The Effects of Music on Maternal Anxiety and the Evaluation of Explicit and Implicit Memory during Cesarean Section / 대한마취과학회지

BACKGROUND: Music is widely used to help a patient relax, and divert their attention from unpleasant and stressful situations. In addition, it eliminates the noise in the operating room. A light level of general anesthesia for a cesarean section is usually applied to the mother to improve the fetal safety. Therefore, there is an increased incidence of maternal explicit and implicit memory with the bispectral index (BIS) monitoring. METHODS: Fifty patients undergoing a cesarean section under general anesthesia were allocated randomly to either a control group (group 1) or a music group (group 2). Patients in group 2 listened to music with a headphone during the procedure. The blood pressure, heart rate, intraoperative awareness, postoperative explicit and implicit memory and the plasma cortisol level were assessed. RESULTS: The systolic blood pressure and heart rate were significantly lower in group 2 than group 1 at 1 minute before intubation and 5 minutes after extubation (P <0.05). The BIS value were significantly lower in group 2 than group 1 at 1 minute after intubation and 10 minutes after delivery (P <0.05). The hit ratios of the implicit of memorial test were significantly higher in the group 2 (2.4 +/- 0.7) than in group 1 (1.6 +/- 0.4) (P <0.05). The hits of the implicit memorial test had no corresponding BIS value (P <0.05). The plasma cortisol level was significantly higher group 1 than in group 2 at 30 minutes after intubation and 10 minutes after arriving at the recovery room (P <0.05). CONCLUSIONS: It was found that the music played to the mother during a cesarean section under general anesthesia decreased the anxiety and stress response, and this technique may help protect patients from unwanted explicit and implicit memory.

The Effects of Intravenous Anesthetics on Human Cytomegalovirus Infection / 대한마취과학회지

BACKGROUND: Reactivation of human cytomegalovirus (HCMV) from latency is a frequent complication of organ transplantation, and the molecular mechanism by which this occurs is unknown. Previous studies have shown that allogenaic transplantation combined with immunosuppression may be required to achieve complete reactivation in vivo and many anesthetics have wide range immunomodulatory properties. HCMV infection of endothelial cells plays an important role in the establishment of latency and persistence, which appears critical for the maintenance of HCMV within the host. METHODS: We compared the effects of intravenous anaesthetics (propofol, thiopental, and ketamine) on the susceptability of endothelial cells to HCMV infection by indirect immunofluorescent assay at 48 hour postinfection and we also have investigated the time course of luciferase gene expression in human umbilical vein endothelial cell (HUVEC) infected with recombinant HCMV. RESULTS: Treatment with anesthetics after HCMV strain Towne inoculation did not increase HUVEC susceptibility to HCMV infection by indirect immunofluorescent assay. Treatment of HUVEC with propofol, thiopental, and ketamine after the recombinant virus inoculation had no significant effects on the level of the late genes expression. CONCLUSIONS: Intravenous anesthetics (propofol, thiopental, and ketamine) did not increase the susceptability of endothelial cells to HCMV infection at plasma concentrations. Further studies are required to evaluate higher anesthetic concentration which may increases the susceptability of HUVEC to HCMV infection without cell destruction.

Misregistration Artifact due to Respiratory Motion on Spiral CT of the Liver

PURPOSE: To determine the frequency and patterns of respiratory-induced misregistration artifact seen on spiral CT of the liver. MATERIALS AND METHODS: Two hundred patients with hepatic mass underwent spiral CT, and arterial phase images were compared with those of the portal phase in all cases and or of the delayed phase in 138. The patterns of misregistration artifact were divided into two groups: skipping, where at least two slices in the craniocaudal length of the mass were missed, and the partial volume veraging artifact thus excluded; and overlapping, where the same or reversed images were seen in succeeding sequences. We reviewed the location and size of the masses, and the presence or absence, and patterns of the misregistration artifact. RESULTS: Fourteen (7%) of 200 spiral CT scans demonstrated the misregistration artifact; in five of these there was skipping (involving a hepatic mass larger than 2 cm in two cases, and one smaller than 2 cm in three cases), and in nine there was overlapping (six masses larger than 2 cm, and three smaller than this). A lipiodol-laden mass measuring 5 mm was completely missed during the arterial phase. and in one case the spleen sequence was reversed. Thirteen (93%) of fourteen masses were located in the right lobe. CONCLUSION: Two patterns of misregistration artifact, skipping and overlapping, were observed, and their combined frequency was 7%. So as not to miss small hepatic masses or overestimate their size, careful respiratory control is therefore needed.