Propofol and Aminophylline Antagonize Each Other During the Mobilization of Intracellular Calcium in Human Umbilical Vein Endothelial Cells

This study examined whether propofol and aminophylline affect the mobilization of intracellular calcium in human umbilical vein endothelial cells. Intracellular calcium was measured using laser scanning confocal microscopy. Cultured and serum-starved cells on round coverslips were incubated with propofol or aminophylline for 30 min, and then stimulated with lysophosphatidic acid, propofol and aminophylline. The results were expressed as relative fluorescence intensity and fold stimulation. Propofol decreased the concentration of intracellular calcium, whereas aminophylline caused increased mobilization of intracellular calcium in a concentration-dependent manner. Propofol suppressed the lysophosphatidic acid-induced mobilization of intracellular calcium in a concentration-dependent manner. Propofol further prevented the aminophylline-induced increase of intracellular calcium at clinically relevant concentrations. However, aminophylline reversed the inhibitory effect of propofol on the elevation of intracellular calcium by lysophosphatidic acid. Our results suggest that propofol and aminophylline antagonize each other on the mobilization of intracellular calcium in human umbilical vein endothelial cells at clinically relevant concentrations. Serious consideration should be given to how this interaction affects mobilization of intracellular calcium when these two drugs are used together.

Severe Hypotension Caused by Coronary Spasm during Recovery from Combined Spinal Epidural Anesthesia: A case report / 대한마취과학회지

In order that anesthesiologists may reduce the anesthetic and surgical stress on the heart, they frequently use regional anesthesia in patients with coronary artery disease, even though there is no evidence that it reduce the incidence of myocardial ischemia. We report a case of life-threatening cardiovascular collapse that occurred in a 47 years old male patient at the emergence from regional anesthesia. He underwent open reduction and internal fixation for femur fracture under combined spinal epidural anesthesia.The cause of serious hypotension is suspected of myocardial ischemia on the basis of ST segment elevation on EKG. We considered that these cardiovascular events were due to coronary spasm.The possible inducing factors of coronary spasm were altered autonomic balance and arteriosclerotic change related endothelial dysfunction.

Tongue Numbness following Endotracheal General Anesthesia: A case report / 대한마취과학회지

Lingual nerve palsy is a rare multi-etiological disease.Almost all devices used for airway manipulation can cause this complication, including laryngoscopes, laryngeal masks, cuffed oropharyngeal airways, tongue retractors, and suspension laryngoscopes.We report a case of transient lingual nerve palsy after general anesthesia, using orotracheal intubation, for surgery of a humerus fracture in the prone position.

Skin Burn after Laparoscopic Radiofrequency Thermal Ablation for Uterine Myoma : A case report / 대한마취과학회지

Laparoscopic radiofrequency thermal ablation is a promising new approach for the conservative treatment of a uterine myoma. I report a pad burn in a patient undergoing laparoscopic radiofrequency thermal ablation for a uterine myoma. The burn occurred at the leading edge of the pad attached to the patient's thigh. The burn was treated successfully with dressings.

A Comparison of the Efficacy of Epidural Steroid Injections in Terms of the Dosages and Frequency of Triancinolone Injections for the Pain Related to Lumbar Spinal Stenosis or Herniated Disks / 대한통증학회지

BACKGROUND: The objective of this study was to describe the extent of pain relief after an epidural steroid injection in the patients suffering from chronic low back pain from herniated disks or lumbar spinal stenosis. METHODS: The study was prospectively designed for patients suffering with lumbar spinal stenosis (LSS) and herniated disks (HD) who were referred to a hospital-based pain clinic for epidural steroid injections (ESI). The pain was assessed with using a visual analog scale at baseline, two weeks after the first ESI and two weeks after the third ESI. RESULTS: Eighty patients were enrolled, and all of them provided pain ratings before and after the injections. The LSS patients seemed to improve less than did the HD patients. The results showed no significant differences in the triamcinolone dosage and the frequency of injections for determining the efficacy of ESI. CONCLUSIONS: The LSS patients tended to have a less effective respond to ESIs than did the HD patients. The unsatisfactory response to ESI by the LSS patients underscores the need for randomized controlled trials of performing ESI in this population.

Effect of Etomidate on N-methyl-D-aspartate Induced Neurotoxicity in Rat Cortical Neurons / 대한마취과학회지

BACKGROUND: The present investigation was undertaken to evaluate the neuroprotective effect of etomidate against N-methyl-D- aspartate (NMDA) induced neurotoxicity in rat cortical neurons by measuring lactate dehydrogenase (LDH). METHODS: The cerebral cortical neurons of fetal rat were grown for 12 days in dissociated cell culture. They were divided into four groups: first group acted as control with no drug administration and other groups treated with either NMDA 100microM or Etomidate (ET) 10microM + NMDA 100microM or ET 100microM + NMDA 100microM After 24 hrs, cell death was assessed by morphology under the light microscope and quantified by measuring the LDH in the culture media. RESULTS: In the light microscopic findings, the intact cortical neurons were increased in the ET groups. NMDA-induced LDH production also significantly suppressed in ET group (P<0.05). There were no significant difference between the ET 10microM and 100microM groups. CONCLUSIONS: These results suggest that the etomidate has protective effect on the cultured rat cortical neurons against NMDA-induced neurotoxicity.

Convulsion, Symptomatic Hyponatremia and Paralytic Ileus Following Tonsillectomy: A case report / 대한마취과학회지

Severe symptomatic hyponatremia shows high mortality in association with cerebral edema and central nervous system dysfunction. Postoperative hyponatremia is usually attributed to administration of hypotonic fluids while antidiuretic hormone is acting. However, we experienced a severe symptomatic hyponatremia in spite of infusion of lactated Ringer's solution perioperatively in a case of 4-year-old girl's tonsillectomy. Inappropriate secretion of ADH caused by pain, stress, anxiety, nausea, vomiting. Paralytic ileus developed several hours after surgery, severe hyponatremia (Na 119 mmol/L) with convulsion notified. After prompt infusion of sodium supplement and fluid restriction, the patient recovered uneventfully.

Epidural Anesthesia for Cesarean Section in a Parturient with Eisenmenger's Syndrome / 대한마취과학회지

Eisenmenger's syndrome is defined as pulmonary hypertension with right-to-left or bidirectional shunting of blood through an intracardiac or aorto-pulmonary commumication. It can occur with complex congenital cardiac malformations, such as septal defect and patent ductus arteriosus. Parturients with Eisenmenger's syndrome are at high risk for peripartum morbidity and mortality. We experienced a case of parturient for cesarean section with Eisenmenger's syndrome and performed epidural anesthesia with fractionated doses of 2% lidocaine and fentanyl. The sensory block reached to T10 level and blood pressure was maintained with intravenous phenylephrine. After baby out, sudden hypotension with severe bradycardia developed and arterial oxygen saturation dropped. Immediate intubation and resuscitation was done, but cardiac rhythm disturbance, hypoxemia, and acidosis did not corrected. Cardiac standstill developed and stopped resuscitation. The neonate's Apgar score was 7 and he was transferred to pediatric ICU.