Korean journal of anesthesiology
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Korean J Anesthesiol · Oct 2012
The effect of low dose ketamine and priming of cisatracurium on the intubating condition and onset time of cisatracurium.
Both ketamine and priming may accelerate the onset time of neuromuscular blocking agents. We investigate the effect of low dose ketamine and cisatracurium priming on the intubating condition and onset time of cisatracurium. ⋯ The combination of the low dose ketamine and cisatracurium priming accelerated the onset time and was improved the intubating conditions.
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Korean J Anesthesiol · Oct 2012
The EC(50) of remifentanil to minimize the cardiovascular changes during head holder pinning in neurosurgery.
During neuroanesthesia, head holder pinning commonly results in sympathetic stimulation manifested by hemodynamic changes, such as increased heart rate and arterial blood pressure. Remifentanil has been used successfully to control acute autonomic responses during neurosurgical procedures. The objective of this study was to determine effect-site concentration of remifentanil for suppressing the hemodynamic response to head holder pinning with the probability of 50% (EC(50)). ⋯ This study showed that EC(50) of remifentanil was 2.19 ± 0.76 ng/ml by TPE. EC(50) was 2.42 ng/ml (95% CI -0.62-4.66) in probit analysis, as back up analysis. The EC(50) estimator comes from isotonic regression is 2.90 ng/ml (95% CI : 1.78-3.65).
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Korean J Anesthesiol · Oct 2012
The effect of positive-end expiratory pressure on oxygenation during high frequency jet ventilation and conventional mechanical ventilation in the rabbit model of acute lung injury.
The use of positive end expiratory pressure (PEEP) in patients with acute lung injury (ALI) improves arterial oxygenation by alleviating pulmonary shunting, helping the respiratory muscles to decrease the work of breathing, decreasing the rate of infiltrated and atelectatic tissues, and increasing functional residual capacity. In a rabbit model of saline lavage-induced ALI, we examined the effects of PEEP on gas exchange, hemodynamics, and oxygenation during high frequency jet ventilation (HFJV), and then compared these parameters with those during conventional mechanical ventilation (CMV). ⋯ The application of PEEP in rabbits with ALI effectively improves oxygenation in either HFJV or CMV.
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Korean J Anesthesiol · Oct 2012
Comparison of surgical conditions during propofol or desflurane anesthesia for endoscopic sinus surgery.
Reduction of intraoperative bleeding is necessary to achieve the ideal surgical field for the endoscopic sinus surgery (ESS). Intraoperative intra nasal bleeding is influenced by various anesthetics. This study compared surgical field condition between propofol/remifentanil (PR) based anesthesia and desflurane/remifentanil (DR) based anesthesia. ⋯ In the high-LM score patients, PR based anesthesia resulted in better surgical field condition for ESS than DR based anesthesia. In ESS, PR based anesthesia is considered to be helpful.
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Korean J Anesthesiol · Oct 2012
The median effective effect-site concentration of remifentanil for minimizing the cardiovascular changes to endotracheal intubation during desflurane anesthesia in pediatric patients.
Desflurane has the most rapid onset and offset of action among the volatile anesthetic agents used for general anesthesia, but it can cause airway reactivity, tachycardia, and hypertension during induction, especially in pediatric patients. This study was designed to determine a median effective effect-site concentration (EC(50)) of remifentanil to prevent the cardiovascular changes due to tracheal intubation during the 1 minimum alveolar concentration (MAC) desflurane inhalation, which was required to prevent movement in response to a noxious stimulus in 50% of subjects, in pediatric patients. ⋯ In pediatric anesthesia, the EC(50) of remifentanil to minimize the cardiovascular changes due to tracheal intubation during 1 MAC desflurane anesthesia was 3.4 ± 0.9 ng/ml.