Lee JH. Korean J Anesthesiol. 2017 Aug;70(4):398-406. https://doi.org/10.4097/kjae.2017.70.4.398

Background and Objectives: Preoperative anxiety is a common emotional response before elective surgery that influences postoperative outcomes and can increase analgesic requirements. However, clinicians frequently overlook these concerns. This study aimed to quantify preoperative anxiety and evaluate its association with patient-related factors. Materials and Methods: Anxiety levels were evaluated in adult patients awaiting elective surgery using the Korean-translated version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the State-Trait Anxiety Inventory-Korean YZ form (STAI-KYZ). The patients were also surveyed regarding the subjective causes of preoperative anxiety. Results: The study found that a total of 55 adult patients had a well-balanced subject distribution. Both questionnaires showed high internal consistency (Cronbach’s alpha values of 0.85 and 0.93). Significant correlations were observed in situational anxiety scores from the questionnaires, indicating differences between groups with high trait anxiety and those with normal anxiety levels (p < 0.05). Notably, female sex was the only patient-related factor that significantly affected the anxiety scores (p < 0.05). Furthermore, when considering additional patient factors stratified by sex, it became evident that younger females and females with prior general anesthesia experience displayed higher anxiety levels than their male counterparts. The most commonly reported subjective concern related to anesthesia was the fear of not regaining consciousness, followed by concerns about postoperative pain, intraoperative emergence, and other issues. Conclusions: This study confirms that being female is a significant risk factor for preoperative anxiety. Therefore, it is necessary to provide enhanced preoperative anxiolytic therapies, including preoperative patient education and other interventions, to individuals undergoing surgical procedures.

Inflammasomes are a group of intracellular multiprotein platforms that play important roles in immune systems. Benzyl isothiocyanate (BITC) is a constituent of cruciferous plants and has been confirmed to exhibit various biological activities. The modulatory effects of BITC on inflammasome-mediated interleukin (IL)-1β expression and its regulatory mechanisms in Pseudomonas aeruginosa (P. aeruginosa) LPS/ATP-stimulated THP-1 cells was investigated. Monocytic THP-1 cells were treated with phorbol myristate acetate (PMA) to induce differentiation into macrophages. Enzyme-linked immunosorbent assays (ELISA) were performed to measure the levels of IL-1β produced in P. aeruginosa LPS/ATP-exposed THP-1 cells. Western blotting was performed to examine the BITC modulatory mechanisms in inflammasome-mediated signaling pathways. BITC inhibited IL-1β production in P. aeruginosa LPS/ATP-induced THP-1 cells. BITC also inhibited activation of leucine-rich repeat protein-3 (NLRP3) and caspase-1 in P. aeruginosa LPS/ATP-induced THP-1 cells. Furthermore, we show that mitogen-activated protein kinase (MAPK) and nuclear factor-κB (NF-κB) activation in P. aeruginosa LPS was attenuated by BITC. These BITC-mediated modulatory effects on IL-1β production may have therapeutic potential for inflammasome-mediated disorders such as a nasal polyp.

Lee JH, et al. Korean J Anesthesiol. 2017 Feb;70(1):58-63. https://doi.org/10.4097/kjae.2017.70.1.58

This study was done to evaluate the effect on pain relief when acetaminophen was added to lidocaine for intravenous regional anesthesia (IVRA). SIXTY PATIENTS UNDERGOING HAND OR FOREARM SURGERY RECEIVED IVRA WERE ASSIGNED TO THREE GROUPS: Group C received 0.5% lidocaine diluted with 0.9% normal saline to a total volume of 40 ml (n = 20), Group P received 0.5% lidocaine diluted with intravenous acetaminophen 300 mg to a total volume of 40 ml (n = 20) and Group K received 0.5% lidocaine diluted with 0.9% normal saline plus ketorolac 10 mg made up to a total volume of 40 ml (n = 20). Sensory block onset time, tourniquet pain onset time, which was defined as the time from tourniquet application to fentanyl administration for relieving tourniquet pain and amount of analgesic consumption during surgery were recorded. Following deflation of tourniquet sensory recovery time, postoperative pain and quantity of analgesic uses in post-anesthesia care unit were assessed. Sensory block onset time was shorter in Group P compared to Group C (P < 0.05). Tourniquet pain onset time was delayed in Group P when compared with group C (P < 0.05). Postoperative pain and analgesic consumption were reduced in Group P and Group K compared to Group C (P < 0.001). The addition of acetaminophen to lidocaine for IVRA shortens the onset time of sensory block and delays tourniquet pain onset time, but not with ketorolac. Both acetaminophen and ketorolac reduce postoperative pain and analgesic consumption.

Lee JH, et al. Korean J Anesthesiol. 2014 Dec;67(Suppl):S30-S31. http://dx.doi.org/10.4097/kjae.2014.67.S.S30