Clinical Evaluation of Liver Function in Biliary System Surgery / 대한마취과학회지

Halothane is usually a safe and effective inhalation anesthetic agent but on occasion it has damaged and the blame put on other anesthetic agents. The author selected at random 33 patients who had had biliary system surgery at Wonju Christian Hospital between December 1983 to August 1984. Their physical status was ASA class l and ll, liver function tests were abnormal state and they had no previous history of operation or liver disease. They were divided into 4 groups according to the anesthetic agent used (halothane: 10, ebtrane: 10, Thalamonal neuroleptanesthesia:10, lidocaine epidural anesthesia:3) the liver function tests were performed before surgery, and on the 1st, 3rd, 5th and 7th postoperative days. The result were as follows: 1) Total protein, albumin, and total cholesterol were not significantly changed. 2) The values of SGOT gradually decreased in the Ethrane group and they were slightly increased on the first postop day in all 3 groups. The changes of the values were in the abnormal range. 3) The values of SGOT gradually decreased in the ethrane group and they were slightly increased on the first postop day in the halothane group. 4) The values of alkaline phosphatane, total bilirubin and direct bilirubin gradually decreased in the Ethrane group and the NLA group. They were slightly increased the first posopday in the halothane group and there was no significant change in the Epidural group. it is suggested that the influences of variable anesthetic agents on liver function is not significant in biliary system surgery with abnormal liver function.

Aneethetic Experienees with 12,608 Cases / 대한마취과학회지

To compare the first report of our anesthetic experiences with 16,457 Cases performed by the Department of Anerthesiology of Wonju Christian Hospital, Wonju Medical College, Yonsei University, from Nov. 1959 to Dec. 1977 which was published in 1980, the anesthetic experiences of 12,608 cases performed from Jan. 1978 to Dec. 1982 were analyzed, according to age, sex, department, physical status, emergency Procedureornotn, anesthetic agent, complication, and in addition, the ratio of medical insurance patients after enforcement of medical insurance patients. The results are as follows; 1) The number of cases receiving anesthesia tended, to increase year by year and the rate of increasi was remarkable for female patients. 2) Sexual distribution was 6049 males(48.0%), and 6559 females(52.0%). 3) 44.4% of patients were in the 2nd to 4th. decade of life and the patients over 60 years had increased markedly, 4) Among the departments General Surgery accounted for 30.7%, aner Obstetric sand Gynecology for 30.0%. 5) General anesthesia was use in 76.2% and regional anesthesia 23.8%. 6) The main anesthetic agent was halothane(47.9%). 7) Emergency operations were 37.6%, of the total. 8) Medical insurancs patients have increasied remarkably year by year. 9) Cardiac arrest in the operating room and the recovery room consisted of 4 cases. (0.032%).

Anesthesia for Tracheal Reconstruetion in Child with Tracheal Stenosis and Cannulation / 대한마취과학회지

As 8 year old boy with a tracheal cannula because of tracheal stenosia was admitted for tracheal raconstruction. The tracheal stenosis site was 2cm below the tracheal soma and 4cm above the carina. The stenotic area was 5mm in diameter and 1.5cm in length. After proper premedication, anesthesia was induced with intramuscular ketamine and maintained mainly with 0.1% ketamine intravenous drip infusion and supplemented by small amounts of muscle relaxants and N2O EKG, direct arterial pressure and arterial blood gas tensions were monitored during anesthesia. Tracheal segmental resection and reconstruction were performed without serious hypoxia and hypercarbia. Anesthetic management for possible risk during operation was discussed and the literature reviewed.

Adult Respiratory Distress Syndrome Following Trauma - Case report / 대한마취과학회지

Adult respiratory distress syndrome(ARDS) is described under various names in the medical literature: post-traumatic pulmonary insufficiency, wet lung. DaNang lung and shock lung etc., and the syndrome has been used to describe a serious and often fatal conditions which may develop in any patient subjected to severe trauma, major surgery or critical illness. ARDS is characterized by increasing intrapulmonary shunting, increasing work of breathing and decreasing lung compliance. There is still desagreement about exact nature of ARDS as well as its care and revention. In ARDS, the use of positive end-expiratory pressure(PEEP) has been widely debated since its introduction by Ashbaugh and Petty in 1969. Its purpose is to increase the lung volume, especially functional residual capacity at end expiration in order to obtain better alveolar expansion and improved pulmonary gas exchange. This report described two cases of ARDS following trauma, and respiratory care problems were reviewed and discussed.