Journal of Yeungnam Medical Science

Original Articles

Changes of Hemodynamic Parameters, Plasma Catecholamines and Vasopressin Level During Laparoscopic Cholecystectomy and in Recovery Period: Heung Dae Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S527-537. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S527

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Abstract PDF: Background
：Laparoscopic cholecystectomy produces less tissue trauma than conventional open procedure does. But, during this procedure, the deliberate pneumoperioneum with carbon dioxide(CO₂) gas insufflation may cause some problems, such as hypercarbia, hypertension, tachycardia, and other changes of cardiovascular function. We analyze the physiologic mechanism of these hemodynamic effects under laparoscopic surgery with CO₂ gas insufflation during inhalation general anesthesia. Materials and Methods：We studied randomly selected 5 healthy patients undergoing laparoscopic cholecystectomy with CO₂ gas insufflation. Each patient inhaled sevoflurane and nitrous oxide gas(50%). The blood pressure, heart rate, end-tidal carbon dioxide level were measured during all the anesthetic procedures. We collected venous blood samples to determine the plasma level of epinephrine, norepinephrine and vasopressin, at 10 minutes after insufflation of CO₂ gas into peritoneal cavity, and at 10 minutes after patient arrived in recovery room. We measured the plasma level of epinephrine and norepinephrine using double antibody method, and vasopressin level using radioimmunoassay method.
Results
：Mean arterial pressure and heart rate was significantly increased, after intraperitoneal insufflation of CO₂ gas(19.3%, 44.7% respectively), and in recovery period(15.8%, 28.6% respectively). The plasma concentration of epinephine was 47.1 ± 30.3 pg/ml(reference intervals, less than 100 pg/ml) at 10 minutes after insufflation of CO₂ gas, and 53.1 ± 25.8 pg/ml at 10 minutes in recovery room. The plasma concentration of norepinephine was 125.7 ± 44.8 pg/ml (reference intervals, less than 600 pg/ml) after insufflation, and 179.1 ± 42.1 pg/ml in recovery room. The plasma concentration of vasopressin was 43.3 ± 34.5 pg/ml(reference intervals, less than 6.7 pg/ml) after insufflation, and 25.3 ± 16.7 pg/ml in recovery room.
Conclusion
：The laparoscopic cholecystectomy with CO₂ gas insufflation in general anesthesia with sevoflurane and in recovery room results in increased mean arterial pressure, heart rate, and decreased plasma concentration of epinephine and norepinephine and increased plasma concentration of vasopressin.

Inhibitory of γ-aminobutyric acid on the contractility of isolated rat vas deferens.: Ki Young Ahn, Oh Cheol Kwon, Jeoung Hee Ha, Kwang Youn Lee, Won Joon Kim; Yeungnam Univ J Med. 1992;9(2):382-395. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.382

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Abstract PDF: GABA is an inhibitory neurotransmitter in central nervous system and produce sedative, antianxiety and muscle relaxing effects via GABA(A) receptor or GABA(B) receptor. Recently it is known that GABA is widely distributed throughout peripheral organs and may play a physiological role in certain organ. The vas deferens is innervated by species-difference. These study, therefore, was performed to investigate the mode and the mechanism of action of GABA on the norepinephrine-, ATP- and electric stimulation-induced contraction of vas deferens of rat. Sprague-Dawley rats were sacrificed by cervical dislocation. The smooth muscle strips were isolated from the prostatic portion and were mounted in the isolated muscle bath. PSS in the bath was aerated with 95/5%-O₂/CO₂ at 33℃. Muscle tensions were measured by isometric tension transducer and were recorded by biological recording system. 1. GABA, muscimol, a GABA(A) agonist, and baclofen, a GABA(B) agonist inhibited the electric field stimulation (EFS, 0.2Hz, 1mSec, 80V, monophasic square wave)-induced contraction with a rank order of potency of GABA greater than baclofen greater than muscimol. 2. The inhibitory effect of GABA was antagonized by delta aminovaleric acid (DAVA), a GABA(B) antagonist, but not by bicuculline, a GABA(A) intagonist. 3. The inhibitory effect of baclofen was antagonized by DAVA, but the effect of muscimol was not antagonized by bicuculline. 4. Exogenous norepinephrine (NE) and ATP contracted muscle strip concentration dependently, but the effect of acetylcholine was negligible and GABA did not affect the NE-and ATP-induced contractions. 5. GABA, baclofen and muscimol did not affect basal tone, and GABA did not affect the NE-and ATP-induced contractions. 6. EFS-induced contraction was inclucling 2 distinctable components. The first phasic component was inhibited by beta gamma-methylene ATP (mATP), a desensitizing agent of APT receptor and the second tonic component was reduced by pretreatment of reserpine (3 mg/Kg, IP). 7. GABA inhibited the EFS-induced contraction of reserpinized strips, but not the mATP-treated strips. These results suggest that in the prostatic portion of the rat vas deferens, adrenergic and purinergic neurotransmissions are exist, and GABA inhibits the release of ATP via presynaptic GABA(B) receptor on the excitatory neurons.

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