Electroconvulsive therapy (ECT) has been used in the treatment of psychiatric disorders such as schizophrenia and major depressive disorders which are resistant to pharmacologic therapy. Seizure duration is a major determinant of treatment efficacy in ECT. Patients requiring ECT need effective sedation and neuromuscular blockade to prevent discomfort and the possibility of fractures of bones during ECT. The Bispectral Index (BIS) reflects the clinical degrees of consciousness during sedation and hypnosis with intravenous and inhalational anesthesia. This study was performed to investigate if there is any correlation between the BIS and seizure duration in the patients with psychiatric disorders during ECT under propofol and succinylcholine anesthesia. A total of 11 patients with schizophrenia and major depressive disorders were monitored for BIS, electroencephalogram (EEG) and seizure duration. Seizure was detected using isolated forearm technique (IFT). The BIS was recorded at four specific time points (baseline before the start of anesthetic induction, before ECT (Pre-ECT BIS), at eye opening to verbal command and at 5 minutes after eye opening). Awake baseline value of the BIS showed significant changes depending on the depth of anesthesia at specific time points after propofol was administered. Pre-ECT BIS was positively correlated with seizure duration.

내시경적 역행성 담췌관 조영술은 일반적인 내시경 시술보다 고도의 술기를 요구한다. 따라서, 환자가 느끼는 불편 함이 클 수 있으므로 적절한 진정이 시술의 성공에 중요한 요소가 된다. 프로포폴이 기존의 미다졸람 등의 진정제들을 대체하며 많은 기여를 하고 있는 것은 사실이다. 하지만 호 흡저하와 심혈관계 영향으로 많은 부작용도 나타낸다. Dexmedetomidine은 선택적으로 α2 adrenoceptor에 작용하여 호흡이 비교적 잘 유지되는 진정상태를 제공한다. 내시경적 역행성 담췌관 조영술과 같은 높은 수준의 진정을 요구하는 시술에서 중요한 역할을 할 수 있다. 주의 깊고 세심한 환자 감시, 적절한 약제의 투여, 산소의 공급 그리고 응급처치 장비나 기구가 준비되어 있다면 좀 더 안전하고 성공적인 시술 이 될 수 있을 것이다.

Background: Patent ductus arteriosus (PDA) is commonly accompanied by premature infants and associated with an increase of comorbidity and mortality. Surgery in the operation room (OR) is more familiar with an anesthesiologist, but transportation of the premature to OR has risks of hypothermia or other unexpected events. These days, PDA ligation in the neonatal intensive care unit (NICU) is highlighted because of its advantages. We compared the postoperative outcome of PDA ligation according to the operating theater in the perspective of an anesthesiologist. Methods: A total of 9 patient who underwent PDA ligation surgery from 2007 to 2018 were enrolled and divided into two groups; Group OR: surgery at the OR, Group NICU: surgery at the NICU. Data of gestational age (GA), body weight (BW), patients’ characteristics, anesthesia and hemodynamic, total hospitalization period, and outcome were collected. Results: There were no significant differences in patient characteristics (GA, BW, PDA size, and comorbidities) and the duration of anesthesia, operation and recovery. Total hospitalization period was shorter in a group OR than NICU, but there were no significant differences in postoperative outcome. Only 1 patient has expired in a group OR. Conclusions: PDA ligation surgery in NICU has the advantage to maintain the body temperature than the surgery in the OR, and there were no significant differences in the outcome of the surgery.

Monitored anesthesia care (MAC) has been described as a specific anesthesia service for diagnostic or therapeutic procedures performed under local anesthesia along with sedation and analgesia, titrated to a level preserving spontaneous breathing and airway reflexes. Radio-frequency ablation (RFA) is a kind of methods to remove benign thyroid nodules (BTNs) by inducing the irreversible injuries with the use of an ultrasound-guided RF electrode placed inside the nodules. A 37 years old, 157 cm, 81 kg woman underwent RFA of BTNs under MAC. We present with a case report where laryngospasm under MAC was resolved by the use of positive pressure ventilation without any complications.

Optimum concentrations of anesthetic clove oil and anesthetic lidocaine-HCl were determined for a species of adult marine medaka, Oryzias dancena, over a range of salinity conditions, and investigated in a transport simulation experiment by analyzing various water and physiological parameters. Research indicated that the higher the concentration of anesthetic at each salinity, the shorter the anesthesia time at each salinity. At each concentration, fish were anesthetized slower at water salinities over 10 ppt (P<0.05). Anesthesia time at 10 ppt was faster than any other salinity. In 10 ppt salinity, the dissolved oxygen (DO) concentrations and respiratory frequencies of the clove-oil-administered groups decreased until 48 hours (P<0.05), whereas the NH4 + and CO2 concentrations increased until 48 hours (P<0.05). In same period, the DO, NH4 +, and CO2 concentrations and respiratory frequencies all decreased as the clove oil concentration increased (P<0.05). The trends in the DO, NH4 +, and CO2 concentrations and respiratory frequencies in the lidocaine-HCl-administered groups were similar to those in the clove-oil-administered groups. In conclusion, clove oil and lidocaine-HCl are effective anesthetics, improving the transportation of the marine medaka. The results from this study will contribute to safe laboratory handling of the marine medaka, which are commonly required by many research studies and experiments.

Brugada syndrome is associated with high risk for sudden death without structural cardiac defects due to ventricular arrhythmias. A 47-years-old man with Brugada syndrome has admitted because of right patella fracture. General anesthesia with sevoflurane and remifentanil was carefully maintained according to the BIS for the maintenance of adequate anesthetic depth and to avoid tachycardia during the surgery. Blood pressure and heart rate of the patient were maintained less than 150/90 mmHg and 100 beat/min perioperatively. There were no adverse events, and the patient was discharged home after ten days.

Wolff-Parkinson-White syndrome (WPW) is a common disorder of the conduction system of the heart. Patients with such disorder may be asymptomatic or present with cardiac symptoms like palpitation and dyspnea. The anesthetic management of these patients is challenging as they are known to develop life threatening tachyarrhythmia. We report a hemodynamic management of a 53-year-old male with WPW syndrome scheduled for laparoscopic cholecystectomy under general anesthesia. We performed total intravenous anesthesia with propofol and remifentanil, and we placed the laryngeal mask airway behind the endotracheal tube using Bailey's Maneuver before extubation of endotracheal tube.