Multi-drug therapy for epilepsy influenced bispectral index after a bolus propofol administration without affecting propofol's pharmacokinetics: a prospective cohort study

Some previous studies have indicated that valproate (VPA) might change the pharmacokinetics and enhance the effects of propofol. We evaluated whether clinical VPA therapy affected the propofol blood level, the protein-unbound free propofol level, and/or the anesthetic effects of propofol in the clinical setting. The subjects were divided into the control group (not medicated with antiepileptics), the mono-VPA group (medicated with VPA alone), and the poly-VPA group (medicated with VPA, other antiepileptics, and/or psychoactive drugs). General anesthesia was induced via the administration of a single bolus of propofol and a remifentanil infusion, and when the bispectral index (BIS) exceeded 60 sevoflurane was started. There were no significant differences in the total blood propofol level at 5, 10, 15, and 20 min or the protein-unbound free propofol level at 5 min after the intravenous administration of propofol between the 3 groups. However, the minimum BIS was significantly lower and the time until the BIS exceeded 60 was significantly longer in the poly-VPA group. In the multivariate regression analysis, belonging to the poly-VPA group was found to be independently associated with the minimum BIS value and the time until the BIS exceeded 60. Clinical VPA therapy did not influence the pharmacokinetics of propofol. However, multi-drug therapy involving VPA might enhance the anesthetic effects of propofol

North Korean "De-Aligned" Diplomacy and Its Political Process in the Early 1970s

論文/Article

Arbitration proceedings in the Czech Republic

The theme of this thesis is the arbitration proceedings in the Czech Republic, which is one of the alternative disputes resolutions. The goal of this thesis is to provide a complete summary of legal regulation of the arbitration proceedings. The thesis is divided into eight chapters. The first three chapters deal with general issues of the arbitration proceedings. The first chapter which is further subdivided into six subchapters is focused on the basic definition of the arbitration proceedings, its theoretical concepts, its advantages and disadvantages, as well as its different types. The second chapter provides a summary mainly of national legal regulation. Chapter three explains the objective conditions under which a certain range of disputes can be heard and decided in the arbitration proceedings, including some specific examples. Chapter four is concerned with the arbitration agreement which is the major institute and the basis condition of the arbitration proceedings. This chapter is subdivided into three subchapters dealing with for example the different types of arbitration agreements, their mandatory requirements and also their invalidity and termination. In a separate subchapter author discusses the arbitration agreement for resolving disputes arising from consumer contracts. Chapter..