The Effect of Enflurane Anesthesia on The Liver in patient with positive HBsAg and increased SGOT, SGPT / 영남의대학술지

Halothane is usually a safe and effective inhalation anesthetic agent but it rarely has damaged liver. The authors selected 11 patients who had HBsAg positive and increased SGOT, SGPT at Yeungnam university hospital. Their physical status was ASA class 1 and 2. They had no previous history of operation or liver disease. The liver function tests were performed before surgery, and on 3rd, 7th and 10th postoperative days. The result were as follows: 1) The values of SGOT and SGPT were gradually increased on 3rd postoperative day and markedly increased on the 7th and 10th postoperative day. 2) Alkaline phosphatase, total protein, albumin, total bilirubin and direct bilirubin were not significantly changed.

The Effect on Serum Electrolytes of Hyperventilation , Steroid and Diuretics in Brain Surgery / 대한마취과학회지

This study was performed to investigate the ranges of electrolyte changes during conventional neurosurgical anesthetic management. We selected 20 patients who were operated for brain tumor, intracranial aneurysm and arteriovenous malformation randomly. All patients were received solumedrol preoperatively and managed with hyperventilation (PaCO2: 25-30 torr), solumedrol (1.0 gm), mannitol, furosemide during operation. At 30 and 60 minutes after mannitol infusion, serum electrolytes (Ka+, K+) were checked. The results were as follows: 1) Serum K+ concentration was decreased from 3.96+/-0.46 mEq/L to 3.63+/-0.40 mEq/L in 30 minutes after diuretic administration (p<0.01). 2) At 60 minutes after diuretic administration, serum K+ concentration was decreased from 3.96+/-0.46mEq/L to 3.75+/-0.37mEq/L (p<0.05) and slightly higher than 30 minutes without statistical significance. 3) Serum Na+ concentration was not significantly changed at 30 and 60 minutes after diuretic administration. In conclusion, frequent evaluation of intraoperative serm electrolytes level should be stressed to prevent distortion of it due to hyperventilation and diuretics in neurosurgical anesthetic management.

Analgesic Effects of Epidural Clonidine / 영남의대학술지

Clonidine, α2-adrenergic agonist, applied spinally or epidurally has been shown to be effective in blocking noxious stimuli in human applications. The purpose of this study is to evaluate the analgesic effect of epidurally administered clonidine. In 40 patients undergoing hemorrhoidectomy or anal fistulectomy, 1.33% lidocaine 15ml (Group I) or 1.33% lidocaine mixed with 75µg clonidine (Group II) administered epidurally through sacral hiatus. Intraoperative changes of vital signs and duration of postoperative analgesic effects were observed. The results were as follows: 1) In the group I, average analgesic duration was 2.42 hours. 2) In the group II, average analgesic duration was 7.32 hours. 3) After epidural clonidine injection, the decrease in heart rate and blood pressure was not significant without sedation. 4) Postoperatively, any complaints related clonidine were not reported. In conclusion, postoperative pain control with epidural clonidine was effective.

A Case of Convulsive Seizure Following Spinal Anesthesia in a Geriatric Patient with COPD / 영남의대학술지

In the geriatric patient with COPD, incidence of postoperative pulmonary complication is higher than young patient. Therefore, some anesthesiologists preferred spinal anesthesia to general anesthesia for surgery of the perineum, lower extrimities, and pelvic extraperitoneal organs. But, during spinal anesthesia, the same careful observation in required as during general anesthesia. We experienced a case of the convulsive seizure at about 1 hour after spinal anesthesia for open prostatectomy in a 76-year-old male patient with COPD. It was suspected that his convulsive seizure be resulted from hypercapnea combined with hypoxia following upper airway obstruction. This patient was treated successfully by ultrashort acting barbiturate and controlled ventilation.

Use of Respiratory Care Pressure Preset Ventilator for Pediatric Anesthesia / 대한마취과학회지

A study was undertatken to determine whether the pressure preset ventilator such as the Bennett PR-1 or PR-2 that are used for respiratory care in the intensive care unit or in the recovery room after anesthesia could also be used as and anesthetic ventilator for pediatric anesthesia. Maintaining anesthesia with halothane(0.5~1.0%)-N2O(2.51/min)-O2(2.51/min)-pancuronium bromide(0.1mg/kg) and using the Jackson-Rees modified Ayre's T-piece, the reservoir bag was removed from that device and the reservoir tube was connected to the pressure present ventilator. The inspiratpry pressure of the ventilator was fixed at 15cm H2O and the respiratory frequency was controlled at 30/min in 15 patients under 10kg of body weight, and at 25/min in 15 patients weighing 11~17kg. Arterial blood gas tension was measured 30 minutes after ventilator use. The following results were obtained: 1) pH: 7.28~7.44(7.35+/-0.04) 2) PaCO2: 28.4~41.3mmHg(35.4+/-2.9mmHg). 3) PaO2: 184.9+/-289.0mmHg(242.7+/-30.5mmHg). 4) HCO2(-): 15.5~23.5mEq/L(19.8+/-1.9mEq/L). 5) B.E.: -10.0~-0.6mEq/L(-4.6+/-2.3mEq/L) The above values of arterial blood gas tension showed a normal ranges in all cases. Therefore, it could be assumed that replacing the reservoir bag of the Jackson-Rees modified Ayre's T-piece with the pressure present ventilator is an excellent device for pediatric anesthesia.

Effects of Starvation and Perioperative Fluid Therapy on the Blood Glucose Concentrations during Anesthesia in Children / 영남의대학술지

This study included 38 children patients of less than 4 years old and 18 kg body weight. After 8 hours of starvation, the children were divided into 2 groups: Group I received Hartmann's solution and Group II received Hartmann's dextrose solution. In both groups, the rates of infusion were 10 ml/kg/hr before and during operation and blood samples were collected just before and 1 hr after induction of anesthesia, respectively. The results were as follows; 1) In the Group I, blood glucose concentration just before induction was decreased than control values that was checked at ward, and 1 hr value after induction was significantly increased then control values. 2) In the Group II, blood glucose concentration was increased just before and 1hr after induction than control values significantly respectively. 3) In the blood glucose concentration 1 hr after induction, difference between Group I and Group II was not significant. 4) In children, duration of starvation about 8 hrs did not significant influence on blood glucose concentration although dextrose was not administered.

Effects of Manually Controlled Ventilation on Gas Exchange during General Anesthesia / 영남의대학술지

In the beginning of anesthetic training, one of the clinical practices that anesthetists have to learn is manually controlled ventilator techniques. The popularity of manually controlled ventilatory techniques has been gradually decreased with increased use for anesthetic ventilators. However it is important and basic for the anesthetists to master manually controlled ventilator techniques skillfully. Recently, we analyzed the arterial blood gas in 30 cases before and during general anesthesia, and studied the effects of the manually controlled ventilation on the pulmonary gas exchange. The results were as follow; 1) Mean value of PaCO₂ during the manually controlled ventilation, 29.9±2.0 mmHg was decreased statistically comparing with that of PaCO₂ before the anesthesia, 39.8±2.8 mmHg. 2) Mean values of pH and HCO₃⁻ during the manually controlled ventilation were 7.48±0.03, 22.2±2.4 mEq/1, respectively and values before the anesthesia were 7.41±0.02, 25.2±1.8 mEq/1, respectively. 3) Mean value of PaO₂ and O₂ saturation during the manually controlled ventilation were 270.0±28.8 mmHg, 99.6±0.2%, respectively and values before the anesthesia were 92.5±4.0 mmHg, 96.9±1.0%, respectively. These results indicates that manually controlled ventilation at our department of anesthesiology produced mild hyperventilatory state. However these were no significant changes in cerebral blood flow and other biochemical parameters.