To evaluate the second gas effect and the effect of solubility of volatile anesthetics on the alveolar concentration, the ratio of the end-tidal to the inspired concentration(FET/F1) of enflurane and isoflurane with or without N2O were measured in 40 adult patients in ASA class I or Il. The patients were devided into four groups ; group 1 received 100% O2-1 vol% enflurane, group 2 received 50% O2-50% N2O-1 vol % enflurane, group 3 received 100 % O2-1 vo1% isoflurane and group 4 received 50% 0 50% N2O-1 vo1% isoflurane. The ratio of FET/F1 were measured at 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 16, 18, 20, 30 minute after administration of inhalation anesthetics in each group. The results were as follows. 1) The increase in FET/F1, compared with previous value in each group was significant at 2 minute in group 1 and 2(p<0.05), and at 2 minute and 3 minute in group 3 and 4(p< 0.05), respectively. 2) To compare between group 1 and 2, the significant differance of FET/F1 was noticed during entire observation period and between group 3 and 4, too(p<0.05). This is the result of the second gas effect. 3) The FET/F1 ratio of isoflurane which has lower blood solubility rised more rapidly than the FET/F1 ratio of enflurane. When given without NO, the FET/F1 ratio of group 3 rised significantly more rapidly than the FET/F1 ratio of group 1(p<0.05). But, when given with N2O, changes of the FET/F1 ratio were not significantly different between group 2 and 4. In this study, the alveolar concentration of enflurane and isoflurane rised more rapidly when given with 50% N2O than when given without N2O, it might be the second gas effect by the uptake of NO. And, to the exclusion of the second gas effect, the FET/F1 ratio of less soluble isoflurane rised more rapidly than the more soluble enflurane. But, under the presence of the second gas effect, the difference of the alveolar concentration which depends on the anesthetic solubility between enflurane and isoflurane was not significant.
Adult ; Anesthetics* ; Anesthetics, Inhalation ; Enflurane ; Humans ; Isoflurane ; Solubility*

BACKGROUND: Spontaneous involuntary movements are a relatively common side effect during induction of anesthesia with propofol and related with the loading dose, especially in children. Midazolam has GABAergic effects that may modify propofol-induced involuntary movements. So the aims of this study was to determine the dose of propofol for induction without involuntary movements in unpremedicated children and to confirm that midazolam may interact with propofol to modify neuroexcitatory movements. METHODS: Seventy two ASA physical status I, II children, between 4~13 yrs of age were included. The children were randomly assigned to group I (propofol 3 mg/kg), II (propofol 4 mg/kg), III (midazolam 0.1 mg/kg+propofol 3 mg/kg), or IV (midazolam 0.1 mg/kg+propofol 4 mg/kg). After the injection of propofol loading dose, an independent anesthesiologist graded the incidence, severity (grade 1~4), and duration of involuntary movements. RESULTS: Spontaneous movements were described as excitatory, dystonic, and choreiform, with twisting, flexion, and extension of the arms and legs. The incidence of involuntary movements did not differ between groups. But the incidence of moderate to severe movements was higher in group II than any other group. CONCLUSIONS: Intravenous midazolam 0.1 mg/kg failed to modify propofol-induced involuntary movements during induction of anesthesia with propofol loading dose 3 mg/kg and 4 mg/kg.
Anesthesia* ; Arm ; Child* ; Dyskinesias* ; GABA Agents ; Humans ; Incidence ; Leg ; Midazolam* ; Propofol*

There have been few case reports on giant sinus of Valsalva aneurysm (SVA). We report a case of a giant unruptured right coronary SVA that was confused with a pericardial cyst by transthoracic echocardiography.
Aneurysm ; Aortic Aneurysm ; Coronary Sinus ; Echocardiography ; Mediastinal Cyst ; Sinus of Valsalva

There have been few case reports on giant sinus of Valsalva aneurysm (SVA). We report a case of a giant unruptured right coronary SVA that was confused with a pericardial cyst by transthoracic echocardiography.
Aneurysm ; Aortic Aneurysm ; Coronary Sinus ; Echocardiography ; Mediastinal Cyst ; Sinus of Valsalva