BACKGROUND/AIMS: Propofol is usually used for anesthesia in the case of day surgery. We studied the effects of propofol plus fentanyl for sedation and the effect of oxygenation during gastroscopy. METHODS: 154 patients who asked conscious sedation during gastroscopy were randomly divided into three groups. The first group (PF-O group, 50 patients) and the second group (PF group, 48 patients) were received an initial bolus dose of propofol (40 mg) plus fentanyl (50 microgram) intravenously, followed by additional doses of propofol at one minute interval until conscious sedation. PF-O group was received preoxygenation (3 L/min) via nasal canula, and PF group was not. The third group (56 patients) received an initial bolus dose of midazolam (3 mg) intravenously, followed by additional doses of midazolam at two minutes interval (M group). RESULTS: In PF-O group, time to achieve sedation, regain orientation, and recover walking ability were 118.0 85.2 sec, 67.5 91.2 sec and 11.1 5.3 min. Gag reflex during the procedure was absent or nearly absent in 96% of patients. Despite the changes of blood pressure and heart rate compared to the values taken prior to the procedures were observed, all values were not clinically significant. In PF-O group, transient oxygen desaturation (SaO2<90%) was observed in four (8.0%) patients. CONCLUSIONS: Propofol plus fentanyl with oxygenation seems to be more acceptable and suitable method for sedation during outpatient gastroscopic examination.
Ambulatory Surgical Procedures ; Anesthesia ; Blood Pressure ; Conscious Sedation ; Endoscopy, Gastrointestinal* ; Fentanyl ; Gastroscopy ; Heart Rate ; Humans ; Midazolam ; Outpatients ; Oxygen* ; Propofol ; Reflex ; Walking

Methylbromide has been widely used of recent years in fire extinguishers for ships and aircraft and in refrigeration plants. because it exists as a gas at ordinary temperatures, most exposures occur by inhalation and absorption through the skin. The principal manifestations in acute poisoning depend on amount ingested or the concentration inhaled or absorbed. If the amount is large or concentration high, nausea, vomiting, vertigo, weakness, drowsiness, hypotention, coma, convulsion and pulmonary edema may occur after a latent period of up to 12 hour. After exposure to lower concentrations, symtoms are less severe and may be delayed twelve to twenty-four hours. We experienced 3 cases of acute methylbromide intoxication after inhalation. Of them, 2 patients with coma and convulsion were managed by mechanical ventilatior, anticonvulsant, hemodialysis and BAL, but they expired on 4th, 5th hospital day. We report them with review of literature.
Absorption ; Aircraft ; Coma ; Fires ; Humans ; Inhalation ; Nausea ; Poisoning ; Pulmonary Edema ; Refrigeration ; Renal Dialysis ; Seizures ; Ships ; Skin ; Sleep Stages ; Vertigo ; Vomiting

The aminoglycoside antibiotics is widely used in the treatment of infectious caused by gram-negative bacteria and for synergistic effect with(beta-lactam antibiotics. However, its therapeutic usefulness is limited by this potential nephrotoxicity and by disturbance of electrolyte homeostasis resulting in hypomagnesemia, hypokalemia, hypocalcemia such as Bartter-like syndrome. Many case repots have been reported on development of Bartter-like syndrome after aminoglycosides administration. But these reports had the many differences of such as types of aminoglycosides, age of patients, duration and total dose of treatment, combined antibiotics and baseline diseases. Therefore, the purpose of this study is to assess the effects of micronomocin sulfate on magnesium, calcium and potassium status of patients in acute pyelonephritis. Twenty one patients in acute pyelonephritis(18 female/3 male, ages 20-75) was treated with single or combined antibiotics. Eleven of twenty one patients as study group were treated with both micronomicin sulfate(aminoglycoside, 4mg/kg/day, during 5-8days) and flomoxef sodium (3rd cephalosporine, 2g/day, during 5-8days), and ten of twenty one patients as control group were treated only with flomoxef sodium(3rd cephalosporine. 2g/day. during 5-8days). Renal values, plasma and urinary electrolytes were measured before and at the end of IV antibiotic therapy. After micronomicin sulfate administrated for 6.4+/-1.5days, serum Mg, Ca, K, FEMg (fractional excretion of Mg), TTKG(transtubular K concentration gradient) and FECa(fractional excretion of Ca) did not significantly change(p>0.05). Therefore, those results suggest that micromonicin sulfate therapy within dose of 240mg/day(4mg/kg/day) for 6.4+/-1.5days may not cause disturbance of electrolyte homeostasis such as Bartter-like syndrome in acute pyelonephritis. Howerever, electrolyte disturbance is an important complication when aminoglycosides is given in larges doses over extended periods. Therefore, monitoring of blood concentration and urinary losses of electrolyte should be carried out along with careful observation of Bartter-like syndrome.
Aminoglycosides ; Anti-Bacterial Agents ; Calcium ; Electrolytes ; Gram-Negative Bacteria ; Homeostasis ; Humans ; Hypocalcemia ; Hypokalemia ; Magnesium ; Male ; Plasma ; Potassium ; Pyelonephritis* ; Sodium