Premixing lidocaine with propofol is one of the useful methods to reduce the injection pain caused by propofol. The influence of lidocaine mixing to propofol emulsion is still unknown. We evaluated the influence of lidocaine mixing to propofol emulsion using three dosages (20mg, 10mg, 5mg) of lidocaine added to 100mg propofol. Visually, an oil-like layer appeared when 20mg and 10mg of lidocaine was added to propofol. The incidence of this change was higher with 20mg lidocaine than with 10mg lidocaine. There was no visual change that occurred by mixing 5mg lidocaine to 100mg propofol for 24hrs after mixing. No visual change was observed in 100mg propofol alone. Mixing of lidocaine with propofol induced the emulsion change in propofol. In premixing methods, we need more studies on safety use and the emlusion changes.

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The evaluation of services by patients is an essential component of quality improvement in anesthesiology. We studied 898 consecutive patients who underwent spinal anesthesia for elective surgery between November 1998 and December 2001. The patients were directly interviewed at the postanesthetic clinic.
Complications occurred more frequently in women than in men and were observed in most of the patients between 13 and 39 years old. Seventy of the 898 patients (7.8%) reported dissatisfaction with spinal anesthesia. Patients' dissatisfactions and unpleasant experiences after spinal anesthesia were related to intraoperative analgesia and lumbar puncture.
Anesthesiologists should understand the complications associated with spinal anesthesia, and preoperatively inform patients of them and manage them during and after the operation. Furthermore, we should allow patients to participate in choosing a method of anesthesia by mutual agreement.

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An investigation was undertaken to evaluate the clinical usefulness and the safety of general anesthesia using propofol for day-case dental treatment in patients with severe intellectual disabilities. Twenty-/six cases of propofol anesthesia were investigated in 10 disabled patients. After induction with oxygen, nitrous oxide and sevoflurane, all patients were intubated. Anesthesia was maintained with intravenous infusion of propofol and intermittent administration of vecuronium. The infusion rate of propofol was adjusted to keep BIS values within the range of 40 to 60. In some cases, regional infiltration of lidocaine was added for invasive procedures. Mean anesthesia time was 167 min and mean infusion rate of propofol was 6.2mg · kg^-1 · h^-1. The mean time required for extubation and drinking water after termination of propofol infusion was 11 min and 41 min, respectively. No patients displayed excitatory movements or agitation. All patients fulfilled the discharge criteria 2 hrs after anesthesia. In conclusion, continuous infusion of propofol can provide a rapid emergence and early discharge without significant complications. Propofol anesthesia for day-case dental treatment appears to be safe and effective even in patients with intellectual disabilities.

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