Analysis of Body Mass Index in 4,966 Patients Undergoing Operations / 대한마취과학회지

BACKGROUND: Obesity is defined as an excess accumulation of body fat. To measure body fat accurately is difficult, but body mass index (BMI, kg/m2) is easily available for routine clinical use. METHODS: A total of 4,966 (male; 2,580, female; 2,386) patients from January to September in 1997 and aged up to 90 years old were studied for BMI. Among these subjects, obstetric patients were excluded in our study. We calculated the BMI as weight (kg) per height squared (m2). The heights and weights of study subjects were obtained from anesthesia records. The BMI was analyzed by 4 different age groups: group 1 (less than 3 years), group 2 (between 3 to 7 years), group 3 (between 8 to 17 years), and group 4 (18 years or more), decade of age, 4 obesity categories according to BMI levels: underweight (less than 18 kg/m2), normal weight (19-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (30 kg/m2 or more), and surgical departments. RESULTS: Mean BMI values of group 1, 2, 3, and 4 were 16.1+/-2.9 kg/m2, 16.2+/-2.4 kg/m2, 19.2+/-3.7 kg/m2 and 23.3+/-4.6 kg/m2 in males and 15.7+/-3.9 kg/m2, 15.8+/-2.7 kg/m2, 19.4+/-3.5 kg/m2 and 23.6+/-3.7 kg/m2 in females, respectively. According to generations, the BMI under teen-age was 16.3+/-2.7 kg/m2 and 14.3+/-2.9 kg/m2 in males and females respectively while it was between 20.4+/-3.3 kg/m2 to 25.0+/-3.6 kg/m2 from 1st to 7th decade patients in both sex. The prevalence of overweight and obesity were nearly zero in group 1 and 2, but males in group 3 had them of 4.6% and 1.4% while 6.9% and 0.8% in females, respectively. In group 4 they were 25.3% and 2.2% in males and 28.8% and 4.8% in females, respectively. Obese patients increased in the order of neurosurgery, gynecology, orthopedic surgery, urology, and general surgery departments. CONCLUSIONS: This study revealed the guidelines of BMI of operating patients. We recognized that the prevalence of overweight and obesity of preschool aged and adolescent patients were nearly zero. Adult patients were the highest at 4th decade in males and 6th decade in females and the obesity rates were 27.4% and 33.6% in males and females, respectively.

Aneathetic Management in Pregnant Myaethenics for Elective Cesariaa-section / 대한마취과학회지

Myasthenia gravis is relatively common in young women and therefore sometimes associated with pregnancy. Since pregnancy influences the course of the myasthenia gravis, and the drugs used for its treatment may influence gestation, the obstetrical management of myas-thenic patient merits special consideration. In myasthenia gravis, it is generally thought that the anesthesia of chice is regional anesthesia during vaginal delivery and general anesthesia during Cesarian section. But in Cesarina section for a pregnant myasthenic with pulmonary disease, epidural or subarachnoid block may be preferable to avoid postoperative hazards. We performed epidural anesthesia with lidocaine in a 39-year-old elderly primigravida myasthenic with COPD and obtained good intra and postoperative results.