurane which has lower blood solubility rised more rapidly than the FET/F1 ratio of enflurane. When given without NO, the FET/F1 ratio of group 3 rised significantly more rapidly than the FET/F1 ratio of group 1(p<0.05). But, when given with N2O, changes of the FET/F1 ratio were not significantly different between group 2 and 4. In this study, the alveolar concentration of enflurane and isoflurane rised more rapidly when given with 50% N2O than when given without N2O, it might be the second gas effect by the uptake of NO. And, to the exclusion of the second gas effect, the FET/F1 ratio of less soluble isoflurane rised more rapidly than the more soluble enflurane. But, under the presence of the second gas effect, the difference of the alveolar concentration which depends on the anesthetic solubility between enflurane and isoflurane was not significant.
Adult ; Anesthetics* ; Anesthetics, Inhalation ; Enflurane ; Humans ; Isoflurane ; Solubility*