Anesthetic Management of Reconstructive Surgery for the Traumatic Thoracic Aortic Aneurysm / 대한마취과학회지

The management of patient undergoing thoracic aortic surgical procedures represents a major challenge for the anesthesiologists. Aortic cross-clamping and unclamping are particularly hszardous during the- course of the thoracic aortic operation. Proximal hypertension, myocardial ischemia and arrhythmia have been reported to occur after application of the aortic cross-clampmg. Removal of the cross-clamp often results in severe hypotension with subsequent myocardial, cerebral and renal ischemia. In this case, the patient was managed successfully using Regitine drip during the cross-clamp and slow release of clamp during unclamp, combined with slight overhydration just before unclamp.

The Change of Heart Rate following the mixed injection of Atropine and Neostigmine for Non-Depolarizing Neuromuscular Blocking Agent-Pancuronium / 대한마취과학회지

Around the time of recovery from general anesthesia we usually use atropine and neostigmine to counteract the effect of muscle relaxant that is remaining in the body. We used various kinds of combinations of atropine and neostigmine to see the effect of them on heart rate. The combinations were as follows: I) atropine 0.02mg/kg+neostigmine 0. 02mg/kg. 2) atropine 0. 2mg /kg+neostigmine 0.03mg/kg. 3) atropine 0. 02mg/kg+neostigmine 0.04mg/kg. 4) atropine 0.02mg/kg+neostigmine 0.05mg/kg. 5) atropine 0.02mg/kg+neostigmine 0.06mg/kg. 6) atropine 0.02mg/kg+neostigmine 0.07mg/kg. Ten subjects(ps.I.ASA) were taken for each combination. Thus total sample size of the six combinations were sixty, Each study has been performed in the state of ASA P.S.1, and anesthetized for b but two hours. N2O-O2-Halothane technique was used for anesthesia. The dosage of pancuronium was 0. 08mg/kg. The age distribution of the sample was 2 to 60, and male to female ratio was 4 to 6. We came to the following conclusions from this study. 1) Types of dosage combinations those caused little change in heart rate were; atrop!ne 0.02mg/kg+neostigmine 0.02mg/kg, and atropine 0.02mg/kg+ neostigmine 0.03mg/kg. 2) Just after the simultaneous injection of the drugs, there appeared mild tachycardia, but fifteen minutes after the administration severe bradycardia came on and, after that the heart rate returned to normal. 3) The combinations which included neostigmine, more than 0. 04mg/kg, caused severe braycardia, and the most severe bradycardia was seen with a combination of atropine 0.02mg/kg and neostigmine 0.06mg/kg.

A Clinical Study on Changes of Body Temperature before and after Extracorporeal Circulation for Open Heart Surgery / 대한마취과학회지

Changes of body temperature were observed in the esophagus and rectum by telethermometer during extracorporeal circulation in 40 cases of open heart for detection of significant differences in survivals and non-survivals. The following results were obtained; 1) Esophageal and rectal temperature(just prior to extracorporeal circulation) were 36.4+/-0.69 degrees C, 36.8+/-0.8 degrees C respectively in non-survivals and 36.0+/-0.73 degrees C, 36.4+/-0.8 degrees C in survivals after open heart surgery 2) Normal differences between rectal and esophageal temperature came to disappear after 30 minutes of extracorporeal circulation in two groups. 3) Esophageal temperatures were higher than rectal temperatures after extracorporeal circulation for open heart surgery in both groups. 4) Changes of temperature differences between rectum and esophagus have no correlation with mortality because of the variation in two areas in both groups.