The Effects of Several Anesthetics on Intraocular Pressure / 대한마취과학회지

The effects of several anesthetios (thiopental, ketamine, Innoyar) and muscle relaxants (succinylcholine and vecuronium) on IOP, blood pressures and pulse rates were studied in 60 Patients ranging in are 12 to 56 years. IOP was measured with the Schiotz tonometer. In addition to tonometric determinations, the blood pressures and pulse rates were recorded. The patients were divided into 4 groups: Thiopental-succinylcholine-intubation(Group 1) ; Ketamine-succinrlcholine-intubation (Group 2) ; Innovar-succitrlcholine-intubation (Group 3) and Thiopental-vecuronium-intubation (Group 4) . The results were as follows : 1) In group 1 and 4, IOP changes following thiopental(5 mg/kg) administration showed highly significant decreases(p0.05) and in group 2, IOP changes after 5 minute following succinylcholine administration shewed highly significant increases (p<0.01) . 3) In group 3, IOP changes after 5 minutes following Innovar (1 ml/15 kg) administration showed highly significant decreases (p<0.01) compared with the control value. 4) IOP changes after 1 minute of endotracheal intubation showed highly significant inc- reases (p<0.01) in all groups compared with the control value. 7) In group 4, IOP changes following vecuronium administration instead of succinylcholine showed highly significant decreases, but could not prevent the increases in IOP following endotracheal intubation. 6) In all groups, blood pressures and pulse rates showed highly significant increases after endotracheal intubation. 7) After succinylcholine administration, blood pressures showed aignificant increases in group 1 and highly significant increases in group 2. 8) In group 2, blood pressures showed highly significant increases after ketamine administration.

Anesthesia for an Acute Necrotizing Cholecystitis Patient with Pulmonary Edema / 대한마취과학회지

A 46 year-old female patient underwent cholecystectomy under general anesthesia. During the preoperative preparation, pulmonary edema developed from fluid overloading in the early septic condition. Pulmonary edema contributed significantly to the acute respiratory failure, which played a major role in the pathogenesis of multiple organ failure. For this condition, early surgical intervention is most important. After preoperative evaluaion, the authors anesthetized the patient with Morphine, used Enfluane intermitently, along with pancronium and oxygen and used endotracheal semiclosed circle absorption techniques with CMV incorporated PEEP. PEEP level was 5cm H2O. Inspired oxygen fraction was 1.0. Arterial oxygen tension increased from 62 torr to 183 torr despite the overt pulmonary edema. A-aDO2 was greater than 480 mmHg during the anesthesia of 2 hrs 40 minutes. For further treatment of pulmonary edema and postoperative respiratory care, synchronized IMV with PEEP, along with conventional methods for pulmonary edema and sepsis, were used in the ICU. After 6 days of intensive care, the patient was transferred to the general ward in good cardiovascular and respiratory function.