Effect of Mixed Administration of Thiopental Sodium on Vascular Pain Associated with Intravenous Propofol Injection / 대한마취과학회지

BACKGROUND: Propofol is a rapidly acting intravenous anesthetic agent used for the induction of anesthesia with a low incidence of side effects. But propofol has a high incidence of pain during intravenous injection, and many methods have been used to minimize the incidence and severity of this pain. The aim of this study was to compare the use of thiopental and lidocaine mixed with propofol for the reduction of pain during the injection of propofol. METHODS: Sixty healthy ASA physical status I or II patients scheduled for general anesthesia were randomly divided into three groups. Each patient received mixed propofol solution (normal saline 1 cc, thiopental 0.5 mg/kg, lidocaine 0.5 mg/kg) via 20 G angiocatheter inserted at the antecubital fossa. The assessment of pain was done at the induction of anesthesia and at the recovery room. The severity of pain was classified as none, mild, moderate, and severe. RESULTS: The severity and incidence of pain diminished significantly in the thiopental group and the lidocaine group compared with control group at the induction of anesthesia (p<0.05), and there was no significant difference between the thiopental and the lidocaine group. Recall of pain during intravenous injection at the recovery room has no significant difference among three groups. CONCLUSIONS: Mixd administration of thiopental or lidocaine could significantly reduce the severity and incidence of pain for intravenous injection of propofol.

Quality Assessment of Blood Transfusion in Operating Room / 대한구급학회지

BACKGOUND: Transfusion of red blood cells is a life saving measure in the management of a variety of surgical conditions. A guideline for blood transfusion during elective surgical procedure is necessary to reduce the risks of transfusion-associated complications, excessive blood bank workload, excessive blood request and overtransfusion, and the cost. From this, a program of quality assessment was adopted to improve blood transfusion practice and to establish the guideline for blood transfusion in elective surgery at Pusan National University Hospital. METHODS: Fifty-six patients undergoing elective surgery was divided 2 groups. Transfusion (T) group was 18 persons. Non-transfusion (NT) group was 38 persons. The preoperative, pre-transfusion, postoperative, and post-transfusion hemoglobin (Hb), hematocrit, mean arterial blood pressure (MAP), heart rate (HR), average amount of transfused red blood cell units, allowable blood loss, and the amount of infused crystalloids and colloids was estimated for 9 months in Pusan National University Hospital. RESULTS: There were no significant differences in Hb between T & NT group. Hb decreased significantly until postoperative 3rd day in NT group. Platelet count decreased in NT group on postop. 3rd day. There were no significant differences in MAP & HR. One-ninth of T group was overestimated blood loss & 18.4% of NT group was underestimated blood loss. One-third of transfusion patient were overtransfused & 36.2% of transfused RBC was unnecessary. Nearly 90% of patient was transfused packed RBC with FFP concurrently. CONCLUSIONS: To minimize overtransfusion, transfusion based on intraoperative hematocrit is necessary. If possible, single use of packed RBC is recommended when the blood loss is below allowable blood loss. In massive bleeding above allowable blood loss, combined administration of FFP and packed RBC or transfusion of whole blood will be better.