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        The optimal anesthetic depth for interventional neuroradiology: comparisons between light anesthesia and deep anesthesia

        전영태,정유선,한예름,최은수,김병건,박희평,황정원 대한마취통증의학회 2015 Korean Journal of Anesthesiology Vol.68 No.2

        Background: This study was designed to determine the optimal anesthetic depth for the maintenance and recovery ininterventional neuroradiology. Methods: Eighty-eight patients undergoing interventional neuroradiology were randomly allocated to light anesthesia(n = 44) or deep anesthesia (n = 44) groups based on the value of the bispectral index (BIS). Anesthesia was inducedwith propofol, alfentanil, and rocuronium and maintained with 1−3% sevoflurane. The concentration of sevoflurane wastitrated to maintain BIS at 40−49 (deep anesthesia group) or 50−59 (light anesthesia group). Phenylephrine was used tomaintain the mean arterial pressure within 20% of preinduction values. Recovery times were recorded. Results: The light anesthesia group had a more rapid recovery to spontaneous ventilation, eye opening, extubation, andorientation (4.1 ± 2.3 vs. 5.3 ± 1.8 min, 6.9 ± 3.2 min vs. 9.1 ± 3.2 min, 8.2 ± 3.1 min vs. 10.7 ± 3.3 min, 10.0 ± 3.9 min vs. 12.9 ± 5.5 min, all P < 0.01) compared to the deep anesthesia group. The use of phenylephrine was significantly increasedin the deep anesthesia group (768 ± 184 vs. 320 ± 82 μg, P < 0.01). More patients moved during the procedure in the lightanesthesia group (6/44 [14%] vs. 0/44 [0%], P = 0.026). Conclusions: BIS values between 50 and 59 for interventional neuroradiology were associated with a more rapid recoveryand favorable hemodynamic response, but also with more patient movement. We suggest that maintaining BIS valuesbetween 40 and 49 is preferable for the prevention of patient movement during anesthesia for interventional neuroradiology.

      • KCI등재후보

        전뇌허혈 모델에서 sevoflurane과 원격 허혈성 전처치의 병용이 뇌보호에 미치는 효과

        손혜민,전영태,황정원,임영진,박희평,한예름 대한마취통증의학회 2013 Anesthesia and pain medicine Vol.8 No.2

        Background: The aim of this study was to investigate the combining effects of sevoflurane and remote ischemic preconditioning (RIPC) on cell death of pyramidal neurons in the CA1hippocampus induced by transient global cerebral ischemia in rats. Methods: Twenty rats were assigned to one of two groups;sevoflurane group and combination of sevoflurane and RIPC group. RIPC was performed by occluding the bilateral femoral arteries for 10 min 3 times in an interval of 10 min. Ischemia was induced by a bilateral common carotid artery occlusion plus hemorrhagic hypotension (26−30 mmHg) and was maintained for 8 min. Histologic outcomes were measured at 7 days after ischemia in CA1pyramidal cells of the rat hippocampus. Results: The combination group contained significantly more viable cells in the hippocampal CA1 area than sevoflurane group (71% vs. 46%, P = 0.03). The mean percentage of apoptotic cells was significantly reduced in the combination group compared to sevoflurane group (11% vs. 41%, P = 0.014). Conclusions: A combination of sevoflurane and RIPC can offer additional neuroprotective effects after transient global cerebral ischemia in rats.

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