The aim of this study was to compare with the effects of baclofen using an animal model of neuropathic pain. The sciatic nerve of rats was ligated unilaterally about dorsal half-portion in the tight according to the method of Seltzer and his colleague. After surgical operation, the rats showed painful symptoms of the ipsilateral hind paw, suggesting the possibility of spontaneous pain. And then, the paw withdrawal latency to the local heating on the paw through the glass plate and the frequency of paw withdrawal response to innocuous mechanical stimulation with modified von Frey filaments were determined to compare with the effects of pre-and post-medication of baclofen, respectively, at postoperative 3, 7, and 10 days. The results obtained were as follows: 1) The thermal hyperalgesia and mechanical allodynia produced by partially tight ligation of sciatic nerve appeared continously postoperative 3 days later. 2) In the hyperesthetic rats, the thermal hyperalgesia was inhibited from the 3rd posroperative day with orally administered baclofen 0.2mg and 1.0mg. 3) In the hyperesthetic rats, the mechanical allodynia was inhibited with baclofen 0.2mg, but not with baclofen 1.0mg, These results suggest that baclofen have more specific effects on thermal hyperalgesia than mechanical allodynia.
Animals* ; Baclofen* ; Glass ; Heating ; Hot Temperature ; Hyperalgesia ; Ligation ; Models, Animal* ; Neuralgia* ; Rats ; Sciatic Nerve

No abstract available.

No abstract available.

No abstract available.
Anesthesia, General* ; Angiography ; Arthroplasty, Replacement, Knee* ; Pulmonary Embolism ; Venous Thromboembolism* ; Venous Thrombosis

BACKGROUND: Lidocaine is often administered intravenously to suppress airway reflexes associated with tracheal intubation or tracheal suction. In addition, lidocaine is known to have airway relaxant effects through a direct relaxant mechanism on the smooth muscle. The presence of airway epithelium has been reported to reduce the sensitivity and maximum contractile response to histamine or acetylcholine(ACh). The purpose of this study was to determine whether the cumulative application of lidocaine may cause a concentration-dependent relaxation of the rat tracheal smooth muscle strips with intact or rubbed epithelium. METHODS: Using the rat tracheal smooth muscle strips, the effects of 10 6~3 10 3M of lidocaine pretreatment on isometric tension induced by 40 mM of K+ or 10 5M of ACh in presence or absence of adherent epithelium, and the influences of 10 6M of propranolol, 10 4M of L-NAME and 10 6M of atropine on relaxing response of lidocaine were studied. RESULTS: The tracheal smooth muscle concentration induced by K+ and ACh was similar magnitude both in presence or absence of adherent epithelium. The removal of epithelium did not affect the relaxant effect of lidocaine on the K+ and ACh-induced tracheal smooth muscle contraction. Lidocaine pretreatment reduced Ca2+-dependent contraction of the rat tracheal smooth muscle. Following pretreatment of the tracheal smooth muscle preparations respectively with propranolol, L-NAME and atropine the relaxing responses to lidocaine of tracheal smooth muscle were not depressed. CONCLUSIONS: These results suggest that the effect of the epithelium on lidocaine-induced relaxation of the tracheal smooth muscle is not significant and lidocaine may directly relax tracheal smooth muscle by the influences on the Ca2+ mobilization.
Anesthetics ; Animals ; Atropine ; Epithelium* ; Histamine ; Intubation ; Lidocaine* ; Muscle, Smooth* ; NG-Nitroarginine Methyl Ester ; Propranolol ; Rats* ; Reflex ; Relaxation ; Suction

BACKGROUND: Pain following shoulder surgery is usually severe and difficult to control using conventional postoperative pain control maneuvers. Therefore, we investigated the pain control efficacy, PONV (postoperative nausea vomiting) and complications by the use of a continuous brachial plexus block in patients who had undergone shoulder surgery. METHODS: Thirty three shoulder surgery patients were enrolled in this study. According to the Borgeat's modified lateral technique, 30 ml of 0.37% ropivacaine were injected into the patients, which was followed by insertion of a continuous brachial plexus catheter into the plexus sheath. The operation was then conducted under general anesthesia, and postoperative pain was evaluated in the recovery room 12, 24, 36, and 48 hr after surgery. In addition, nausea and vomiting was calculated using the visual analogue scale (VAS) and sedation was evaluated using the modified Ramsay score. A total of 400 ml of 0.2% Ropivacaine was administered at a rate of 8 ml/hr to control the postoperative pain for 2 days. In addition, other neurological complications were investigated, and the catheter tips were cultured after they were removed to determine if any infection had occurred. RESULTS: The postoperative pain scores were below 2 on the 10 cm VAS, and the level of nausea and vomiting was also satisfactorily (< 2/10 cm VAS). In addition, the mean sedation score of the patients in the recovery room was 2. There were complications including motor weakness (24%), dyspnea (15%), Hornor's syndrome (9%), postauricular numbness (9%) and metallic taste (3%), however, there were no patients who complained of neurological symptoms after one month of follow-up, and no signs of infection were found when the results of catheter tip cultures were evaluated. CONCLUSIONS: The use of a continuous interscalene brachial plexus block is a feasible method of postoperative pain control for patients who undergo major shoulder surgery.
Anesthesia, General ; Brachial Plexus* ; Catheters ; Dyspnea ; Follow-Up Studies ; Humans ; Hypesthesia ; Nausea ; Nerve Block ; Pain, Postoperative ; Postoperative Nausea and Vomiting ; Recovery Room ; Shoulder* ; Taste Disorders ; Vomiting

BACKGROUND: Most local anesthetics decrease neuromuscular transmission and potentiate the neuromuscular blocks of muscle relaxants. The purpose of this study was to examine the influence of lidocaine on it effects rocuronium onset and intubation conditions in rapid-sequence intubation and to compare with those of succinylcholine. METHODS: Seventy five ASA physical status 1 and 2 patients were randomly allocated to three groups. Group S received succinylcholine (1.0 mg/kg), Group R received rocuronium (0.6 mg/kg) and additional lidocaine (1.5 mg/kg) was given intravenously prior to the administration of rocuronium 0.6 mg/kg in Group RL. Anesthesia was induced with midazolam 0.03 mg/kg, fentanyl 2microgram/kg, and thiopental 5 mg/kg. Intubation was performed 60 seconds after the administration of muscle relaxants and intubation conditions were evaluated. Neuromuscular blockades were assessed by single twitch responses of the adductor pollicis after ulnar nerve stimulation by accelerography (0.1 Hz, 0.2 ms supramaximal stimuli). RESULTS: The onset time of Group S (47.8+/-11.3) was shorter than those of Group R (87.8+/-30.2) and Group RL (75.4+/-21.5), but no differences was observed between the onset times of Group R and Group RL. Intubation conditions were good or excellent in all groups. CONCLUSIONS: Additional lidocaine to rocuronium neither influences intubation condition nor accelerate the rocuronium onset, and it is cannot be viewed as an alternative for succinylcholine in rapid-sequence tracheal intubation.
Anesthesia ; Anesthetics, Local ; Fentanyl ; Humans ; Intubation* ; Lidocaine* ; Midazolam ; Neuromuscular Blockade* ; Succinylcholine ; Thiopental ; Ulnar Nerve

We report a case of cavernous hemangioma of the anterior mediastinum that was incidentally detected by chest radiography taken at a routine health check-up. A mass lesion was seen in the anterior mediastinum on computed tomography and magnetic resonance imaging. Direct surgical removal was performed for diagnosis and treatment through right thoracotomy. Histopathology confirmed the mass as a cavernous haemangioma. Post-operative course was uneventful.
Caves ; Hemangioma ; Hemangioma, Cavernous ; Magnetic Resonance Imaging ; Mediastinum ; Thoracotomy ; Thorax

Despite the high incidence of subdural block (SDB) during epidural anesthesia, the condition is unfamiliar to anesthesiologist. We experienced a case of SDB: severe hypotension, transient hemiplegia, wide extent of block and late onset and recovery from block. The case described is an examples of SDB and should remind anesthesiologist of the clinical course and treatment.
Anesthesia, Epidural* ; Hemiplegia ; Hypotension ; Incidence

BACKGROUND: Hypotension is the most frequent side effect of spinal anesthesia. Unilateral spinal anesthesia may be advantageous because it reduce the extent of spinal block. The aim of this study was to compare the incidence of hypotension and the difference of heart rate between unilateral and conventional bilateral spinal anesthesia. METHODS: Seventy patients were randomly allocated into two groups, which both received 2.0 ml (10 mg) of 0.5% hyperbaric bupivacaine. In group 1, local anesthetic was injected for two minutes with the needle orifice turned toward the dependent side; the lateral position was maintained for 20 minutes (unilateral, n = 35). In group 2, local anesthetic was injected through a cranially directed needle orifice, then patients were immediately turned supine (conventional, n = 35). Observers recorded noninvasive hemodynamic variables, as well as loss of cold and touch sensation and motor block on both side. RESULTS: In the unilateral group, 16 patients (45.7%) showed a unilateral loss of cold sensation and 23 patients (65.7%) had no motor block on the nondependent side for the duration of the study, whereas all conventional patients had bilateral distribution of spinal block (P < 0.001). The incidence of hypotension was higher in the conventional (22.9%) than unilateral group (5.7%) (P < 0.01). Considering the mean changes from baseline values of arterial blood pressure, patients of the conventional group showed greater decreases in systolic arterial blood pressure at 40, 50, 60, and 70 min (P < 0.05). Maximum percentage changes from baseline values of systolic arterial blood pressure and heart rate were greater in the conventional group (-17.8 +/- 9.8% and -19.7 +/- 10.4%) than in unilateral group (-14.6 +/- 5.5% and -16.9 +/- 11.2%). CONCLUSIONS: Unilateral spinal anesthesia reduces the incidence of hypotension during spinal anesthesia.
Anesthesia, Spinal* ; Arterial Pressure ; Bupivacaine* ; Heart Rate ; Hemodynamics ; Humans ; Hypotension* ; Incidence* ; Needles ; Sensation