BACKGORUND: inhalation anesthetics have been known as bronchodilators, and there are reports that enflurane has some relaxing effects on tracheal smooth muscles. However, there are not so many reports on the ACh release in the postganglion nerve endings. We tried to evaluate the effect of enflurane on the contraction of the tracheal smooth muscle in the postganglion nerve ending in guinea pigs. METHODS:isolated tracheal preparations of guinea pigs were used and contractions were induced by electrical field stimulation (3 Hz & 30 Hz). in the pilocarpine- enflurane group, pilocarpine (10(-5) M) was administrated and enflurane (1 MAC and 2 MAC) was administered. in the gallamine-enflurane group, gallamine (10(-6) M) was administrated and enflurane (1 MAC and 2 MAC) was administered. in the enflurane 1 MAC group and 2 MAC group, contractions were induced by electrical field stimulation before and after administration of enflurane. The percentile contraction to the contraction induced by acetylcholine (10(-4) M) were evaluated. RESULTS: The potentiation of the contraction which was induced by electrical field stimulation was observed by enflurane administration and with prior administration of pilocarpine (10(-6) M), with prior administration of gallamine (10(-5) M). There was no potentiation of contractions, but potentiation of the contraction was observed with enflurazne (2 MAC, 30 Hz). CONCLUSiONS:Enflurane potentiates the contraction induced by electrical field stimulation in guinea pig tracheal smooth muscle. These findings seem to be related with prejunctional M2 receptor in the postganglionic nerve endings.
Acetylcholine ; Anesthetics, Inhalation ; Animals ; Bronchodilator Agents ; Enflurane* ; Gallamine Triethiodide ; Guinea Pigs* ; Guinea* ; Muscle, Smooth* ; Nerve Endings ; Pilocarpine ; Receptors, Muscarinic

BACKGROUND: Intraoperative oculocardiac reflex (OCR) is a common problem of pediatric strabismus surgery and potentially fatal as it can cause cardiac arrest. The goal of this study was to assess the effects of gallamine, vecuronium and rocuronium on the oculocardiac reflex, blood pressure and heart rate in pediatric strabismus surgery. METHODS: Ninety healthy children undergoing strabismus surgery were randomly assigned to three groups; gallamine, vecuronium or rocuronium group. All children were under general anesthesia induced with thiopental sodium and received gallamine 3 mg/kg, vecuronium 0.1 mg/kg, or rocuronium 0.8 mg/kg as a muscle relaxant, and were maintained with sevoflurane in 50% nitrous oxide. Systolic blood pressure, diastolic blood pressure, and heart rate were measured before anesthesia, before the operation, before traction and after traction of the ocular muscle. The OCR was defined as a 20% or greater decrease in heart rate from before traction of the ocular muscle. RESULTS: Compared with three groups, there were decreased incidences of OCR and increased heart rate at before the operation, before traction and after traction in the gallamine group (P<0.05). Systolic blood pressure and diastolic blood pressure were no differences occurred among three groups. CONCLUSIONS: We found that the gallamine group results in decreased incidences of OCR and increased heart rate were comparable with three groups.
Anesthesia ; Anesthesia, General ; Blood Pressure* ; Child ; Gallamine Triethiodide* ; Heart Arrest ; Heart Rate* ; Heart* ; Humans ; Incidence ; Nitrous Oxide ; Reflex, Oculocardiac* ; Strabismus* ; Thiopental ; Traction ; Vecuronium Bromide*

BACKGROUND: The serotonin type 3 receptors are diffusely distributed in both the central and the peripheral nervous system. Physiological and pathophysiological processes thought to be mediated by this receptor include nausea and vomiting, peripheral nociception and central antinociception, conditioned aversion response to drugs, anxiety, and cognition. Because of the structural similarity between the nicotinic acetylcholine receptor and the 5HT3 receptor, we investigated the effects of clinically used neuromuscular blockers on the 5HT3 receptor function related with PONV. METHODS: A cDNA clone encoding the full length murine 5HT3a receptor was subcloned into an oocyte expression vector and 50 ng of cRNA transcribed in vitro injected per oocyte. After 24 72 h incubation, oocytes were placed into a recording chamber continuously perfused with frog Ringer's solution and electrophysiological recordings were obtained by the two electrode voltage clamp technique. Serotonin with or without the various drugs were bath applied by a computer controlled solenoid valve. Peak currents induced by the drug applications were measured and dose responses were obtained. RESULTS: The 5HT3 receptor expression in Xenopus oocyte was identified by the pharmacologic tools. Serotonin induced rapid inward currents, and thus was showed dose-dependent: KD = 2.5 micrometer, Hill coefficiency = 2.09. Inhibition by the neuromuscular blockers showed dose-dependence and their inhibitory potency on 5HT3 receptor (IC50) was in order of d-tubocurarine (0.046 micrometer) > vecuronium (16.32 micrometer) > gallamine (1,169 micrometer). CONCLUSIONS: There was a different inhibitory effect of nicotinic cholinergic antagonists, clinically used neuromuscular blockers, on the 5HT3 receptor and a judicious selection of them might contribute to reducing the incidence of PONV clinically.
Anxiety ; Baths ; Cholinergic Antagonists ; Clone Cells ; Cognition ; DNA, Complementary ; Electrodes ; Gallamine Triethiodide ; Incidence ; Nausea ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents* ; Nociception ; Oocytes* ; Peripheral Nervous System ; Postoperative Nausea and Vomiting ; Receptors, Nicotinic ; RNA, Complementary ; Serotonin* ; Tubocurarine ; Vecuronium Bromide ; Vomiting ; Xenopus*

BACKGROUND: The serotonin type 3 receptors are diffusely distributed in both the central and the peripheral nervous system. Physiological and pathophysiological processes thought to be mediated by this receptor include nausea and vomiting, peripheral nociception and central antinociception, conditioned aversion response to drugs, anxiety, and cognition. Because of the structural similarity between the nicotinic acetylcholine receptor and the 5HT3 receptor, we investigated the effects of clinically used neuromuscular blockers on the 5HT3 receptor function related with PONV. METHODS: A cDNA clone encoding the full length murine 5HT3a receptor was subcloned into an oocyte expression vector and 50 ng of cRNA transcribed in vitro injected per oocyte. After 24 72 h incubation, oocytes were placed into a recording chamber continuously perfused with frog Ringer's solution and electrophysiological recordings were obtained by the two electrode voltage clamp technique. Serotonin with or without the various drugs were bath applied by a computer controlled solenoid valve. Peak currents induced by the drug applications were measured and dose responses were obtained. RESULTS: The 5HT3 receptor expression in Xenopus oocyte was identified by the pharmacologic tools. Serotonin induced rapid inward currents, and thus was showed dose-dependent: KD = 2.5 micrometer, Hill coefficiency = 2.09. Inhibition by the neuromuscular blockers showed dose-dependence and their inhibitory potency on 5HT3 receptor (IC50) was in order of d-tubocurarine (0.046 micrometer) > vecuronium (16.32 micrometer) > gallamine (1,169 micrometer). CONCLUSIONS: There was a different inhibitory effect of nicotinic cholinergic antagonists, clinically used neuromuscular blockers, on the 5HT3 receptor and a judicious selection of them might contribute to reducing the incidence of PONV clinically.
Anxiety ; Baths ; Cholinergic Antagonists ; Clone Cells ; Cognition ; DNA, Complementary ; Electrodes ; Gallamine Triethiodide ; Incidence ; Nausea ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents* ; Nociception ; Oocytes* ; Peripheral Nervous System ; Postoperative Nausea and Vomiting ; Receptors, Nicotinic ; RNA, Complementary ; Serotonin* ; Tubocurarine ; Vecuronium Bromide ; Vomiting ; Xenopus*

To study the effects of small amounts of non-depolarizing neuromuscular blockers on the muscle fasciculation, postoperative muscle pains and relaxation time by succinylcholine, three groups of patients were pretreated with vecuronium (0.01 mg/kg), pancuronium (0.015 mg/kg) and gallamine (0, 2 mg/kg) 3 minutes before succinylcholine injection, respectively and compared their results with control group-saline pretreated group. The results are as follows; 1) Intensity of muscle fasciculation deereased significantly in all groups with non-depolarizing neuromuscular blockers, and frequency had the fewest in pancuronium pretreated group than the others. 2) Intensity of postoperative muscle pains decreased significantly in groups pretreated with pancuronium and gallamine, and frequency had the fewest in gallamine pretreated group than the others. 3) Pretreatment with non-depolarzing neuromuscular blocker had no effects on the onset time of muscle relaxation of succinylcholine but recovery of muscle relaxation by succinylchoine was more rapidly occured than control group. Above results, it will be suggest that gallamine and pancuronium can be used more effectively to prevent muscle fasciculation and postoperative muscle pain without influence on succinylcholine-induced muscle relaxation.
Fasciculation* ; Gallamine Triethiodide ; Humans ; Muscle Relaxation ; Myalgia ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents* ; Pancuronium ; Relaxation* ; Succinylcholine* ; Vecuronium Bromide

Sinus Bradycardia per se does not necessitate therapy. In fact, its presence often implies good health or a good prognosis. A 56-year-old patient, whose pulse rate was about 35 beats per minute and blood pressure was 80/50 mmHg, underwent total gastrectomy under general anesthesia. Ventricular dysrhythmia occurred after the second dose of gallamine managed with lidocaine, and after the administration of atropine and ephednne managed with hydralazine. Authors report this case with the evaluation of references.
Anesthesia, General ; Atropine ; Blood Pressure ; Bradycardia* ; Gallamine Triethiodide ; Gastrectomy ; Heart Rate ; Humans ; Hydralazine ; Hypotension* ; Lidocaine ; Middle Aged ; Prognosis

Sinus Bradycardia per se does not necessitate therapy. In fact, its presence often implies good health or a good prognosis. A 56-year-old patient, whose pulse rate was about 35 beats per minute and blood pressure was 80/50 mmHg, underwent total gastrectomy under general anesthesia. Ventricular dysrhythmia occurred after the second dose of gallamine managed with lidocaine, and after the administration of atropine and ephednne managed with hydralazine. Authors report this case with the evaluation of references.
Anesthesia, General ; Atropine ; Blood Pressure ; Bradycardia* ; Gallamine Triethiodide ; Gastrectomy ; Heart Rate ; Humans ; Hydralazine ; Hypotension* ; Lidocaine ; Middle Aged ; Prognosis

Among nondepolarizing neuromuscular blocking agents, d-tubocurarine may cause blood pressure reduction due to ganglionic blockade and histamine release, while pancuronium and gallamine are associated with vagal blockade and heart rate acceleration. Metocurine, as a trimethylated derivative of d-tubocurarine synthesized by King in 1935, is known to have relatively long duration of action and produces little change in cardiovascular system. Despite its relative lack of cardiovascular effects, the accumulation of data with regard to human neuromus- cular pharmacology and the clinical use has been scant. One hundred and nine adult patients of either sex were anesthetized with thiopental sodium and 50% nitrous oxide with 1.5-2.5% enflurane. For evaluation of neuromuscular blocking effect of metocurine, train-of-four stimulation (2.0 Hz for 2 seconds) was applied at the wrist along the ulnar nerve distribution and the response was measured via ABM Datex. Systolic, diastolic blood pressure and heart rate were recorded continuously after administration of metocurine, d-tubocurarine or pancuronium. All data were analized by ANOVA, Scheffe test. The results are follows : 1) The mean onset times of metocurine 0.1, 0.2, 0.3 mg/kg groups were 119.5+/-40.0, 120.9+/-61.1, 84.8+/-61,1 seconds and the mean durations were 75.1+/-37.6, 104.9+/-42.1, 131.0+/-42.5 minutes respectively. 2) Single-bolus dose of metocurine 0.1, 0.2, and 0.3 mg/kg did not cause significant cardiovascular changes from the control values, but d-tubocurarine 0.3 mg/kg decreased mean systolic blood pressure significantly from 116.6+/-15.7 to 99.0+/-10.9 mmHg 2 minutes after injection. 3) Systolic blood pressures of metocurine 0.2 mg/kg (107.2+/-11.7 mmHg) and d-tubocurarine 0.3 mg/ kg (100.4+/-12.9 mmHg) were significantly different from that of pancuronivm 0.06 mg/kg (127.8+/-16. 0 mmHg) after 1 minute, and 2 minutes after injection, systolic blood pressure of metocurine 0.2 mg/ kg (110.2+/-14.3 mmHg) and d-tubocurarine 0.3 mg/kg (99.0+/-10.9 mmHg) were different from that of pancuronium 0.06 mg/kg (125.3+13.1 mmHg). Five minutes after injection, systolic pressure of d- tubocurarine 0.3mg/kg group (101.110.2mmHg) was significantly different from that of pancur-onium 0.06 mg/kg group (118.7+/-11.0 mmHg). 4) Diastolic blood pressure of d-tubocurarine 0.3 mg/kg (63.4+/-12.9 mmHg) was significantly differ- ent from that of pancuronium 0.06mg/kg (84.2+/-13.3mmHg) after 1 minute, and 2 minutes after injection, diastolic blood pressure or d-tubocurarine 0.3 mg/kg (65.4+/-11.3 mmHg) was different from that of pancuronium 0.06mg/kg (83.1+/-11.6mmHg). There was no significant difference among the groups with respect to heart rate. In summary, metocurine has relatively rapid onset and long duration of action, and used in a dose sufficient to provide surgical relaxation, it produces little change in cardiovascular system in contrast to d-tubocurarine or pancuronium. 1t is therefore suggested that metocurine may be recommended as a muscle relaxant for patients having cardiovascular disease.
Acceleration ; Adult ; Blood Pressure ; Cardiovascular Diseases ; Cardiovascular System ; Enflurane ; Gallamine Triethiodide ; Ganglion Cysts ; Heart Rate ; Hemodynamics* ; Histamine Release ; Humans ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents ; Nitrous Oxide ; Pancuronium ; Pharmacology ; Relaxation ; Thiopental ; Tubocurarine ; Ulnar Nerve ; Wrist

To evaluate the historical trend of anesthetic experience for the past 22 years a total of 68,473 cases which were performed at the National Medical Center from 1959 to 1981 were studied. To simplify the analysis statistically, the author selected the anesthetic cases every other year(12 years). 1) General anesthesia was performed in more than 78% of the total cases and of this number endotracheal intubation has been used with increasing frequency(average 92.8%). 2) For intravenous induction, thiopental sodium was used as the main agent, in more than 90% since 1980. 3) Trichlorethylene, cyclopropane and ethylchloride which had been used since 1961, were abandoned from 1978 except for training purposes. Methoxyflurane was used from 1973 to 1979, but given up there after because of it's nephrotoxicity. The use of halothane has steadily increased(86% of the total inhalation anesthetics) and ethrane has also been used with increasing frequency since 1980. 4) Pancuronium has been used as a primary muscle relaxant instead of gallamine and D-tubocurarine which had been used as the main durgs from 1959 till 1979. 5) Innovar and morphine as intravenous anesthetics, have recently been with increasing grequency.
Anesthesia, General ; Anesthetics, Intravenous ; Enflurane ; Gallamine Triethiodide ; Halothane ; Inhalation ; Intubation, Intratracheal ; Methoxyflurane ; Morphine ; Pancuronium ; Thiopental ; Tubocurarine

To evaluate anesthetic experience during open heart surgery, 145 cases of patients under 15kg of body weight from January 1980 to June 1982 were analyzed according to age, sex, technique of anesthesia, anesthetica, premedicants, muscle relaxants, flow rates and mortality. The results were as follows: 1) Premedicants were mainly atropine, meperidine, hydroxyzine, triflupromazine and morphine. 2) Induction agents were thiopental in acyanotic group, but cyanotic group were mainly used ketamine. 3) The inhalation anesthetica that were halothane, methoxyflurane, N@O and enflurane were used in acyanotic group but cyanotic group did not used. 4) Early stage of open heart surgery, gallamine were mainly used but now, pancuronium were used. 5) During cardiopulmonary bypass, the lowest temperature were mean 27 degrees C and flow rate were 80~100ml/kg/m(2). 6) Overall mortality was 17.2%.
Anesthesia* ; Atropine ; Body Weight ; Cardiopulmonary Bypass ; Child* ; Enflurane ; Gallamine Triethiodide ; Halothane ; Heart Defects, Congenital* ; Heart* ; Humans ; Hydroxyzine ; Infant* ; Inhalation ; Ketamine ; Meperidine ; Methoxyflurane ; Morphine ; Mortality ; Pancuronium ; Thiopental ; Thoracic Surgery* ; Triflupromazine