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Kang S, Chae YJ, Bae SY, Song JY, Joe HB. Remifentanil requirement for acceptable intubation conditions with two different doses of ketamine without a neuromuscular blocking agent in pediatric patients. Eur Rev Med Pharmacol Sci 2022; 26:1632-1639. [PMID: 35302210 DOI: 10.26355/eurrev_202203_28231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The optimal remifentanil concentration for improving intubation conditions when intubation is performed without neuromuscular blocking agents (NMBAs) but with ketamine as an induction agent remains unknown. Here, we aimed to identify the effective bolus doses of remifentanil required to achieve acceptable intubation conditions upon anesthesia induction with 1 or 2 mg/kg ketamine without NMBAs. PATIENTS AND METHODS In this prospective, double-blinded, randomized up-down sequential allocation study, we enrolled pediatric patients aged 3-12 years undergoing general anesthesia for inguinal hernia surgery. The patients were randomly allocated to one of two groups to receive either ketamine 1.0 mg/kg (K1 group) or 2.0 mg/kg (K2 group) intravenously until seven success-failure pairs were achieved. The remifentanil dose for each patient was determined using the modified Dixon's up-and-down method with an initial dose of 2.5 μg/kg and a step size of 0.5 μg/kg. RESULTS In total, 51 patients (22 in the K1 group and 29 in the K2 group) were enrolled. The effective dose (ED)50s of remifentanil for obtaining clinically acceptable intubation conditions under anesthesia induction with ketamine but without NMBAs was 3.2 μg/kg in the K1 group and 1.6 μg/kg in the K2 group. High-dose remifentanil with 1 mg/kg ketamine was associated with more severe chest wall rigidity and lower mean blood pressure and heart rate than was low-dose remifentanil with 2 mg/kg ketamine. CONCLUSIONS The ED50 of remifentanil required for clinically acceptable intubation conditions with anesthesia induction using 1 mg/kg ketamine without NMBAs in pediatric patients was twice that when using 2 mg/kg ketamine. The combination of 2 mg/kg ketamine and remifentanil was better at preventing chest wall rigidity.
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Affiliation(s)
- S Kang
- Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, South Korea.
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Kim JS, Shah GM, Chae YJ, Hwang JS, Ahn JM, Gong HS. Ulnar nerve morphology on magnetic resonance imaging predicts nerve recovery after surgery for cubital tunnel syndrome. Hand Surg Rehabil 2021; 41:90-95. [PMID: 34763114 DOI: 10.1016/j.hansur.2021.10.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 10/19/2021] [Accepted: 10/25/2021] [Indexed: 10/19/2022]
Abstract
Magnetic resonance imaging (MRI) can evaluate nerve morphology in cubital tunnel syndrome (CuTS), but its value in predicting surgical outcome is unclear. The purpose of this study was to determine whether ulnar nerve morphology on MRI correlated with outcome after CuTS surgery. We reviewed 40 patients who had preoperative MRI and electrodiagnostic (EDX) examinations for CuTS and outcome evaluation 6 months and 2 years postoperatively. Using MRI, ulnar nerve cross-sectional area (UNCSA), changes in signal intensity, and any space-occupying lesion were evaluated. Other factors assessed were age, symptom duration and severity, type-2 diabetes and EDX parameters. Factors associated with unfavorable surgical outcome were identified. At 6 months postoperatively, 12 patients (30%) had excellent, 19 (47.5%) good, 8 (20%) fair and 1 (2.5%) poor results on modified Wilson-Krout criteria. On univariate analysis, unfavorable outcomes were associated with increased UNCSA, space-occupying lesion, and decreased motor nerve conduction velocity (mNCV), and on multivariate analysis with increased UNCSA 1 cm distal from the epicondyle only (model 1) or increased UNCSA 1 cm proximal from the epicondyle and decreased mNCV (model 2). At 2 years, 15 patients (37.5%) had excellent, 21 (52.5%) good, 3 (7.5%) fair and 1 (2.5%) poor results, and no factors correlated with unfavorable outcome. Increased UNCSA on MRI was associated with unfavorable outcome at 6 months but not at 2 years. This study suggests that morphologic ulnar nerve changes can predict delayed nerve recovery after surgery for CuTS.
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Affiliation(s)
- J S Kim
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea
| | - G M Shah
- Department of Orthopedics and Trauma Surgery, Patan Academy of Health Sciences, Lagankhel-5, 44700 Bagmati, Nepal
| | - Y J Chae
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea
| | - J S Hwang
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea.
| | - J M Ahn
- Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea
| | - H S Gong
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea.
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Kim DH, Yoo JY, Ha SY, Chae YJ. Comparison of the paediatric blade of the Pentax-AWS and Ovassapian airway in fibreoptic tracheal intubation in patients with limited mouth opening and cervical spine immobilization by a semi-rigid neck collar: a randomized controlled trial. Br J Anaesth 2019; 119:993-999. [PMID: 28981579 DOI: 10.1093/bja/aex272] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 01/19/2023] Open
Abstract
Background We compared the performances of the paediatric blade of a Pentax Airway Scope and an Ovassapian airway in fibreoptic tracheal intubation in patients whose necks were stabilized by semi-rigid neck collars. Methods Ninety patients were enrolled in this prospective, open-label, randomized controlled trial. Patients were randomly allocated to one of two groups (Group OVA-FOB and Group AWS-FOB). The time to tracheal intubation, success rate of tracheal intubation, number of optimization manoeuvres (jaw thrust), and difficulty of manipulation of the fibreoptic bronchoscope were compared between the groups. Results The time to tracheal intubation was significantly shorter (32 vs 50 s; median difference 19 s; 95% confidence interval 14-25 s; P<0.001) and manipulation of the fibreoptic bronchoscope was significantly easier for Group AWS-FOB. Optimization manoeuvres were rarely required to facilitate fibreoptic tracheal intubation in Group AWS-FOB [jaw thrust, 0 (0%); jaw thrust with anterior neck collar removal, 1 (2%)] compared with that required in Group OVA-FOB [jaw thrust, 39 (87%); jaw thrust with anterior neck collar removal, 2 (4%)]. There was no significant difference in the success rate of tracheal intubation on the first attempt between groups [Group AWS-FOB, 45 (100%); Group OVA-FOB, 44 (98%)]. Conclusions Combined use of the paediatric blade of a Pentax Airway Scope and a fibreoptic bronchoscope enabled rapid tracheal intubation, minimizing the use of external manoeuvres of the airway, in patients with limited mouth opening and cervical spine immobilization by semi-rigid neck collars, compared with use of the Ovassapian airway and the fibreoptic bronchoscope. Clinical trial registration NCT02827110.
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Affiliation(s)
- D H Kim
- Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea
| | - J Y Yoo
- Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea
| | - S Y Ha
- Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Y J Chae
- Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea
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Hwang J, Chae YJ, Ha S, Yi IK. Effect of different doses of ketamine with low-dose rocuronium on intubation conditions in children: prospective randomized double blind trial. Eur Rev Med Pharmacol Sci 2019; 23:1807-1815. [PMID: 30840307 DOI: 10.26355/eurrev_201902_17144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The effect of ketamine on intubation condition, when used as an induction agent with low-dose rocuronium, is unknown. This study aimed to compare the effects of three doses of ketamine used with 0.3 mg/kg rocuronium and 1 µg/kg fentanyl on intubation conditions in children undergoing short elective surgery. PATIENTS AND METHODS The study was performed as a prospective, randomized double-blind clinical trial. A total of 60 children aged 2 to 12 years, who were scheduled for inguinal herniorrhaphy under general anesthesia, were randomly allocated into three groups on the basis of ketamine dose: 1 mg/kg (Group K1, n = 20), 1.5 mg/kg (Group K1.5, n = 20), and 2 mg/kg (Group K2, n = 20). The primary outcome was the intubation condition. Other assessments included hemodynamic data, recovery profile, adverse events in the postanesthetic care unit (PACU) and use of fentanyl as a rescue analgesic in the PACU were also assessed. RESULTS The occurrence of a clinically acceptable intubation condition increased with the use of an increased dose (≥ 1.5 mg/kg) (K1/K1.5/K2: 30%/65%/65%; p=0.038, for trends p=0.028). Hemodynamic data, recovery profile and adverse events in PACU showed no difference among groups. Fentanyl dose used in the PACU was higher in K1 than K2 and the number of patients requiring rescue analgesics in the PACU decreased in accordance with the dose of ketamine (K1/K1.5/K2: 30%/15%/0%; p=.031, for trends p=0.013). CONCLUSIONS Different intubation conditions were observed on the basis of ketamine dose used in conjunction with 0.3 mg/kg rocuronium and fentanyl 1 µg/kg. Ketamine dose ≥ 1.5 mg/kg with low-dose rocuronium should be used to improve intubation conditions in pediatrics.
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Affiliation(s)
- J Hwang
- Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, South Korea.
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Kwak HJ, Chae YJ, Lee KC, Kim JY. Target-controlled infusion of remifentanil for laryngeal mask airway insertion during sevoflurane induction in adults. J Int Med Res 2013; 40:1476-82. [PMID: 22971499 DOI: 10.1177/147323001204000426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This randomized, double-blind study investigated the suitable target effect-site concentration of remifentanil for laryngeal mask airway (LMA) insertion during inhalation induction with sevoflurane. METHODS Patients aged 18 - 60 years were randomly assigned to one of three groups receiving infusions of normal saline (control group), or infusions with target effect-site remifentanil concentrations of either 1 ng/ml (R1 group) or 2 ng/ml (R2 group), 1 min after the induction of anaesthesia with sevoflurane. LMA insertion was attempted 2 min after induction. Insertion conditions were graded using a six-variable, three-point scale (excellent, intermediate or poor). RESULTS A total of 102 patients were included. The proportion of patients ranked as excellent for the LMA insertion was significantly higher in groups R1 and R2 compared with the control group. The incidence of apnoea was significantly more frequent in the R2 group than in the control or R1 groups. CONCLUSIONS Compared with 1 ng/ml remifentanil or normal saline, target-controlled infusion of 2 ng/ml remifentanil significantly improved the LMA insertion conditions during sevoflurane inhalational induction, although apnoeic episodes were more frequently observed.
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Affiliation(s)
- H J Kwak
- Department of Anaesthesiology and Pain Medicine, Gachon University of Science and Medicine, Gil Medical Centre, Incheon, Republic of Korea
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Cho HB, Kim JY, Kim DH, Kim DW, Chae YJ. Comparison of the Optimal Effect-Site Concentrations of Remifentanil for Preventing Cough during Emergence from Desflurane or Sevoflurane Anaesthesia. J Int Med Res 2012; 40:174-83. [DOI: 10.1177/147323001204000118] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE: To compare the effect-site concentrations of remifentanil target-controlled infusion (TCI) that produced 50% and 95% of the maximal effect (EC50 and EC95, respectively) for preventing cough during emergence from desflurane or sevoflurane anaesthesia, in patients undergoing elective thyroidectomy. METHODS: Adults undergoing elective thyroidectomy were randomized to receive anaesthesia with desflurane or sevoflurane. The EC50 and EC95 values for remifentanil TCI were determined using Dixon's up-and-down method and probit analysis with sigmoid curve. RESULTS: In total, 48 patients aged 20 – 64 years were enrolled in the study. The EC50 ± SD of remifentanil TCI, determined by Dixon's up-and-down method, were 1.54 ± 0.70 and 1.11 ± 0.24 ng/ml for desflurane and sevoflurane, respectively. The EC95 of remifentanil TCI, analysed by probit analysis, were 2.88 ng/ml and 2.29 ng/ml for desflurane and sevoflurane, respectively. The effect-site concentration of remifentanil TCI for preventing cough during emergence from desflurane anaesthesia was not significantly higher than that observed for sevoflurane. CONCLUSIONS: During emergence from anaesthesia, variations in effect-site concentrations of remifentanil for preventing cough are of limited importance as they do not generate significant differences in results.
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Affiliation(s)
- HB Cho
- Department of Anaesthesiology and Pain Medicine, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - JY Kim
- Department of Anaesthesiology and Pain Medicine, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - DH Kim
- Department of Anaesthesiology and Pain Medicine, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - DW Kim
- Department of Anaesthesiology and Pain Medicine, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - YJ Chae
- Department of Anaesthesiology and Pain Medicine, School of Medicine, Ajou University, Suwon, Republic of Korea
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Won YJ, Yoo JY, Chae YJ, Kim DH, Park SK, Cho HB, Kim JS, Lee JH, Lee SY. The Incidence of Postoperative Nausea and Vomiting after Thyroidectomy using Three Anaesthetic Techniques. J Int Med Res 2011; 39:1834-42. [DOI: 10.1177/147323001103900526] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The choice of anaesthetics can affect the incidence of postoperative nausea and vomiting (PONV). This study compared the incidence of PONV in 177 female patients who underwent thyroidectomy, with anaesthesia induced and maintained using one of three regimens: (i) sevoflurane (thiopental sodium 4–5 mg/kg and sevoflurane 2.0–2.5 vol% in 50% air); (ii) total intravenous anaesthesia (TIVA; propofol-remifentanil [target blood concentrations 2.5–3.5 μg/ml and 3.5–4.5 ng/ml, respectively]); or (iii) combined inhalation and intravenous anaesthesia (sevoflurane 1.0 vol% in 50% air plus propofol-remifentanil [target blood concentrations 1.5–2.5 μg/ml and 2.5–3.5 ng/ml, respectively]). The incidence and severity of PONV and the need for rescue antiemetics were assessed at 0–24 h postoperatively. Overall, the incidence of PONV was significantly lower in the TIVA and combined groups compared with the sevoflurane group (33.9%, 39.0% and 64.4%, respectively). In conclusion, the maintenance of anaesthesia with propofol-remifentanil or sevoflurane-propofol-remifentanil decreased the incidence of PONV compared with sevoflurane alone.
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Affiliation(s)
- YJ Won
- Department of Anaesthesia and Pain Medicine, Ajou University, School of Medicine, Youngtong-Gu, Suwon, Republic of Korea
| | - JY Yoo
- Department of Anaesthesia and Pain Medicine, Ansan Korea University Medical Centre, Danwon-Gu, Ansan, Republic of Korea
| | - YJ Chae
- Department of Anaesthesia and Pain Medicine, Ajou University, School of Medicine, Youngtong-Gu, Suwon, Republic of Korea
| | - DH Kim
- Department of Anaesthesia and Pain Medicine, Ajou University, School of Medicine, Youngtong-Gu, Suwon, Republic of Korea
| | - SK Park
- Department of Anaesthesia and Pain Medicine, Ajou University, School of Medicine, Youngtong-Gu, Suwon, Republic of Korea
| | - HB Cho
- Department of Anaesthesia and Pain Medicine, Ajou University, School of Medicine, Youngtong-Gu, Suwon, Republic of Korea
| | - JS Kim
- Department of Anaesthesia and Pain Medicine, Ajou University, School of Medicine, Youngtong-Gu, Suwon, Republic of Korea
| | - JH Lee
- Department of Anaesthesia and Pain Medicine, Ajou University, School of Medicine, Youngtong-Gu, Suwon, Republic of Korea
| | - SY Lee
- Department of Anaesthesia and Pain Medicine, Ajou University, School of Medicine, Youngtong-Gu, Suwon, Republic of Korea
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Min SK, Lee SY, Park KS, Yoo J, Chae YJ. Bolus Effective Dose of Ketamine for Preventing Withdrawal Movement on Injection of Rocuronium in Paediatric Patients. J Int Med Res 2011; 39:1408-12. [DOI: 10.1177/147323001103900427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The bolus effective dose of ketamine required to prevent withdrawal movement on injection of rocuronium was determined in 27 paediatric patients undergoing elective surgery. A predetermined dose of ketamine was given intravenously on arrival in the operating room and anaesthesia (2.5% thiopental, 5 mg/kg) was administered 1 min later. After loss of consciousness, 1% rocuronium at 0.6 mg/kg was injected over 5 s and the presence or absence of withdrawal movement recorded. The effective dose of ketamine was determined using a modified Dixon up-and-down method with a step size of 0.1 mg/kg, successful prevention of withdrawal movement being defined as no response or movement at the wrist only. The bolus effective dose of ketamine for preventing withdrawal movement after injection of rocuronium following thiopental anaesthesia in 50% of paediatric patients (ED50) was 0.21 mg/kg according to the modified Dixon up-and-down method. Probit analysis indicated an ED50 of 0.18 mg/kg and an ED95 of 0.33 mg/kg. The latter was the most satisfactory dose in the clinical setting.
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Affiliation(s)
- SK Min
- Department of Anaesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - SY Lee
- Department of Anaesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - KS Park
- Department of Anaesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - J Yoo
- Department of Anaesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - YJ Chae
- Department of Anaesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
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Choi EW, Shin IS, Chae YJ, Koo HC, Lee JH, Chung TH, Park YH, Kim DY, Hwang CY, Lee CW, Youn HY. Effects of GM-CSF gene transfer using silica-nanoparticles as a vehicle on white blood cell production in dogs. Exp Hematol 2008; 36:807-15. [DOI: 10.1016/j.exphem.2008.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2007] [Revised: 01/21/2008] [Accepted: 01/23/2008] [Indexed: 10/22/2022]
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Kwak HJ, Kim JY, Kim YB, Chae YJ, Kim JY. The optimum bolus dose of remifentanil to facilitate laryngeal mask airway insertion with a single standard dose of propofol at induction in children. Anaesthesia 2008; 63:954-8. [PMID: 18557970 DOI: 10.1111/j.1365-2044.2008.05544.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to determine the optimal bolus dose of remifentanil required for the successful insertion of the laryngeal mask airway during propofol induction in children without a neuromuscular blocking agent. Twenty-six paediatric patients, aged 3-10 years, requiring anaesthesia for short ambulatory surgery were recruited. A predetermined bolus dose of remifentanil was injected over 30 s, followed by propofol 2.5 mg.kg(-1) over 10 s. The bolus dose of remifentanil was determined by a modified Dixon's up-and-down method, starting from 0.5 microg.kg(-1) (0.1 microg.kg(-1) as a step size). Laryngeal mask insertion was attempted 90 s after the end of remifentanil injection and the response of patients was classified as either 'movement' or 'no movement'. The bolus dose of remifentanil at which there was a 50% probability of successful laryngeal mask insertion (ED(50)) during induction with 2.5 mg.kg(-1) propofol was 0.56 (0.07) microg.kg(-1) in children without a neuromuscular blocking agent. From probit analysis, the ED(50) and ED(95) of remifentanil were 0.52 microg.kg(-1) (95% confidence limits, 0.42-0.62 microg.kg(-1)) and 0.71 microg.kg(-1) (95% confidence limits, 0.61-1.40 microg.kg(-1)), respectively.
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Affiliation(s)
- H J Kwak
- Department of Anaesthesiology and Pain Medicine, Gachon University of Science and Medicine, Gil Medical Center, Incheon, Korea
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Choi EW, Koo HC, Shin IS, Chae YJ, Lee JH, Han SM, Lee SJ, Bhang DH, Park YH, Lee CW, Youn HY. Preventive and therapeutic effects of gene therapy using silica nanoparticles-binding of GM-CSF gene on white blood cell production in dogs with leukopenia. Exp Hematol 2008; 36:1091-7. [PMID: 18550260 DOI: 10.1016/j.exphem.2008.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2007] [Revised: 02/15/2008] [Accepted: 04/08/2008] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Our previous study has shown that granulocyte-macrophage colony-stimulating factor (GM-CSF) gene/silica nanoparticles have a leukocytosis effect in normal dogs. Therefore, this study was conducted to determine whether treatment of canine GM-CSF gene/silica nanoparticles has preventive or therapeutic effects in dogs with leukopenia. MATERIALS AND METHODS To induce leukopenia, vinblastine was administered intravenously at a dose of 2 mg/m(2) of body surface area on day 0. Then 7.5 microg GM-CSF/nanoparticles (1:100, w/w) were administered intravenously to each of four dogs in the prevention group on day 2 and an equivalent amount of GM-CSF/nanoparticles was administered to the post-nadir group on day 4 (other groups were administered phosphate-buffered saline intravenously). RESULTS Therapeutic GM-CSF gene was expressed in peripheral blood mononuclear cells for 10 days and both the prevention and post-nadir groups showed significant increases in white blood cell counts when compared with the control group, as confirmed by complete blood count, differential count, and flow cytometry. CONCLUSIONS GM-CSF/nanoparticles can be useful for correction of acute leukopenia, such as chemotherapy-induced myelosuppression, without developing neutralizing antibodies.
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Affiliation(s)
- Eun Wha Choi
- KRF Zoonotic Disease Priority Research Institute, Research Institute of Veterinary Science, Seoul National University, Seoul, Republic of Korea
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Abstract
AIMS Local anaesthetics, which act as neurolytics and Na(+) channel blockers, have been used for disrupting the neural firings in certain neuropathic pain conditions. This study was undertaken to investigate the clinical outcome of trigeminal nerve block with 10% lidocaine in the management of trigeminal neuralgia (TN). METHODS Thirty-five patients with primary TN received trigeminal nerve blocks with 10% lidocaine. Success was defined as complete pain relief or mild pain without medication 1 day after the treatment. We followed the patients up every 2 months assessing for pain recurrence, sensory changes and other complications for a total of 37-45 months (median 43 months). RESULTS Twelve of the 35 patients (34.3%) responded favourably to the treatment and were considered as success. Eleven patients experienced complete pain relief and one could tolerate pain without medication 1 day after the blocks, which lasted for 3-172 weeks. Four patients experienced mildly decreased sensation in the region of the face supplied by the nerve 1 day after the blocks; however, all recovered normal skin sensation in 6 months. There was neither allodynia nor other sensory discomfort. The pain intensity and current pain duration before treatment were significantly different between the two groups. CONCLUSION Trigeminal nerve block with high concentration lidocaine (10%) is capable of achieving an intermediate period of pain relief, particularly in patients with lower pain intensity and shorter pain duration prior to the procedure.
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Affiliation(s)
- K R Han
- Pain Clinic, Department of Anesthesia and Pain Medicine, Ajou University Hospital, Suwon, Korea
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Abstract
Brugada syndrome is characterized by right bundle branch block, ST segment elevation in the precordial leads and sudden death caused by ventricular fibrillation. We present two successful anaesthetic management cases in patients with Brugada syndrome.
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Affiliation(s)
- J S Kim
- Department of Anaesthesia and Pain Medicine, Ajou University School of Medicine, Suwon, Korea
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Abstract
Previous studies from this laboratory showed that high levels of guanidinoacetate methyltransferase are present in mouse testis and epididymis, whereas guanidinoacetate methyltransferase mRNA and protein are not detected in seminal vesicles where large amounts of creatine (Cr) and phosphocreatine are found (Lee et al., Biol Reprod 1994; 50:152-162). To further investigate the origin(s) of Cr in the male reproductive tract, the expression patterns of the three enzymes and a transporter involved in Cr metabolism were examined with rat reproductive tissues. Western blot analysis showed that expression of L-arginine:glycine amidinotransferase was limited to the kidney. On the other hand, high levels of the mRNAs for both guanidinoacetate methyltransferase and Sadenosylhomocysteine hydrolase were expressed in the testis and epididymis as well as the liver and kidney. Cr transporter mRNA was highly expressed in the seminal vesicle and vas deferens. These results suggest that the source of Cr in the male reproductive tract varies depending on the tissue; in the testes and epididymides, Cr is synthesized from guanidinoacetate, while in the seminal vesicles, Cr is transported from blood. Previous and present findings suggest the importance of Cr metabolism and/or transport for reproductive functions.
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Affiliation(s)
- H Lee
- Laboratory of Biochemistry, Seoul National University College of Veterinary Medicine, Suwon, Republic of Korea
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Chae YJ, Chung CE, Kim BJ, Lee MH, Lee H. The gene encoding guanidinoacetate methyltransferase (GAMT) maps to human chromosome 19 at band p13.3 and to mouse chromosome 10. Genomics 1998; 49:162-4. [PMID: 9570966 DOI: 10.1006/geno.1998.5236] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Y J Chae
- Laboratory of Biochemistry, Seoul National University College of Veterinary Medicine, Suwon, Republic of Korea
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