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*

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

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 conventional laryngeal mask airway (LMA) has been used to facilitate blind tracheal intubation in numerous situations where laryngoscopy and conventional intubation has been difficult, but it has the disadvantage that its airway tube is too long and narrow for intubation. The intubating laryngeal mask airway (ILM) has been specifically designed to increase the success rate of blind intubation. A specially constructed ILM tracheal tube is available for use with the ILM, But this tube is in short supply and expensive. Thus, this study was performed to compare the success rate and time of blind intubation through ILM with reinforced tracheal tube or specially-designed tracheal tube, and to assess the use of reinforced tracheal tube as a substitute for specially-designed tracheal tube. METHODS: After acquiring informed consent, 60 ASA grade 1 or 2 patients undergoing anesthesia for elective surgical procedures who normally required tracheal intubation were randomized into two groups. In group 1 (n = 30), the patients were intubated with a specially-designed tracheal tube through ILM. In group 2 (n = 30), reinforced tracheal tubes were used. The patients were induced and relaxed with an iv injection of thiopental sodium, fentanyl-ketamine-midazolam mixture and vecuronium. When an adequate level of anesthesia was achieved, the ILM was inserted. After adequate ventilation was confirmed, blind tracheal intubation with either of the two types of tracheal tubes through the ILM was attempted. Then we recorded success rate, intubation time and adjusting maneuvers. RESULTS: The ILM was successfully inserted at first attempt in 59/60 (98%) patients, but in 1 patient, adequate ventilation was not acheived. The success rate of tracheal intubation was 27 (93%) in group 1 and 28 (93%) in group 2. In group 1, 21 (72%) patients were successfully intubated on the first attempt, 1 (4%) patient on the second attempt, and 5 (17%) patients on the third attempt. In group 2, 20 (67%) patients were successfully intubated on the first attempt, 2 (6%) patients on the second attempt, and 6 (20%) patients on the third attempt. The mean time taken for intubation was 116.9 sec in group 1 and 122.3 sec in group 2. CONCLUSIONS: The authors conclude that the reinforced tracheal tube can be substitute for a specially- designed tracheal tube.
Anesthesia ; Humans ; Informed Consent ; Intubation* ; Laryngeal Masks* ; Laryngoscopy ; Surgical Procedures, Elective ; Thiopental ; Vecuronium Bromide ; Ventilation

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

BACKGROUND: Bupivacaine is a potent, and commonly used, long acting local anesthetic. If accidentally injected into the systemic circulation, bupivacaine can cause lethal dysrhythmias and circulatory collapse. Attempts to treat bupivacaine induced cardiac toxicity have been varied and controversial, and they have not been very successful. The aim of this study was to investigate the electrophysiologic effects of bupivacaine in Purkinje fibers. METHODS: Effects of bupivacaine on the membrane potential were studied in 12 isolated canine Purkinje fibers. Purkinje fibers from ventricle were dissected and mounted in a tissue chamber perfused with Tyrode's solution. Transmembrane potentials recorded through glass microelectrodes filled with 3M KCI in the beating or quiescent Purkinje fibers during infusions of bupivacaine at concentratons of 3*10/-7M,10/-6M, 3*10/-6M,10/-5M, and 3*10/-5M. RESULTS: Bupivacaine reduced action potential druation in a dose-dependent manner. Bupivacaine produced a decrease in intracelullar sodium ion activity in driven(1Hz) and quiescent canine Purkinje fibers. Bupivacaine-induced hyperpolarizaton of diastolic membrane potential in quiescent Purkinje fibers was dose dependent, and the hyperpolarization by bupivacaine was attenuated by depolarization induced by high potassium extracellular concentration in part. CONCLUSIONS: These results suggest that bupivacaine decreases the fast inward sodium current, and inhibits pacemaker current in canine Purkinje fibers.
Action Potentials ; Bupivacaine* ; Glass ; Membrane Potentials* ; Membranes* ; Microelectrodes ; Potassium ; Purkinje Fibers ; Shock ; Sodium ; Sodium Channels

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