Evaluation of Flunitrazepam ( Rohypnol ) as a Preanesthetic Medicant for Small Children / 대한마취과학회지

To assess the effect of premedication for pediatric cases, flunitrazepam (Rohypnol) was given to small children under 6 years of age. 70 patients were divided into 4 groups to which the drug was given intramuscularly, 0. 06 mg, 0.1 mg, 0.15 mg and 0. 2 mg per kilogram of body weight, of the drug respectively. The dose was given 30 minutes before anesthesia and the maximum dose was limited to 2.0 mg for each patient if the calculated dose of the drug exceeded this amount. 1) The shortest time of onset of sleep was 5 minutes. The group which fell asleep between 5 and 10 minutes did not respond to needle stimulation. The group which fell asleep between 11 and 15 minutes moved upon needle stimuli but an intravennous needle was inserted without difficulty. 2) The group which fell between 16 and 20 minutes and became sedated after 20 minutes. without asleep was induced by anesthesia with an inhalational agent but aroused by needle stick. The last group was sedated in presence of their guardian only and became uncooperative when they were separated from the latter. 3) The patients were not affected at all with the dose of 0.06mg/kg of flunitrazepam. 4) With the dose of 0. 1 mg/kg, the group under 6 months of age did not sleep and in the; group between 4 and 6 years of age, half did sleep. ) With the dose of 0.15 mg/kg, in the group under the age of one year, 50% of the cases slept and in the group between 2 and 6 years of age, 30% of the cases slept. 6) With the dose of 0. 2 mg/kg, the sleep group was 25% under 1 year of age, 30. 8% between one and 3 years of age and 33% between 4 and 5 years of age, but the maximum. dose given was limited to 2 mg for each case. A tendency to increased effect according to the increase of age was noticed. 7) The optimum dose of the drug was suggested to be 0. 15 mg/kg and if a dose was used of more than 2. 0 mg, it was not needed to increase above this amount for the purpose of sedation. 8) Optimal time for premedication was suggested to be 30 minutes before the induction of anesthesia. 9) Respiratory and circulatory depression were not noticed with the above doses. 10) Endotracheal intuhation was faeilitated without the aid of muscle relaxant in about 30% of cases when 0.15mg)kg Of the drug was given. (Acknowledgement: We are grateful to Roche Far East Research Foundation for supplies of flu- nitrazepam for this study and to Dr. R. Lassere for advice.)

Thalamonal-N2O-O2 Anesthesia for Orthopedic Surgery / 대한마취과학회지

Orthopedic surgery was performed under Thalamonal-N2O-O2 anesthesia by an intravenous injection of a small dose of Thalamonal and N2O inhalation. Respiratory rate was compared before and after intravenous administration of nalorphine at the end of operation. From 22 cases, the following results were obtained: 1) Average dose of Thalamonal during induction of anesthesia was 1.67ml/10kg. During induction, rigidity of chest wall developed in 5 cases, 2) Intermittent injections of Thalamonal for maintenance of anesthesia were needed at. each 43. 8 min. interval, and average dose of Thalamonal was 0. 013 ml/kg/30min. 3) After injection of nalorphine, average rate of respiration per minute increased from 15. 1 to 21. 1(39. 9%) 4) 21 cases among 22 cases recovered promptly after discontinuation of N2O, and recovery was delayed in 1 case. Self extubation was seen in 3 cases.