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

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

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

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

BACKGROUND: Epinephrine is commonly used to reduce bleeding by constriction of nasal vessels in endoscopic sinus surgery. However, when it absorbs to other organs systemically, tachycardia and hypertension may occur and result in more bleeding. This study is performed to evaluate the dose response effects of remifentanil infusion to suppress these adverse responses without delaying emergence. METHODS: Sixty healthy patients who scheduled for endoscopic sinus surgery were randomly allocated into three groups by the dose of remifentanil infusion. For induction and maintenance of anesthesia, 0.05, 0.15, 0.25microgram/kg/min of remifentanil and 3.5microgram/ml of intravenous propofol by TCI were infused to each group. Systolic and diastolic blood pressure, heart rate and bispectral index were measured for 15 minutes at the 1 minute intervals after nasal packing of epinephrine. RESULTS: Systolic and diastolic blood pressure in R0.15 and R0.25 group were significantly lower compared to R0.05 group during 9 to 12 minutes after epinephrine packing, but heart rate and bispectral index were not significantly different among the groups. The frequency of hypotension and bradycardia were significantly higher in R0.25 than R0.05 and R0.15. CONCLUSIONS: Continuous infusion of 3.5microgram/ml of propofol with 0.15microgram/kg/min of remifentanil attenuate hypertension and tachycardia induced by epinephrine with little side effects.
Anesthesia ; Blood Pressure ; Bradycardia ; Constriction ; Epinephrine* ; Heart Rate ; Hemodynamics* ; Hemorrhage ; Humans ; Hypertension ; Hypotension ; Propofol ; Tachycardia

BACKGROUND: Combined spinal-epidural anesthesia has been used to reduce the side effect of spinal or epidural anesthesia. The epinephrine test dose to prevent intravascular injection of local anesthetics after subarachnoid block has not been clearly understood. The purpose of present study is to see the efficacy of simulated intravenous test dose during subarachnoid block. METHODS: 20 ASA physical status 1 and 2 patients underwent subarachnoid block with tetracaine 10 mg in hyperbaric solution at the L3-4 interspace and were divided into two groups, Group 1 (n=10) and Group 2 (n=10). 3 ml of Normal saline was injected intravenously to group 1, while 1:200,000 epinephrine 3 ml (15 microgram) was injected intravenously to group 2 at regression of sensory block to T8-10. 1:200,000 epinephrine 3 ml (15 microgram) was given to each volunteer (Group 3, n=10). Heart rate (HR) was measured at 15 seconds intervals for 3 minutes and systolic blood pressure (SBP) was measured at 1 minute intervals for 5 minutes. RESULTS: SBP increased significantly in group 2 and group 3 at 1 minute after epinephrine test dose injection. Maximal HR changes was 39.7 3.7 beat per minute in group 2 and 25.8 5.2 beat per minute in group 3. There was 100% incidence of detection of intravascular injection of 15 microgram epinephrine in both group when HR increase > or = 20 beats per minute is regarded as positive response. CONCLUSIONS: This study demonstrates that the epinephrine test dose is useful method to detect intravascular injection of local anesthetics either in the combined spinal-epidural anesthesia or epidural anesthesia. The heart rate response after injection of epinephrine was greater than the blood pressure response.
Adult* ; Anesthesia* ; Anesthesia, Epidural ; Anesthetics, Local ; Blood Pressure ; Epinephrine* ; Heart Rate ; Humans ; Incidence ; Tetracaine ; Volunteers

There is some controversy regarding the effect of general inhalation anesthesia on platelet function. In 20 patients undergoing long operations over 3 hours, and anesthetized with either nitrous oxide-oxygen and enflurane (A group) or nitrous oxide-oxygen and halothane (B group), we could not find any clinically significant impairment of coagulation. Platelet functions were consecutively evaluated on the samples collected at preinduction, during anesthesia (3 hours) and at postoperation (24 hours) using an aggregometer and several aggregating agents including ADP, epinephrine, collagen and ristocetin. There were no statistically significant changes between the maximum aggregation rate of preinduction and that duirng anesthesia in either group.
Adenosine Diphosphate ; Anesthesia ; Anesthesia, Inhalation ; Anesthetics, Inhalation* ; Blood Platelets* ; Collagen ; Enflurane ; Epinephrine ; Halothane ; Humans ; Inhalation* ; Ristocetin