Delayed Obstruction of Endotracheal Tube by Previously Aspirated Foreign Body: A Case Report / 대한구급학회지

Acute airway obstruction during endotracheal intubation status is embarrassing and critical situation which requires early diagnosis and immediate management. Endotracheal tube obstruction with foreign body is rare but a variety of objects have been reported. We present a case of endotracheal tube obstruction as a result of previous aspirated foreign body that moved from the bronchial tree into the endobroncheal tube.

A Study on the Health-related Quality of Life after ICU Care / 대한구급학회지

BACKGROUND: This study was designed to analyze the influences of ICU patients' experiences in the ICU setting and the effect of ICU patient families' stress derived from their needs and daily life stress on the patients' quality of life. METHODS: ICU patients' quality of life was evaluated with KQOLS surveying 144 patients alive. The data was classified into 2 groups according to severity of illness and analyzed with an ANOVA. With a t-test, comparative analysis was made to examine deficiency of responses on patient families' needs and patients' quality of life. RESULTS: The patients in the group of higher severity of illness showed lower quality of life. The APACHEII score had a negative correlation with all domains except health status change domain, health status perception domain, and spiritual domain. There was a negative correlation between patients' age and three domains of physical function, role limitation, and social function and a positive correlation between patients' hospital LOS and health status change domain. The families in the group of lower severity of illness showed higher level of deficiency of responses on their needs for medical treatment and nursing information, and emotional support. Also, patients' quality of life in lower daily life stress group was higher than that in higher stress group especially in psychological health domain. CONCLUSIONS: The findings show that ICU patients `quality of life was influenced by not only medical factors but also psychosocial factors and suggest that multidimensional intervention plans are required for improving patients' quality of life and recovering their health.

The Comparison of Ropivacaine and Bupivacaine in Epidural Patient Controlled Analgesia (PCA) / 대한마취과학회지

BACKGROUND: Local anesthetics combined with an opiate are frequently used as a postoperative epidural PCA regimen. Ropivacaine is known to have a selective blockade of the sensory nerve without motor blockade. This study is designed to show advantages of ropivacaine over bupivacaine. METHODS: Patients undergoing elective abdominal and orthopedic surgeries were randomly selected and divided into two groups, B and R. The patients in group B and R received 0.2% bupivacaine and 0.2% ropivacaine respectively through an epidural catheter using a PCA pump. Both local anesthetic solutions were mixed with 4 microgram/ml of fentanyl. The PCA pumps of both groups were set in the same manner. A basal rate of 2 ml/hr was infused from 1hour after the onset of surgery. This basal rate was continued postoperatively. A bolus dose and lock out time were set at 2 ml and 20 minutes respectively. The Visual analogue pain scale (VAS), demand dose, complication and additional intramuscular analgesic requirements were checked up to 24 hours after surgery in 6-hour interval. RESULTS: The VAS was significantly lower in group R than in group B at 6, 12, 18 and 24 hours after the surgery (P < 0.05). Total additional bolus doses of the PCA pump were not significantly different in either group at 6, 12, 18 and 24 hours after surgery. The patients in group R showed more satisfaction and less additional intramuscular injections. CONCLUSIONS: 0.2% Ropivacaine, mixed with 4microgram/ml of fentanyl, was more effective than bupivacaine, mixed with the same concentration of fentanyl, in controlling postoperative pain using an epidural PCA pump.