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

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

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 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

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 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

Although platelet have been implicated in the pathogenesis of the thrombotic disease, the platelet aggregability was not well studied in Korea. Author measured platelet aggregability in 103 clinical cases including 30 healthy volunteers to evaluate the platelet function and the effect of Aspirin and Dipyridamole on aggregability in Korean. 24 patients with cerebral thrombosis, 24 patients with ischemic heart disease and 25 patients with hypercholesterolemia were included for this study. Aggregation tests were performed at three final concentrations of epinephrine(10microM/L) and ADP(4 microM/L, 10 microM/L) with platelet aggregometer which was made by Chrono-Log Corp. in all cases. Platelet aggregations were measured in patients who were treated with Aspirin, Dipyridamole and combined treatment of Aspirin and Dipyridamole respectively. The following results were obtained. 1) The mean maximal platelet aggregability in the normal subjects induced by 10 microM/L epinephrine was 59.3+/-24.26%, 66.6+/-14.00% in Bm and 62.5+/-19.30% in B5 in induction by 4 microM/L ADP, and 77.2+/-8.99% in Bm and 76.6+/-9.83% in B5 in induction by 10microM/L ADP. 2) The mean maximal platelet aggregability in patients with cerebral thrombosis induced by 10 microM/L epinephrine was 89.2+/-7.33%, 78.8+/-9.41% in Bm and 78.5+/-9.93% in B5 in induction by 4 microM/L ADP, and 86.4+/-7.69% in Bm and B5 in induction by 10 microM/L ADP. The results showed significantly elevated platelet aggergability than that of normal subjects(p<0.01). 3) The mean maximal platelet aggregability in patients with ischemic heart disease induced by 10 microM/L epinephrine was 88.1+/-11.99%, 78.2+/-12.50% in Bm and B5 in induction by 10 microM/L ADP. The results showed significantly elevated platelet aggregability than that of normal subjects(P<0.01). 4) The mean maximal platelet aggregability in patients with hypercholesterolemia induced by 10 microM/L epinephrine was 86.8+/-15.99%, 82.7+/-11.19% in Bm and 82.0+/-12.87% in B5 in induction by 4 microM/L ADP, and 88.5+/-11.47% in Bm and B5 in induction by 10 microM/L ADP. The results showed signifcantly elevated platelet aggregability than that of normal subjects(P<0.01). 5) The mean maximal platelet aggregability in patients with thrombotic disease was studied by Dipyridamole administration. The platelet aggregability induced by epinephrine before administration was 90.9+/- 8.52% and after administration it was 78.9+/-15.68%, and the results showed that Dipyidamole lowered aggregability significantly. The platelet aggregability induced by 4 microM/L ADP before administration was 84.0+/-11.90% in Bm and B5 and after administration it was 78.0+/-11.44% in Bm and B5, and the results showed that Dipyridamole lowered aggregability but not significant. The platelet aggregability induced by 10 microM/L ADP before administration was 89.2+/-10.39% in Bm and B5 and after administration it was 80.5+/-8.44% in Bm and B5, and the results showed that Dipyridamole lowered aggregability significantly. 6) The mean maximal platelet aggregability in patients with thrombotic disease was studied by Aspirin administration. The platelet aggregability induced by epinephrine before administration was 91.0+/-4.79% and after administration it was 47.6+/-17.72%. The platelet aggregability induced by 4 microM/L ADP before administration was 84.6+/-10.37% in Bm and B5 and after administration it was 72.6+/-11.85% in Bm and 65.3+/-15.97% in B5. The platelet aggregability induced by 10 microM/L ADP before administration was 84.9+/-6.30% in Bm and B5 and after adminstration it was 77.7+/-8.60% in Bm and 75.0+/-8.89%. The results showed that Aspirin lowered aggregability markedly. 7) The mean maximal platelet aggregability in patients with thrombotic disease was studied by combined administration of Aspirin and Dipyridamole. The platelet aggregability induced by epinephrine before administration was 86.7+/-13.77% and after administration it was 36.7+/-14.01%. The platelet aggregability induced by 4 microM/L ADP before administration was 81.5+/-12.93% in Bm and 80.6+/-14.15% in B5 amd after administration it was 54.7+/-17.27% in Bm and 44.6+/-21.17% in B5. The platelet aggregability induced by 10 microM/L ADP before administration was 87.8+/-10.11% in Bm and B5 and after administration it was 65.7+/-13.59% in Bm and 62.0+/-16.42% in B5. The results showed that combined administration of Aspirin and Dipyridamole lowered aggregability significantly and the results were lower than that of normal subjects. 8) The effects of combined treatment of Aspirin and Dipyridamole showed marked reduction of platelet aggregability than that of single treatment of Aspirin or Dipyridamole in thrombotic disease.
Adenosine Diphosphate ; Aspirin* ; Blood Platelets* ; Dipyridamole* ; Epinephrine ; Healthy Volunteers ; Humans ; Hypercholesterolemia* ; Intracranial Thrombosis ; Korea ; Myocardial Ischemia

Although the conclusion is controversial, there has long been an appealing notion that catecholamines may be involved in some way in the pathogenesis of primary hypertension and almost invariably most of hypotensive drugs involve at various sites of the neuron and produce their effect by depletion of norepinephrine in the sympathetic nerve ending. The authors undertook the comparative study on catecholamine depleting action of 3 most effective drugs available for the treatment of hypertension, reserpine, guanethidine and alpha-methyldopa, measuring the plasma catecholamine levels and urinary exceretion of caecholamine by the modified fluorometric method of Weil-Malherbe and Bone during the treatment of hypertension. The results are as follows: 1) Before the administration of hypotensive drugs, mean blood pressure was 180/110mmH, mean psalma epinephrine level was 0.36+/-0.23gamma%, mean plasma norepinephrine level was 0.48+/-0.35gamma%, 24 hours urinary excretion of epinephrine was 3.6+/-0.12gamma/day and 24 hours urinary excretion of norepinephrine was 68.9+/-0.34gamma/day. 2) In group 1 (reserpin administered group), the mean blood pressure was 190/110mmHg before the treatment and which was declined to 155/89mmHg on the last day of 4th week, in group 2 (guanethidine administered group), the mean blood pressure measured before the treatment was 185/110mmHg and which was declined to 150/85mmHg on the last day of 4th week, and in group 3 (alpha-methylodpa administered group), the mean blood measured pressure measured before the treatment was 182/110mmHg and which was declined to 153/88mmHg on the last day of 4th week. 3) After the treatment for 4 weeks with reserpin guanethidine and alpha-methyldopa, the mean plasma epinephrine levels were declined from 0.37+/-0.12gamma% to 0.11+/-0.08gamma% in group 1, from 0.38+/-0.16gamma% to 0.14+/-0.10gamma% in group 2 and from 0.33+/-0.23gamma% to 0.10+/-0.09gamma% in group 3. 4) The mean plasma norepinephrine levels were declined from 0.05+/-0.21gamma% to 0.22+/-0.12gamma% in group 1, from 0.51+/-0.25gamma% to 0.20+/-0.10gamma% in group 2 and from 0.51+/-0.21gamma% to 0.20+/-0.11gamma% in group 3 after the treatment of 4 weeks respectively. 5) Urinary exceretion of epinephine was declined from 32.3+/-0.16gamma/day to 10.4+/-0.10gamma/day in group 1, from 34.5+/-0.34gamma/day to 17.2+/-0.16gamma/day in group 2, and from 28.2+/-0.14gamma/day to 10.3+/-0.11gamma/day in group in group 3 after the treatment of 4weeks duration. 6) The mean value of 24 hours urinary excretion of norepinephrine was declined to from 72.2+/-0.35gamma/day to 28.5+/-0.14gamma/day in group1, from 69.2+/-0.34gamma/day to 22.6+/-0.21gamma/day in group 2 and from 68.6+/-0.34gamma/day to 18.2+/-0.10gamma/day in group 3 after the treatment of 4 weeks duration. 7) From the above result we can summarized as follows: Antihypertensive effect of each drugs was; guanethidine>alpha-methylodopa>reserpin in order but depressing action plasma norepinephrine levels was; alpha-methyldopa>guanethidine>reserpin and depressing effect of urinary norepinephrine excretion was; alpha-methyldopa>guanethidine>reserpin, in order.
Antihypertensive Agents* ; Blood Pressure ; Catecholamines ; Epinephrine ; Guanethidine ; Humans ; Hypertension ; Methyldopa ; Nerve Endings ; Neurons ; Norepinephrine ; Plasma* ; Reserpine

Vasoconstrictors such as epinephrine or phenylephrine have been used as an adjunct to local anesthetics to prolong the duration of spinal anesthesia. Recently, clonidine, an areceptor agonist, has been proved to have analgesic effect and to prolong epidural and spinal anesthesia. We used 0.3mg of epinephrine, 75 ug and 150 ug of clonidine in spinal anesthesia with 12 mg of T-Cain respectively and compared hemodynamic 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 and motor blockade was measured by Bromages scale. The results were as follows. 1) Heart rate changed little in the epinephrine group and decreased significantly in all other groups.2) Systolic blood pressure decreased significantly in all groups except the epinephrine group. Both 75 ug and 150 ug of clonidine caused a significant fall in diastolic pressure. 3) The onset time for sensory and motor blockade varied little among all groups. 4) Sensory blockade was significantly higher in the 150 ug of clonidine group than the control group. Time to achieve the maximum level of sensory blockade was significantly faster in control group than 150 ug of clonidine group. 5) The duration of sensory and motor blockade was significantly prolonged in epinephrine and clonidine group than control group. The results indicate that clonidine, when used as an adjunct to T-Cain spinal anesthesia, is as effective as epinephrine in prolongation of motor and sensory blockade.
Anesthesia ; Anesthesia, Spinal* ; Anesthetics, Local ; Blood Pressure ; Clonidine* ; Epinephrine* ; Heart Rate ; Hemodynamics ; Phenylephrine ; Vasoconstrictor Agents

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