Lidocaine is widely used as local anesthetic agent in the emergency department. Lidocaine crosses the blood brain barrier rapidly, and has been recognized generally as a proconvulsant drug. Acute lidocaine intoxication has a variety of causes, most of which related to excessive or inappropriate therapeutic dose. It has been recommended the total amount of lidocaine should not exceed 5 mg/kg without epinephrine and 7 mg/kg with epinephrine. We present a case of a patient who developed generalized convulsive status epilepticus following administration of lidocaine for epidermograft.
Blood-Brain Barrier ; Emergencies ; Epinephrine ; Humans ; Lidocaine ; Seizures ; Status Epilepticus

The purpose of this study is to evaluate the effects of Chu-ma therapy and to suggest that the therapy is an effective nursing intervention tool to reduce blood pressure. The research design employed was the non-synchronized research method with non- equivalent control group. A total of 30 people with essential hypertension, who were from forty to sixty five years old, participated in the study. The Chu-ma therapy was administered by every day for ten or fifteen minutes for eight weeks from 19, April to 13, June in 1999. In order to evaluate the effects of Chu-ma therapy, blood pressure of the two groups were measured once a week, and physiological parameters (epinephrine, norepinephrine, total cholesterol, HDL-cholesterol, triglycerides) were measured before and after the treatment. Collected data was analyzed by SAS package. The results of this study can be summarized as follows: 1) There were significant decrease in systolic blood pressure and diastolic blood pressure in the experimental group. 2) There were no significant changes in epinephrine, norepinephrine of the two groups. 3) There were significant decrease in total cholesterol and triglycerides, and HDL- cholesterol increased significantly in the experimental group. 4) The effect of Chu-ma therapy on the measured time on the blood pressure in experimental group was as follows: Both of systolic and diastolic blood pressures were significantly decreased after 5weeks. The result proved that Chu-ma therapy is an effective nursing intervention tool for clients with essential hypertenion. However further research is still necessary to compare the effect with the different periods and number of times for Chu-ma therapy.
Blood Pressure* ; Cholesterol ; Epinephrine ; Hypertension* ; Norepinephrine ; Nursing ; Research Design ; Triglycerides

The effect of spinal anesthesia with hyperbaric bupivacaine with and without 1: 1000 epinephrine were studied in 35 patients. Patients in group A received 0.4% hyperbaric bypivacaine 20 mg and patients in group B received the same anesthetic, only 0.2 mg of epinephrine was mixed to it. The following results were obtained. 1) The highest level of sensory loss was similar in both groups. 2) The duration of sensory loss was significantly longer in group B(391+/-12.9 vs 289+/-18.8min, p<0.05) The duration of motor block was also significantly longer in group B than group A(254 +/-13.7 vs 17l+/-4.4 min). 3) The systolic blood pressure significantly decreased at 20-40 minutes after spinal anesthesia in both groups. 4) The pulse rate in group A significantly increased at 2-10 minutes after spinal anesthesia and in group B, it decreased significantly at 45-50 minutes after spinal anesthesia.
Anesthesia, Spinal* ; Blood Pressure ; Bupivacaine* ; Epinephrine* ; Heart Rate ; Humans

OBJECTIVETo develop an HPLC-ECD for the determination of monoamine transmitters in serum of macaque.

METHODThe analysis was carried out on a ZORBAX SB-C18 column (4.6 mm x 250 mm, 5 microm) eluted with a mobile phase of methanol-water (18:82) at a flow rate of 0.9 mL x min(-1).

RESULTThe recoveries of NE, E, DA, 5-HT were 97.0%, 97.8%, 99.5%, 100.3%, RSD was 0.22%-0.93%, and the repeatability was good.

CONCLUSIONThe results prove that the method is simple, fast, accurate and can be used to determine simultaneously the concentration of monoamine transmitters in serum of macaque.

Animals ; Biogenic Monoamines ; blood ; Chromatography, High Pressure Liquid ; methods ; Dopamine ; blood ; Electrochemistry ; methods ; Epinephrine ; blood ; Female ; Humans ; Macaca ; Norepinephrine ; blood ; Premenstrual Syndrome ; blood ; Reproducibility of Results ; Serotonin ; blood

OBJECTIVETo investigate the stratification risk of catecholamines-beta-adrenoceptor (beta-AR)-cAMP pathway for cardiogenic death events in patients with congestive heart failure (CHF).

METHODSA total of 83 identified CHF patients with a baseline and follow-up plasma levels of norepinephrine (NE) and epinephrine (E), lymphocytes beta-AR density (Bmax), and intralymphocyte cAMP content in peripheral blood were followed up. Major cardiogenic death events were registered.

RESULTSThe period between the initial entry and the last follow-up measurement were 51 +/- 16 months, the total duration of clinical follow-up after the last measurement were 14 +/- 8 months. During follow-up, 39 patients died of cardiogenic (sudden death 17 patients, worsening heart failure 22 patients). Persistence of high NE, E, and cAMP from baseline to follow-up were confirmed as risk predicting factors of cardiovascular events. Persistence NE above 4.0 nmol/L, E above 3.5 nmol/L, and the intralymphocyte cAMP content above 3.5 pmd x mg(-1) x pro(-1) from baseline to follow-up were significant adverse prognostic predictors. The major cardiogenic death events rates per 100 patients-years were 1.33 and 4.82 in patients with NE below and above 4.0 nmol/L (HR: 2.91; 95% CI: 1.08-7.33; P = 0.015); were 1.42 and 4.36 in the patients with E levels below and above 3.5 nmol/L (HR: 2.64; 95% CI: 1.02-6.41; P = 0.019); were 1.81 and 4.67 in the patients with the intralymphocyte cAMP content below and above 3.5 pmd x mg(-1) x pro(-1) (HR: 2.79; 95% CI: 1.04-6.83; P = 0.017), but difference was not significant between the beta-AR density below and above median.

CONCLUSIONSPersistent increase in circulating catecholamines and intralymphocyte cAMP content may increase the long-term mortality in CHF patients.

Aged ; Catecholamines ; blood ; Cyclic AMP ; blood ; Death, Sudden, Cardiac ; Epinephrine ; blood ; Female ; Heart Failure ; blood ; mortality ; Humans ; Lymphocytes ; chemistry ; Male ; Middle Aged ; Norepinephrine ; blood ; Receptors, Adrenergic, beta ; blood

OBJECTIVETo study the effect of dimethoate on the monoamine Neurotransmitters, including norepinephrine (NE), epinephrine (E), serotonin (5-HT), dopamine (DA) and its metabolite (3, 4-hydroxyphenylacetic acid, DOPAC) in the serum of rats and furthermore to explore the non-cholinergic mechanism of organophosphate induced toxicity.

METHODSGroups of rats were treated with saline and 38.9, 83.7 and 180 mg/kg dimethoate respectively and were decapitated at the different time course from 0.5 to 24 hours after the administration. The monoamines neurotransmitters were determined by the reverse-phase high-performance liquid chromatography with the electrochemical detection.

RESULTSThe serum concentrations of DA (8.42% - 248.42% of the control), DOPAC (17.22% - 68.21% of the control) increased, according with the DM dosage and the exposure time, while the levels of NE (9.65% - 38.26% of the control) and E (11.00% - 32.62% of the control) contents decreased at the same time.

CONCLUSIONThese findings indicate that dimethoate induced toxic effects can alter the monoamine levels at the different dosage and the time exposure in the serum of rats. It suggests that some non-cholinergic mechanisms may be involved in the dimethoate intoxication.

3,4-Dihydroxyphenylacetic Acid ; blood ; Animals ; Biogenic Monoamines ; blood ; Dimethoate ; toxicity ; Dopamine ; blood ; Dose-Response Relationship, Drug ; Epinephrine ; blood ; Male ; Norepinephrine ; blood ; Rats ; Rats, Sprague-Dawley ; Serotonin ; blood

Epidural clonidine is reported to produce analgesia in humans. To investigate the analgesic effect and prolongation of epidural and spinal anesthesia, we mixed 0.2mg epinephrine, 150 mcg clonidine, or 1 cc normal saline with 0.5% bupivacaine and compared the hemodynamie and analgesic effects of each drug. Heart rate and blood pressure were checked before, during and after anesthesia. Sensory level was checked by pin-prick method. The results were as follows; 1) The analgesia onset time and the time to highest level of sensory loss was most rapid in the epinephrine group. 2) The two segment regression time was significantly prolonged in the epinephrine group. 3) The analgesia duration was significantly prolonged in the clonidine and epinephrine group. 4) Although the heart rate gradually decreased over 60 min. After injection of each drug, there was no significant change between the groups. 5) Blood pressure decreased over 20-30 min. After injection of each drug, but there was no significant change between the groups.
Analgesia ; Anesthesia ; Anesthesia, Epidural* ; Anesthesia, Spinal ; Blood Pressure ; Bupivacaine* ; Clonidine* ; Epinephrine* ; Heart Rate ; Humans

BACKGROUND: Epidural test solution is administered to confirm the correct positioning of an epidural catheter. Hemodynamic changes after administration of epidural test solution reportedly help confirm intravenous (IV) placement of epidural catheters. The change in T wave amplitude is important for checking intravascular placement of epidural catheters. We examined changes in T wave amplitude according to the level of spinal anesthesia after IV epinephrine administration. METHODS: Eighty-one healthy patients undergoing spinal anesthesia were randomized into three groups: group C (control), group L (low spinal block), and group H (high spinal block). All patients received an IV administration of test solution, 3 ml of 1% lidocaine and epinephrine 10 µg. Systolic blood pressure (SBP), heart rate (HR), and T wave amplitude were measured up to 5 min after test solution administration. Adverse reactions post administration of test solution were also recorded. RESULTS: In all groups, after administration of IV test solution, SBP and HR increased, and the T wave amplitude decreased. There were no significant differences in HR, SBP, and T wave amplitude changes between the groups after administrating test solution. Fifteen out of 25 patients (60.0%), 10 out of 24 (41.6%), and 11 out of 23 (47.8%) complained of adverse symptoms in groups C, L, and H, respectively. CONCLUSIONS: This study suggests that change in T wave amplitude after administration of a low dose of epinephrine is not affected by the spinal block range.
Anesthesia, Spinal ; Blood Pressure ; Catheters ; Electrocardiography ; Epinephrine* ; Heart Rate ; Hemodynamics ; Humans ; Lidocaine

BACKGROUND: Arthroscopic shoulder surgery has been performed in the sitting position under interscalene block (ISB). Bradycardia hypotension (BH) episodes have a reported incidence of 13-29% in this setting. We performed a retrospective study to investigate contributing factors to the occurrence of BH episodes. METHODS: According to BH episodes, we divided 63 patients into two groups: BH group (n = 13) and non-BH group (n = 50). Anesthetic records and block data sheets were reviewed for demographic data, intraoperative medications, sites of ISB, use of epinephrine in local anesthetics, degree of sensory blockade, and percent change of heart rate or systolic blood pressure (SBP). Statistical analysis was done using Chi square test and Student's t-test. RESULTS: There were no significant differences in the use of epinephrine in local anesthetics between the two groups. The location of ISB site was different between the two groups in that there were relatively more right-sided ISBs in the BH group than in the non-BH group (P = 0.048). The degree of sensory blockade was lower, but not significantly, in the C8 and T1 dermatomes of the BH group than in the non-BH group (P = 0.060 and 0.077, respectively). There was a relatively higher incidence of fentanyl supplementation in the BH group than in the non-BH group (P = 0.000). CONCLUSIONS: These results suggest that right ISB and perioperative supplementation of fentanyl due to incomplete block are possible contributing factors to the occurrence of BH episodes in the sitting position during shoulder surgery using ISB.
Anesthetics, Local ; Arthroscopy ; Blood Pressure ; Bradycardia ; Epinephrine ; Fentanyl ; Heart Rate ; Humans ; Hypotension ; Incidence ; Retrospective Studies ; Shoulder

The purpose of this study is to evaluate the effects of QiGong gymnastics exercise program in the physiopsychological parameter inessential hypertension. The design of the research was a one group pretest-posttest design. A total of 20 patients with hypertension who were from forty to sixty-five years old participated in the study. The Qi Gong gymnastics program was carried out twice a week for thirty minutes or forty minutes for six weeks from 22, Sep. to 31, Oct. in 1997. In order to evaluate the effect of the QiGong gymnastics program physiological parameter(blood pressure, pulse rate, FVC, FEV1, Epinephrine, Norepinephrine, Cortisol) and psychological parameter(self-efficacy, Life satisfaction) were measured before and after the exercise program. Collected data was analyzed by the paired t-test with SAS package. The result are as follows: 1) There were significant decrease in systolic blood pressure and diastolic pressure, but there was no significant change in pulse rate. 2) There were no significant difference in FVC and FEV1. 3) There were significant decrease in epinephrine, norepinephrine and cortisol. 4) There were significant improved in general self-efficacy and life satisfaction. 5) The effect of QiGong gymnastics program by measurement time on blood pressure and pulse rate were as follows: In a systolic blood pressure was gradually significant decreased from 1 week to 6 weeks and diastolic blood pressure was significantly decreased after 4 weeks. But there was no significant in pulse rate. This results suggest that QiGong gymnastics are an appropriate nursing intervention for clients with hypertension. For further research is necessary to reevaluate the effect with a letter experimental design and longer period than 8 weeks for the QiGong gymnastics program.
Blood Pressure ; Epinephrine ; Gymnastics* ; Heart Rate ; Humans ; Hydrocortisone ; Hypertension* ; Norepinephrine ; Nursing ; Qi* ; Qigong* ; Research Design