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*

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

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

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

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: 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