PURPOSE: Levodopa is the most effective anti-Parkinsonian agent. It has also been known to exhibit analgesic properties in laboratory and clinical settings. However, studies evaluating its effects on neuropathic pain are limited. The aim of the present study was to examine the anti-allodynic effects of levodopa in neuropathic rats. MATERIALS AND METHODS: Sprague-Dawley male rats underwent the surgical procedure for L5 and L6 spinal nerves ligation. Sixty neuropathic rats were randomly divided into 6 groups for the oral administration of distilled water and levodopa at 10, 30, 50, 70, and 100 mg/kg, respectively. We co-administered carbidopa with levodopa to prevent peripheral synthesis of dopamine from levodopa, and observed tactile, cold, and heat allodynia pre-administration, and at 15, 30, 60, 90, 120, 150, 180, and 240 min after drug administration. We also measured locomotor function of neuropathic rats using rotarod test to examine whether levodopa caused side effects or not. RESULTS: Distilled water group didn't show any difference in all allodynia. For the levodopa groups (10-100 mg/kg), tactile and heat withdrawal thresholds were increased, and cold withdrawal frequency was decreased dose-dependently (p<0.01). In addition, levodopa induced biphasic analgesia. Different dosage of levodopa did not impact on the rotarod time (p>0.05). CONCLUSION: Levodopa reversed tactile, cold and heat allodynia in neuropathic rat without any side effects.
Animals ; Carbidopa/administration & dosage/adverse effects/therapeutic use ; Dopamine Agents/administration & dosage/adverse effects/*therapeutic use ; Hyperalgesia/*drug therapy ; Levodopa/administration & dosage/adverse effects/*therapeutic use ; Male ; Neuralgia/*drug therapy ; Rats ; Rats, Sprague-Dawley ; Rotarod Performance Test

No abstract available.
Extracorporeal Membrane Oxygenation ; Stents

BACKGROUND: Robotic radical prostatectomy is performed in elderly patients and requires extreme changes in the patient's position and is often associated with a long surgery time. This study reviewed the pulmonary complications occurring after a robotic radical prostatectomy and analyzed the potential risk factors. METHODS: The medical records of all patients who had undergone robotic radical prostatectomy at our institution were reviewed. Among the 80 total patients, 58 were capable of spontaneous respiration at the end of surgery (Group I), whereas 22 patients required assisted ventilation (Group II). A comparison between the two groups was made in terms of the demographic characteristics, coexisting diseases, anesthesia and operation time, amount of intraoperative blood loss and transfused blood products. RESULTS: The mean age of the patients was 67.2 +/- 7.3 years. The mean operation time was 384.1 +/- 203.4 min (range, 195-1,180 min). The anesthesia and operation time, amount of intraoperative blood loss and number of transfused patients were all significantly higher in Group II. Univariate analysis revealed age, body mass index, intraoperative blood loss and transfusion, anesthesia and operation time to be related to postoperative respiratory insufficiency. Multivariate analysis revealed intraoperative transfusion and operation time to be predictive risk factors. CONCLUSIONS: Prolonged laparoscopic surgery in a steep Trendelenburg position has a high likelihood of postoperative respiratory insufficiency, with the intraoperative transfusion and a longer operation time being possible contributing factors.
Aged ; Anesthesia ; Body Mass Index ; Head-Down Tilt ; Humans ; Laparoscopy ; Medical Records ; Multivariate Analysis ; Prostatectomy ; Respiration ; Respiratory Insufficiency ; Risk Factors ; Ventilation

Chronic treatment with renin-angiotensin system antagonists frequently causes deleterious hypotension during anesthesia. We present a case of marked intra-operative refractory hypotension in a 61-year-old male patient undergoing elective total thyroidectomy. He has been chronically treated for hypertension with angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists and atenolol, which were taken until the morning of surgery. After induction of anesthesia, marked hypotension which was refractory to fluid therapy occurred and did not respond to ephedrine administration. After continuous norepinephrine infusion, blood pressure increased and remained stable during the anesthesia period. Before extubation, norepinephrine was discontinued and recovery took place without complications. We discuss the anesthetic implication of chronic renin-angiotensin system antagonists treatment and intra-operative hemodynamic instability.
Anesthesia ; Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Atenolol ; Blood Pressure ; Ephedrine ; Fluid Therapy ; Hemodynamics ; Humans ; Hypertension ; Hypogonadism ; Hypotension ; Male ; Middle Aged ; Mitochondrial Diseases ; Norepinephrine ; Ophthalmoplegia ; Renin-Angiotensin System ; Thyroidectomy

We experienced one lung anesthesia using Fogarty embolectomy catheter as a bronchial blocker in an infant undergoing thoracotomy for foreign body removal. For the guidance of catheter placement in left mainstem bronchus, C-arm fluoroscopy was used. Size of catheter and its balloon was decided beforehand by measuring the diameter and length of bronchus based on the view obtained from computerized tomography. There was no accidental episode during anesthesia. C-arm fluoroscopy is safe and useful method to decide the position of Fogarty occlusion catheter in an infant.
Anesthesia ; Bronchi ; Catheters ; Embolectomy ; Fluoroscopy ; Foreign Bodies ; Humans ; Infant ; Lung ; One-Lung Ventilation ; Thoracotomy

BACKGROUND: The effects of local and inhalation anesthesia on the contraction of the tracheal smooth muscle have been reported. However, when inhalation and local anesthesia are administered simultaneously, their effects on the contraction of the airway smooth muscle are not well known. Therefore, this study evaluated the effects of lidocaine, bupivacaine, with or without enflurane, on the histamine induced tracheal smooth muscle contraction in guinea pigs. METHODS: Isolated tracheal rings of guinea pigs were suspended in Krebs solution. The contractions were recorded isometrically using a transducer. A contraction was induced by histamine (10(-5) M). Enflurane (1 MAC) was administered for 15 min after administering the histamine. The cumulative dose responses of the lidocaine and bupivacaine (10(-8) M, 10(-7) M, 10(-6) M, 10(-5) M, 10(-4) M, and 10(-3) M), enflurane-lidocaine and enflurane-bupivacaine groups were checked. RESULTS: The contraction by histamine were inhibited by lidocaine (10(-4) M and 10(-3) M) and bupivacaine (10(-5) M, 10(-4) M and 10(-3) M). In addition, the contractions were inhibited more significantly in the bupivacaine group (10(-7) M, 10(-6) M, 10(-5) M, 10(-4) M and 10(-3) M) after administering enflurane. CONCLUSIONS: Lidocaine and bupivacaine inhibited the contractions induced by histamine. The contractions by bupivacaine were further inhibited after administering enflurane.
Anesthesia, Inhalation ; Anesthesia, Local ; Animals ; Bupivacaine* ; Enflurane* ; Guinea Pigs* ; Guinea* ; Histamine ; Inhalation ; Lidocaine* ; Muscle, Smooth* ; Trachea ; Transducers

BACKGROUND: Several reports have indicated that heparin has a bronchodilative effect in asthma patients, and that it enhances airway smooth muscle contraction in vitro, protamine is known to inhibit or enhance contraction of tracheal smooth muscle. Thus the effects of protamine and heparin on airway smooth muscle contraction are not consistent. However, no report is available on the effects of enflurane on heparin and protamine tracheal smooth muscle contraction. We performed this study to evaluate the effects of heparin or protamine on the carbachol induced contraction of tracheal smooth muscle in the guinea pig. And we also evaluated the effects of enflurane on heparin or protamine induced tracheal smooth muscle contraction. METHODS: Isolated tracheal rings of the guinea pig were suspended in Krebs solution. Contractions were recorded isometrically using a transducer. Contraction was induced by carbachol (10-6 M) and then cumulative dose responses of heparin or protamine (0.006 mg/ml, 0.02 mg/ml, 0.06 mg/ml, 0.2 mg/ml, 0.4 mg/ml) and in heparin (E) group and protmine (E) group, enflurane (4.34%) was administered for 15 minute after carbachol adminstration. RESULTS: Contraction by carbachol was inhibited by level of heparin or protamine at concentrations of 0.2 mg/ml and 0.4 mg/ml. At an enflurane (4.34%) contraction was inhibited, and no further inhibition of contraction by heparin or protamine was observed. CONCLUSIONS: Heparin or protamine inhibited the tracheal smooth muscle contraction induced by carbachol at 0.2 mg/ml and 0.4 mg/ml, and no further significant inhibition of contraction by heparin or protamine was observed after enflurane administration (4.34%).
Animals ; Asthma ; Carbachol* ; Enflurane ; Guinea Pigs* ; Guinea* ; Heparin* ; Humans ; Muscle, Smooth* ; Transducers

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

Hand assisted laparoscopic donor nephrectomy (HALDN) has recently emerged as a very attractive modality in standard donor nephrectomy because of its many advantages. However, it also has disadvantages, which include gas emboli, subcutaneous emphysema, hypercarbia, pneumothorax and pneumomediastinum. This case involves a male patient who had suffered from temporary hypercarbia due to increased carbon dioxide absorption due to massive subcutaneous emphysema about 1 hour after pneumoperitoneum during HALDN. Following multiple skin punctures with an 18 G disposable needle, chest compliance and blood gas findings improved. Three hours later the operation ended successfully and he was transferred to the recovery room, and show no further problems. We report upon this clinical experience and include a brief review of the literature.
Absorption ; Carbon Dioxide ; Compliance ; Hand* ; Humans ; Male ; Mediastinal Emphysema ; Needles ; Nephrectomy* ; Pneumoperitoneum ; Pneumothorax ; Punctures ; Recovery Room ; Skin ; Subcutaneous Emphysema* ; Thorax ; Tissue Donors*

BACKGROUND: It is well known that anticonvusant drugs such as carbamazepine are effective in the management of various neuropathic pain conditions. Oxcarbazepine, a keto analogue of carbamazepine, might also be expected to have an analgesic effect because it is a derivative of carbamazepine. The aim of this study is to evaluate the analgesic effect of oxcarbazepine in a rat neuropathic pain model. METHODS: Male Sprague-Dawley rats were prepared by tightly ligating the L5 and L6 spinal nerves to reproduce neuropathic pain. Sixty neuropathic rats were randomly assigned into 6 groups for the intraperitoneal administration of drugs. Normal saline, vehicle (polyethylene glycol 400), oxcarbazepine (10 mg/kg, 20 mg/kg, 30 mg/kg and 50 mg/kg) were administered respectively to the individual groups. We examined mechanical and cold allodynia preadministration, and 15, 30, 60, 90, 120, 150 and 180 min after intraperitoneal drug administration. Mechanical allodynia was quantified by measuring the withdrawal frequency to stimuli with two von Frey filaments of 35.6 mN and 115.2 mN. Cold allodynia was quantified by measuring the frequency of foot lift to 100% acetone. Pain behavior may be influenced by the adverse effects of anticonvulsants, which include sedation, motor incoordination. We therefore measured the locomotor function of the neuropathic rats by using the rotarod test. RESULTS: The vehicle group showed no significant differences in the mechanical and cold allodynia versus the saline group. In the oxcarbazepine-treated groups, withdrawal frequencies to mechanical and cold stimuli were significantly reduced versus the pre-administration values and versus the vehicle group. The duration of antiallodynic effects increased dose-dependently, and these were maintained for 150 min at the highest dose. Only at the highest dose (50 mg/kg) did oxcarbazepine reduce the rotarod performance time. CONCLUSIONS: We conclude that oxcarbazepine reduces mechanical and cold allodynia in a rat neuropathic pain model and may be a candidate for the management of neuropathic pain.
Acetone ; Animals ; Anticonvulsants ; Ataxia ; Carbamazepine ; Foot ; Humans ; Hyperalgesia* ; Male ; Models, Animal* ; Neuralgia ; Rats* ; Rats, Sprague-Dawley ; Rotarod Performance Test ; Spinal Nerves