No abstract available.

BACKGROUND: We have previously demonstrated the isoflurane and halothane may be detrimental to in vitro fertilization of mouse oocytes in high concentrations. The aim of this study is to compare the toxic effects of volatile anesthetics on mouse embryos using in vitro growth model of two cell mouse embryos. METHODS: Mouse two-cell embryos exposed to three volatile anesthetics, enflurane(0.5 mM; 1.5 mM), isoflurane(0.26 mM; 0.78 mM) and halothane(0.24 mM; 0.72 mM). Mouse two-cell embryos unexposed to any drugs were included as controls. RESULTS: The percentages of two-cell mouse embryos developed over morula stages on the third day after exposure of high concentrations of isoflurane and halothane decreased significantly compared with controls. The rates of embryos arrested at 2-8 cell stage in these groups were significantly higher than that of controls. There were no significant differences in these rates between enflurane group, isofiurane and halothane group of lower concentrations and controls. The hatching and/or hatched blastocysts development were significantly lower in isoflurane and halothane group than in controls. No significant differences in the hatching rate of blastocyst developed were observed among groups. CONCLUSIONS: Our data show that isoflurane and halothane in high concentrations have harm effects of the in vitro growth of two cell mouse embryos.
Anesthesia* ; Anesthetics ; Animals ; Blastocyst ; Embryonic Development ; Embryonic Structures ; Enflurane ; Female ; Fertilization in Vitro ; Halothane ; Isoflurane ; Mice ; Morula ; Oocytes ; Pregnancy

BACKGROUND: We have previously demonstrated the isoflurane and halothane may be detrimental to in vitro fertilization of mouse oocytes in high concentrations. The aim of this study is to compare the toxic effects of volatile anesthetics on mouse embryos using in vitro growth model of two cell mouse embryos. METHODS: Mouse two-cell embryos exposed to three volatile anesthetics, enflurane(0.5 mM; 1.5 mM), isoflurane(0.26 mM; 0.78 mM) and halothane(0.24 mM; 0.72 mM). Mouse two-cell embryos unexposed to any drugs were included as controls. RESULTS: The percentages of two-cell mouse embryos developed over morula stages on the third day after exposure of high concentrations of isoflurane and halothane decreased significantly compared with controls. The rates of embryos arrested at 2-8 cell stage in these groups were significantly higher than that of controls. There were no significant differences in these rates between enflurane group, isofiurane and halothane group of lower concentrations and controls. The hatching and/or hatched blastocysts development were significantly lower in isoflurane and halothane group than in controls. No significant differences in the hatching rate of blastocyst developed were observed among groups. CONCLUSIONS: Our data show that isoflurane and halothane in high concentrations have harm effects of the in vitro growth of two cell mouse embryos.
Anesthesia* ; Anesthetics ; Animals ; Blastocyst ; Embryonic Development ; Embryonic Structures ; Enflurane ; Female ; Fertilization in Vitro ; Halothane ; Isoflurane ; Mice ; Morula ; Oocytes ; Pregnancy

No abstract available.
Anesthesia, General* ; Humans ; Laryngeal Masks* ; Pierre Robin Syndrome*

Acute hyperkalemia may result from many causes, i.e. excessive load, transcellular shift, decreased renal excretion, and so on, and may be associated with irreversible and fatal cardiac manifestations, muscle weakness, ventilatory and adrenal insufficiency, etc. We experienced a case of acute hyperkalemia probably due to red cell lysis which was evident immediately after the induction of general anesthesia with thiopental sodium and succinylcholin in 1 33 year-old female patient with common bile duct obstructive jaundice. In spite of active management during anesthesia and posoperative period, eventually she died of cardiac arrest. For the successful management of the acute hyperkalemia, the anesthesiologist should be aware of its etiologies, pathophysiology, diagnosis & treatment.
Adrenal Insufficiency ; Adult ; Anesthesia ; Anesthesia, General* ; Common Bile Duct ; Diagnosis ; Female ; Heart Arrest ; Humans ; Hyperkalemia* ; Jaundice, Obstructive ; Muscle Weakness ; Thiopental

Spermatic cord block anesthesia for scrotal Surgery with 0.5% bupivacaine hydrochloride, 1% lidocaine hydrochloride or 1% lidocaine hydrochloride-0.5% bupivacaine hydrochloride combination was perpermed in 25 patients from March 1983 to August 1984. The injection was made to and around the spermatic cord approximately 1 cm below and medial to the pubic tubercle. The overlying skin was infiltrated with the same local anesthetic. The results were as follows. 1) The changes in blood pressure and pulse rate were minimal before, during, and after the anesthesia. 2) The recovery from anesthesia was smooth and the requirement of postoperative analge-sics was minimal both with 0.5% bupivacaine hydrochloride and 1% lidocaine hydrochloride -0.5% bupivacaine hydrochloride combination. 3) There were no complications directly attributable to the anesthetic agent or to the technique of performing the spermatic cord block anesthesia. 4) The technique was simple and safe as well as cost-saving. It had another benefit that the patients were capable of dietary intake immediately after operation. 5) So the spermatic cord block anesthesia was thought to be superior to other techniques for surgery of the scrotal region. 6) The combination of 1% lidocaine hydrochloride and 0.5% bupivacaine hydrochloride is recommended for its rapid onset and long duration of action as an anesthetic of choice in conduction anesthesia.
Anesthesia* ; Anesthesia, Conduction ; Blood Pressure ; Bupivacaine ; Heart Rate ; Humans ; Lidocaine ; Skin ; Spermatic Cord*

BACKGROUND: The larynx is longitudinally stretched and anteriorly displaced by inducing the general anesthesia and muscle paralysis, thus the laryngoscopic visualization might become difficult during direct laryngoscopy. The study was designed to assess the efficacy of the "laryngeal lift" maneuver in improving the laryngoscopic visualization to facilitate tracheal intubation. METHODS: Following the induction of general anesthesia and muscle paralysis, the laryngoscopic views of 287 patients were evaluated while the laryngeal lift by which the cricoid cartilage was displaced 0.5 cm posteriorly and 1.0~1.5 cm cephaladly were performed. One hundred and three patients with grade 2-4 laryngoscopic veiw were analysed. The laryngoscopic view which was described by Cormack and Lehane was classified from grade 1 to grade 4. The postoperative complications such as dysphasia and/or dyspnea were also observed. RESULTS: Seventy four patients of 81 patients with the laryngoscopic view of grade 2 were improved by one grade. Twenty one patients of 22 patients with the laryngoscopic view of grade 3 were improved by more than one grade. However, the laryngoscopic views of eight patients out of 103 patients were not improved. The tracheal intubation was successful in all patients. The overall, grade 2 and grade 3 improvement rate of laryngoscopic view was 92.2%, 91.4% and 95.5% respectively. The improvement rate by one grade and two grade was 89.3% and 2.9% respectively. CONCLUSIONS: The laryngeal lift had the high improvement rates of laryngoscopic view without any complications. Thus it is concluded that the laryngeal lift is a useful maneuver for improving laryngoscopic view during direct laryngoscopy with curved blade of laryngoscope.
Anesthesia, General ; Aphasia ; Cricoid Cartilage ; Dyspnea ; Humans ; Intubation ; Intubation, Intratracheal* ; Laryngoscopes ; Laryngoscopy ; Larynx ; Paralysis ; Postoperative Complications

In recent year, some thoracic operations were performed by use of videothoracoscopy becauae of its benefits: minimal postoperative pain and complications, small surgical scars and shorter hospital stay. We reyort our experience of the anesthetic management for a patient who underwent thoracic endoscopic sympathectomy for upper limh hyperhidrosia. One lung ventilation with a left-sided double lumen endobroncheal tube was performed to provide adequate surgical access, and a careful monitoring was done for adequate oxygenation and ventilation. The patient developed a hypercarbia and sinus tachycardia after CO2 insufflation into the right pleural cavity. We discusaed the benefits and risks of endoscopic thoracic surgery and aneethetic managements.
Cicatrix ; Humans ; Hyperhidrosis* ; Insufflation ; Length of Stay ; One-Lung Ventilation ; Oxygen ; Pain, Postoperative ; Pleural Cavity ; Risk Assessment ; Sympathectomy* ; Tachycardia, Sinus ; Thoracic Surgery ; Thoracoscopy ; Upper Extremity* ; Ventilation

Arterial cannulation for constant monitoring of arterial pressure and blood gase analyses has become commonplace in the care of the critically ill patients. The radial artery is often regarded as causing a negligible complication risk because of extensive collateral arterial flow in the hand. One of other alternative sites for arterial cannulation is femoral artery. Femoral artery cannulation has a high degree of success in very small, critically ill children. It should be considered an acceptable alternative to small-vessel cannulation when the latter is not technically achievable, or in the unstable patient where rapid establishment of reliable artery access is necessary. Arterial cannulation may cause many complications: arterial catheters can directly injure the vessels, resulting in thrombosis, occlusion, distal embolization or ischemia. Local insertion site complications, such as hematoma, hemorrhage, and infection may occur. Arterial catheter may also be a source of systemic sepsis. We report an unusual case of unintentional release of a catheter fragment into the external iliac artery in a 7-month (7.8 kg) male patient with tetralogy of Fallot, which was inadvertently inserted during right femoral artery cannulation. The catheter fragment was successfully retrieved with the Amplatz Goose Neck microsnare under fluoroscopy without any problems.
Arterial Pressure ; Arteries ; Catheterization* ; Catheters* ; Child ; Critical Illness ; Femoral Artery* ; Fluoroscopy ; Hand ; Hematoma ; Hemorrhage ; Humans ; Iliac Artery* ; Ischemia ; Male ; Neck ; Radial Artery ; Sepsis ; Tetralogy of Fallot ; Thrombosis

Epilepsy surgery is performed in patients with epilepsy of focal origin and seizures which are refractory to medical treatment. Electrophysiologic mapping of the epileptic foci and other cortical areas (e.g., language, memory, sensorimotor) is frequently used to maximize the resection of the epileptogenic lesion while minimizing the neurologic deficits. For language area mapping, general endotracheal anesthesia can not be used because a patient can not vocalize. So awake craniotomy is frequently used. However, during awake craniotomy for language area mapping with local infiltration anesthesia and intravenous sedation and narcotics supplementation analgesia, respiratory arrest or depression and hypoxemia may occur. The airway securement is crucial to the patients. As an alternative to tracheal tubes, laryngeal mask airway can secure the airway and does not interference the vocalization. We could successfully performed the language area mapping in a 17-year-old male patient with laryngeal mask airway under deep intravenous anesthesia with local infiltration anesthesia of the scalp.
Adolescent ; Analgesia ; Anesthesia ; Anesthesia, Intravenous ; Anesthesia, Local ; Anoxia ; Craniotomy ; Depression ; Epilepsy ; Humans ; Laryngeal Masks* ; Male ; Memory ; Narcotics ; Neurologic Manifestations ; Scalp ; Seizures