Clinical Investigation of Laryngeal Mask Airway / 대한마취과학회지

Laryngeal mask airway(LMA) is a new type of airway, which may be used as an alternative to either the endotracheal tube or the face-mask with either spontaneous or positive pressure ventilation without penetration of the larynx or esophagus. LMA have many advantages of easy intubation without laryngoscope and muscle relaxants, decreasing damages of larynx and pharynx., and also useful in difficult intubation or emergency airway care. Recently its interesting has been increased. Clinical studies of LMA was done in 242 patients, about hemodynamic changes, volume and pressure changes of cuff, problems and complications during insertion and maintaining of LMA. The results were as follows: 1) The average time taken to insert the laryngeal mask airway was 9.9sec(range:5~60sec), and 43 cases were correct placement at the second attempt. And the total insertion time was 103 min(range:15~355min). 2) Total ari volume of cuff was 20.5ml(range:15~35ml) in LMA No 3, 28.1 ml(range:25~60ml) in LMA No 4. The least volume of cuff without air leakage was 15ml in LMa No 3 and 25ml in LMA No 4. During positive pressure ventilation the peak airway pressure was 20 cmH2O(15mmHg). 3) In hemodynamic changes, blood pressure was increased about 27.5 mmHg in systolic, 21.2 mmHg in diastolic, and 22.4 mmHg in mean arterial pressure after LMA insertion. 4) Cuff pressure was increased from 70.5mmHg at insertion to 98.9mmHg after 1hours with use of N2O for anesthesia and more increased than without N2O. 5) LMA was used 229 patients in supine position and 5 patients in lateral position. In 8 cases was failed to insertion of LMA. 6) Compilcations were 3 cases of gastric distention, 1 case of difficult nasogastirc tube insertion, and 1 case of severe sore throat with mucosal bleeding on pharyax. Sor throat was complained 26.9% without regard to severity.

The History of Surgical Anesthesia in Korea ( 1910 ~ 1945 ) / 대한마취과학회지

The Oriental countries have had long histories and large populations. While they were the civilized country with the profound culture and thoughts, they were backward in material civilization bacause of their delayed development of science. Extending from the end of the 18th century to the 19th century the Western countries perturbed the Eastern countries with their sudden appearance. The Western countries visited the East with their threatening attitudes by giant war vessels and guns. They also strongly demanded to import their advanced daily commodities and the studies including the medical science. Since the most of the Eastern countries were too conservative, they resisted and rejected the Western forces at first. At that time, most Eastern countries located in the southern region of Asian continent were colonized by the West. The other countries in the nortern region came to realize that they were behind the West in material civilization, so had to open their door to the West through the foreign contact. China, Japan and Korea had to accept the Western culture and urged the civilization. Especially Japan adapted herself to new circumstances before others. She accepted the Western culture, thoughts and all studies actively with even reforming her political system. Starting from the yesr of 1868, Japan not only was reborn and formed independent position in the cultural region of China and Korea but also succeeded to construct the first westernized country among the Eastern countries and weekened the influence of China and Russia. Japan provoked and won wars such as the Sino-Japanese War {1894} and the Russia-Japanese War (1904). Follwing up these victories, Japan also occupied Korea in 1910, and the period of colonization had continued for 35 years until 1945 when Japan surrendered to the Allies at the end of the World War II. With these historical cirumstances, the purpose of this research paper is to collect the medical data, especially that of the anesthesia, and show its historical contributions through the documents. The long history of Korea had developed with the traditional and peculiar medical science, such as a herb medical science and a medical science in acupuncture and moxibustion. Korean medical science, however, has been greatly changed since 1876, the year of opening her door to Japan. There were two ways of introducing the Western medical science in Korea. As the indirect import, the japanese Western medical scince through the city of Busan was one. As the direct imports, the American medical science by an American missionary, Allen through the city of Incheon was the other. In these two currents of the Western medical science, it was natural that the Japanese one formed the main stream after 1910, the year of japanese occupation. The field of anestheia science was not an exception. Its developing process was no better than following the path of Japanese anesthesia science history. Comparing the Western developing history of anesthesia to that of Japan in general, there were a few ears difference in the level of quality between the East and the West until about 1930. Japanese anesthesia, however, fell behind over 20 years, comparing to the Western one, in the period from the late of 1930s to 1945. I believe that it is beyond the scope of this paper to explain and it leaves us with meaningful lessons.