Objective: To estimate the consumption level of four drugs in Beijing using wastewater-based epidemiology (WBE). Methods: The primary sludge from one large wastewater treatment plants (WWTPs) was collected in Beijing from July 2020 to February 2021. The concentrations of codeine, methadone, ketamine and morphine in the sludge were detected through solid-phase extraction-liquid chromatography-tandem mass spectrometry. The consumption, prevalence and number of users of four drugs were estimated by using the WBE approach. Results: Among 416 sludge samples, codeine had the highest detection rate (82.93%, n=345) with a concentration [M (Q₁, Q₃)] of 0.40 (0.22-0.8) ng·g^-1, and morphine had the lowest detection rate (28.37%,n=118) with a concentration [M (Q₁, Q₃)] of 0.13 (0.09, 0.17) ng·g^-1. There was no significant difference in the consumption of the four drugs on working days and weekends (all P values>0.05). Drug consumption was significantly higher in winter than that in summer and autumn (all P values <0.05). The consumption [M (Q₁, Q₃)] of codeine, methadone, ketamine and morphine in winter was 24.9 (15.58, 38.6), 9.39 (4.57, 26.72), 9.84 (5.18, 19.45) and 5.67 (3.57, 13.77) μg·inhabitant^-1·day^-1, respectively. For these drugs, there was an upward trend in the average drug consumption during summer, autumn and winter (the Z values of the trend test were 3.23, 3.16, 2.19, and 3.32, respectively and all P values<0.05). The prevalence [M (Q₁, Q₃)] of codeine, methadone, ketamine and morphine were 0.0056% (0.003 4%, 0.009 2%), 0.0148% (0.009 6%, 0.026 7%),0.0333% (0.0210%, 0.0710%) and 0.0072% (0.003 8%, 0.011 7%), respectively. The estimated number of drug users [M (Q₁, Q₃)] was 918 (549, 1 511), 2 429 (1 578, 4 383), 5 451 (3 444, 11 642) and 1 173 (626, 1 925),respectively. Conclusion: Codeine, methadone, ketamine and morphine have been detected in the sludge of WWTPs in Beijing, and the consumption level of these drugs varies in different seasons.
Humans ; Beijing ; Wastewater-Based Epidemiological Monitoring ; Sewage/analysis* ; Wastewater ; Ketamine/analysis* ; Codeine/analysis* ; Methadone/analysis* ; Water Pollutants, Chemical/analysis*

The dose-ralated dffects of intravenous infusion of thiopental and ketamine on the rat EEG were evaluated quantitatively by spectrum analysis of EEG recorded from the rat scalp. The anesthetics were infused into jugular vein at various rates ranging from 0 to 8ug/min/g body weight, and then bipolar EEG was recorded from the rat scalp and tis spectrum were calculated by powere wpectrum analysis. the density of each bands(delta 1-3.25, theta 3.5-7.75, alpha 8-12.15, beta 1.13-17.75, beta 2.18-20.75, and beta 3.21-31.75Hz) and total density were derived from the spectrums. In visual inspection of conventional EEG, low doses of thiopental increased the amplitudes of spinles. but higher doses decreased the amplitube gradually to electrical silence with increase of infusion rates. During infusion of higher doses of ketamine, two types of EEG were identified by the spectral patterns:The one was the cases in which increases of the power density over all frequency ranges were observed, and the other was those in which marked increases of density in specific frequency were observed. In thiopental infusion, the densities of all bands were increased to peak at 1~2ug/min/g and therafter were decreased with higher rates of infusion. In ketamine infusion, the densities were increased when the infusion rate was increased. These results suggest that, by the changing patterns of the band densities dervied from spectrum analysis of EEG, not only the effect on EEG of thiopental of tetamine can be quantified but also their differences of mechanisms of action on brain be reflected.
Anesthetics ; Animals ; Body Weight ; Brain ; Electroencephalography* ; Infusions, Intravenous ; Jugular Veins ; Ketamine* ; Rats* ; Scalp ; Spectrum Analysis* ; Thiopental*

This study was undertaken to estimate the effects of the induction agents on the bioparameters such as changes in blood pressure, pulse rate, Apgar score, patients movement, fetal arterial and venous blood gas analysis, memory and emergence reactions. 116 parturients undergoing cesarian section were divided into two groups: ketamine group and thiopental group, and were given 1.2 mg/kg ketamine in ketamine group and 4 mg/kg thiopental sodium in thiopental group as an induction agent respectively. The results were as follows; I) Blood pressure increased in both groups, but ketamine group less increased than thiopental group statistically. Pulse rate did not increased in skin incision in ketamine group statistically. 2) The patient's movement were 5 case(9%) in ketamine group and 17 cases(29%) in thiopental group. 3) There was not significant difference in fetal arterial and venous blood gas analysis. 4) In Apgar score, ketamine group is better than thiopental group. 5) There was no psychologic side reactions in both groups. 6) Postoperative recalling of intraoperative awareness occured in seven patients(12%) only in the thiopental group.
Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section ; Female ; Heart Rate ; Humans ; Intraoperative Awareness ; Ketamine* ; Memory ; Pregnancy ; Skin ; Thiopental*

The author observed the effects of an intravenous drip of ketamine hydrochloride to 60 patients with in high surgical risk who had undergone abdominal surgery at Pusan National University Hospital from March, 1981 to February, 1982. The results obtained were follows. 1) Average duration of anesthesia was 148 minutes and the rate of intravenous drip of ketamine was ranged from 0.017 to 0.02mg/kg/min. Total dose of ketamine was 264.2mg on and average. 2) Significant increase in blood pressure and heart rate was observed in the ketamine drip group during the operation (p<0.05). 3) Changes in values of arterial blood gas analysis during ketamine drip were within normal limits. 4) Duration from anesthesis to awakening in recovery room was longer in ketamine drip group than thiopental-halothane group. 5) Psychotomimetic symptoms after ketamin administration included convulsions, discomfort, and hallucinations etc. and diazepam premedcation could not completely relieve the above symptoms. 6) Relief of postoperative incisiional pain was excellent in ketamine drip group.
Anesthesia ; Blood Gas Analysis ; Blood Pressure ; Busan ; Diazepam ; Hallucinations ; Heart Rate ; Humans ; Infusions, Intravenous* ; Ketamine* ; Recovery Room ; Seizures

We replaced anesthesia of operations, which has done under local or general anesthesia, by MAC(monitored anesthesia care) with various patient's monitoring devices such as BIS(bispectral index). From April 2003 to March 2004, 48 cases of operations were done in MAC with supplemental equipments. Induction, maintenance of anesthesia was performed by propofol and midazolam. Pain control was done by fentanyl and ketamine. For monitoring the depth of anesthesia in real time, and BIS scale was checked and was maintained in 40-60. All anesthesias were done by the anesthesiologist that was communicated with operator for information between patient's status and operation procedures. All operations and anesthesias progressed with stability and safety, and there was no major postoperative complication. Because BIS was relatively accurate device, there was no over dose of anesthetic agents, which was induced by patient's uncertain pain complain under sedation and no anxiety of operator, that was raised by no responsive patient. BIS made possible that operation under MAC was effective and safe, operator perform it with non-stress condition and followed by good surgical result.
Anesthesia* ; Anesthesia, General ; Anesthesia, Intravenous ; Anesthetics ; Anxiety ; Conscious Sedation* ; Fentanyl ; Humans ; Ketamine ; Midazolam ; Postoperative Complications ; Propofol ; Spectrum Analysis ; Surgery, Plastic*

BACKGROUND: Serious pulmonary complications after lung surgery increase morbidity and mortality in perioperative period. Ketamine hydrochloride produces strong analgesic effect in spite of the psychomimetic effects. Intravenous anesthesia with ketamine was performed in lung surgery of patients with decreased pulmonary function and compared with inhalation anesthesia with enflurane. METHODS: Sixty patients, scheduled for elective lung surgery, were randomly assigned to two groups. Patients received either enflurane (Group 1, n=30) or ketamine (Group 2, n=30) as main anesthetic drug. Blood pressure and heart rate were compared in preinduction, postinduction, postintubation, postincision, intraoperative period (30 minutes, 60 minutes) and recovery room between groups, and in each group. Arterial blood gas analysis was compared in preoperative period, intraoperative period and recovery room between groups. Postoperative psychological complications evaluated in group 2. RESULTS: Blood pressure and heart rate were significantly different in postinduction, postintubation and recovery room between groups. PaO2 in group 2 was higher than in group 1 during intraoperative period and recovery room. Postoperative psychological complications occured in 4 patients (13%) in group 2. CONCLUSIONS: Ketamine affords advantage over enflurane anesthesia in terms of PaO2 during intraoperative period and recovery room in lung surgery of patients with decreased pulmonary function.
Anesthesia ; Anesthesia, Inhalation* ; Anesthesia, Intravenous* ; Blood Gas Analysis ; Blood Pressure ; Enflurane* ; Heart Rate ; Humans ; Inhalation* ; Intraoperative Period ; Ketamine* ; Lung* ; Mortality ; Perioperative Period ; Preoperative Period ; Recovery Room

Physostigmine has been used to counteract somnolence or coma induced by different types of phamacological agent, such as anticholinergics, opioids, ketamine and tricyclic antidepressants. In this study, we have assesed the effects of physostigmine on arousal after laryngomicroscopic surgery under enflurane-N2O general anesthesia and the effects of muscle relaxants. Forty patients were divided randomly into four groups such as I (succinylcholine only), II (vecuronium only), III(succinylcholine and physostigmine) and IV(vecuronium and physostigmine). Physostigmine 1mg was administered intravenously at the end of operation. We evaluated the recovery time of spontaneous respiration, gag reflex, pain response, extubation, eye opening on command and orientation after the end of operation. We also observed the end tidal CO2 and expired enflurane concentration with SARA(R) spectrometry at the end of operation and at the time of each recovery parameters returned . Our results revealed that physostigmine groups(group III and IV) were recovered more rapidly in the recovery time of eye opening to verbal command and orientation than non-physostigmine groups(group I and II ). But there was no difference in recovery time of spontaneous respiration, gag reflex, pain response and extubation. Therefore, we concluded that physostigmine 1 mg, i.v. has the effects of early arousal after short and deep general anesthesia and it did not show any specific complications such as bradycardia, bronchospasm, nausea and vomiting.
Analgesics, Opioid ; Anesthesia, General ; Antidepressive Agents, Tricyclic ; Arousal* ; Bradycardia ; Bronchial Spasm ; Cholinergic Antagonists ; Coma ; Enflurane ; Equidae ; Humans ; Ketamine ; Nausea ; Physostigmine* ; Reflex ; Respiration ; Spectrum Analysis ; Vomiting

In anesthesia for Caesarean section, some induction agents have been used. Thiopental so- dium is regarded as the standard induction agent. Propofol and ketamine have properties which suggest that it might be useful alternstives to thiopental. The purpose of our study was to evaluate the maternal and neonatal effect of propofol and ketamine used as induction agent for general anesthesia for elective Caeearean section. Sixty mothers undergoing elective Caesarean section under general anesthesia were allocated randomly to receive thiopental 4 mg/kg or ketamine 1 mg/kg or propofol 2 mg/ kg for induction of anesthesia. The results were as follows; 1) There were significant increase in systolic pressure, diastolic pressure and heart rate at postintubation within three groups(p<0.05). But there were no significant differences in cardiovascular responses between three groups during the induction. 2) The Apgar scores and blood gas analyses of neonates did not differ between three groups significsntly and the results were within normal range in all groups. As a result, propofol and ketamine are acceptable alternatives to thiopental for the induction of general anesthesia in Caesarean section. But in view of maternal cardiovascular changes and fetal well being, propofol and ketamine offer no significant advantage over thiopental.
Anesthesia ; Anesthesia, General ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section* ; Female ; Fetal Blood* ; Heart Rate ; Humans ; Infant, Newborn* ; Ketamine ; Mothers ; Pregnancy ; Propofol ; Reference Values ; Thiopental ; Umbilical Cord*

BACKGROUND: This study was aimed to elucidate the effect of ketamine anesthesia on circulatory response to hemorrhage in rats by power spectral analysis of heart rate and blood pressure variability. METHODS: Nineteen male Sprague-Dawley rats weighing 290~475 g were divided into ketamine (100 mg/kg, im)-anesthetized(K, n=10) and conscious(C, n=9) groups. Hemorrhage was induced with a withdrawal pump from the femoral artery at 3 ml/kg/min for 5 min. Arterial pressure was measured with a pressure transducer connected to the contralateral femoral artery for 5 min before, during and after hemorrhage. The blood pressure signal digitized at 500 Hz through a data acquisition system was analyzed with fast Fourier transform algorithm to yield power spectra of sytolic(SP) and diastolic(DP) blood pressure and instantaneous heart rate(HR). Powers of very low frequency(VLF, 0.02~0.26 Hz), low frequency (LF, 0.26~0.75 Hz) and high frequency(HF, 0.75~5.00 Hz) band were expressed as percent of total power. RESULTS: Before hemorrhage blood pressure was higher in K(152.4+/-3.7/99.9+/-4.9 mmHg) than in C(143.3+/-5.7/95.5+/-4.1 mmHg) rats, but was changed by hemorrhage in both groups. Before hemorrhage HR in K and C rats were 361.4+/-17.5 and 363.4+/-18.5 beats/min . HR were significantly increased to 403.2+/-20.3 and 396.2+/-18.9 beats/min during and after hemorrhage in K rats, and increased to 409.1+/-20.9 beats/min during hemorrhage in C rats. Before hemorrhage total powers of blood pressure and HR variability were higher in K than in C rats. During hemorrhage, total powers of blood pressure and heart rate variability tended to increase in both groups. Before hemorrhage, percent powers of systolic pressure variability of HF and VLF were higher in K than in C rats and LF was lower in K than in C rats. During hemorrhage, K group showed no significant changes but C group showed significant changes. Before hemorrhage, percent powers of diastolic pressure variability of VLF was higher in Kthan in C rats, and HF and LF were lower in K than in C rats. During and after hemorrhage, K group showed no significant changes, but C group showed significant decrease in LF and increase in VLF. Before hemorrhage, percent powers of heart rate variability of K rats showed higher HF and VLF, and lower LF than C rats. During and after hemorrhage HF and VLF of both groups showed no significant changes except significant increase in VLF after hemorrhage in C rats, but LF of both groups showed significant decrease. CONCLUSIONS: It was concluded that autonomic activity, especially cardiac sympathetic activity, was increased in response to hemorrhage in K rats. Ketamine anesthesia stimulated overall autonomic activity, especially sympathetic activity and vasomotor tone. In C rats hormonal factor contributed to blood pressure and heart rate variability during hemorrhage.
Anesthesia ; Animals ; Arterial Pressure ; Blood Pressure* ; Femoral Artery ; Fourier Analysis ; Heart Rate* ; Heart* ; Hemorrhage* ; Humans ; Ketamine ; Male ; Rats* ; Rats, Sprague-Dawley ; Transducers, Pressure

BACKGROUND: Propofol and ketamine had been used for anesthesia induction and for total intravenous anesthesia. The nature of any hypnotic interactions occurring between propofol and ketamine are unknown. A comparison of maternal and neonatal effects among propofol-ketamine combination, ketamine and propofol were studied when used for anesthesia induction in Cesarean section. METHODS: Forty five patients in ASA class I or II scheduled for Cesarean section randomly assigned to either propofol 2 mg/kg (n=15), ketamine 1 mg/kg (n=15) or propofol 1 mg/kg - ketamine 0.5 mg/kg combination group (n=15) as an induction agent. Maternal systolic and diastolic blood pressure, heart rate, Apgar score and umbilical blood gas analysis were measured. RESULTS: Before intubation, systolic and diastolic pressure were decreased in propofol group but increased in ketamine and propofol-ketamine combination group. Heart rate were increased in all three groups. But there were no significant differences among three groups (p<0.05). After intubation, there were significant increase in systolic, diastolic pressure and heart rate in three groups but no significant differences among three groups (p<0.05). And there was no significant neonatal depression as assessed by Apgar scores and blood gas analyses. CONCLUSIONS: Propofol-ketamine combination was found to be similar to propofol or ketamine only in the effects on the mother and neonate. But propofol-ketamine gained more stable hemodynamic change than propofol or ketamine before intubation. Therefore propofol-ketamine appears to be a suitable alternatives to propofol or ketamine as an induction agent for anesthesia in Cesarean section.
Anesthesia ; Anesthesia, Intravenous ; Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section* ; Depression ; Female ; Heart Rate ; Hemodynamics ; Humans ; Infant, Newborn ; Intubation ; Ketamine* ; Mothers ; Pregnancy ; Propofol*